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School climate has been identified as a critical systemic variable associated with many desirable academic and social-emotional outcomes. However, little research has been conducted regarding the students with disabilities' perceptions of school climate. This review aimed to investigate and synthesize the existing research on this topic to identify trends in the literature, guide future research, and inform intervention and reform. Following a systematic search of four major databases, 12 studies were determined to meet the inclusion criteria. Generally, students with disabilities reported more negative perceptions of school climate in comparison to peers without disabilities. However, when an intersectional lens was applied to discern this population's perspectives, a more nuanced understanding of school climate was able to be identified. This approach suggests evaluating school climate data in a disaggregated form may better inform decision-making in schools. Future research regarding students with disabilities' perceptions of school climate and related outcomes is needed. This should include both a wider and more specified sample of students, what school climate subdomains are impacted and how, how these variables relate to school-related outcomes, and how school climate interventions specifically impact students with disabilities.

Anyone who went to school in the United States from the late ’80s to early 2000s is likely familiar with the DARE program. For decades American schoolchildren across the nation sat through police-led lectures on how to “just say no” to drugs and alcohol. DARE capitalized on waves of federal funding to ensure DARE-trained police officers were in nearly every U.S. classroom. The problem was, though, DARE, and programs like it, didn’t work. DARE was as ineffective as it was widespread. Those who underwent hours of DARE lectures likely remember the program as a massive failure. And to this day, the failures of the DARE program persist: misinformation on drugs and drug users abounds, children are lied to or kept in the dark on valuable, life-saving information, and police officers run rampant through schools arresting kids. These failures persist because American schools have refused to leave behind the original, unsuccessful DARE program. After DARE was exposed as an educational failure, the program underwent a rebranding as “DARE: keepin’ it REAL,” which is now spreading across the country. But all that has changed is the name. This new DARE still relies on police-officer instruction, stereotyping students, and at-best-untested curricula. This Note highlights the many similarities between the DARE of thirty years ago and the DARE of today and suggests that DARE’s refusal to change from its roots has and will keep the program ineffective. Further, this Note discusses more promising pedagogical approaches to school-based drug education and how those programs can be advocated for, incentivized, and implemented. [ABSTRACT FROM AUTHOR]

Objective: Our goal was to assess the fertility knowledge and educational experiences of graduating U.S. medical students to evaluate areas of improvement for future educational interventions. Design: Web-based cross-sectional survey. Subjects: Medical students graduating in 2023 from the University of Miami Miller School of Medicine (SOM), New York University (NYU) Grossman SOM, Wayne State University SOM, Perelman SOM at the University of Pennsylvania, and Mayo Clinic Alix SOM. Main Outcome Measures: Fertility-related knowledge and educational experiences of U.S. medical students in their final year of school. Results: In total, 117 students (14.4%) completed the survey. The average knowledge score was 78%. Twenty-three (22%) overestimated the age of most precipitous fertility decline, and 50 (52%) overestimated the chance of getting pregnant for a 40-year-old person with ovaries. One-third of students (30, 32%) incorrectly believe that physicians have equivalent infertility rates to the general population. Students were less cognizant of male fertility issues, incorrectly believing there was no negative impact on male fertility by age (43, 42%) among other factors. Seventy-five (81%) reported less than 5 hours of fertility-related education in medical school. Only one-third (32%) were satisfied or very satisfied with the fertility education they received. In an open-response question, students expressed interest in additional education on transgender and cancer patient care, fertility preservation, assisted reproductive technologies, and reproductive life planning in medicine. Conclusions: There is a need and an opportunity for medical education programs to enhance fertility education. Giving students and trainees the knowledge required to make informed decisions for their family-building purposes and improving their ability to counsel patients adequately should be a goal of future educational endeavors. The data collected in this study will serve as a guide for the development of fertility-related learning modules for medical students and trainees. [ABSTRACT FROM AUTHOR]

Monitoring the therapeutic alliance throughout treatment can improve client outcomes and lead to improved care. The individual, couple, and family versions of the intersession alliance measure (IAM) were developed to facilitate routine monitoring of the expanded therapeutic alliance. Psychometric properties of the three versions of the IAM were examined using a clinical sample. Participants were drawn from clinics in the United States participating in the Marriage and Family Therapy Practice Research Network. Using this sample, results indicate that items on each version of the IAM load on one factor, are invariant across sex, and that each version has good internal consistency, test–retest reliability, and concurrent validity. The IAM‐C and IAM‐F also have good predictive validity, while the IAM‐I has more limited evidence for its predictive validity. These results suggest that the IAMs are valid and reliable measures that can facilitate the routine monitoring of the expanded therapeutic alliance in psychotherapy. [ABSTRACT FROM AUTHOR]

