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Aim: The climate change‐induced transition from grass‐dominated marshes to woody‐plant‐dominated mangrove forests has the potential to impact the ecosystem goods and services provided by coastal wetlands. To better anticipate and prepare for these impacts, there is a need to advance understanding of future changes in mangrove distribution and coastal wetland vegetation structural properties due to warming winters. Location: Southeastern United States. Time Period: Recent (1981–2010) and future (2071–2100). Major Taxa Studied: Coastal wetland vegetation. Methods: We estimated changes in mangrove distribution and coastal wetland vegetation structure using known climate‐ecological relationships, recent climate data for the period 1981–2010, and future projected climate data for the period 2071–2100. We quantified potential changes in mangrove presence, mangrove relative abundance, coastal wetland vegetation height, and coastal wetland vegetation aboveground biomass under two Shared Socio‐Economic Pathway scenarios (SSPs; SSP2‐4.5 and SSP5‐8.5), which correspond to intermediate and high greenhouse gas emissions scenarios, respectively. Results: Our analyses indicate that mangrove presence and relative abundance will dramatically increase in the northern Gulf of Mexico and the southeast Atlantic coast of the United States, particularly under the high emissions scenario. Because of the higher stature of mangroves relative to salt marsh vegetation, this expansion will cause a transformative change in coastal wetland vegetation height and aboveground biomass in many areas. However, along the arid southern Texas coast, low precipitation and high salinities are expected to constrain mangrove expansion and growth. Main Conclusions: Our results show where and to what extent climate change, in the form of winter temperature warming, is projected to enable the transition from shorter, grass‐dominated salt marshes to taller, woody plant‐dominated mangrove forests in the southeastern United States, with consequent impacts on ecosystem goods and services. [ABSTRACT FROM AUTHOR]

Context: Exertional heat stroke (EHS) is the most deadly form the exertional heat illness with a higher incidence among active duty US military members than in the general population. Current guidelines on EHS recovery timelines and return to duty vary among the military branches. In some cases, individuals experience prolonged heat and exercise intolerance with repeat exertional heat illness events, which can complicate the recovery process. Management and rehabilitation of such individuals is unclear. Case Presentation: This manuscript addresses the case and management of a US Air Force Special Warfare trainee who experienced 2 episodes of EHS, despite early recognition, gold standard treatment, and undergoing 4 weeks of a stepwise recovery after an initial EHS. Management and Outcomes: After the second episode, a 3-step process was utilized, consisting of a prolonged and personalized recovery period, heat tolerance testing using Israeli Defense Force advanced modeling, and stepwise reacclimatization. This process allowed the trainee to successfully recover from repeat EHS and return to duty, and set a framework for future repeat EHS treatment guidelines. Conclusions: In individuals with repeat EHS, a prolonged recovery period followed by heat tolerance testing can be used to demonstrate appropriate thermotolerance and safely clear an individual to begin stepwise reacclimatization. Overall, patient care and military readiness may be improved by unified Department of Defense guidelines for return to duty after EHS. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic directly threatened our health and safety, while contradictory scientific and media reports generated uncertainty. Social information processing theory suggests that employees may have relied on their coworkers, via coworker support, to make sense of the confusion. Because previous research shows that coworker support can counterintuitively increase strain, we investigated the effects of coworker support on strain during the pandemic. Specifically, we collected data from a heterogeneous US sample of 314 working parents in May 2020 to illustrate the path from personal traits (i.e., optimism, generalized self‐efficacy, and internal locus of control) to COVID‐19 anxiety to workplace outcomes (i.e., self‐rated performance, emotional exhaustion, and work–family conflict) in a multiphasic study design. Employees with low levels of these traits reported more COVID‐19 anxiety, and in turn, more decrement to their workplace outcomes. This mediation is moderated by coworker social support, such that the indirect effect is exacerbated by coworker social support. This is consistent with social information processing theory, which states that coworker social support can unintentionally corroborate and amplify employee stress perceptions. We therefore recommend that, when faced with significant adversity, organizations provide communication training oriented toward increasing positive coworker interactions and guiding social information. [ABSTRACT FROM AUTHOR]

Nonmedical prescription stimulant use (NPSU) is an ongoing public health crisis in the United States. There exists, however, a dearth of research investigating specific childhood risk factors that may contribute to this illicit use. Adverse childhood experiences (ACEs) may be a significant risk factor to address in the prevention and treatment of NPSU, as research has provided evidence for increased substance use, potentially including prescription stimulant misuse, among individuals who have experienced trauma. A systematic review of the literature was conducted to gather and synthesize research articles specifically examining the relationship between nonmedical prescription stimulant use in adults and the experience of adverse childhood experiences (ACEs). Four studies met all inclusion criteria and were included in the review. The results demonstrated that the nonmedical use of prescription stimulants in adults is significantly associated with ACEs, with a higher numerical count of ACEs associated with a greater likelihood of nonmedical prescription stimulant use. Gaps in the literature were identified, specifically noting a lack of information available regarding the relationship between ACEs and NPSU within gender- and racially diverse populations. The findings have implications for informing interventions related to ACEs and the misuse of prescription stimulant medication in adults. [ABSTRACT FROM AUTHOR]

