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This article explores factors that facilitate or impede data sharing and linkage collaborations between state public health agencies and managed care organizations (MCOs). The exploration is based upon a review of both recent literature and the four years' experience of the Massachusetts Health Assessment Partnership (MHAP). MHAP has undertaken six collaborative data sharing and linkage projects that have involved diverse topics and methods. This article summarizes both exogenous and endogenous factors that have affected MHAP as a successful collaboration and indicates those factors that might be replicated in future collaborations between public health agencies and MCOs in other locations. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The purpose of the study was to examine the effect of language proficiency on enrollment in a state-sponsored child health insurance program. METHODS: 1055 parents of Medicaid-eligible children, who were enrolled in a state-sponsored child health insurance program, were surveyed about how they learned about the state program, how they enrolled their children in the program, and perceived barriers to Medicaid enrollment. We performed weighted chi2 tests to identify statistically significant differences in outcomes based on language. We conducted multivariate analyses to evaluate the independent effect of language controlling for demographic characteristics. RESULTS: Almost a third of families did not speak English in the home. These families, referred to as limited English proficiency families, were significantly more likely than English-proficient families to learn of the program from medical providers, to receive assistance with enrollment, and to receive this assistance from staff at medical sites as compared to the toll-free telephone information line. They were also more likely to identify barriers to Medicaid enrollment related to 'know-how'--that is, knowing about the Medicaid program, if their child was eligible, and how to enroll. Differences based on language proficiency persisted after controlling for marital status, family composition, place of residence, length of enrollment, and employment status for almost all study outcomes. CONCLUSIONS: This study demonstrates the significant impact of English language proficiency on enrollment of Medicaid-eligible children in publicly funded health insurance programs. Strong state-level leadership is needed to develop an approach to outreach and enrollment that specifically addresses the needs of those with less English proficiency. [ABSTRACT FROM AUTHOR]

Objective: To express human soluble CD14 (sCD14) in eukaryotic cells.Methods: Human sCD14 cDNA was amplified from U937 cells with RT-PCR method. The recombinant expression plasmid pEF1/HisC/sCD14(348aa) was constructed and the expression in COS-7 cells was carried out using liposome transfection method. The yield was examined with scanning map identification. The expressed product was purified by immuno-affinity chromatography.Results: Sequence analysis demonstrated that the amplified gene sequence and those reported by documents were completely identical. sCD14 was expressed with high-yield. The expressed product was purified to above 90%. Recombinant sCD14, specifically combinable with endotoxins, had a natural biological activity.Conclusions: Human sCD14 was expressed in COS-7 cells, which laid a foundation for further study. [ABSTRACT FROM AUTHOR]

Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result.Methods: Defects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps.Results: Wounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control.Conclusions: Skin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate. [ABSTRACT FROM AUTHOR]

