Search

Background: Bullying is widely acknowledged as one of the most harmful events in a child's life, leading to negative life experiences and outcomes. However, 'school effects of bullying' are rarely studied from an international perspective, especially with international large-scale data. Purpose: In this study, we aim to look at bullying through an international comparative approach, focusing on the contribution of the school, the education system and culture, and pupil level factors such as socio-economic status (SES) and gender. Our key question is whether school factors can affect bullying prevalence. Methods: We used data from six countries (USA, Finland, England, Romania, Korea and Italy) from the Trends in International Mathematics and Science Study (TIMSS), a large-scale international study. We used multilevel modelling to analyse the dataset. Findings: We find little evidence of a relation between country policies and levels of bullying, though there are differences in the extent to which school and pupil factors are related to bullying. The most consistent relationship was between gender and bullying, with prevalence higher among boys, while school factors were not significant. Conclusion: The findings indicate that 'one size fits all' school policies might not be the best course of action, and individual support might be a more fruitful avenue.

We evaluate communication policies related to COVID-19 adopted by governors in the United States and explore how communication and policy directives are impacted by hyper-polarised situations, namely the presence of a divided government. This work sheds light on the challenges of crisis communication and executive leadership. Using a combination of robust regression and text and sentiment analyses, we compare the timing of and the language used by governors who imposed state-wide facemask mandates in 2020. We find that racially diverse states with Democratic governors acted more quickly than states with comparably older populations, had more people living in one household, and without health insurance. Further, we find that Democratic governors were slower to act when their decision could be checked by a Republican legislature highlighting the restrictive nature that executives face in crises. [ABSTRACT FROM AUTHOR]

In the aftermath of Dobbs v. Jackson Women's Health Organization, which overturned the federal constitutional right to abortion, states have begun to recriminalize the procedure. These abortion bans raise important questions about the political and social status of women and pregnant people in the United States. Moreover, restrictions in social welfare programs such as the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children and Temporary Assistance for Needy Families, which serve low-income pregnant people and parents, raise similar questions. The regulation and administration of all three are framed by race, class, and gender. To understand how these restrictions (a) claim to protect women but ultimately function to control, police, and surveil and (b) rely on imagined, stereotype-laden psychological states such as vulnerability, irresponsibility, or irrationality, we turn to the British Common Law doctrine of coverture, which subsumed a married woman's legal, financial, and political identities under her husband's. The American colonies, and later, states of the United States, drew from British Common Law to craft laws that regulated relationships between men and women. Taken together, this analysis can provide a more comprehensive accounting of the cumulative harms experienced by women, poor people, people of color, and pregnant people in today's health and social welfare landscape. We conclude with recommendations for psychologists and other mental health providers to address, in practice and advocacy, the ethical dilemmas and obligations raised by the reach of coverture's logics in people's lives. [ABSTRACT FROM AUTHOR]

Holsteins and Jerseys, the 2 most prominent dairy breeds in the United States, differ in many regards. They have not been evaluated for differences in oral behavior performance, despite anecdotal evidence that Jerseys perform more abnormal behaviors than Holsteins. As abnormal behaviors can indicate compromised welfare, we evaluated whether breed differences existed in year-old heifers. Because many oral behaviors could be expressed in abnormal ways, we also sought to describe performance of a wide range of behaviors and whether these varied among individuals. We studied 42 pair-housed heifers (33 Holstein, 9 Jersey) at 12.8 ± 1.1 mo of age (mean ± SD) that were restricted to 50% of their ad libitum total mixed ration (TMR) intake for 2 d as part of a short-term feed challenge. Using continuous video recording from 0800 to 2000 h on the second day of feed restriction, we scored time spent performing tongue rolling, tongue flicking, self-grooming, allogrooming, intersucking, drinking urine, drinking water, and nonnutritive oral manipulation (NNOM) of rice hull bedding, the feed bin, or other pen fixtures. Eating TMR was recorded at 5-min intervals. We found that Jerseys spent more time tongue rolling (3.3% vs. 0.2% proportion of 12-h observations) and performing all types of NNOM than Holsteins (feed bin: 3.8% vs. 2.4%; bedding: 7.7% vs. 5.4%; other: 7.5% vs. 4.2%; total: 19.0% vs. 12.0%), and tended to spend more time tongue flicking (1.4% vs. 1.1%). Jerseys spent less time allogrooming than Holsteins (1.3% vs. 3.4%). There was no evidence of an effect of breed on self-grooming (2.0%), water drinking (1.0%), eating TMR (16.0%), or intersucking (0.06%). Urine drinking was performed by 9 total heifers and was not compared between breeds. All behaviors were highly variable across individuals, particularly tongue rolling and intersucking. Allogrooming was more variable than self-grooming, and each subcategory of NNOM was more variable than total NNOM. Outliers, or extreme performance of oral behaviors relative to the rest of our population, were present in most behaviors. Heifers who were outliers in one behavior were not consistently outliers in all. Overall, there are breed differences in many oral behaviors in a feed-restricted environment. Despite no difference in proportion of time spent eating, Jerseys often performed higher levels of potentially abnormal behaviors than Holsteins, though both breeds performed many oral behaviors, sometimes at extreme levels, that may indicate a concern. [ABSTRACT FROM AUTHOR]

