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Background: Cardiovascular disease (CVD) disproportionately affects Black adults in the United States. This is increasingly acknowledged to be due to inequitable distribution of health-promoting resources. One potential contributor is inequities in educational opportunities, although it is unclear what aspects of education are most salient. School racial segregation may affect cardiovascular health by increasing stress, constraining socioeconomic opportunities, and altering health behaviors. We investigated the association between school segregation and Black adults' CVD risk.Methods and Findings: We leveraged a natural experiment created by quasi-random (i.e., arbitrary) timing of local court decisions since 1991 that released school districts from court-ordered desegregation. We used the Panel Study of Income Dynamics (PSID) (1991 to 2017), linked with district-level school segregation measures and desegregation court order status. The sample included 1,053 Black participants who ever resided in school districts that were under a court desegregation order in 1991. The exposure was mean school segregation during observed schooling years. Outcomes included several adult CVD risk factors and outcomes. We fitted standard ordinary least squares (OLS) multivariable linear regression models, then conducted instrumental variables (IV) analysis, using the proportion of schooling years spent in districts that had been released from court-ordered desegregation as an instrument. We adjusted for individual- and district-level preexposure confounders, birth year, and state fixed effects. In standard linear models, school segregation was associated with a lower probability of good self-rated health (-0.05 percentage points per SD of the segregation index; 95% CI: -0.08, -0.03; p < 0.001) and a higher probability of binge drinking (0.04 percentage points; 95% CI: 0.002, 0.07; p = 0.04) and heart disease (0.01 percentage points; 95% CI: 0.002, 0.15; p = 0.007). IV analyses also found that school segregation was associated with a lower probability of good self-rated health (-0.09 percentage points; 95% CI: -0.17, -0.02, p = 0.02) and a higher probability of binge drinking (0.17 percentage points; 95% CI: 0.04, 0.30, p = 0.008). For IV estimates, only binge drinking was robust to adjustments for multiple hypothesis testing. Limitations included self-reported outcomes and potential residual confounding and exposure misclassification.Conclusions: School segregation exposure in childhood may have longstanding impacts on Black adults' cardiovascular health. Future research should replicate these analyses in larger samples and explore potential mechanisms. Given the recent rise in school segregation, this study has implications for policies and programs to address racial inequities in CVD. [ABSTRACT FROM AUTHOR]

The purpose of the current study is to investigate teachers' digital content evaluation (DCE) competency as a combined set of teachers' intellectual ability and affect-motivation in evaluating digital content. To this end, this study employed an exploratory sequential mixed-methods design to examine 102 in-service teachers’ experiences in a one-year DCE professional development program. Qualitative thematic analysis followed by quantitative K -means cluster analysis identified and validated four levels of teacher competency in DCE: familiarization, utilization, integration, and reorientation. In addition, this study also proposed design guidelines to scaffold DCE competency development tailored to the needs of teachers at various competency levels. [ABSTRACT FROM AUTHOR]

This study explored treatment participation rate as a mediator between individuals’ baseline alcohol use, drug use, and psychiatric issue levels and post-treatment employment status. The study sample included 106 unemployed or underemployed individuals with substance use disorders who were participants in an intensive drug abuse treatment program. Structural equation modeling was applied to examine relationships between study variables. The results showed that (a) the direct effect of individuals’ baseline alcohol use, drug use, and psychiatric issue severities reduced treatment participation rate; (b) the direct effect of treatment participation rate ameliorated post-treatment employment status; and (c) the indirect effect of individuals’ baseline alcohol use, drug use, and psychiatric issue severities on post-treatment employment status was mediated by treatment participation rate, which reduced the negative influence of baseline issue severity on employment. This significant mediating effect has both practical and theoretical importance in that it indicates the need for increased focus on treatment participation in practice and future research. [ABSTRACT FROM AUTHOR]

Objective: The objectives of the current study are to provide nationally representative estimates of hospital based emergency department visits (ED) attributed to self inflicted injuries and attempted suicides among children in United States; and to identify potential methods of such intentional self inflicted injuries and attempted suicides. Methods: The Nationwide Emergency Department Sample (year 2007) was used. All ED visits occurring among children (aged ≤18 years) with an External Cause of Injury for any of self inflicted injuries were selected. Outcomes examined include hospital ED charges and hospitalization charges. All estimates were projected to national levels. Results: 77,420 visits to hospital based emergency departments were attributed to self inflicted injuries among children (26,045 males and 51,370 females). The average age of the ED visits was 15.7 years. 134 patients died in ED’s (106 males and 28 females) and 93 died in hospitals following in-patient admission (75 males and 18 females). A greater proportion of male ED visits were discharged routinely as opposed to female ED visits (51.1% versus 44%). A greater proportion of male ED visits also died in the emergency departments compared to female visits (0.4% versus 0.05%). 17,965 ED visits necessitated admission into same hospital. The mean charge for each ED visit was $1,874. Self inflicted injuries by poisoning were the most frequently reported sources accounting for close to 70% of all ED visits. Conclusions: Females comprise a greater proportion of ED visits attributed to self inflicted injuries. 227 children died either in the ED’s or in hospitals. The current study results highlight the burden associated with such injuries among children. [ABSTRACT FROM AUTHOR]