This study examines how white Americans' beliefs about affirmative action intersect with three important workplace factors: supervisory status (supervisors vs. subordinates), employment sector (public vs. private), and workplace racial composition. Using data from the 1996–2018 General Social Surveys, we first examine trends over time in three beliefs: (1) the perception that whites are hurt by affirmative action, (2) attitudes toward the preferential hiring and promotion of blacks, and (3) opinions regarding special treatment by the government for blacks. We then examine how the three workplace factors shape support for (or opposition to) such race-targeted policies. Our analyses reveal declining opposition to affirmative action over time, though a majority of whites, regardless of authority level, still hold conservative stances on race-targeted policies. Further, results for our three key predictors (supervisory status, employment sector, workplace racial composition) provide support for group position, new governance, and intergroup contact theories, respectively. We conclude by discussing implications of our findings for intergroup relations with special focus on understanding barriers to the implementation of antidiscrimination and diversity policies aimed at ameliorating racial inequities in U.S. workplaces. [ABSTRACT FROM AUTHOR]

Evidence-based parenting interventions (EBPI) support children and families to promote resilience, address emotional and behavioral concerns, and prevent or address issues related to child maltreatment. Critiques of EBPIs include concerns about their relevance and effectiveness for diverse populations when they are implemented at population scale. Research methods that center racial equity and include community-based participatory approaches have the potential to address some of these concerns. The purpose of the present review was to document the extent to which methods associated with promoting racial equity in research have been used in studies that contribute to the evidence base for programs that meet evidentiary standards for a clearinghouse that was developed to support the Family First Prevention Services Act in the United States. We developed a coding system largely based on the Culturally Responsive Evaluation model. A sample of 47 papers that are part of the evidence base for ten in-home parent skill-based programs were reviewed and coded. Only three of 28 possible codes were observed to occur in over half of the studies (including race/ethnicity demographic characteristics, conducting measure reliability for the study sample, and including information on socioeconomic status). Although the overall presence of equity-informed methods was low, a positive trend was observed over time. This review highlights ways in which rigorous research can incorporate racial equity into the planning, design, execution, and interpretation and dissemination of programs of study. We posit that doing so improves the external validity of studies while maintaining high-quality research that can contribute to an evidence base. [ABSTRACT FROM AUTHOR]

The article discusses the growing influence of the financial sector, particularly private equity, in the home health and hospice industries in the U.S. Topics discussed include the shift from nonprofit to for-profit ownership, the potential conflict between profit motives and patient care quality, and the implications for care outcomes and Medicare costs.

In response to the diverse number of child sexual abuse (CSA) prevention programs currently implemented in school contexts, this paper examines key considerations for selecting such initiatives and the multiplicity of understandings required to inform facilitation of contextually relevant prevention curriculum. First, the paper examines concerns about the lack of explicit professional development for educators concerning child protection, and the need to develop understandings about prevention program best practices within pre-service and in-service training. Second, drawing on a systematic review of literature, the paper identifies five key considerations to inform teachers' selection and facilitation of CSA prevention curriculum in school contexts. Third, the paper advances calls by Wurtele (2009) and presents CSA prevention "best practices" overview and "model programs" list for professionals such as teachers. (Contains 1 table.)

Education Diplomacy engages the business sector with educators, policymakers, and government agencies by building consensus on policy, practice, and lifelong outcomes and taps into business people's natural skills and influence. The Education Diplomat is an important role for all stakeholders to make a lasting difference in the lives of children, and thereby society at large.

This journal has a brief but important history, encompassing the support of major Catholic colleges and universities across the United States. In particular, the University of Dayton and the University of Notre Dame have provided a home for the editorial offices and the contributed services of the editors. As the journal prepares for a transition to its third home at Boston College, this article offers a summative and evaluative overview of the contents of the journal since its inception. Recommendations are offered regarding ways to continue to grow the field of educational research situated in Catholic schools. (Contains 5 tables and 1 note.)

This article presents responses from Thomas C. Hunt, James L. Heft, S.M., and Ronald J. Nuzzi to the report of the Notre Dame Task Force on Catholic Education's (2006), "Making God Known, Loved and Served: The Future of Catholic Primary and Secondary Schools in the United States." Hunt analyzes the 12 recommendations offered by Notre Dame on behalf of Catholic schools as its tangible manifestation of embodying leadership to meet the following goals: (1) To strengthen Catholic identity; (2) To attract and form talented leaders; (3) To ensure academic excellence; and (4) To finance Catholic schools so that they are accessible for all families. He then considers the five general recommendations the report made to the broader Church community regarding Catholic schools. In a brief essay, Heft offers a reflection on the report and provides a summary of the Carnegie meeting whose purpose was to explore how a "field" of Catholic educational research might be created. In his response, Nuzzi suggests that although the Notre Dame Task Force report (2006) does not represent official Church teaching of any sort, it may be helpful to review its reception in the community of the Church, and especially among Catholic educational professionals. Following the convictions of an incarnational theology, analyzing the reception of the report should provide some insight into the current challenges facing schools and even suggest some approaches to address them.