Children and youth with special health care needs have increasingly been included in community and society over the past 50 years. Changing definitions and programs in the education, health, and public health/Title V sectors document this greater inclusion. The most profound change was in the education system, with the passage of legislative mandates for inclusion and parental rights. Although the health system has no similar universal mandate, the sequential passage of Medicaid, Children's Health Insurance Plan, and the Patient Protection and Affordable Care Act led to expanded health care coverage with no pre-existing conditions and lifetime caps. Title V of the Social Security Act, originally passed in 1935, evolved from a focus on individual medical services to a public health systems approach focusing on building family-centered, coordinated, comprehensive care in community settings. Most of the changes in all the sectors are the result of the advocacy and engagement of parents and families; the Maternal and Child Health Bureau was a supportive and innovative leader for family-professional partnerships. Much work on understanding disparities across the sectors has led to more recent focus on equity., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: To compare the demographic characteristics of active physicians, trainees, medical school clinical sciences faculty, and department chairs in radiology with those in other medical specialties., Methods: An analysis was conducted using publicly available deidentified aggregate data from the Association of American Medical Colleges (AAMC). Our data collection included information from the 2022 AAMC Physician Specialty Data Report, the 2022 AAMC Report on Residents, and the 2022 AAMC Faculty Roster. We examined factors such as graduation country, gender, and self-identified race/ethnicity. MedCalc software was used for the analyses., Results: Compared to other specialties, active radiologists exhibited a significantly lower percentage of females, International Medical Graduates (IMGs), individuals of American Indian/Alaska Native (AIAN) descent, Black/African-American individuals, and individuals of Hispanic/Latino/Spanish origin. Conversely, the proportion of White active radiologists was higher. Among radiology trainees, there was a notably lower percentages of females, IMGs, individuals of Black/African-American descent, and individuals of Hispanic/Latino/Spanish origin, while the percentage of Asians was significantly higher. Furthermore, medical school radiology faculty showed a significant lower proportion of females, Black/African-American individuals, Hispanic/Latino/Spanish individuals, and individuals categorized under the white race/ethnicity, with Asians having a higher representation. As radiology department chairs, Asians were noted at significantly lower percentages compared to their proportions among medical school radiology faculty, while Black/African-American individuals were observed at significantly higher percentages in the same comparison., Conclusion: This study revealed a notable underrepresentation of females, individuals of Black/African-American descent, and those of Hispanic/Latino/Spanish origin among active radiologists, radiology trainees, and medical school radiology faculty when compared to their counterparts in other medical specialties. Given these findings, further investigation into the underlying causes of these disparities is warranted., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Statins, or hydroxy-methyl-glutaryl coenzyme A (HMG-CoA) reductase inhibitors, are one of the most commonly prescribed medications for lowering cholesterol. Myopathic side-effects ranging from pain and soreness to critical rhabdomyolysis are commonly reported and often lead to discontinuation. The pathophysiological mechanism is, in general, ascribed to a downstream reduction of Coenzyme Q10 synthesis. HMG-CoA is a metabolite of leucine and its corresponding keto acid α-ketoisocaproic acid (KIC) and β-hydroxy-β-methylbutyrate (HMB), however, little is known about the changes in the metabolism of leucine and its metabolites in response to statins., Objective: We aimed to investigate if statin treatment has implications on the upstream metabolism of leucine to KIC and HMB, as well as on other branched chain amino acids (BCAA)., Design: 12 hyperlipidemic older adults under statin treatment were recruited. The study was conducted as a paired prospective study. Included participants discontinued their statin treatment for 4 weeks before they returned for baseline measurements (before). Statin treatment was then reintroduced, and the participants returned for a second study day 7 days after reintroduction (after statin). On study days, participants were injected with stable isotope pulses for measurement of the whole-body production (WBP) of all BCAA (leucine, isoleucine and valine), along with their respective keto acids and HMB., Results: We found a reduced leucine WBP (22 %, p = 0.0033), along with a reduction in valine WBP (13 %, p = 0.0224). All other WBP of BCAA and keto acids were unchanged. There were no changes in the WBP of HMB., Conclusions: Our study shows that statin inhibition of HMG-CoA reductase has an upstream impact on the turnover of leucine and valine. Whether this impairment in WBP of leucine may contribute to the known pathophysiological side effects of statins on muscle remains to be further investigated., Competing Interests: Declaration of competing interest SP is associated with Abbott Nutrition. Apart from this and the funding from the mentioned source, the authors report no other conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Abstract: Renal cortical echogenicity represents a marker of renal function. However, evaluation of the renal echotexture is subjective and thus disposed to error and interrater variability. Computer-aided image analysis may be used to objectively assess renal cortical echogenicity by comparing the echogenicity of the left kidney to that of the spleen; the resultant ratio is referred to as the splenorenal index (SRI). We performed a retrospective review of all adult patients who received a renal ultrasound over a 45-day period at our institution. Demographic data and kidney function laboratory values were documented for each patient. Regions of interest (ROIs) were selected in the left renal cortex and spleen using ImageJ software. The SRI was calculated as a ratio of the mean pixel brightness of the left kidney cortex ROI to the mean pixel brightness of the spleen ROI. The SRI was then correlated with serum creatinine, blood urea nitrogen, and estimated glomerular filtration rate. We found that among the 94 patients included in the study, the SRI had a significant positive correlation with serum creatinine ( r = 0.43, P < 0.001) and serum blood urea nitrogen ( r = 0.45, P < 0.001) and negative correlation with estimated glomerular filtration rate ( r = -0.47, P < 0.001). Our data indicate that SRI may serve as a valuable tool for sonographic evaluation of renal parenchymal disease., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Since its founding, American Orthopsychiatric Association (AOA) has been at the forefront of working at the intersection of mental health and social justice. In Mental Health and Social Change: 50 Years of Orthopsychiatry (Shore & Mannino, 1975), former organization president and journal editor Milton Shore and Fortune Mannino wrote that the association had consistently held a philosophy that included (a) a commitment to an interdisciplinary approach in the study of mental health problems and the development of mental health programs; (b) an emphasis on prevention as well as treatment; (c) the integration of the clinical and the social; (d) a major focus on the social scene and its interweaving with mental health problems in individuals within society; and (e) an avoidance of dilettantism, superficiality, and well-meaning generalizations through a commitment to high-quality research, thoughtful analysis of mental health issues, and high professional standards of practice in all areas of mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Competing Interests: Conflict-of-Interest Disclosures: Erin Fox discloses employment by the National Academies of Sciences, Engineering, and Medicine while this paper series was being drafted.