Background: Binge-eating disorder (BED) is the most common eating disorder phenotype and is linked to several negative health outcomes. Yet, little is known about the social epidemiology of BED, particularly in early adolescence. The objective of this study was to examine the associations between sociodemographic characteristics and BED and binge-eating behaviors in a large, national cohort of 10–14-year-old adolescents in the United States (U.S.) Methods: We conducted a cross-sectional analysis of two-year follow-up data from the Adolescent Brain Cognitive Development (ABCD) Study (2018 − 2020) that included 10,197 early adolescents (10 − 14 years, mean 12 years) in the U.S. Multivariable logistic regression models were used to assess the associations between sociodemographic characteristics and BED and binge-eating behaviors, defined based on the Kiddie Schedule for Affective Disorders and Schizophrenia. Results: In this early adolescent sample (48.8% female, 54.0% White, 19.8% Latino/Hispanic, 16.1% Black, 5.4% Asian, 3.2% Native American, 1.5% Other), the prevalence of BED and binge-eating behaviors were 1.0% and 6.3%, respectively. Identifying as gay or bisexual (compared to heterosexual; adjusted odds ratio [AOR]: 2.25, 95% CI 1.01–5.01) and having a household income of less than $75,000 (AOR: 2.05, 95% CI: 1.21–3.46) were associated with greater odds of BED. Being male (AOR: 1.28, 95% CI: 1.06–1.55), of Native American (AOR: 1.60, 95% CI: 1.01–2.55) descent, having a household income less than $75,000 (AOR: 1.34, 95% CI: 1.08–1.65), or identifying as gay or bisexual (AOR for 'Yes' Response: 1.95, 95% CI: 1.31–2.91 and AOR for 'Maybe' Response: 1.81, 95% CI: 1.19–2.76) were all associated with higher odds of binge-eating behaviors. Conclusion: Several sociodemographic variables showed significant associations with binge-eating behaviors, which can inform targeted screening, prevention, and education campaigns for BED among early adolescents. Plain English Summary: Binge-eating disorder is the most common eating disorder, yet little research has characterized the social and demographic factors that contribute to it, especially in adolescents. We studied the social and demographic risk factors for binge-eating disorder and binge-eating behaviors for U.S. children aged 10–14. Low household income, identifying as gay or bisexual, and being of Native American descent were associated with engagement in binge-eating behaviors. Low household income and identifying as gay or bisexual were associated with binge-eating disorder. These results can help better identify, prevent, and spread awareness of binge-eating disorder. [ABSTRACT FROM AUTHOR]

This conceptual article aims to inform social work educators on facilitating critical discourse among social work students by applying reproductive justice, leveraging interdisciplinary practice, and addressing the Social Work Grand Challenges. Reproductive justice tenets provide an interdisciplinary framework that assists in the development of the learning environment, participant's critical thinking, self-awareness, and self-regulation; preparing them for professional dialog and ethical decision making. This article will outline the tenets of reproductive justice, providing resources and tools for creating an environment that will assist in the facilitation of critical and professional conversations; while providing strategies that incorporate interdisciplinary partners into the classroom thus providing a reproductive justice sensitive analysis and solutions for approaching social issues that affect the people social workers serve. [ABSTRACT FROM AUTHOR]

During the first year of the COVID‐19 pandemic in the United States, the coordination and cooperation between the federal government and the states failed. American governors were thus tasked with making critical public health policy choices—under extreme uncertainty—with varying institutional capacities, partisan pressures, and state demographic differences. Yet most of the nation's governors chose to impose a face covering or mask mandate to limit the spread of cases. We collected each governor's executive order that mandated the conditions under which their residents would be required to wear a mask and employed a sentiment analysis program to extract key qualities of crisis leadership communication. Our analyses provide insights into the institutional and partisan factors that determined a face mask mandate as well as the institutional, demographic, and leadership communication qualities that affected the total number of cases per capita in the states. Our findings have important implications for post‐pandemic policy recommendations with respect to the effectiveness of policies that seek to lower the transmission of viruses in public spaces and the characteristics of impactful public health messaging by government leaders. [ABSTRACT FROM AUTHOR]

