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Although empirical research has explored the relationship of perceived corporate social responsibility with turnover intention, how the connection develops and the internal mechanism of this link require further exploration. In this study we examined the mediating roles of work meaningfulness and affective commitment in the relationship between perceived corporate social responsibility and turnover intention. Employees ( = 802) from real estate and manufacturing firms in China completed an online survey. The study model was assessed by structural equation modeling. Results indicated that a positive perception of corporate social responsibility indirectly and negatively affected employees' turnover intention. The mediating roles of work meaningfulness and affective commitment in the relationship between perceived corporate social responsibility and turnover intention were supported. This study provides managers with new insights regarding the value of employees' perception of the organization's corporate social responsibility, which can play a significant role as a future employee governance tool.

Adherence to antiretroviral therapy (ART) is vital for reducing racial and gender disparities in morbidity and mortality among people living with HIV/AIDS (PLWH). Little research attention has been given to aspects of family functioning affecting ART adherence among PLWH vulnerable to disparities. Data were from n = 313 participants (93% African American) in the BEACON study, which recruited injection-drug-using PLWH on ART. Using factor analysis and longitudinal structural equation modeling, we found that current substance use and negative family conflict tactics (i.e., non-negotiation) predicted PLWH's lower probability of ART adherence at 12-month follow-up; and greater HIV disclosure to support network members predicted a higher probability of adherence. These findings suggest the importance of family and other support network members in this vulnerable population's ART adherence. Social network-focused interventions promoting prosocial response to conflict and negotiation skills are important for improving vulnerable PLWH's HIV outcomes and reducing health disparities.

© 2023 Retina. All right reserved.Purpose:To report outcomes of pediatric patients with combined hamartoma of the retina and the retina pigment epithelium followed up conservatively or after pars plana vitrectomy.Methods:This retrospective multicenter study included 62 eyes of 59 pediatric patients with combined hamartoma of the retina and the retina pigment epithelium from 13 different international centers with an average age of 7.7 ± 4.7 (0.3-17) years at the time of the diagnosis and having undergone pars plana vitrectomy or followed conservatively. At baseline and each visit, visual acuity values, optical coherence tomography for features and central foveal thickness, and tumor location were noted. Lesions were called as Zone 1, if it involves the macular and peripapillary areas, and the others were called as Zone 2 lesions.Results:Twenty-one eyes of 20 patients in the intervention group and 41 eyes of 39 patients in the conservative group were followed for a mean of 36.2 ± 40.4 (6-182) months. Best-corrected visual acuity improved in 11 (68.8%) of 16 eyes in the intervention group and 4 (12.9%) of 31 eyes in the conservative group (P < 0.001). The mean central foveal thickness decreased from 602.0 ± 164.9 µm to 451.2 ± 184.3 µm in the intervention group, while it increased from 709.5 ± 344.2 µm to 791.0 ± 452.1 µm in Zone 1 eyes of the conservative group. Posterior location of tumor, irregular configuration of the foveal contour and ellipsoid Zone defect in optical coherence tomography, subretinal exudate and prominent vascular tortuosity were associated with poor visual acuity.Conclusion:Vitreoretinal surgery is safe and effective in improving vision and reducing retinal distortion in Zone 1 combined hamartoma of the retina and the retina pigment epithelium in children.

Undergraduate research experience has been proven to improve student learning and retention. Since 2018, Oregon State University Department of Wood Science and Engineering has offered Research and Extension Experiences for Undergraduates (REEU) through support from the United States Department of Agriculture (USDA) Education and Workforce Development program. Between 2018 and 2020, 31 undergraduate students conducted research and/or gained experience in Extension projects during a 12-wk summer internship. The goal of this work is to assess the success of mentor–mentee relationships and how the program benefits the mentees’ career. Data for this research consists of transcribed interviews of seven mentor–mentee pairs. Transcripts are qualitatively analyzed to capture insights regarding participants’ experiences in the program. Students who participated in the REEU program improved their research skills and soft skills such as adaptation, writing, and communication. As a result of their participation, students are more likely to attend graduate school.

