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BACKGROUND: Patients hospitalized after emergency care are at risk for later mental health problems such as depression, anxiety, and posttraumatic stress disorder symptoms. The American College of Surgeons Committee on Trauma standards for verification require Level I and II trauma centers to screen patients at high risk for mental health problems. This study aimed to develop and examine the performance of a novel mental health risk screen for hospitalized patients based on samples that reflect the diversity of the US population. STUDY DESIGN: We studied patients admitted after emergency care to 3 hospitals that serve ethnically, racially, and socioeconomically diverse populations. We assessed risk factors during hospitalization and mental health symptoms at follow-up. We conducted analyses to identify the most predictive risk factors, selected items to assess each risk, and determined the fewest items needed to predict mental health symptoms at follow-up. Analyses were conducted for the entire sample and within 5 ethnic and racial subgroups. RESULTS: Among 1,320 patients, 10 items accurately identified 75% of patients who later had elevated levels of mental health symptoms and 71% of those who did not. Screen performance was good to excellent within each of the ethnic and racial groups studied. CONCLUSIONS: The Hospital Mental Health Risk Screen accurately predicted mental health outcomes overall and within ethnic and racial subgroups. If performance is replicated in a new sample, the screen could be used to screen patients hospitalized after emergency care for mental health risk. Routine screening could increase health and mental health equity and foster preventive care research and implementation. (J Am Coll Surg 2024;238:147-156. Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a "work of the United States Government" for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.) [ABSTRACT FROM AUTHOR]

The negative impact of misinformation on public discourse and public safety is increasingly a focus of attention. From the COVID-19 pandemic to national elections, exposure to misinformation has been linked to conflicting perceptions of social, economic, and political issues, which has been found to lead to polarization, radicalization, and acts of violence at the individual and group level. While a large body of research has emerged examining the development and spread of misinformation, little has been done to examine the human processes of being exposed to, and influenced by, misinformation material online. This article uses reinforcement sensitivity theory to examine the effect of individual differences in the Behavioral Inhibition System (BIS) on the behavioral and cognitive intentions to engage in violence after exposure to misinformation online. Using an online panel sample (Mechanical Turk), and a behavioral study that involved exposure to, and interaction with, misinformation, this study found that trait BIS score impacted how much individuals engaged with misinformation, as well as their ensuing activism and radicalism toward the narratives that were depicted. This study identified that engagement with misinformation impacted intentions for activism and radicalism, as did trait BIS. However, these effects were present for both misinformation and correct information conditions. These findings highlight the importance of BIS-related processes and raise important questions about the degree to which we need to think about online influence as a general process versus specific processes that directly relate to the effect of misinformation. [ABSTRACT FROM AUTHOR]

Premise: Cultivated species and their wild relatives often hybridize in the wild, and the hybrids can survive and reproduce in some environments. However, it is unclear whether cultivar alleles are permanently incorporated into the wild genomes or whether they are purged by natural selection. This question is key to accurately assessing the risk of escape and spread of cultivar genes into wild populations. Methods: We used genomic data and population genomic methods to study hybridization and introgression between cultivated and wild carrot (Daucus carota) in the United States. We used single nucleotide polymorphisms (SNPs) obtained via genotyping by sequencing for 450 wild individuals from 29 wild georeferenced populations in seven states and 144 cultivars from the United States, Europe, and Asia. Results: Cultivated and wild carrot formed two genetically differentiated groups, and evidence of crop–wild admixture was detected in several but not all wild carrot populations in the United States. Two regions were identified where cultivar alleles were present in wild carrots: California and Nantucket Island (Massachusetts). Surprisingly, there was no evidence of introgression in some populations with a long‐known history of sympatry with the crop, suggesting that post‐hybridization barriers might prevent introgression in some areas. Conclusions: Our results provide support for the introgression and long‐term persistence of cultivar alleles in wild carrots populations. We thus anticipate that the release of genetically engineered (GE) cultivars would lead to the introduction and spread of GE alleles in wild carrot populations. [ABSTRACT FROM AUTHOR]