Purpose: We sought to understand concerns fundamental to planning medical education specific to rural southern African Americans who are virtually nonexistent in American medical schools. Methods: A diverse multidisciplinary research team conducted this qualitative study with 3 focus groups, including 17 rural medical educators recruited nationwide, 10 African American alumni of a rural medical education pipeline in Alabama, and 5 community and institutional associates of this pipeline. Analysis of recorded transcripts generated themes fitting an ecological model suggesting concerns and intervention foci at individual, community, and institutional levels. Findings: Three major themes operating at all ecological levels were: (1) How "rural minority student" is defined, with "rural" often supplanting race to indicate minority status; (2) Multiple factors relate to rural racial minority student recruitment and success, including personal relationships with peers, mentors, and role models and supportive institutional policies and culturally competent faculty; and (3) Challenges to recruitment and retention of rural minority students, especially financial concerns and preparation for medical education. Conclusions: Our findings suggest that individuals, communities, and institutions provide intervention points for planning medical education specific to southern rural African Americans. These spheres of influence project a need for partnership among communities and rural medical educators to affect broad programmatic and policy changes that address the dire shortage of rural African American health professionals to help ameliorate health inequities experienced in their home communities. It is likely that linear thinking and programming will be replaced by integrated, intertwined conceptualizations to reach this goal. [ABSTRACT FROM AUTHOR]

Given the persistence of health inequities in the United States, scholars and health professionals alike have turned to the social determinants of health (SDH) framework to understand the overlapping factors that produce and shape these inequities. However, there is scant empirical literature on how frontline health and social service workers perceive and apply the SDH framework, or related movements such as the right to health, in their daily practice. Our study seeks to bridge this gap by applying constructs from the sociological imagination and structural competency (an emerging paradigm in health professions' education) to understand the perspectives and experiences of social work case managers, community health workers, legal advocates, and mental health counselors at a maternal and child health center in a large US city. This frontline workforce displayed strong sociological imagination, elements of structural competency, and engagement with the principles of the right to health. Workers shared reflections on the SDH framework in ways that signaled promising opportunities for frontline workers to link with the global movement for the right to health. We offer a novel approach to understanding the relationships between frontline worker perspectives on and experiences with the SDH, sociological imagination, structural competency, and the right to health. [ABSTRACT FROM AUTHOR]

Objectives: We showed in a previous analysis the patterns of disruption for private dental insurance claims in the United States caused by the SARS‐CoV‐2 pandemic in 2020. The present report examines trends during 2020 and 2021, that is, contrasting perspectives during 2019 with the acute phase of the pandemic in 2020, and 2021. Methods: Private dental insurance paid claims from a data warehouse were obtained, encompassing a 5% random sample of records between January 2019 and December 2021 for child and adult insureds who filed a claim in 2019, 2020, and 2021. We classified claims into one of four categories based on the likelihood of being associated with urgent/emergency care. Results: The precipitous reduction in dental care claims in March–June 2020 recovered to almost pre‐pandemic levels by the fall of 2020. However, a downward decline in private dental insurance claims started in the late fall of 2020 and continued through 2021. Differential impacts in dental care categories—in terms of urgency of care—were evident 2021, closely resembling previous trends in 2020. Conclusions: Dental care claims from the first year of the 2020 SARS‐CoV‐2 pandemic were contrasted with perspectives in 2021. A downward trend in demand/availability changes in dental care insurance claims set in for 2021, perhaps linked to perceptions of the overall economic situation. Such downward trend has continued overall, even after considering seasonal changes and the acceleration of the pandemic during the Delta, Omicron, and other variants. [ABSTRACT FROM AUTHOR]

Background Recently, researchers have commented that shoulder special tests cannot identify the structure causing rotator cuff symptoms and should only be considered pain provocation tests. Others have disagreed, reporting that special tests were able to accurately detect the presence of rotator cuff involvement. Purpose The purpose of this study was to determine the knowledge, use, and perceived effectiveness of 15 selected special tests utilized to examine patients with possible rotator cuff dysfunction. Study Design Descriptive study using survey. Methods An electronic survey was returned by 346 members of the Academies of Orthopedic and Sports Physical Therapy through list serves. Descriptions and pictures for 15 special tests of the shoulder were included in the survey. Information regarding years of clinical experience and American Board of Physical Therapy Specialties (ABPTS) specialist certification in Sports or Orthopedics was collected. Respondents were asked if they could identify and use the special tests to evaluate dysfunction of the rotator cuff - and how confident they were in ability of the tests to diagnose dysfunction of the rotator cuff. Results The four tests most readily known by respondents included the empty can, drop arm, full can, and Gerber's tests, and the four tests used regularly by the respondents included the infraspinatus, full can, supraspinatus, and champagne toast tests. The infraspinatus, champagne toast, external rotation lag (ERLS), and the belly-off tests were found to be the be most useful for establishing a diagnosis of the muscle-tendon complex involved. Years of experience and clinical specialization was not relevant to knowledge or use or these tests. Conclusions This study will allow clinicians and educators to understand which special tests are easily identified, regularly used, and perceived as helpful for the diagnosis of muscles involved in a rotator cuff dysfunction. Level of Evidence 3b [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify differences in usage trends for 2 specific pulpal therapy treatments in pediatric patients during an 11-year period from January 1, 2010, through December 31, 2020. Insurance data claims for children aged 2 through 12 years undergoing a pulpotomy or a pulpectomy performed by a general dentist (GD) or pediatric dentist (PD) from 2010 through 2020 were extracted from a dental data warehouse. The state where the provider was located was included in the extracted claim. Rates of undergoing a pulpotomy or pulpectomy declined from 2010 through 2020 (odds ratio [OR], 0.978 or 0.946, respectively; P <.001). PDs were more likely to perform pulpotomies than GDs (OR, 1.393; P <.001), but PDs were less likely to perform pulpectomies than GDs (OR, 0.225; P <.001). Younger patient age was a significant predictor for undergoing pulpotomy treatment for both GDs and PDs (ORs, 0.850 and 0.892, respectively; P <.001). With increasing patient age, PDs had increased odds of performing a pulpectomy (OR, 1.030; P <.001) and GDs had decreased odds of performing a pulpectomy (OR, 0.995; P =.04). When examining effects according to American Academy of Pediatric Dentistry national membership districts, the trends remained consistent with those above. The percentage of children undergoing pulpotomy and pulpectomy therapy declined from 2010 through 2020 among both GDs and PDs. These changes in pulpal therapy practice might indicate a teaching change in pulpal therapy guidelines, suggesting that less invasive pulpal therapy can be used rather than pulpotomies or pulpectomies. [ABSTRACT FROM AUTHOR]

