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ObjectiveTo provide guidance on the management of Multisystem Inflammatory Syndrome in Children (MIS-C), a condition characterized by fever, inflammation, and multiorgan dysfunction that manifests late in the course of SARS-CoV-2 infection. Recommendations are also provided for children with hyperinflammation during COVID-19, the acute, infectious phase of SARS-CoV-2 infection.MethodsThe Task Force is composed of 9 pediatric rheumatologists and 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care physician. Preliminary statements addressing clinical questions related to MIS-C and hyperinflammation in COVID-19 were developed based on evidence reports. Consensus was built through a modified Delphi process that involved anonymous voting and webinar discussion. A 9-point scale was used to determine the appropriateness of each statement (median scores of 1-3 for inappropriate, 4-6 for uncertain, and 7-9 for appropriate). Consensus was rated as low, moderate, or high based on dispersion of the votes. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, which were prespecified before voting.ResultsThe guidance was approved in June 2020 and updated in November 2020 and October 2021, and consists of 41 final guidance statements accompanied by flow diagrams depicting the diagnostic pathway for MIS-C and recommendations for initial immunomodulatory treatment of MIS-C.ConclusionOur understanding of SARS-CoV-2-related syndromes in the pediatric population continues to evolve. This guidance document reflects currently available evidence coupled with expert opinion, and will be revised as further evidence becomes available.

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

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

Systemic lupus erythematosus (SLE) is an autoimmune disease with marked gender and ethnic disparities. We report a large transancestral association study of SLE using Immunochip genotype data from 27,574 individuals of European (EA), African (AA) and Hispanic Amerindian (HA) ancestry. We identify 58 distinct non-HLA regions in EA, 9 in AA and 16 in HA (∼50% of these regions have multiple independent associations); these include 24 novel SLE regions (P

A statewide "Reparative Probation" intervention was evaluated in Vermont in which volunteers serve on local Boards and meet with probationers to negotiate a "reparative contract." Our sample (n = 229) was drawn from the universe of Vermont volunteers who completed a 54-question instrument measuring perceived equity, efficiency, and reciprocity in the program. Subscales for the questionnaire showed alpha levels from 0.43 to 0.77. OLS regression results found that education, reported religiosity, political conservatism, length of time as a member of a Reparative Board, and number of cases managed as a Reparative Board member explained significant variation in volunteers' perceptions of equity, efficiency, and reciprocity. We believe our results generalize to the universe of Vermont volunteers and provide a basis for replication in other samples. (Contains 4 tables.)

Criminal justice agencies often call for partnerships with the community. In restorative and community justice initiatives, citizen volunteers often serve as decision makers in nonadversarial sanctioning. Although prior research has reported the attitudes of other participants in restorative decision making, such as victims and offenders, none have examined those of community volunteers. We report on findings from a state-wide survey of volunteers serving on Vermont Reparative Probation Boards. In this program, board members meet with probationers to negotiate a "reparative contract" that may include apologies, restitution, community service, and other tasks. We found a board membership that is generally representative of the community, highly supportive of the program, and knowledgeable of restorative justice principles. (Contains 7 tables.)

Explores the recent implementation of restorative justice practices in Minnesota, Colorado, and Pennsylvania school communities, examining how their approaches can address substance abuse problems and offer alternatives to zero-tolerance policies. The three programs are committed to the idea that restoration is a more appropriate educational tool than traditional punishment for handling harms done to both individuals and communities. (SM)

While several studies have examined the relationship between hegemonic masculinity and criminality, prior research has not explored correctional interventions that respond to the pernicious effects of hypermasculinity in prison. This article reports the findings of an exploratory, qualitative study of two related men's programs at prisons in Massachusetts and California. The study included participant observation and interviews with program volunteers. The article describes how the programs seek to deconstruct hypermasculinity in the prison setting and help inmates redefine masculinity to produce prosocial outcomes. The programs are offshoots of a large, voluntary organization called the ManKind Project. Drawing on the philosophy of the 'mythopoetic men's movement' as well as popular personal growth and therapeutic techniques, the program seeks to offer inmates the opportunity to explore their conceptions of masculinity and redefine them in ways that will serve them both in prison and upon reintegration into society. Keywords: hegemonic masculinity, hypermasculinity, criminality, prison setting, mythopoetic men's movement, men's program in prison, Prison is an ultramasculine world where nobody talks about masculinity. (Sabo, Kupers, & London, 2001, p. 3) Recent scholarship has drawn attention to the relationship between gender and crime, more [...]