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Within the United States, 1 in 4 women and 1 in 10 men experience intimate partner violence (IPV): psychological aggression, sexual violence, physical violence, and/or stalking from an intimate partner. Although some studies highlight the complexity of post-IPV recovery, the role of communication in post-IPV recovery remains underexplored. This study employs Communication Theory of Identity (CTI) to analyze in-depth interviews with post-IPV adults. Analysis reveals how individuals negotiate post-IPV identity gaps between the personal-personal and personal-relational layers of identity. The forwarded concept of identity veiling explicates how IPV tactics cause the relational layer of identity to eclipse the personal layer in IPV relationships. Therefore, post-IPV recovery involves unveiling the personal layer of identity—communicatively (re)constructing self-image beyond the IPV relationship and the identity gaps it engendered. This study conceptualizes the role of violent communication in the construction of identity gaps and identity gap negotiation. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore and describe current trends in the augmentative and alternative communication (AAC) use and service delivery experiences of people with amyotrophic lateral sclerosis (PALS) in the U.S. Cross-sectional data were collected from 216 PALS via an anonymous online questionnaire in 2021. Over 70% of participants reported at least some detectable speech disturbance, and approximately half used aided communication during face-to-face interactions. Among respondents with severe speech impairment, over 90% reported using speech-generating devices, and just over half reported using low-tech AAC. Most participants had met with an SLP to discuss speech and communication, but varied in both timing of the initial intervention and frequency of ongoing intervention. Fewer than half reported that their family members or other important people had received education or support related to communication for PALS. Participants also shared their use of and experiences with telephone and video calls, access methods, mounting systems, word prediction and stored phrases, and message and voice banking. Results highlight the importance of early referral for AAC intervention, ongoing re-evaluation and treatment, involvement of communication partners and support for multimodal communication and adaptation to changing needs. Most people with amyotrophic lateral sclerosis (PALS) in this sample reported experiencing dysarthria, with 71.3% indicating at least some detectable speech disturbance (Revised ALS Functional Rating Scale [ALSFRS-R] speech rating ≤ 3) and 56.5% reporting reduced intelligibility (ALSFRS-R speech rating ≤ 2). Respondents used a wide variety of communication methods. Among respondents who were unable to meet their communication needs with speech alone, 84.6% used unaided methods (including speech), 52.3% used low-tech augmentative and alternative communication (AAC) and 90.8% used a speech-generating device. Service delivery improvements are needed to ensure timely, ongoing and comprehensive AAC education and intervention for PALS and their families. Communication over video calls (including virtual healthcare visits) is common among PALS and may be an important target for AAC intervention as the COVID-19 pandemic continues to limit in-person gatherings and appointments. [ABSTRACT FROM AUTHOR]

Psychology is a high burnout profession; however, little empirical research has examined the emotional labour (i.e., surface acting, deep acting, expression of naturally felt emotions) of psychologists who provide psychological therapy. The present study examined whether a relationship exists between emotional labour and wellbeing (operationalised as burnout and affective symptoms) in this sample, and whether individual or work-related factors moderate this relationship. 113 Australian psychologists who provide regular psychological therapy responded to an anonymous, online, cross-sectional survey. This survey collected information on demographic and workplace variables; it also contained measures of emotional labour and wellbeing. The results indicated that, at a bivariate level, surface acting was a significant predictor of adverse wellbeing; deep acting had no predictive qualities; and the expression of naturally felt emotions was a significant predictor of improved wellbeing. Surface acting appeared to be the most salient predictor, and its relationship to burnout was moderated by compensation type. Reported rates of burnout were high within our sample, and our findings suggest that the masking of emotions by psychologists (i.e., surface acting) may be a contributing factor to adverse wellbeing. These findings carry implications for psychological training and practice. What is already known about this topic: Psychologists work in emotion-eliciting environments, which can necessitate the regulation of their emotions. Across industries, burnout arises when demands exceed resources; for psychologists, this may include instances in which the emotional demands of their work exceed their capacity to regulate effectively. Emotional labour, or the regulation of emotions in the workplace, is a reliable predictor of adverse wellbeing in the general working population; however, there has been little empirical examination of emotional labour in psychologists. What this topic adds: Psychologists who provide therapy report high rates of burnout. Psychologists adopt each emotional labour strategy (surface acting, deep acting, expression of naturally felt emotions) at comparable rates to previously published rates for workers in other work domains. Surface acting is a salient predictor of burnout in psychologists, even when controlling for the engagement in deep acting or the expression of naturally felt emotions. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the association between cardiorespiratory fitness (CRF) and long-term survival in United States (US) Veterans undergoing CABG. We identified 14,550 US Veterans who underwent CABG at least six months after completing a symptom-limited exercise treadmill test (ETT) with no evidence of cardiovascular disease. During a mean follow-up period of 10.0 ± 5.4 years, 6502 (43.0%) died. To assess the association between CRF and risk of mortality, we formed the following five fitness categories based on peak workload achieved (metabolic equivalents or METs) prior to CABG: Least-Fit (4.3 ± 1.0 METs (n = 4722)), Low-Fit (6.8 ± 0.9 METs (n = 3788)), Moderate-Fit (8.3 ± 1.1 METs (n = 2608)), Fit (10.2 ± 0.8 METs (n = 2613)), and High-Fit (13.0 ± 1.5 METs (n = 819)). Cox proportional hazard models were used to calculate risk across CRF categories. The models were adjusted for age, body mass index, race, cardiovascular disease, percutaneous coronary intervention prior to ETT, cardiovascular medications, and cardiovascular disease risk factors. P-values < 0.05 using two-sided tests were considered statistically significant. The association between cardiorespiratory fitness and mortality was inverse and graded. For every 1-MET increase in exercise capacity, the mortality risk was 11% lower (HR = 0.89; CI: 0.88–0.90; p < 0.001). When compared to the Least-Fit category (referent), mortality risk was 22% lower in Low-Fit individuals (HR = 0.78; CI: 0.73–0.82; p < 0.001), 31% lower in Moderate-Fit individuals (HR = 0.69; CI: 0.64–0.74; p < 0.001), 52% lower in Fit individuals (HR = 0.48; CI: 0.44–0.52; p < 0.001), and 66% lower in High-Fit individuals (HR = 0.34; CI: 0.29–0.40; p < 0.001). Cardiorespiratory fitness is inversely and independently associated with long-term mortality after CABG in Veterans referred for exercise testing. [ABSTRACT FROM AUTHOR]

