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Exercise with unstable objects is a popular intervention used by health care and fitness professionals. Understanding different professional beliefs and usage patterns might provide insight for future research and development of evidence-based guidelines. The purpose of this survey study was to document the perceptions, beliefs, and the use of exercise with unstable objects among health care and fitness professionals in the United States. Six hundred and sixteen respondents completed the survey. Most respondents used unstable objects for musculoskeletal postinjury fitness/return to performance (72%). Most believed the main therapeutic effects were enhanced motor control (88%), balance (86%), and somatosensory (85%) function. Most reported using the foam pad (80%) and BOSU (84%). The most used subjective measure was the Activities-specific Balance Confidence scale. Most respondents used single limb stance (85%) to measure static motor control and the single leg squat assessment (51%) for dynamic motor control. Respondents used variables such as dynamic movement, repetition and sets, and time during training. Respondents considered recent injury or surgery and neurological or vestibular conditions as the top precautions. Respondents considered acute injury or surgery and neurological or vestibular conditions as the top contraindications. This survey provides insight into health care and fitness professionals perceptions, beliefs, and use of exercise with unstable objects. [ABSTRACT FROM AUTHOR]

Gun violence is a principal cause of premature death in America. It has been suggested that solutions to gun violence may be found using a public health approach, which is broader than dealing with the problem via law enforcement alone. A component of a public health approach to gun violence is the implementation of policies or laws. Unfortunately, there is a serious gap in our understanding of how street-level police officers view proposed or existing firearms legislation. This is an important omission, because it is line-level personnel who are tasked with enforcing these policies within highly discretionary contexts. We surveyed police from three jurisdictions to establish a baseline understanding of officers' views about potential gun legislation and identify possible resistance and implementation barriers of firearms laws. The findings suggest that those responsible for enforcing new laws show limited or mixed support for the same. Officers were most supportive of laws that increase the presence of trained gun owners within certain contexts and ensure that individuals with criminal backgrounds or mental health concerns do not have access to firearms. Most officers support prohibiting gun ownership following conviction of a domestic violence offense. However, officers generally opposed gun legislation banning assault weapons, large capacity magazines, and internet ammunition purchases. Finally, officers with the Buffalo Police Department—which recently had experienced an active-shooter event—were more supportive of almost all types of legislation. Respondents expressing greater concern about officer safety related to firearms were supportive of several types of firearm legislation. [ABSTRACT FROM AUTHOR]

The onset of the COVID-19 pandemic in the United States may have led investors or other individuals to expect sharp drops in output and rising prices, as well as drastic changes in fiscal and/or monetary to deal with the crisis. This paper analyses the co-movement between expected inflation and interest in the U.S. by using a battery of wavelet tools over the period from January 21, 2020 to March 28, 2022. Wavelet methods are used to examine the linkages between expected inflation and nominal interest rates of varying terms, focusing on the direction of co-movement and their sub-time horizons. Both bivariate wavelet and partial wavelet models that incorporate daily COVID-19 case counts or a financial stress variable find that the relationship holds primarily in the longer short-run (more than 6 months), with connections stronger for maturities of 5 years than for 1 year or less. The expectation related to the 'inflation–interest rate' nexus and type of bond maturity seem to be significantly shaped by the pandemic peak and anticipated duration of the disease. More precisely, the longer the anticipated duration of the pandemic is, the higher the expected inflation rate, bond yield rate, and maturity are. The interaction between expected inflation and interest seems to be very sensitive to pandemic and financial stress in terms of lead-lag status, in the very short to short-run, for 5 and 10 years bond maturity. This seems to be explained by investor hazard to a new particular unknown stimulus caused by the pandemic and its socio-economic consequences. [ABSTRACT FROM AUTHOR]

Objective: To evaluate practitioner use of ketamine and identify potential barriers to use in acutely and critically ill patients. To compare characteristics, beliefs, and practices of ketamine frequent users and non-users. Methods: An online survey developed by members of the Society of Critical Care Medicine (SCCM) Clinical Pharmacy and Pharmacology Section was distributed to physician, pharmacist, nurse practitioner, physician assistant and nurse members of SCCM. The online survey queried SCCM members on self-reported practices regarding ketamine use and potential barriers in acute and critically ill patients. Results: Respondents, 341 analyzed, were mostly adult physicians, practicing in the United States at academic medical centers. Clinicians were comfortable or very comfortable using ketamine to facilitate intubation (80.0%), for analgesia (77.9%), procedural sedation (79.4%), continuous ICU sedation (65.8%), dressing changes (62.4%), or for asthma exacerbation and status epilepticus (58.8% and 40.4%). Clinicians were least comfortable with ketamine use for alcohol withdrawal and opioid detoxification (24.7% and 23.2%). Most respondents reported "never" or "infrequently" using ketamine preferentially for continuous IV analgesia (55.6%) or sedation (61%). Responses were mixed across dosing ranges and duration. The most common barriers to ketamine use were adverse effects (42.6%), other practitioners not routinely using the medication (41.5%), lack of evidence (33.5%), lack of familiarity (33.1%), and hospital/institutional policy guiding the indication for use (32.3%). Conclusion: Although most critical care practitioners report feeling comfortable using ketamine, there are many inconsistencies in practice regarding dose, duration, and reasons to avoid or limit ketamine use. Further educational tools may be targeted at practitioners to improve appropriate ketamine use. [ABSTRACT FROM AUTHOR]

In an effort to aid the reopening of workplaces and curb the spread of COVID-19 in the workplace, the Occupational Safety and Health Administration (OSHA) in the United States of America issued a set of guidelines for COVID-19. While the importance of these measures has been touted, studies focusing on antecedents of compliance with workplace safety guidelines, including those of COVID-19, are at a nascent stage. The current research draws on social cognitive theory to investigate the effect of psychological entitlement on adherence to COVID-19 workplace safety protocols. Specifically, the present study proposes that psychological entitlement increases one's tendency for moral disengagement, which subsequently reduces compliance with COVID-19 workplace safety protocols. Consistent with social cognitive theory, the study further proposes moral identity as a conditional moderator in mitigating the proposed relationships. The current study finds general support for the hypothesized moderated mediation model by employing multi-wave data collected from various organizations in the United States (N = 351). Theoretical and practical implications, as well as future research directions, are discussed. [ABSTRACT FROM AUTHOR]