Background: Families who must decide about pediatric home ventilation rely on the clinicians who counsel them for guidance. Most studies about pediatric home ventilation decisions focus on families who opt for this intervention, leaving much unknown about the families who decline. Objective: To describe the rationales of families who decline home ventilation. Design: Semi-structured interview study. Setting/Subjects: We interviewed 16 families in hospitals across 3 U.S. states, identified by their clinicians as previously deciding to not pursue home ventilation via tracheostomy within the past five years. Measurements: Targeted content and narrative analyses were used to understand family intentions and reasons for declining. Results: The clinical and social context varied among the 16 families in this study. Families' intentions in saying "no" fell into two categories: (1) definitive "No": Families who stood firm on in their decision and (2) contingent "No": Families who may consider this in the future. Families described four reasons why their child did not receive home ventilation: (1) concern about medical impacts, (2) concern about physical and/or communication restrictions, (3) concern that there would be no clear health benefit, and (4) concern about no clear meaningful life. Most families mentioned all four reasons, but concern about no clear meaningful life predominated. Conclusions: Though these families did not see home ventilation as an appropriate option, each reported a complex interplay of intentions behind and reasons for declining. Clinicians who counsel families about home ventilation could share the reasons that families commonly decline this intervention to facilitate a balanced discussion. [ABSTRACT FROM AUTHOR]

Background: Approximately 1 in 4 adults will develop hallux valgus (HV). Up to 80% of adult Internet users reference online sources for health-related information. Overall, with the high prevalence of HV combined with the numerous treatment options, we believe patients are likely turning to Internet search engines for questions relevant to HV. Using Google's people also ask (PAA) or frequently asked questions (FAQs) feature, we sought to classify these questions, categorize the sources, as well as assess their levels of quality and transparency. Methods: On October 9, 2022, we searched Google using these 4 phrases: "hallux valgus treatment," "hallux valgus surgery," "bunion treatment," and "bunion surgery." The FAQs were classified in accordance with the Rothwell Classification schema and each source was categorized. Lastly, transparency and quality of the sources' information were evaluated with the Journal of the American Medical Association's (JAMA) Benchmark tool and Brief DISCERN, respectively. Results: Once duplicates and FAQs unrelated to HV were removed, our search returned 299 unique FAQs. The most common question in our sample was related to the evaluation of treatment options (79/299, 26.4%). The most common source type was medical practices (158/299, 52.8%). Nearly two-thirds of the answer sources (184/299; 61.5%) were lacking in transparency. One-way analysis of variance revealed a significant difference in mean Brief DISCERN scores among the 5 source types, F(4) = 54.49 (P < .001), with medical practices averaging the worst score (12.1/30). Conclusion: Patients seeking online information concerning treatment options for HV search for questions pertaining to the evaluation of treatment options. The source type encountered most by patients is medical practices; these were found to have both poor transparency and poor quality. Publishing basic information such as the date of publication, authors or reviewers, and references would greatly improve the transparency and quality of online information regarding HV treatment. [ABSTRACT FROM AUTHOR]

The United States spends substantially more on health care than most developed countries, yet leaves a greater share of the population uninsured. We argue that incremental insurance expansions focused on addressing market failures will propagate inefficiencies and will fail to facilitate the active policy decisions needed to achieve socially optimal coverage. By instead defining a basic bundle of services that is publicly financed for all, while allowing individuals to purchase additional coverage, policymakers could both expand coverage and maintain incentives for innovation, ensuring universal access to innovative care in an affordable system. [ABSTRACT FROM AUTHOR]

An interesting educational phenomenon is occurring across the United States in relation to middle grades education. Many middle level educators and parents are asking, "What's wrong with our school?" Sometimes their concerns are supported by such comments as "We don't seem to be going anywhere" and "Our students do not seem to be learning enough" or by such questions as "We have a good school, but what's next?" "Is that all there is?" and "To what extent have we truly continued with the middle school model?" These are critical reevaluations and contemporary inquiries of the concept that was developed some 40 years ago by educators who cared about the 10- to 14-year-old transescents in middle level classrooms. The initial conversion to middle level education took a lot of discussion, debate, energy, and commitment. There was a potpourri of recommendations--some fragmented, some connected, and some that were never fully adopted. But now what? What follows the history of over expenditure of human resources: the long meetings, the writing and rewriting of mission statements for a more accurate purpose? What of the newer question that has been presented by the nation's pundits: "Why aren't our middle grades scores higher?" To answer these questions, middle level educators must take some steps: reread, rewrite, reexamine, don't buy anything yet, and hit the road. In this article, the authors discuss these steps.