Competing Interests: Conflict-of-Interest Disclosures: Erin Fox discloses employment by the National Academies of Sciences, Engineering, and Medicine while this paper series was being drafted.

While family engagement at the individual level of health care, such as families partnering with providers in decision-making about health care for an individual child has been well studied, family engagement in systems-level activities (e.g., participation in advisory and other decision-making groups, or creation and revision of policies) that impact the health services families and children receive has not. This note from the field presents a framework that describes the information and supports that help families partner with professionals and contribute to systems-level activities. Without attention to these components of family engagement, family presence and participation may be only token. We engaged an expert Family/Professional Workgroup whose members represented key constituencies and diverse geography, race/ethnicity, and areas of expertise; conducted a review of peer-reviewed publications and grey literature; and conducted a series of key informant interviews to identify best practices for supporting meaningful family engagement at the systems level. Based on an analysis of the findings, the authors identified four action-oriented domains of family engagement and key criteria that support and strengthen meaningful family engagement in systems-level initiatives. Child- and family-serving serving organizations can use this Family Engagement in Systems framework to support meaningful family engagement in the design of policies, practices, services, supports, quality improvement projects, research, and other systems-level activities., (© 2023. The Author(s).)

Rationale and Objectives: Work-life experience of physicians is a driver of work engagement vs. burnout. We aimed to determine individual and institutional factors affecting work-life experience of the clinical faculty at a large tertiary care academic medical center., Materials and Methods: The Department of Radiology clinical faculty (n = 62) were surveyed electronically in October 2022. Twenty-three questions, consisting of multiple choice, Yes/No, and Likert scale ratings were administered to obtain demographic information and data for life outside of work, life at work, and work-life integration for the prior 12 months. Work engagements in terms of clinical, research, administrative, and education; work practices including engagement in extra work and remote work; life responsibilities; and utilization of work-life balance strategies were analyzed for percentages and differences in seniority levels and genders. Ratings of faculty work engagement and life integration strategies were assessed utilizing a 1-5 Likert scale. Descriptive statistics were utilized to report mean, standard deviation, median, Q1 and Q3 for continuous measurements, while count and percentage for categories measurements. Comparisons between seniority and gender categories were conducted using independent t-test or Wilcoxon rank sum test depending on data normality assessed through histogram analysis. Chi-square test was used to make comparisons for categorical data. When encountered with small cell (category with <5 count), Fisher's exact test was used for 2 × 2 table analysis and Freeman-Halton test was used for comparisons with more than two categories. SAS 9.4 was used for the data analysis., Results: Twenty-eight faculty (M:F = 17:11) responded to the survey (survey response rate 45%). The vast majority of faculty reported working extra hours, with 40% working at least 10 hours extra per week. Total of 42.9% reported performing clinical work in the extra hours worked. Total 70.4% of faculty had caregiver responsibilities and 64.3% reported other individual stresses (e.g., financial, family/social, health-related), which required consistent demand of time and effort. A total of 35.7% of faculty reported not being able to balance competing life and work demands. A total of 21.4% respondents reported not utilizing any individual healthy lifestyle choices on a consistent basis over the prior 12 months. Protected time off work and remote work were perceived as effective strategies to provide adequate work-life balance; however, remote work engagement was relatively minor and 35.7% bought back vacation. Total 53.6% respondents reported a level 