Search

Background: Telehealth has been proposed as one strategy to improve the quality of time‐sensitive sepsis care in rural emergency departments (EDs). The purpose of this study was to measure the association between telehealth‐supplemented ED (tele‐ED) care, health care costs, and clinical outcomes among patients with sepsis in rural EDs. Methods: Cohort study using Medicare fee‐for‐service claims data for beneficiaries treated for sepsis in rural EDs between February 1, 2017, and September 30, 2019. Our primary hospital‐level analysis used multivariable generalized estimating equations to measure the association between treatment in a tele‐ED–capable hospital and 30‐day total costs of care. In our supporting secondary analysis, we conducted a propensity‐matched analysis of patients who used tele‐ED with matched controls from non–tele‐ED–capable hospitals. Our primary outcome was total health care payments among index hospitalized patients between the index ED visit and 30 days after hospital discharge, and our secondary outcomes included hospital mortality, hospital length of stay, 90‐day mortality, 28‐day hospital‐free days, and 30‐day inpatient readmissions. Results: In our primary analysis, sepsis patients in tele‐ED–capable hospitals had 6.7% higher (95% confidence interval [CI] 2.1%–11.5%) total health care costs compared to those in non–tele‐ED–capable hospitals. In our propensity‐matched patient‐level analysis, total health care costs were 23% higher (95% CI 16.5%–30.4%) in tele‐ED cases than matched non–tele‐ED controls. Clinical outcomes were similar. Conclusions: Tele‐ED capability in a mature rural tele‐ED network was not associated with decreased health care costs or improved clinical outcomes. Future work is needed to reduce rural–urban sepsis care disparities and formalize systems of regionalized care. [ABSTRACT FROM AUTHOR]

Large-scale meteorological pattern (LSMP)–based analysis is used in a novel way to understand meteorological conditions before and during short-duration dry spells over the northeastern United States. These LSMPs are useful to assess models and select better-performing models for future projections. Dry-spell events are identified from histograms of consecutive dry days below a daily precipitation threshold. Events lasting 12 days or longer, which correspond to ∼10% of dry-spell events, are examined. The 500-hPa streamfunction anomaly fields for the first 12 days of each event are time averaged, and k-means clustering is applied to isolate the dry-spell-related LSMPs. The first cluster has a strong low pressure anomaly over the Atlantic Ocean, southeast of the region, and is more common in winter and spring. The second cluster has strong high pressure over east-central North America and is most common during autumn. Over the region, both clusters have negative specific humidity anomalies, negative integrated vapor transport from the north, and subsidence associated with a midlatitude jet stream dipole structure that reinforces upper-level convergence. Subsidence is supported by cold-air advection in the first cluster and the location on the east side of the lower-level high pressure in the second cluster. Extratropical cyclone storm tracks are generally shifted southward of the region during the dry spells. Individual events lie on a continuum between two distinct clusters. These clusters have similar local, but different remote, properties. Although dry spells occur with greater frequency during drought months, most dry spells occur during nondrought months. Significance Statement: This study examines the large-scale weather patterns and meteorological conditions associated with dry-spell events lasting at least 2 weeks while affecting the northeastern United States. A statistical approach groups events together on the basis of similar atmospheric features. We find two distinct sets of patterns that we call large-scale meteorological patterns. These patterns reduce moisture, foster localized sinking, and shift the storm track southward along the Atlantic seaboard, all of which reduce precipitation. Besides greater understanding, knowing the meteorological patterns during short-term dryness in the region provides an important tool to assess how well atmospheric models reproduce these specific patterns. More dry spells occur in nondrought months than in drought months, which means that dry spells can occur without preexisting drought conditions. [ABSTRACT FROM AUTHOR]

Simple Summary: Neurofibromatosis type 1 is a common autosomal dominant inherited condition, with variable phenotype among affected individuals. Abnormalities of the cerebral vasculature are an acknowledged but poorly understood complication, leading to high morbidity and mortality for individuals with neurofibromatosis type 1. The current review discusses the different types of cerebral vasculopathy, the clinical presentation and diagnosis, followed by proposed pathogenesis. Medical and surgical management options are presented, with a goal to prevent lasting neurologic injury. Cerebrovascular abnormalities are a severe and often underrecognized complication of childhood neurofibromatosis type 1 (NF1). There are no prospective studies of cerebral vasculopathy in NF1; thus, the estimated frequency of vasculopathy varies between studies. The data is difficult to interpret due to the retrospective data collection and variability in whether imaging is done based on screening/surveillance or due to acute neurologic symptoms. The prevalent NF1-associated cerebral vasculopathy is moyamoya syndrome (MMS). Vascular changes can present without symptoms or with acute TIA or stroke-like symptoms or a range of progressive neurologic deficits. Advanced imaging may enhance sensitivity of neuroimaging in children. Medical and/or surgical interventions may prevent short- and long-term complications. Challenges for establishment of a screening protocol for cerebral vasculopathy in children with NF1 include the relatively large number of patients with NF1, the potential need for sedation to achieve quality imaging and the broad age range at time of detection for cerebral vascular changes. The goal of this review is to present the epidemiology, clinical presentation, imaging features and medical/surgical management of cerebral arteriopathies in children with NF1. [ABSTRACT FROM AUTHOR]

Background:School-based health services, particularly those available to underserved and rural communities, remain in high demand. Advancements in telehealth services present clinical resources otherwise typically unavailable to students from rural communities. Methods:Data were collected during 4 semesters on all students receiving primary care or urgent care health services from 8 school-based telehealth programs delivering care to 40 schools across the United States. Results:Across the 4 semesters, 2,769 students received primary care telehealth and 2,238 students received urgent care telehealth. The primary care telehealth services were delivered by a primary care provider with a registered nurse also involved in half of the encounters. In contrast, the urgent care telehealth services were delivered almost exclusively by a registered nurse. Primary care telehealth delivered a variety of services including medication management, counseling, and sports physicals in addition to assessments and evaluations. Urgent care telehealth primarily involved an assessment. Both services returned most students to the classroom without the need for further follow-up, thus reducing or eliminating the need for seeking health care outside of the school setting. Notably, 67.7% of students seeking primary care telehealth services did not have a primary care provider outside of the school, clearly demonstrating the importance of these school-based services in increasing access to basic health care services for these students in rural and underserved communities. Conclusions:Telehealth provides a reliable solution and immediate access to care for students in need of health care, which, in turn, presents advantages to educators and parents. [ABSTRACT FROM AUTHOR]

