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Young children often struggle to answer the question "what would have happened?" particularly in cases where the adult-like "correct" answer has the same outcome as the event that actually occurred. Previous work has assumed that children fail because they cannot engage in accurate counterfactual simulations. Children have trouble considering what to change and what to keep fixed when comparing counterfactual alternatives to reality. However, most developmental studies on counterfactual reasoning have relied on binary yes/no responses to counterfactual questions about complex narratives and so have only been able to document when these failures occur but not why and how. Here, we investigate counterfactual reasoning in a domain in which specific counterfactual possibilities are very concrete: simple collision interactions. In Experiment 1, we show that 5- to 10-year-old children (recruited from schools and museums in Connecticut) succeed in making predictions but struggle to answer binary counterfactual questions. In Experiment 2, we use a multiple-choice method to allow children to select a specific counterfactual possibility. We find evidence that 4- to 6-year-old children (recruited online from across the United States) do conduct counterfactual simulations, but the counterfactual possibilities younger children consider differ from adult-like reasoning in systematic ways. Experiment 3 provides further evidence that young children engage in simulation rather than using a simpler visual matching strategy. Together, these experiments show that the developmental changes in counterfactual reasoning are not simply a matter of whether children engage in counterfactual simulation but also how they do so.

Introduction Although gender inequity persists globally in academic leadership positions, the United States Military has equitable pay and, in academic pediatrics, has equitable gender representation in leadership positions. To better understand how the US Military framework affects physician leaders, pediatricians were interviewed to illuminate the factors that facilitated their success and what barriers they faced in their career. Materials and Methods In 2022, following institutional review board approval, semi-structured interviews were conducted with 13 total participants (69% female, 31% male) serving as general pediatricians or pediatric subspecialists in the US Military. These pediatricians were in leadership positions of military academic medicine across seven graduate medical education (GME) sites. The interviews examined the leaders' perceptions of facilitators and barriers to their success. The authors analyzed the interviews using Acker's theory of gendered organizations as a theoretical framework, which explains embedded gender roles within work environments. Results Drawing on the theory of gendered organizations, the authors identified that participants described several facilitators to their success, including the availability of mentorship/sponsorship, inclusive leadership, and early and persistent exposure to women leaders in GME training and beyond. Because medicine's ideal worker was normed around the traditional roles of men, men observed and women experienced barriers to leadership success around issues related to childbearing, maternity leave, and microaggressions. Conclusions This study revealed that equitability for pediatric GME leadership in the military heavily relied on structures and support created by former leaders and mentors. Isolating these structures within a unique context of military academic medicine can illuminate physicians' experiences to address barriers and better support equitable leadership roles in both military and civilian academic medicine. [ABSTRACT FROM AUTHOR]

The use of the Sequential Organ Failure Assessment (SOFA) score, originally developed to describe disease morbidity, is commonly used to predict in-hospital mortality. During the COVID-19 pandemic, many protocols for crisis standards of care used the SOFA score to select patients to be deprioritized due to a low likelihood of survival. A prior study found that age outperformed the SOFA score for mortality prediction in patients with COVID-19, but was limited to a small cohort of intensive care unit (ICU) patients and did not address whether their findings were unique to patients with COVID-19. Moreover, it is not known how well these measures perform across races. In this retrospective study, we compare the performance of age and SOFA score in predicting in-hospital mortality across two cohorts: a cohort of 2,648 consecutive adult patients diagnosed with COVID-19 who were admitted to a large academic health system in the northeastern United States over a 4-month period in 2020 and a cohort of 75,601 patients admitted to one of 335 ICUs in the eICU database between 2014 and 2015. We used age and the maximum SOFA score as predictor variables in separate univariate logistic regression models for in-hospital mortality and calculated area under the receiver operator characteristic curves (AU-ROCs) and area under precision-recall curves (AU-PRCs) for each predictor in both cohorts. Among the COVID-19 cohort, age (AU-ROC 0.795, 95% CI 0.762, 0.828) had a significantly better discrimination than SOFA score (AU-ROC 0.679, 95% CI 0.638, 0.721) for mortality prediction. Conversely, age (AU-ROC 0.628 95% CI 0.608, 0.628) underperformed compared to SOFA score (AU-ROC 0.735, 95% CI 0.726, 0.745) in non-COVID-19 ICU patients in the eICU database. There was no difference between Black and White COVID-19 patients in performance of either age or SOFA Score. Our findings bring into question the utility of SOFA score-based resource allocation in COVID-19 crisis standards of care. [ABSTRACT FROM AUTHOR]

The Implicit Association Test (IAT, Greenwald et al., J. Pers. Soc. Psychol., 74, 1998, 1464) is a popular instrument for measuring attitudes and (stereotypical) biases. Greenwald et al. (Behav. Res. Methods, 54, 2021, 1161) proposed a concrete method for validating IAT stimuli: appropriate stimuli should be familiar and easy to classify – translating to rapid (response times <800 ms) and accurate (error < 10%) participant responses. We conducted three analyses to explore the theoretical and practical utility of these proposed validation criteria. We first applied the proposed validation criteria to the data of 15 IATs that were available via Project Implicit. A bootstrap approach with 10,000 'experiments' of 100 participants showed that 5.85% of stimuli were reliably valid (i.e., we are more than 95% confident that a stimulus will also be valid in a new sample of 18‐ to 25–year‐old US participants). Most stimuli (78.44%) could not be reliably validated, indicating a less than 5% certainty in the outcome of stimulus (in)validity for a new sample of participants. We then explored how stimulus validity differs across IATs. Results show that only some stimuli are consistently (in)valid. Most stimuli show between‐IAT variances, which indicate that stimulus validity differs across IAT contexts. In the final analysis, we explored the effect of stimulus type (images, nouns, names, adjectives) on stimulus validity. Stimulus type was a significant predictor of stimulus validity. Although images attain the highest stimulus validity, raw data show large differences within stimulus types. Together, the results indicate a need for revised validation criteria. We finish with practical recommendations for stimulus selection and (post‐hoc) stimulus validation. [ABSTRACT FROM AUTHOR]

The article focuses on the legal and practical implications of the U.S. Supreme Court decision in the case, Luna Perez v. Sturgis Public Schools, for youth with disabilities. Topics discussed include the special education services being received by youth with disabilities before the decision, the opportunity for students and their families to use remedies under federal laws that protect youth with disabilities, and the impact of the decision on the protection of students' rights.

