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We define racial transcendence as an elevated status in which evaluations of an individual are no longer shaped by the race of the attitudinal target or the race of the person making the evaluations. Observers argue that Oprah Winfrey transcends race, meaning that she is just as likely to receive support from non-Blacks as she is from fellow Blacks. But this argument may not follow when Oprah moves into the political arena. We use two surveys to demonstrate this: The first survey supports Winfrey's transcendence, while we see in-group support in the second. We find that Oprah enjoys her greatest support among racial fellows, and her favorability flows along the lines of race and gender: Her greatest supporters are Black women. Oprah's ability to offer political cues also flows along lines of race and gender: Those most likely to be influenced by her Obama endorsement are Black women. [ABSTRACT FROM AUTHOR]

There is much debate about the reach and seriousness of racial prejudice today. We ask: How do ordinary people come to view events as racist? Using an experiment, we investigate the effects of elite charges of racism on public perceptions of police conduct. We test several hypotheses, including discounting, expertise, and ingroup bias, pertaining to how public stereotypes moderate elite influence. We find that stereotypes matter, and that Democrats, Republicans, blacks, and whites cannot make claims about racism with equal success. [ABSTRACT FROM AUTHOR]

The importance of the political church in Black political participation has brought to the attention of scholars the differences among Black churches and their effect on Black mobilization. The Black church has on many occasions transformed itself into a politicized organization. These political churches become settings that encourage political knowledge and skills ( ) and communicate political activity as a norm ( ). The earlier work on political churches has established the importance of these organizations for voter turnout and other forms of political participation. What has been left unexamined is the nature of the political churches themselves. This project disentangles these churches by looking at the heterogeneity within the structures of the political churches. In general, we seek to understand which of the internal activities of the political church tend to foster acts of political participation. We hypothesize that cost- underwriting activities and obligation-creating activities within the church setting have the greatest impact on participation. By examining a robust and expansive operationalization of the political church construct, we find that these types of political church activities matter more than other activities. In specifying how churches may work to directly affect the participation of their members, we seek to expand the scope of general comprehension of political churches. [ABSTRACT FROM AUTHOR]

The relationship between black constituency size and congressional support for black interests has two important attributes: magnitude and stability. Although previous research has examined the first characteristic, scant attention has been directed at the second. This article examines the relationship between district racial composition and congressional voting patterns with a particular emphasis on the stability of support across different types of votes and different types of districts. We hypothesize that, among white Democrats, the influence of black constituency size will be less stable in the South, owing in part to this region's more racially divided constituencies. Examining LCCR scores from the 101st through 103rd Congress, we find that this expectation is largely confirmed. We also find that, among Republicans, the impact of black constituency size is most stable—albeit negligible in size—in the South. We conclude by discussing the implications of these findings for the relative merits of “influence districts” and “majority minority” districts. [ABSTRACT FROM AUTHOR]

Objective: Pediatric injuries in performance sports represent a significant healthcare burden and account for over 50,000 annual Emergency Department (ED) visits in the United States. The objective of this study was to characterize and compare pediatric injury presentation across the most common performance sports., Methods: The National Electronic Injury Surveillance System (NEISS) database was retrospectively analyzed for pediatric injuries (3-18 years) related to gymnastics, dance, or cheerleading from 2015-2019. Cases were categorized as children (˂11 years) or adolescent (≥11 years). Injuries were categorized as orthopedic (fractures, dislocations, sprain, strains), non-orthopedic (contusion, internal injury, laceration), concussion, or other/unknown. Case narratives were used to categorize mechanism of injury as contact or non-contact. Appropriate sample NEISS weights estimation was applied for statistical analysis and Confidence Intervals (CI)., Results: A total of 393,110 injuries were observed over the five-year study period, with a mean of 78,622 annual injuries. Gymnastics, dance, and cheerleading accounted for 136,422 injuries, 96,416 injuries, and 160,272 injuries, respectively. Most cases were adolescent (71%; 95% CI: 68-74%) and occurred in a sports-related setting (65%, 95% CI: 57-72%). Gymnastics had the highest proportion of injuries among children (50%) as compared to dancers (25%) or cheerleaders (12%) (p < 0.01). Non-contact injuries most affected the lower extremity (43-68%) and resulted in an orthopedic diagnosis (63-71%), and contact injuries had a higher proportion of injuries affecting the head, neck, and face (29-51%) and non-orthopedic diagnoses (29-38%). Gymnastics had the most upper extremity non-contact injuries (42%) and dance the most lower extremity non-contact injuries (68%) (p < 0.01). Cheerleading had the highest incidence of overall concussions (8%), contact injuries (47%), and concussions due to contact injury (15%)., Conclusion: Pediatric gymnasts, cheerleaders, and dancers have important similarities and differences in injury pattern which may lead to the development of sport-specific injury prevention programs for pediatric performance athletes.

The COVID-19 pandemic presented enormous data challenges in the United States. Policy makers, epidemiological modelers, and health researchers all require up-to-date data on the pandemic and relevant public behavior, ideally at fine spatial and temporal resolution. The COVIDcast API is our attempt to fill this need: Operational since April 2020, it provides open access to both traditional public health surveillance signals (cases, deaths, and hospitalizations) and many auxiliary indicators of COVID-19 activity, such as signals extracted from deidentified medical claims data, massive online surveys, cell phone mobility data, and internet search trends. These are available at a fine geographic resolution (mostly at the county level) and are updated daily. The COVIDcast API also tracks all revisions to historical data, allowing modelers to account for the frequent revisions and backfill that are common for many public health data sources. All of the data are available in a common format through the API and accompanying R and Python software packages. This paper describes the data sources and signals, and provides examples demonstrating that the auxiliary signals in the COVIDcast API present information relevant to tracking COVID activity, augmenting traditional public health reporting and empowering research and decision-making., Competing Interests: The authors declare no competing interest., (Copyright © 2021 the Author(s). Published by PNAS.)