Despite the emerging influence of anthropogenic climate change on the global water cycle, at regional scales the combination of observational uncertainty, large internal variability, and modeling uncertainty undermine robust statements regarding the human influence on precipitation. Here, we use output from global climate models in a perfect-data sense to develop a framework for conducting regional detection and attribution (D&A) for precipitation, starting with the contiguous United States (CONUS) where observational uncertainty is lower than in other regions. Our unified approach can simultaneously detect systematic trends in mean and extreme precipitation, attribute trends to anthropogenic forcings, compute the effects of forcings as a function of time, and map the effects of individual forcings. Model output is used to conduct a set of tests that yield a parsimonious representation for characterizing seasonal precipitation over the CONUS for the historical record (1900 to present day), which ensures our D&A is insensitive to structural uncertainty. Our framework is developed using synthetic data in a Pearl-causal perspective wherein causality can be identified using intervention-based simulations. While the hypothesis-based framework and accompanying generalized D&A formula we develop should be widely applicable, we include a strong caution that the hypothesis-guided simplification of the formula for the historical climatic record of CONUS as described in this paper will likely fail to hold in other geographic regions and under future warming. [ABSTRACT FROM AUTHOR]

This study analyzes the quality of simulated historical precipitation across the contiguous United States (CONUS) in a 12-km Weather Research and Forecasting model version 4.2.1 (WRF v 4.2.1)-based dynamical downscaling of the fifth generation ECMWF atmospheric reanalysis (ERA5). This work addresses the following questions: First, how well are the 3- and 24-hr precipitation characteristics (diurnal and annual cycles, precipitation frequency, annual and seasonal mean and maximum precipitation, and distribution of seasonal maximum precipitation) represented in the downscaled simulation, compared to ERA5? And second, how does the performance of the simulated WRF precipitation vary across seasons, regions, and timescales? Performance is measured against the NCEP/EMC 4-km Stage IV and PRISM data on 3-hr and 24-hr timescales, respectively. Our analysis suggests that the 12-km WRF exhibits biases typically found in other WRF simulations, including those at convection-permitting scales. In particular, WRF simulates both the timing and magnitude of the summer diurnal precipitation peak as well as ERA5 over most of the CONUS, except for a delayed diurnal peak over the Great Plains. As compared to ERA5, both the month and the magnitude of the precipitation peak annual cycle are remarkably improved in the downscaled WRF simulation. WRF slightly overestimates 3- and 24-hr precipitation maximum over the CONUS, in contrast to ERA5 which generally underestimates these quantities mainly over eastern half of the CONUS. Notably, WRF better captures the probability density distribution (PDF) of 3- and 24-hr annual and seasonal maximum precipitation. WRF exhibits seasonally-dependent precipitation biases across the CONUS, while ERA5's biases are relatively consistent year-round over most of the CONUS. These results suggest that dynamical downscaling to a higher resolution improves upon some precipitation metrics, but is susceptible to common regional climate model biases. Consequently, if used for operational purposes, we suggest moderate bias-correction be applied to the dynamically downscaled product. [ABSTRACT FROM AUTHOR]

Since the infamous extreme drought of the 1960s, the climate of the northeastern United States (NEUS) has generally trended toward warmer and wetter conditions. Nonetheless, there is mounting evidence that short-term droughts will continue to pose a significant risk for this region. To better explore the processes governing events such as these, climate models have adopted more complex representations of the fully coupled atmosphere–land–ocean–sea ice system; however, large uncertainties in future projections still persist, with internal variability necessitating large ensembles to understand trends in both rare and high-impact extreme events such as rapidly developing droughts (a term here that includes flash droughts developing on monthly scales). In this study, seven large ensemble (LE) models are employed to answer the outstanding question: How are the frequency and character of drought in the NEUS changing under a warming climate? We find that most LE models indicate the NEUS will experience a long-term wetting trend with more "extremely wet" months, but also more frequent short-term extreme droughts. These changes are associated with increasing precipitation, atmospheric water demand, and climate variability. We also conclude that discrepant trends in precipitation and evapotranspiration variability will lead to increasing anticorrelation of these variables, which is relevant to the intensification of rapidly developing drought, particularly in the spring season. These changes are associated with an increase in evapotranspiration from plants, brought by an earlier emergence of the growing season and denser vegetation. Significance Statement: Droughts are extreme events with the potential to produce considerable social and economic damage. Because droughts emerge slowly and are relatively infrequent, large datasets are needed to study these features. Using multiple climate models, each producing multiple long-duration simulations, along with a novel drought index, we characterize rapidly developing droughts (those flash droughts identifiable from monthly data) and understand their drivers in the northeastern United States. We find that short-term extreme droughts are projected to be more frequent, while rapidly developing droughts will become more intense in the spring season. Intensification of rapidly developing droughts is attributed to differences in patterns of precipitation and evapotranspiration (soil evaporation and plant transpiration), which will be magnified by an extended growing season and an increase in vegetation. [ABSTRACT FROM AUTHOR]

Psychological research has offered valuable insights into how to combat misinformation. The studies conducted to date, however, have three limitations. First, pre‐emptive ("prebunking") and retroactive ("debunking") interventions have mostly been examined in parallel, and thus it is unclear which of these two predominant approaches is more effective. Second, there has been a focus on misinformation that is explicitly false, but implied misinformation that uses literally true information to mislead is common in the real world. Finally, studies have relied mainly on questionnaire measures of reasoning, neglecting behavioural impacts of misinformation and interventions. To offer incremental progress towards addressing these three issues, we conducted an experiment (N = 735) involving misinformation on fair trade. We contrasted the effectiveness of prebunking versus debunking and the impacts of implied versus explicit misinformation, and incorporated novel measures assessing consumer behaviours (i.e., willingness‐to‐pay; information seeking; online misinformation promotion) in addition to standard questionnaire measures. In general, both prebunking and debunking reduced misinformation reliance. We also found that individuals tended to rely more on explicit than implied misinformation both with and without interventions. [ABSTRACT FROM AUTHOR]

The fluid immersion simulation system (FIS) has demonstrated good clinical applicability. This is the first study to compare surgical flap closure outcomes of FIS with an air‐fluidised bed (AFB), considered as standard of care. The success of closure after 14 days post‐op was the primary endpoint. Secondary endpoints were incidences of complications in the first 2 weeks after surgery and the rate of acceptability of the device. Thirty‐eight subjects were in the FIS group while 42 subjects were placed in the AFB group. Flap failure rate was similar between groups (14% vs. 12%; p = 0.84). Complications, notably dehiscence and maceration, were significantly higher in the FIS group (40% vs. 17%; p = 0.0296). The addition of a microclimate regulation device (ClimateCare®) to FIS for the last 43 patients showed a significant decrease in the rate of flap failure (71% vs. 16%; p = 0.001) and incidence of complications (33% vs. 0%; p = 0.011). There was no statistically significant difference between the FIS and air‐fluidised bed (AFB) in the rate of acceptability (nurse acceptance: 1.49 vs. 1.72; p = 0.8; patient acceptance: 2.08 vs. 2.06; p = 0.17), which further illustrates the potential implementation of this tool in a patient‐care setting. Our results show that the use of ClimateCare® in combination with FIS can be a better alternative to the AFB in surgical closure of pressure ulcers. [ABSTRACT FROM AUTHOR]