PURPOSE The onset of the COVID-19 pandemic created major disruptions in the conduct of cancer clinical trials. In response, regulators and sponsors allowed modifi- cations to traditional trial processes to enable clinical research and care to continue. We systematically evaluated how these mitigation strategies affected data quality and overall trial conduct. METHODS This study used surveys and live interviews. Forty-one major industry and National Cancer Institute Network groups (sponsors) overseeing anticancer treatment trials open in the United States from January 2015 to May 2022 were invited to participate. Descriptive statistics were used for survey data summaries. Key themes from interviews were identified. RESULTS Twenty sponsors (48.8%; 15 industry and five Network groups) completed the survey; 11/20 (55.0%) participated in interviews. Sponsors predominantly (n 5 12; 60.0%) reported large (≥11 trials) portfolios of phase II and/or phase III trials. The proportion of sponsors reporting a moderate (9) or substantial (8) increase in protocol deviations in the initial pandemic wave versus the prepandemic period was 89.5% (17/19); the proportion reporting a substantial increased dropped from 42.1% (n 5 8/19) in the initial wave to 15.8% (n 5 3/19) thereafter. The most commonly adopted mitigation strategies were remote distribution of oral anticancer therapies (70.0%), remote adverse event monitoring (65.0%), and remote consenting (65.0%). Most respondents (15/18; 83.3%) reported that the pandemic had minimal (n 514) or no impact (n 51) on overall data integrity. CONCLUSION Despite nearly all sponsors observing a temporary increase in protocol deviations, most reported the pandemic had minimal/no impact on overall data integrity. The COVID-19 pandemic accelerated an emerging trend toward greater flexibility in trial conduct, with potential benefits of reduced burden on trial participants and sites and improved patient access to research. [ABSTRACT FROM AUTHOR]

Background: High rates of mental health symptoms such as depression, anxiety, and posttraumatic stress disorder (PTSD) have been found in patients hospitalized with traumatic injuries, but little is known about these problems in patients hospitalized with acute illnesses. A similarly high prevalence of mental health problems in patients hospitalized with acute illness would have significant public health implications because acute illness and injury are both common, and mental health problems of depression, anxiety, and PTSD are highly debilitating. Methods and findings: In patients admitted after emergency care for Acute Illness (N = 656) or Injury (N = 661) to three hospitals across the United States, symptoms of depression, anxiety, and posttraumatic stress were compared acutely (Acute Stress Disorder) and two months post-admission (PTSD). Patients were ethnically/racially diverse and 54% female. No differences were found between the Acute Illness and Injury groups in levels of any symptoms acutely or two months post-admission. At two months post-admission, at least one symptom type was elevated for 37% of the Acute Illness group and 39% of the Injury group. Within racial/ethnic groups, PTSD symptoms were higher in Black patients with injuries than for Black patients with acute illness. A disproportionate number of Black patients had been assaulted. Conclusions: This study found comparable levels of mental health sequelae in patients hospitalized after emergency care for acute illness as in patients hospitalized after emergency care for injury. Findings of significantly higher symptoms and interpersonal violence injuries in Black patients with injury suggest that there may be important and actionable differences in mental health sequelae across ethnic/racial identities and/or mechanisms of injury or illness. Routine screening for mental health risk for all patients admitted after emergency care could foster preventive care and reduce ethnic/racial disparities in mental health responses to acute illness or injury. [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence of acute stress disorder (ASD) symptoms and to examine proposed "DSM-5" symptom criteria in relation to concurrent functional impairment in children and adolescents. Method: From an international archive, datasets were identified that included assessment of acute traumatic stress reactions and concurrent impairment in children and adolescents 5 to 17 years of age. Data came from 15 studies conducted in the United States, United Kingdom, Australia, and Switzerland and included 1,645 children and adolescents. Dichotomized items were created to indicate the presence or absence of each of the 14 proposed ASD symptoms and functional impairment. The performance of a proposed diagnostic criterion (number of ASD symptoms required) was examined as a predictor of concurrent impairment. Results: Each ASD symptom was endorsed by 14% to 51% of children and adolescents; 41% reported clinically relevant impairment. Children and adolescents reported from 0 to 13 symptoms (mean = 3.6). Individual ASD symptoms were associated with greater likelihood of functional impairment. The "DSM-5" proposed eight-symptom requirement was met by 202 individuals (12.3%) and had low sensitivity (0.25) in predicting concurrent clinically relevant impairment. Requiring fewer symptoms (three to four) greatly improved sensitivity while maintaining moderate specificity. Conclusions: This group of symptoms appears to capture aspects of traumatic stress reactions that can create distress and interfere with children's and adolescents' ability to function in the acute post-trauma phase. Results provide a benchmark for comparison with adult samples; a smaller proportion of children and adolescents met the eight-symptom criterion than reported for adults. Symptom requirements for the ASD diagnosis may need to be lowered to optimally identify children and adolescents whose acute distress warrants clinical attention. (Contains 5 tables and 1 figure.)