4 (out of 5) rating for work being meaningful and being positively engaged in their work., Conclusion: Institutions should invest in providing the infrastructure for physician work-life balance and in facilitating healthy lifestyle choices for physicians., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Hand hygiene product usage characteristics by food employees when hand sanitizers are made available are not well understood. To investigate hand hygiene product usage in casual dining and quick-service restaurants, we placed automated monitoring soap and sanitizer dispensers side-by-side at handwash sinks used by food employees in seven restaurants. Dispenses were monitored, and multiple dispenses that occurred within 60 s of each other were considered a single hand hygiene event. This resulted in 186,998 events during the study (149,779 soap only, 21 985 sanitizer only, and 15,234 regimen [defined as soap followed by sanitizer at the same sink within 60 s]) over 15,447 days of use. Soap was the most frequently used hand hygiene method by food employees in both restaurant types. Regimen use, despite being the preferred hand hygiene method by both restaurant chains, was the least used hand hygiene method. When pooled over restaurant types, the median daily usage for soap was statistically significantly highest of all methods at 23.5 dispenses per sink per day (p < 0.0001), the sanitizer median daily usage was 4.27 dispenses per sink per day, and regimen use was statistically significantly lowest of all methods at 4.02 dispenses per sink per day (p < 0.0001). When hand hygiene event types were pooled, casual dining restaurants had similar median hand hygiene event rates (11.4 dispenses per sink per day) compared to quick-service restaurants (11.9 dispenses per sink per day; p = 0.890). The number of events by sink location varied, with sinks located at a warewash station having the highest number of events (19.3 dispenses per sink per day; p < 0.0001), while sinks located by a ready-to-eat food preparation area had the lowest number of events (6.8 dispenses per sink per day; p < 0.0001). These data provide robust baseline benchmarks for future hand hygiene intervention studies in these settings., (Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.)

Background: Perfluoroalkyl substances (PFAS) are ubiquitous synthetic chemicals with long half-lives and are known to cross the placenta during pregnancy. We examined the influence of maternal PFAS levels on in utero fetal growth trajectories and assessed whether maternal stress modified these associations., Methods: Blood serum concentrations of five PFAS (PFOS, PFHxS, PFNA, PFOA, PFDA) were measured in 335 prenatal specimens (mean gestational age (GA): 21±9 weeks) in the MADRES cohort. Fetal growth outcomes (head circumference (HC), abdominal circumference (AC), biparietal diameter (BPD), femur length (FL), and estimated fetal weight (EFW)) were abstracted from ultrasound medical records and measured at the 3rd trimester study visit ( N = 833 scans, GA range 10-42 weeks, mean 2.4 scans/participant). Adjusted linear mixed models with a GA quadratic growth curve were used for each PFAS exposure and growth outcome. PFOS and PFHxS were modeled continuously (100% sample detection), while PFOA, PFNA, and PFDA were modeled categorically (57-70% sample detection). Scores on the Perceived Stress Scale (PSS) measured in pregnancy were dichotomized at the median (<13 vs. ≥ 13) in stratified models., Results: Participants were on average 29±6 years old and predominately Hispanic (76%). Median serum concentrations of PFOS, PFHxS, PFNA, PFOA and PFDA were 1.34, 1.10, 0.07, 0.12, and 0.04 ng/mL, respectively. Participants with detected PFOA concentrations had fetuses with -2.5 mm (95% CI -4.2, -0.8) smaller HC and-0.7 mm (95% CI -1.3, -0.2) smaller BPD on average for a fixed GA than those without detected PFOA concentrations. In models stratified by PSS level, the effects of PFOA on fetal growth parameters were stronger and only significant in participants with higher stress levels (HC: β = -3.5, 95% CI -5.8, -1.4; BPD: β = -0.8, 95% CI -1.6, -1.1)., Conclusions: Prenatal PFOA exposure adversely impacted fetal head biometric parameters in participants experiencing higher stress during pregnancy., Competing Interests: Declaration of Competing Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Potential conflict of interest exists:

Introduction: Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are persistent synthetic chemicals found in household products that can cross the placenta during pregnancy. We investigated whether PFAS exposure during pregnancy was associated with infant birth outcomes in a predominantly urban Hispanic population., Methods: Serum concentrations of perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), perfluorohexanesulfonic acid (PFHxS), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) were measured in 342 prenatal biospecimens (mean gestational age: 21 ± 9 weeks) from participants in the ongoing Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) cohort. PFAS compounds were modeled continuously or categorically, depending on the percentage of samples detected. The birth outcomes assessed were birthweight, gestational age at birth, and birthweight for gestational age (BW-for-GA) z-scores that accounted for parity or infant sex. Single pollutant and multipollutant linear regression models were performed to evaluate associations between PFAS exposures and birth outcomes, adjusting for sociodemographic, perinatal, and study design covariates., Results: Maternal participants (n = 342) were on average 29 ± 6 years old at study entry and were predominantly Hispanic (76%). Infants were born at a mean of 39 ± 2 weeks of gestation and weighed on average 3,278 ± 522 g. PFOS and PFHxS were detected in 100% of the samples while PFNA, PFOA, and PFDA were detected in 70%, 65%, and 57% of the samples, respectively. PFAS levels were generally lower in this cohort than in comparable cohorts. Women with detected levels of PFOA during pregnancy had infants weighing on average 119.7 g less (95% CI -216.7, -22.7) than women with undetected levels of PFOA in adjusted single pollutant models. PFOA results were also statistically significant in BW-for-GA z-score models that were specific for sex or parity. In models that were mutually adjusted for five detected PFAS compounds, PFOA results remained comparable; however, the association was only significant in BW-for-GA z-scores that were specific for parity (β = -0.3; 95% CI -0.6, -0.01). We found no significant adjusted associations with the remaining PFAS concentrations and the birth outcomes assessed., Conclusion: Prenatal exposure to PFOA was associated with lower birthweight in infants, suggesting that exposure to these chemicals during critical periods of development might have important implications for children's health., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Peterson, Eckel, Habre, Yang, Faham, Farzan, Grubbs, Kannan, Robinson, Lerner, Al-Marayati, Walker, Grant, Bastain and Breton.)