The purpose of this exploratory mixed methods study was to investigate how teacher beliefs were related to technology integration practices. We were interested in how and to what extent teachers' (a) beliefs about the nature of knowledge and learning, (b) beliefs about effective ways of teaching, and (c) technology integration practices were related to each other. The participants were twenty two teachers who have participated in a four-year professional development project funded by the U.S. Department of Education. Specific relations between teachers' beliefs and technology integration practices are presented. The implications for professional development and suggestions for teacher belief change and technology integration are discussed. [Copyright &y& Elsevier]

Abstract: Interdependence of the interest rates of the US, the UK, and Japan is analyzed in this work by means of spectral analysis and network methods. A predominant effective factor in the interest rate market is which country floats a bond issue, and a minor effective factor is time to maturity of bonds. Power-law cross-correlation among different countries is analyzed by the detrended cross-correlation analysis method. Long-range cross-correlation is found between the first factors of interest rate, while there is no cross-correlation between some of the second factors. The tail dependency is indicated by tail indices from Archimedean copulas, including an empirical copula. In contrast to other pairs, the US–UK first factor pair has tail dependencies in both the upper-tail and lower-tail. Dynamic properties of interest rate are modeled by a stochastic volatility model. The properties of mean reverting and volatility clustering are observed and reflected in this model. The proposed simulation method combines the dependence structures and the factor dynamics model; it simultaneously describes the interest rates of different countries. [Copyright &y& Elsevier]

The rapid transition from face-to-face to online teaching due to the COVID-19 pandemic provided unprecedented experiences for Adapted Physical Education (APE) teachers while they have had many different emerging roles, demands, and expectations related to program delivery. The purpose of this study was to examine APE teachers' experiences teaching online during COVID-19. Participants included 11 APE teachers from the south region of the United States (8 females, 3 males). Data were collected through semi-structured interviews with each participant. Thematic analysis was used to analyse the data. Data analysis resulted in five themes: 'initial thought: how are we going to even do this?', 'challenges in teaching online', 'collaboration: key to overcome challenges', 'Parents' support is critical', and 'it's doable, but I am over it'. Despite the challenges experienced by the participants during COVID-19, they were able to navigate and adapt the online teaching; however, the quality and delivery of instruction declined. [ABSTRACT FROM AUTHOR]

- Objective: The face is a complex architectural structure in the body and is a high-risk site for fractures. Hospitalization is necessary for adequate treatment. The objective of this study is to examine hospitalization outcomes associated with reduction in facial fractures in the United States. Methods: The Nationwide Inpatient Sample (NIS) of the health care cost and utilization project for 2008 was used. This database provides weighted estimates of all hospitalizations in the United States, which approximates 39.88 million admissions in the entire United States. Hospital discharges with primary procedure ICD-9-CM codes for reduction in facial fractures were selected. Outcomes examined included hospitalization charges, length of stay, and causes of injuries. All estimates obtained from the sample were projected to national levels. Results: Reduction in facial fractures was performed as primary procedure in 21 244 hospitalizations. The total hospitalization charges were about $1.06 billion, and total hospitalization days was 93 808. About 80% of all hospitalizations occurred among men. The frequently occurring external causes of injuries leading to hospitalization for reduction in facial fractures include assault (36.5% of all hospitalizations), motor vehicle traffic accidents (16%), falls (15%), and other transportation accidents (3.5%). The frequently performed procedures were open reduction in mandibular fractures (52.2%), open reduction in facial fractures including those of orbital rim or wall (14.7%), closed reduction in mandibular fractures (12.1%), and open reduction in malar and zygomatic fractures (11.8%). Conclusions: National hospitalization outcomes related to reduction in facial fractures indicate an extensive consumption of hospital resources. If hospital emergency room protocols and inpatient protocols relating to the most expensive fractures and longest hospital stays that we have identified can improve, this may lead to improved outcomes and a reduction in hospital charges for facial fractures. [ABSTRACT FROM AUTHOR]