Background: Pediatric palliative care (PPC) consultation is infrequent among children on extracorporeal membrane oxygenation (ECMO). Objective: Investigate intensive care unit (ICU) team members' perceptions of automatic PPC consultation for children on ECMO in an ICU in the United States. Methods: Cross-sectional survey assessing benefits, barriers to PPC, and consultation processes. Results: Of 291 eligible respondents, 48% (n = 140) completed the survey and 16% (n = 47) answered an open-ended question. Benefits included support in decision-making (n = 98; 70%) and identification of goals of care (n = 89; 64%). Barriers included perception of giving up on families (n = 59; 42%) and poor acceptability by other team members (n = 58; 41%). Respondents endorsed communication with the primary ICU team before (n = 122; 87%) and after (n = 129; 92%) consultation. Open-ended responses showed more positive (79% vs. 13%) than negative statements. Positive statements reflected on expanding PPC to other critically-ill children where negative statements revealed unrecognized value in PPC. Conclusions: Results demonstrate opportunities for education about the scope of PPC and improvements in PPC delivery. [ABSTRACT FROM AUTHOR]

BACKGROUND: Receiving treatment for behavioral health disorders remains problematic due to profound provider shortages. Telebehavioral health services are effective for providing quality care, but research literature on these services in schools is limited. METHODS: Data were collected during Fall 2019 and Spring 2020 semesters on all students receiving telebehavioral health services from 15 school‐based telehealth programs across the U.S. RESULTS: From Fall 2019 to Spring 2020, 62 schools providing services during both periods increased the number of students served from 396 to 745, increased the average number of encounters per student from 2.4 to 4.1, increased the percentage of encounters delivered by clinical social workers, mental health counselors, and clinical psychologists (all p <.001), and increased the use of individual counseling, family counseling, and group counseling (all p <.001). Schools that initiated the service in Spring 2020 (n = 25) averaged 6.5 encounters for the 301 students receiving services, delivered mostly by clinical social workers or professional counselors, using individual counseling. CONCLUSION: Overall, data indicate programs significantly increased both behavioral services provided to their ongoing schools and increased the number of schools served. Undoubtedly telebehavioral health care delivery provided a swift and necessary response to the challenges posed by the growing pandemic threat. [ABSTRACT FROM AUTHOR]

Introduction: The neurofibromatoses (NF) are a group of rare, genetic diseases sharing a predisposition to develop multiple benign nervous system tumors. Given the wide range of NF symptoms and medical specialties involved in NF care, we sought to evaluate the level of awareness of, and agreement with, published NF clinical guidelines among NF specialists in the United States.Methods: An anonymous, cross-sectional, online survey was distributed to U.S.-based NF clinicians. Respondents self-reported demographics, practice characteristics, awareness of seven NF guideline publications, and level of agreement with up to 40 individual recommendations using a 5-point Likert scale. We calculated the proportion of recommendations that each clinician rated "strongly agree", and assessed for differences in guideline awareness and agreement by respondent characteristics.Results: Sixty-three clinicians (49% female; 80% academic practice) across > 8 medical specialties completed the survey. Awareness of each guideline publication ranged from 53%-79% of respondents; specialists had higher awareness of publications endorsed by their medical professional organization (p < 0.05). The proportion of respondents who "strongly agree" with individual recommendations ranged from 17%-83%; for 16 guidelines, less than 50% of respondents "strongly agree". There were no significant differences in overall agreement with recommendations based on clinicians' gender, race, specialty, years in practice, practice type (academic/private practice/other), practice location (urban/suburban/rural), or involvement in NF research (p > 0.05 for all).Conclusions: We identified wide variability in both awareness of, and agreement with, published NF care guidelines among NF experts. Future quality improvement efforts should focus on evidence-based, consensus-driven methods to update and disseminate guidelines across this multi-specialty group of providers. Patients and caregivers should also be consulted to proactively anticipate barriers to accessing and implementing guideline-driven care. These recommendations for improving guideline knowledge and adoption may also be useful for other rare diseases requiring multi-specialty care coordination. [ABSTRACT FROM AUTHOR]

Climate models are frequently used tools for adaptation planning in light of future uncertainty. However, not all climate models are equally trustworthy, and so model biases must be assessed to select models suitable for producing credible projections. Drought is a well-known and high-impact form of extreme weather, and knowledge of its frequency, intensity, and duration are key for regional water management plans. Droughts are also difficult to assess in climate datasets, due to the long duration per event, relative to the length of a typical simulation. Therefore, there is a growing need for a standardized suite of metrics addressing how well models capture this phenomenon. In this study, we present a widely applicable set of metrics for evaluating agreement between climate datasets and observations in the context of drought. Two notable advances are made in our evaluation system: first, statistical hypothesis testing is employed for normalization of individual scores against the threshold for statistical significance. And second, within each evaluation region and dataset, principal feature analysis is used to select the most descriptive metrics among 11 metrics that capture essential features of drought. Our metrics package is applied to three characteristically distinct regions in the conterminous United States and across several commonly employed climate datasets (CMIP5/6, LOCA, and CORDEX). As a result, insights emerge into the underlying drivers of model bias in global climate models, regional climate models, and statistically downscaled models. [ABSTRACT FROM AUTHOR]

Objective: This analysis identified the rate of transfers and averted transfers and their associated costs across multiple emergency department telemedicine (teleED) networks. Methods: This study is a prospective cohort analysis in six teleED networks operating in 65 hospitals in 11 states across the United States. Each submitted uniform data on all teleED encounters for a 26-month period to a data co-ordinating center. Averted transfers were identified if an encounter met specific criteria. Cost savings from averted transfers were estimated from hospital-specific costs of transferred patients. Results: A total of 4,324 teleED encounters were reported. Excluding patients who died, 1,934 (46.2%) were transferred to another inpatient facility. Records of the remaining 2,248 teleED patients were examined and 882 (39.2% of nontransfers; 20.4% of all teleED cases) teleED patients met the criteria for an averted transfer. Of the averted transfer cases, 53.3% were admitted to the local inpatient facility, and 43.5% were discharged. Patients who averted transfer had lower levels of severity and less billed services than those who were transferred. Transport savings for averted transfers were estimated to total $1,074,663 annually across the six teleED networks. Average estimated transport savings were $2,673 for each averted transfer. Conclusions: In a large cohort of teleED cases, 39% of nontransfer cases were averted transfers (20% of all teleED cases). Importantly, 43% of these patients were routinely discharged rather than being transferred. Averted transfers saved on average $2,673 in avoidable transport costs per patient, with 63.6% of these cost savings accruing to public insurance. [ABSTRACT FROM AUTHOR]

