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Background Research on influenza burden in adults has focused on crude subgroups with cut-points at 65 years, limiting insight into how burden varies with increasing age. This study describes the incidence of influenza-related outpatient visits, emergency room visits, and hospitalizations, along with healthcare resource use and complications in the aging adult population. Methods Individuals aged ≥18 years in the United States were evaluated retrospectively in 5 seasonal cohorts (2015–2020 seasons) in strata of age with 5-year increments. Person-level electronic medical records linked to pharmacy and medical claims were used to ascertain patient characteristics and outcomes. Influenza-related medical encounters were identified based on diagnostic codes (International Classification of Diseases, 10th Edition, codes J09*–J11*). Results Incidence of influenza-related outpatient visits was highest among people aged 18–34 years and declined with increasing age. For emergency room visits, incidence tended to be elevated for people aged 18–34 years, relatively stable from 35 through 60, and increased rapidly after age 60 years. Hospitalization incidence remained relatively stable until about 50 years of age and then increased with age. One in 3 patients was diagnosed with pneumonia after hospitalization, regardless of age. Across seasons, age groups, and clinical settings, on average, 40.8% of individuals were prescribed antivirals and 17.2% antibiotics. Conclusions Incidence of influenza-related hospitalizations begins to increase around age 50 years rather than the more common cut-point of 65, whereas incidence of outpatient visits was highest among younger adults. Influenza infections frequently led to antiviral and antibiotic prescriptions, underscoring the role influenza vaccination can play in combating antimicrobial resistance. [ABSTRACT FROM AUTHOR]

Across multiple countries the term "big ideas" of mathematics has become a construct advocated as important for teachers' mathematical knowledge. Indeed, several policy or position statement documents about math learning in the United States (U.S.) have stated that "big ideas" of math is a crucial construct for teacher knowledge. With this study we sought to determine if there was consistency about this "big idea" construct that teachers of mathematics in the U.S. are advised to know. To this end, we conducted a content analysis of resources for U.S. teachers of preschool through grade 12. We determined that few resources defined a big idea and those that did lacked agreement with each other. Although most resources delineating big ideas cited Charles (2005) as the basis of their use of the construct, our analysis of the actual big ideas in each resource revealed inconsistent implementation of Charles' theoretical perspective. Thus, to move research and practice forward by more precisely defining and prioritizing this abstract construct we (a) clarified a definition, (b) specified five criteria, and (c) constructed a scholar- and teacher-friendly framework: The Big Ideas Framework. This framework consists of three ordinal levels to distinguish and prioritize the importance of big ideas based on relative size and power: Mighty Mega Math Ideas, Power Math Ideas, and Strong Math Ideas. Moreover, the big ideas construct has focused on Mathematical Knowledge for Teaching (MKT), whereas we urge the field to shift its theoretical perspective to value the entire construct or at least the two most powerful levels of the framework as aspects of Common Content Knowledge. In other words, we urge teachers and mathematics teacher educators to foreground Mighty Mega Math Ideas and Power Math Ideas with P-12 students and families to empower those we serve. Furthermore, given the dearth of peer-reviewed research about big ideas, we encourage a new branch of scholarship to analyze the impact of the practical recommendations we offered here. [ABSTRACT FROM AUTHOR]

Background Influenza vaccine viruses grown in eggs may acquire egg-adaptive mutations that may reduce antigenic similarity between vaccine and circulating influenza viruses and decrease vaccine effectiveness. We compared cell- and egg-based quadrivalent influenza vaccines (QIVc and QIVe, respectively) for preventing test-confirmed influenza over 3 US influenza seasons (2017–2020). Methods Using a retrospective test-negative design, we estimated the relative vaccine effectiveness (rVE) of QIVc vs QIVe among individuals aged 4 to 64 years who had an acute respiratory or febrile illness and were tested for influenza in routine outpatient care. Exposure, outcome, and covariate data were obtained from electronic health records linked to pharmacy and medical claims. Season-specific rVE was estimated by comparing the odds of testing positive for influenza among QIVc vs QIVe recipients. Models were adjusted for age, sex, geographic region, influenza test date, and additional unbalanced covariates. A doubly robust approach was used combining inverse probability of treatment weights with multivariable regression. Results The study included 31 824, 33 388, and 34 398 patients in the 2017–2018, 2018–2019, and 2019–2020 seasons, respectively; ∼10% received QIVc and ∼90% received QIVe. QIVc demonstrated superior effectiveness vs QIVe in prevention of test-confirmed influenza: rVEs were 14.8% (95% CI, 7.0%–22.0%) in 2017–2018, 12.5% (95% CI, 4.7%–19.6%) in 2018–2019, and 10.0% (95% CI, 2.7%–16.7%) in 2019–2020. Conclusions This study demonstrated consistently superior effectiveness of QIVc vs QIVe in preventing test-confirmed influenza over 3 seasons characterized by different circulating viruses and degrees of egg adaptation. [ABSTRACT FROM AUTHOR]