The COVID-19 pandemic led to widespread disruption and termination of clinical research and a prompt adoption of mobile health (mHealth) technologies in the healthcare space. As the United States' healthcare system has rapidly become reliant on remotely conducted activities, the implementation of decentralized methods using mHealth technology in research investigation has become a necessary alternative to traditional in-person cohort studies. The aim of this article is to: report successful and unsuccessful examples of remote asthma clinical studies, explore the benefits and potential drawbacks of virtual clinical investigation, discuss the potential impact on equity and representation in asthma research, and provide suggestions through which investigators can implement decentralized clinical trials. Enhanced study accessibility, participant diversity, safety measures, and research efficacy are some of the benefits identified with a focused discussion on the impact on equity that decentralized clinical trials renders. Furthermore, potential concerns regarding regulatory compliance, data privacy, and effective mHealth design and solutions are discussed. Despite the setbacks and interruptions faced by the study participants and investigators due to the pandemic, the transition to decentralized clinical studies using mHealth technology is a positive, feasible step toward innovation and equity in the allergy and immunology field. [ABSTRACT FROM AUTHOR]

Metastatic pancreatic adenocarcinoma (PDAC) is the third leading cause of cancer-related death in the United States, with a 5-year survival rate of only 11%, necessitating identification of novel treatment paradigms. Tumor tissue specimens from patients with PDAC, breast cancer, and other solid tumor malignancies were collected and tumor cells were enriched using laser microdissection (LMD). Reverse phase protein array (RPPA) analysis was performed on enriched tumor cell lysates to quantify a 32-protein/phosphoprotein biomarker panel comprising known anticancer drug targets and/or cancer-related total and phosphorylated proteins, including HER2Total, HER2Y1248, and HER3Y1289. RPPA analysis revealed significant levels of HER2Total in PDAC patients at abundances comparable to HER2-positive (IHC 3+) and HER2-low (IHC 1+ /2+ , FISH−) breast cancer tissues, for which HER2 screening is routinely performed. These data support a critical unmet need for routine clinical evaluation of HER2 expression in PDAC patients and examination of the utility of HER2-directed antibody–drug conjugates in these patients. [ABSTRACT FROM AUTHOR]

In healthcare administration as well as a variety of health professions, interprofessional education (IPE) has become more widespread. Faculty in health professions programs work together to prepare students for collaborative practice in the workforce and the pursuit of the best outcomes for patients. With this, much of the focus of IPE is on clinical practices. The purpose of this article is to share the experience of three faculty members as they developed an under-graduate interprofessional health policy course. Students from three health programs experienced a braided model of policy content and student feedback is discussed, as well as faculty lessons learned. [ABSTRACT FROM AUTHOR]

African Americans and other Black Students on predominantly white college campuses often face challenges in becoming fully integrated into these white-normed spaces. In the current cultural climate, policing and the Black community has received growing national attention. This has served to raise questions about how these types of relationships exist in college communities. The purpose of this exploratory study was to investigate the nature of the interactions between African American and other Black students with campus police in the northeastern United States. Using an exploratory qualitative design, one core concept of estrangement emerged along with three main categories on how estrangement operated in this higher educational context. The three main categories include cultural influences, racial oppression, and trauma. The results from the study suggest that African American and other Black students employ varying types of estrangement to avoid direct contact with campus police who are viewed as campus agents that function to perpetuate white supremacist norms on campus. The article concludes with a discussion and practical implications of these findings. [ABSTRACT FROM AUTHOR]

Concussion research has primarily focused on sport-related mechanisms and excluded non–sport-related mechanisms. In adult populations, non–sport-related concussions (non-SRCs) demonstrated worse clinical outcomes compared with sport-related concussions (SRCs); however, investigations of non-SRCs in college-aged patients are limited. To examine clinical outcomes in collegiate athletes with non-SRCs compared with SRCs and explore sex differences in outcomes among collegiate athletes with non-SRCs. Prospective cohort study. Clinical setting. A total of 3500 athletes were included (n = 555 with non-SRCs, 42.5% female) from colleges or universities and service academies participating in the National Collegiate Athletic Association Department of Defense Concussion Assessment, Research and Education (CARE) Consortium. Dichotomous outcomes (yes or no) consisted of immediate reporting, mental status alterations, loss of consciousness, posttraumatic amnesia, retrograde amnesia, motor impairments, delayed symptom presentation, and required hospital transport. Continuous outcomes were symptom severity, days with concussion symptoms, and days lost to injury. Data were collected within 24 to 48 hours of injury and at return to play. Adjusted relative risks (ARRs) compared the likelihood of dichotomous outcomes by mechanism and by sex within patients with non-SRCs. Multivariate negative binomial regressions were used to assess group differences in continuous variables. Athletes with non-SRCs were less likely to report immediately (ARR = 0.73, 95% CI = 0.65, 0.81) and more likely to report delayed symptom presentation (ARR = 1.17, 95% CI = 1.03, 1.32), loss of consciousness (ARR = 3.15, 95% CI = 2.32, 4.28), retrograde amnesia (ARR = 1.77, 95% CI = 1.22, 2.57), and motor impairment (ARR = 1.45, 95% CI = 1.14, 1.84). Athletes with non-SRCs described greater symptom severity, more symptomatic days, and more days lost to injury (P <.001) compared with those who had SRCs. Within the non-SRC group, female athletes indicated greater symptom severity, more symptomatic days, and more days lost to injury (P <.03) than male athletes. Athletes with non-SRCs had worse postinjury outcomes compared with those who had SRCs, and female athletes with non-SRCs had worse recovery metrics than male athletes. Our findings suggest that further investigation of individuals with non-SRCs is needed to improve concussion reporting and management. [ABSTRACT FROM AUTHOR]