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are a large class of synthetic (man-made) chemicals widely used in consumer products and industrial processes. Thousands of distinct PFAS exist in commerce. The 2019 U.S. Environmental Protection Agency (U.S. EPA) Per- and Polyfluoroalkyl Substances (PFAS) Action Plan outlines a multiprogram national research plan to address the challenge of PFAS. One component of this strategy involves the use of systematic evidence map (SEM) approaches to characterize the evidence base for hundreds of PFAS. OBJECTIVE: SEM methods were used to summarize available epidemiological and animal bioassay evidence for a set of ~150 PFAS that were prioritized in 2019 by the U.S. EPA’s Center for Computational Toxicology and Exposure (CCTE) for in vitro toxicity and toxicokinetic assay testing. METHODS: Systematic review methods were used to identify and screen literature using manual review and machine-learning software. The Populations, Exposures, Comparators, and Outcomes (PECO) criteria were kept broad to identify mammalian animal bioassay and epidemiological studies that could inform human hazard identification. A variety of supplemental content was also tracked, including information on in vitro model systems; exposure measurement-only studies in humans; and absorption, distribution, metabolism, and excretion (ADME). Animal bioassay and epidemiology studies meeting PECO criteria were summarized with respect to study design, and health system(s) were assessed. Because animal bioassay studies with ≥21-d exposure duration (or reproductive/developmental study design) were most useful to CCTE analyses, these studies underwent study evaluation and detailed data extraction. All data extraction is publicly available online as interactive visuals with downloadable metadata. RESULTS: More than 40,000 studies were identified from scientific databases. Screening processes identified 44 animal and 148 epidemiology studies from the peer-reviewed literature and 95 animal and 50 epidemiology studies from gray literature that met PECO criteria. Epidemiological evidence (available for 15 PFAS) mostly assessed the reproductive, endocrine, developmental, metabolic, cardiovascular, and immune systems. Animal evidence (available for 40 PFAS) commonly assessed effects in the reproductive, developmental, urinary, immunological, and hepatic systems. Overall, 45 PFAS had evidence across animal and epidemiology data streams. DISCUSSION: Many of the ~150 PFAS were data poor. Epidemiological and animal evidence were lacking for most of the PFAS included in our search. By disseminating this information, we hope to facilitate additional assessment work by providing the initial scoping literature survey and identifying key research needs. Future research on data-poor PFAS will help support a more complete understanding of the potential health effects from PFAS exposures. [ABSTRACT FROM AUTHOR]

Copyright of Question (1669-6581) is the property of Universidad Nacional de La Plata and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Economic disruptions generally create winners and losers. The compensation problem consists of designing a reform of the existing income tax system that offsets the welfare losses of the latter by redistributing the gains of the former. We derive a formula for the compensating tax reform and its impact on the government budget when only distortionary tax instruments are available and wages are determined endogenously in general equilibrium. We apply this result to the compensation of robotization in the United States. [ABSTRACT FROM AUTHOR]

How does early social experience affect children's inferences and exploration? Following prior work on children's reasoning in pedagogical contexts, this study examined U.S. children with less experience in formal schooling and Yucatec Mayan children whose early social input is predominantly observational. In Experiment 1, U.S. 2-year-olds (n = 77) showed more restricted exploration of a toy following a pedagogical demonstration than an interrupted, accidental, or no demonstration (baseline). In Experiment 2, Yucatec Mayan and U.S. 2-year-olds (n = 66) showed more restricted exploration following a pedagogical than an observational demonstration, while only Mayan children showed more restriction with age. These results suggest that although schooling is not a necessary precursor for sensitivity to pedagogy, early social experience may influence children's inferences and exploration in pedagogical contexts.

Background: Clinical Practice Guidelines for Gulf War Illness (GWI) recommend integrative health approaches such as yoga for relief from symptoms, yet little is known about the long-term efficacy of yoga in reducing symptoms of GWI. Here, we evaluated the long-term efficacy of yoga and cognitive-behavioral therapy (CBT) chronic pain treatment in a randomized controlled trial (RCT) of 75 Veterans (57 men, 42–71 ± 7.1 years of age) with Gulf War Illness (GWI). Methods: Participants received either 10 weeks of yoga or 10 weeks of CBT for chronic pain. The primary outcome measures were pain severity, and pain interference (Brief Pain Inventory-Short Form). The secondary outcome measures were fatigue, as indicated by a measure of functional exercise capacity (6-Minute Walk Test), depression, autonomic symptom severity, and quality of life. Piecewise linear mixed models were used to examine study hypotheses. Results: Compared to the CBT group, yoga was associated with greater reductions in pain severity during the 6-month follow-up period (group × time interaction: b = 0.036, se = 0.014, p =.011). Although we did not find between-group differences in the other primary or secondary outcome measures during follow-up (p's > 0.05), exploratory analyses revealed within-group improvements in pain interference, total pain (an experimental outcome variable which combines pain severity and interference), and fatigue in the yoga group (p's < 0.05) but not in the CBT group. Conclusions: This is the first study to report long-term follow-up results of yoga as a treatment for GWI. Our results suggest that yoga may offer long-term efficacy in reducing pain, which is a core symptom of GWI. Trial registration: Secondary analyses of ClinicalTrials.gov NCT02378025. [ABSTRACT FROM AUTHOR]