In the US, 3 rescue treatment options are approved for patients with seizure clusters (ie, acute repetitive seizures), which are intermittent increases of seizure activity. This narrative PubMed review of these 3 treatments examines newer intranasal options that are well suited for adolescent and adult patients who may desire a transition from rectal treatment. Diazepam rectal gel is indicated for patients ≥ 2 years, diazepam nasal spray for those ≥ 6 years, and midazolam nasal spray for those ≥ 12 years. Approvals for diazepam rectal gel and midazolam nasal spray were based on safety and efficacy comparisons with placebo. Approval for diazepam nasal spray was based on results from long-term safety and tolerability studies in addition to its comparable bioavailability to diazepam rectal gel, while also showing less interpatient variability. The safety profiles of diazepam rectal gel and nasal spray are similar, and the medications share safety, warning, and precaution labeling. Thus, patients ≥ 6 years could be introduced to intranasal diazepam, allowing for continuity of familiar treatment while improving access and comfort. Intranasal midazolam also has a well-characterized safety profile. A proxy for effectiveness is the number of seizure clusters that were treated with a single dose, and these differed in separate, noncomparative studies. The safety and effectiveness of diazepam nasal spray have been examined in multiple subpopulations, whereas patient/caregiver experiences with both approved intranasal formulations have been characterized. Users may prefer nasal administration because it is noninvasive and effective, and provides social advantages, comfort, ease of use, and less variability compared with rectal gel. Nasal sprays are portable and convenient for use in the community (school, work, travel), and self-administration was reported in one study, with patients as young as 11 years old self-administering diazepam nasal spray. These newer, intranasal rescue treatments for seizure clusters provide an alternative to the rectal route. Plain Language Summary: Some people with epilepsy may have seizure clusters, which are often defined as 2 or more seizures in a day that are not part of their normal seizure pattern. Rescue treatments approved in the United States are diazepam rectal gel, diazepam nasal spray, and midazolam nasal spray. These rescue drugs can help stop seizure clusters at home, school, or work. Diazepam rectal gel is for adults and children ages 2 years or older. To give a rectal dose, the caregiver must pull down the patient's underwear. Spraying nasal treatment into the nose may be less embarrassing. Because some patients may want to switch their treatment, we looked for articles about how to use these treatments and summarized what we found. Diazepam nasal spray is for patients ages 6 years or older and midazolam nasal spray is for patients 12 years or older. Diazepam rectal gel and nasal spray use the same drug, and dosing is based on patient age and weight. Midazolam nasal spray uses a different drug, and everyone uses the same dose. Some drugs may be more likely than others to need a second dose for a seizure. Patients and caregivers (care partners) felt that diazepam nasal spray was easier to use than rectal gel. They were also more comfortable using diazepam nasal spray in public. Patients as young as 11 years have used diazepam nasal spray by themselves. In all, patients may prefer nasal treatment and now have options to change from rectal treatment of seizure clusters. [ABSTRACT FROM AUTHOR]

Organizational identification underpins a range of important outcomes in the workplace, including workers' well‐being. Drawing on the social identity approach to health (SIAH), here we explore whether certain organizational forms—specifically, organizational decentralization—can boost organizational identification and, in this way, employee well‐being. We test this possibility in four high‐powered samples of workers in the UK, US and Italy (N total = 1960). Results confirm that workers are more likely to identify with an organization when they perceive power to be decentralized. Importantly, we find the expected indirect effects between increased decentralization perceptions and ratings of improved well‐being (including job satisfaction, work engagement and reduced burnout) through organizational identification. These results were consistent across samples, proving the generality of the findings across different cultural contexts. Empirical and practical implications of shared decision‐making power to increase workers' well‐being are discussed. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement. [ABSTRACT FROM AUTHOR]

This study investigated the impacts of the COVID-19 pandemic on recent arts graduates from three universities in the United States. We present evidence of shifting definitions of adaptability, resilience, transformation, excellence, and success in arts training. Based on surveys and interviews, it reinforces findings from the Strategic National Arts Alumni Project (SNAAP). The of experiences of recent arts and arts administration graduates affirms some current pedagogies and suggests others. We synthesize these findings to amplify some models, propose new ones, rebalance traditional outcomes toward a social mission, and consider the need for an expanded notion of excellence in the arts. [ABSTRACT FROM AUTHOR]

The author reflects on the care economy in the healthcare sector like disability care, personal care, and education as a catalyst for inclusive and sustainability growth. Other topics include how the care economy affects employer-employee relations, as well as how a robust care economy fosters gender parity, workforce participation, and social cohesion.

BACKGROUND: Surgical patients with perioperative coronavirus disease 19 (COVID-19) infection experience higher rates of adverse events than those without COVID-19, which may lead to imprecision in hospital-level quality assessment. Our objectives were to quantify differences in COVID-19--associated adverse events in a large national sample and examine distortions in surgical quality benchmarking if COVID-19 status is not considered. STUDY DESIGN: Data included 793,280 patient records from the American College of Surgeons NSQIP from April 1, 2020, to March 31, 2021. Models predicting 30-day mortality, morbidity, pneumonia, and ventilator dependency greater than 48 hours, and unplanned intubation were constructed. Risk adjustment variables were selected for these models from standard NSQIP predictors and perioperative COVID-19 status. RESULTS: A total of 5,878 (0.66%) had preoperative COVID-19, and 5,215 (0.58%) had postoperative COVID-19. COVID-19 rates demonstrated some consistency across hospitals (median preoperative 0.84%, interquartile range 0.14% to 0.84%; median postoperative 0.50%, interquartile range 0.24% to 0.78%). Postoperative COVID-19 was always associated with increased adverse events. For postoperative COVID-19 among all cases, there was nearly a 6-fold increase in mortality (1.07% to 6.37%) and15-fold increase in pneumonia (0.92% to 13.57%), excluding the diagnosis of COVID-19 itself. The effects of preoperative COVID-19 were less consistent. Inclusion of COVID-19 in risk-adjustment models had minimal effects on surgical quality assessments. CONCLUSIONS: Perioperative COVID-19 was associated with a dramatic increase in adverse events. However, quality benchmarking was minimally affected. This may be the result of low overall COVID- 19 rates or balance in rates established across hospitals during the 1-year observational period. There remains limited evidence for restructuring ACS NSQIP risk-adjustment for the time-limited effects of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Australian rural and remote areas are faced with the double burden of an ageing population paired with inequitable access to health resources due to the paradigm of major city centred health care. This complicates fall management within this space. Paramedics are a registered health profession, which provides mobile, equitable health care. However, this resource is not being effectively utilised in rural and remote areas where primary care access barriers may cause patient needs to go unmet. Objective: To describe the existing literature and describe the international scope of current paramedicine practice in the out‐of‐hospital management of falls amongst older adults in rural and remote settings. Design: Joanna Briggs Institute scoping review methodology was employed. CINAHL (EBSCO), MEDLINE (Ovid), EMBASE (Ovid), SCOPUS (Elsevier), Google Scholar and These Global were searched and Australian, New Zealand and the UK ambulance service guidelines were sought. Findings: Two records met inclusion criteria. Currently, rural and remote paramedic fall management involves preventative health promotion through patient education, population‐based screening and referrals. Discussion: The use of paramedics to screen at‐risk populations and refer is vital, as many rural adults had screened positive to fall risks and other unmet needs. There is poor recollection of physically printed education material and low acceptance of further in‐home assessments following paramedic departure. Conclusion: This scoping review has highlighted a significant knowledge gap on this topic. Further research is needed to effectively utilise paramedicine within areas where access to primary care is not possible to achieve downstream, risk reducing care in the home. [ABSTRACT FROM AUTHOR]