Background: Racial and ethnic disparities persist in preterm birth (PTB) and gestational age (GA) at delivery in the United States. It remains unclear whether exposure to environmental chemicals contributes to these disparities. Objectives: We applied recent methodologies incorporating environmental mixtures as mediators in causal mediation analysis to examine whether racial and ethnic disparities in GA at delivery and PTB may be partially explained by exposures to polybrominated diphenyl ethers (PBDEs), a class of chemicals used as flame retardants in the United States. Methods: Data from a multiracial/ethnic US cohort of 2008 individuals with lowrisk singleton pregnancies were utilized, with plasma PBDE concentrations measured during early pregnancy. We performed mediation analyses incorporating three forms of mediators: (1) reducing all PBDEs to a weighted index, (2) selecting a PBDE congener, or (3) including all congeners simultaneously as multiple mediators, to evaluate whether PBDEs may contribute to the racial and ethnic disparities in PTB and GA at delivery, adjusted for potential confounders. Results: Among the 2008 participants, 552 self-identified as non-Hispanic White, 504 self-identified as non-Hispanic Black, 568 self-identified as Hispanic, and 384 self-identified as Asian/Pacific Islander. The non-Hispanic Black individuals had the highest mean ΣPBDEs, the shortest mean GA at delivery, and the highest rate of PTB. Overall, the difference in GA at delivery comparing non-Hispanic Black to non-Hispanic White women was -0.30 (95% CI: -0.54, -0.05) weeks. This disparity reduced to -0.23 (95% CI: -0.49, 0.02) and -0.18 (95% CI: -0.46, 0.10) weeks if fixing everyone's weighted index of PBDEs to the median and the 25th percentile levels, respectively. The proportion of disparity mediated by the weighted index of PBDEs was 11.8%. No statistically significant mediation was found for PTB, other forms of mediator(s), or other racial and ethnic groups. Conclusion: PBDE mixtures may partially mediate the Black vs. White disparity in GA at delivery. While further validations are needed, lowering the PBDEs at the population level might help reduce this disparity. [ABSTRACT FROM AUTHOR]

Depressive and anxiety disorders are two common presenting concerns among adults in the United States who seek mental health counseling services. Mental health counselors need screening tools with validated scores for detecting their clients' symptoms of depression and anxiety. The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) are popular screening tools for measuring symptoms of depression and anxiety, respectively. However, the literature is lacking temporally valid research on these popular screening tools, which is concerning, as the psychometric properties of instrumentation can vary substantially over time. We tested the psychometric properties of the PHQ-9 and GAD-7 with a national stratified random sample (N = 1,812) of adults in the United States. The results were promising and begin to address the temporal validity gap in the extant literature regarding the psychometric properties of GAD-7 and PHQ-9. Collectively, findings supported the utility of the GAD-7 and PHQ-9 for enhancing the practice of mental health counselors. [ABSTRACT FROM AUTHOR]

Crustaceans, which are highly susceptible to the effects of climate change, are critical for food security worldwide. Yet, management rarely evaluates the performance of alternative regulatory strategies under climate‐driven life history change. This limits the development of climate‐ready management plans, undermining fisheries sustainability. We compared the performance of alternative minimum legal size (MLS) regulations under shifts in growth and maturity for American lobster in the Gulf of Maine, the most valuable single‐species commercial fishery in the United States. Across the life history change scenarios examined, increasing MLS improved status indicators, while decreasing MLS eroded status indicators for spawning stock biomass, legal abundance, landings, and exploitation rate. Our results demonstrate that protecting the lobster stock by increasing MLS improves fishery output, highlighting that conservation and industry goals can be complementary. This study exemplifies the utility of MLS as a conservation measure for crustacean fisheries under climate change. [ABSTRACT FROM AUTHOR]

As global mean temperature rises, extreme drought events are expected to increasingly affect regions of the United States that are crucial for agriculture, forestry, and natural ecology. A pressing need is to understand and anticipate the conditions under which extreme drought causes catastrophic failure to vegetation in these areas. To better predict drought impacts on ecosystems, we first must understand how specific drivers, namely, atmospheric aridity and soil water stress, affect land surface processes during the evolution of flash drought events. In this study, we evaluated when vapor pressure deficit (VPD) and soil moisture thresholds corresponding to photosynthetic shutdown were crossed during flash drought events across different climate zones and land surface characteristics in the United States. First, the Dynamic Canopy Biophysical Properties (DCBP) model was used to estimate the thresholds that define reduced photosynthesis by assimilating vegetation phenology data from theModerate Resolution Imaging Spectroradiometer (MODIS) to a predictive phenology model. Next, we characterized and quantified flash drought onset, intensity, and duration using the standardized evaporative stress ratio (SESR) and NLDAS-2 reanalysis. Once periods of flash drought were identified, we investigated how VPD and soil moisture coevolved across regions and plant functional types. Results demonstrate that croplands and grasslands tend to be more sensitive to soil water limitations than trees across different regions of the United States. We found that whether VPD or soil moisture was the primary driver of plant water stress during drought was largely region specific. The results of this work will help to inform land managers of early warning signals relevant for specific ecosystems under threat of flash drought events. [ABSTRACT FROM AUTHOR]