Background: Worldwide, 1.3 million people die because of a road traffic collision each year, with over half (57.7%) of such deaths in the United States involving a psychoactive substance. The prevalence of drink-drivers is slowly declining; however, the number of drivers under the influence of other drugs, such as sedatives, continues to rise. Objectives: This study aimed to examine alcohol use and risky driving practices among individuals who consume sedatives nonmedically. Methods: A total of 36,309 US adults (48.1% male) who participated in wave 3 (2012) of the National Epidemiologic Survey on Alcohol and Related Conditions were included for analysis. Results: Overall, 827 respondents reported past-year nonmedical sedative use. Almost two-third (64.9%) of these individuals exceeded recommended drinking guidelines and 42.5% met the criteria for a past-year DSM-5 alcohol use disorder. When controlling for demographic, lifestyle, and health factors, they were 1.84 times as likely to drink-drive (95% confidence interval = 1.46–2.33, p <.001) compared to those not using sedatives or using them as prescribed. Among those who reported both drink-driving and driving under the influence of sedatives in the last 12 months, 68.1% met the criteria for a past-year DSM-5 sedative use disorder. Conclusion: Several driving outcomes relevant to road safety, such as driving under the influence of alcohol or sedatives, are impacted by sedative consumption. Given that individuals who consume sedatives nonmedically may be unaware or misperceive the impacts of substance use on safe driving, interventions to reduce such behavior should be targeted among this high-risk group. [ABSTRACT FROM AUTHOR]

Researchers established that inclusive postsecondary education programs are beneficial for students with and without disabilities. However, research regarding faculty perspectives of these programs and faculty-perceived benefits and challenges is limited. This qualitative study interviewed faculty members (n=8) at a university in the southeastern United States who included university students with an intellectual disability in their general courses. The purpose of this study was to explore the perceptions of university faculty regarding the benefits and challenges of including students with intellectual disability in their courses, as well as gaining their recommendations for faculty members who may include students with ID in future courses. Key findings included higher levels of inclusivity, increased awareness of disability, increased engagement, and a focus on improving teaching skills. Challenges were identified in the areas of awareness, worrying about making mistakes, and practical concerns. Recommendations for future instructors included being prepared with strong pedagogy, having structured classroom management plans, and being provided the opportunity to meet students with ID prior to future inclusive courses. [ABSTRACT FROM AUTHOR]

Objective: To evaluate breast density notification legislation (BDNL) on breast imaging practice patterns, risk assessment, and supplemental screening. Methods: A 20-question anonymous web-based survey was administered to practicing Society of Breast Imaging radiologists in the U.S. between February and April 2021 regarding breast cancer risk assessment, supplemental screening, and density measurements. Results were compared between facilities with and without BDNL using the two-sided Fisher's exact test. Results: One hundred and ninety-seven radiologists from 41 U.S. states, with (187/197, 95%) or without (10/197, 5%) BDNL, responded. Fifty-seven percent (113/197) performed breast cancer risk assessment, and 93% (183/197) offered supplemental screening for women with dense breasts. Between facilities with or without BDNL, there was no significant difference in whether risk assessment was (P = 0.19) or was not performed (P = 0.20). There was no significant difference in supplemental screening types (P > 0.05) between BDNL and non-BDNL facilities. Thirty-five percent (69/197) of facilities offered no supplemental screening studies, and 25% (49/197) had no future plans to offer supplemental screening. A statistically significant greater proportion of non-BDNL facilities offered no supplemental screening (P < 0.03) and had no plans to offer supplemental screening compared to BDNL facilities (P < 0.02). Conclusion: Facilities in BDNL states often offer supplemental screening compared to facilities in non- BDNL states. Compared to BDNL facilities, a statistically significant proportion of non-BDNL facilities had no supplemental screening nor plans for implementation. Our data suggest that upcoming federal BDNL will impact how supplemental screening is addressed in currently non-BDNL states. [ABSTRACT FROM AUTHOR]