In prior work, Friends of Cancer Research convened multiple data partners to establish standardized definitions for oncology real-world end points derived from electronic health records (EHRs) and claims data. Here, we assessed the performance of real-world overall survival (rwOS) from data sets sourced from EHRs by evaluating the ability of the end point to reflect expected differences from a previous randomized controlled trial across five data sources, after applying inclusion/exclusion criteria. The KEYNOTE-189 clinical trial protocol of platinum doublet chemotherapy (chemotherapy) vs. programmed cell death protein 1 (PD-1) in combination with platinum doublet chemotherapy (PD-1 combination) in first-line nonsquamous metastatic non-small cell lung cancer guided retrospective cohort selection. The Kaplan-Meier product limit estimator was used to calculate 12-month rwOS with 95% confidence intervals (CIs) in each data source. Cox proportional hazards models estimated hazard ratios (HRs) and associated 95% CIs, controlled for prognostic factors. Once the inclusion/exclusion criteria were applied, the five resulting data sets included 155 to 1,501 patients in the chemotherapy cohort and 36 to 405 patients in the PD-1 combination cohort. Twelve-month rwOS ranged from 45% to 58% in the chemotherapy cohort and 44% to 68% in the PD-1 combination cohort. The adjusted HR for death ranged from 0.80 (95% CI: 0.69, 0.93) to 1.15 (95% CI: 0.71, 1.85), controlling for age, gender, performance status, and smoking status. This study yielded insights regarding data capture, including ability of real-world data to precisely identify patient populations and the impact of criteria on end points. Sensitivity analyses could elucidate data set-specific factors that drive results.

Informal care of family and friends is important for the health and well-being of disadvantaged persons living with HIV (PLWH). Caregiver role strain may threaten the function and continuity of their main relationships and their health impacts. Data were from a disadvantaged, primarily African American, sample of PLWH care recipients. Caregiver role strain was operationalized as a latent factor measured by variables including PLWH's perceptions of their caregiver not wanting or complaining about helping them or wanting a break. We found that greater caregiver role strain was associated with higher levels of HIV-related stigma and depressive symptoms. Lower role strain was associated with more collaborative problem solving and shared medical treatment decision-making. Caregiver role strain was linked to disadvantaged PLWHs' worse stigma and mental health; collaborative engagement in care and coping assistance were protective of role strain. Caregiving relationship-focused research and interventions are needed for resourcing and sustaining disadvantaged African American communities' caregiving and health.

Understanding barriers to implementation of Industry 4.0 strategies is a first step to enable companies to begin to use and implement new technologies; using new technologies will allow mills to improve efficiency and stay relevant in the face of increasing international competition. This study uses a mail survey to gather insights regarding awareness of technologies within the US primary wood products industry as well as the barriers to using new technologies. Awareness of technologies is generally low, especially with respect to additive manufacturing, autonomous systems, and big data. Lack of skilled workers is the primary limiting factor to implementation of new technologies with other key factors being out-of-date facilities and unclear financial benefits. Existing expertise was highest in manufacturing process monitoring and data analysis, and lowest in robotics. Only a very small group of respondents have already implemented any form of robotics. Overall, only six respondents (6.7 %) have an Industry 4.0 strategy, while 77 % did not recognize the terms “Industry 4.0” or “Smart Manufacturing.” Results suggest considerable room for additional application of I4.0 technologies in the industry., Razumijevanje prepreka za implementaciju strategija industrije 4.0 prvi je korak koji će omogućiti tvrtkama uvođenje i primjenu novih tehnologija. Uvođenjem tih novih tehnologija pilane će poboljšati svoju učinkovitost uz zadržavanje konkurentnosti. Ovo se istraživanje temelji na poštom upućenoj anketi kako bi se dobio uvid u svjesnost o tehnologijama u industriji primarne prerade drva u SAD-u, kao i o preprekama za primjenu novih tehnologija. Svjesnost o tehnologijama općenito je niska, posebice za aditivnu proizvodnju, autonomne sustave i velike baze podataka. Nedostatak kvalificiranih radnika najveći je ograničavajući faktor za primjenu novih tehnologija, a ostali su otežavajući činitelji zastarjela postrojenja i nejasnoće o financijskim koristima što ih donosi primjena novih tehnologija. Najveća je stručnost zabilježena u području praćenja proizvodnih procesa i analizi podataka, a najmanja u robotici. Samo je vrlo mala skupina ispitanika već primijenila neki od oblika robotike. Ukupno samo šest ispitanika (6,7 %) ima strategiju Industrije 4.0, dok 77 % ispitanika nije prepoznalo pojmove "industrija 4.0" ili "pametna proizvodnja". Rezultati pokazuju da postoji znatan prostor za dodatnu primjenu tehnologija Industrije 4.0 u primarnoj preradi drva.