Everyone under the age of 20 who has grown up in North America has lived in the common market created by NAFTA--the North American Free Trade Agreement. In a zone linking the United States, Canada, and Mexico, most goods and investments flow freely across borders to users, consumers, and investors. In 1994, NAFTA created the largest relatively free trade zone in the world by phasing out tariffs and other trade restrictions on goods and investments. Today, the NAFTA area is home to approximately 450 million people, with a Gross Domestic Product (GDP) of almost $20 trillion. NAFTA countries create 23 percent of the world's total wealth. Twenty years after its enactment, how is the free trade zone working out? Did NAFTA make Canada and Mexico better off at the expense of the United States? Or did it help boost production, employment, investment, and consumption across all three countries?

Context: Although elite adolescent female soccer athletes have unique injury risk factors and management challenges, limited epidemiological data exist for this population. Objective: To describe lower-body injury patterns and to determine whether a screening hip physical examination is predictive of future injuries in elite adolescent female soccer athletes. Design: Prospective cohort study. Setting: One US premier soccer club. Participants: One hundred seventy-seven female soccer athletes aged 10–18 years (mean [SD] 14.6 [1.8] y) completed a demographic questionnaire and screening hip physical examination that included range of motion and provocative tests. Interventions: At least 5 years after baseline screening, athletes completed an electronic follow-up injury survey. Injury was defined as pain that interfered with sporting activity. Main Outcome Measures: In addition to descriptive analyses of athletes' injury profiles, associations between players' baseline demographics and subsequent injury profiles were evaluated using chi-square tests, and potential predictors of injury based on players' baseline hip examinations were evaluated using multivariable logistic regression. Results: Ninety-four of 177 athletes (53%) were contacted for follow-up, and 88/94 (93.6%) completed the survey. With mean follow-up of 91.9 (9.3) months (range 66–108 mo), 42/88 (47.7%) reported sustaining a new lower-body injury. The low back was the most common injury region (16/42, 38.1%). Almost half of all injured athletes (20/42, 47.6%) sustained overuse injuries, and 16/42 (38.1%) had an incomplete recovery. Higher body mass index and reaching menarche were associated with sustaining an injury (P =.03 and.04, respectively). Athletes' baseline hip examinations were not predictive of their subsequent rate of lower-body, lumbopelvic, overuse, or incomplete recovery injury (all P >.05). Conclusions: Lower-body injuries were common in elite adolescent female soccer athletes, with over one third of injured athletes reporting permanent negative impact of the injury on their playing ability. Baseline hip physical examinations were not associated with future injury rate. [ABSTRACT FROM AUTHOR]

Background: There is an ongoing need for research to support the practice of high quality family medicine. The Family Medicine Discovers Rapid Cycle Scientific Discovery and Innovation (FMD RapSDI) program is designed to build capacity for family medicine scientific discovery and innovation in the United States. Our objective was to describe the applicants and research questions submitted to the RapSDI program in 2019 and 2020. Methods: Descriptive analysis for applicant characteristics and rapid qualitative analysis using principles of grounded theory and content analysis to examine the research questions and associated themes. We examined differences by year of application submission and the applicant's career stage. Results: Sixty-five family physicians submitted 70 applications to the RapSDI program; 45 in 2019 and 25 in 2020. 41% of applicants were in practice for five years or less (n = 27), 18% (n = 12) were in in practice 6–10 years, and 40% (n = 26) were ≥ 11 years in practice. With significant diversity in questions, the most common themes were studies of new innovations (n = 20, 28%), interventions to reduce cost (n = 20, 28%), improving screening or diagnosis (n = 19, 27%), ways to address mental or behavioral health (n = 18, 26%), and improving care for vulnerable populations (n = 18, 26%). Conclusion: Applicants proposed a range of research questions and described why family medicine is optimally suited to address the questions. Applicants had a desire to develop knowledge to help other family physicians, their patients, and their communities. Findings from this study can help inform other family medicine research capacity building initiatives. [ABSTRACT FROM AUTHOR]

Background: Additional therapies for hepatic encephalopathy (HE) treatment are warranted. There are data evaluating the use of zinc for HE; however, clinical outcomes, specifically in the United States, are unknown. Objective: To compare 30-day and 1-year all-cause readmission rates in patients with cirrhosis complicated by HE on lactulose and rifaximin to those on lactulose, rifaximin, and zinc. Methods: This retrospective study included patients admitted with documented cirrhosis and home medications of lactulose and rifaximin, with or without zinc. Patients were stratified into 2 groups: those receiving lactulose and rifaximin for HE (control) and those receiving lactulose, rifaximin, and zinc for HE (treatment). The primary outcomes were 30-day and 1-year all-cause readmission rates. Results: One-hundred fifty-seven patients were included (102 in control group, 55 in treatment group). Regarding 30-day and 1-year all-cause readmission rates, there was no difference between the control and treatment groups. Conclusion and Relevance: This is the first study conducted in the United States evaluating zinc for HE treatment. Zinc did not impact 30-day or 1-year all-cause readmission rates. Further studies are warranted to evaluate the potential benefit of zinc for HE, possibly in correlation with Model for End-stage Liver Disease-Sodium (MELD-Na) scores. [ABSTRACT FROM AUTHOR]