Objective: To provide a position statement update from The American Headache Society specifically regarding therapies targeting calcitonin gene‐related peptide (CGRP) for the prevention of migraine. Background: All migraine preventive therapies previously considered to be first‐line treatments were developed for other indications and adopted later for migraine. Adherence to these therapies is often poor due to issues with efficacy and tolerability. Multiple new migraine‐specific therapies have been developed based on a broad foundation of pre‐clinical and clinical evidence showing that CGRP plays a key role in the pathogenesis of migraine. These CGRP‐targeting therapies have had a transformational impact on the management of migraine but are still not widely considered to be first‐line approaches. Methods: Evidence regarding migraine preventive therapies including primary and secondary endpoints from randomized placebo‐controlled clinical trials, post hoc analyses and open‐label extensions of these trials, and prospective and retrospective observational studies were collected from a variety of sources including PubMed, Google Scholar, and ClinicalTrials.gov. The results and conclusions based upon these results were reviewed and discussed by the Board of Directors of The American Headache Society to confirm consistency with clinical experience and to achieve consensus. Results: The evidence for the efficacy, tolerability, and safety of CGRP‐targeting migraine preventive therapies (the monoclonal antibodies: erenumab, fremanezumab, galcanezumab, and eptinezumab, and the gepants: rimegepant and atogepant) is substantial, and vastly exceeds that for any other preventive treatment approach. The evidence remains consistent across different individual CGRP‐targeting treatments and is corroborated by extensive "real‐world" clinical experience. The data indicates that the efficacy and tolerability of CGRP‐targeting therapies are equal to or greater than those of previous first‐line therapies and that serious adverse events associated with CGRP‐targeting therapies are rare. Conclusion: The CGRP‐targeting therapies should be considered as a first‐line approach for migraine prevention along with previous first‐line treatments without a requirement for prior failure of other classes of migraine preventive treatment. [ABSTRACT FROM AUTHOR]

Despite a long line of scholarship on race and social control, evidence that incarceration can be connected to slavery is difficult to provide. This study evaluates whether slavery had long-term effects on growth in state incarceration rates by focusing on two key theoretical indicators: the size of the enslaved population prior to the Civil War and demographic changes during the Great Migration. Results reveal that states that historically had larger enslaved populations and those that acted as destinations for southern migrants experienced increased growth in incarceration between 1970 and 2015. Mediation analyses show that both variables have indirect effects on change in incarceration rates through contemporary demographic composition and public opinion. These findings lend support to theoretical claims that link slavery to mass incarceration and shed light on the mechanisms that enable racial histories to map onto current criminal punishments. [ABSTRACT FROM AUTHOR]

Purpose: The Polish economy has undergone major challenges and changes over the past few decades. The country's trade flows, in particular, have become more firmly tied to the country's Western neighbors as they have grown in volume. This study examines Poland's trade balances in ten Standard International Trade Classification (SITC) sectors versus the United States of America, first testing for and isolating structural breaks in each time series. These breaks are then included in a set of the cointegration models to examine their macroeconomic determinants. Design/methodology/approach: Linear and nonlinear and nonlinear autoregressive distributed lag models, both with and without dummies corresponding to structural breaks, are estimated. Findings: One key finding is that incorporating these breaks reduces the significance of the real exchange rate in the model, supporting the hypothesis that this variable already incorporates important information. It also results in weaker evidence for cointegration of all variables in certain sectors. Research limitations/implications: This study looks only at one pair of countries, without any third-country effects. Originality/value: An important country pair's trade relations is examined; in addition, the real exchange rate is shown to incorporate economic information that results in structural changes in the economy. The paper extends the existing literature by conducting an analysis of Poland's trade balances with the USA, which have not been studied in such a context so far. A strong point is a broad methodology that lets compare the results the authors obtained with different kinds of models, both linear and nonlinear ones, with and without structural breaks. [ABSTRACT FROM AUTHOR]

Simple Summary: The khapra beetle is considered by many to be one of the most destructive stored product pests in the world and it is a quarantine species of significant concern in the United States. This beetle is known to feed on >100 commodities, leaving behind frass, broken and damaged grain kernels, and cast skins, which can make products unsuitable for consumption. Because its immature stage is so problematic, it is critical to identify effective management strategies, which could include fumigation, trapping, and insecticides. In this study, we investigated whether two different grain protectants applied to bulk corn, wheat, and brown rice could be efficacious for inhibiting the development from larvae to adult. Both grain protectants reduced adult emergence on brown rice for 6 months of storage and wheat and corn for up to 12 months of storage. Additional studies are needed to directly measure the amount of frass, feeding damage, and/or insect-damaged kernels (IDK), and larval weight, which would provide further insight on the relationship between commodity type and the efficacy of the insecticide application. Reducing adult emergence inhibits reproduction and population growth during storage. Thus, grain protectants can be a useful preventative tactic for stored commodity managers against the khapra beetle. Trogoderma granarium Everts, the khapra beetle, is a serious pest of stored products throughout the world. Larvae pose a significant threat to stored products because they feed on >100 different commodities, possess the ability to enter facultative diapause, and are difficult to detect. Control methods for T. granarium include fumigation, contact insecticides, trapping, and insecticide-incorporated packaging. The objective of this study was to determine the residual efficacy of two insecticide formulations (methoprene + deltamethrin + piperonyl butoxide synergist Gravista® and methoprene + deltamethrin, DiaconIGR®Plus). These insecticides were evaluated on three stored product commodities, corn, wheat, and brown rice, by exposing T. granarium larvae during a 12-month testing period. Both formulations significantly reduced adult emergence on corn and wheat for 12 months and on brown rice for up to 6 months. Adult emergence was highest at month 12 for corn (8.41%), and brown rice (85.88%), and month 9 for wheat (39.52%), treated with DiaconIGR®Plus or Gravista®, respectively. A biological index used to measure the development of exposed larvae on the treated grain from the larval stage (low values) to adult emergence (high values) was lower (fewer adults) on corn and wheat compared to controls. Despite differences in formulations, each of these grain protectants could be utilized by stored commodity managers to protect commodities during storage and transportation for T. granarium when and if this pest is detected at USA ports of entry. [ABSTRACT FROM AUTHOR]

This study evaluates how homicide, racial threat, and media discourse interacted to shape the timing and persistence of prison growth in the United States. Drawing on Blumer's classic work, I argue that media discourse circulates threat narratives that portray racial minorities as either economically, politically, or criminally threatening. Criminal threat narratives increase in response to highly salient crimes, like homicide, and exert institutionally specific pressures that increase incarceration. To evaluate these claims, I use machine learning to classify 1,026,862 news articles in accordance with economic, political, and criminal threat themes in a time series analysis of the national incarceration rate between 1926 and 2016. Results reveal that the period of prison growth is characterized by an influx of criminal threat narratives that coincides with increases in the homicide rate. Criminal threat narratives and the homicide rate both have sizable long-term effects on the incarceration rate, whereas economic and political threat narratives have little explanatory power. Further analyses show that criminal threat narratives account for roughly half of the effect of the homicide rate on incarceration, and that the homicide rate has an indirect effect on racial disparity in prison admissions by acting through criminal threat narratives. These findings support core theoretical claims and expand our understanding of the complex interaction between racial threat and homicide in the historical rise of incarceration. [ABSTRACT FROM AUTHOR]