New gene editing techniques, such as CRISPR‐Cas9, have created the potential for rapid development of new gene‐edited food (GEF) products. Unlike genetically modified organism foods, there is limited research and literature on U.S. public opinions about GEFs. We address this knowledge gap by examining how crop‐based GEF adoption is linked to public trust in institutions and values using the Theory of Planned Behavior. We employ ordinal regression models to predict adoption intentions (direct benefits, acceptability, willingness to eat, and labeling) using a unique and nationally representative survey of n = 2,000 adults in the United States. We find that adoption hinges on public trust in institutions overseeing GEF development, especially trust in university scientists. The 29 percent of Americans likely to adopt GEFs highly trust government food regulators and the biotech industry. A nearly equal number of likely non‐adopters distrust current regulatory systems in favor of consumer and environmental advocacy groups. However, most Americans (41 percent) are uncertain about GEF adoption and whom to trust. Although 75 percent of Americans want GEFs labeled, few trust government agencies who have authority to issue labels. Our findings suggest public trust in GEFs and labels can only be obtained by tripartite oversight by universities, advocacy groups, and government food regulators. [ABSTRACT FROM AUTHOR]

1) Gain insight into PA prescription by United States-based physical therapists treating patients 50 years and older, and 2) Explore the contextual factors that impact PA prescription. We integrated ethnographic study data, including a questionnaire, observations, and semi-structured interviews. Our nine participants with 24.7 years (SD= 11.6) of clinical experience completed frequent PA assessments, but PA prescription was inconsistent. The following themes helped explain the participants' clinical decisions: 1) treatment prioritization; 2) physical therapists' intentions of addressing PA; and 3) contextual factors that impact treatment and treatment prioritization (e.g., experience, beliefs, concerns related to PA prescription, and work environment). Most participants did not address PA among adults 50 years and older. Due to the importance of performing regular PA, it is vital for physical therapists to reflect on their PA prescription. Organizations and health service researchers need to implement strategies that address the PA prescription barriers. [ABSTRACT FROM AUTHOR]

Organized in the US in 1917, dietetics emerged from the discipline of home economics as an "acceptable" area of study for women. Since its inception, dietetics has lacked diversity; most dietetics professionals identify as white, cisgender, heterosexual, middle to upper-middle-class women. In the supervised practice setting, interns are expected to dress "professionally" and follow health/safety protocols. Given the field's history, it is reasonable to suspect that dress codes—rules/expectations regarding what employees/participants can/cannot wear—for dietetics programs may be problematic. To explore this, we conducted a discourse analysis using a Foucauldian feminist approach, drawing on the notion of governmentality. Eighty-five dietetics dress codes, supplemented with survey questions, from US-based accredited dietetics education programs were analyzed. Three primary discursive effects were identified: "Invisibilizing" informs dietetics students/interns how to be professional and modest. "Protecting" highlights dress to promote health and safety. "Normalizing" privileges conforming to thin, cisgender, white European women of higher SES. These findings show how the dress codes reify a "model" dietitian and privilege/oppress/discipline some bodies over others, supporting criticisms of dietetics dress codes as discriminatory and oppressing/privileging select societal groups. Recommendations are provided to address biases and prevent dress codes from negatively impacting diversity/inclusion in the profession. [ABSTRACT FROM AUTHOR]

This article explores West Virginia's history with the complex interactions between primary care services, community engagement, and the role of community health workers (CHWs). Using archival research and oral histories, this article looks at four historical time periods marked by the Great Depression, the War on Poverty, Community Health Centers, and the Affordable Care Act. Key findings include the need for sustained investment in outreach by the primary care system and parallel engagement of communities. Outreach-centered roles more recently held by CHWs and performed by other primary care workers improve engagement and health outcomes when they are led from and adapted to each local context. Flexible and inclusive policy environments that aim to provide evidence-based services in rural communities can enable CHW programs to provide continuous care and iteratively improve their effectiveness. These findings can inform approaches for the primary care system to engage communities and the use of CHWs in the state and in other rural, low-income populations in the United States. [ABSTRACT FROM AUTHOR]

The article discusses the court case Clean Air Council v. U.S. Steel related to U.S. Steel's violation of the Clean Air Act (CAA) permits and regulations. Topics include the responsibility of facilities that release hazardous substances to notify the federal government under threat of penalty as required under the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), the CERCLA exemptions on mandatory reporting, and details of the U.S. Third Circuit ruling on the case.

Objective: Stimulant use among college students is a significant public health concern due to its consequential effects. Given that many students reportedly use prescription stimulants for academic purposes, empirical investigations are needed to identify those students at risk for prescription stimulant misuse (PSM). The purpose of the current study was to examine the role of coping styles on the association between prescription stimulant use and related consequences. We hypothesized that more maladaptive (vs. adaptive) coping strategies would mediate this association, particularly for underclassmen (freshmen/sophomores) and men. Method: Participants were n = 787 college students across seven universities in the United States who completed an online survey assessing substance use and coping behaviors. Prior to hypothesis testing, we conducted factor analysis on the COPE measure and found support for a three-factor solution, which we named maladaptive coping, adaptive coping, and supportive coping. Results: Prescription stimulant use was positively related to stimulant-related negative consequences. Multiple mediation analyses indicated that the maladaptive coping factor partially mediated this direct association. Multi-group analyses revealed that maladaptive coping style was a significant mediator for college women in the sample, but not men. Conclusions: These results scratch the surface of the relationship between coping and risky stimulant use among college students and imply that the building of coping strategies is a useful target in identifying at-risk students. [ABSTRACT FROM AUTHOR]

Most medical schools and primary care residency programs do not teach proper oral examination skills. Despite the existence of proven national oral health curricula for medical professionals, many medical trainees and graduates are ill-equipped to identify oral cancers, make proper referrals, avoid unnecessary referrals, or help patients focus on oral disease prevention. This commentary on a case suggests the importance of educating clinicians to promote and evaluate patients' oral health and proposes curricula for and reasonable scope of such training. [ABSTRACT FROM AUTHOR]