The loose‐equilibrium concept (LEC) predicts that ecological assemblages change transiently but return towards an earlier or average structure. The LEC framework can help determine whether assemblages vary within expected ranges or are permanently altered following environmental change.Long‐lived, slow‐growing animals typically respond slowly to environmental change, and their assemblage dynamics may respond over decades, which transcends most ecological studies. Unionid mussels are valuable for studying dynamics of long‐lived animals because they can live >50 years and occur in dense, species‐rich assemblages (mussel beds). Mussel beds can persist for decades, but disturbance can affect species differently, resulting in variable trajectories according to differences in species composition within and among rivers.We used long‐term data sets (10–40 years) from seven rivers in the eastern United States to evaluate the magnitude, pace and directionality of mussel assemblage change within the context of the LEC.Site trajectories varied within and among streams and showed patterns consistent with either the LEC or directional change. In streams that conformed to the LEC, rank abundance of dominant species remained stable over time, but directional change in other streams was driven by changes in the rank abundance and composition of dominant species.Characteristics of mussel assemblage change varied widely, ranging from those conforming to the LEC to those showing strong directional change. Conservation approaches that attempt to maintain or create a desired assemblage condition should acknowledge this wide range of possible assemblage trajectories and that the environmental factors that influence those changes remain poorly understood. [ABSTRACT FROM AUTHOR]

We applied a structural intersectionality approach to cross-sectionally examine the relationships between macro-level systems of oppression, their intersections, and access to oral care in the United States. Whether and the extent to which the provision of government-funded dental services attenuates the emerging patterns of associations was also assessed in the study. To accomplish these objectives, individual-level information from over 300,000 respondents of the 2010 US Behavioral Risk Factor Surveillance System was linked with state-level data for 2000 and 2010 on structural racism, structural sexism, and income inequality, as provided by Homan et al. Using multilevel models, we investigated the relationships between systems of oppression and restricted access to oral health services among respondents at the intersections of race, gender, and poverty. The degree to which extended provision of government-funded dental services weakens the observed associations was determined in models stratified by state-level coverage of oral care. Our analyses bring to the fore intersectional groups (e.g., non-Hispanic Black women and men below the poverty line) with the highest odds of not seeing a dentist in the previous year. We also show that residing in states where high levels of structural sexism and income inequality intersect was associated with 1.3 greater odds (95% confidence interval, 1.1–1.5) of not accessing dental services in the 12 mo preceding the survey. Stratified analyses demonstrated that a more extensive provision of government-funded dental services attenuates associations between structural oppressions and restricted access to oral health care. On the basis of these and other findings, we urge researchers and health care planners to increase access to dental services in more effective and inclusive ways. Most important, we show that counteracting structural drivers of inequities in dental services access entails providing dental care for all. [ABSTRACT FROM AUTHOR]