Objectives: The ideal clinical model to deliver palliative care to patients with advanced kidney disease is currently unknown. Internationally, ambulatory kidney palliative care clinics have emerged with positive outcomes, yet there is limited data from the United States (US). In this exploratory study we report perceptions of a US-based ambulatory kidney palliative care clinic from the perspective of patient and caregiver attendees. The objective of this study was to inform further improvement of our clinical program., Methods: Semi-structured interviews were conducted to elicit the patient and caregiver experience. Eleven interviews (8 patients with chronic kidney disease stage IV or V and 3 caregivers) were analyzed using qualitative description design., Results: We identified 2 themes: "Communication addressing the emotional and physical aspects of disease" and "Filling gaps in care"; Subthemes include perceived value in symptom management, assistance with coping with disease, engagement in advance care planning, program satisfaction and patient activation., Significance of Results: Qualitative analysis showed that attendees of an ambulatory kidney palliative care clinic found the clinic enhanced the management of their kidney disease and provided services that filled current gaps in their care. Shared experiences highlight the significant challenges of life with kidney disease and the possible benefits of palliative care for this population. Further study to determine the optimal model of care for kidney palliative care is needed. Inclusion of the patient and caregiver perspective will be essential in this development.

Background: Increasingly, occupational and physical therapists are using safe patient handling and mobility (SPHM) equipment, such as mechanical lifts, in rehabilitation. However, there is little guidance in the literature on how SPHM equipment can be used to assist patients to reach rehabilitation goals. The purpose of this projectwas to document and categorize common and innovative ways rehabilitation therapists use SPHM equipment in their clinical practice., Objective: This article investigates common and innovative uses of SPHM equipment in rehabilitation practice., Methods: Occupational, physical and kinesio therapist employed at the Veterans Health Administration wrote narratives and took photos describing rehabilitation therapy activities where they used SPHM equipment in their clinical practice. The authors used a systematic process to review and categorize the narratives and subsequent photos by using the World Health Organization's International Classification of Functioning, Disability and Health (ICF)., Results: Thirty narratives (13 innovative and 17 common) were coded into four categories on the ICF section of mobility. The most common category was "changing and maintaining basic body position"(21) followed by "walking and moving" (5). The category "carrying, moving and handling objects" garnered two narratives and there were no narratives for "using transportation.", Conclusions: Project findings may serve as a guide for therapists who would like to enhance their use of SPHM equipment in rehabilitation. Additional research is needed to expand the use of SPHM in rehabilitation practice and evaluate the impact on patient rehabilitation outcomes and therapist safety outcomes.

This article describes the relatively new technology of freezing human eggs and examines whether egg freezing, specifically when it is used by healthy women as 'insurance' against age-related infertility, is a legitimate exercise of reproductive autonomy. Although egg freezing has the potential to expand women's reproductive options and thus may represent a breakthrough for reproductive autonomy, I argue that without adequate information about likely outcomes and risks, women may be choosing to freeze their eggs in a commercially exploitative context, thus undermining rather than expanding reproductive autonomy.

Background and Purpose: Physical therapy is faced with the challenge of producing evidence that physical therapy interventions are effective. The fundamental question confronting physical therapy is whether or not physical therapy interventions make a contribution to function, health, and well-being. The individual's ability to perform actions can serve as a theoretical construct related to movement and health around which physical therapy interventions can be assessed. To this end, the aims of this study were: (1) to develop a self-report instrument to assess ability to perform mobility actions in an adult outpatient population and (2) to assess the psychometric properties of such an instrument in the appropriate population., Subjects and Methods: An instrument was developed to assess difficulty and confidence related to 24 actions. Descriptive statistics and measures of reliability, validity, and responsiveness were computed. A total of 391 patients participated in the study., Results: The coefficient for reliability was in the required range, and measures of validity and responsiveness were established as well. Three factors were identified., Discussion and Conclusion: The instrument provides the beginning of documentation of outcomes in movement to identify the unique contributions of physical therapist practice.

Making a decision about breast cancer treatment is complex for women. Patients and caregivers are given a lot of information, then asked to make choices that affect their lives in many ways. Many are facing their mortality for the first time as well. Nurses are key players in providing information and support, and guiding patients in making treatment choices. However, the ultimate decision is up to the patient.

We have developed an educational program to train industry-based physicians in a new low back pain assessment procedure based on the recommendation of The Clinical Practice Guidelines on Acute Low Back Pain Problems in Adults published by the Agency for Health Care Policy and Research, U.S. Department of Health and Human Services. The clinical classification system based on the findings from the Quebec Task Force was used to categorize the subjects. The educational program included group and individual sessions with an extensive period of active follow-up. Protocol compliance was measured through a computer-based surveillance system that monitored evaluation form completion. The results showed significant change (p < 0.001) in physician compliance in completing a standardized examination following an administrative mandate to change. Little change in clinical practice was recorded with an educational training program only. Further research into the factors responsible for the results is suggested.

The rescue, treatment, and evacuation of thousands of patients from a natural disaster or armed conflict that is coordinated by the National Disaster Medical System must be performed in accordance to health care standards recognized in this country. Without an effective communication system, morbidity and mortality will needlessly rise. A medical communication protocol that addresses this problem is proposed.