Purpose Striking disparities persist in cardiovascular disease risk factors among minority youth. We examined the association between multiple indicators of neighborhood quality and minority youth fitness. Methods The primary exposure was the Child Opportunity Index (COI), a measure comprised of indicators that facilitate healthy child development. Outcome data were drawn from the 2018–2019 Fit2Play Study (Miami-Dade County, FL). Hotspot analysis evaluated COI spatial clustering. Generalized linear mixed models examined cross-sectional COI-fitness associations. Results The sample included 725 youth (53% Black, 43% Hispanic; 5–17 years). Significant neighborhood quality spatial clusters were identified (Gi*z-score = −4.85 to 5.36). Adjusting for sociodemographics, walkability was associated with lower percentiles in body mass index (BMI) and diastolic blood pressure percentiles (DBP) (β = −5.25, 95% CI: −8.88, −1.62 and β = −3.95, 95% CI: −7.02, −0.89, respectively) for all, lower skinfold thickness (β = −4.83, 95% CI: −9.97, 0.31 and higher sit-ups (β = 1.67, 95% CI: −0.17, 3.50) among girls, and lower systolic blood pressure percentiles (SBP) (β = −4.75, 95% CI: −8.99, −0.52) among boys. Greenspace was associated with higher BMI (β = 6.17, 95% CI: 2.47, 9.87), SBP (β = 3.47, 95% CI: −0.05, 6.99), and DBP (β = 4.11, 95% CI: 1.08, 7.13). Conclusions COI indicators were positively associated with youth fitness. Disparities in youth cardiovascular disease risk may be modifiable through community interventions and built environment initiatives targeting select neighborhood factors.

Ongoing pressure for public schools to prioritize academics has increased attention on after-school settings as a critical space for social-emotional learning (SEL). After-school programs are uniquely positioned to build protective and promotive factors that contribute to positive future orientation, especially within communities where systemic inequities create barriers to high school graduation, higher education, employment, and earnings. This study examines Fit2Lead Youth Enrichment and Sports (YES), a county-funded, parks-based after-school collaboration for middle schoolers that merges mental health and recreation to promote healthy trajectories. Eight Miami neighborhood parks were selected based on county data indicating high rates of violence. An open trial design (N = 9 parks, 198 youth; ages 9-15; 40.5% female; 66.5% Black/African American, 24.9% Hispanic/Latinx, and 76.3% low-income) tested hypotheses that participation for adolescents exposed to community violence would disrupt a commonly reported decline in self-regulation and self-efficacy, and mitigate risk for anxiety and depression. Youth completed questionnaires at the beginning and end of one school year. Paired t-tests revealed no changes from pre to post, and no differences by baseline levels of youth and parent mental health. Findings highlight the promise of prevention programs to disrupt downward trajectories for youth during the risky time of early adolescence.

Management of depression symptoms in hospice patients is complicated by the fact that an appropriate trial of antidepressant therapy requires 4-6 weeks and most hospice patients receive hospice services for less than 8 weeks. Intravenously administered ketamine has been shown to produce rapid improvement in depression symptoms but is not an ideal route for hospice patients and oral ketamine appears to have a slower onset of antidepressant activity. We present a case series that illustrates the use of a single subcutaneous dose of ketamine (0.5 mg/kg) followed by daily oral ketamine (0.5 mg/kg daily) therapy to manage depression symptoms in three hospice patients. Clinical improvement of depression symptoms occurred quickly for all patients as measured by the PHQ-4, numeric ratings, and subjective reporting. A single subcutaneous dose of ketamine followed by oral therapy presents itself as an option to quickly reduce depression symptoms in hospice patients that do not also require additional pain management. Combining the use of the subcutaneous and oral routes takes advantage of the possibly faster onset, home administration, and milder side effects than intravenous dosing. Prospective studies are needed to determine which dosing strategy would be the most beneficial for hospice patients.

Cross-sector collaboration is emphasized as a means for forest sector companies to remain competitive in a global marketplace that is evolving toward greater use of bio-based products (bioeconomy)....