Background: In the United States, the National Alzheimer's Coordinating Center (NACC) and the Alzheimer's Disease Neuroimaging Initiative (ADNI) are two major data sharing resources for Alzheimer's Disease (AD) research. NACC and ADNI strive to make their data more FAIR (findable, interoperable, accessible and reusable) for the broader research community. However, there is limited work harmonizing and supporting cross-cohort interoperability of the two resources. Method: In this paper, we leverage an ontology-based approach to harmonize data elements in the two resources and develop a web-based query system to search patient cohorts across the two resources. We first mapped data elements across NACC and ADNI, and performed value harmonization for the mapped data elements with inconsistent permissible values. Then we built an Alzheimer's Disease Data Element Ontology (ADEO) to model the mapped data elements in NACC and ADNI. We further developed a prototype cross-cohort query system to search patient cohorts across NACC and ADNI. Results: After manual review, we found 172 mappings between NACC and ADNI. These 172 mappings were further used to construct common concepts in ADEO. Our data element mapping and harmonization resulted in five files storing common concepts, variables in NACC and ADNI, mappings between variables and common concepts, permissible values of categorical type data elements, and coding inconsistency harmonization, respectively. Our cross-cohort query system consists of three core architectural elements: a web-based interface, an advanced query engine, and a backend MongoDB database. Conclusions: In this work, ADEO has been specifically designed to facilitate data harmonization and cross-cohort query of NACC and ADNI data resources. Although our prototype cross-cohort query system was developed for exploring NACC and ADNI, its backend and frontend framework has been designed and implemented to be generally applicable to other domains for querying patient cohorts from multiple heterogeneous data sources. [ABSTRACT FROM AUTHOR]

Objectives The Behavioral Risk Factor Surveillance System sampled 54,076 caregivers between 2015 and 2017 providing an opportunity to evaluate risk factors for poor mental and physical health among a representative sample of U.S. adult caregivers. This study aimed to evaluate the impact of childcare, work status, and intensity of caregiving among men and women caring for older adults (n = 17,271). Methods Controlling for sociodemographic factors, separate logistic regression analysis for women and men were carried out to assess the main and interaction effects of childcare, work status, and intensity of caregiving on number of poor mental and physical health days in the last month. Results Intensive caregiving demands had adverse effects on both women and men, but being in the workforce was beneficial to both men and women. Women with children at home reported adverse mental health effects but better physical health, while men with children at home reported adverse physical health effects. For women, the combination of not working, children in the household, and high-intensity caregiving were most detrimental to their mental health. Among men, those not working with children in the household, regardless of caregiving intensity, were at highest risk of adverse mental health effects. Discussion Our findings identify caregivers at high risk of adverse outcomes but also point to the need for more fine-grained analyses of how families negotiate the allocation of childcare, work, and caregiving responsibilities over time. [ABSTRACT FROM AUTHOR]

This study assessed effectiveness of an educational community intervention taught by "promotoras de salud" in reducing cardiovascular disease (CVD) risk among Hispanics using a structural equation modeling (SEM) approach. Model development was guided by a social ecological framework proposing CVD risk reduction through improvement of protective health behaviors, health beliefs, contextual and social factors. Participants were 328 Hispanic adults with at least one CVD risk factor. SEM analyses assessed direct and indirect effects of intervention participation on CVD risk (Framingham score) and latent variables nutrition intake and health beliefs. The model fit was adequate (root mean square error of approximation = 0.056 [90% confidence interval = 0.040, 0.072], comparative fit index = 0.967, normed fit index = 0.938, nonnormed fit index = 0.947). Intervention participation was associated with improved nutritional consumption, but not lower CVD risk. Stronger health beliefs predicted healthier nutritional habits. This project provided evidence for the adequacy of a conceptual framework that can be used to elicit new pathways toward CVD risk reduction among at-risk Hispanic populations. (Contains 1 table and 2 figures.)

Existing research rarely considers important ethnic subgroup variations in violent behaviors among Latino youth. Thus, their risk for severe violent behaviors is not well understood in light of the immense ethnic and generational diversity of the Latino population in the United States. Grounded in social control theory and cultural analyses of "familism," we examine differences in the risk for severe youth violence, as well its associations with family cohesion, parental engagement, adolescent autonomy, household composition, and immigrant generation among Mexican (n = 1,594), Puerto Rican (n = 586), Cuban (n = 488), and non-Latino Black (n = 4,053), and White (n = 9,921) adolescents with data from the National Longitudinal Study of Adolescent Health. Results indicate a gradient of risk; White youth had the lowest risk for severe violence and Puerto Rican youth had the highest risk compared to all other racial/ethnic subgroups. Within-group analysis indicates that family factors are not universally protective or risk-inducing. While family cohesion decreased the risk of severe violence among all groups, parental engagement was associated with increased risk among Blacks and Whites, and adolescent autonomy was associated with increased risk among Puerto Ricans and Cubans. In addition, Cuban and White adolescents who lived in single parent households or who did not live with their parents, had higher risk for severe violent behaviors than their counterparts who lived in two parent households. Among Latinos, the association of immigrant generation was in opposite directions among Mexicans and Cubans. We conclude that family and immigration factors differentially influence risk for violence among Latino subgroups and highlight the significance of examining subgroup differences and developing intervention strategies that are tailored to the needs of each ethnic subgroup.

There is accumulating evidence that individual differences in stress reactivity contribute to the risk for stress-related disease. However, the assessment of stress reactivity remains challenging, and there is a relative lack of questionnaires reliably assessing this construct. We here present the Perceived Stress Reactivity Scale (PSRS), a 23-item questionnaire with 5 subscales and 1 overall scale, based on an existing German-language instrument. Perceived stress reactivity and related constructs were assessed in N = 2,040 participants from the United Kingdom, the United States, and Germany. The 5-factor structure of the PSRS was found to be similar in the 3 countries. In the U.S. sample the questionnaire was applied using 2 modes of administration (paper-pencil and computerized), and measures were repeated after 4 weeks. Measurement invariance analyses demonstrated full invariance across mode of administration and partial invariance across gender and countries. Scale scores differed between countries and genders, with women scoring higher on most scales. Overall, reliability analysis suggested good stability of PSRS scores over a 4-week period, and validation analysis showed expected associations with related constructs such as self-efficacy, neuroticism, chronic stress, and perceived stress. Perceived stress reactivity was also associated with depressive symptoms and sleep. These associations were particularly strong when individuals scoring high on perceived stress reactivity were exposed to chronic stress. In sum, our findings suggest that the PSRS is a useful and easy-to-administer instrument to assess perceived stress reactivity. (Contains 3 figures and 5 tables.)