Background: People living with mental health disorders are at increased risk for developing obesity due to poor diet, physical inactivity, and antipsychotic medications. In the United States, the obesity rate is 36% in the general population and more than 50% for people living with mental health disorders. Although mental health clinicians concentrate on managing psychiatric disorders, they seldom recognize the gradual increase in body mass index of their patients. The result is a disconnection between the clinical management of psychiatric disorders and the medical management of obesity. Purpose: This study assessed the effectiveness of an evidence-based education program for improving the obesity management practices of mental health clinicians caring for residents at a state psychiatric hospital. Methods: This was a quasi-experimental study design with a pretest and posttest evaluation. Convenience sampling was used to recruit mental health professionals, or clinicians, at a large psychiatric hospital in the Southern region of the United States. Data was collected with the Advising and Treating Overweight and Obese Patient questionnaire (17 items). Data analysis included descriptive and inferential statistics. The findings were reported in accordance with the TREND and GREET guidelines. Results: The education program was completed by 50 MHCs. The pretest indicated that 76% of MHCs were not involved in helping obese residents manage their weight, but the posttest indicated 90% were involved. There was a significant increase in MHC knowledge about obesity management and reported actions 90-days after the program. MHCs were unable to arrange follow-up visits for residents, a task not directly within their control. Conclusions: Mental health clinicians reported increased knowledge and improved clinical practice after an education program. Because the outcomes were reported at 90-days after the program, further research needs to evaluate the longitudinal impact of this type of program, where the reported behaviors are correlated to process and clinical outcome measures for obesity. [ABSTRACT FROM AUTHOR]

The article discusses the efforts of the U.S. government health agencies to address HIV-related intersectional stigma. Topics include efforts that are important to the National HIV/AIDS Strategy for the United States 2022-2025, examples of HIV-related intersectional stigma (HIVIS)-related efforts from several Health and Human Services (HHS) agencies, and actions needed by the federal agencies to better address the challenges of intersectionality.

This study evaluated an antibiotic stewardship program (ASP) intervention aimed at reducing inpatient fluoroquinolone (FQ) use and examined its impact on ciprofloxacin susceptibilities of gram-negative bacteria in a large 611-bed community hospital. A two-step ASP intervention was implemented: an electronic medical record algorithm that prompted physicians to re-evaluate FQ use shortly after admission and changed institutional UTI/pneumonia guidelines that recommended options alternate to FQs for first-line empiric antibiotic therapy in 2010 and 2011 respectively. Between 2007 and 2017 FQ use and ciprofloxacin susceptibilities of all non-duplicate cultured isolates of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, and Pseudomonas aeruginosa obtained ≥72 h after admission were reviewed. Ambulatory care isolates served as a comparison group. FQ utilization rates and relationships to ciprofloxacin susceptibility were evaluated using interrupted time series models. Over the 11-year period, FQ use decreased from 110.0 (2007) to 26.2 (2017) days of therapy/1000 days at risk (p < 0.001). Compared to pre-intervention, the estimated (post-intervention) reduction in FQ utilization was 28.4 (95% CI: 10.9–46) days of therapy/1000 days at risk. Reduced FQ utilization was correlated with increase susceptibilities to ciprofloxacin of hospital onset isolates of Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis (p < 0.02), and Pseudomonas aeruginosa (p = 0.07). No significant susceptibility change was observed in the ambulatory care isolates. Persuasive interventions by an ASP successfully modified physicians' inpatient empiric antibiotic use, produced a sustained reduction in FQ utilization rates and increased ciprofloxacin susceptibility to four commonly encountered gram-negative bacteria in a community hospital. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the combined impact of experience and decision making on frontal plane knee joint biomechanics during a cutting maneuver. Kinematic and kinetic data were collected from 12 recreationally active and 18 NCAA Division I female athletes during execution of anticipated and unanticipated single-leg land-and-cut maneuvers. Knee joint abduction angles and external knee joint abduction torques were calculated and discrete peak stance-phase variables were extracted. Angle and torque time-series data were also submitted to separate functional data analyses. Variables derived from the functional data analyses indicated that decision making influenced knee abduction angle and torque time series in the recreational group only. Specifically, these variables pointed to greater knee abduction at the end of stance as well as a greater, albeit delayed peak in knee abduction torque at the beginning of landing in the recreational athletes during the unanticipated condition. In addition, the recreational athletes displayed greater discrete peak knee abduction angles than the Division I athletes regardless of condition. Discrete peak knee abduction torque did not differ between groups or conditions. [ABSTRACT FROM AUTHOR]