Objectives: Colorectal cancer (CRC) is a serious challenge for the health system. In 2022 CRC represented 8% of cancer diagnoses in the United States. 30% of patients already show metastases at the initial tumor staging. The majority of these metastases are sited in the liver. According to their extension and the status of the tumor colorectal liver metastases can be treated in several ways, with hepatic resection being the gold-standard. Contrast-enhanced computed tomography (CE-CT), positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI) can be used for evaluation of resectability of these liver metastases. The aim of this study is to assess the most economic imaging modality for detecting liver metastases eligible for hepatic resection by analyzing their cost-effectiveness. Materials and methods: In our study, a Markov state transition model was built to calculate the quality-adjusted life years (QALYs) and overall costs for each diagnostic strategy in accord with the stated input values obtained from scientific research. Further, probabilistic sensitivity analyses by means of Monte Carlo simulations were performed to consider possible model uncertainties. For evaluation of the cost-effectiveness on an economic threshold, the Willingnessto- pay (WTP) was set at $ 100,000. The applied values and the calculated results are based on the U.S. healthcare system. Results: CE-CT led to overall costs of $ 42,874.02 and 8.47 QALYs, whereas MRI led to $ 40,863.65 and 8.50 QALYs. PET/CT resulted in overall costs of $ 43,216.74 and 8.48 QALYs. Therefore, MRI was determined to be the dominant strategy in the model. According to the performed sensitivity analyses, MRI remained cost-effective over a wide range of WTPs. Conclusion: In conclusion, according to our analysis, MRI is the dominant strategy for detecting hepatic metastases eligible for hepatic resection in colorectal cancer. [ABSTRACT FROM AUTHOR]

Background The MF59-adjuvanted trivalent inactivated influenza vaccine (aIIV3) is designed to overcome immunosenescence and enhance vaccine responses in older adults. We expanded on the Centers for Disease Control and Prevention (CDC) modeling method to estimate the number of additional influenza-related outcomes averted with aIIV3 versus generic quadrivalent inactivated influenza vaccine (IIV4) in adults ≥65 years over 3 influenza seasons (2017–2018 to 2019–2020) in the United States. Methods A static compartmental model was developed based on an existing CDC model with 2 previously recommended calculation methods that increased the accuracy of the model in providing estimates of burden averted. Model inputs included vaccine effectiveness, vaccine coverage, population counts, and disease burden estimates. Additional burden averted (symptomatic cases, outpatient visits, hospitalizations, intensive care unit [ICU] admissions, and deaths) was expressed as total incremental cases averted between the vaccines. Sensitivity analyses tested the resilience of the model results to uncertainties in model inputs. Results The model estimated that vaccination with aIIV3 versus IIV4 would avert 2.24 times as many symptomatic cases, outpatient visits, hospitalizations, ICU stays, and deaths during 2017–2018; the burden averted in 2018–2019 and 2019–2020 with aIIV3 would be 3.44 and 1.72 times that averted with IIV4, respectively. Disease burden estimates and relative vaccine effectiveness of aIIV3 had the greatest impact on model estimates. Conclusions Over 3 influenza seasons, the model estimated that aIIV3 was more effective than IIV4 in averting influenza-related outcomes, preventing 1.72 to 3.44 times as many influenza illnesses with proportionate decreases in related healthcare use and complications. [ABSTRACT FROM AUTHOR]

Using the framework of multicultural education, this article presents an analysis of multicultural picture books that depict the features of assimilation ideology. The findings suggest that assimilationist ideas are presented through the main characters' identities in the resolution of the story and through the portrayal of a glorified dominant culture. These findings contribute to the literature by exploring the assumptions that multicultural texts are indeed "multicultural" and that they promote cultural pluralism. Additional criteria for selecting multicultural texts that critically examine underlying ideologies are included, as well as suggestions for promoting critical reading practices to support multicultural education. (Contains 3 tables.)

The COVID-19 pandemic, along with disruptions to routine medical care, brought renewed urgency to public health messaging about the importance of influenza vaccination. This retrospective cohort study used a database of linked claims and electronic medical record data to evaluate clinical and demographic characteristics and influenza vaccination history associated with changes in influenza vaccine uptake following the start of the COVID-19 pandemic. Influenza vaccine uptake was examined in six seasons (2015–2016 through 2020–2021). Individuals were grouped by vaccination history in the five seasons before 2020–2021. Characteristics of 2020–2021 vaccinated vs. unvaccinated individuals were compared, stratified by vaccination history. Overall influenza vaccination uptake was highest in 2020–2021 (35.4%), following a trend of increasing uptake since 2016–2017 (31.4%). Uptake in 2020–2021 was observed in all age groups except ≥65 years, and the increase was particularly notable in individuals <18 years. In the previous five seasons, individuals ≤17 and >65 years, White, and Asian individuals were most likely, while 18-to-49-year-olds and those with fewer comorbidities were least likely, to be consistently vaccinated. Influenza vaccination status in 2020–2021 aligned with vaccination history; few differences in patient characteristics (age, comorbidities, state of residence) were observed when stratified by vaccination history. [ABSTRACT FROM AUTHOR]