Overt and covert conflict across two parental dyads (biological mother and biological father, biological mother and stepfather) in the same family were examined in relation to emerging adults' mental health (i.e., perceived stress, depressive symptoms, anxiety) and aggression (i.e., relational aggression, verbal hostility). In this study, the results from dominance analyses and relative weight analyses revealed the most important interparental conflict variable related to males' mental health and aggression was conflict between biological mothers and stepfathers (particularly covert). For females, conflict between biological parents (especially covert) was most important to mental health, while conflict between mothers and stepfathers was more strongly related to females' aggression (particularly overt for verbal hostility and covert for relational aggression). [ABSTRACT FROM AUTHOR]

This article presents a mixed-methods study of the methods and maturity of user experience (UX) practice in academic libraries. The authors apply qualitative content analysis and quantitative statistical analysis to a research dataset derived from a survey of UX practitioners. Results reveal the type and extent of UX methods currently in use by practitioners in academic libraries. Themes extracted from the survey responses also reveal a set of factors that influence the development of UX maturity. Analysis and discussion focus on organizational characteristics that influence UX methods and maturity. The authors conclude by offering a library-focused maturity scale with recommended practices for advancing UX maturity in academic libraries. [ABSTRACT FROM AUTHOR]

Explaining the spread and impact of health misinformation has garnered considerable attention with the uptake of social media and group messaging applications. This study contributes to that line of work by investigating how reliance on multiple digital media may help support or suppress misinformation belief, and how individual differences in misinformation susceptibility condition this process. Alternative health outlets (AH media), advocating home/homeopathic remedies over conventional medicine can be important sources of misinformation, yet are largely ignored previously. In this study, we first test how reliance on different platforms predicts health misinformation belief. Drawing from the elaboration likelihood model, we further investigate how need for cognition (NFC) and faith in intuition (FI) moderate the relationship between news reliance and susceptibility to misinformation. We conducted a survey in Singapore, Turkey, and the U.S (N = 3,664) to measure how these proposed relationships explain misinformed beliefs about vaccines, genetically modified foods and alternative medicine. We found reliance on online legacy news was negatively associated with the likelihood of believing health misinformation, while the reverse was true for social media and AH media. Additionally, those with both greater NFC and FI were more susceptible to health misinformation when they relied on social media and AH media more. In contrast, neither NFC nor FI moderated the relationship between reliance on online legacy news and health misinformation belief. These findings, mostly consistent across countries, also show that extensive reliance on social media and AH media for news mostly overwhelms the individual differences in predicting misinformation belief. [ABSTRACT FROM AUTHOR]

Research on effectiveness of school bullying interventions has lagged behind descriptive studies on this topic. The literature on bullying intervention research has only recently expanded to a point that allows for synthesis of findings across studies. The authors conducted a meta-analytic study of school bullying intervention research across the 25-year period from 1980 through 2004, identifying 16 studies that met our inclusion criteria. These studies included 15,386 K through 12 student participants from European nations and the United States. Applying standard meta-analysis techniques to obtain averaged effect size estimates across similar outcomes, the authors found that the intervention studies produced meaningful and clinically important positive effects for about one-third of the variables. The majority of outcomes evidenced no meaningful change, positive or negative. The authors conclude that school bullying interventions may produce modest positive outcomes; that they are more likely to influence knowledge, attitudes, and self-perceptions rather than actual bullying behaviors; and that the majority of outcome variables in intervention studies are not meaningfully impacted. (Contains 4 tables.)

The tally of occurrences of a PC buzzword on academic and other websites seems to corroborate the suspicion that we're quickly abandoning "e pluribus unum" as the governing principle for treating individuals justly. In its place is the new image of America as a melange of competing interest groups. In this NAS research on comparative usage, word-counts indicate that higher education, more than any other opinion-determining segment of our society, is exalting the fractious concept of "diversity" over such unifying ideals as freedom, liberty, democracy, and equality. (Contains 8 tables and 9 notes.)

The U.S. Food and Drug Administration and European Commission have developed successful orphan drug legislation to promote the research, development, and marketing approval of drugs to treat rare diseases. Central to these regulations are the concepts of structural similarity and clinical superiority/significant benefit to achieve orphan drug exclusivity. However, differences in health authority expectations remain regarding the qualification for an orphan drug designation, defining structural similarity, and demonstrating clinical superiority/significant benefit. These differences can create sponsor company uncertainty regarding the approvability of products (e.g., blocking risk by an existing orphan product) and divergent orphan drug decisions among health authorities. A comprehensive assessment of current regulations, case studies in exclusivities, and recommendations for improvement are presented. [ABSTRACT FROM AUTHOR]

Mobile media are fundamental to social life in a growing number of ways. Beyond the mundane, the technology has come to play a meaningful role in protests and emergent demonstrations worldwide, including recent cases of political violence among far-right groups in the U.S. Drawing from the folk theory tradition, this study samples Alt-Right supporters to investigate how perceived essence of mobile media, particularly as a tool for collective action, is associated with willingness to engage in racially motivated and extreme political action in offline and online contexts. Findings reveal that perceptions of the mobile phone as a tool for collective action are associated with greater intentions to participate in online and offline activity explicitly in support of White people. Additionally, we find cases where links between essence and intentions are strengthened among those reporting higher levels of micro-coordination, or use of mobile media for coordinating with others in daily life. The findings indicate how everyday life perceptions and practices function and interact in ways that help explain willingness to join racially motivated calls to action among this group. The discussion offers implications for studying mobile media and collective action more broadly, especially in the context of under-researched political groups. [ABSTRACT FROM AUTHOR]

Rising poverty in suburbs has led to increased interest in how well suburban safety nets function. Apart from public assistance programs, community-based nonprofit health and human service organizations play a central role in suburban efforts to address racial and economic inequalities. Understanding how nonprofit services are distributed across the suburban and urban landscape, therefore, is critical to assessing how communities may be able to address need. In this paper, we examine the presence and volatility of nonprofit health and human service expenditures in suburban and urban counties across the United States from 2000 to 2017. We find the nonprofit safety net to be more responsive in urban centers than in suburban places, and less robust in suburban areas experiencing high rates of poverty or with a larger share of residents who are Black. Nonprofit health and human service spending also appears less countercyclical than is commonly understood. Suburban-urban disparities in nonprofit health and human service spending persist after controlling for several county-level demographic and socioeconomic factors. [ABSTRACT FROM AUTHOR]