A veterinarian and pet owner survey (Project Jake) examined the use and safety of isoxazoline parasiticides given to dogs. Data were received during August 1–31, 2018 from a total of 2,751 survey responses. Forty‐two percent (1,157) reported no flea treatment or adverse events (AE), while 58% (1594) had been treated with some parasiticide for flea control, and of those that received a parasiticide, the majority, or 83% (1,325), received an isooxazoline. When any flea treatment was given, AE were reported for 66.6% of respondents, with no apparent AE noted for 36.1%. Project Jake findings were compared to a retrospective analysis of publicly available Food and Drug Administration (FDA) and European Medicines Agency (EMA) reported AE. The number of total AE reported to FDA and EMA were comparable, although a 7 to 10 times higher occurrence of death and seizures was reported from the EMA or from outside the United States (US). Serious AE responses for death, seizures and neurological effects reported in our survey were higher than the FDA but moderately lower than the EMA reports. These sizable global data sets combined with this pre‐ and post‐parasiticide administration survey indicated that isoxazoline neurotoxicity was not flea‐ and tick‐specific. Post‐marketing serious AE were much higher than in Investigational New Drug (IND) submissions. Although the labels have recently been updated, dogs, cats and their caregivers remain impacted by their use. These aggregate data reports support the need for continued cross‐species studies and critical review of product labelling by regulatory agencies and manufacturers. [ABSTRACT FROM AUTHOR]

Burn care remains among the most complex of the time-sensitive treatment interventions in medicine today. An enormous quantity of specialized resources are required to support the critical and complex modalities needed to meet the conventional standard of care for each patient with a critical burn injury. Because of these dependencies, a sudden surge of patients with critical burn injuries requiring immediate and prolonged care following a burn mass casualty incident (BMCI) will place immense stress on healthcare system assets, including supplies, space, and an experienced workforce (staff). Therefore, careful planning to maximize the efficient mobilization and rational use of burn care resources is essential to limit morbidity and mortality following a BMCI. The U.S. burn care profession is represented by the American Burn Association (ABA). This paper has been written by clinical experts and led by the ABA to provide further clarity regarding the capacity of the American healthcare system to absorb a surge of burn-injured patients. Furthermore, this paper intends to offer responders and clinicians evidence-based tools to guide their response and care efforts to maximize burn care capabilities based on realistic assumptions when confronted with a BMCI. This effort also aims to align recommendations in part with those of the Committee on Crisis Standards of Care for the Institute of Medicine, National Academies of Sciences. Their publication guided the work in this report, identified here as "conventional, contingency, and crisis standards of care." This paper also includes an update to the burn Triage Tables- Seriously Resource-Strained Situations (v.2). [ABSTRACT FROM AUTHOR]

Previous research on burn patients who test positive for methamphetamines (meth) has yielded mixed results regarding whether meth-positive status leads to worse outcomes and longer hospitalizations. We hypothesized that meth-positive patients at our regional burn center would have worse outcomes. We reviewed burn admissions from January 2014 to December 2017 and compared total patients versus meth-positive, and matched meth-negative versus meth-positive for total BSA burn, length of stay (LOS), intensive care unit (ICU) days, days on ventilator, discharge status (lived/died), number of operating room (OR) visits, number of procedures, socioeconomic status, comorbidities, and discharge disposition. Of 1363 total patients, 264 (19.4%) were meth-positive on toxicology screen. We matched 193 meth-positive patients with meth-negative controls based on TBSA burn, age, and inhalation injury. In the total population comparison, meth-positive patients had larger burns (15.6% vs 12.2%; P = .004), longer LOS (17.8 vs 14.3 days; P = .041), and fewer operations/TBSA (0.12 vs 0.2; P = .04), and lower socioeconomic status. Meth-positive patients were less likely to be discharged to a skilled nursing facility, and more likely to leave against medical advice. In the matched patients, we found no significant differences in LOS or OR visits/TBSA burn. Meth-positive patients have lower socioeconomic status, larger burns, and longer LOS compared to the total burn population. Methamphetamine use, by itself, does not appear to change outcomes. Methamphetamine use leads to larger burns in a population with fewer resources than the general population. [ABSTRACT FROM AUTHOR]

The article analyze data protection regimes in three large jurisdictions across the globe including the European Union, China, and the U.S., to offer insight into the strengths and weaknesses of each regime, and to predict the path that data protection laws in the U.S. It discusses the use of a five-element framework put forth by Professor Fred H. Cate to analyze the regimes, and mentions the element like data stewardship, a balance between harms and benefits, and a system of transparency.