Introduction: The American Public Health Association (APHA) policy statements are written by members and approved by the APHA Governing Council. Policy statements inform APHA's position on key public health issues. Maternal and child health (MCH) is a broad discipline focused on health issues concerning women, children, youth, and families. APHA's MCH policies from the last 50 years were reviewed in celebration of the 100th anniversary of the MCH Section of APHA., Methods: A cross-sectional design was utilized to identify MCH-related statements within the larger APHA policy statement database from 1970 to 2019 (N = 1,110). The policy statements were coded as primary MCH (main focus was MCH) or secondary MCH (mentioned MCH subpopulations as vulnerable population). The primary MCH themes were also identified., Results: 545 (49%) of the APHA policy statements were related to MCH, including 226 (20%) coded as primary MCH and 319 (29%) secondary MCH. The primary MCH policy statements had a main focus on the following subpopulations: women (44%), children (33%), adolescents/young adults (15%), infants (12%), families (5%), and men (2%). Major themes included reproductive health/family planning, school health, children's health, pregnancy/childbirth, and breastfeeding/nutrition., Conclusions: MCH policy statements remained an important part of APHA's policy and advocacy focus over time as indicated through the continuous high number and proportion of MCH policy statements. The historical overview of MCH policy provides insight into critical policy issues confronting the MCH field over the decades and provides guidance for future policy initiatives including a need for increased emphasis on diverse MCH populations., Significance: This analysis provides a 50 year overview of MCH themes as viewed by the policy statements published by APHA, the largest public health professional organization in the United States. These policy statements represent the cutting edge of MCH policy efforts and were written to influence national, state, and local public health policy. APHA policy statements should continue to address these important MCH topics in the future with an increased emphasis on diverse MCH populations. APHA policy making is a valuable national professional activity for the MCH field with the goal of improving the health for MCH communities., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Biofilm methods consist of four distinct steps: growing the biofilm in a relevant model, treating the mature biofilm, harvesting the biofilm from the surface and disaggregating the clumps, and analyzing the sample. Of the four steps, harvesting and disaggregation are the least studied but nonetheless critical when considering the potential for test bias. This article demonstrates commonly used harvesting and disaggregation techniques for biofilm grown on three different surfaces. The three biofilm harvesting and disaggregation techniques, gleaned from an extensive literature review, include vortexing and sonication, scraping and homogenization, and scraping, vortexing and sonication. Two surface types are considered: hard non-porous (polycarbonate and borosilicate glass) and porous (silicone). Additionally, we provide recommendations for the minimum information that should be included when reporting the harvesting technique followed and an accompanying method to check for bias.

Social determinants of health is a concept relevant to parenting in two ways. First, parenting behavior is a social determinant for child health and development; effective parenting is essential for successful emotional, physical and cognitive development. Second, social determinants of health are critical to the development and sustainability of adequate parenting behaviors, which, in term, are a social determinant of child health. Key social determinants related to parenting include economic stability, education, social and community context, neighborhood and built environment, access to health care and parenting interventions, and racism., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Listeria monocytogenes is one of the most concerning pathogens for the food industry due to its ability to form biofilms, particularly in difficult-to-clean sites of processing facilities. There is a current industry-wide lack of data to refer to when selecting a strategy to control L. monocytogenes biofilms in the food premises. Many strategies have been developed to study biofilm formation of bacteria; however, few have targeted L. monocytogenes biofilms under dynamic conditions. This study addresses the biofilm formation ability of L. monocytogenes on stainless steel and polycarbonate under dynamic conditions using TSBYE or BHI as media culture at 30 °C or 37 °C. Higher cell counts were recovered at 30 °C in TSBYE on polycarbonate while lower counts were obtained at 37 °C in BHI on stainless steel (P < 0.05). Nonetheless, all factors (temperature, media and material) were statistically significant (P < 0.05) and an interaction between temperature and media was observed (P < 0.05). To our knowledge, this work represents an initial framework to develop L. monocytogenes biofilms under different dynamic conditions. The use of CDC Biofilm Reactor is not widely used yet in the food industry and represent a novel approach to help sanitary control strategies implementation., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

A standard method for growing Pseudomonas aeruginosa biofilm in the Drip Flow Biofilm Reactor was assessed in a 10-laboratory study. The mean log density was 9.29 Log 10 (CFU/cm 2 ). The repeatability and reproducibility SDs were equal to 0.22 and 0.24, respectively, providing statistical confidence in data generated by the method., Competing Interests: Declaration of Competing Interest The authors have no conflict of interested or ethical concerns to report for this study., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Competing Interests: Conflict-of-Interest Disclosures: None to disclose.