The silicon (Si) cycle is an important driver of the long-term climate cycle and Si is an important micronutrient for some plant species, but our understanding of Si partitioning into various soil fractions remains incomplete. The biogeochemical processes that result in the various Si fractions are poorly constrained in most soil environments, especially in soil horizons that are partially-cemented with Si, such as fragipans. Here, we investigate the fractionation of Si, iron (Fe), aluminum (Al), and Mn (manganese) in fragipans and compare these fractions to non-fragipan soils, including sandstone- and limestone-derived soils. We performed a sequential silicon fractionation scheme using water (4 h and 21 day), sodium pyrophosphate, and citrate dithionite extractions. On average, fragipan soils contained significantly greater extractable Si (6.08 ± 1.87, µ ± 1sd) compared to non-fragipans (2.17–3.55 ± 0.49–0.81). More Si was released from fragipan horizons following the 21 day water, sodium pyrophosphate and citrate dithionite extractions suggesting the presence of a silica pool not present in other soils. A significant relationship was observed between fragipan dithionite-extractable Si and Fe (r2 = 0.64, y = 1.06x − 98.85), and the slope of this relationship was significantly greater when compared to other horizons. Water-extractable Si correlated with dithionite-extractable Si, which may indicate overlap between these fractions. A more rigorous fractionation scheme may be required to better differentiate these Si pools. These results suggest that additional Si sorbs to the surfaces of secondary, crystalline Fe oxides and at a potentially greater rate, which may have implications for fragipan genesis. [ABSTRACT FROM AUTHOR]

Reproductive diapause serves as biological mechanism for many insects, including the mosquito Culex pipiens, to overwinter in temperate climates. While Cx. pipiens diapause has been well-studied in the laboratory, the timing and environmental signals that promote diapause under natural conditions are less understood. In this study, we examine laboratory, semi-field, and mosquito surveillance data to define the approximate timeline and seasonal conditions that contribute to Cx. pipiens diapause across the United States. While confirming integral roles of temperature and photoperiod in diapause induction, we also demonstrate the influence of latitude, elevation, and mosquito population genetics in shaping Cx. pipiens diapause incidence across the country. Coinciding with the cessation of WNV activity, these data can have important implications for mosquito control, where targeted efforts prior to diapause induction can decrease mosquito populations and WNV overwintering to reduce mosquito-borne disease incidence the following season. The combination of laboratory and semifield experiments, paired with surveillance data, demonstrate the natural timeline for mosquito diapause, highlighting the importance of latitude and population genetics. [ABSTRACT FROM AUTHOR]

Background: Respiratory syncytial virus (RSV), a leading cause of lower respiratory tract infection in US children, reduces quality of life (QOL) of children, their caregivers, and families.Methods: We conducted a systematic literature review in PubMed, EconLit, and other databases in the United States of articles published since 2000, derived utility lost per RSV episode from cohort studies, and performed a systematic analysis.Results: From 2262 unique citations, 35 received full-text review and 7 met the inclusion criteria (2 cohort studies, 4 modeling studies, and 1 synthesis). Pooled data from the 2 cohort studies (both containing only hospitalized premature infants) gave quality-adjusted life-year (QALY) losses per episode of 0.0173 at day 38. From the cohort study that also assessed caregivers' QOL, we calculated net QALYs lost directly attributable to RSV per nonfatal episode from onset to 60 days after onset for the child, caregiver, child-and-caregiver dyad of 0.0169 (167% over prematurity alone), 0.0031, and 0.0200, respectively.Conclusion: Published data on QOL of children in the United States with RSV are scarce and consider only premature hospitalized infants, whereas most RSV episodes occur in children who were born at term and were otherwise healthy. QOL studies are needed beyond hospitalized premature infants. [ABSTRACT FROM AUTHOR]

Background: Limited data are available on the economic costs of respiratory syncytial virus (RSV) infections among infants and young children in the United States.Methods: We performed a systematic literature review of 10 key databases to identify studies published between 1 January 2014 and 2 August 2021 that reported RSV-related costs in US children aged 0-59 months. Costs were extracted and a systematic analysis was performed.Results: Seventeen studies were included. Although an RSV hospitalization (RSVH) of an extremely premature infant costs 5.6 times that of a full-term infant ($10 214), full-term infants accounted for 82% of RSVHs and 70% of RSVH costs. Medicaid-insured infants were 91% more likely than commercially insured infants to be hospitalized for RSV treatment in their first year of life. Medicaid financed 61% of infant RSVHs. Paying 32% less per hospitalization than commercial insurance, Medicaid paid 51% of infant RSVH costs. Infants' RSV treatment costs $709.6 million annually, representing $187 per overall birth and $227 per publicly funded birth.Conclusions: Public sources pay for more than half of infants' RSV medical costs, constituting the highest rate of RSVHs and the highest expenditure per birth. Full-term infants are the predominant source of infant RSVHs and costs. [ABSTRACT FROM AUTHOR]