Burns are among the most common injuries to children, and, although survival rates have improved, many burn survivors are left with scars and/or other visible differences, which may be associated with anxiety, depression, and/or low self-esteem. A better understanding of the prevalence and persistence of these problems in child and adolescent burn survivors might lead to an expanded paradigm of care and possibly to better outcomes. The present study provides longitudinal prevalence data for the Appearance Concerns (AC) subscale of the parent-reported Burn Outcomes Questionnaire (BOQ) for 5- to 18-year-old children and identifies patient characteristics associated with higher risk for appearance concerns. Subjects were 799 pediatric burn survivors who were assessed prospectively using the parent-reported BOQ5-18, which was administered soon after their discharge from acute care and again every 3 to 6 months for up to 4 years. Approximately 20% of all youth were reported to have appearance concerns over the first 2 years, after which the rate declined gradually, falling to around 10% after 3 years. This study showed that such concerns were prevalent and persistent years after burn injuries and suggested that larger burns, facial burns, and country of origin outside of the United States were all associated with higher scores on the AC subscale. These findings highlight the importance of assessing appearance concerns in the long-term care of young burn survivors and suggest that the BOQ5-18 AC subscale could be used to identify individuals with heightened appearance concerns and to measure their response to interventions. [ABSTRACT FROM AUTHOR]

The article discusses the Black Power movement in the United States. Black Power economics rejects welfare liberalism and proposes a philosophy of free enterprise, which requires social, political, and economic power that comes from capital investment and job opportunities. Four areas where business can contribute to change include developing human resources practices for hiring and training that prevent bias. The mobilization of black consciousness which led to the demand for equality and to riots in the urban areas of Watts, Newark, and Detroit, the issue of competence from a black perspective, and three models for promoting black ownership of business enterprises are mentioned, as well as the Small Business Investment Company Act and franchising.

The article explores the relationship between the government and the private sector in the United States in 1967. The author feels that the term "private sector" is overly broad since it can refer to businesses ranging from local retailers to government-funded defense contractors as well as government-regulated utility companies. He calls for the privatization of government corporations as a more effective way to streamline certain businesses that are creatively stagnant. He also suggests that welfare reform and social policies such as federally financed medical care offer great hopes for a better society.

Firefighting is wrought with risk, as 80-100 firefighters (FFs) die on the job each year in the United States. Many of the fatalities have been analyzed by the National Institute for Occupational Safety and Health (NIOSH) to determine contributing factors. The purpose of this study is to determine variables that put FFs at risk for potentially preventable workplace mortality such as use of personal protective equipment (PPE), seat belts, and appropriate training/fitness/clearance for duty. The NIOSH FF Fatality Database reports from 2009 to 2014 were analyzed. Data including age, gender, years on the job, weather, other calls on the same shift, and department type were compared between FFs who employed PPE, seat belts, or wellness/fitness and those who did not. A second group of FFs was determined by NIOSH to have inexperience, lack of training, or inappropriate clearance for duty implicated in their fatalities. Comparisons for the second group were between those whose department used training and safety-related standard operating protocols and those who did not. In 84/176 deaths, PPE/seat belts/fitness was implicated in the fatality. Lack of PPE was more likely on clear days (P = .03) but less likely on cloudy and windy days (P < .001). These FFs dying with lack of PPE had more time on the job in a single department, 18 vs 13 years (P = .03), and more time in a volunteer department, 17 vs 8 years (P < .01). Being deployed on another call during the same shift was associated with lack of PPE-34 vs 16% of those who had not been on another call (P = .005). Lack of training, experience, or medical clearance was implicated in fatalities for 100/176 FFs. FFs who worked in departments that lacked standard operating protocols for respirator fit testing, PPE, fitness testing, rapid intervention, medical clearance, safety/distress alarms, vehicle maintenance, or incident command were statistically more likely to have lack of experience/training/clearance implicated in the fatality. Good weather during a call and more years on the job, particularly in a volunteer department, are associated with FF mortality related to unsafe practices. These factors might create an air of complacency that puts FFs at risk for safety-related omissions. Having been on a recent call may create distraction or fatigue that puts FF at risk during subsequent calls. Lack of key safety-related protocols appears to put FFs at risk of mortality, and the risk may be increasing over time. Further study and prevention efforts from multidisciplinary groups are needed to better understand and combat this problem. [ABSTRACT FROM AUTHOR]

Previously developed models for predicting absolute risk of invasive epithelial ovarian cancer have included a limited number of risk factors and have had low discriminatory power (area under the receiver operating characteristic curve (AUC) <0.60). Because of this, we developed and internally validated a relative risk prediction model that incorporates 17 established epidemiologic risk factors and 17 genome-wide significant single nucleotide polymorphisms (SNPs) using data from 11 case-control studies in the United States (5,793 cases; 9,512 controls) from the Ovarian Cancer Association Consortium (data accrued from 1992 to 2010). We developed a hierarchical logistic regression model for predicting case-control status that included imputation of missing data. We randomly divided the data into an 80% training sample and used the remaining 20% for model evaluation. The AUC for the full model was 0.664. A reduced model without SNPs performed similarly (AUC = 0.649). Both models performed better than a baseline model that included age and study site only (AUC = 0.563). The best predictive power was obtained in the full model among women younger than 50 years of age (AUC = 0.714); however, the addition of SNPs increased the AUC the most for women older than 50 years of age (AUC = 0.638 vs. 0.616). Adapting this improved model to estimate absolute risk and evaluating it in prospective data sets is warranted. [ABSTRACT FROM AUTHOR]