Traditional influenza vaccines may be less immunogenic in adults ≥65 years of age due to immunosenescence. Two influenza vaccines—MF59®-adjuvanted trivalent inactivated influenza vaccine (aIIV3) and high-dose influenza vaccine (HD-IIV3)—were developed to overcome this problem. We summarize estimates of the relative vaccine effectiveness (rVE) of aIIV3 vs. HD-IIV3 and aIIV3 vs. standard, egg-based quadrivalent influenza vaccines (IIV4e) during the 2017–2018, 2018–2019, and 2019–2020 US influenza seasons using the same underlying electronic medical record and linked claims dataset for all three seasons. The primary outcome was influenza-related medical encounters (IRMEs), defined by diagnostic codes specific to influenza (ICD J09*-J11*). rVE was estimated using propensity score methods adjusting for demographics and health status. rVE estimates demonstrated consistent benefit for aIIV3 over IIV4e in the overall and at-risk populations. Relative to HD-IIV3, aIIV3 provided improved benefit in the overall study population and comparable benefit in the at-risk population across each season. [ABSTRACT FROM AUTHOR]

Objective: Research on racial oral health inequities has relied on individual-level data with the premise being that the unequal distribution of dental diseases is an intractable problem. We address these insufficiencies by examining the relationships between structural racism, structural sexism, state-level income inequality, and edentulism-related racial inequities according to a structural intersectionality approach.Methods: Data were from two sources, the 2010 survey of the U.S. Behavioral Risk Factor Surveillance System, and Patricia Homan et al.'s (2021) study on the health impacts from interlocking systems of oppression. While the first contains information on edentulism from a large probabilistic sample of older (65+) respondents, the second provides estimates of racism, sexism, and income inequality across the US states. Taking into account a range of individual characteristics and contextual factors in multilevel models, we determine the extent to which structural forms of marginalization underlie racial inequities in edentulism.Results: Our analysis reveals that structural racism, structural sexism, and state-level income inequality are associated with the overall frequency of edentulism and the magnitude of edentulism-related racial inequities, both individually and intersectionally. Coupled with living in states with both high racism and sexism (but not income inequality), the odds of edentulism were 60% higher among non-Hispanic Blacks, relative to Whites residing where these structural oppressions were at their lowest.Conclusions: These findings provide evidence that racial oral health inequities cannot be disentangled from social forces that differentially allocate power and resources among population groups. Mitigating race-based inequities in oral health entails dismantling the multifaceted systems of oppression in the contemporary U.S. society. [ABSTRACT FROM AUTHOR]

The lack of a precise and reliable definition of a concept has an impact on how well we can use it. The present study is an evolutionary concept analysis of psychological trauma. Review of all the 2015 publications from the main journals in the area. Our findings indicate that the concept is composed by the attributes death, serious injury, and sexual violence. The majority use is based on the American Psychological Association (APA) manuals, assessed through semistructured interviews and questionnaires. West European Countries and the United States produced almost every research, and this may create a cultural and sample bias. [ABSTRACT FROM AUTHOR]

The article presents a discussion on sports science. In the German language, "Sportwissenschaft" stands for all scientific aspects of the field named in the English language with different terms like physical education, kinetics, sport studies, and physical activity sciences. "Sportwissenschaft" includes the aspects of humanities, arts, and sciences as they relate to the phenomenon of sport. Since an exact translation for "Sportwissenschaft" into English is not possible, the term sport science is used in the present analysis to express a wide range of aspects from the philosophical to the medical dimension. The term physical education, which is still widely used in the United States, as a name for an academic field should no longer be used, since it is a term for describing a procedure.