Brain meninges and associated vasculature participate in brain clearance and are implicated in many neurological conditions such as Alzheimer’s disease, meningitis, multiple sclerosis, stroke, and traumatic brain injury. However, most of our knowledge concerning brain clearance via meninges is based on rodent data, and relevance to human disease remains unclear. One of the technical barriers in studies of meningeal physiology in health and disease is that existing imaging modalities are suboptimal for large and optically non-transparent meningeal tissue of humans and non-human primate (NHP) animal models. To address this barrier, we performed first characterization of NHP dura by high resolution confocal microscopy of clarified tissue. We investigated vascular structures and resident cells in normal monkeys and primate models of tauopathy and synucleinopathy. We demonstrated the presence of an extensive meningeal vascular network covering the entire tissue surface with resolution to the smallest capillaries. This is also the first work to map lymphatic vessels in the dura of non-human primate (NHP). Overall, the NHP lymphatic meningeal system resembles the anatomy found in rat dura, but it is more complex. Analysis of dura from NPH models of tauopathy and synucleinopathy revealed an association with disease-specific biomarkers (amyloid, tau, α-synuclein) with both the blood and lymphatic vasculature. This work has broad relevance to many brain diseases where solute accumulation and abnormal macromolecular clearance is a part of the pathogenesis.

Why do some candidates advertise their pre-office experience to voters while others do not? We ask whether the sex of the candidate makes a difference. Women often gain more qualifications than men before running for office. Female candidates have incentives to message those qualifications to voters to compensate for gendered expectations of prior experience. For evidence, we analyze the contents of 1044 televised advertisements from 2018 state legislative candidates from the Wesleyan Media Project. We find that women are no more likely than men to highlight their professional backgrounds in TV ads. However, we find that male candidates are significantly more likely to highlight prior political experience. The relationship is moderated by incumbency status, such that male challengers advertise their political experience more than female challengers. The results raise fresh questions about gender differences in campaign communication and voters’ expectations of male and female candidates.

TGF-β is an immunosuppressive cytokine that is upregulated in colorectal cancer. TGF-β blockade improved response to chemoradiotherapy in preclinical models of colorectal adenocarcinoma. We aimed to test the hypothesis that adding the TGF-β type I receptor kinase inhibitor galunisertib to neoadjuvant chemoradiotherapy would improve pathological complete response rates in patients with locally advanced rectal cancer.This was an investigator-initiated, single-arm, phase 2 study done in two medical centres in Portland (OR, USA). Eligible patients had previously untreated, locally advanced, rectal adenocarcinoma, stage IIA-IIIC or IV as per the American Joint Committee on Cancer; Eastern Cooperative Oncology Group status 0-2; and were aged 18 years or older. Participants completed two 14-day courses of oral galunisertib 150 mg twice daily, before and during fluorouracil-based chemoradiotherapy (intravenous fluorouracil 225 mg/mBetween Oct 19, 2016, and Aug 31, 2020, 38 participants were enrolled. 25 (71%) of the 35 patients who completed chemoradiotherapy proceeded to total mesorectal excision surgery, five (20%) of whom had pathological complete responses. Ten (29%) patients had non-operative management, three (30%) of whom ultimately chose to have total mesorectal excision. Two (67%) of those three patients had pathological complete responses. Of the remaining seven patients in the non-operative management group, five (71%) had clinical complete responses at 1 year after their last modified FOLFOX6 infusion. In total, 12 (32% [one-sided 95% CI ≥19%]) of 38 patients had a complete response. Common grade 3 adverse events during treatment included diarrhoea in six (16%) of 38 patients, and haematological toxicity in seven (18%) patients. Two (5%) patients had grade 4 adverse events, one related to chemoradiotherapy-induced diarrhoea and dehydration, and the other an intraoperative ischaemic event. No treatment-related deaths occurred.The addition of galunisertib to neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer improved the complete response rate to 32%, was well tolerated, and warrants further assessment in randomised trials.Eli Lilly via ExIST program, The Providence Foundation.

Women have been historically underrepresented in the forest sector. Given a graying workforce, there is a significant opportunity to diversify the sector via a younger generation entering the indus...