A number of programs, policies, and practices have been tested using rigorous scientific methods and shown to prevent behavioral health problems (Catalano et al., Lancet 379:1653-1664, 2012; National Research Council and Institute of Medicine, 2009). Yet these evidence-based interventions (EBIs) are not widely used in public systems, and they have limited reach (Glasgow et al., American Journal of Public Health 102:1274-1281, 2012; National Research Council and Institute of Medicine 2009; Prinz and Sanders, Clinical Psychology Review 27:739-749, 2007). To address this challenge and improve public health and well-being at a population level, the Society for Prevention Research (SPR) formed the Mapping Advances in Prevention Science (MAPS) IV Translation Research Task Force, which considered ways to scale up EBIs in five public systems: behavioral health, child welfare, education, juvenile justice, and public health. After reviewing other efforts to scale up EBIs in public systems, a common set of factors were identified as affecting scale-up in all five systems. The most important factor was the degree to which these systems enacted public policies (i.e., statutes, regulations, and guidance) requiring or recommending EBIs and provided public funds for EBIs. Across systems, other facilitators of scale-up were creating EBIs that are ready for scale-up, public awareness of and support for EBIs, community engagement and capacity to implement EBIs, leadership support for EBIs, a skilled workforce capable of delivering EBIs, and data monitoring and evaluation capacity. It was concluded that the following actions are needed to significantly increase EBI scale-up in public systems: (1) provide more public policies and funding to support the creation, testing, and scaling up of EBIs; (2) develop and evaluate specific frameworks that address systems level barriers impeding EBI scale-up; and (3) promote public support for EBIs, community capacity to implement EBIs at scale, and partnerships between community stakeholders, policy makers, practitioners, and scientists within and across systems.

Methods validated by a standard setting organization enable public, industry and regulatory stakeholders to make decisions on the acceptability of products, devices and processes. This is because standard methods are demonstrably reproducible when performed in different laboratories by different researchers, responsive to different products, and rugged when small (usually inadvertent) variations from the standard procedure occur. The Single Tube Method (ASTM E2871) is a standard method that measures the efficacy of antimicrobials against biofilm bacteria that has been shown to be reproducible, responsive and rugged. In support of the reproducibility assessment, a six-laboratory study was performed using three antimicrobials: a sodium hypochlorite, a phenolic and a quaternary/alcohol blend, each tested at low and high efficacy levels. The mean log reduction in viable bacteria in this study ranged from 2.32 to 4.58 and the associated reproducibility standard deviations ranged from 0.89 to 1.67. Independent follow-up testing showed that the method was rugged with respect to deviations in sonication duration and sonication power but slightly sensitive to sonicator reservoir degassing and tube location within the sonicator bath. It was also demonstrated that when a coupon was dropped into a test tube, bacteria can splash out of reach of the applied antimicrobials, resulting in substantial bias when estimating log reductions for the products tested. Bias can also result when testing products that hinder the harvesting of microbes from test surfaces. The culmination of this work provided recommended changes to the early version of the standard method E2871-13 (ASTM, 2013b) including use of splashguards and microscopy checks. These changes have been incorporated into a revised ASTM method E2871-19 (ASTM 2019) that is the basis for the first regulatory method (ATMP-MB-20) to substantiate "kills biofilm" claims for antimicrobials registered and sold in the US., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.