Background. Recent data have suggested that regular aspirin use improves overall and cancer-specific survival in the subset of colorectal cancer (CRC) patients harboring PIK3CA mutations. However, the number of PIK3CA-mutated CRC patients examined in these studies was modest. Our collaborative study aims to validate the association between regular aspirin use and survival in patients with PIK3CA-mutated CRC. Patients and methods. Patients with PIK3CA-mutated CRC were identified at Moffitt Cancer Center (MCC) in the United States and Royal Melbourne Hospital (RMH) in Australia. Prospective clinicopathological data and survival data were available. At MCC, PIK3CA mutations were identified by targeted exome sequencing using the Illumina GAIIx Next Generation Sequencing platform. At RMH, Sanger sequencing was utilized. Multivariate survival analyses were conducted using Cox logistic regression. Results. From a cohort of 1487 CRC patients, 185 patients harbored a PIK3CA mutation. Median age of patients with PIK3CA-mutated tumors was 72 years (range: 34-92) and median follow up was 54 months. Forty-nine (26%) patients used aspirin regularly. Regular aspirin use was not associated with improved overall survival (multivariate HR 0.96, p = 0.86). There was a trend towards improved cancer-specific survival (multivariate HR 0.60, p = 0.14), but this was not significant. Conclusions. Despite examining a large number of patients, we did not confirm that regular aspirin use was associated with statistically significant improvements in survival in PIK3CA-mutated CRC patients. Prospective evaluation of this relationship is warranted. [ABSTRACT FROM AUTHOR]

Police officers have often been reported to experience high rates of suicide compared to the general population. Suicidal ideation (SI) is considered a strong predictor of suicidal acts. However, few studies have examined SI in U.S. law enforcement officers. This study investigated the prevalence of SI and the association between SI and amount of subjective work-related traumatic stress, personal relationship stress, work-related but non-traumatic stress, age, depression, posttraumatic stress disorder symptoms, alcohol use, and posttraumatic growth among law enforcement officers (N = 193) from a Midwestern state. Multiple regression analysis demonstrated that greater depression symptoms significantly predicted greater SI among officers. [ABSTRACT FROM AUTHOR]

Cutaneous myiasis in humans is a temporary parasitic infestation of the skin by fly larvae or maggots of a variety of Dipteran families. In the United States, autochthonous cases of myiasis are infrequently seen. Most cases of cutaneous myiasis are acquired when traveling to tropical areas of Africa, Central America or South America. This case report involves a 26-year-old male medical student who visited Tanzania on a medical mission trip. Three weeks following his return to the United States he developed a furuncular lesion on the side of the fifth digit on his right foot, which contained the larva of the tumbu fly, Cordylobia anthropophaga. [ABSTRACT FROM AUTHOR]

The author discusses the copyright and authorship and the implications in the U.S. laws related to copyright. A focus is on the transferability of copyrights, work made for hire and the laws related to its termination of transfer of copyrights. He questions the statutory requirements related to the written instrument needed for considering the work as a work made for hire and the issues related to its execution. The bright-line rule for the execution of written agreements is also discussed.

Progress in understanding the molecular basis of melanoma has made possible the identification of molecular targets with important implications in clinical practice. In fact, new therapeutic approaches are emerging from basic science and it will be important to implement their rapid translation into clinical practice by active clinical investigation. The first meeting of Melanoma Research: a bridge Naples-USA, organized by Paolo A. Ascierto (INT, Naples, Italy) and Francesco Marincola (NIH, Bethesda, USA) took place in Naples, on 6-7 December 2010. This international congress gathered more than 30 international and Italian faculty members and was focused on recent advances in melanoma molecular biology, immunology and therapy, and created an interactive discussion across Institutions belonging to Government, Academy and Pharmaceutical Industry, in order to stimulate new approaches in basic, translational and clinical research. Four topics of discussion were identified: New pathways in Melanoma, Biomarkers, Clinical Trials and New Molecules and Strategies. [ABSTRACT FROM AUTHOR]