Purpose: This report compares COVID‐19 incidence and mortality rates in the nonmetropolitan areas of the United States with the metropolitan areas across three 11‐week periods from March 1 to October 18, 2020. Methods: County‐level COVID‐19 case, death, and population counts were downloaded from USAFacts.org. The 2013 NCHS Urban‐Rural Classification Scheme was collapsed into two categories called metropolitan (large central, large fringe, medium, and small metropolitans) and nonmetropolitan (micropolitan/noncore). Daily COVID‐19 incidence and mortality rates were computed to show temporal trends for each of these two categories. Maps showing the ratio of nonmetropolitan to metropolitan COVID‐19 incidence and mortality rates by state identify states with higher rates in nonmetropolitan areas than in metropolitan areas in each of the three 11‐week periods. Findings: In the period between March 1 and October 18, 2020, 13.8% of the 8,085,214 confirmed COVID‐19 cases and 10.7% of the 217,510 deaths occurred among people residing in nonmetropolitan counties. The nonmetropolitan incidence and mortality trends steadily increased and surpassed those in metropolitan areas, beginning in early August. Conclusions: Despite the relatively small size of the US population living in nonmetropolitan areas, these areas have an equal need for testing, health care personnel, and mitigation resources. Having state‐specific rural data allow the development of prevention messages that are tailored to the sociocultural context of rural locations. [ABSTRACT FROM AUTHOR]

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has had unprecedented impact on the provision of medical care for genetic disorders. The purpose of this study was to assess the effects of the pandemic on neurofibromatosis (NF) care and research.Methods: Sixty-three United States NF clinics were surveyed to identify the impact of the pandemic on clinician role, patient volume, continuity of guideline-driven surveillance, research protocols, and use of (and satisfaction with) telehealth for the delivery of NF care.Results: Fifty-two clinic directors or their representatives completed the survey (83% response rate). About 2/3 of the clinics reported a greater than 50% decrease in the number of available patient appointments, and modified clinical surveillance and research protocols. Fifty-one clinics (98%) newly instituted telehealth during the pandemic. Barriers to telehealth prior to the pandemic were insurance reimbursement concerns and lack of infrastructure. Since telehealth was initiated, high provider satisfaction was reported with ease of use. The most common area of concern was related to inability to perform a physical examination.Conclusion: Results show marked impacts on NF care and research since the beginning of the pandemic, with potential long-term changes related to the introduction (or adoption) of telehealth for clinical care. [ABSTRACT FROM AUTHOR]

Atmospheric rivers (ARs) can be a boon and bane to water resource managers as they have the ability to replenish water reserves, but they can also generate million‐to‐billion‐dollar flood damages. To investigate how anthropogenic climate change may influence AR characteristics in the coastal western United States by end century, we employ a suite of novel tools such as variable resolution in the Community Earth System Model (VR‐CESM), the TempestExtremes AR detection algorithm, and the Ralph, Rutz, et al. (2019, https://doi.org/10.1175/BAMS‐D‐18‐0023.1) AR category scale. We show that end‐century ARs primarily shift from being "mostly or primarily beneficial" to "mostly or primarily hazardous" with a concomitant sharpening and intensification of winter season precipitation totals. Changes in precipitation totals are due to a significant increase in AR (+260%) rather than non‐AR (+7%) precipitation, largely through increases in the most intense category of AR events and a decrease in the interval between landfalling ARs. Plain Language Summary: Atmospheric rivers are central to water resource management in the western United States. Anthropogenic climate change has and continues to alter these storms, which has a cascade of societally relevant impacts. We evaluate how end‐century atmospheric river behavior is altered, assuming little‐to‐no carbon mitigation occurs. To do this, we use a state‐of‐the‐art global climate simulation that allows us to connect global‐to‐regional scales and, compared with conventional global climate models, better represent the interactions between atmospheric rivers and mountains when they make landfall. To isolate changes in atmospheric river behavior in our simulations, we use a newly developed atmospheric river detection algorithm and category scale devised to communicate risk more clearly. Using these tools, we find that by end‐century atmospheric river character shifts from being "mostly or primarily beneficial" to "mostly or primarily hazardous." This results in increased precipitation totals, primarily from the most hazardous atmospheric rivers, resulting in a sharpening and intensification of the water year. Some end‐century atmospheric rivers exceed the highest levels of the category scale; however, we do not find that any single storm produces significantly more precipitation. Therefore, the increased precipitation is due to an increase in the number of hazardous atmospheric rivers that more regularly occur back‐to‐back. Key Points: Atmospheric rivers in variable‐resolution‐enabled Community Earth System Model simulations are validated and projected under climate changeShifts in end‐century atmospheric river character lead to sharper, more intense winter season precipitation totals in the coastal western United StatesNo single end‐century atmospheric river event produces unprecedented precipitation totals, yet totals from sequential atmospheric rivers do [ABSTRACT FROM AUTHOR]

Tropical cyclones (TCs) can subject an area to heavy precipitation for many hours, or even days, worsening the risk of flooding, which creates dangerous conditions for residents of the U.S. East and Gulf Coasts. To study the representation of TC-related precipitation over the eastern United States in current-generation global climate models, a novel analysis methodology is developed to track TCs and extract their associated precipitation using an estimate of their dynamical outer size. This methodology is applied to three variableresolution (VR) configurations of the Community Atmosphere Model, version 5 (CAM5), with highresolution domains over the North Atlantic and one low-resolution conventional configuration, as well as to a combination of reanalysis and observational precipitation data. Metrics and diagnostics such as TC counts, intensities, outer storm sizes, and annual mean total and extreme precipitation are compared between the CAM5 simulations and reanalysis/observations. The high-resolution VR configurations outperform the global low-resolution configuration for all variables in the North Atlantic. Realistic TC intensities are produced by the VR configurations. The total North Atlantic TC counts are lower than observations but better than reanalysis. [ABSTRACT FROM AUTHOR]

When the therapist and patient are from different cultures, there may be impediments to the development of empathy and a therapeutic alliance. South India culture provides an example of contrasting values and customs about which patients may be reluctant to discuss. The initial case history is of a South Indian who sought treatment in the United States. The remaining cases, drawn from a village in South India with which the author has had a 55-year history of research, illustrate cultural factors potentially inhibiting or facilitating the development of empathy and a therapeutic alliance. [ABSTRACT FROM AUTHOR]

The article presents abstracts of 2003 North American Society for the Psychology of Sports & Physical Activity Conference to be held on June 5-7, 2003 in Savannah, Georgia. The purpose of this symposium is to present the results of three empirical studies that were conducted to examine social relationships in the competitive sport setting. The purpose of this study was to describe peer relationship profiles of youth sport participants and to determine whether these profiles correspond with differences in sport motivation variables. The article reports results of combining three attributes of treatment when applied to verbal communication activities in patients with speech/language production difficulties associated with aphasia resulting from stroke.