Introduction: A successful living donor liver transplant (LDLT) is the culmination of a multifaceted process coordinated among key stakeholders. Methods: We conducted an electronic survey of US liver transplant (LT) centers (August 26, 2021–October 10, 2021) regarding attitudes, barriers, and facilitators of LDLT to learn how to expand LDLT safely and effectively in preparation for the American Society of Transplantation Living Donor Liver Transplant Consensus Conference. Results: Responses were received from staff at 58 programs (40.1% of US LT centers). There is interest in broadening LDLT (100% of LDLT centers, 66.7% of non‐LDLT centers) with high level of agreement that LDLT mitigates donor shortage (93.3% of respondents) and that it should be offered to all suitable candidates (87.5% of respondents), though LDLT was less often endorsed as the best first option (29.5% of respondents). Key barriers at non‐LDLT centers were institutional factors and surgical expertise, whereas those at LDLT centers focused on waitlist candidate and donor factors. Heterogeneity in candidate selection for LDLT, candidate reluctance to pursue LDLT, high donor exclusion rate, and disparities in access were important barriers. Conclusion: Findings from this study may help guide current and future expansion of LDLT more efficiently in the US. These efforts require clear and cohesive messaging regarding LDLT benefits, engagement of the public community, and dedicated resources to equitably increase LDLT access. [ABSTRACT FROM AUTHOR]

Introduction: Living donor liver transplantation (LDLT) reduces liver transplant waitlist mortality and provides excellent long‐term outcomes for persons with end stage liver disease. Yet, utilization of LDLT has been limited in the United States (US). Methods: In October 2021, the American Society of Transplantation held a consensus conference to identify important barriers to broader expansion of LDLT in the US, including data gaps, and make recommendations for impactful and feasible mitigation strategies to overcome these barriers. Domains addressed encompassed the entirety of the LDLT process. Representation from international centers and living donor kidney transplantation were included for their perspective/experience in addition to members across disciplines within the US liver transplantation community. A modified Delphi approach was employed as the consensus methodology. Results: The predominant theme permeating discussion and polling results centered on culture; the beliefs and behaviors of a group of people perpetuated over time. Conclusions: Creating a culture of support for LDLT in the US is key for expansion and includes engagement and education of stakeholders across the spectrum of the process of LDLT. A shift from awareness of LDLT to acknowledgement of benefit of LDLT is the primary goal. Propagation of the maxim "LDLT is the best option" is pivotal. [ABSTRACT FROM AUTHOR]

In the United States, living donor liver transplantation (LDLT) is limited to transplant centers with specific experience. However, the impact of recipient characteristics on procedure selection (LDLT vs. deceased donor liver transplant [DDLT]) within these centers has not been described. Transplant registry data for centers that performed ≥1 LDLT in 2002–2019 were analyzed using hierarchal regression modeling to quantify the impact of patient and center factors on the adjusted odds ratio (aOR) of LDLT (vs DDLT). Among 73,681 adult recipients, only 4% underwent LDLT, varying from <1% to >60% of total liver transplants. After risk adjustment, the likelihood of receiving an LDLT rose by 73% in recent years (aOR 1.73 for 2014‐2019 vs. 2002‐2007) but remained lower for older adults, men, racial and ethnic minorities, and obese patients. LDLT was less commonly used in patients with hepatocellular carcinoma or alcoholic cirrhosis, and more frequently in those with hepatitis C and with lower severity of illness (Model for End‐Stage Liver Disease (MELD) score < 15). Patients with public insurance, lower educational achievement, and residence in the Northwest and Southeast had decreased access. While some differences in access to LDLT reflect clinical factors, further exploration into disparities in LDLT utilization based on center practice and socioeconomic determinants of health is needed. [ABSTRACT FROM AUTHOR]