Findings from this survey of China and the United States support the proposition that bounded connected mobility, or use of mobile media while moving within locations, can be distinctively meaningful for how and why people use the technology. Among the results, we found that in China, connected mobility at home was associated with use of the technology for coordination, while between locations was associated with news. In the United States, connected mobility at home was associated with the use of the technology for passing time, and between locations was associated with personal relationships. The discussion interprets these and other findings in light of the COVID-19 pandemic and different lockdown conditions in China and the United States, as well as implications for scholarship on placemaking, mobilities, and mobile media and communication. [ABSTRACT FROM AUTHOR]

Background: In sports medicine, the interprofessional care of athletes has become a frequent practice. This type of care often involves different interventions used among professionals. One common intervention prescribed is roller massage (RM) or selfmyofascial release. The trends in the use of RM among allied health professionals are nonexistent. The surveillance of such responses has not been documented. Purpose: To survey and document responses in the knowledge, clinical application, and use of RM devices among allied health professionals in the United States. Design: Cross-sectional descriptive survey study. Methods: A 20-question survey was sent to allied health professionals including physical therapists, athletic trainers, and fitness professionals. The survey covered topics such as demographics, beliefs about RM, preferred devices, exercise prescription, and client education. Results: One thousand and forty-two professionals (N = 1042) completed the survey. Most respondents believed thatRM decreases pain (82%) and increases mobility (76%). A high percentage use a foam roller in their practice (81%), recommend a full-size foam roller (49%), and believe the medium density (48%) is the most effective. A high proportion of respondents prescribe RM for injury treatment (69%) and for preexercise and postexercise (61%). They also recommend rolling daily for 30 seconds to 2 minutes per muscle group (33%) at a self-paced cadence (46%). A high percentage of respondents use patient-reported outcomes (74%), joint range of motion (49%), and movement-based testing (48%) to measure effects of RM. Eighty-seven percent use live instruction to educate clients, and 88% believe there is a gap in the research. Conclusion: The results of this survey document responses in the use of RM among allied health professionals. The reported responses provide insight into how professionals are using RM as an intervention and the potential gaps between the research and professional practice. Future studies are needed to further validate these findings. [ABSTRACT FROM AUTHOR]

The United States pays more for medical care than any other nation in the world. including for prescription drugs. These costs are inequitably distributed, as individuals from underrepresented racial and ethnic groups in the United States experience the highest costs of care and unequal access to high-quality, evidence-based medication therapy. Pharmacciequity refers to equity in access to pharmacotherapies or ensuring that all patients, regardless of race and ethnicity, socioeconomic status, or availability of resources, have access to the highest quality of pharmacotherapy required to manage their health conditions. Herein the authors describe the urgent need to prioritize pharmacoequity. This goal will require a bold and innovative examination of social policy, research infrastructure, patient and prescriber characteristics, as well as health policy determinants of inequitable medication access. In this article, the authors describe these determinants, identify drivers of ongoing inequities in prescription drug access, and provide a framework for the path toward achieving pharmacoequity. [ABSTRACT FROM AUTHOR]

Special education administrators have an influence over adapted physical education (APE) services, however little research to date has assessed special education administrators' knowledge of APE services. Thus, the purpose of this study was to determine special education administrators' knowledge of APE services. Fifty-one special education administrators completed a 21-question content knowledge test about key areas within the field of APE. A series of exploratory t-tests were used to determine whether their overall test scores differed significantly by a variety of demographic variables (e.g., gender, prior APE training). In addition, a repeated measures ANOVA was used to determine whether there were any significant differences between the three subsections of the test. Participants' overall test scores were approximately 40% (M = 8.41, SD = 2.28), which was similar to all three sub-sections within the test ('federal laws and APE' = 43%, M = 3.04, SD = 1.34; 'best teaching practices in APE' = 38%, M = 2.76, SD = 1.29; 'inclusion and least restrictive environment and APE' = 39%, M = 2.63, SD = 1.06). Test scores did not significantly differ by any of the demographic variables, p >.05. Recommendations for future research and professional development are discussed. [ABSTRACT FROM AUTHOR]

Background: The definition for anemia in pregnancy is outdated, derived from Scandinavian studies in the 1970's to 1980's. To identity women at risk of blood transfusion, a common cause of Severe Maternal Morbidity, a standard definition of anemia in pregnancy in a modern, healthy United States cohort is needed. Objective: To define anemia in pregnancy in a United States population including a large county vs. private hospital population using uncomplicated patients. Materials and methods: Inclusion criteria were healthy women with the first prenatal visit before 20 weeks. Exclusion criteria included preterm birth, preeclampsia, hypertension, diabetes, short interval pregnancy (<18 months), multiple gestation, abruption, and fetal demise. All women had iron fortification (Ferrous sulfate 325 mg daily) recommended. The presentation to care and pre-delivery hematocrits were obtained, and the percentiles determined. A total of 2000 patients were included, 1000 from the public county hospital and 1000 from the private hospital. Each cohort had 250 patients in each 2011, 2013, 2015, and 2018. The cohorts were compared for differences in the fifth percentile for each antepartum epoch. Student's t-test and chi-squared statistical tests were used for analysis, p-value of ≤0.05 was considered significant. Results: In the public and private populations, 777 and 785 women presented in the first trimester while 223 and 215 presented in the second. The women at the private hospital were more likely to be older, Caucasian race, nulliparous, and present earlier to care. The fifth percentile was compared between the women in the private and public hospitals and were clinically indistinguishable. When combining the cohorts, the fifth percentile for hemoglobin/hematocrit was 11 g/dL/32.8% in the first trimester, 10.3 g/dL/30.6% in the second trimester, and 10.0 g/dL/30.2% pre-delivery. Conclusions: Fifth percentile determinations were made from a combined cohort of normal, uncomplicated pregnancies to define anemia in pregnancy. Comparison of two different cohorts confirms that the same definition for anemia is appropriate regardless of demographics or patient mix. [ABSTRACT FROM AUTHOR]

Inquiry-based and problem-based learning are teaching strategies that classrooms across the United States are utilizing. Many agricultural education programs have incorporated hands-on or experiential learning activities, not only to teach their students, but to allow students to develop different skills to be successful within the agricultural industry. This study focused on students' perceptions of Curriculum for Agricultural Science Education (CASE). Leagans Major Elements in a Teaching-Learning Situation was the framework for this study. Students indicated through focus groups that hands-on experiences and activities worked well in allowing them to learn the curriculum. Students indicated a strength of the CASE curriculum was the objectives that guided the learning. Challenges students experienced were with equipment and instructions that were lengthy and wordy. Future research should focus on a larger audience in multiple high school CASE certified programs across the country as well as identify administrator's perceptions of the benefits and challenges of CASE. [ABSTRACT FROM AUTHOR]