Student affairs could potentially play a vital role in the internationalization of colleges and universities, but the extent to which international issues are included in the preparation of future student affairs administrators has remained relatively unknown. As such, a team of researchers sought to investigate the extent of internationalization among student affairs graduate preparation programs in the United States. More specifically, this study was commissioned to reveal: (1) what types of institutions have student affairs graduate preparation programs that are internationalized, (2) the types of international program components being embraced by student affairs graduate preparation programs, and (3) anticipated future trends and factors that inhibit or promote the development of international program components. The findings of this study have implications for future research on internationalization and the preparation of student affairs administrators.

The present study uses item response theory (IRT) to establish comparability between the English and Portuguese versions of the Goal Instability Scale (GIS), a measure of generalized motivation. A total of 2,848 American and 679 Portuguese high school students were administered their respective language versions of the GIS. Results showed only minor differences in item performance between language versions, suggesting equivalent measurement of the underlying motivational construct. Implications regarding the interpretation of IRT analyses for intervention purposes, as well as future research, are discussed. (Contains 3 tables and 3 figures.)

Recent clinical trials have failed to identify a benefit of antiarrhythmic administration during cardiac arrest. However, little is known regarding the time to administration of antiarrhythmic drugs in clinical practice or its impact on return of spontaneous circulation (ROSC). We utilized a national EMS registry to evaluate the time of drug administration and association with ROSC. We utilized the 2018 and 2019 NEMSIS datasets, including all non-traumatic, adult 9-1-1 EMS activations for cardiac arrests with initial shockable rhythm and that received an antiarrhythmic. We calculated the time from 9-1-1 call to administration of antiarrhythmic. We excluded cases with erroneous time stamps. Stratified by initial antiarrhythmic (amiodarone and lidocaine), we created a mixed-effect logistic regression model evaluating the association between every 5-minute increase in time to antiarrhythmic and ROSC. We modeled EMS agency as a random intercept and adjusted for confounders. There were 449,630 adults, non-traumatic cardiac arrests identified with 11,939 meeting inclusion criteria. 9,236 received amiodarone and 1,327 received lidocaine initially. The median time in minutes to initial dose for amiodarone was 19.9 minutes (IQR 15.8–25.6) and for lidocaine was 19.5 minutes (IQR 15.2–25.4). Increasing time to initial antiarrhythmic was associated with decreased odds of ROSC for both amiodarone (aOR 0.9; 95% CI 0.9–0.94) and lidocaine (aOR 0.9; 95% CI 0.8–0.97). Time to administration of anti-arrhythmic medication varied, but most patients received the first dose of anti-arrhythmic drug more than 19 minutes after the initial 9-1-1 call. Longer time to administration of an antiarrhythmic in patients with an initial shockable rhythm was associated with decreased ROSC rates. [ABSTRACT FROM AUTHOR]

Recent police brutality and related violence against Black people, coupled with the COVID-19 pandemic, has further evidenced the disproportionate impact of systemic racism in our institutions and across society. In the United States, the alarming mortality rates for Black people due to police violence and COVID-19 related deaths are clear demonstrations of inequities within a long history of disparate outcomes. In understanding systemic racism, it is essential to consider how it is embedded within society and across socio-ecological levels. The Social-Ecological Model (SEM) is used to examine conditions within the environment that maintain systemic racism, including within our field and discipline. A behavioral-community approach for examining racism aids in determining points of intervention across multiple ecological levels that may contribute to behavior change, including with behaviorists. The science of behavior is well-suited to help examine the contingencies governing behaviors within and across systems, which is pivotal for addressing operant behaviors to influence long-term behavior change. This paper calls on the behavioral community to address systemic racism within our environments and systems of influence to contribute to a more equitable community. Systemic racism, including within the context of anti-Blackness, is examined by considering behavior change strategies that can be supported by behaviorists across socio-ecological levels. Tools for collaborative action are provided to support behaviorists in demonstrating the skills needed across a continuum of behaviors from allyship to anti-racism to actively address systemic racism. [ABSTRACT FROM AUTHOR]

With a comparative lens, this article explores the trajectory of women's advancement in policing in China and the United States (US), two major countries, one in the Global South and the other in the Northern part of the world. The article describes the rich history of women police in the US and China and compares the development of women policing in these two jurisdictions, which are sharply contrasting in many respects. Starting from the model of women's stage-by-stage integration into policing developed in the Northern contexts, we examine women's evolution in police and their local conditions in the two systems. Framed in Southern Criminology and Southern Theory, we conclude that the US model of sexual integration does not apply to China, where traditional cultural norms continue to reinforce women's gendered roles in policing. More generally, the progress of women is unlikely, nor necessary, to share the same trajectory everywhere. [ABSTRACT FROM AUTHOR]

Zoos offer university researchers unique opportunities to study animals that would be difficult or impractical to work with in the wild. However, the different cultures, goals, and priorities of zoos and universities can be a source of conflict. How can researchers build mutually beneficial collaborations with their local zoo? In this article, we present the results of a survey of 117 personnel from 59 zoos around the United States, where we highlight best practices spanning all phases of collaboration, from planning to working alongside the zoo and maintaining contact afterward. Collaborations were hindered if university personnel did not appreciate the zoo staff's time constraints as well as the differences between zoo animals and laboratory animals. We include a vision for how to improve zoo collaborations, along with a history of our own decade-long collaborations with Zoo Atlanta. A central theme is the long-term establishment of trust between institutions. [ABSTRACT FROM AUTHOR]