Asian American Christian faith leaders support and provide an array of services within their communities. However, little is known about their response to congregants' mental health concerns. This study examined correlates of mental health referral behavior among 103 Asian American Christian clergy in California who completed an anonymous mail survey. Using multiple regression analyses, we found that clergy's prior mental health education, knowledge of mental illness, education level, time spent providing individual counseling and referral to general practitioners were positively associated with making mental health referrals. Outreach efforts (including mental health education, and mental health referral information) to facilitate clergy's support of congregants with mental health needs are discussed. [ABSTRACT FROM AUTHOR]

The current study examined the relationship between suicidal behaviors and physical and psycho-social predictors including body image, weight control behaviors, and risky sexual behaviors among Asian, African American, Caucasian, and Hispanic adolescents. This study used the 2007 Youth Risk Behavior Survey (YRBS). The target populations were 11,134 adolescents (5,636 female and 5,498 male) in 9th-12th grade who completed the survey. A linear regression was conducted to examine the correlation between predictors and suicidal behaviors. The results showed that gender, grade, depression, substance use, body image, weight control behaviors, and risky sexual behaviors were significant predictors of adolescents' suicidal behaviors, while race/ethnicity was not a good predictor. Also, there were significant gender and grade differences in suicidal behaviors. Based on the results, practice implications for suicide prevention were discussed. [ABSTRACT FROM AUTHOR]

Abstract: The objective of our study was to estimate the complementary role of ultrasound evaluation in the diagnosis of acute appendicitis after abdominoplevic CT. A total of 104 patients initially underwent abdominopelvic CT before appendix US due to acute abdominal pain. All CT examinations were evaluated retrospectively for the presence of acute appendicitis. The findings of appendix on CT were classified into five categories (definite appendicitis, probably appendicitis, equivocal CT findings for diagnosis of appendicitis, probably not appendicitis, and normal looking appendix). Appendix US images and their radiologic reports were also evaluated retrospectively. Then, CT and US findings were correlated with clinical or pathologic diagnosis. Three all patients with definite appendicitis initially on CT again showed US findings of appendicitis. In the 32 patients of probably appendicitis on CT, US showed normal looking appendix in seven patients (21.8%, 7 of 32) who improved with medical treatment and discharged. In the 16 patients of equivocal CT findings for diagnosis of appendicitis, US showed appendicitis in seven patients (43.8%, 7 of 16) and normal looking appendix in nine patients. In the 12 patients of probably not appendicitis on CT, US showed acute appendicitis in two patients (16.7%, 2 of 12). In the 41 patients of normal looking appendix on CT, US showed acute appendicitis in five patients (12.2%, 5 of 41). US reevaluation enables us to avoid misdiagnosis of appendicitis on CT and improve diagnostic accuracy of acute appendicitis. [Copyright &y& Elsevier]

Background: We investigated the characteristics and clinical outcomes of respiratory syncytial virus (RSV)‐related pediatric intensive care unit (PICU) hospitalization and assessed the palivizumab (PZ) prophylaxis eligibility according to different guidelines from Korea, EU, and USA. Methods: In this multicenter study, children <18 years of age hospitalized in six PICU from different hospitals due to severe RSV infection between September 2008 and March 2013 were included. A retrospective chart review was performed. Results: A total of 92 patients were identified. The median length of PICU stay was 6 days (range, 1–154 days) and median PICU care cost was USD2,741 (range, USD556–98 243). Of 62 patients who were <2 years old at the beginning of the RSV season, 33 (53.2%) were high‐risk patients for severe RSV infection. Hemodynamically significant congenital heart disease (22.6%) was the most common risk factor, followed by chronic lung disease (11.3%), neuromuscular disease or congenital abnormality of the airway (NMD/CAA) (11.3%), and prematurity (8.1%). The percentage of patients eligible for PZ prophylaxis ranged from 38.7% to 48.4% based on the guidelines, but only two (2.2%) received PZ ≤30 days prior to PICU admission. The median duration of mechanical ventilation was longer in children with NDM/CAA than in those without risk factors (26 days; range, 24–139 days vs 6 days, range, 2–68 days, P = 0.033). RSV‐attributable mortality was 5.4%. Conclusions: Children <2 years old with already well‐known high risks represent a significant proportion of RSV‐related PICU admissions. Increasing of the compliance for PZ prophylaxis practice among physicians is needed. Further studies are needed to investigate the burden of RSV infection in patients hospitalized in PICU, including children with NMD/CAA. [ABSTRACT FROM AUTHOR]

In unassuming neighborhood locales, such as coffee shops, hair salons, and malls, people meet to socialize, express themselves, and support one another. These 'third places' enrich social interaction, sense of community, and belonging outside of the home and workplace. Yet third places are closing across the United States. Americans may be losing access to key services, goods, and amenities, in addition to community sites that help buffer against loneliness, stress, and alienation. The relevance of third places to health and quality life is under-researched. These sites may support wellbeing through mechanisms of stimulation, support, protection, and care. We call on researchers to investigate how third places contribute to wellbeing and consider the consequences that the disappearance of such places has for public health. Future research on third places may be mobilized to innovatively reduce health disparities and improve quality of life. [ABSTRACT FROM AUTHOR]