Objective Duration of Untreated Psychosis (DUP) remains unacceptably long and limits effectiveness of care. To determine whether an early detection campaign ("Mindmap") can reduce DUP in a US community setting. Methods In this nonrandomized controlled trial, Mindmap targeted the catchment of one specialty first-episode service or FES (STEP, Greater New Haven) from 2015 to 2019, while usual detection efforts continued at a control FES (PREP, Greater Boston). Mindmap targeted diverse sources of delay through mass & social media messaging, professional outreach & detailing, and rapid enrollment of referrals. Both FES recruited 16–35 years old with psychosis onset ≤3 years. Outcome measures included DUP-Total (onset of psychosis to FES enrollment), DUP-Demand (onset of psychosis to first antipsychotic medication), and DUP-Supply (first antipsychotic medication to FES enrollment). Results 171 subjects were recruited at STEP and 75 at PREP. Mindmap was associated with an increase in the number of referrals and in efficiency of engagement at STEP. Pre-campaign DUP (2014–2015) was equivalent, while Mindmap was associated with DUP reductions at STEP but not PREP. DUP-Total fell significantly in both the first and the second quartile (11.5 and 58.5 days reduction per campaign year, respectively). DUP-Demand and DUP-Supply fell in the third quartiles only (46.3 and 70.3 days reduction per campaign year, respectively). No reductions were detectable across all quartiles at PREP, but between site comparisons were not significant. Conclusions This is the first controlled demonstration of community DUP reduction in the US, and can inform future early detection efforts across diverse settings. [ABSTRACT FROM AUTHOR]

Adefining characteristic of mass incarceration is the overwhelming racial disparity in US prison populations. Yet, little research has examined the role of public attitudes in the growth of racial disparity in incarceration rates during the prison boom. This article considers the influence of explicit and modern forms of prejudice and traces a portion of the rise in racial disparity in incarceration rates to historically high levels of fear of crime. It analyzes roughly forty years of annual data on incarceration at the state level, leveraging recent methodological developments for polling data to construct longitudinal measures of state public opinion from 386,751 individual survey responses to a pooled sample of 102 national surveys. Results from panel models show that public fear of crime played a larger role in explaining rising racial disparity in incarceration rates than explicit prejudice or laissez-faire racial attitudes. Further analyses demonstrate that fear of crime mediates a sizable portion of the effect of race-specific offending. These findings reveal that it is fear of crime and its radicalized overtones, rather than explicit or laissez-faire racial attitudes, that contributes to much of the observed racial inequality in the criminal justice system. [ABSTRACT FROM AUTHOR]

Background: Surgical treatment of partial-thickness rotator cuff tears remains challenging and controversial, with several traditional options including debridement with acromioplasty, transtendon or in situ repair, and take-down and repair. A resorbable bioinductive bovine collagen implant has shown promise as an alternative treatment option for partial-thickness tears. Purpose: Data from a registry were analyzed to further establish that the implant contributes to improved patient-reported outcome (PRO) scores across a large number of patients treated for partial-thickness rotator cuff tears. Study Design: Case series; Level of evidence, 4. Methods: A total of 19 centers in the United States enrolled patients >21 years old with partial-thickness tears of the rotator cuff in a comprehensive prospective multicenter registry. PRO scores were recorded preoperatively and postoperatively at 2 and 6 weeks, 3 and 6 months, and 1 year: American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, Veterans RAND 12-Item Health Survey (physical and mental component scores), and Western Ontario Rotator Cuff scores. Revisions were reported throughout the study. Results: The registry included 272 patients with partial-thickness tears (49 grade 1 tears, 101 grade 2 tears, and 122 grade 3 tears), 241 who underwent isolated bioinductive repair (IBR; collagen implant placed after bursectomy without a traditional rotator cuff repair), and 31 who had take-down and repair with bioinductive augmentation. Patients experienced statistically significant and sustained improvement from baseline for all PRO scores beginning at 3 months. Among patients with grade ≥2 tears, those with take-down and repair had significantly inferior scores at 2 and 6 weeks for most PRO scores as compared with those who underwent IBR, but the difference was no longer significant at 1 year for all but the physical component score of the Veterans RAND 12-Item Health Survey. There were 11 revisions, which occurred at a mean ± SD of 188.7 ± 88.0 days after the index surgery. There were no infections. Conclusion: This registry analysis further establishes across a large data set that this resorbable bioinductive bovine collagen implant improves PROs in all grades of partial-thickness tears, whether used as IBR or in conjunction with take-down and repair. IBR may offer improved early clinical outcomes (≤6 weeks) and comparable outcomes at 1 year when compared with a more invasive "take-down and repair" approach. [ABSTRACT FROM AUTHOR]

Background The existing body of kinesiology tape (KT) research reveals inconsistent results which challenges the efficacy of the intervention. Understanding professional beliefs and KT clinical application might provide insight for future research and development of evidence-based guidelines. Purpose The purpose of this study was to survey and document the beliefs and clinical application methods of KT among healthcare professionals in the United States. Design Cross-sectional survey study. Methods A 30-question online survey was emailed to members of the National Athletic Trainers Association, Academy of Orthopedic Physical Therapy, and American Academy of Sports Physical Therapy. Professionals were also informed through a recruitment post in different private healthcare Facebook groups. Results One thousand and eighty-three respondents completed the survey. Most respondents used KT for post-injury treatment (74%), pain modulation (67%), and neuro-sensory feedback (60%). Most believed that KT stimulates skin mechanoreceptors (77%), improve local circulation (69%), and modulates pain (60%). Some respondents believed KT only created a placebo effect (40%) and use it for such therapeutic purposes (58%). Most used a standard uncut roll (67%) in black (71%) or beige (66%). Most respondents did not use any specialty pre-cut tape (83%), infused tape (99.54%), or a topical analgesic with tape (65%). The most common tape tension lengths used by respondents were 50% tension (47%) and 25% (25%) tension. Patient reported outcomes (80%) were the most common clinical measures. Most respondents provided skin prep (64%) and tape removal (77%) instructions. Some did not provide any skin prep (36%) or tape removal (23%) instruction. The average recommended times to wear KT were two to three days (60%). The maximum times ranged from two to five days (81%). Conclusion This survey provides insight into how professionals use KT and highlights the gap between research and practice. Future research should address these gaps to better determine evidence-based guidelines. [ABSTRACT FROM AUTHOR]