Background: Long term risk of Alzheimer's disease (AD) and related dementias (ADRD) associated with vascular diseases in people with colorectal cancer is unknown.Objective: To determine the risk of ADRD in association with cardiovascular diseases (CVD), stroke, hypertension, and diabetes in a cohort of patients with colorectal cancer.Methods: This retrospective cohort study consisted of 210,809 patients diagnosed with colorectal cancer at age≥65 years in 1991-2015 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database with follow-up from 1991-2016, who were free of any ADRD at the baseline (<12 months prior to or < 30 days after the date of cancer diagnosis).Results: The crude 26-year cumulative incidence of total ADRD in men and women with colorectal cancer was higher in those with versus without CVD (31.92% versus 28.12%), with versus without stroke (39.82% versus 26.39%), with versus without hypertension (31.88% versus 24.88%), and with versus without diabetes (32.01% versus 27.66%). After adjusting for socio-demographic and tumor factors, the risk of developing ADRD was significantly higher in patients with CVD (adjusted hazard ratio: 1.17, 95% confidence intervals: 1.14-1.20), stroke (1.65, 1.62-1.68), hypertension (1.07, 1.05-1.09), and diabetes (1.26, 1.24-1.29) versus persons without. For those with 1, 2, 3 and 4 vascular diseases present versus absent, the risk of AD increased from 1.12 (1.07-1.16) to 1.31 (1.25-1.36), 1.66 (1.57-1.75), and 2.03 (1.82-2.27).Conclusion: In older patients with colorectal cancer, a significant dose-response relationship was observed between an increasing number of these vascular diseases and the risk of all types of dementia. [ABSTRACT FROM AUTHOR]

Background: No study on the long-term incidence of Alzheimer's disease (AD) and related dementias (ADRD) has been reported in women with breast cancer by vascular diseases.Objective: To determine the risk of ADRD in association with cardiovascular diseases (CVD), stroke, hypertension, and diabetes in women with breast cancer.Methods: Study identified 246,686 women diagnosed with breast cancer at age≥65 years in 1991-2015 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Women were free of ADRD at the time of cancer diagnosis and followed from 1991 to 2016.Results: Cumulative incidence of AD over 26 years of follow-up varied from 10.7% to 13.6% by CVD, stroke, hypertension, and diabetes. Cumulative incidence of ADRD was higher in those with CVD (40.75%) versus no-CVD (31.32%), stroke (40.24%) versus no-stroke (31.34%), hypertension (33.06%) versus no-hypertension (30.47%), and diabetes (33.38%) versus no-diabetes (31.77%). After adjusting for confounders, those with CVD (hazard ratio:1.30, 95% CI: 1.27-1.33), stroke (1.50,1.47-1.54), hypertension (1.08,1.06-1.09), and diabetes (1.26,1.24-1.29) had significantly higher risks of developing ADRD. Women aged 80-84, and≥85 had 5- and 7-fold higher risks of AD than those aged 65-69. As compared to white women, black women had a significantly higher risk of AD (1.21, 1.16-1.27), whereas Asians/Pacific-Islanders had a significantly lower risk of AD (0.77, 0.71-0.83).Conclusion: In women with breast cancer, CVD, stroke, hypertension, and diabetes were associated with a significantly higher risk of developing any ADRD combined. The risk of ADRD was higher in black women and lower in Asian/Pacific-Islanders than white women. [ABSTRACT FROM AUTHOR]

Background: Population-based research and community-based interventions are integral to occupational therapy’s scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the PersonEnvironment-Occupation-Performance Model. Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health behaviors and psychosocial health indicators across five US regions. Results: Findings suggest that African Americans RDP are engaging in fewer positive physical health behaviors and experiencing worse psychosocial health compared to their counterparts FTE. There are also nuanced regional variations in the differences between African Americans RDP and FTE in physical health behaviors and psychosocial health indicators. Conclusion: This research highlighted some health challenges of African Americans RDP and FTE using a regional lens, demonstrating the value of OT population-based research. There is a need for OT population-specific community-based practice to address the health disparities of underserved and minority populations, such as African Americans. [ABSTRACT FROM AUTHOR]

This article presents logistic models examining how pandemic anxiety and COVID-19 comprehension vary with digital confidence among adults in the United States during the first wave of the pandemic. As we demonstrate statistically with a nationally representative data set, the digitally confident have lower probability of experiencing physical manifestations of pandemic anxiety and higher probability of adequately comprehending critical information on COVID-19. The effects of digital confidence on both pandemic anxiety and COVID-19 comprehension persist, even after a broad range of potentially confounding factors are taken into account, including sociodemographic factors such as age, gender, race/ethnicity, metropolitan status, and partner status. They also remain discernable after the introduction of general anxiety, as well as income and education. These results offer evidence that the digitally disadvantaged experience greater vulnerability to the secondary effects of the pandemic in the form of increased somatized stress and decreased COVID-19 comprehension. Going forward, future research and policy must make an effort to address digital confidence and digital inequality writ large as crucial factors mediating individuals' responses to the pandemic and future crises. [ABSTRACT FROM AUTHOR]

We investigate how individual factors moderate the impact of bankruptcy exemption levels—that is, the amount of wealth individuals can keep in case of bankruptcy—on entry into self-employment. Conceptually, we combine Prospect Theory's axiom of diminishing sensitivity with insights from research on entrepreneurial failure. We hypothesize that individuals who face higher financial, social, or psychological costs because of bankruptcy will be less sensitive to higher exemption levels than will those who face lower costs across these dimensions. Our empirical results, which are based on a quasi-natural experiment in the United States, support our theoretical predictions. [ABSTRACT FROM AUTHOR]

The article reports that the Plaintiff-Relator Keegan Mason, a citizen of the State of Lincoln filed proceeding qui tam under seal on November 22, 2019 against Defendant Southern American Metropolitan Clinics, Inc. Topics include examines it is a collection of wound care centers across the state of Lincoln and considered Mason alleges that SAM Clinics violated the False Claims Act (FCA).