This paper estimates the medium‐ to long‐run effects of slavery in the United States in a spatial regression discontinuity design. Using the boundary between free and slave states immediately antebellum, we find that legal slavery decreased per capita manufacturing output by as much as 30% in the decades following the Civil War. Perhaps surprisingly, agricultural output and farm values were only briefly depressed in former slave states after the war. Although emancipation ended slavery, political forces kept the institution from being completely disintegrated, and we explore channels through which this was possible. We show that slavery affected the structure of the economy in a given region—specifically through agricultural production decisions—and that these structures persisted long after passage of the 13th Amendment. However, sharecropping played a relatively small role in this region. Our results support mounting evidence in recent literature of the significant and lasting effects of institutions on economic development. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to estimate multi-trait genetic parameters for somatic cell score (SCS), milk yield and type traits in Nigerian Dwarf (ND) goats from the United States. Methods: Data from 1,041 ND goats in the United States with kiddings in 95 herds were used to estimate multi-trait genetic parameters for SCS, milk (MILK), fat (FAT), and protein (PROT) yields, and 14 type traits. An 18-trait mixed linear animal model for lactation mean SCS (Log2), MILK, FAT, PROT, and 14 type traits was applied. A factor analytic approach (FA1) in ASReml software was used to obtain convergence. Results: Averages for SCS were low (2.85±1.29 Log2), and were 314±110.6, 20.9±7.4, and 14±4.9 kg, respectively, for MILK, FAT, and PROT. Heritabilities for SCS, MILK, FAT, and PROT were 0.32, 0.16, 0.16, and 0.10, respectively. The highest heritabilities for type traits were for stature (0.72), teat diameter (0.49), and rump width (0.48), and the lowest estimates were for dairyness (0.003) and medial suspensory ligament (0.03). Genetic correlations of SCS with MILK, FAT, and PROT were positive but low (0.25, 0.18, and 0.23, respectively). Genetic and phenotypic correlations between MILK, FAT, and PROT were high and positive (=0.66). Absolute values of genetic correlations involving SCS with type traits were generally low or no different from zero. Most of the phenotypic correlations involving SCS with type traits were low. No serious unfavorable genetic correlations between milk yield traits and SCS or between milk yield traits or SCS and type traits were found. Conclusion: Genetic variation exists in the ND breed for most studied traits. The development of selection programs based on these estimates may help accelerate favorable multitrait genetic changes in this breed. [ABSTRACT FROM AUTHOR]

Background: In randomized controlled trials, lung cancer screening with low‐dose chest computed tomography (LCS) has been reported to reduce lung cancer mortality. Although initial studies suggested that only approximately 5% of eligible patients have undergone LCS, recent studies have indicated that use of LCS may be increasing nationwide. The objective of the current study was to estimate recent LCS use using cross‐sectional survey data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS) survey. Methods: The BRFSS is a nationally representative, cross‐sectional telephone survey of adults in the United States (response rate of approximately 50%). The 2018 BRFSS survey included questions regarding LCS eligibility and use in 8 states. The primary outcome was the percentage of participants (aged 55‐79 years with a smoking history of >30 pack‐years) who reported undergoing LCS. Logistic regression analyses evaluated the association between LCS use and sociodemographic characteristics, adjusted for potential confounders and accounting for complex survey design elements. Results: A total of 26,910 participants were included, 9.9% of whom were eligible for LCS (95% CI, 8.8%‐10.6%). Of the eligible patients, 19.2% reported undergoing LCS (95% CI, 14.0%‐24.4%). Approximately 16.4% of current smokers were eligible for LCS (95% CI, 14.2%‐18.6%). In our multiple variable analyses of eligible patients, age, sex, marital status, current smoking status, and race were not found to be associated with statistically significant differences in reported LCS (P >.05). Retired patients, patients with personal physicians, and patients who did not complete a high school education were more likely to report receiving LCS (P <.05). Conclusions: Compared with previously published studies, the results of the current study suggested that LCS use is increasing. However, LCS use remains low (19%) among eligible participants. Compared with previously published studies, the results of the current study suggest that the use of lung cancer screening with low‐dose chest computed tomography (LCS) is increasing. However, use of LCS remains low (19%) among eligible participants. [ABSTRACT FROM AUTHOR]

Background: High out-of-pocket costs (OOPCs) often are found to be inversely associated with adherence to medical treatment. The introduction of generic aromatase inhibitors (GAIs) significantly reduced the OOPCs of patients. The objective of the current study was to explore the impact of the introduction of GAIs on adjuvant hormone therapy (AHT) adherence over the full course of breast cancer treatment.Methods: Women aged ≥65 years who were diagnosed with hormone receptor-positive breast cancer from 2007 through mid-2009 were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked database. Multivariate logistic regression was used to estimate the likelihood of AHT initiation and an interrupted time series model was used to predict the association between the introduction of GAIs and AHT adherence. The model was stratified further using Medicare low-income subsidy (LIS) status.Results: A total of 10,905 women were included, approximately 62.8% of whom initiated AHT within the first year of their breast cancer diagnosis. Adjusted adherence among LIS beneficiaries was 11.4% higher than among non-LIS beneficiaries (P < .001). Non-LIS beneficiaries had an overall decreasing trend of adherence (-0.035; P < .001) prior to the introduction of GAIs. They experienced a 3.4% increase in the slope 6 months after the first GAI, anastrozole, entered the market, and an additional 0.8% increase in the slope 6 months after letrozole and exemestane were introduced (P < .001). Adherence change among LIS patients was small and statistically insignificant.Conclusions: With the introduction of GAIs, the decrease trend of adherence to therapy atteunated over the course of treatment. Although the successful implementation of the Medicare LIS program minimized the OOPCs for financially vulnerable patients, policymakers should be cautious not to introduce disparities for those who may be of low income but ineligible for such a program. [ABSTRACT FROM AUTHOR]