Objective: To provide guidance on the management of Multisystem Inflammatory Syndrome in Children (MIS‐C), a condition characterized by fever, inflammation, and multiorgan dysfunction that manifests late in the course of severe acute respiratory syndrome coronavirus 2 (SARS–CoV‐2) infection. Recommendations are also provided for children with hyperinflammation during coronavirus disease 2019 (COVID‐19), the acute, infectious phase of SARS–CoV‐2 infection. Methods: The Task Force was composed of 9 pediatric rheumatologists and 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care physician. Preliminary statements addressing clinical questions related to MIS‐C and hyperinflammation in COVID‐19 were developed based on evidence reports. Consensus was built through a modified Delphi process that involved anonymous voting and webinar discussion. A 9‐point scale was used to determine the appropriateness of each statement (median scores of 1–3 for inappropriate, 4–6 for uncertain, and 7–9 for appropriate). Consensus was rated as low, moderate, or high based on dispersion of the votes. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, which were prespecified before voting. Results: The first version of the guidance was approved in June 2020, and consisted of 40 final guidance statements accompanied by a flow diagram depicting the diagnostic pathway for MIS‐C. The document was revised in November 2020, and a new flow diagram with recommendations for initial immunomodulatory treatment of MIS‐C was added. Conclusion: Our understanding of SARS–CoV‐2–related syndromes in the pediatric population continues to evolve. This guidance document reflects currently available evidence coupled with expert opinion, and will be revised as further evidence becomes available. [ABSTRACT FROM AUTHOR]

The present, exploratory study examined retrospective and current peer victimization in a multi-university sample of 58 college students with disabilities, 18 (31%) of whom identified as sexual minorities. Fifty-seven participants reported peer victimization during childhood, and approximately half reported experiencing peer victimization in the past 2 months. Students who identified as sexual minorities reported more retrospective victimization but current victimization did not differ between the two groups. Current and retrospective peer victimization were significantly correlated with present psychological distress. Professionals who work with students with disabilities should be aware of the high prevalence of peer victimization and its psychological correlates in this population. [ABSTRACT FROM AUTHOR]

Objective: To provide guidance on the management of multisystem inflammatory syndrome in children (MIS‐C), a condition characterized by fever, inflammation, and multiorgan dysfunction that manifests late in the course of severe acute respiratory syndrome coronavirus 2 (SARS–CoV‐2) infection, and to provide recommendations for children with hyperinflammation during coronavirus disease 2019 (COVID‐19), the acute, infectious phase of SARS–CoV‐2 infection. Methods: A multidisciplinary task force was convened by the American College of Rheumatology (ACR) to provide guidance on the management of MIS‐C associated with SARS–CoV‐2 and hyperinflammation in COVID‐19. The task force was composed of 9 pediatric rheumatologists, 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care physician. Preliminary statements addressing clinical questions related to MIS‐C and hyperinflammation in COVID‐19 were developed based on evidence reports. Consensus was built through a modified Delphi process that involved 2 rounds of anonymous voting and 2 webinars. A 9‐point scale was used to determine the appropriateness of each statement (median scores of 1–3 for inappropriate, 4–6 for uncertain, and 7–9 for appropriate), and consensus was rated as low, moderate, or high based on dispersion of the votes along the numeric scale. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, as prespecified prior to voting. Results: The ACR task force approved a total of 128 guidance statements addressing the management of MIS‐C and hyperinflammation in pediatric COVID‐19. These statements were refined into 40 final clinical guidance statements, accompanied by a flow diagram depicting the diagnostic pathway for MIS‐C. Conclusion: Our understanding of SARS–CoV‐2–related syndromes in the pediatric population continues to evolve. The guidance provided in this "living document" reflects currently available evidence, coupled with expert opinion, and will be revised as further evidence becomes available. [ABSTRACT FROM AUTHOR]

The traditional understanding of the relations of courts-martial to the Article III courts was set out in Dynes v. Hoover 7, where a sailor who had been convicted of attempted desertion by a naval court-martial brought an action of assault and battery and false imprisonment. The Supreme Court, in Northern Pipeline Construction Co. v. Marathon Pipe Line Co. 5 - a less-than-successful 1982 attempt to draw lines between matters that had to go to the Article III courts and those that did not - listed courts-martial as one of three traditional areas where Congress has used Article I courts. 797 Catholic University Law Review Symposium KEYNOTE SPEECH APPELLATE REVIEW OF COURTS-MARTIAL IN THE UNITED STATES January 24, 2020 Chief Judge Scott W. Stucky + United States Court of Appeals for the Armed Forces William Tecumseh Sherman was one of the greatest commanders of the 19 th century. Thus, Robert Quinn, the original chief judge, served as such for almost 20 years until President Nixon designated someone else, and Chief Judge Robinson Everett was chief judge for virtually his whole tenure on the Court. [Extracted from the article]

Has the Supreme Court adequately atoned for Dred Scott and Plessy? A Court majority has never confessed and apologized for the horrors associated with those decisions. And the horrors are so great that Dred Scott and Plessy have become the anti-canon of constitutional law. Given the extraordinary circumstances surrounding the Court's historical complicity in the brutal campaign against African Americans, this Article contends that the Court could appropriately do more to atone. The Article asserts that the Court could profitably pursue atonement while abolishing capital punishment for aggravated murder. The Article shows why substantial abolition of the capital sanction would constitute a relevant response to the Court's past complicity in the long, violent campaign for white supremacy. The Article also explains why substantial abolition, with a confession and apology, would involve little social cost and could send a valuable message. As for how our racial history could help justify substantial abolition in the language of the Constitution, the Article proposes an approach suggested by decisions in which the Court has combined two or more clauses to justify an outcome that neither clause would authorize on its own. In the death-penalty context, the Court could aggregate the prohibition on cruel and unusual punishments and the command of equal protection. Under that approach, the Court need not find a national consensus against death-penalty systems, nor must it find purposeful discrimination. The Court could rely, instead, on the inability to refute that those systems are remnants of the judicially authorized pursuit of white supremacy. The nature of that conclusion would also distinguish death from other punishments and thereby solve some problems that the Court has identified with abolition using a single-clause methodology. The arguments for vigorous Supreme Court atonement and for limiting the death penalty connect, although they stand apart. The Court could look for a better context than the death penalty to apologize for Dred Scott and Plessy, but a better context is hard to fathom. Likewise, the Court could justify, without apology, restricting the penalty based on our judicially sanctioned quest for white supremacy, but an apology for Dred Scott and Plessy would add a healing message. The actions are synergistic. The Court could achieve something special through the mutually-reinforcing symbolism that could come with simultaneous restriction of the death sanction and robust atonement for Dred Scott and Plessy. [ABSTRACT FROM AUTHOR]

Endovaginal sonographic imaging has been shown to reliably identify pelvic endometriosis, but most United States imaging practices do not adequately assess locations and features of endometriosis beyond ovarian endometrioma. In this article, we propose a protocol for sonographer-acquired images and maneuvers to be interpreted subsequently by sonologists (radiologists or gynecologists). The purpose is to improve the sensitivity of endovaginal sonography for the detection of endometriosis in imaging practices that involve the non-physician sonographer as part of their workflow. [ABSTRACT FROM AUTHOR]

The article discusses the Crisis of Diagnosis and Management of Migraine in Primary Care. Topics include the American Headache Society (AHS) Board of Directors and Education Committee established that a priority of the AHS is improving migraine care in front-line primary care clinical settings; and headache medicine as a topic on specialty medical examinations and coverage in medical school or residency curricula;.