Alternative antibiotics for surgical prophylaxis are associated with increased adverse events and surgical site infection compared to cefazolin. In a sample of perioperative inpatients from 100 hospitals in the United States, cefazolin was 9-fold less likely to be used in patients with a documented β-lactam allergy whereas clindamycin was 45-fold more likely. [ABSTRACT FROM AUTHOR]

Background: To assess variations in adherence to guideline-recommended processes of care for oral cavity cancer patients. Methods: Retrospective study using a U.S. healthcare research database (MarketScan). Index diagnoses were considered from 2010 to 2012 with follow-up from 2013 to 2014. Diagnostic and procedure codes were utilized to identify oral cavity patients with a defined treatment modality. Compliance with guideline-recommended processes of care, which included pre-treatment imaging, thyroid-function testing (TFTs), multidisciplinary consultation and gastrostomy-tube insertion rates, were assessed. Results: A total of 2752 patients were identified. Surgery alone was the most common treatment (60.8%), followed by surgery with adjuvant chemoradiotherapy (20.4%) and surgery with adjuvant radiotherapy (18.8%). Head/neck and chest imaging were obtained in 60% and 62.5% of patients respectively. Significant geographical differences in head and neck imaging were observed between North-central (64%), South (58.4%) and West (56.1%) regions (p = 0.026). Differences in chest imaging were also present between North-east (65%) and West (56.8%; p = 0.007). TFTs were obtained in 54.4% of the patients after radiation treatment, and 18.6% of patients had multidisciplinary consultation during the 6 months before and 3 months after initiation of treatment. During the year after treatment initiation, 21.2% of patients underwent G-tube placement, with significantly higher rates in patients receiving triple modality treatment (58%) when compared to surgery plus radiation (27%) and surgery alone (15%; p < 0.01). Conclusion: Adherence to evidence-based practices was low based on the database coding. These data suggest a potential to improve adherence and increase the routine use of practices delineated in national clinical practice guidelines. Clinical relevance: This study reflects a suboptimal adherence to guidelines based on the database employed. This study should be considered by healthcare providers and efforts should be maximized to follow the processes of care which have proven to impact on patient's outcomes. [ABSTRACT FROM AUTHOR]

Aims Non-invasive assessment and risk stratification of coronary artery disease in patients with large body habitus is challenging. We aim to examine whether body mass index (BMI) modifies the prognostic value and diagnostic utility of stress cardiac magnetic resonance imaging (CMR) in a multicentre registry. Methods and results The SPINS Registry enrolled consecutive intermediate-risk patients who presented with a clinical indication for stress CMR in the USA between 2008 and 2013. Baseline demographic data including BMI, CMR indices, and ratings of study quality were collected. Primary outcome was defined by a composite of cardiovascular death and non-fatal myocardial infarction. Of the 2345 patients with available BMI included in the SPINS cohort, 1177 (50%) met criteria for obesity (BMI ≥ 30) with 531 (23%) at or above Class 2 obesity (BMI ≥ 35). In all BMI categories, >95% of studies were of diagnostic quality for cine, perfusion, and late gadolinium enhancement (LGE) sequences. At a median follow-up of 5.4 years, those without ischaemia and LGE experienced a low annual rate of hard events (<1%), across all BMI strata. In patients with obesity, both ischaemia [hazard ratio (HR): 2.14; 95% confidence interval (CI): 1.30–3.50; P  = 0.003] and LGE (HR: 3.09; 95% CI: 1.83–5.22; P  < 0.001) maintained strong adjusted association with the primary outcome in a multivariable Cox regression model. Downstream referral rates to coronary angiography, revascularization, and cost of care spent on ischaemia testing did not significantly differ within the BMI categories. Conclusion In this large multicentre registry, elevated BMI did not negatively impact the diagnostic quality and the effectiveness of risk stratification of patients referred for stress CMR. [ABSTRACT FROM AUTHOR]

The human capital of a firm as manifested by employee knowledge and experience represents a key resource of a firm's capabilities. Prior empirical studies have found that firms composed of high levels of human capital experience superior firm performance. Human capital theory proposes that an individual's general or firm-specific human capital is positively related to compensation. However, empirical studies examining firm-specific human capital's association with higher employee compensation have been inconclusive. The current study proposes that firm-specific human capital be categorized as task-specific and non-task-specific. Employees accumulate task-specific human capital through duties conducted in their current position. Non-task-specific human capital represents experiences gained in prior positions to an employee's current job within the firm. Utilizing human capital data from 38,390 employees representing 76 firms in the IT sector, this study examines the association between forms of human capital and employee compensation at different levels of firm productivity. Results show that task-specific human capital is associated with higher employee compensation. In addition, firm productivity moderates this association. [ABSTRACT FROM AUTHOR]

Public abortion attitudes are important predictors of abortion stigma and accessibility, even in legal settings like the U.S. and South Africa. With data from the U.S. General Social Survey and South African Social Attitudes Survey, we used ordinal logistic regressions to measure whether abortion acceptability (in cases of poverty and fetal anomaly) is related to attitudes about social welfare programs and gender roles, then assessed differences by race/ethnicity and education. Social welfare program attitudes did not correlate with abortion acceptability in the U.S., but in South Africa, greater support for income equalization (OR: 0.59, 95% CI: 0.41–0.85) and increased government spending on the poor (OR: 0.66, 95% CI: 0.49–0.91) correlated with lower abortion acceptability in circumstances of poverty. This was significant for Black African and higher educated South Africans. In the U.S., egalitarian gender role attitudes correlated with higher acceptability of abortion in circumstances of poverty (OR: 1.18, 95% CI: 1.03–1.36) and fetal anomaly (OR: 1.15, 95% CI: 1.01–1.31). This was significant for White and less educated Americans. In South Africa, egalitarian gender role attitudes correlated with higher abortion acceptability for fetal anomaly (OR: 1.12, 95% CI: 1.01–1.25) overall and among Black and less educated respondents, but among non-Black South Africans they correlated with higher abortion acceptability in circumstances of poverty. These results suggest abortion attitudes are distinctly related to socioeconomic and gender ideology depending one's national context, race/ethnicity, and socioeconomic status. Reducing abortion stigma will require community-based approaches rooted in intersectional reproductive justice frameworks. [ABSTRACT FROM AUTHOR]