Background: Oncology navigation reduces barriers to cancer care, yet patient navigation is not universally provided. Geographic location may limit physical access to care, and patients can be confused about their cancer diagnosis and treatment options. A virtual navigation program was created with the Oncology Nursing Society Nurse Navigation Core Competencies. The program provides access to care, individualized education, and care coordination promoting self-advocacy in the cancer journey. Objectives: The program included the following objectives: (1) to provide individualized patient education through phone contact as well as through written communication; (2) to increase awareness of the cancer diagnosis, associated health issues, and treatment options; and (3) to provide patient referrals and connections to others (eg, consultation with a medical oncologist, clinical trial evaluation, or genetic counseling). Methods: The study was guided by a mixed methods approach using an online instrument with a key research question: How effective is virtual navigation in providing critical factors to promote self-advocacy along the cancer continuum? Ninety-five oncology patients participated in the research by completing an online assessment after navigation that examined individualized education and coordinated cancer care. Results: Diversity in age, tumor type, and geographical location emerged in the national data. After virtual navigation, 84% of patients better understood their diagnosis and treatment options; 83% were better able to make informed decisions. A statistically significant increase in knowledge on "health issues that come from cancer" emerged postnavigation (P <.0001). Navigation also improved "coordinated cancer care" (P = .018). Discussion: Virtual navigation increased patient access and has the potential to facilitate self-advocacy in the oncology patient despite geographical location, age, and tumor type. Conclusion: The findings suggest virtual navigation is a viable solution to reduce barriers to cancer care and increase patient outcomes, despite geographical location. Through virtual connection, navigation may empower patients to help them overcome the challenges many face in the cancer journey. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study sought to understand chief nurse executive perceptions of nursing peer review (NPR) and current NPR practices in their organizations to provide insights and recommendations for the path forward to a robust NPR approach nationally. BACKGROUND: Nursing peer review is a key component of professional nursing practice focused on self-regulation and improving quality and safety. Despite its known benefits, NPR is not broadly disseminated, and how it is currently used and perceived is not well understood. METHODS: A causal-comparison study design was used. A 25-question, Web-based survey was administered to collect data variables. RESULTS: Chief nurse executives perceived NPR as important in improving quality and safety; however, its prevalence was low. Chief nurse executives also reported NPR practices not aligned with the American Nurses Association (ANA) NPR guidelines. CONCLUSIONS: Results suggest that knowledge gaps exist regarding NPR's purpose, outcomes, and alignment with the ANA peer review guidelines. Interventions are needed to address these gaps to further advance NPR adoption nationally. [ABSTRACT FROM AUTHOR]

This study examines the relationship between online presence and U.S. small firm performance during the 2007-2009 recessionary period. The paper specifically explores the impact of having a web presence on the return on assets of 570 U. S. small businesses. The analysis revealed that having a web presence positively and significantly improved the return on assets. [ABSTRACT FROM AUTHOR]

The article addresses issues under the tender offer regulations for debt securities in the U.S. It attempts to show how the current methods implemented by the Securities and Exchange Commission (SEC) make substantial risks and costs for market participants and the transactional attorneys who must guide and approve the tender offer transaction. It discusses how the SEC interpreted and promulgated relevant statutes and regulations of tender offers through its various administrative options.

Information on the Children's Literature Workshop held in the U.S. on November 22, 2010 is presented. The workshop has offered an intimate setting that focused on the connection between literacy and the arts. It highlights several award-winning authors and illustrators who shared their dynamic processes for the creation and illustration of the books showcased for the workshop. Presenters include Doreen Rappaport, Bryan Collier, and David Diaz.