Background: The genus Arachis comprises 80 species and it is subdivided into nine taxonomic sections (Arachis, Caulorrhizae, Erectoides, Extranervosae, Heteranthae, Procumbentes, Rhizomatosae, Trierectoides, and Triseminatae). This genus is naturally confined to South America and most of its species are native to Brazil. In order to provide a better understanding of the evolution of the genus, we reconstructed the phylogeny of 45 species using the variation observed on nucleotide sequences in internal transcribed spacer regions (ITS1 and ITS2) and 5.8 S of nuclear ribosomal DNA. Results: Intraspecific variation was detected, but in general it was not enough to place accessions of the same species in different clades. Our data support the view that Arachis is a monophyletic group and suggested Heteranthae as the most primitive section of genus Arachis. The results confirmed the circumscriptions of some sections (Caulorrhizae, Extranervosae), but raised questions about others. Sections Erectoides, Trierectoides and Procumbentes were not well defined, while sections Arachis and Rhizomatosae seem to include species that could be moved to different sections. The division of section Arachis into A and B genome species was also observed in the phylogenetic tree and these two groups of species may not have a monophyletic origin. The 2n = 2x = 18 species of section Arachis (A. praecox, A. palustris and A. decora) were all placed in the same clade, indicating they are closely related to each other, and their genomes are more related to B genome than to the A genome. Data also allowed insights on the origin of tetraploid A. glabrata, suggesting rhizome appeared twice within the genus and raising questions about the placement of that species in section Rhizomatosae. Conclusion: The main clades established in this study in general agreed with many other studies that have used other types of evidences and sets of species, being some of them included in our study and some not. Thus, the relationships established can be a useful framework for future systematic reviews of genus Arachis and for the selection of species to pre-breeding programs. [ABSTRACT FROM AUTHOR]

A chapter from the book "Biennial Review of Health Care Management: Meso Perspectives" is presented. It examines a multidisciplinary literature to assess the impact of attribution theory on healthcare management. It cites the report from the Institute of Medicine (IOM) that examines the traditional punitive healthcare culture. It presents the Healthcare Attribution Error Model to assess the human behavior in clinical practice and healthcare management. It examines the emerging theory of Just Culture as a prerequisite for healthcare safety and quality.

The article focuses on a literature review regarding associations between obesity and recommended screening tests for breast, cervical and colorectal cancer among women in the U.S. Based on several studies, it says that the association between decreased cervical cancer screening and increasing body size was more consistent among whites than African Americans. It states that body size, cancer site and race affect screening behavior.

Background. In contrast to pharmaceutical manufacturers, compounding pharmacies adhere to different quality-control standards, which may increase the likelihood of undetected outbreaks. In 2005, the Centers for Disease Control and Prevention received reports of cases of Serratia marcescens bloodstream infection occurring in patients who underwent cardiac surgical procedures in Los Angeles, California, and in New Jersey. An investigation was initiated to determine whether there was a common underlying cause. Methods. A matched case-control study was conducted in Los Angeles. Case record review and environmental testing were conducted in New Jersey. The Centers for Disease Control and Prevention performed a multistate case-finding investigation; isolates were compared using pulsed-field gel electrophoresis analysis. Results. Nationally distributed magnesium sulfate solution (MgSO4) from compounding pharmacy X was the only significant risk factor for S. marcescens bloodstream infection (odds ratio, 6.4; 95% confidence interval, 1.1-38.3) among 6 Los Angeles case patients and 18 control subjects. Five New Jersey case patients received MgSO4 from a single lot produced by compounding pharmacy X; culture of samples from open and unopened 50-mL bags in this lot yielded S. marcescens. Seven additional case patients from 3 different states were identified. Isolates from all 18 case patients and from samples of MgSO4 demonstrated indistinguishable pulsed-field gel electrophoresis patterns. Compounding pharmacy X voluntarily recalled the product. Neither the pharmacy nor the US Food and Drug Administration could identify a source of contamination in their investigations of compounding pharmacy X. Conclusions. A multistate outbreak of S. marcescens bloodstream infection was linked to contaminated MgSO4 distributed nationally by a compounding pharmacy. Health care personnel should take into account the different quality standards and regulation of compounded parenteral medications distributed in large quantities during investigations of outbreaks of bloodstream infection. [ABSTRACT FROM AUTHOR]

The authors examined the structural validity of the parent informant version of the Strengths and Difficulties Questionnaire (SDQ) with a sample of 733 custodial grandparents. Three models of the SDQ's factor structure were evaluated with confirmatory factor analysis based on the item covariance matrix. Although indices of fit were good across all 3 models, a model that included a newly hypothesized positive construal method factor in addition to the 4 symptom factors (Emotional Symptoms, Conduct Problems, Hyperactivity-Inattention, Peer Problems) and the single Prosocial Behavior factor originally intended for the SDQ provided the best representation of this instrument's latent structure. Structural validity was further evidenced by measurement invariance across grandparent race and grandchild gender and age, a conceptually meaningful pattern of cross-scale correlations, and the acceptable internal reliability estimates found for each subscale. Measurement and clinical implications of the results are discussed. [ABSTRACT FROM AUTHOR]