Objectives: The 21st century has seen a rise in racism and xenophobia in the United States. Few studies have examined the health implications of heightened institutional and interpersonal racism. This study examines changes in reported discrimination and associations with blood pressure over time among non-Latino Blacks (NLBs), Latinos, and non-Latino Whites (NLWs) in an urban area, and variations by nativity among Latinos. Design: Data from a probability sample of NLB, Latino, and NLW Detroit, Michigan residents were collected in 2002–2003, with follow-up at the same addresses in 2007–2008. Surveys were completed at 80% of eligible housing units in 2008 (n = 460). Of those, 219 participants were interviewed at both time points and were thus included in this analysis. Discrimination patterns across racial/ethnic groups and associations with blood pressure were examined using generalized estimating equations. Results: From 2002 to 2008, NLBs and Latinos reported heightened interpersonal and institutional discrimination, respectively, compared with NLWs. There were no differences in associations between interpersonal discrimination and blood pressure. Increased institutional discrimination was associated with stronger increases in systolic and diastolic blood pressure for NLBs than NLWs, with no differences between Latinos and NLWs. Latino immigrants experienced greater increases in blood pressure with increased interpersonal and institutional discrimination compared to US-born Latinos. Conclusions: Together, these findings suggest that NLBs and Latinos experienced heightened discrimination from 2002 to 2008, and that increases in institutional discrimination were more strongly associated with blood pressure elevation among NLBs and Latino immigrants compared to NLWs and US-born Latinos, respectively. These findings suggest recent increases in discrimination experienced by NLBs and Latinos, and that these increases may exacerbate racial/ethnic health inequities. [ABSTRACT FROM AUTHOR]

Improving how health care providers respond to medical injury requires an understanding of patients' experiences. Although many injured patients strongly desire to be heard, research rarely involves them. Institutional review boards worry about harming participants by asking them to revisit traumatic events, and hospital staff worry about provoking lawsuits. Institutions' reluctance to approve this type of research has slowed progress toward responses to injuries that are better able to meet patients' needs. In 2015–2016, we were able to surmount these challenges and interview 92 injured patients and families in the USA and New Zealand. This article explores whether the ethical and medico‐legal concerns are, in fact, well‐founded. Consistent with research about trauma‐research‐related distress, our participants' accounts indicate that the pervasive fears about retraumatization are unfounded. Our experience also suggests that because being heard is an important (but often unmet) need for injured patients, talking provides psychological benefits and may decrease rather than increase the impetus to sue. Our article makes recommendations to institutional review boards and researchers. The benefits to responsibly conducted research with injured patients outweigh the risks to participants and institutions. [ABSTRACT FROM AUTHOR]

Researchers have employed various methods to identify symptom clusters in cardiovascular conditions, without identifying rationale. Here, we test clustering techniques and outcomes using a data set from patients with acute coronary syndrome. A total of 474 patients who presented to emergency departments in five United States regions were enrolled. Symptoms were assessed within 15 min of presentation using the validated 13-item ACS Symptom Checklist. Three variable-centered approaches resulted in four-factor solutions. Two of three person-centered approaches resulted in three-cluster solutions. K -means cluster analysis revealed a six-cluster solution but was reduced to three clusters following cluster plot analysis. The number of symptoms and patient characteristics varied within clusters. Based on our findings, we recommend using (a) a variable-centered approach if the research is exploratory, (b) a confirmatory factor analysis if there is a hypothesis about symptom clusters, and (c) a person-centered approach if the aim is to cluster symptoms by individual groups. [ABSTRACT FROM AUTHOR]

Young adults experiencing first-episode psychosis have historically been difficult to retain in mental health treatment. Communities across the United States are implementing Coordinated Specialty Care to improve outcomes for individuals experiencing first-episode psychosis. This mixed-methods research study examined the relationship between program services and treatment retention, operationalized as the likelihood of remaining in the program for 9 months or more. In the adjusted analysis, male gender and participation in home-based cognitive behavioral therapy were associated with an increased likelihood of remaining in treatment. The key informant interview findings suggest the shared decision-making process and the breadth, flexibility, and focus on functional recovery of the home-based cognitive behavioral therapy intervention may have positively influenced treatment retention. These findings suggest the use of shared decision-making and improved access to home-based cognitive behavioral therapy for first-episode psychosis patients may improve outcomes for this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Empirical evidence on how health literacy affects diabetes outcomes is inconsistent. The purpose of this meta-analysis was to quantitatively summarize the findings on the associations between health literacy and diabetes knowledge, self-care activities, and glycemic control as disease-related outcomes, with specific focus on the type of health literacy assessment.Data Sources: Nine databases (MEDLINE, CINAHL, Communication and Mass Media Complete, PsychInfo, PsychArticles, Psychology and Behavioral Sciences Collection, ERIC, Sociology, Embase) were searched for peer-reviewed original research articles published until 31 March 2018.Methods: Studies with type 1 and/or type 2 diabetes patients aged 18 or older, providing a calculable baseline effect size for functional health literacy and diabetes knowledge, self-care activities, or HbA1C were included.Results: The meta-analysis includes 61 studies with a total of 18,905 patients. The majority were conducted in the USA, on type 2 diabetes patients, and used the S-TOFHLA as a performance-based or the BHLS as a perception-based measure of functional health literacy. Meta-analytic results show that all three outcomes are related to health literacy. Diabetes knowledge was best predicted by performance-based health literacy measures, self-care by self-report measures, and glycemic control equally by both types of health literacy assessment.Discussion: Health literacy plays a substantial role in diabetes knowledge. Findings for the role of health literacy in self-care and glycemic control remain heterogeneous, partly due to the type of health literacy assessment (performance- vs. perception-based). This has implications for the use of health literacy measures in clinical settings and original research. This meta-analysis was limited to functional health literacy and, due to the paucity of studies, did not investigate the role of other dimensions including communicative and critical health literacy. [ABSTRACT FROM AUTHOR]

The American rusty crayfish, Faxonius rusticus , is an invasive species in parts of North America where it displaces native crayfish species. In Europe, various invasive North American crayfish species are carriers of the crayfish plague disease agent Aphanomyces astaci that causes devastating population declines of European crayfish. Little is known about either the presence or the influence of A. astaci in North America where it originates. Here, we attempted to isolate A. astaci from North American F. rusticus for the first time and compare it to the strains detected in Europe. We tested the infection status of 84 F. rusticus samples from 10 different locations in the midwestern United States that are outside of the F. rusticus native distribution range. We used quantitative real-time PCR (qPCR) to assess the infection status in each individual, and we determined the mitochondrial haplotypes and multilocus microsatellite genotypes when it was possible. We detected A. astaci DNA in 9 individuals from 4 out of 10 locations. Analyses of the axenic culture isolates and the crayfish tissue samples by sequence analyses, haplotyping, and genotyping confirmed the results and revealed a novel A. astaci microsatellite genotype. Our results clearly identify F. rusticus as a host of A. astaci in North America. The threat of these strains to endangered crayfish species in North America remains unknown, but the potential of A. astaci infections should be considered when developing and implementing invasive species management plans for conservation purposes. [ABSTRACT FROM AUTHOR]