This qualitative study examined the current schooling experiences of eight Korean high school students in the United States. By comparing and contrasting recent immigrant adolescents and 1.5/2nd generation students, the purpose of this study was to explore how their identities as Koreans or Korean Americans were formed and shifted while they engaged with American teachers and peers in mainstream contexts. The findings suggest that even in the same ethnic group, differences were conspicuous. The newcomer group desperately wished to assimilate to mainstream culture by associating with American classmates. On the other hand, the 1.5/2nd generation group lived bi-culturally with dual identities as Korean and American and shifted their identities according to their convenience. Despite these differences, both of the groups suffered a similar experience by receiving unwelcome gestures from their mainstream teachers and peers: the newcomers as invisible outsiders and the 1.5/2nd generation as visible and marked outsiders. [ABSTRACT FROM AUTHOR]

With the Navy's development of the integrated electric warship, large amounts of electrical energy will be made available, thus allowing the addition of pulsed weaponry and sensors. Electromagnetic railguns will increase the thermal load on such a ship by an order of magnitude or more over a conventional gun. To represent the expected loads, a numerical model has been created to simulate the system-level energy balance for a capacitive-based railgun system and is currently in development for a rotating machine-based system. In order to better study the system-level effects of the increased thermal burden, multiple shot profiles and scenarios were used. The simulation outputs are used as inputs to a ship-based, thermal management architecture built in the dynamic thermal software package Pro TRAX. Our analysis quantifies additional thermal management capacity that will be necessary for the future all-electric ship and provides the first step in simulating potential ship wide thermal management systems of pulsed loads in a dynamic sense. [ABSTRACT FROM AUTHOR]

1. This paper documents a diverse, reproducing freshwater mussel community (20 species) in Lower Lake — an impounded, regulated portion of the Little Tallahatchie River below Sardis Dam in Panola Co., Mississippi, USA. 2. Despite being regulated and impounded, the lake has a heterogeneous array of habitats that differ markedly in mussel community attributes. Four distinct habitat types were identified based on current velocity and substrate characteristics, representing a gradient from habitats having lotic characteristics to lentic habitats. All four habitat types supported mussels, but habitats most resembling unimpounded, lotic situations (relatively higher current velocity and coarser substrate) had the highest mussel abundance and species density (10.1 mussels m-2, 1.8 species m-2, respectively). Lentic habitats (no flow, fine substrate) were characterized by lower abundance and species density (2.0 mussels m-2, 0.8 species m-2, respectively), but supported mussel assemblages distinctive from lotic habitats. 3. Evidence of strong recent recruitment was observed for most species in the lake and was observed in all four habitat types. 4. Although impounded and regulated, Lower Lake represents one of the few areas of stable large-stream habitat in the region. The presence of a diverse, healthy mussel community in this highly modified habitat suggests that a large component of the regional mussel fauna is relatively resilient and adaptable and is limited primarily by the absence of stable river reaches. Management actions that increase stream stability are likely to result in expansion of the mussel fauna and restoration of a valuable component of ecosystem function in this region. [ABSTRACT FROM AUTHOR]

Two hundred seventy-three White undergraduates participated in an investigation of how beliefs relate to support for affirmative action (AA) policies. Beliefs included belief in the fairness of AA, belief in merit, and belief in the value of diversity. Analyses predicted support for a general affirmative action policy, a tiebreak policy, and a policy using banding from beliefs and individual-level variables such as future benefit from AA and demographics. For the general policy, each belief predicted support for AA. Fairness and value of diversity predicted support for a tiebreak policy. Value of diversity predicted support for aptitude testing. Individual characteristics improved prediction for AA in general but not for tiebreak policy or aptitude testing. We discuss predictions and results in terms of procedural and distributive justice, fairness heuristic theory, and models of support for AA. [ABSTRACT FROM AUTHOR]

1. Life histories of the highly diverse and endangered North American freshwater mussel fauna are poorly known. We investigated reproductive traits of eight riverine mussel species in Alabama and Mississippi, U.S.A.: Amblema plicata, Elliptio arca, Fusconaia cerina, Lampsilis ornata, Obliquaria reflexa, Pleurobema decisum, Quadrula asperata and Q. pustulosa, and compare our results with existing life history information for other species. 2. These eight species had reproductive traits characteristic of large, outcrossing populations: hermaphrodites were rare, we found no evidence of protandry, and sex ratios were even or slightly male-biased. 3. Age at sexual maturity varied among species, ranging from <1 to 2 years for L. ornata to 3–9 years for Q. asperata. In all species, most mature females participated in reproduction and fertilisation success was high. 5. Fecundity was related positively to both length and age, but length was the best predictor. In six species, fecundity increased exponentially with increasing size; in two species the rate of increase in fecundity declined in larger animals. In four species, fecundity declined in older animals. These latter results indicate weak reproductive senescence; however, in all species, older individuals continued to produce large numbers of offspring. Mean annual fecundity differed widely among species ranging from 9647 to 325 709. Within-species differences in fecundity were found among rivers and among populations within a river. 6. The wide variation in reproductive traits among species indicates the existence of widely divergent life history strategies in freshwater mussels. [ABSTRACT FROM AUTHOR]