Transition to practice programs for nurse practitioners and physician assistants are gaining popularity and becoming more specialized. As these providers seek opportunities to strengthen their clinical skills and bridge the gap from school to practice, it is important to recognize the benefits and barriers of such programs. In this article, The George Washington University Hospital shares its experience in managing a transition to practice program for trauma and critical care. [ABSTRACT FROM AUTHOR]

An entrenched assumption in the mental health field is that if left "untreated" the aftermath of sexual assault will inevitably lead to some diagnosable form of emotional distress. This assumption has focused the search for pathology on individual survivors rather than systems and led to societal pressure for medical or psychotherapeutic treatment following unwanted sexual experiences in the United States and globally. Humanistic psychology is grounded in an existential phenomenological approach that privileges agency and a sociopolitical context of lived experience. As such, it has great overlap with the social justice mission of liberation psychology and is well equipped to respond to sexual assault survivors and the oppressive and patriarchal systems that perpetuate gender-based violence. This article explores the rising use of neoliberal medicalized frameworks to respond to sexual assault in therapy, analyzing both positive and negative aspects of medicalization. Implications for responses to the global prevalence of sexual violence are discussed. Suggestions for alternative epistemic and therapeutic approaches that can be used by humanistic psychologists and that aim to enhance an appreciation for the context of survivor's experiences are provided. [ABSTRACT FROM AUTHOR]

The objective of this study was to assess the association between United States county-level COVID-19 mortality and changes in presidential voting between 2016 and 2020. The study design is a county-level ecological study. We analysed county-level population-weighted differences in partisan vote change, voter turnout and sociodemographic and health status characteristics across pre-election COVID-19 mortality quartiles. We estimated a population-weighted linear regression of the 2020–2016 Democratic vote change testing the significance of differences between quartiles of COVID-19 mortality, controlling for other county characteristics. The overall change in the 2020–2016 Democratic vote was +2.9% but ranged from a +4.3% increase in the lowest mortality quartile counties to +0.9% in the highest mortality quartile counties. Change in turnout ranged from +9.1% in the lowest mortality counties to only +6.2% in highest mortality counties. In regression estimates, the highest mortality quartile was associated with a −1.26% change in the Democratic 2020–2016 vote compared with the lowest quartile (P < 0.001). Higher county-level COVID-19 mortality was associated with smaller increases in Democratic vote share in 2020 compared with 2016. Possible explanations to be explored in future research could include fear of in-person voting in heavily Democratic, high-mortality counties, fear of the economic effects of perceived Democratic support for tighter lockdowns and stay-at-home orders and general exhaustion that lowered political participation in hard-hit counties. [ABSTRACT FROM AUTHOR]

Study Question: Does having a male co-twin, older brothers, or sons lead to an increased probability of persistent male microchimerism in female members of twin pedigrees?Summary Answer: The presence of a male co-twin did not increase risk of male microchimerism and the prevalence of male microchimerism was not explained by having male offspring or by having an older brother.What Is Known Already: Microchimerism describes the presence of cells within an organism that originate from another zygote and is commonly described as resulting from pregnancy in placental mammals. It is associated with diseases with a female predilection including autoimmune diseases and pregnancy-related complications. However, microchimerism also occurs in nulliparous women; signifying gaps in the understanding of risk factors contributing to persistent microchimerism and the origin of the minor cell population.Study Design, Size, Duration: This cross-sectional study composed of 446 adult female participants of the Netherlands Twin Register (NTR).Participants/materials, Setting, Methods: Participants included in the study were female monozygotic (MZ) twins, female dizygotic same-sex twins and females of dizygotic opposite-sex twin pairs, along with the mothers and sisters of these twins. Peripheral blood samples collected from adult female participants underwent DNA extraction and were biobanked prior to the study. To detect the presence of male-origin microchimerism, DNA samples were tested for the relative quantity of male specific Y chromosome gene DYS14 compared to a common β-globin gene using a highly sensitive quantitative PCR assay.Main Results and the Role Of Chance: We observed a large number of women (26.9%) having detectable male microchimerism in their peripheral blood samples. The presence of a male co-twin did not increase risk of male microchimerism (odds ratio (OR) = 1.23: SE 0.40, P = 0.61) and the prevalence of male microchimerism was not explained by having male offspring (OR 0.90: SE 0.19, P = 0.63) or by having an older brother (OR = 1.46: SE 0.32, P = 0.09). The resemblance (correlation) for the presence of microchimerism was similar (P = 0.66) in MZ pairs (0.27; SE 0.37) and in first-degree relatives (0.091; SE 0.092). However, age had a positive relationship with the presence of male microchimerism (P = 0.02).Limitations, Reasons For Caution: After stratifying for variables of interest, some participant groups resulted in a low numbers of subjects. We investigated microchimerism in peripheral blood due to the proposed mechanism of cell acquisition via transplacental blood exchange; however, this does not represent global chimerism in the individual and microchimerism may localize to numerous other tissues.Wider Implications Of the Findings: Immune regulation during pregnancy is known to mitigate allosensitization and support tolerance to non-inherited antigens found on donor cells. While unable to identify a specific source that promotes microchimerism prevalence within pedigrees, this study points to the underlying complexities of natural microchimerism in the general population. These findings support previous studies which have identified the presence of male microchimerism among women with no history of pregnancy, suggesting alternative sources of microchimerism. The association of detectable male microchimerism with age is suggestive of additional factors including time, molecular characteristics and environment playing a critical role in the prevalence of persistent microchimerism. The present study necessitates investigation into the molecular underpinnings of natural chimerism to provide insight into women's health, transplant medicine and immunology.Study Funding/competing Interest(s): This work is funded by Royal Netherlands Academy of Science Professor Award (PAH/6635 to D.I.B.); The Netherlands Organisation for Health Research and Development (ZonMw)-Genotype/phenotype database for behavior genetic and genetic epidemiological studies (ZonMw 911-09-032); Biobanking and Biomolecular Research Infrastructure (BBMRI-NL, 184.021.007; 184.033.111); The Netherlands Organisation for Scientific Research (NWO)-Netherlands Twin Registry Repository (NWO-Groot 480-15-001/674); the National Institutes of Health-The Rutgers University Cell and DNA Repository cooperative agreement (NIMH U24 MH068457-06), Grand Opportunity grants Integration of genomics and transcriptomics in normal twins and major depression (NIMH 1RC2 MH089951-01), and Developmental trajectories of psychopathology (NIMH 1RC2 MH089995); and European Research Council-Genetics of Mental Illness (ERC 230374). C.B.L. declares a competing interest as editor-in-chief of Human Reproduction and his department receives unrestricted research grants from Ferring, Merck and Guerbet. All remaining authors have no conflict-of-interest to declare in regards to this work.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