Background: Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate atopic dermatitis (AD). Objectives: The aim of this study was to evaluate the safety, effectiveness, and pharmacokinetics (PK) of crisaborole in infants aged 3 to < 24 months with mild-to-moderate AD in an open-label study. Methods: Infants (3 to < 24 months) with Investigator's Static Global Assessment (ISGA) of mild (2) or moderate (3) and percentage of treatable body surface area (%BSA) ≥ 5 received crisaborole twice daily for 28 days; a cohort with moderate AD per ISGA and %BSA ≥ 35 were included in a PK analysis. Endpoints included safety (primary), efficacy, and PK (exploratory). Results: Included were 137 infants total (mean age [SD], 13.6 months [6.42]), with 21 in the PK cohort (12.7 months [6.58]). Treatment-emergent adverse events (TEAEs) were reported for 88 (64.2%) patients (98.9% rated as mild/moderate). TEAEs were considered treatment-related for 22 patients (16.1%); most frequently reported were application site pain (3.6%), application site discomfort (2.9%), and erythema (2.9%). ISGA clear/almost clear with ≥ 2-grade improvement at day 29 was achieved by 30.2% of patients. From baseline to day 29, mean percentage change in Eczema Area and Severity Index score was − 57.5%, and mean change in Patient-Oriented Eczema Measure total score was − 8.5. Crisaborole systemic exposures in infants were characterized and, based on nonlinear regression analysis, were comparable with that in patients aged ≥ 2 years. Conclusions: In this open-label study, crisaborole was well tolerated and effective in infants (3 to < 24 months) with mild-to-moderate AD with systemic exposures similar to patients aged ≥ 2 years. Clinical Trial Registration: NCT03356977. [ABSTRACT FROM AUTHOR]

There is increasing interest in expanding Medicare health insurance coverage in the United States, but it is not clear whether the current program is the right foundation on which to build. Traditional Medicare covers a uniform set of benefits for all income groups and provides more generous access to providers and new treatments than public programs in other developed countries. We develop an economic framework to assess the efficiency and equity trade-offs involved with reforming this generous uniform structure. We argue that three major shifts make a uniform design less efficient today than when Medicare began in 1965. First, rising income inequality makes it more difficult to design a single plan that serves the needs of both higher- and lower-income people. Second, the dramatic expansion of expensive medical technology means that a generous program increasingly crowds out other public programs valued by the poor and middle class. Finally, as medical spending rises, the tax financing of the system creates mounting economic costs and increasingly untenable policy constraints. These forces motivate reforms that shift toward a more basic public benefit that individuals can "top up" with private spending. If combined with an increase in other progressive transfers, such a reform could improve efficiency and reduce public spending while benefiting low-income populations. [ABSTRACT FROM AUTHOR]

The article discusses the policies and political views of former U.S. representative from California Aaron Augustus Sargent concerning Chinese immigration to the U.S. from 1862 until 1886. It discusses Sargent's political career, foreign relations between the U.S. and China following the U.S. Civil War, and xenophobia in California concerning Chinese immigration. The article also discusses a group of Chinese American businessmen in California known as the Chinese Six Companies.

The article discusses the conservative politics of U.S. Senator Barry Goldwater, primarily focusing on his decision to vote against the 1964 Civil Rights Act. Despite this decision, the author argues that Goldwater was not racist. Goldwater's lack of support from various racist organizations, such as the American Nazi Party, is documented. The author relates Goldwater's ideas concerning civil rights to the political philosophy of U.S. President Thomas Jefferson.

By combining normative philosophy and empirical social science, we craft a research framework for assessing differential expectations embodied in normative conceptions of the economic social contract in the United States. We argue that there are distinct views of such a contract grounded in individualist and communitarian philosophical ideologies. We apply this framework to organizational downsizing, postulating that certain human resource practices, in combination with the respective ideological orientations, will affect perceptions of the justice of downsizing policies. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to quantify the impact of dental caries and missing anterior teeth on employment, estimate the impact of a routine dental visit on the health of anterior teeth, and the benefits of expanding dental coverage for nonelderly adults.Methods: We used the 2013-2014 Continuous National Health and Nutritional Examination Survey to develop a dental problem index (DPI) using tooth counts and tooth surface conditions. We estimated the impact of DPI on employment with logistic regression, controlling for seven demographic and socioeconomic covariates. We used a routine dental visit within 6 months as a proxy for access to dental services, and a linear regression to predict the DPI score for an average individual with and without a recent routine dental visit. We then computed the incremental probability of employment associated with a recent routine dental visit. Finally, we estimated the additional number of working age adults who might become employed due to improved access to dental services.Results: The probability of being employed was negatively associated with poor oral health: a one-point increase in DPI decreased the odds of being employed by 7.70 percent (CI: 5.15-10.19%). Having a routine dental visit had a negative and statistically significant impact on DPI [-0.41 (CI: -0.68 to -0.14)]. The incremental probability of employment associated with a routine dental visit was 0.62 percent (CI: 0.21-1.03%).Conclusions: Oral health in the United States is worse among minorities and poor than among other residents. The benefits associated with access to dental care should justify expanding dental services. [ABSTRACT FROM AUTHOR]