The article discusses Swiss-born and German born immigration to Louisville, Kentucky and the experiences these immigrants had when settling down in Louisville and the surrounding areas. Topics include riots against the German and Swiss immigrants who mostly spoke German, and the Turner movement which was founded by gymnastics educator Friedrich Ludwig Jahn.

Since 2017, immigration enforcement in the US has increased, and as a consequence, many more young children are vulnerable to being separated from their parents and are living with daily fear and stress of parental deportation. This article documents stories from interviews with early care service providers and immigrant parents in six states conducted by the Center for Law and Social Policy in 2017. It outlines concerns for children in the current immigration context and offers recommendations for classroom practice, family supports, and actions that early childhood educators can take when working with young children of immigrants and their families. [ABSTRACT FROM AUTHOR]

Background: The relationship between obesity and health expenditures is not well understood. We examined the relationship between genetic predisposition to obesity measured by a polygenic risk score for body mass index (BMI) and Medicare expenditures.Methods: Biennial interview data from the Health and Retirement Survey for a nationally representative sample of older adults enrolled in fee-for-service Medicare were obtained from 1991 through 2010 and linked to Medicare claims for the same period and to Genome-Wide Association Study (GWAS) data. The study included 6,628 Medicare beneficiaries who provided 68,627 complete person-year observations during the study period. Outcomes were total and service-specific Medicare expenditures and indicators for expenditures exceeding the 75th and 90th percentiles. The BMI polygenic risk score was derived from GWAS data. Regression models were used to examine how the BMI polygenic risk score was related to health expenditures adjusting for demographic factors and GWAS-derived ancestry.Results: Greater genetic predisposition to obesity was associated with higher Medicare expenditures. Specifically, a 1 SD increase in the BMI polygenic risk score was associated with a $805 (p < .001) increase in annual Medicare expenditures per person in 2010 dollars (~15% increase), a $370 (p < .001) increase in inpatient expenses, and a $246 (p < .001) increase in outpatient services. A 1 SD increase in the polygenic risk score was also related to increased likelihood of expenditures exceeding the 75th percentile by 18% (95% CI: 10%-28%) and the 90th percentile by 27% (95% CI: 15%-40%).Conclusion: Greater genetic predisposition to obesity is associated with higher Medicare expenditures. [ABSTRACT FROM AUTHOR]

Medicare Part D has improved access to prescription drugs for Medicare beneficiaries. However, the program has raised certain issues that threaten the viability of pharmacies. After a decade of Part D, we assess these issues as they concern rural pharmacies using survey responses. Independent rural pharmacies, the only retail pharmacy outlets in their communities, were surveyed. Email-based surveys were returned by 118 respondents. Rural pharmacies ranked two issues – direct and indirect remuneration (DIR) fees and delayed maximum allowable cost (MAC) adjustment – highest on scales of magnitude and immediacy of the challenge they posed to sustainability. 80% of respondents reported DIR fees as a challenge of very large magnitude and 83% reported it as a very immediate challenge. 78% of respondents reported MACs not being updated quickly enough as a very large magnitude challenge, with 80% indicating it is a very immediate challenge. Exclusion from the preferred networks of Part D plans was reported as a challenge of very large magnitude and immediacy by about 60% of pharmacies. Pharmacy staffing, competition from pharmacy chains, and contracts for services rendered to Medicaid patients were less likely to be reported as significant or immediate challenges. Policies that address the issues of delayed MAC adjustment and DIR fees could go a long way in ensuring the viability of these critical sources of pharmaceutical services. [ABSTRACT FROM AUTHOR]

Purpose The aim of the study was to examine whether Critical Access Hospitals (CAHs), the predominant type of hospital in small and isolated rural areas, perform better than, the same as, or worse than Prospective Payment System (PPS) hospitals on measures of quality. Methods The Healthcare Cost and Utilization Project State Inpatient Databases and American Hospital Association annual survey data were used for analyses. A total of 35,674 discharges from 136 nonfederal general hospitals with fewer than 50 beds were included in the analyses: 14,296 from 100 CAHs and 21,378 from 36 PPS hospitals. Outcome measures included 6 bivariate indicators of adverse events (including complications) of surgical care developed from the Agency for Healthcare Research and Quality's Patient Safety Indicators. Multiple logistic regression models were developed to examine the relationship between hospital adverse events and CAH status. Findings Compared with PPS hospitals, CAHs are significantly less likely to have any observed (unadjusted) adverse event on 4 of the 6 indicators. After adjusting for patient mix and hospital characteristics, CAHs perform better on 3 of the 6 indicators. Accounting for the number of discharges eliminated the differences between CAHs and PPS hospitals in the likelihood of adverse events across all indicators except one. Conclusions The study suggests there are no differences in surgical patient safety outcomes between CAHs and PPS hospitals of comparable size. This reinforces the central role of CAHs in providing quality surgical care to populations in rural and isolated areas, and underscores the importance of strategies to sustain rural surgery infrastructure. [ABSTRACT FROM AUTHOR]

Background: Proxy respondents are frequently used in health surveys, and the proxy is most often the spouse. Longstanding concerns linger, however, about the validity of using spousal proxies, especially for older adults. The purpose of this pilot study was to evaluate the concordance between self-reports and spousal proxy reports to a standard health survey in a small convenience sample of older married couples.Methods: We used the Seniors Together in Aging Research (STAR) volunteer registry at the University of Iowa to identify and consent a cross-sectional, convenience sample of 28 married husband and wife couples. Private, personal interviews with each member of the married couple using a detailed health survey based on the 2012 Health and Retirement Study (HRS) instrument were conducted using computer assisted personal interviewing software. Within couples, each wife completed the health survey first for herself and then for her husband, and each husband completed the health survey first for himself and then for his wife. The health survey topics included health ratings, health conditions, mobility, instrumental activities of daily living (IADLs), health services use, and preventative services. Percent of agreement and prevalence and bias adjusted kappa statistics (PABAKs) were used to evaluate concordance.Results: PABAK coefficients indicated moderate to excellent concordance (PABAKs >0.60) for most of the IADL, health condition, hospitalization, surgery, preventative service, and mobility questions, but only slight to fair concordance (PABAKs = -0.21 to 0.60) for health ratings, and physician and dental visits.Conclusions: These results do not allay longstanding concerns about the validity of routinely using spousal proxies in health surveys to obtain health ratings or the number of physician and dental visits among older adults. Further research is needed in a nationally representative sample of older couples in which each wife completes the health survey first for herself and then for her husband, each husband completes the health survey first for himself and then for his wife, and both spouses' Medicare claims are linked to their health survey responses to determine not just the concordance between spousal reports, but the concordance of those survey responses to the medical record. [ABSTRACT FROM AUTHOR]