Simple Summary: The planting of genetically modified crops that express insecticidal proteins is central to modern pest management, particularly for maize and cotton in the United States. An understanding of how the presence of transgenic proteins can affect the movement and feeding behavior of insect pests will allow us to better design resistance management strategies to prolong the use of this technology. In this study, the western bean cutworm, a regionally important pest of maize, was studied in artificial arena and on-plant experiments. Two more artificial experiments did not indicate significant changes to young caterpillar behavior when exposed to maize tissues expressing transgenic proteins; however, the more field-realistic and longer exposure period studies did indicate that young caterpillars would abandon plants that expressed transgenic proteins more often that those that did not. This finding has particular importance for the use of integrated versus structured refuges. Exposure of lepidopteran pests to Bacillus thuringiensis (Bt) proteins has been shown to affect the behavior of larvae, including increased movement and avoidance of Bt-expressing plants or diet. Therefore, we hypothesized that the behavior of western bean cutworm, Striacosta albicosta (Smith) (Lepidoptera: Noctuidae), an important pest of maize, could be affected when exposed to Bt plants. To test this hypothesis, we conducted a series of artificial arena and on-plant experiments to determine S. albicosta neonate behavior when exposed to Bt and non-Bt plant tissue. Video tracking experiments presented neonate larvae with the choice of Bt or non-Bt pollen in a Petri dish for 15 min while being video recorded for analysis with EthoVision software. This study showed an increase in mean velocity and total time spent moving for larvae in the presence of Cry1F vs. non-Bt when compared with Vip3A vs. non-Bt or Cry1F vs. Vip3A. However, there was no difference in total distance moved or time spent in the food zone for all scenarios. Maize tissue choice experiments allowed neonatal larvae the choice of feeding on Bt or non-Bt tassel or leaves for 9 h in Petri dish arenas. This experiment showed that larvae preferred tassel tissue over leaves but did not indicate that larvae could distinguish between Bt and non-Bt tissue. In contrast, on-plant experiments (including a whole plant neonate dispersal study under controlled conditions and an in-field silking behavior experiment) indicated that the presence of Cry1F and Vip3A Bt toxins increased plant abandonment, suggesting that larvae are able to detect and avoid Bt toxins. The discrepancy of these results is likely due to the on-plant studies providing more field-realistic environmental conditions and a longer duration of exposure to Bt toxins for the behavioral experiments. Our results represent the first steps in understanding the complex behavior of S. albicosta when exposed to Bt plants. A better understanding of the response of larvae when exposed to Bt traits can aid in the management of this pest, particularly for the design of resistance management strategies and refuge design. [ABSTRACT FROM AUTHOR]

Both the US and European higher education systems have long histories of transatlantic cooperation, a tradition that it is important to preserve and enhance even in the context of increased competition and important systemic reforms in both North America and Europe. The Bologna Process has led to several systemic reforms in European higher education, including new degree structures, credit systems, intra-European mobility opportunities and transparency that are important in creating a more dynamic, flexible and socio-economically orientated brand of higher education. Institutional autonomy and a broader and more flexible content for degrees are also being discussed, both driven by economic realities and the need to improve both social access and outcomes. In the United States, the issues of accountability to societal stakeholders (citizens, employers and government) and outcomes-orientated quality assurance are realigning the historic relationship of the self-governing university corporations to society and the state. Accreditation, which is a century-old process, is now actively addressing outcomes as an integral concept in quality assurance. And both state and federal governments, as well as non-governmental organisations, are more active in combating degree mills and fraud than in the recent past. Both Europe and the United States are doing what is necessary to improve their higher education "brands". More academic flexibility and institutional independence are important if Europe is to overcome the rigidities that hamper its competitiveness, just as more accountability and improved quality control are important to the continued attractiveness of US higher education in an increasingly regulated and interdependent world. These steps do not mean that European and US higher education are becoming alike, but they should lead to greater possibilities for cooperation and better mutual understanding of our respective systems. (Contains 1 table and 15 notes.)

A team of researchers revised the Motivation to Read Profile for use with adolescents. Instruments to assess adolescents' in- and out-of-school reading motivations were administered. A survey adapted for adolescents was administered to 384 teens at eight sites throughout the United States and Trinidad, and 100 students were interviewed using a revised instrument designed to capture the real reading of adolescents today. The teens were asked questions about fiction, expository, and computer-based reading materials; about what instruction in school motivated them to read; and in which classes was the reading material most difficult. Results revealed that student experiences with academic reading and writing did not match their interests and needs. The authors offer many recommendations for how students' preferred types of reading and instruction can be used in middle school and high school classrooms. (Contains 6 figures.)

This article presents a historical overview of Catholic schooling in the United States from colonial times to the present. Presented in order of eras in American history, the growth of Catholic schools and the challenges they faced are documented. The author concludes with a discussion of contemporary trends, realities challenges, and opportunities facing Catholic educators.

Since the COVID-19 pandemic, intimate partner violence (IPV) rates have increased in the United States. Although accumulating research has documented the effectiveness of couple-based interventions in reducing HIV/STIs, it remains unclear whether they are effective and safe for couples experiencing IPV. We used moderation analysis from a randomized clinical trial to evaluate whether a couples-based HIV/STI intervention may have differential effectiveness in reducing HIV/STI risks among couples where one or both partners reported experiencing IPV compared to couples without such IPV among a sample of 230 men at risk for HIV/STIs who reported using drugs and were mandated to community supervision settings in New York City and their main female sexual partners. The findings of this study suggest that the effectiveness of this evidence-based couple HIV intervention in reducing condomless sex and other HIV/STI risks did not differ between couples with IPV compared to couples without IPV. Intimate partners who use drugs and are involved in the criminal legal system are disproportionately impacted by both HIV/STIs and IPV, underscoring the importance of couple-level interventions that may be scaled up to address the dyadic HIV risks and IPV together in community supervision settings. [ABSTRACT FROM AUTHOR]