Residential racial segregation is a key manifestation of anti-Black structural racism, thought to be a fundamental cause of poor health; evidence has shown that it yields neighborhood disinvestment, institutional discrimination, and targeting of unhealthy products like tobacco and alcohol. Yet research on the long-term impacts of childhood exposure to residential racial segregation is limited. Here, we analyzed data on 1823 Black participants in the Panel Study of Income Dynamics, estimating associations between childhood segregation trajectories and young adult health. Black young adults who consistently lived in high-segregation neighborhoods throughout childhood experienced unhealthier smoking and drinking behaviors and higher odds of obesity compared to other trajectory groups, including children who moved into or out of high-segregation neighborhoods. Results were robust to controls for neighborhood and family poverty. Findings underscore that for Black children who grow up in segregated neighborhoods, the roots of structurally-determined health inequities are established early in life. [ABSTRACT FROM AUTHOR]

Emergency departments and jails provide medical services to persons at risk for HIV infection and are recommended venues for HIV screening. Our main objective in this study was to analyze the cost per new HIV diagnosis associated with the HIV screening program in these two venues. The emergency department’s parallel testing program was conducted at Grady Memorial Hospital in Atlanta, Georgia starting in 2008; the jail’s integrated testing program began at the Fulton County (GA) Jail in 2011. The two sites, four miles apart from one another, employed the same rapid HIV test. Ascertainment that cases were new differed by site; only the jail systematically checked identities against health department HIV registries. The program in the emergency department used dedicated HIV test counselors and made 242 diagnoses over a 40-month period at a cost of $2,981 per diagnosis. The jail program used staff nurses, and found 41 new HIV cases over 10.5 months at a cost of $6,688 per new diagnosis. Differences in methods for ascertainment of new diagnoses, previously undiagnosed HIV sero-positivity, and methodologies used for assessing program costs prevent concluding that one program was more economical than the other. Nonetheless, our findings show that testing in both venues yielded many new diagnoses, with the costs within the range reported in the literature. [ABSTRACT FROM AUTHOR]

This study investigated whether transitioning into the role of activities of daily living (ADL) spousal caregiver is associated with increased depressive symptoms for older husbands and wives among a sample of coresiding community-dwelling older couples. Using data from the Health and Retirement Study, we estimated a two-level linear model to examine the association between change in caregiver status and respondents’ depressive symptoms at follow-up, controlling for other factors identified in Pearlin’s stress process model (PSPM). Results indicate that both husbands and wives who become ADL caregivers have more follow-up depressive symptoms than noncaregivers. Furthermore, wives continuing as caregivers have more follow-up depressive symptoms than wives who do not provide care. Finally, the physical health of the spousal caregiver is related to depressive symptoms at follow-up. We conclude with policy and practice implications of these three main findings. [ABSTRACT FROM PUBLISHER]

Early experience with ultrasound guided distal trans-radial access in the anatomical snuffbox in coronary angiography and intervention. Objective: We aimed to demonstrate the feasibility and safety of the ultrasound guided distal trans-radial coronary angiography and intervention. Methods: Patients assigned to one operator program underwent diagnostic or procedural intervention through distal trans-radial approach in the anatomical snuffbox between January 2018 and May 2018. All of patients had palpable artery in their distal radial artery. The operator did the coronary procedure via distal radial access at anatomical snuffbox. When the pulse was weak or the target artery was very small, the operator punctured under ultrasound guidance (V-scan with dual probe, GE heathcare, USA) Results: 56 patients were enrolled. Mean age of patients was 65.1 years old and 68% were male. About 70% of patients were presented with stable angina feature. In diagnostic procedure, 4F (3, 5.6%) or 5F (29, 54.7%) sheath was used and we did coronary intervention via 6F (21, 39.6%) Sheath. Ultrasound guided puncture was done for 33 patients (58.9%). Overall Success rate of distal trans-radial angiography and intervention was 94.6% (3 failed cases). Success rate of ultrasound guided procedure was 97% (only 1 failed case). Left distal radial puncture was done for 18 patients (33.9%). 16% of patients had chronic kidney disease, especially end stage renal disease (11%) to preserve radial artery which was potential candidate of arteriovenous fistulae for dialysis. There was no BARC type 2-5 bleeding in hospital stay and follow up at out-patient clinic. Conclusion: Ultra sound guided distal radial approach is feasible and safe as a good alternative technique for coronary angiography and interventions. [ABSTRACT FROM AUTHOR]