Solid wood packaging material (WPM) is widely recognized as a high-risk pathway for transport and potential introduction of wood-boring insects, including longhorned beetles in the family Cerambycidae. These beetles also are occasionally imported in finished wood products, such as furniture and decorative items. A targeted effort to identify wood borers intercepted as larvae in WPM at U.S. ports between 2012 and 2018 revealed that one of the most frequently intercepted species was Trichoferus campestris (Faldermann), a cerambycid native to Asia. Trichoferus campestris is a pest of quarantine concern in the United States, Canada, and Europe. The establishment risk of this beetle in the United States is high because of its frequent introduction through multiple pathways and its potential to inhabit natural and urban forests as well as agricultural systems. In this study, we compiled port interception and detection data to examine risk based on historical introductions and pathways. We tested whether the intended destination of cargo intercepted with T. campestris -infested WPM can be used as a predictor of inland introductions, assuming that individuals of T. campestris are likely to be moved through established trade routes between export–import partners. We also developed maps to predict likely areas of introduction and establishment in the United States based on pathway analysis and climate suitability data. The maps will enable informed prioritization of resources in pest surveillance, and may serve as models for other wood borers identified in the WPM and wood products pathway. [ABSTRACT FROM AUTHOR]

This study extends generational research by delineating actual versus perceived cohort differences through a theoretically grounded model using the Social Identity Approach (SIA). Subjects rated how much they valued 15 workplace characteristics and then provided value ratings for generational cohorts based on their perceptions of said cohorts. This allowed for the determination of actual and perceived cohort differences by characteristics. Results revealed actual cohort value differences across seven characteristics; however, perceived differences exceeded actual ones. Post-hoc, an examination of cohort values by characteristics revealed generational identities and the presence of prototypical distancing between cohort in groups and out groups. [ABSTRACT FROM AUTHOR]

This study explored the phenomenon of the role episode in sport. Performance profiles and interviews were conducted with 11 male collegiate soccer players to identify the factors that contributed to the formation of positive perceptions of role states and the consequences for the individual and team. Role clarity developed via a combination of learning through implicit experiences in the sport and explicit instruction from role senders. Role acceptance formed through the focal person's perceptions of the assigned performance role and the role sender. Positive perceptions of role states were suggested to improve performance by enhancing individual and group-related variables, including role satisfaction, group cohesion, and collective efficacy. The findings highlight the significance of understanding the factors that contribute to a positive role episode in sport and present implications for future team-building interventions. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine major depressive disorder (MDD) and posttraumatic stress disorder (PTSD) diagnosed at age < 55 as predictors, and sex and race as potential moderators, of dementia and other forms of cognitive impairment. Method: Veterans (N = 4,800) aged ⩾ 56 years were grouped by psychiatric history, sex, and race. Hierarchical and stepwise regression were employed to determine significant predictors. Results: MDD and PTSD were associated with almost double the risk for developing dementia or cognitive impairment at age ⩾ 56. Sex, as a moderator, had small effects whereas race increased the risk almost twofold for Black veterans, given the presence of MDD history. Discussion: MDD and PTSD act as significant risk factors for dementia and other forms of cognitive impairment, and Black veterans, given a history of MDD, may be at an increased risk. An important endeavor for future research is to examine how this risk may vary across dementia subtypes and related conditions. [ABSTRACT FROM AUTHOR]

This Article uncovers a blatantly sexist dynamic that has persisted, largely unnoticed, in American common law for more than a century: courts are far more willing to accept invasive examinations for sexually transmitted infections in women than in men. Remarkably, this disparity has been justified by the same assumption throughout the twentieth century: women with STIs are viewed as a threat to the health of the general public, while men with STIs are viewed as a threat only to individuals, not the public at large. This Article uncovers a blatantly sexist dynamic that has persisted, largely unnoticed, in American common law for more than a century: courts are fa r more willing to accept invasive examinations for sexually transmitted infections in women than in men. Remarkably, this disparity has been justified by the same assumption throughout the twentieth century: women with STIs are viewed as a threat to the health of the general public, while men with STIs are viewed as a threat only to individuals, not the public at large. This doctrine emerged in the early 1900s, as scientific advancements made relatively reliable STI testing a reality, and it evolved throughout the twentieth century. Even following the rights revolution of the Warren Court, this doctrine persisted; remarkably, in the late 1980s and early 1990s, the assumptions underlying the doctrine were actually written into law for the first time. These years marked the heyday of hysteria surrounding the HIV/AIDS epidemic, and authorities across the country called for compulsory HIV testing statutes for both men accused of rape and women accused of prostitution. After considerable struggle, legislatures enacted these laws in dozens of states--and they remain on the books today. Yet these laws were firmly grounded in the gendered assumptions of decades past: male rapists were a threat only to their victims, while prostitutes were a threat to the public at large. These laws openly reflect their underlying assumptions--some testing statutes for accused rapists explicitly declare that their purpose is to provide peace of mind to individual victims, and many of these statutes allow testing only at the request of the alleged victim. Compulsory testing statutes for prostitutes, on the other hand, largely remain grounded in general public health powers. When these laws were challenged, courts across the country unanimously upheld them, and once again they openly relied upon gendered assumptions. Significantly, the venereal doctrine flies in the face of scientific data. Modern studies show that female prostitutes very rarely transmit STIs to their customers, while male rapists are relatively likely to transmit STIs to their victims. Therefore, this Article concludes that compulsory pre-conviction STl examinations of accused prostitutes are unconstitutional. The same may be (but is not necessarily) true for examinations of accused rapists. [ABSTRACT FROM AUTHOR]