Objectives: The SARS‐CoV‐2 pandemic disrupted health care services. Previous reports estimated reductions in demand and supply of dental care services, but actual changes have not been reported. The present report depicts a perspective of trends in claims from private dental practice in the United States during 2019 and 2020. Methods: Private dental insurance paid claims data from a data warehouse (encompassing 66+ carriers in the United States) were obtained for children and adults (treatments identified by their American Dental Association Code of Dental Procedures and Nomenclature [CDT]), encompassing a 5% random sample of all records between January 2019 and December 2020. A market‐based treatment classification placed CDT codes into one of four categories based on the likelihood of being associated with urgent/emergency care. Results: Claims for 3.8 million patients constituted the 5% random sample for analyses. Substantial drops in the provision of treatment items were quantified for a large segment of private dental insurance plans at a national level, showing differential impacts in dental care categories. Conclusions: Week‐by‐week, detailed descriptions of demand/availability changes in dental care throughout the first year of the 2020 SARS‐CoV‐2 pandemic were obtained through contrasting perspectives in 2019. Provision of dental care and associated impacts fluctuated over time subject to treatment urgency, but also modified as the weeks/months of dental office lockdowns ebbed in and out of the dental market. [ABSTRACT FROM AUTHOR]

Purpose: This study explored and documented rural adults' perceptions of family roles in prescription opioid misuse prevention and the predisposing, reinforcing, and enabling factors that influence family members from taking those roles. Methods: Nine focus groups with rural adults (n = 55) were conducted to evoke discussion about family roles in prescription opioid misuse prevention. Transcripts were coded based on common ideas that arose during the focus groups, previous literature, and the PRECEDE‐PROCEED program planning model. Findings: Findings suggest that rural adults perceive the opioid epidemic as partially a family problem. Additionally, rural adults perceive themselves as having a critical role in preventing prescription opioid misuse among family members. Participants identified specific predisposing, reinforcing, and enabling factors that influence whether or not family members take responsibility in preventing prescription opioid misuse within their families. Rural adults also perceive that family‐based education is important in preventing prescription opioid misuse. Conclusions: These results suggest that there is an interest in family‐based approaches that enable or foster the skills and resources necessary to engage in prescription opioid misuse prevention behaviors. Specifically, family‐based prevention programming should include efforts to shape knowledge and attitudes about prescription opioid misuse, increase resources to facilitate prevention behaviors, and build skills related to prevention. [ABSTRACT FROM AUTHOR]

Substance use is a common issue worldwide, but it disproportionately affects the Indigenous population in America. As culture affects many aspects of health and wellness, including the presentation and effectiveness of treatment interventions, it is vital that health care providers look at substance use within a cultural context. The Campinha-Bacote Model: The Process of Cultural Competemility in the Delivery of Healthcare Services model is a helpful tool to assess a cultural group in the context of health care. The knowledge and use of this model may assist health care professionals in providing culturally competent care for the Indigenous population in America, as well as other people from various cultural backgrounds. This model also promotes the consideration of cultural factors in nursing research and evidence-based interventions, which may assist in reducing the current disparities that exist within the Indigenous population. The current article addresses the Campinha-Bacote Model in reference to substance use disorder in the Indigenous population in America and the relation to nursing practice and research. [Journal of Psychosocial Nursing and Mental Health Services, 59(6), 7–12.] [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of the COVID-19 pandemic on breast imaging education. Methods: A 22-item survey addressing four themes during the early pandemic (time on service, structured education, clinical training, future plans) was emailed to Society of Breast Imaging members and members-in-training in July 2020. Responses were compared using McNemar's and Mann-Whitney U tests; a general linear model was used for multivariate analysis. Results: Of 136 responses (136/2824, 4.8%), 96 U.S. responses from radiologists with trainees, residents, and fellows were included. Clinical exposure declined during the early pandemic, with almost no medical students on service (66/67, 99%) and fewer clinical days for residents (78/89, 88%) and fellows (48/68, 71%). Conferences shifted to remote live format (57/78, 73%), with some canceled (15/78, 19%). Compared to pre-pandemic, resident diagnostic (75/78, 96% vs 26/78, 33%) (P < 0.001) and procedural (73/78, 94% vs 21/78, 27%) (P < 0.001) participation fell, as did fellow diagnostic (60/61, 98% vs 47/61, 77%) (P = 0.001) and procedural (60/61, 98% vs 43/61, 70%) (P < 0.001) participation. Most thought that the pandemic negatively influenced resident and fellow screening (64/77, 83% and 43/60, 72%, respectively), diagnostic (66/77, 86% and 37/60, 62%), and procedural (71/77, 92% and 37/61, 61%) education. However, a majority thought that decreased time on service (36/67, 54%) and patient contact (46/79, 58%) would not change residents' pursuit of a breast imaging fellowship. Conclusion: The pandemic has had a largely negative impact on breast imaging education, with reduction in exposure to all aspects of breast imaging. However, this may not affect career decisions. [ABSTRACT FROM AUTHOR]