Recently, several plant-made recombinant proteins received favorable regulatory review as food antibacterials in the United States through the Generally Recognized As Safe (GRAS) regulatory procedure, and applications for others are pending. These food antimicrobials, along with approved biopharmaceuticals and vaccines, represent new classes of products manufactured in green plants as production hosts. We present results of new research and development and summarize regulatory, economic and business aspects of the antibacterial proteins colicins and salmocins as new food processing aids. [ABSTRACT FROM AUTHOR]

Automated electronic data loggers revolutionized environmental monitoring by enabling reliable high-frequency measurements. However, the potential to monitor the complex environmental interactions involved in global change has not been fully realized due to the high cost and lack of modularity of commercially available data loggers. Responding to this need, we developed the ALog (Arduino logger) series of three open-source data loggers, based on the popular and easy-to-program Arduino microcontroller platform. ALog data loggers are low cost, lightweight, and low power; they function between -30 and +60 ∘ C, can be powered by readily available alkaline batteries, and can store up to 32 GB of data locally. They are compatible with standard environmental sensors, and the ALog firmware library may be expanded to add additional sensor support. The ALog has measured parameters linked to weather, streamflow, and glacier melt during deployments of days to years at field sites in the USA, Canada, Argentina, and Ecuador. The result of this work is a robust and field-tested open-source data logger that is the direct descendant of dozens of individuals' contributions to the growing open-source electronics movement. [ABSTRACT FROM AUTHOR]

The persuasiveness of right-wing populist communication has become a widely discussed topic; it is often assumed that such messages might foster anti-immigrant attitudes among citizens. The present study explores the effects of the different components of right-wing populist communication—anti-immigrant messages, populist content, and populist style—on attitudes toward immigrants. By combining a media content analysis (N = 605 articles) with a panel survey (N = 1,968) in metropolitan areas of four Western European countries (France, Germany, Switzerland, and the United Kingdom), this study analyzes how citizens’ attitudes toward immigrants are influenced by the right-wing populist communication with which they are confronted in their individual media diet. The results show that anti-immigrant statements in the media lead to more negative cognitions toward immigrants, while populist content leads to more negative emotions. The study, thus, demonstrates that not only anti-immigrant rhetoric but also populism as a thin-centered ideology influence citizens’ attitudes toward immigrants on top of pre-existing attitudes. [ABSTRACT FROM AUTHOR]

This article examines the effects of digital inequality in conjunction with curricular tracking on academic achievement. Capitalizing on an original survey administered to seniors (fourth-year secondary school students), our survey data (N = 972) come from a large American public high school with a predominantly disadvantaged student body. The school’s elective tracking system and inadequate digital resources make for an excellent case study of the effects of a differentiated curriculum and digital inequalities on academic achievement. Multilevel random-effects and fixed-effects regression models applied to the survey data reveal the important role played by digital inequalities in shaping academic achievement as measured by GPA. As the models establish, academic achievement is positively correlated with both duration of digital experience and usage intensity regarding academically useful computing activities, even when students’ curricular and class placement are taken into account. In contrast, both leisure computing and smartphone usage are negatively correlated with academic achievement as measured by GPA. Also with regard to GPA, findings show that students in the higher curricular tracks benefit more from longer durations of digital experience than do students in lower curricular tracks. These results underscore the importance of focusing attention on the ways in which digital inequalities combine with curricular tracking in shaping academic achievement. [ABSTRACT FROM AUTHOR]

Background: To estimate the burden of diseases, it is important to consider patient-reported outcomes including Quality of Life (QoL). The aim of this study is to provide population-based reference data for the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25), stratified by sex and age.Methods: The Gutenberg Health Study (GHS) is a population-based, prospective, observational cohort study in Germany, including 15,010 participants aged between 35 and 74. The baseline examination was conducted between 2007 and 2012. To overcome known shortcomings of the NEI VFQ-25, we calculated the previously proposed visual functioning scale and the socio-emotional scale based on Rasch-transformed person-level data. We present mean values, standard deviations and percentiles for age decades stratified by sex. We used a linear regression model to assess the influence of age, sex, socioeconomic status, distance-corrected visual acuity (better-seeing eye) and the absolute difference in distance-corrected visual acuity of both eyes on vision-related QoL.Results: NEI VFQ-25 data are available from 12,231 participants (82%). Both the long-form visual functioning scale (LFVFS) and the long-form socio-emotional scale (LFSES) showed a clear age dependency, with an average LFVFS score of 92.8 for men and 90.5 for women in the youngest age group and 85.7 and 83.4 in the oldest age group, and a LFSES score of 98.3 for men and 98.1 in women in the youngest and 94.7 and 94.5 in the oldest decade. The largest difference was observed between the youngest age group (35-44 years) and the 45-54 years group. Men tended to have slightly higher scores than women. In the multivariable linear regression analysis, age (per 5 years -0.42), female sex (-1.57), worse distance-corrected visual acuity of the better eye (per 0.1 increase in logMAR -2.92) and the difference between both eyes (per 0.1 increase in logMAR -0.87) were associated with a reduced LFVFS score (all p < 0.001). For the LFSES score, we showed that the influence of sex was minor, and that age (per 5 years -0.22), visual acuity of the better eye (-1.65), and the difference between both eyes (-0.56) were associated with a lower score (all p < 0.001).Conclusions: We report age- and sex-specific reference data from a large population-based study of mainly Caucasian ethnicity of two unidimensional scores based on Rasch-transformed NEI VFQ-25 data. Vision-related QoL is lower in older and in female individuals. Our results support the association of vision-related QoL not only with the distance-corrected visual acuity of the better eye but also with the difference in visual acuity between each eye. Our findings could be used as a reference for comparison in future studies addressing the influence of eye diseases on vision-related QoL. [ABSTRACT FROM AUTHOR]