Third-party candidates in the United States routinely see a decline in support in the final weeks of presidential campaigns. While political scientists attribute this partially to Duverger's Law, many communication scholars have tied this collapse to media coverage that frames third-party candidates as fringe outsiders, longshots, and spoilers. This study extends these explanations of third-party failure by describing the rhetorical containment of third-party voters. Based on a case study of the 2016 presidential election and public debate about supporters of Gary Johnson and Jill Stein, the essay suggests such voters face a form of marginalization that portrays them as intruders in a two-party race, as immature and uninformed, and responsible for eventual victors, while presenting them a false choice of winning by sacrificing their cause. [ABSTRACT FROM AUTHOR]

How much are low-income individuals willing to pay for health insurance, and what are the implications for insurance markets? Using administrative data from Massachusetts' subsidized insurance exchange, we exploit discontinuities in the subsidy schedule to estimate willingness to pay and costs of insurance among low-income adults. As subsidies decline, insurance take-up falls rapidly, dropping about 25 percent for each $40 increase in monthly enrollee premiums. Marginal enrollees tend to be lower-cost, indicating adverse selection into insurance. But across the entire distribution we can observe (approximately the bottom 70 percent of the willingness to pay distribution) enrollees' willingness to pay is always less than half of their own expected costs that they impose on the insurer. As a result, we estimate that take-up will be highly incomplete even with generous subsidies. If enrollee premiums were 25 percent of insurers' average costs, at most half of potential enrollees would buy insurance; even premiums subsidized to 10 percent of average costs would still leave at least 20 percent uninsured. We briefly consider potential explanations for these findings and their normative implications. (JEL G22, H51, H75, I13, I18) [ABSTRACT FROM AUTHOR]

This article presents information on a study which examined the salary differential between male and female administrators in higher education institutions in the United States. The focus of research on gender-based salary differentials in public institutions of higher education is on faculty members. It reveals that female administrators were paid only about 80 percent as much as men with the same job titles who were employed by the same types of institutions in terms of salary, according to a nationwide survey of colleges and universities conducted in 1975-1976.

Objectives. To assess stakeholder perceptions of the impact and feasibility of 21 national, state, and local nutrition policies for cancer prevention across 5 domains in the United States. Methods. We conducted an online survey from October through December 2018. Participants were invited to take the survey via direct e-mail contact or an organizational e-newsletter. Results. Federal or state Medicare/Medicaid coverage of nutrition counseling and federal or state subsidies on fruits, vegetables, and whole grains for participants in the Supplemental Nutrition Assistance Program were the policies rated as having the highest perceived impact and feasibility. Overall, the 170 respondents rated policy impact higher than policy feasibility. Polices at the federal or state level had a higher perceived impact, whereas local policies had higher perceived feasibility. Conclusions. Our findings might guide future research and advocacy that can ultimately motivate and target policy actions to reduce cancer burdens and disparities in the United States. [ABSTRACT FROM AUTHOR]

Objective To evaluate the cost--effectiveness of results-based financing and input-based financing to increase use and quality of maternal and child health services in rural areas of Zambia. Methods In a cluster-randomized trial from April 2012 to June 2014, 30 districts were allocated to three groups: results-based financing (increased funding tied to performance on pre-agreed indicators), input-based financing (increased funding not tied to performance) or control (no additional funding), serving populations of 1.33, 1.26 and 1.40 million people, respectively. We assessed incremental financial costs for programme implementation and verification, consumables and supervision. We evaluated coverage and quality effectiveness of maternal and child health services before and after the trial, using data from household and facility surveys, and converted these to quality-adjusted life years (QALYs) gained. Findings Coverage and quality of care increased significantly more in results-based financing than control districts: difference in differences for coverage were 12.8% for institutional deliveries, 8.2% postnatal care, 19.5% injectable contraceptives, 3.0% intermittent preventive treatment in pregnancy and 6.1% to 29.4% vaccinations. In input-based financing districts, coverage increased significantly more versus the control for institutional deliveries (17.5%) and postnatal care (13.2%). Compared with control districts, 641 more lives were saved (lower--upper bounds: 580-700) in results-based financing districts and 362 lives (lower--upper bounds: 293-430) in input-based financing districts. The corresponding incremental cost--effectiveness ratios were 809 United States dollars (US$) and US$ 413 per QALY gained, respectively. Conclusion Compared with the control, both results-based financing and input-based financing were cost--effective in Zambia. [ABSTRACT FROM AUTHOR]