To predict whether the COVID‐19 pandemic and transplant center responses could have resulted in preventable deaths, we analyzed registry information of the US end‐stage renal disease (ESRD) patient population awaiting kidney transplantation. Data were from the Organ Procurement and Transplantation Network (OPTN), the US Centers for Disease Control and Prevention, and the United States Renal Data System. Based on 2019 OPTN reports, annualized reduction in kidney transplantation of 25%–100% could result in excess deaths of wait‐listed (deceased donor) transplant candidates from 84 to 337 and living donor candidate excess deaths from 35 to 141 (total 119–478 potentially preventable deaths of transplant candidates). Changes in transplant activity due to COVID‐19 varied with some centers shutting down while others simply heeded known or suspected pandemic risks. Understanding potential excess mortality for ESRD transplant candidates when circumstances compel curtailment of transplant activity may inform policy and procedural aspects of organ transplant systems allowing ways to best inform patients and families as to potential risks in shuttering organ transplant activity. Considering that more than 700 000 Americans have ESRD with 100 000 awaiting a kidney transplant, our highest annual estimate of 478 excess total deaths from postponing kidney transplantation seems modest. [ABSTRACT FROM AUTHOR]

Sewers can become hydraulically overburdened during high‐intensity precipitation resulting in untreated water entering receiving streams. Combined (CSOs) and sanitary sewer overflows (SSOs) cause adverse public health and environmental impacts as well as management challenges for many wastewater utilities. This novel review presents information regarding wet weather flow regulation, impacts, and current management methods, and offers ideas for future approaches in the United States. Currently, storage followed by conventional municipal water reclamation facility treatment after precipitation events is often employed. Stand‐alone alternative technologies include high‐rate solids removal, rapid disinfection, filtration, and green infrastructure. However, most current stand‐alone approaches do not address soluble BOD5 or emerging contaminants in stormwater and wastewater. As the needs for wet weather flow management change, future approaches should include a goal of zero overflows and achieve effluent quality as good as or better than conventional treatment. To help achieve zero overflows and complete treatment, the "peaker facility" concept is proposed. The peaker facility often remains idle but treats excess flow when needed. Considering the challenges of remaining idle for long periods, starting up quickly, and handling high flows, chemical oxidation may be an applicable peaker facility component. However, more research and development are needed to determine best practices. Practitioner points: Combined (CSO) and sanitary sewer overflows (SSOs) pose both environmental and public health risks as untreated water is discharged into lakes and rivers during high‐intensity rain events.Current stand‐alone approaches for managing or treating CSOs focus on particulate BOD/COD and solids removal, and do not typically address soluble BOD or emerging contaminants in stormwater and wastewater (including pathogens).New wet weather policies and regulations encourage more holistic approaches by wastewater utilities, and future approaches should include a zero‐overflow goal for all CSOs and SSOs.To help achieve zero overflows, the concept of the "peaker facility" is proposed.Chemical oxidation may be an applicable component of peaker facilities for its short detention time and ability to remove, oxidize, or inactive water impairment‐causing contaminants. [ABSTRACT FROM AUTHOR]

Background: Reslizumab, an anti-IL-5 monoclonal antibody, is indicated as add-on maintenance treatment for adults with severe eosinophilic asthma.Research Question: What are the real-world outcomes associated with reslizumab use in patients with severe eosinophilic asthma in a US clinical practice?Study Design and Methods: In this retrospective study, patient-level data from adults treated with reslizumab were obtained from center- and panel-based medical chart reviews. Eligible patients had available medical records and treatment history for ≥ 6 months before initiation of reslizumab treatment (index date) to ≥ 7 months after reslizumab initiation. The primary outcome was response to reslizumab treatment, based on clinical expert predefined definitions of response. Other outcomes included clinical asthma exacerbations (CAEs), use of maintenance oral corticosteroids (OCS), FEV1 percent predicted, Asthma Control Test (ACT) score, and health-care resource use (HRU).Results: Medical charts were obtained for 215 patients. Most patients (58.6%) showed an excellent response, 16.3% showed a clinically meaningful response, 21.9% showed a partial response, and 3.3% were nonresponders or treatment failures. A significant reduction was observed in the proportion of patients experiencing a CAE in a 6-month period (from 86.0% to 40.5%; P < .001) and in the mean number of CAEs per patient (2.84 [SD, 2.41] vs 0.94 [SD, 1.86]) after reslizumab initiation. Improvements were observed in FEV1 percent predicted (65.1% [SD, 20.5%] vs 73.1% [SD, 23.1%]; P < .001) and in ACT scores (13.8 [SD, 4.2] vs 18.6 [SD, 4.0]; P < .001) before to after reslizumab initiation. Among patients using maintenance OCS at baseline, more than half discontinued use of these by approximately 10 months after reslizumab initiation. Significant reductions in asthma-related HRU were observed after reslizumab initiation.Interpretation: In clinical practice, reslizumab may have been initiated in response to heavy symptom burden and CAEs. Reslizumab was associated with improved clinical and patient-reported outcomes and significant reductions in asthma-related HRU. [ABSTRACT FROM AUTHOR]

Background: Rates for recurrent coronary heart disease (CHD) events have declined in the United States. However, few studies have assessed whether this decline has been similar among women and men.Methods: Data were used from 770 408 US women and 700 477 US men <65 years of age with commercial health insurance through MarketScan and ≥66 years of age with government health insurance through Medicare who had a myocardial infarction (MI) hospitalization between 2008 and 2017. Women and men were followed up for recurrent MI, recurrent CHD events (ie, recurrent MI or coronary revascularization), heart failure hospitalization, and all-cause mortality (Medicare only) in the 365 days after MI.Results: From 2008 to 2017, age-standardized recurrent MI rates per 1000 person-years decreased from 89.2 to 72.3 in women and from 94.2 to 81.3 in men (multivariable-adjusted P interaction by sex <0.001). Recurrent CHD event rates decreased from 166.3 to 133.3 in women and from 198.1 to 176.8 in men (P interaction <0.001). Heart failure hospitalization rates decreased from 177.4 to 158.1 in women and from 162.9 to 156.1 in men (P interaction=0.001). All-cause mortality rates decreased from 403.2 to 389.5 in women and from 436.1 to 417.9 in men (P interaction=0.82). In 2017, the multivariable-adjusted rate ratios comparing women with men were 0.90 (95% CI, 0.86-0.93) for recurrent MI, 0.80 (95% CI, 0.78-0.82) for recurrent CHD events, 0.99 (95% CI, 0.96-1.01) for heart failure hospitalization, and 0.82 (95% CI, 0.80-0.83) for all-cause mortality.Conclusions: Rates of recurrent MI, recurrent CHD events, heart failure hospitalization, and mortality in the first year after an MI declined considerably between 2008 and 2017 in both men and women, with proportionally greater reductions for women than men. However, rates remain very high, and rates of recurrent MI, recurrent CHD events, and death continue to be higher among men than women. [ABSTRACT FROM AUTHOR]