• The current status of Biosimilars and Biobetters for the treatment of cancer and other diseases are presented. • Recent regulatory guidance documents are highlighted to guide in the development of Biosimilars and Biobetters. • Current lists of approved products in the U.S. and E.U. are presented. • The challenges of obtaining reference/comparator drug information are discussed. There has been an increasing trend toward the approval of biosimilars in the USA and the EU. The regulatory requirements for demonstration of bioequivalence with comparator and reference products are now better understood. The original goal of legislation to approve biosimilars through a fast-track process that would lead to more competition and price reductions is starting to be realized. This article updates the current list of approved biosimilars in the USA and the EU. Data are presented that outline products in development, and we discuss some of the hurdles for new entries into the market place. The availability of reference data for comparator products has been a major obstacle to drug development, forcing companies to perform their own side-by-side comparison studies, or pursue new drug development candidates as biobetters. [ABSTRACT FROM AUTHOR]

Federal government databases recording officer-involved shooting fatalities are incomplete and unreliable. Voluntary reporting to the Supplementary Homicide Report (SHR), the National Vital Statistics System (NVSS), and the Arrest-Related Death Program (ARDP) are subject to underreporting and classification errors. The same shortcomings apply to statewide reporting in California and Texas, the only states with mandatory reporting requirements. Content analysis of open source records identified officer-involved shooting fatalities that occurred in the United States from January 1, 2006, through December 31, 2015. Those data were compared with data from the government databases. Analysis revealed 7,869 officer-involved shooting fatalities, an average increase of 51.8 incidents per year. Fatalities increased from 594 in 2006 to 1,007 in 2015—an increase of 69.5% in 10 years. Government data sources reported a low of 46.0% of incidents to a high of 75.3%, depending on the reporting year. Open source research reveals 30% to 45% more cases than official federal or state databases and can reveal much more data about other critical questions. The history of federal program efforts suggests it is unlikely that government recording of data on officer-involved shooting fatalities will improve. Government reporting programs have produced decreasingly effective results. Current web-based data collection efforts suffer from many of the same limitations exhibited in the federal programs. One promising option for improved data collection includes funding an independent party, such as a university, to collect data from open sources and supplement that data with public records requests and the currently collected official government data. [ABSTRACT FROM AUTHOR]

Background: Roller massage (RM) has become a popular intervention prescribed by physical therapy (PT) professionals. While this popularity has stimulated an increase in research and product development, the trends in the use of RM among PT professionals remain undocumented. It is unknown how professionals are using RM and integrating the research into their clinical practice. Purpose: To survey and document responses in the knowledge, clinical application methods, and use of RM devices among PT professionals in the United States. Design: Cross-sectional survey study Methods: A 20-question online survey related to personal and professional demographics, beliefs about RM, preferred RM devices, RM exercise prescription, and client education was emailed to PT members of the Orthopedic and Sports Physical Therapy Sections. Results: A total of 685 sports and orthopedic PT professionals completed the survey. Most professionals surveyed believe that RM decreases pain (80%), increases mobility (68%), and increases range of motion (ROM) (40%). Fiftyone percent believed moderate density rollers have the greatest effect. Eighty percent of professionals use a foam roller in their practice and 51% recommend to clients. A high proportion of professionals prescribe RM for injury treatment (82%) and for pre and post-exercise interventions (55%). Most professionals recommend rolling daily for 30 seconds to two minutes (55%), per muscle group (64%), at a self-paced cadence (47%). A high proportion of professionals use patient reported outcomes (80%), followed by joint ROM (59%), and movement-based testing (42%) to measure effects of RM. Eighty-seven percent of professionals use live instruction to educate clients and 91% believe there is a gap in the research. Conclusion: The results of this survey should be considered descriptive and a starting point for future research to establish a consensus on optimal RM programming, devices, and application parameters for different musculoskeletal conditions. The observed responses provide some insight into how PT professionals are using RM in their practice and highlight the existing gap between the research and professional practice. Further research is needed to explore the responses documented in this study. [ABSTRACT FROM AUTHOR]

* BACKGROUND: Musculoskeletal injuries during military service are a primary source of disability, resulting in 2.4 million annual health care visits and 25 million limited-duty days. While the injury incidence during basic training is well documented, there is little understanding of injury distribution by organization type in the US Army following initial training. * OBJECTIVE: To compare injury incidence, distribution, and impact across various military units. * METHODS: In this prospective observational cohort study, comprehensive injury data from subject questionnaires and medical chart reviews were collected over 12 months for 1430 initially healthy Army personnel, representing combat, combat support, combat service support, and ranger units. Health care utilization and time loss due to injury were also collected. * RESULTS: Of 1430 soldiers, 481 (33.6%) had time-loss injury, 222 (15.5%) were injured without limited work, 60 (4.2%) reported an injury but did not seek medical care, and 667 (46.6%) were uninjured. Across the whole sample, injuries were responsible for 5.9 ± 14.4 medical visits per soldier, 21 902 days of limited work, and $1 337 000 ($1901 ± $6535 per soldier) in medical costs. Considering only those reporting injury, each person averaged 36.3 ± 59.7 limited-work days. The injury incidence was highest in combat service support units (65.6%), with a risk ratio 1.60 times that of the reference group (combat, 41.1%). * CONCLUSION: Combat support and combat service support personnel were more likely to have 1 or more injuries compared to rangers and combat personnel. The higher relative risk of injury in support units should be explored further. [ABSTRACT FROM AUTHOR]

State and national educational leaders encourage the use of an integrated multitiered system of supports (MTSS) to improve services to students with academic and social behavior problems. Implementing and sustaining MTSS is facilitated by support from leaders in state education agencies (SEAs). The purpose of this study was to identify the specific events, resources, and supports that help or hinder the work of scaling up an integrated MTSS approach from the perspective of MTSS leaders in SEAs. Researchers interviewed leaders in 27 U.S. states using the critical incident technique, a qualitative methodology to identify critical incidents associated with changes in practice. Eight helping incident, seven hindering incident, and nine “wish list” categories were identified. Helping categories included multidisciplinary leadership, access to professional development, consistent language and/or practices, consultation with external partners, and a focus on student outcomes in evaluation and planning. Seven hindering categories included competing philosophies, high personnel turnover, varying levels of readiness, and inadequate data systems. Participants also identified two unique categories associated with the items they wished had happened or could happen in the future including access to personnel with high-level MTSS training and access to more effective interventions. [ABSTRACT FROM AUTHOR]

This study investigates how the administrative complexity (in funding and personnel) of American public school districts varies, depending on the importance of local, state, and federal funding environments. The analyses are based on a data set integrated from several national data sources describing school districts in the 1970s. Dependence on federal funding--which takes the form of complex and fragmented programs--generates more administrative positions and expenditures than does dependence on the other levels, as hypothesized. State funding, reflecting the legitimated and integrated state control over public education, generates the least administrative intensity, as hypothesized. High levels of local funding--reflecting dependence on an environment that is complex but not highly formally organized--generates intermediate levels of administrative staffing and funding. [ABSTRACT FROM AUTHOR]