Wetlands are frequently cited for their ability to reduce the adverse effects of flooding. Despite the growing negative impacts of storm surge and tidal flood events on coastal communities in the United States (U.S.), little if any, systematic, observation-based work has been done that measures the effects of estuarine wetlands in reducing actual flood loss. This study quantitatively assesses the role of estuarine and tidal wetlands in mitigating the amount of surge-induced flood damage experienced on Galveston Island by Hurricane Ike in 2008. Using a novel approach to measuring potential wetland influence, statistical analysis is performed on site-level flood damage observations to detect under which locations and configurations naturally-occurring estuarine wetlands might reduce impacts to residential structures. Results suggest that tidal wetlands may reduce storm-surge induced flood damage under certain distance and location characteristics, yet increase damage in others. Specifically, structures that were within 500' and sheltered by tidal wetlands demonstrated decreased flood damage, however damages increased at distances beyond this threshold, relative to non-sheltered structures. These results provide critical information to the debate on the effectiveness of wetlands for coastal flood mitigation and provide guidance to local decision makers interested in facilitating the development of more flood resilient communities over the long term. [ABSTRACT FROM AUTHOR]

Individuals tend to judge bad side effects as more intentional than good side effects (the Knobe or side-effect effect). Here, we assessed how widespread these findings are by testing eleven adult cohorts of eight highly contrasted cultures on their attributions of intentional action as well as ratings of blame and praise. We found limited generalizability of the original side-effect effect, and even a reversal of the effect in two rural, traditional cultures (Samoa and Vanuatu) where participants were more likely to judge the good side effect as intentional. Three follow-up experiments indicate that this reversal of the side-effect effect is not due to semantics and may be linked to the perception of the status of the protagonist. These results highlight the importance of factoring cultural context in our understanding of moral cognition. [ABSTRACT FROM AUTHOR]

The 2016 presidential election saw the rise and fall of third-party candidates Jill Stein and Gary Johnson. This essay proposes that such third-party candidates are challenged in navigating the dichotomous nature of the myth of the American Dream that serves as the basis of party master narratives. Suggesting that third-party candidates attempt to create alternative narratives through what Rushing and Frentz called dialectical transformation and dialectical synthesis, the essay examines how such strategies were put to use by Stein and Johnson, and how they demonstrate a significant disadvantage for third parties. [ABSTRACT FROM AUTHOR]

Abstract: This first-person narrative reviews the resistance to the first year of the Trump Administration. The author recalls a trip to Washington DC to disrupt the peaceful transfer of power in Washington DC, as well as three other trips to fight the assault on social policy by the Trump Administration and the Republican controlled congress, getting arrested each time. Back in New York, the author worked with his union and and engaged in civil disobedience fighting for the homeless with Voices of Community Activists and Leaders (VOCAL). The author reviews debates about strategies and tactics, as well as the efforts of groups such as ADAPT, Rise and Resist, Housing Works, Center for Popular Democracy, ACT UP, New Sanctuary Coalition, and VOCAL. He considers the friendships which support such efforts to renew democracy from the bottom up, while fighting the war on the poor. [ABSTRACT FROM AUTHOR]

Many studies state that African Americans are underdiagnosed with major depressive disorder when compared to Whites, yet little research exists on the specific differences in symptom expression in African Americans. Even fewer studies explore gender-based differences in depressive symptom expression between African Americans. This article reviews literature on African-American symptom expression differences through a social determinants of health framework. While commonalities exist, the differences in symptom expression between African-American women and men should not be ignored. Based on research information presented, implications for social work and mental health intervention are discussed, and best practice recommendations are provided. [ABSTRACT FROM PUBLISHER]

Since clergy are often first responders to mental health issues, it is important to understand clergy views on handling such issues. A discussion occurred in 2012 amongst clergy involved in a popular social utility network clergy’s group. One clergyperson asked peers: “If the church is where we are to come for healing, how do we handle people who are depressed, suicidal, suffering from PTSD or anxiety?” Over 140 comments were made during 13 days, and 35 clergy from the United States, Africa, and India contributed to the discussion. Data from this conversation were examined via classic grounded theory. Analysis revealed a spectrum of beliefs that clergy hold regarding the causes and best treatments for emotional issues. Findings shed light on the candid thoughts clergy have about mental health care. The findings provide greater understanding for mental health practitioners with clients who rely on their church for emotional support. [ABSTRACT FROM PUBLISHER]

The national cost of suicides and suicide attempts in the United States in 2013 was $58.4 billion based on reported numbers alone. Lost productivity (termed indirect costs) represents most (97.1%) of this cost. Adjustment for under-reporting increased the total cost to $93.5 billion or $298 per capita, 2.1-2.8 times that of previous studies. Previous research suggests that improved continuity of care would likely reduce the number of subsequent suicidal attempts following a previous nonfatal attempt. We estimate a highly favorable benefit-cost ratio of 6 to 1 for investments in additional medical, counseling, and linkage services for such patients. [ABSTRACT FROM AUTHOR]