The development of inclusive STEM high schools that have no academic admission requirements has been a national goal in the United States. However, there is no umbrella organization that gives guidance for structuring such schools. The purpose of this study was to develop and validate a self‐assessment using critical components of successful inclusive STEM high schools for school personnel and educational researchers who wish to better understand their STEM programs and identify areas of strength. A multi‐phase methodology was employed. In the first step, eight in‐depth case studies were generated, and common themes were identified. In the second step, inventory items were iteratively generated and tested for reliability and validity, using a sample of 78 teachers and researchers in five schools. In the third step, the inventory was field‐tested in a single school. The OSPRI inventory demonstrates strong content validity and reliability. Teachers and researchers generally responded similarly, although some differences emerged that are indicative of their respective experiences and perspectives. School stakeholders and educational researchers can use this inventory, in whole or in part, to better understand their STEM programs and establish a future agenda that best capitalizes on their strengths. [ABSTRACT FROM AUTHOR]

In this article, 2 women investigators distill the complex process of obtaining National Institutes of Health K series funding into 5 major steps and highlight lessons that they learned in their experience with the process. [ABSTRACT FROM AUTHOR]

An editorial is presented on protests and support of the U.S. and Europe to protestors in Hong Kong. Topics include the demand for democracy in the state and removal of communism; that protestors are demanding assistance from western nations in relation to the protests; and that Hong Kong people waved United States flags in an apparent request for American aid.

Objective: The use of equine movement as a therapy tool in a plan of care, or hippotherapy, has grown considerably over the past three decades. However, there is little evidence of safety rates and related practice patterns to guide key stakeholders such as clients, therapists, the health care team, and third-party payers. The purpose of this article is to describe the safety and practice patterns of contemporary use of hippotherapy. Design: A survey was distributed to occupational therapy (OT), physical therapy (PT), and speech-language pathology clinicians who incorporate hippotherapy into their practice. The survey included questions about clinicians' practice patterns, safety procedures, and rates of safety incidents. Results: Results indicate that hippotherapy is most often used by PT and OT clinicians for pediatric clients. Use of hippotherapy varies by geographic location, and frequency and duration vary widely. Clinicians most often contract their services to a program that provides a facility and horses. Recommended safety practices are widely adopted, and rates of safety incidents requiring basic first aid (0.05% of sessions) or off-site care (0.01% of sessions) are low. Emergency dismounts are frequently practiced and often effective in preventing an incident. Conclusions: Although there are inherent risks to incorporating horses into a therapeutic plan of care, these risks appear to be well managed by recommended safety practices. Results of this study can (1) help clinicians to make informed decisions regarding practice and safety procedures, (2) provide evidence of safety practices and incident rates to clients, members of the health care team, and third-party payers, and (3) maximize safety for clients who participate in hippotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Use of e-cigarettes among never-smokers has substantially increased; yet there are few descriptions of the consequences of such use. We assessed whether adult never-smokers can have withdrawal from cessation of e-cigarettes.Methods: In an un-blinded pre-post clinical trial, 30 never-smoker daily e-cigarette users used their own nicotine-containing e-cigarette for 7 days followed by 6 days of biologically confirmed abstinence. Participants monitored symptoms of nicotine withdrawal nightly via an Interactive Voice Response system. They attended three lab visits/week to provide expired carbon monoxide and urine samples to determine compliance.Findings: Abstinence increased all the DSM5 symptoms of tobacco withdrawal and this occurred in the majority of participants. The increase in severity of withdrawal was small and rarely impaired functioning.Conclusions: Our finding suggests that withdrawal symptoms can occur in never-smokers who stop e-cigarettes abruptly. However, the severity of withdrawal appears to be small and may not be of clinical or regulatory significance. Although our sample size was small and thus replication tests of our results are indicated, it may be prudent to warn never-smokers that withdrawal symptoms may occur.Implications: This study indicates that withdrawal symptoms can occur in never-smokers who are daily e-cigarette users. However, the severity of withdrawal from e-cigarette abstinence in never-smokers appears to be small and may not be of clinical or regulatory significance. Given our small sample size, replication of our results is warranted. Nevertheless, it might be prudent to warn never-smokers of addiction to e-cigarettes.Clinical Trial Registration = NCT02825459. [ABSTRACT FROM AUTHOR]

Introduction: The major aim of this study was to test whether abstinence from e-cigarettes causes withdrawal symptoms in former smokers.Methods: We conducted an unblinded, within-participants, pre-post clinical trial in which 109 former smokers who were current daily electronic cigarette (e-cigarette) users used their own e-cigarette for 7 days followed by 6 days of biologically confirmed abstinence engendered via an escalating contingency payment system. Participants monitored symptoms of nicotine withdrawal daily via an Interactive Voice Response system. They also attended three laboratory visits per week for carbon monoxide and cotinine testing to verify abstinence.Results: Half of participants completely abstained for a week. All the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) tobacco withdrawal symptoms, craving for e-cigarettes, craving for tobacco cigarettes, and the four possible new withdrawal symptoms (anhedonia, impulsivity, mood swings, and positive affect) increased during abstinence. Weight increased and heart rate decreased with abstinence. Symptoms showed the prototypical inverted U time pattern of a withdrawal state. The magnitude of withdrawal appeared to be somewhat less than that in a prior study of abstinent daily tobacco cigarette smokers. More severe withdrawal on the first 2 days of abstinence did not predict abstinence on the last day of the study.Conclusions: Former smokers who are daily e-cigarette users transfer physical dependence on tobacco cigarettes to dependence on e-cigarettes. The severity of withdrawal from e-cigarettes appears to be only somewhat less than that from daily tobacco cigarette use. Replication tests that include placebo controls, testing for pharmacological specificity, and including never-smokers, non-daily e-cigarette users and dual users are indicated.Implications: Our results indicate e-cigarettes can maintain physical dependence. This adverse effect should be included in any risk vs. benefit calculation. Also, potential and current e-cigarette users should be informed that abrupt cessation of e-cigarettes can cause withdrawal symptoms.Trial Registration: NCT02825459. [ABSTRACT FROM AUTHOR]