Transportation vulnerability (defined as lack of personal/public transportation access) is particularly prevalent in areas with high racial/ethnic segregation where communities typically lack proximity to quality education, jobs, healthy food, playgrounds, and medical care. Prior research has shown an association between residential segregation and youth cardiovascular health, although little work has examined the effects of transportation vulnerability on this relationship. Longitudinal mixed methods were used to compare the effects of transportation vulnerability on the association between changes in exposure to residential segregation (defined as the uneven geographic distribution of minorities) and five cardiovascular health outcomes across sex in minority youth for up to four consecutive years of participation in an afterschool fitness program during 2010–2018 (n = 2742; Miami-Dade County, Florida, US). After accounting for child race/ethnicity, age, year, and poverty, girls with high transportation vulnerability and reduced exposure to segregation (vs. increased or no change in segregation) showed the most improvements across all outcomes, including body mass index percentile (26% (95% CI 23.84, 28.30)), sum of skinfold thicknesses (18% (95% CI 14.90, 20.46)), run time (17% (95% CI 14.88, 18.64)), systolic blood pressure percentile (15% (95% CI 11.96, 17.08)), and diastolic blood pressure percentile (12% (95% CI 9.09, 14.61)). Transportation inequities related to concentrated racial/ethnic segregation may be an important factor in reducing disparities in youth cardiovascular health, particularly among girls. These study findings provide important longitudinal evidence in support of health interventions to reduce transportation vulnerability for racial/ethnic minority youth in underserved areas.

Transportation vulnerability, defined as lack of access to transportation resulting in financial, social, or health consequences, reduces quality of life. While research has focused on the relationship between transportation vulnerability and the built environment among adults, youth have received less attention. This study examined the association between transportation vulnerability and school attendance in Miami-Dade County, Florida from 2010 to 2017 across schools that were/were not provided free transportation for students to attend a park-based physical activity afterschool program called Fit2Play (n = 289 public schools; 84% with Title I status; 41% located in high transportation vulnerable areas, 28% provided with free transportation to a program park). Adjusted longitudinal generalized linear mixed models showed a positive association between transportation vulnerability and school attendance with stronger magnitude in schools with versus without free school-to-program transportation (β = 1.16, 95% CI 0.69, 1.63). Sub-analyses showed a 3.23% (95% CI 2.45, 4.02) mean increase in school attendance for program sites with high program attendance located in high versus low transportation vulnerable areas. These findings suggest that transportation interventions have potential to improve school attendance and community-based recreation participation over time for youth exposed to high transportation vulnerability. Study results highlight the need to explore sustainable services that reduce transportation vulnerability for youth in high-need subgroups to improve school and community program participation.

INTRODUCTION AND OBJECTIVE:Primary treatment options for patients with high-risk non-metastatic prostate cancer (CaP) include radical prostatectomy or radiation therapy. The optimal treatment appro...

The purpose of this study was to evaluate the potential collective opportunities and challenges of transforming real-world data (RWD) to real-world evidence (RWE) for clinical effectiveness by focusing on aligning analytic definitions of oncology endpoints. Patients treated with a qualifying therapy for advanced non-small cell lung cancer (aNSCLC) in the frontline setting meeting broad eligibility criteria were included to reflect the real-world population. While a trend toward improved outcomes in patients receiving PD-(L)1 therapy over standard chemotherapy was observed in RWD analyses, the magnitude and consistency of treatment effect was more heterogeneous than previously observed in controlled clinical trials. The study design and analysis process highlighted the identification of pertinent methodological issues and potential innovative approaches that could inform the development of high-quality RWD studies.

Background: Outpatients with cancer commonly have nonmedical opioid use (NMOU) behaviors and use opioids to dull emotional and existential suffering. Buprenorphine is often used for cancer pain due to less reported euphoria when compared to other opioids. Methods: A retrospective review was done in patients who were prescribed buprenorphine for cancer pain. Pain scores were reported on a Likert pain scale of 1 to 10. Nonmedical opioid use was defined as patients taking opioids for emotional pain at or above the maximum prescribed amount. Results: For 16 patients, the mean pain score prior to buprenorphine (pain pre) was 8.3 (Standard deviation (Std) 1.6), and the mean pain score on follow-up post-buprenorphine (pain post) was 6.1 (Std 2.3) with a reduction in mean pain score (pain change) of −2.0 (Std 2.9, P = .059). Those patients without NMOU had a pain prescore of 9.5 (Std 1.0) and pain post of 4.3 (Std 2.5) with a mean pain change of −5.0 (Std 1.7, P = .20). The mean pain change in those with chemical coping (−1.3/Std 2.7), illicit drug use (−2.8/Std 1.0), or psychiatric comorbidity (−2.4/Std 2.7) were reduced after buprenorphine, however, not statistically significant. Outpatient rotation to buprenorphine was well tolerated. Conclusions: The pain score in those patients without NMOU was significantly lower after rotation to buprenorphine than those with NMOU. We deduce that in those with NMOU, it is more challenging to achieve pain relief with buprenorphine. Overall, for all patients, rotation to buprenorphine resulted in a marginally significantly reduced pain score.