Objectives: The primary objective of this study was to determine whether there was a change in the rate and types of patients with psychiatric illnesses being seen in the emergency department (ED) from 2012 to 2015 using the National Ambulatory Care Survey. A secondary objective was to determine what if any changes occurred in the resources available to care for these patients.Methods: Our study used 2012-2015 data from the National Hospital Ambulatory Medical Care Survey and the State Mental Health Agency Per Capita Mental Health Services Expenditures, and expenditures data from 2012-2015 to examine whether there was a significant change in the rate and type of mental illness ED visits. Additional data on the number of beds per region from the National Mental Health Services Survey, 2012-2015 were used. A t test was used to look for significant (P = 0.05) changes in the rate and types of patients, ED dispositions, ED reimbursement types, region and community level income, sex, age, state mental health funding, and psychiatric beds from 2012 to 2015.Results: There was an 8% increase in the rate of patients who presented with a diagnosed mental health disorder (P = 0.03, 95% confidence interval [CI] 5.32-5.96) and substance use disorders (P = 0.03, 95% CI 0.564-0.122). The reimbursement for these visits did change (P = 0.01, 95% CI 0.245-0.685); however, there was no significant increase (P = 0.07, 95% CI-214 to 101) in state mental health budgets and the number of psychiatric and detox hospital beds from 2012 to 2015.Conclusions: The rate and types of mental health patients coming to the ED are still on the rise. This is coupled with a lack of mental health infrastructure to address the needs and diagnoses that continue to be seen in the ED. States may need increased, targeted funding for mental health outside the increase in coverage via the Patient Protection and Affordable Care Act to slow the rate of mental health patients seen in the ED. [ABSTRACT FROM AUTHOR]

Advancements in dental materials and changing parental preferences are modifying the frequency of use of restorative materials. This insurance claims analysis examined the trends in the use of amalgam and resin composite in the United States. Commercial dental insurance claims were analyzed to compare 505,994 restorations, corresponding with procedure codes for 1-, 2-, and 3-surface amalgam or resin restorations. Paid claims collected nationwide from January 2010 through March 2020 were analyzed. Data for children aged 3 through 12 years were used, resulting in 219,632 unique patient identification numbers. Generalized estimating equation models applied to logistic regression were used. All tests were conducted using a 2-sided 5% significance level. In general, girls were less likely to receive amalgam than boys. A $20,000 increase in median household income was associated with a 16% decrease in the odds of amalgam being placed. Pediatric dentists (performing 15.1% of all restorations) were not as likely as general dentists (18.4%) to use amalgam. Having more surfaces in a restoration was associated with higher probability of amalgam placement. The percentage of amalgam restorations was higher for 2010 (26.9%) than for 2011 through 2020, and this pattern recurred in several of the years analyzed. Generally, patient age at time of amalgam restoration increased over time. The use of amalgam is trending down; the sharpest decline was noted in 2014. Pediatric dentists were less likely to use amalgam than general dentists. Girls and patients with higher socioeconomic status were less likely to have amalgam. The findings of this study can inform and support clinical decisions and the formation of public policies. [ABSTRACT FROM AUTHOR]

Background - Payment source affects the amount paid to the ED for services rendered. The Patient Protection and Affordable Care Act (ACA) which was implemented in 2010 to help increase the quality and affordability of health insurance, lower the uninsured rate, and to reduce healthcare costs for patients and the government. Before the ACA, there had been an increase of financial strain in the Emergency Departments. This was due to three factors the passing of EMATA in 1986, the economic recession, and an increased number of uninsured and underinsured patients. If the Emergency Department (ED) has a more diverse payer mixture, they will receive a higher reimbursement ratio. The payer mix could change due to the requirement to obtain health insurance under the Affordable Care Act (ACA), This could have a positive impact on reimbursement rates for the ED. Objective - The objective of this case study was to determine if there has been a change in the rate and type of reimbursement seen in a safetynet ED during the first five years of the Affordable Care Act (ACA). These findings could indicate how the ACA has or has not impacted a safety net ED's Methods - This was a retrospective, randomly sampled chart review of 1200 ED patients who presented to an inner city, level one adult and pediatric trauma center from 2010-2015. Data were analyzed using SPSS version 23, and the study was IRB approved. Results - There was a relationship between types of insurance (payers) (p = .01) , and the dependent variables of payments (p= .01), and balance remaining after 90 days (p= .00). Since the implementation of the ACA, there has been a shift in methods of payment, with private third-party payers increasing from 3% in 2010, to 28% in 2015. There was also a decrease in the percentage of self-pay from 30% in 2010 to less than 10% in 2015and for Medicaid from 11% to 10%. Conclusion - The results of this study indicate that this safety net ED reimbursement rates are positively associated with changes in payers during the first five years of the implementation of ACA. Thus, overall the ED reimbursement rates have increased post ACA for this safety net hospital. The positive association of a change in reimbursement rates for this safety net EDs indicates it might be impacted by how the ACA is or is not implemented currently and in the future. [ABSTRACT FROM AUTHOR]