The Distance Library Services Conference was founded in 1982 by the librarians of the Off-Campus Library Services department at Central Michigan University. From its inception through its 18th conference in 2018, Central Michigan University planned and administered this conference for the benefit of librarians serving distance learners and faculty at their institutions. This article discusses the founding of the Distance Library Services Conference and its role as the library profession's preeminent forum for the exchange of ideas on the topic of distance librarianship. [ABSTRACT FROM AUTHOR]

As the immigrant and refugee population continues to increase in the United States, healthcare providers need to be aware of Adverse Childhood Experiences (ACEs) these populations may have endured, and the potential health effects of these events. ACE research has been conducted with predominantly highly-educated, older Caucasians living in high-income countries which limits generalizability. A systematic review examined ACE prevalence and outcomes in persons living in poor, low-, and middle-income nations, often the home countries of U.S. immigrants and refugees. Fourteen studies conducted in 17 nations were included. Two main ACE measures were used. Prevalence of reporting at least one ACE ranged from 1.9% (Lebanon) to 80% (Saudi Arabia). Analysis established a graded dose–response, with increases in ACEs associated with increased risky behavior and negative health outcomes across all countries. Results reveal immigrants and refugees within the U.S. need to be evaluated for ACE exposure. [ABSTRACT FROM AUTHOR]

President Trump campaigned on "making America great again" through trade and immigration restrictions. I argue that it is difficult for policymakers to restrict both trade and immigration because of trade's effects on business support for immigration. When trade is restricted, more low-skill intensive goods are made in the US, leading to more demand for low-skill immigration from businesses. As businesses are relatively powerful, we should expect immigration to open. Conversely, when trade opens, fewer low-skill intensive goods are made in the US, leading to the closure of the firms that produce these goods. This reduces demand for low-skill labor and, with it, the demand for low-skill immigration. As business demand for immigration recedes, policymakers restrict immigration to appease anti-immigrant groups. Using data on immigration and trade in the US, I show that this relationship has held over US history. At the end of the article I hypothesize several reasons why Trump's tariffs are not leading to more demand for immigration due to their limited effects on trade and the job market. [ABSTRACT FROM AUTHOR]

Bee diversity is declining in agricultural landscapes, altering pollination services that may support or enhance crop yields. Pollination services provided by wild bees are often limited to field margins adjacent to natural habitats, but methods to increase pollinators and their ecosystem services within field interiors remain elusive. Evidence is growing that wild bees enhance yields of flowering crops, including soybean (Glycine max (L.) Merrill). We tested responses of bee communities and soybean yield following pollinator exclosure and nesting manipulation experiments within production areas of the United States. We found that pollinator exclosures resulted in lower seed yield of soybean plants, and providing nesting substrate resulted in a yield increase as well as increases in ground-nesting bees. We provide evidence for soybean-associated bees and suggest these species may benefit from supplemental nesting substrate within production areas and increase soybean yields. [ABSTRACT FROM AUTHOR]

The history of education for African Americans in the United States is one of struggle largely due to laws that forbade the education of enslaved Africans. Resultingly, education exists in a broader system of oppression. Historically, school desegregation displaced many Black teachers and administrators and ultimately forced Black professionals into other fields out of fear of limited employment opportunities in education. In contrast, currently, while the majority of school-aged children are people of color, the vast majority of school leaders and administrators are White. This essay examines the robust body of literature that details the effects of the Brown decision. In addition to a careful review of Brown literature, the literature on urban education (undertaken because of the numbers of Black school leaders and Black children in those contexts) is examined as well. This literature is analyzed to understand the extant far-reaching and deep-seated consequences of the Brown decision. Desegregation closed Black schools, not White ones, and disintegrated the impact of Black educators on their students and the communities they served. The effects of this decision have significantly altered the course of education for Black educators and Black children. [ABSTRACT FROM AUTHOR]

The Drexel University Center for Public Health Readiness and Communication developed a quantitative public health risk assessment tool that has been used in Pennsylvania and across the United States. The tool assesses hazard impacts on health care and public health metrics and incorporates the planning needs of at-risk populations. The flexible platform using Microsoft Excel allows planners to customize hazard assessment and use jurisdiction-specific data. Findings from the risk assessment can guide planning and evaluate preparedness progress over time. [ABSTRACT FROM AUTHOR]

Objectives. To examine associations of county-level demographic, socioeconomic, and labor market characteristics on overall drug mortality rates and specific classes of opioid mortality. Methods. We used National Vital Statistics System mortality data (2002–2004 and 2014–2016) and county-level US Census data. We examined associations between several census variables and drug deaths for 2014 to 2016. We then identified specific classes of counties characterized by different levels and rates of growth in mortality from specific opioid types between 2002 to 2004 and 2014 to 2016. We ran multivariate and multivariable regression models to predict probabilities of membership in each "opioid mortality class" on the basis of county-level census measures. Results. Drug mortality rates overall are higher in counties characterized by more economic disadvantage, more blue-collar and service employment, and higher opioid-prescribing rates. High rates of prescription opioid overdoses and overdoses involving both prescription and synthetic opioids cluster in more economically disadvantaged counties with larger concentrations of service industry workers. High heroin and "syndemic" opioid mortality counties (high rates across all major opioid types) are more urban, have larger concentrations of professional workers, and are less economically disadvantaged. Syndemic opioid counties also have greater concentrations of blue-collar workers. Conclusions. Census data are essential tools for understanding the importance of place-level characteristics on opioid mortality. Public Health Implications. National opioid policy strategies cannot be assumed universally applicable. In addition to national policies to combat the opioid and larger drug crises, emphasis should be on developing locally and regionally tailored interventions, with attention to place-based structural economic and social characteristics. [ABSTRACT FROM AUTHOR]

The article offers information on the National Call to Action (NCTA) initiative led by Dr. Chadwick to end child abuse and neglect in the United States. Topics include the formation and goals of the NCTA, the long-term commitment required to achieve these goals, and the scholarly work inspired by Dr. Chadwick's vision.

Examines library consortia in the U.S. Importance of library consortia; Discontents on consortia and consortial activities; Ways to address the discontents.

Talks about the issue of possible national digital repositories in the U.S. Definitional aspects of digital repositories; Examples of institutional digital repositories; Examples of consortial digital repositories; Arguments in favor of consortial digital repositories; Arguments against consortial digital repositories.

Presents the urban changes in California. Implication of the growing population and periodic economic restructuring during the post-war expansion; Role of demography in shaping the urban growth and changes; Diversity of people and individuals.