This article presents current research information on the treatment of panic disorder. Specific guidelines are presented to guide the mental health counselor in the delivery of effective psychopharmacological and cognitive-behavioral treatment. [ABSTRACT FROM AUTHOR]

Studies the occurrence of the rayed creekshell, Anodontoides radiatus, a freshwater mussel, at eight sites in the upper Yazoo River drainage in northern Mississippi. Introduction to the rayed creekshell; Methods; Results; Discussion.

Describes a doctoral-level assignment that uses a genogram format to trace academic lineage and uncover historical themes that continue to influence the student's professional development. [ABSTRACT FROM AUTHOR]

Examines the iron status and iron supplementation in peritoneal dialysis patients in the United States. Role of iron deficiency in peritoneal dialysis; Benefits of intravenous iron therapy; Decrease incidence of iron deficiency.

Provides insights on the School-to-Work Opportunities Act of 1994 in the United States. Provisions of the act; Implications for schools and school counselors; Role of school counselors in the act implementation and school-to-work transition.

Examines the use of the death penalty in the U.S. Information on the moral aspects of the death penalty; Use of the death penalty to deter murders and other heinous crimes; Details on cost and brutalization issues related to the death penalty.

Argues that patterns of discourse on violence in the working-class community from 1860-1880 expose competing and sometimes contradictory ideas of masculinity and male status within the working class. The idea of masculinity rooted in the machismo of the streets; The idea of masculinity revealed in assaults against wives --rooted in the tradition of male privilege and prerogative; Day of the week domes tic assaults, aggregate; More.

The article discusses common stressors facing dual-career couples. The article states that dual-career couples represent a rapidly growing segment of the population of partners in the United States. They couples increasingly seek assistance from counselors in negotiating the particular stresses that arise from the dual-career lifestyle. In 1950, that typical family structure with a full-time working father, a stay- at-home mother, and one or more school-age children at home represented 70 percent of all U.S. households. By 1991, only 4 percent of all households fit that stereotype. Today, employed couples represent the largest segment of workers in the workplace. As more wives enter the workplace, an increasing number are becoming career oriented rather than simply holding jobs. In dual-career marriages, money is rarely the only motivation.

Focuses on the transformation of the social structure, economy and political landscape in the U.S. Reflections of philosophical orientation patterns; Relationship between man and human institutions; Expansion of ecological consciousness.

Objective To assess factors influencing uptake of amniocentesis after a positive Down's syndrome screening result. Methods Interviews of 53 Montana women with screening risks ≥1 in 300 after delivery. Results Thirty had accepted amniocentesis (“yes” group) and 23 had declined (“no” group) (57% uptake). Age at delivery was significantly higher (p=0.02) for the “no” than the “yes” group (mean 35.3 v 31.7 years). The mean risk of Down's syndrome ascertained by screening was 1 in 190 for the “no” group and 1 in 115 for the “yes” group (p=0.05). Statistically significant differences (p≤0.05) between opinions in the two groups included: (a) desire to know if the fetus had Down's syndrome; (b) perception of the burden of care for an affected child; (c) support of doctor, spouse, and relatives for choice about amniocentesis; (d) attitudes toward abortion; (e) importance of religion; and (f) concerns about the amniocentesis procedure. The most important factor for those choosing amniocentesis was knowing if the fetus had Down's syndrome, and for those not choosing amniocentesis, attitude about abortion. Conclusion Our results show the need for prescreening education to enable pregnant women to make informed decisions about screening for Down's syndrome and diagnostic testing. [ABSTRACT FROM AUTHOR]

The article discusses the significance of developing an American Foreign Legion or mercenaries, which could be paid and train to fight for the country. The most popular objections regarding the proposal and possible provisions of its establishment are taken into account. It is also revealed that the U.S. strategic superiority over Soviet Union may not be sufficient to deter and defend Soviet attacks on remote or minor targets of interest to the country.