Background: In response to increasing fiscal pressures, the Affordable Care Act (ACA) sought to reduce Medicare Advantage plan expenses by restructuring the bidding and payment processes. The purpose of this study is to assess the effects of the ACA's payment freeze and restructuring of the bidding and payment processes on favorable risk selection in Medicare Advantage plan enrollment (objective 1) and changes in the health status of beneficiaries enrolled in Medicare Advantage plans over time (objective 2).Methods: We used the Medicare Health Outcome Survey baseline data (2007→2013) for analyses of the first objective (7 cohorts, 1.7 million beneficiaries) and the linked baseline and follow-up data (2007-2009→2011-2013) for analyses of the second objective (5 cohorts, 0.5 million beneficiaries). To examine favorable risk selection we used the following outcomes: self-rated health, falls, balance problems, falls management, frailty, and morbidity. To examine changes in beneficiary health status over time, we examined changes (over time) in these same outcomes. The focal independent variable is the policy implementation measure, which is time dependent and measures the accumulation of changes to Medicare Advantage payment policies resulting from the ACA. Multiple regression models were developed to examine the relationship between ACA implementation and outcomes of interest.Results: In terms of favorable selection, individuals enrolled in Medicare Advantage plans post-ACA have, on average, better self-rated health (b = 0.003, p < 0.01), lower odds of falls (AOR = 0.981, p < 0.001), higher odds of falls management (AOR = 1.040, p < 0.001), lower frailty risks (IRR = 0.983, p < 0.001), and lower risks of comorbidities (IRR = 0.989, p < 0.001). In terms of health status changes over time, the results indicate that in the post-ACA period, beneficiaries reported better self-rated health (b = 0.028, p < 0.001), lower odds of falls (AOR = 0.965, p < 0.001), lower odds of balance problems (AOR = 0.958, p < 0.001), lower odds of falls management (AOR = 0.981, p < 0.05), lower frailty risks (IRR = 0.944, p < 0.001), and lower risks of comorbidity (IRR = 0.986, p < 0.001) at follow up compared to the same risks at baseline.Conclusions: These findings suggest that as the Medicare Advantage payment policies in the ACA were being implemented, plans may have engaged in favorable selection activities, yet beneficiaries exhibited more favorable health outcomes. [ABSTRACT FROM AUTHOR]

Objectives: To compare concordance of survey reports of health service use versus claims data between self respondents and spousal and nonspousal relative proxies.Data Sources: 1995-2010 data from the Survey on Assets and Health Dynamics among the Oldest Old and 1993-2010 Medicare claims for 3,229 individuals (13,488 person-years).Study Design: Regression models with individual fixed effects were estimated for discordance of any hospitalizations and outpatient surgery and for the numbers of under- and over-reported physician visits.Principal Findings: Spousal proxies were similar to self respondents on discordance. Nonspousal proxies, particularly daughters/daughters-in-law and sons/sons-in-law, had less discordance, mainly due to reduced under-reporting.Conclusions: Survey reports of health services use from nonspousal relatives are more consistent with Medicare claims than spousal proxies and self respondents. [ABSTRACT FROM AUTHOR]

The article focuses on aspects related to involvement of the U.S. in nuclear forces in Europe. Topics discussed include the strategic advantage of 1972 Strategic Arms Limitation Treaty (SALT) and New Strategic Arms Reduction Treaty (New START), the launched of 1988 Intermediate-Range Nuclear Forces (INF) Treaty, and the deployment of military weapons by U.S. in Europe in 1954.

Key message: We report malt quality QTLs relevant to breeding with greater precision than previous mapping studies. The distribution of favorable alleles suggests strategies for marker-assisted breeding and germplasm exchange. Abstract: This study leverages the breeding data of 1,862 barley breeding lines evaluated in 97 field trials for genome-wide association study of malting quality traits in barley. The mapping panel consisted of six-row and two-row advanced breeding lines from eight breeding populations established at six public breeding programs across the United States. A total of 4,976 grain samples were subjected to micro-malting analysis and mapping of nine quality traits was conducted with 3,072 SNP markers distributed throughout the genome. Association mapping was performed for individual breeding populations and for combined six-row and two-row populations. Only 16 % of the QTL we report here had been detected in prior bi-parental mapping studies. Comparison of the analyses of the combined two-row and six-row panels identified only two QTL regions that were common to both. In total, 108 and 107 significant marker-trait associations were identified in all six-row and all two-row breeding programs, respectively. A total of 102 and 65 marker-trait associations were specific to individual six-row and two-row breeding programs, respectively indicating that most marker-trait associations were breeding population specific. Combining datasets from different breeding program resulted in both the loss of some QTL that were apparent in the analyses of individual programs and the discovery of new QTL not identified in individual programs. This suggests that simply increasing sample size by pooling samples with different breeding history does not necessarily increase the power to detect associations. The genetic architecture of malting quality and the distribution of favorable alleles suggest strategies for marker-assisted selection and germplasm exchange. [ABSTRACT FROM AUTHOR]

A renewed interest in breeding barley specifically for food end-uses is being driven by increased consumer interest in healthier foods. We conducted association mapping on physicochemical properties of barley that play a role in food quality and processing including grain hardness, polyphenol oxidase activity, total phenolics, amylose content, and β-glucan. We used 3,069 elite two-row and six-row spring barley breeding lines from eight US breeding programs and 2,041 SNP markers for association mapping. Marker-trait associations were identified using a mixed model that incorporated population structure and kinship. We detected two previously identified QTL for grain hardness on chromosome 2H in the telomeric region of 5H along with two novel regions on 4H and 6H. For amylose content, we detected marker-trait associations on 7H from 0.63 to 30 cM. We detected four regions on chromosomes 1H, 2H, 3H, and 4H associated with polyphenol oxidase activity. The chromosome 2H region co-localized with the two previously mapped polyphenol oxidase genes PPO1 and PPO2, and the regions on chromosomes 1H, 3H, and 4H QTL were novel. For total phenolics, we identified three significant regions on 3H, 4H, and 5H. Two regions on 2H and 7H were associated with β-glucan. Both previously identified and novel QTL are segregating in elite US breeding germplasm. Only three of the 24 SNPs that were associated with traits using either the two-row or six-row mapping panel were identified in both panels. Nine SNPs were detected in the individual two-row or six-row panels that were not detected in the analysis using the complete panel and accounting for population structure. The distribution of favorable alleles at these loci that underpin food quality across the breeding programs suggests several strategies to use markers to improve barley for food uses. [ABSTRACT FROM AUTHOR]