Purpose: From 1996 to 2013, a 6-day Physical Activity and Public Health Course for Practitioners has been offered yearly in the United States. An evaluation was conducted to assess the impact of the course on building public health capacity for physical activity and on shaping the physical activity and public health careers of fellows since taking the courses.Method: An evaluation quantified time that fellows spent in different course offerings and surveyed fellows.Results: From 1996 to 2012, 410 fellows attended the course, and in 2013, 186 participated in the Web-based survey (56% response rate). The number of fellows attending the course ranged from 15 to 33 yearly. From 1996 to 2012, the course averaged 38 hr of instructional time that included topics on interventions and environment/policy work to increase physical activity, program evaluation, public health research, and health disparities. The course included consultations, collaborative work, and field-based experiences. Fellows who participated in the survey agreed that the course had a positive impact on the physical activity research or practice work they did (98%), met their expectations (96%), helped them with research/practice collaborations with other physical activity professionals (96%), assisted them in conducting higher-quality interventions/programs (95%), helped increase their professional networking in the field (93%), and had a positive impact on other work they did (91%). Following the course, 66% and 56% had further contact with faculty and other fellows, respectively.Conclusion: The Physical Activity and Public Health Course for Practitioners made important contributions toward building the capacity of physical activity and public health practitioners. [ABSTRACT FROM AUTHOR]

Aims To estimate the incremental cost, cost-effectiveness and benefit-cost ratio of incorporating a significant other (SO) into motivational intervention for alcohol misuse. Design We obtained economic data from the one year with the intervention in full operation for patients in a recent randomized trial. Setting The underlying trial took place at a major urban hospital in the United States. Participants The trial randomized 406 (68.7% male) eligible hazardous drinkers (196 during the economic study) admitted to the emergency department or trauma unit. Intervention The motivational interview condition consisted of one in-person session featuring personalized normative feedback. The significant other motivational interview condition comprised one joint session with the participant and SO in which the SO's perspective and support were elicited. Measurements We ascertained activities across 445 representative time segments through work sampling (including staff idle time), calculated the incremental cost in per patient of incorporating an SO, expressed the results in 2014 US$, incorporated quality and mortality effects from a closely related trial and derived the cost per quality-adjusted life-year (QALY) gained. Findings From a health system perspective, the incremental cost per patient of adding an SO was $341.09 [95% confidence interval (CI) = $244.44-437.74]. The incremental cost per year per hazardous drinker averted was $3623 (CI = $1777-22 709), the cost per QALY gained $32 200 (CI = $15 800-201 700), and the benefit-cost ratio was 4.73 (95% CI = 0.7-9.66). If adding an SO into the intervention strategy were concentrated during the hours with highest risk or in a trauma unit, it would become even more cost-beneficial. Conclusions Using criteria established by the World Health Organization (cost-effectiveness below the country's gross domestic product per capita), incorporating a significant other into a patient's motivational intervention for alcohol misuse is highly cost-effective. [ABSTRACT FROM AUTHOR]

State medical marijuana programs have proliferated in the United States in recent years. Marijuana sales are now estimated in billions of dollars per year with over two million patients, yet it remains unlawful under Federal law, and there is limited and conflicting evidence about potential effects on society. We present new evidence about potential effects on crime by estimating an economic crime model following the general approach developed by Becker. Data from 11 states in the Western United States are used to estimate the model and test hypotheses about potential effects on rates of violent and property crime. Fixed effects methods are applied to control for state-specific factors, with adjustments for first-order autocorrelation and cross-section heteroskedasticity. There is no evidence of negative spillover effects from medical marijuana laws (MMLs) on violent or property crime. Instead, we find significant drops in rates of violent crime associated with state MMLs. [ABSTRACT FROM AUTHOR]

Objectives. We measured HIV care outcomes of transgender persons, who have high HIV infection rates but are rarely distinguished from men who have sex with men (MSM) in HIV surveillance systems. Methods. New York City's surveillance registry includes HIV diagnoses since 2000 and HIV laboratory test results for transgender persons since 2005. We determined immunological status at diagnosis, delayed linkage to care, and nonachievement of viral suppression 1 year after diagnosis for transgender persons diagnosed with HIV in 2006 to 2011 and compared transgender women with MSM. Results. In 2006 to 2011, 264 of 23 805 persons diagnosed with HIV were transgender (1%): 98% transgender women and 2% transgender men. Compared with MSM, transgender women had similar CD4 counts at diagnosis and rates of concurrent HIV/AIDS and delayed linkage to care but increased odds of not achieving suppression (adjusted odds ratio =1.56; 95% confidence interval = 1.13, 2.16). Conclusions. Compared with MSM, transgender women in New York City had similar immunological status at diagnosis but lagged in achieving viral suppression. To provide appropriate assistance along the HIV care continuum, HIV care providers should accurately identify transgender persons. [ABSTRACT FROM AUTHOR]

A major problem resulting from interrupted tuberculosis (TB) treatment is the development of drug-resistant TB, including multidrug-resistant TB (MDR TB), a more deadly and costly-to-treat form of the disease. Global health systems are not equipped to diagnose and treat the current burden of MDR TB. TB-infected foreign visitors and temporary US residents who leave the country during treatment can experience treatment interruption and, thus, are at greater risk for drug-resistant TB. Using epidemiologic and demographic data, we estimated TB incidence among this group, as well as the proportion of patients referred to transnational care-continuity and management services during relocation; each year, ≈2,827 visitors and temporary residents are at risk for TB treatment interruption, 222 (8%) of whom are referred for transnational services. Scale up of transnational services for persons at high risk for treatment interruption is possible and encouraged because of potential health gains and reductions in healthcare costs for the United States and receiving countries. [ABSTRACT FROM AUTHOR]

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