This study used confirmatory factor analysis to examine the factor structure of the Cambodian version of the Harvard Trauma Questionnaire in 488 Cambodian refugees residing in the United States. Five alternative conceptual models were compared. A model with four correlated factors reflecting symptoms of reexperiencing, avoidance, emotional numbing, and hyperarousal provided the best fit to these data. The avoidance and emotional numbing clusters demonstrated distinct associations with depression symptoms, providing some evidence of the construct validity of the four-factor solution. [ABSTRACT FROM AUTHOR]

The article discusses the risks of common settlement options in the United States. Attorneys should examine their responsibility to their clients. The clients must be provided with the necessary information to be able to make informed decisions for themselves. Clients who receive a recovery will confront challenges to preserve their assets from unwise spending, inflation, and escalating medical costs. Expert advice should be provided so that client assets are invested properly.

OBJECTIVE:: To delineate blood transfusion practices and outcomes in patients with major burn injury.CONTEXT:: Patients with major burn injury frequently require multiple blood transfusions; however, the effect of blood transfusion after major burn injury has had limited study.DESIGN:: Multicenter retrospective cohort analysis.SETTING:: Regional burn centers throughout the United States and Canada.PATIENT POPULATION:: Patients admitted to a participating burn center from January 1 through December 31, 2002, with acute burn injuries of ≥20% total body surface area.OUTCOMES MEASURED:: Outcome measurements included mortality, number of infections, length of stay, units of blood transfused in and out of the operating room, number of operations, and anticoagulant use.RESULTS:: A total of 21 burn centers contributed data on 666 patients; 79% of patients survived and received a mean of 14 units of packed red blood cells during their hospitalization. Mortality was related to patient age, total body surface area burn, inhalation injury, number of units of blood transfused outside the operating room, and total number of transfusions. The number of infections per patient increased with each unit of blood transfused (odds ratio, 1.13; p < .001). Patients on anticoagulation during hospitalization received more blood than patients not on anticoagulation (16.3 ± 1.5 vs. 12.3 ± 1.5, p < .001).CONCLUSIONS:: The number of transfusions received was associated with mortality and infectious episodes in patients with major burns even after factoring for indices of burn severity. The utilization of blood products in the treatment of major burn injury should be reserved for patients with a demonstrated physiologic need. [ABSTRACT FROM AUTHOR]

Presents information on numbers and legal status of recent Cuban and Haitian refugees. Summarizes presidential recommendations for the admission to the United States and resettlement of these refugees. (ST)

Hypothesis: Recent power shortages in California resulted in rolling blackouts and increased utility prices. Residents turned to alternative heating devices, such as space heaters, to decrease utility bills. Our hypothesis is that the incidence of heater-related injuries increased owing to the use of alternative heating methods during the power crisis. Design: Retrospective case-series database and medical record review of all burn admissions for the 4 months of November through February for the period 1998-2002. Setting: Regional pediatric and adult burn unit in northern California. Patients: Patients admitted during the study interval with burn injury. Main Outcome Measures: Parameters recorded included patient demographics, cause of burn, total body surface area burn, number of operative procedures, and hospital length of stay during each of the 4 months in the interval. Results: A total of 512 patients were admitted during all 4-month intervals. During the power crisis there were significant increases in the number of hospital admissions (151 in 2000-2001 vs 117 in 1998-1999, 124 in 1999-2000, and 152 in 2001-2002) and heater-related burn admissions (36 in 2000-2001 vs 25 in 1998-1999, 26 in 1999-2000, and 29 in 2001-2002). The percentage total body surface area burn (mean ± SEM, 24.0% ± 4.6% in 2000-2001 vs 16.5% in 1998-1999, 12.3% in 1999-2000, and 12.0% in 2001-2002), hospital length of stay (15.0 days in 2000-2001 vs 9.9 days in 1998-1999, 12.3 days in 1999-2000, and 7.0 days 2001-2002), and the number of operations (55 in 2000-2001 vs 7 in 1998-1999, 18 in 1999-2000, and 19 in 2001-2002) also increased during the crisis. Conclusions: The number of heater-related burn admissions, as well as their magnitude, increased during the energy crisis, resulting in increased resource use and health care costs. The economic stresses of the power shortage had societal costs that extended far beyond the price of electricity. [ABSTRACT FROM AUTHOR]