An interview with the George Yancy, African-American philosopher of critical philosophy of race at Emory University is presented. Topics discussed include information on the book, "Backlash: What Happens When We Talk Honestly about Racism in America" by George; discussions on the several aspects of the whiteness and racism in America; and the information on the discrimination against African Americans.

Background: Pictorial cigarette warning labels are thought to increase risk knowledge, but experimental research has not examined longer-term effects on memory for health risks named in text.Purpose: To investigate memory-consolidation predictions that high- versus low-emotion warnings would support better long-term memory for named cigarette health risks and to test a mediational model of warning-label effects through memory on risk perceptions and quit intentions.Methods: A combined sample of U.S.-representative adult smokers, U.S.-representative teen smokers/vulnerable smokers, and Appalachian-representative adult smokers were randomly assigned to a warning-label condition (High-emotion pictorial, Low-emotion pictorial, Text-only) in which they were exposed four times to nine warning labels and reported emotional reactions and elaboration. Memory of warning-label risk information, smoking risk perceptions, and quit intentions were assessed immediately after exposures or 6 weeks later.Results: Recall of warning-label text was low across the samples and supported memory-consolidation predictions. Specifically, immediate recall was highest for Low-emotion warnings that elicited the least emotion, but recall also declined the most over time in this condition, leaving its 6-week recall lowest; 6-week recall was similar for High-emotion and Text-only warnings. Greater recall was associated with higher risk perceptions and greater quit intentions and mediated part of warning-label effects on these important smoking outcomes. High-emotion warnings had additional non-memory-related effects on risk perceptions and quit intentions that were superior to text-only warnings.Conclusions: High- but not Low-emotion pictorial warning labels may support the Food and Drug Administration's primary goal to "effectively convey the negative health consequences of smoking."Clinicaltrials.gov Identifier: NCT03375840. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the menstrual hygiene needs of low-income women in St. Louis, Missouri. METHODS: Using an exploratory, cross-sectional design, women 18 years of age and older were recruited from a purposive sample of 10 not-for-profit community organizations that serve low-income women in St. Louis. From July 2017 to March 2018, 183 interviewer-administered surveys and three focus group discussions were conducted. Surveys and focus groups identified where and how women access menstrual hygiene products and what they do when they cannot afford to buy them. Using a snowball sampling strategy, 18 community organizations were also surveyed electronically to assess what services and supplies they provide for menstrual hygiene. RESULTS: All women invited to participate in the interviews and the focus groups agreed to do so. Nearly two thirds (64%) of women were unable to afford needed menstrual hygiene supplies during the previous year. Approximately one fifth of women (21%) experienced this monthly. Many women make do with cloth, rags, tissues, or toilet paper; some even use children's diapers or paper towels taken from public bathrooms. Nearly half of women (46%) could not afford to buy both food and menstrual hygiene products during the past year. There was no difference in menstrual hygiene needs by age. Two thirds of organizations indicated that menstrual hygiene was a need of their clients. Thirteen provide menstrual hygiene supplies to their clients; two provide menstrual hygiene education. CONCLUSION: Menstrual hygiene supplies are a basic necessity that many low-income women lack. We document the extent to which low-income women in a major metropolitan area in the United States are unable to afford these basic necessities and what they do to cope. Women's health care providers should advocate for improved access to menstrual hygiene supplies for low-income females across the United States. [ABSTRACT FROM AUTHOR]

Three Supreme Court cases--United States v. Di Re, Ybarra v. Illinois, and Maryland v. Pringle--established the need for individualized or particularized probable cause in multiple-suspect arrests and searches. These three Supreme Court decisions have been used by plaintiffs seeking to sue police departments and municipalities under 42 U.S.C. § 1983 for civil rights violations stemming from mass arrests unsupported by probable cause. Oddly enough, these decisions have also been relied upon by defendants who allege that the law is unclear when it comes to particularized probable cause and multiple-suspect arrests. This Article seeks to carefully examine the history of mass arrests in America and analyze the probable cause requirement of the Fourth Amendment along with existing federal cases on multiple-suspect, group, and mass arrests, to demonstrate that the jurisprudence in this area is settled and clear. The Fourth Amendment's probable cause analysis is and should be no different for individual arrests than for high-volume arrests. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the likelihood of exceeding the occupational exposure limit (OEL) for annual ionizing radiation doses among transient workers at the Hope Creek Nuclear Generating Station, and to propose a method for forecasting exposures among transient workers in general. Methods We obtained personal dosimeter data from the Hope Creek Nuclear Generating Station for the period of January–December 2014, comprising 1955 monthly dose measurements from 498 transient workers. The majority of the transient workers (96%) did not report 12 months of data. The missing months indicate that transient workers may receive ionizing radiation doses at other nuclear power plants throughout the year. We estimated the likelihood of a worker exceeding the Nuclear Regulatory Commission’s annual OEL of 5000 mrem. To do so, we had to account both for left-censored data below the limit of detection (27% of all measurements) and make assumptions about doses received during months not employed at the facility. We used a maximum likelihood estimation method for non-detected measurements that accounted for repeated measurements on an individual. To account for missing months of measurements, we considered two extreme scenarios: the best case of workers who receive zero exposures outside of the Hope Creek, and the illustrative worst case of workers who receive multiple exposures at other nuclear power plants with similar exposure scenarios to Hope Creek. We employed a bootstrap procedure to forecast annual personal doses under both scenarios, while imputing non-detected measurements. Results None of the workers’ reported measurements exceeded the OEL. Bootstrapped annual exposure doses revealed similar patterns, with a very small likelihood of exceeding the OEL, but great potential for variability. Some workers under the best-case scenario may reach Hope Creek’s 2000 mrem internal action limit if exposed at the 98th percentile of their projected annual dose. This scenario becomes more likely when assuming that a worker received doses at other nuclear power plants besides Hope Creek throughout the year. Conclusions The Hope Creek Nuclear Generating Station appears to be typical of its industry peers in terms of annual ionizing radiation doses, which makes it a good test subject for predicting worker doses received elsewhere. Transient workers may receive doses at more than one nuclear power plant throughout the year, which makes them especially at risk for overexposure. The presence of internal plant monitoring systems and the use of tools such as bootstrapping to predict compliance are therefore important for health protection. An argument can also be made for better tracking of exposures in real time of transient workers across facilities. Our method applies to transient workers in any industry for whom exposure assessment is complicated by gaps in exposure histories and records. [ABSTRACT FROM AUTHOR]

Reports on a low-cost study conducted at the University of Missouri-Kansas City to test the viability of transaction log analysis as an everyday source of data in an academic library. Information on the Libraries of the University of Missouri Information Network (LUMIN), a union of online catalog used by the campuses of the university; Search types available on LUMIN; Results of the study; Conclusion.