Our study demonstrates that the proportion of workers compensation claims with longer lost time from work after infection with SARS-CoV-2 decreased over the study duration. These data support that factors such as population level immunity though natural infection vaccination and mutations in the SARS-CoV-2 genome may be contributing to overall decreased morbidity or functional impairment from SARS-CoV-2. Objective: To explore the long-term persistence of COVID-19–related impairment and the ability to work after the acute phase of the illness. Method: The 19,101 COVID-19 workers' compensation claims filed between January 1, 2020, and December 31, 2021, with follow-up to May 31, 2022, were analyzed. Results: The average time lost from work decreased from 77 days in the first quarter of 2020 to 9.2 days in the fourth quarter of 2021, and the proportion of claims with 30 days or more of lost time decreased from 40.4% to 2.8 days in the same time frame. Conclusion: COVID-19 indemnity claims filed in later quarters of the SARS-CoV-2 pandemic have much lower average time lost from work and lower proportions of workers' compensation claims with more than 30, 60, and 150 days of lost time compared with earlier quarters. [ABSTRACT FROM AUTHOR]

Involvement in college campus Greek organizations is associated with an elevated risk of experiencing sexual assault victimization. Experiencing sexual assault victimizaiton is associated with myriad of consequences that could be mitigated by reporting the experience to friends, campus authorities, or police, yet researchers' understanding of reasons why women participating in Greek organizations do not report sexual assaults committed by a fraternity member is understudied. Thus, the goal of this study was to assess perceived barriers to reporting a sexual assault committed by a member of a fraternity. Women associated with Greek organizations from two large universities in the south and southwestern region of the US (n = 235) completed an online survey about sexual assault. Participants were asked to describe why they thought women assaulted by a fraternity member would not report their experience. An inductive and deductive coding process suggested women perceived barriers to reporting across intrapersonal (e.g. feeling afraid/shame), interpersonal (e.g. sorority sisters would ostracize them), organizational (e.g. reporting would jeopardize Greek life), community (e.g. reporting on campus/police is challenging) and societal levels (e.g. victim blame culture). Findings suggest larger socio-cultural factors may influence whether women would report a sexual assault committed by a fraternity member. Collaboration between Greek organizations, campus Fraternity and Sorority advisors, and sexual assault prevention advocates could help to provide a supportive environment for women when sexual assaults occur. [ABSTRACT FROM AUTHOR]

Background: Medicare home health could be leveraged to care for those near the end of life (EOL), especially for those who cannot access nor desire the Medicare hospice benefit. It is unknown what role home health currently has either preceding or as an alternative to hospice use. Objective: The aim of this study is to compare populations served and visit patterns of Medicare beneficiaries receiving home health/hospice/both near the EOL. Design: Nationally representative cohort study of National Health and Aging Trends Study (NHATS) respondents. Setting/Subjects: A total of 1,057 U.S. decedents in NHATS from 2012 to 2017 with linked Medicare claims were included in this study. Measurements: Measurements included the proportion of decedents who received home health/hospice/both/neither (yes/no) in the last six months of life (EOL) and mean number of visits by discipline (nurse/therapist [physical/occupational speech–language pathologist]/social worker/home health aide) per 30 eligible days at home for home health/hospice/both at the EOL. The primary independent variable was the clinician discipline providing services (nurse/therapist/social worker/aide). Results: In our sample, 19.9% received home health only, 25.8% hospice only, 18.8% both, and 35.6% neither at the EOL. These populations varied in their demographic, region, and clinical characteristics. Decedents who received home health only compared with hospice only were younger (44.1% over age 85 vs. 58.4%), members of a racially/ethnically diverse group (19.7% vs. 10.9%), and with less disability (37.2% required no assistance with activities of daily living vs. 22.7%), all p values <0.05. In adjusted models, those receiving home health versus hospice received similar numbers of visits per 30 days (average 5.4/30 vs. 6.6/30), while those receiving both received more visits (10.5/30). Home health provided more therapy visits, while hospice provided more social work and aide visits. Conclusions: More than one in three Medicare decedents nationwide received home health at the EOL. Home health has the potential to serve a population not reached by hospice and improve the quality of end-of-life care. [ABSTRACT FROM AUTHOR]

Suicide rates among veterans are higher than those of the general US population. Although veterans compose only 7.6% of the US population, nearly 14% of American adult suicides are among veterans. The rate of suicide is 1.5 times higher among all veterans and 2.1 times higher among female veterans compared with the general population. Only 47% of all veterans are enrolled in the US Department of Veterans Affairs (VA) Healthcare System, leaving a large number either not receiving health care or receiving it outside the VA. Recent legislation has improved access to care for veterans outside the VA, highlighting the need for a broad public health approach to address veteran suicide and the need for all health care institutions and clinicians to be familiar with the unique health concerns in this population. The purpose of this narrative review was to summarize the risk factors contributing to veteran suicide and to provide guidance on how to assess and mitigate these risks. Suicide is preventable through recognition of risk and prompt intervention. Health care providers both inside and outside the VA system are uniquely situated at the intersection of the many contributing factors to veteran suicide and should have a structured, proactive approach to address the problem. [ABSTRACT FROM AUTHOR]