OBJECTIVES To identify the top priority areas for research to optimize pharmacotherapy in older adults with cardiovascular disease (CVD). DESIGN Consensus meeting. SETTING Multidisciplinary workshop supported by the National Institute on Aging, the American College of Cardiology, and the American Geriatrics Society, February 6–7, 2017. PARTICIPANTS Leaders in the Cardiology and Geriatrics communities, (officers in professional societies, journal editors, clinical trialists, Division chiefs), representatives from the NIA; National Heart, Lung, and Blood Institute; Food and Drug Administration; Centers for Medicare and Medicaid Services, Alliance for Academic Internal Medicine, Patient‐Centered Outcomes Research Institute, Agency for Healthcare Research and Quality, pharmaceutical industry, and trainees and early career faculty with interests in geriatric cardiology. MEASUREMENTS Summary of workshop proceedings and recommendations. RESULTS: To better align older adults' healthcare preferences with their care, research is needed to improve skills in patient engagement and communication. Similarly, to coordinate and meet the needs of older adults with multiple comorbidities encountering multiple healthcare providers and systems, systems and disciplines must be integrated. The lack of data from efficacy trials of CVD medications relevant to the majority of older adults creates uncertainty in determining the risks and benefits of many CVD therapies; thus, developing evidence‐based guidelines for older adults with CVD is a top research priority. Polypharmacy and medication nonadherence lead to poor outcomes in older people, making research on appropriate prescribing and deprescribing to reduce polypharmacy and methods to improve adherence to beneficial therapies a priority. CONCLUSION: The needs and circumstances of older adults with CVD differ from those that the current medical system has been designed to meet. Optimizing pharmacotherapy in older adults will require new data from traditional and pragmatic research to determine optimal CVD therapy, reduce polypharmacy, increase adherence, and meet person‐centered goals. Better integration of the multiple systems and disciplines involved in the care of older adults will be essential to implement and disseminate best practices. J Am Geriatr Soc 67:371–380, 2019. See related Editorial by Forman et al. in this issue. [ABSTRACT FROM AUTHOR]

Reproductive health disparities--particularly those experienced by racial and ethnic minority groups--are considered a persistent public health issue in the United States. Frameworks that focus on social determinants of health seek to identify the forces producing these disparities, particularly social conditions that create vulnerability to premature death and disease. Such frameworks pose challenges to health care provision, as structural factors can seem immutable to health care professionals trained to treat individual patients. Here, we discuss the links between reproductive health disparities and social determinants of health. We then apply to reproductive health care the structural competency framework, developed by physician-scholars to encourage health care professionals to address health disparities by analyzing and intervening upon sociopolitical forces. [ABSTRACT FROM AUTHOR]

Many accounts of contemporary mediated communication of various kinds emphasise speed, immediacy and simultaneity as overriding temporal characteristics, and accounts of journalism are no exception. Acceleration in journalistic practice and the associated changes in news content and its communication have a variety of consequences. In the most extreme accounts, this produces ever-shallower news content while the immediacy of its delivery collapses deliberative time for its interpretation. This article attempts to challenge some of the assumptions on which these assertions are based by taking an alternative starting point in analysing news time and temporality: the news audience. We argue that many accounts which emphasise the paralysing effects of fast communication and the acceleration of news in particular fail to acknowledge the complexities of news consumption, instead pessimistically reading off the effects of speed from communications technologies themselves. We go on to consider the value of social scientific audience research characterisation of practices of consuming the news in contemporary culture and suggest that these need to be accompanied by ethnographic approaches to the audience which engage with the ways in which meaning is produced from the resources that journalism provides in everyday lived contexts. [ABSTRACT FROM AUTHOR]

Effective assessment practice requires clearly defining and operationalizing terminology. We illustrate the importance of this practice by focusing on academic “undermatching”—when students enroll in colleges that are less academically selective than those for which they are academically prepared. Undermatching has been viewed as a potential obstacle in the United States’ goal of increasing degree attainment but operationalizing undermatching is difficult. Using ELS: 2002, a national dataset from the U.S. Department of Education National Center for Education Statistics (NCES, 2014), we developed eight operationalizations of undermatching by altering three commonly used variables. We then compared the number and demographics of students who were identified as undermatched. Differences in operationalizations resulted in significant differences in undermatching by gender, race, parental education, and socioeconomic status. Results of this study illustrate the importance of the need to operationalize terminology used in assessment carefully and consistently. [ABSTRACT FROM AUTHOR]

At the time of writing, the Trump Administration is nascent, in existence for less than ten weeks. During that short time, however, the President has made it abundantly clear that he intends to occupy his new office in the same way he ran his presidential campaign – loudly, caustically and with a single-minded vision bent on turning government and United States policy upside down, ostensibly to benefit American citizens, American workers and American business. Although many commentators have said that this broad-brushed approach to governance overemphasises bold results over thoughtful process and idealism over nuance, thereby ignoring or otherwise casting aside important details, no one should be the least bit surprised that it’s happening. [ABSTRACT FROM PUBLISHER]

The article presents citations for several American Association of Petroleum Geologists (AAPG) honorees in 2009. Among the honorees are Sidney Memorial awardee Marlan W. Downey, Outstanding Leadership Award recipient M. Ray Thomasson and Honorary Member awardee Peter A. Ziegler. It profiles individuals who were recognized for their contributions in the field of petroleum geology including J. C. Sproule Memorial Awardee David R. Pyles and Teacher of the Year Awardee Ty Scott Robinson.