Significance How arthritis-causing T cells trigger rheumatoid arthritis (RA) is not understood since it is difficult to differentiate T cells activated by inflammation in arthritic joints from those activated through their T cell antigen receptor (TCR) by self-antigens. We developed a model to identify and study antigen-specific T cell responses in arthritis. Nur77—a specific marker of TCR signaling—was used to identify antigen-activated T cells in the SKG arthritis model and in patients with RA. Nur77 could distinguish highly arthritogenic and autoreactive T cells in SKG mice. The enhanced autoreactivity was associated with increased interleukin-6 (IL-6) receptor signaling, likely contributing to their arthritogenicity. These data highlight a functional correlate between Nur77 expression, arthritogenic T cell populations, and heightened IL-6 sensitivity in SKG mice with translatable implications for human RA., How pathogenic cluster of differentiation 4 (CD4) T cells in rheumatoid arthritis (RA) develop remains poorly understood. We used Nur77—a marker of T cell antigen receptor (TCR) signaling—to identify antigen-activated CD4 T cells in the SKG mouse model of autoimmune arthritis and in patients with RA. Using a fluorescent reporter of Nur77 expression in SKG mice, we found that higher levels of Nur77-eGFP in SKG CD4 T cells marked their autoreactivity, arthritogenic potential, and ability to more readily differentiate into interleukin-17 (IL-17)–producing cells. The T cells with increased autoreactivity, nonetheless had diminished ex vivo inducible TCR signaling, perhaps reflective of adaptive inhibitory mechanisms induced by chronic autoantigen exposure in vivo. The enhanced autoreactivity was associated with up-regulation of IL-6 cytokine signaling machinery, which might be attributable, in part, to a reduced amount of expression of suppressor of cytokine signaling 3 (SOCS3)—a key negative regulator of IL-6 signaling. As a result, the more autoreactive GFPhi CD4 T cells from SKGNur mice were hyperresponsive to IL-6 receptor signaling. Consistent with findings from SKGNur mice, SOCS3 expression was similarly down-regulated in RA synovium. This suggests that despite impaired TCR signaling, autoreactive T cells exposed to chronic antigen stimulation exhibit heightened sensitivity to IL-6, which contributes to the arthritogenicity in SKG mice, and perhaps in patients with RA.

Increasing gender diversity is no longer just the right thing to do, but also the smart thing to do. Although there is general literature about gender diversity and the perspectives of females in top management and leadership, there are, however, very few forest sector specific studies. This exploratory study utilizes interviews to better understand how female executives in North America and the Nordic countries of Finland and Sweden perceive the impact of the situation of gender diversity in the forest industry. Respondents also provide career advice for young females entering or considering entry into the industry. Female executives in both regions agree that although the forest sector is still seen as a male-oriented industry, there are signs of increasingly positive attitudes regarding industry and company culture towards the benefits of greater gender diversity; however, the described changes represent an evolution, not revolution. Interestingly, despite the status of Nordic countries as leaders in bridging the gender gap, respondents from this region believe that there is significant progress yet to be made in the forest industry, especially at the entry level. With respect to career development, North American respondents suggested that young females should consider sacrificing their social life and leisure time activities, whereas Nordic respondents instead emphasized personal supports or using exit strategy from an unsupportive company or boss.

In recent years, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain have undergone substantial revisions focusing on the appropriate and safe prescription of opioid analgesics, optimization of nonopioid analgesics and adjuvant medications, and integration of nonpharmacologic methods of cancer pain management. This selection highlights some of these changes, covering topics on management of adult cancer pain including pharmacologic interventions, nonpharmacologic interventions, and treatment of specific cancer pain syndromes. The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional aspects of this topic, including pathophysiologic classification of cancer pain syndromes, comprehensive pain assessment, management of pain crisis, ongoing care for cancer pain, pain in cancer survivors, and specialty consultations.