Current models of stress posit that perceptions of resources and demands determine whether stress will be experienced. To test this theory, cross-nationally with educators, previous research examining the relationship of elementary teachers' occupational experience, stress, and coping resources to burnout symptoms in the United States was replicated with elementary teachers in Germany. Participants were 469 elementary teachers in Baden-Württemberg, Germany. Individual teacher burnout levels within and between schools were examined Teacher experience, perceptions of classroom demands and resources, and personal coping resources were tested for associations with burnout symptoms. Multilevel modeling was used to determine that variance in reported burnout symptoms between schools was minimal, but variance was found between teachers within the same school Replicating previous research, individual teacher factors were associated with burnout symptoms in the predicted direction. [ABSTRACT FROM AUTHOR]

The ESPR Uroradiology Task Force and the ESUR Paediatric Working Group present two new recommendations on imaging in childhood cystic kidney disease and in childhood renal transplantation, and address the presently restricted availability of contrast-enhanced (ce) US in children. New insights into the genetics require an updated classification of paediatric cystic kidney disease along with a new concept of diagnostic imaging. Characteristic imaging features are key to the new classification. Available recommendations for imaging renal transplantation in children are not satisfactory. The following consensus-based algorithm proposes a more effective and more uniform imaging concept, reducing invasiveness, enhancing diagnostic accuracy, and facilitating future multicentre studies and meta-analysis. At present, ce-US in children can only be performed off-license, since the only approved US contrast agent (CA) for children has been taken off the market. Nevertheless, paediatric ce-US is practiced at multiple places using Sonovue® (Bracco, Milan, Italy), a generally available agent in Europe. From a medical and scientific perspective, paediatric ce-US should be promoted, and efforts are undertaken to collect data on paediatric US-CA applications. Routine paediatric imaging depends on local expertise and availability of equipment. The imaging recommendations and supportive data are intended to ease the physicians' difficult task of dealing with the specific diagnostic demands of paediatric paediatric cystic kidney disease and transplantation. [ABSTRACT FROM AUTHOR]

Estimates of 12-month and lifetime prevalence and of lifetime morbid risk (LMR) of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) anxiety and mood disorders are presented based on US epidemiological surveys among people aged 13+. The presentation is designed for use in the upcoming DSM-5 manual to provide more coherent estimates than would otherwise be available. Prevalence estimates are presented for the age groups proposed by DSM-5 workgroups as the most useful to consider for policy planning purposes. The LMR/12-month prevalence estimates ranked by frequency are as follows: major depressive episode: 29.9%/8.6%; specific phobia: 18.4/12.1%; social phobia: 13.0/7.4%; post-traumatic stress disorder: 10.1/3.7%; generalized anxiety disorder: 9.0/2.0%; separation anxiety disorder: 8.7/1.2%; panic disorder: 6.8%/2.4%; bipolar disorder: 4.1/1.8%; agoraphobia: 3.7/1.7%; obsessive-compulsive disorder: 2.7/1.2. Four broad patterns of results are most noteworthy: first, that the most common (lifetime prevalence/morbid risk) lifetime anxiety-mood disorders in the United States are major depression (16.6/29.9%), specific phobia (15.6/18.4%), and social phobia (10.7/13.0%) and the least common are agoraphobia (2.5/3.7%) and obsessive-compulsive disorder (2.3/2.7%); second, that the anxiety-mood disorders with the earlier median ages-of-onset are phobias and separation anxiety disorder (ages 15-17) and those with the latest are panic disorder, major depression, and generalized anxiety disorder (ages 23-30); third, that LMR is considerably higher than lifetime prevalence for most anxiety-mood disorders, although the magnitude of this difference is much higher for disorders with later than earlier ages-of-onset; and fourth, that the ratio of 12-month to lifetime prevalence, roughly characterizing persistence, varies meaningfully in ways consistent with independent evidence about differential persistence of these disorders. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

BACKGROUND: The widespread acceptance of reduced-tillage farming in cereal cropping systems in the Pacific Northwest of the United States has resulted in increased use of herbicides for weed control. However, soil residual concentrations of widely used imidazalone herbicides limit the cultivation of barley, which is more sensitive than wheat. In addition, increased severity of the root rot disease caused by Rhizoctonia solani is associated with reduction in tillage. Many crops exhibit altered disease responses after application of registered herbicides. In this study, the injury symptoms in barley caused by sublethal rates of two acetolactate synthase (ALS)-inhibiting herbicides, imazamox and propoxycarbazone-sodium, were assessed in factorial combinations with a range of inoculum concentrations of the root rot pathogen Rhizoctonia solani AG-8. RESULTS: Both herbicides and pathogen had negative impacts on plant growth parameters such as root and shoot dry weight, shoot height and first leaf length, and interactions between pathogen and herbicide were detected. CONCLUSIONS: The results suggested that sublethal rates of herbicides and R. solani could alter severity of injury symptoms, possibly owing to the herbicide predisposing the plant to the pathogen. Copyright © 2012 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

This study was designed to assess the link of attachment relationships with physical activity motivation. Potential mediators of this link were examined in a cross-sectional study targeting college student physical activity motivation and behaviour. Participants completed self-reports of attachment relationships (with mother, father and best friend), self-determined motivation for physical activity, physical activity behaviour and the hypothesised mediator variables of perceived competence, autonomy and relatedness. The results provide support for the mediating role of these variables in the association of father attachment with self-determined motivation. Meaningful variance in self-determined motivation for physical activity and physical activity behaviour was explained. Overall, attachment relationships appear to be relevant, albeit modestly, to physical activity motivation of college students. The findings support continued efforts to integrate attachment and motivational perspectives in the study of college student health behaviour. [ABSTRACT FROM AUTHOR]

Physical fitness performance is an important health correlate yet is often unrelated to sedentary behaviour in early adolescence. In this study, we examined the association of sedentary behaviour (i.e. screen time) with weight-related health markers and blood pressure, after controlling for cardiorespiratory fitness performance. American middle school students (N = 153, 56% females) aged 11-15 years (mean 12.6 years, s = 0.5) completed assessments of cardiorespiratory fitness performance, screen time, weight status (BMI percentile, waist-to-height ratio), and blood pressure. Multivariate analysis of covariance, controlling for cardiorespiratory fitness performance, found those who met the daily recommendation of 2 h or less of screen time (n = 36, 23.5%) had significantly lower BMI (p < 0.05) and systolic blood pressure (p < 0.01) compared with those who exceeded this recommendation. Findings suggest specific intervention programmes may be designed to target both cardiorespiratory fitness and sedentary behaviours to maximize early adolescent health because these behaviours are likely to have unique and independent effects on youth health markers. [ABSTRACT FROM AUTHOR]