In recent years, private for-profit education has been the fastest growing segment of the U.S. postsecondary system. Traditional hiring models suggest that employers clearly and efficiently evaluate college credentials, but this changing institutional landscape raises an important question: How do employers assess credentials from emerging institutions? Building on theories of educational authority, we hypothesize that employers respond to an associate's degree itself over the institution from which it came. Using data from a field experiment that sent applications to administrative job openings in three major labor markets, we found that employers responded similarly to applicants listing a degree from a fictional college and applicants listing a local for-profit or nonprofit institution. There is some evidence that educational authority is incomplete, but employers who prefer degree-holders do not appear to actively evaluate institutional quality. We conclude by discussing implications of our work for research on school to labor market links within the changing higher education marketplace. [ABSTRACT FROM AUTHOR]

Classroom assistants and one-to-one assistants are an important part of the staffing structure of many autism support classrooms. Limited studies, however, have examined how one-to-one assistants spend their time in the classroom. The purpose of this article was to examine the percentage of time one-to-one assistants were engaged in instruction or support of students with autism and to determine the factors associated with their engagement. Direct observations were conducted in 46 autism support classrooms. Teachers and classroom assistants were engaged in instruction or support 98% and 91% of the time, respectively. One-to-one assistants were engaged in instruction or support 57% of the time. Classroom assistants’ and one-to-one assistants’ engagement was significantly correlated. The low rate of one-to-one assistants’ engagement suggests an inefficient use of an important resource. [ABSTRACT FROM AUTHOR]

In pursuit of innovative educational opportunities, district administration piloted competency-based education in their alternative program. This qualitative study used semi-structured interviews with school personnel to document perspectives of the programmatic shift. Analyses found local and national mandates, a catalyst, and a common moral purpose to be key factors for change. Challenges included: effective communication among all stakeholders; finding adequate time to develop and implement an alternative educational approach; and difficulties with alignment between two systems of accountability. Successes included increased teacher and student engagement and an increase in the academic rigor of the program. Evidence suggests successes far surpassed challenges. [ABSTRACT FROM AUTHOR]

The article presents abstracts on dance therapy topics which include the impact of a dance/movement therapy (DMT) program and an exercise aerobics program on elderly population, sexuality of women in group DMT, and the recurrence of the quality of movement with Japanese onomatopoeias.

Demand-Driven Acquisition (DDA) has been commonly adopted by academic libraries in the United States for acquiring e-books in recent years. Implementation of the e-book DDA model varies by library. This paper introduces and demonstrates a scenario analysis approach for libraries to evaluate, identify, and select a DDA plan that works best for them based on their DDA program data. This approach helps address some key questions facing libraries with a DDA e-book program: How may a DDA program be evaluated under different scenarios? Does a short-term loan (STL) option make sense? And, is the current DDA implementation a good fit for the library? The implications and related issues are discussed. [ABSTRACT FROM AUTHOR]

BackgroundOverweight and obesity are growing problems for primary care. Although effective weight management programs exist, these programs experience significant attrition, which limits effectiveness.ObjectivesThis study examined provider and staff perceptions of attrition from the Veterans Health Administration MOVE!® Weight Management Program as an initial step toward understanding attrition from primary care-based programs.ParticipantsMOVE!® clinicians, primary care providers, and other staff members who interacted with patients about participating in MOVE!® (n=754) from Department of Veterans Affairs medical centers throughout the United States. Respondents were predominantly female (80.8%), Caucasian (79.2%), and trained as nurses (L.P.N., R.N., or N.P.; 50%).MeasureParticipants completed a web-mediated survey; items assessed agreement with personal and programmatic reasons for dropout, and allowed respondents to indicate the number one reason for dropout in an open-ended format. This survey was adapted from an existing tool designed to capture patient perceptions.ResultsRespondents indicated that veterans experienced practical barriers to attendance (eg, transportation and scheduling difficulties) and desire for additions to the program (eg, a live exercise component). Low motivation was the primary factor identified by respondents as associated with dropout, particularly as noted by MOVE!® clinicians (versus other providers/staff; P<0.01).ConclusionsThese findings suggest that programmatic changes, such as adding additional meeting times or in-session exercise time, may be of benefit to MOVE!®. In addition, increasing the use of techniques such as Motivational Interviewing among providers who refer patients to MOVE!® may improve participant engagement in MOVE!® and other primary care-based weight management programs. Further research is needed to effectively identify those likely to withdraw from weight management programs before achieving their goals, and the reasons for withdrawal. [ABSTRACT FROM PUBLISHER]