The article focuses on the issues of the subsidies given by the government to arts in the U.S. According to the author, the attention given by the government to arts raises question such as the role of arts in the society, and on the role of the government in arts. He adds that the government should justify their subsidies of arts. Other information related to the government subsidies are also mentioned.

The article focuses on the underlying issues of global foreign policy of the U.S. and its foreign relations with the allied countries. As mentioned in the Foreign Policy Agenda of the U.S. Department of State, the policy is to create a more secure, democratic, and prosperous world for the benefit of the American people and the international community. However, issues are raised whether the U.S. government is still to conform with the agenda considering its unstable national security.

The way in which data envelopment analysis (DEA) can be used to assess the relative technical efficiency of agricultural production units is illustrated. Two variants of the existing DEA additive model are introduced, each eliminating earlier difficulties encountered in application and theory. These new models are demonstrated through application to agricultural data obtained from the Blackland Prairie, Texas.
Charnes et al. (1978) introduced a promising new methodology which has subsequently been called data envelopment analysis (DEA). Developed specifically to measure the relative technical efficiency of non-trivial multi-input multi-output systems (at least two variables in each category), it suffers neither of the aforementioned shortcomings. The original model, the ratio (CCR) model, has been joined by the multiplicative model (Charnes et al., 1982) and, most recently, the additive model (Charnes et al., 1985) to form the nucleus of analytic structures which presently compose DEA. These models classify each of the production units as either efficient or inefficient. The latter model, based on the Charnes-Cooper test for Pareto-Koopmans optimality of a production unit's consumption and production levels with respect to a particular reference set (the convex hull of all observed levels), is the one of interest for this discussion.
Our objective in this paper is to demonstrate how the
DEA (additive) methodology might be used to assess the relative technical efficiency -- henceforth termed efficiency -- of observed agricultural production/consumption levels in counties with similar soil types. To clarify the theory, we have included a case study of counties from the Blackland Prairie, a region of homogeneous soil composition (order: Vertisol, suborder: Usterts, see Soil Survey Staff 1960) in Texas.
As with all DEA applications, a preconceived notion of important production/consumption characteristics is manifested in the selection of i... [ABSTRACT FROM AUTHOR]

The article focuses on the general nature, causes and effects of mass culture. Although the American culture is characterized by common traits which are distinctive enough, it is not a homogeneous entity anymore than the people who bear it are a homogeneous mass. Almost fifty years ago, sociologist Van Wyck Brooks introduced a first intracultural typology independent of social and economic class. He grouped people according to their selective participation in the common culture as high, middle, or low brows. Although meant mainly to serve the purposes of literary criticism, Van Wyck Brooks' distinction was found generally fruitful. These groupings shed some light on the differentiations and polarizations within the American culture, but it is a spotlight which pulls matters out of shape by leaving large areas in obscurity. In short, the mass which includes middle and low brows fatally attracts the high brows and causes those that do not join to function not as an elite but as a marginal group.

The article discusses the price-control programs of the U.S. Department of Agriculture. These programs were creatures of depression. They were set up to relieve the agricultural distress which existed in 1933 after farmers had been subjected to the drastic effects of more than three years of sharply falling prices. The commonly accepted explanation of low farm prices in the depression period was overproduction of farm products. Production control programs have been used to curtail the production of certain crops and to encourage the production of others. Limitations have been placed on the acreages which might be planted to such crops as corn, cotton, wheat, rice and tobacco and overall limitations established for acreages to be used for "soil-depleting" crops. The most important criticism of the farm relief programs is the method of attack on the problem of farm price disparity. Low purchasing power and distressed conditions were not limited to agriculture; they were prevalent throughout the entire economy.

Discusses short term disability, long term disability, Social Security Disability Insurance and the Family Medical Leave Act of 1993 and how these disability policies relate to case management practice in the U.S. Coverage of the Medicare insurance program; Provisions of the FMLA; Developments in California employment law.