With 2 figures and 2 tables To study the genetic control of malting quality, in North American and European barley varieties, over five contrasting environments, 106 doubled haploid (DH) lines, from the cross ‘Triumph’ × ‘Morex’, were grown at Pullman (Washington State, USA) in 2002, Dundee (Scotland) in 2003 and 2005 and Lleida and Valladolid (Northern Spain) in 2006. The vrs locus, associated with two-row vs. six-row ear type, had a significant effect, as two-row lines had higher grain protein content at all sites. This had variable effects on other malting parameters, but hot water extract (EXT) was not significantly affected at the two Spanish sites. Quantitative trait loci associated with malting characters were distributed across all seven chromosomes, but the most influential, with effects on EXT and alcohol yield, at more than one site, were on 1H, with ‘Morex’ providing the increasing allele and 5H, with the increasing allele from ‘Triumph’. Transgressive segregation, in both directions, occurred at all sites. It was concluded that crosses between European and North American germplasm could enhance quality attributes in barley cultivated across diverse environments. [ABSTRACT FROM AUTHOR]

This article contributes to the literature on the effect of state and local education spending on U.S. state economic growth by separately analyzing higher and K-12 education spending and by taking into account the possibility that education spending may generate spillover effects to neighboring states. Results from a series of fixed-effects regressions using a 1992-2002 panel of state-level data indicate that increased spending on higher education generally exhibits a relatively large negative effect on private sector employment or gross state product growth when the increase in education spending is financed through own-source revenue. Results do not identify a statistically significant relationship between K-12 education spending and economic growth. This finding is an important clarification in the literature because an analysis of combined higher and K-12 education spending yields an overall negative effect. Results do not provide consistent evidence of cross-state spillover effects associated with either form of education spending. [ABSTRACT FROM AUTHOR]

The Department of Veterans Affairs Veterans Health Administration cares for approximately 15% of persons with spinal cord injury (SCI) in the United States. However, the nature and characteristics of pain among veterans with SCI are not well understood. This study used a postal survey to compare veterans with SCI and nonveterans with SCI on pain intensity; pain interference; functioning; and other pain, demographic, and medical characteristics. Veterans tended to be older than nonveterans but these groups were otherwise comparable on demographic and medical variables. Veterans were not significantly different from nonveterans on pain intensity or pain interference. Veterans reported lower levels of functioning than nonveterans and higher levels of pain-related catastrophizing. However, differences in functioning between veterans and non-veterans were attributable to age differences between the groups. In summary. differences between veterans with SCI and nonveterans with SCI were few and small in magnitude, suggesting that veterans with SCI are not at greater risk for pain and pain-related problems. However, pain-related catastrophizing may be a particular concern among veterans with SCI. [ABSTRACT FROM AUTHOR]

Each year in the United States, an average of one to two children per 10,000 develop cancer. The etiology of most childhood cancer remains largely unknown but is likely attributable to random or induced genetic aberrations in somatic tissue. However, a subset of children develops cancer in the setting of an underlying inheritable condition involving a germline genetic mutation or chromosomal aberration. Despite overall improved survival rates for children with cancer over recent decades, many patients experience neurological and neurocognitive complications during the course of their illness and/or as late effects of treatment. Improvements in therapy, longer survival times, and improved imaging techniques have all increased both the time that patients are at risk and the ability to detect such complications. How an underlying inherited disorder influences the incidence, timing, etiology, and treatment of such sequelae has not been extensively documented, but evidence exists for an increased risk for secondary malignancies and in some cases life-threatening sensitivity/toxicity to conventionally dosed cancer treatments, thus emphasizing the need for the early recognition of such syndromes. This review outlines the major tumor- and treatment-related neurodevelopmental sequelae in pediatric cancer patients, with particular attention to children with an underlying inheritable disorder. © 2008 Wiley-Liss, Inc. Dev Disabil Res Rev 2008;14:229–237. [ABSTRACT FROM AUTHOR]

Objectives: To examine cardiovascular disease (CVD) risk factors and changes in the 10-year coronary heart disease (CHD) risk factors in women who participated in the WISEWOMAN program in Nebraska. Methods: Data for analysis were available for a total of 10,739 women who received CVD screening between September 2002 and December 2004. We examined the relationships between sociodemographic characteristics and CVD risk factors, including high cholesterol, high blood pressure, high body mass index (BMI), and diabetes. Additionally, we assessed the 10-year CHD risk and the change in risk factors for CVD. Results: The incidence was 31 per 1000 for hyperglycemia, 66 per 1000 for hypertension, and 157 per 1000 for high cholesterol. The prevalence of obesity was 447 per 1000. Nonwhite, older, less educated, and rural women were more likely to be overweight or obese. Older, less educated, and overweight to obese women were more likely to have hyperglycemia and high blood pressure. Older and overweight to obese women were more likely to have high total cholesterol and an increased 10-year CHD risk. Conclusions: Race, age, and rural residence were related to CVD risk factors among low-income women in Nebraska. The effect of program eligibility requirements as a barrier to return visits should be more closely examined, and strategies to facilitate repeat screenings on WISEWOMAN projects should be undertaken. Additionally, women on the lower end of the socioeconomic spectrum were less likely to return for repeat visits, suggesting that further investigation is needed to understand why these women fail to return for screening services. [ABSTRACT FROM AUTHOR]

Presents a study that assessed the prevalence of antibody to the HIV type 1 (HIV-1) among male and female entrants to correctional systems in the U.S. Background on HIV; Data collection procedures used in the study; Identification of independent predictors of HIV-1 seropositivity.

The article presents a study aimed to explore the relationship of the social background characteristics of teachers to the quality of college they had attended. The study looks into the relationship among a group of young men and women who became elementary and secondary school teachers. The paper is based on the two surveys in Wisconsin dealing with educational plans, parental educational and occupational status, residential characteristics. Basing on the results of the study, it was found out that female teachers are more likely to attend higher quality schools if they are coming from families of high socioeconomic status. On the other hand, male teachers are more likely to attend higher quality schools if they were high in academic performance in high school.

Features the 'Bob' barley, a two-row spring feed barley which was developed and released by barley improvement team at the Washington State University in cooperation with the Idaho and Oregon agricultural experiment stations and the U.S. Department of Agriculture's Agricultural Research Service. Origin; Selection; Disease and pest resistance; Yield potential.

Reports on the development of Farmington barley, a semidwarf two-row spring feed barley, by the barley improvement team at the Washington State University Agricultural Research Center. Adaptation of Farmington to the intermediate to high rainfall production zones and irrigated areas of eastern Washington; Malting quality.

Presents guidelines for registering mapping populations from the Crop Registration Committee and the Crop Science Society of America in the United States. Submission of a draft of mapping registration article; Responsibilities of the author and developer to distribute the seed or other propagules in the mapping population; Criteria for registration of mapping populations.