Objectives. To examine the association of Fit2Lead, an afterschool park-based youth mental health promotion program, and neighborhood juvenile arrests (2015–2017) in Miami–Dade County, Florida. Methods. We tracked juvenile (ages 12–17 years) arrest rates over 2 years of program implementation across zip codes matched by (1) park and (2) baseline sociodemographics and youth arrests. Fit2Lead mental and physical health, meditation, resilience, and life skills activities were offered in 12 high-need areas for youths (n = 501) aged 12 to 17 years. We tested the association of Fit2Lead implementation (binary variable) and change in juvenile arrest rates by zip code, adjusting for area-level gender, age, race/ethnicity, single-parent households, and poverty. Results. Fit2Lead was offered in areas composed of 48% male youths, 60% Hispanics, 29% non-Hispanic Blacks, 33% single-parent households, and 33% of residents living in poverty. After covariate adjustment, zip codes with Fit2Lead implementation showed a significant mean reduction (P Conclusions. Park-based programs may have the potential to promote mental health and resilience, and also to prevent violence among at-risk youths.

Mass timber construction systems, such as cross-laminated timber (CLT), which originated in Europe, are gaining acceptance within North America as a viable alternative to multi-story steel-frame or...

Violence exposure increases teens' risk for emotion dysregulation, anxiety, depression, and aggression towards peers. Teens of color are disproportionately more likely to be exposed to violence and less likely to receive mental health services. Community after-school programs can help reduce disparities by offering opportunities for skills development and mental health promotion to mitigate risk associated with violence exposure. The present study explores the promise of a parks-based after-school paid internship program for black and Latinx teens with weekly, group-based enrichment to promote educational attainment, job skills, and health behaviors. University and park administrators collaborated to design a program comprised of paid work (10 hr/week at US$9.05/hr) and weekly 2 hr enrichment (e.g., job skills, meditation, and sleep health psychoeducation). The sample includes 38 youth (n = 38; 15-17 years old [M = 16.26, SD = .73]; 42.1 per cent female; 95.2 per cent non-Latinx black, 4.8 per cent Latinx white). Data analyses include pre-/post-measures of violent and nonviolent adversity, emotion regulation, anxiety, depression, and self-efficacy to manage peer conflict. There were no significant changes from Time 1 (T1) to Time 2 (T2) in teen-reported cognitive reappraisal, emotion suppression, anxiety, depression, or self-efficacy to resolve peer conflict. Teens with more violence exposure at T1 reported significant reductions in anxiety at T2. Teens with more overall adversity reported significant reductions in anxiety and improvements in self-efficacy to resolve peer conflict. Findings indicate that after-school programs infused with poly-strengths programming can benefit diverse teens at high risk for violence exposure.

Transportation vulnerability (lack of community/personal access to transportation that in turn increases the risk for health or financial consequences in the event of hardship/disease/disasters) may be an important mechanistic factor linking residential segregation to youth cardiovascular health inequities. This natural experiment examined the impact of transportation vulnerability on the association between changes in exposure to residential segregation and cardiovascular health among minority youth (n = 2,129, mean age 9.1 years, 54% male; 52% Hispanic, 48% non-Hispanic black [NHB]; 49% high area poverty) over two years. Two-level generalized linear mixed models with random intercepts were fit to test the effects of transportation vulnerability on the association between changes in segregation and cardiovascular health (body mass index percentile (BMIP), sum of skinfold thicknesses, 400 m run time, systolic and diastolic blood pressure percentiles (SBPP and DBPP, respectively) over two school years and across gender. After adjusting for potential confounders (individual-level race/ethnicity, age, time, and park-area poverty), improvements in cardiovascular health were greatest for girls exposed to reduced segregation with high compared with low transportation vulnerability for all outcomes. Specifically, BMIP and SBPP decreased 29% (IRR 95% CI: 0.69, 0.73) and 13% (IRR 95% CI: 0.85, 0.90) vs. 10% (IRR 95% CI: 0.84, 0.96) and no significant change (IRR 95% CI: 0.88, 1.00), for high and low transportation vulnerability, respectively. Adjusted models showed the greatest improvements in cardiovascular health for boys exposed to reduced segregation and low compared with high transportation vulnerability for BMIP and skinfold thicknesses. Specifically, BMIP and skinfold thicknesses decreased 33% (IRR 95% CI: 0.73, 0.81) and 21% (IRR 95% CI: 0.74, 0.84) vs. increased 8% (IRR 95% CI: 1.05, 1.11) and no significant change (IRR 95% CI: 0.96, 1.03), for low and high transportation vulnerability, respectively. Policy interventions that promote transportation equity should be further studied as a means to reduce youth cardiovascular health disparities, particularly for girls living in areas with high racial/ethnic segregation.