Objectives: To review the current evidence on the relationship between specialty nurse certification and outcomes., Design: A structured and comprehensive systematic review was undertaken using the Joanna Briggs Institute framework to include both published research studies and expert opinion papers., Data Sources: Four electronic databases CINAHL, MEDLINE, PubMed, and PsychINFO were searched between 2000 and 2018. The search for expert opinion papers included nursing organizations, OaLster, Grey Literature Report, and The National Database of Nursing Quality Indicators., Review Methods: The records generated through the search were exported to EndNote X8 and duplicates were removed. Title and abstracts of the records were screened by three reviewers for eligibility using the selection criteria. In the absence of an abstract, records were retained for full text review. Full text assessment of each paper was conducted by two reviewers with a third referee, if necessary, to review any discrepancies. In the case of multiple articles drawing on one set of primary data, only one article was included. A review of each article was completed using the JBI Quality Appraisal checklists to assess internal and external reliability and validity. Both quality appraisal and data extraction were conducted by the review team independently and were validated by one other member of the team. Discrepancies were resolved through rigorous discussion between the reviewers., Results: Forty one original research studies were included in the final analysis of the literature. The findings from the included articles were synthesized into three major categories and subsequent sub-categories: Patient outcomes, nurse outcomes and organizational outcomes. Twenty seven findings contributed to the sub-category of specialty nurse certification and patient outcomes. Patient outcomes were further classified into nurse sensitive outcomes, patient mortality and patient satisfaction. Fifty-four findings related to nurse outcomes with the sub-categories: personal and professional factors, knowledge and skills, organizational commitment, job satisfaction, empowerment and confidence. Six findings related to organizational benefits: including the sub-categories of nursing turnover and vacancy rates, perception of healthcare, and costs to the organization., Conclusions: The current model risks driving further proliferation of specialty certifications and certifying organizations without questioning the assumptions underlying the goals of certification. The challenges of measuring impact and the cost and value to individual nurses and healthcare organizations are key areas for consideration., (Copyright © 2019. Published by Elsevier Ltd.)

The treatment of mental illness is often done on a trial-and-error basis and achieving therapeutic benefits from a medication is not always guaranteed. Pharmacogenomics explores the role of gene-gene interactions and interindividual responses to a drug and may be promising in the guidance of pharmacotherapeutic options. In the present study, the impact of pharmacogenomic testing in management of mental health medication was investigated. Participants were identified at a local outpatient mental health facility through convenience sampling. Retrospective chart review included medication history, adverse drug reactions, pharmacogenomic history, and demographic data including insurance coverage. Chart review focused on six months pre- and post-pharmacogenomic for a comparison with the patient serving as their own control. Results indicate a high incidence of alterations in two specific cytochrome enzymes, CYP2D6 and CYP2C19. In total, 82% of the sample had variations with CYP2D6, while 64% of individuals had variations with CYP2C19. In total, 91% of patients tested received Medicaid or Medicare. Post-pharmacogenomic testing, all patient drug regimens were modified, and all reported less adverse side effects. Moreover, advanced practice nurse providers educated patients about the availability of genetic testing, initiated testing and provided care based on findings. These results demonstrate the utility of genetic testing in the realm of mental health. Future directions involve further exploring the benefits of pharmacogenomic testing in this vulnerable population.

Mental health needs have been recognized as a priority area by the World Health Organization (WHO), and a Comprehensive Mental Health Action Plan (2013) was proposed to address the needs of millions of people around the world. Concerns have been raised about the degree to which current global efforts are appropriate and sufficient for promoting mental health (MH), reducing the risk for common MH disorders, and addressing the needs of individuals experiencing mental illness. This commentary expands on the presentation of the Global Alliance for Behavioral Health and Social Justice's Task Force on Global Mental Health at the 16th Biennial Conference of the Society for Community Research and Action, held in Ottawa, Ontario, Canada June 21-24, 2017, "Building Capacity to Address Mental Illness and Emotional Distress in Low-Resource Settings and Among Refugee Populations." Utilizing a socioecological framework, this commentary offers a call to action in addressing global mental health by emphasizing the need for greater investments in wellness promotion, prevention, treatment, and recovery. Importantly, such efforts need to value local knowledge and culture, harness natural existing resources and assets, and ensure equitable distribution of key resources for MH. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The inactivation of Pseudomonas aeruginosa biofilms grown on glass under high shear stress and exposed to a range of dissolved ozone concentrations (2, 5 and 7 ppm) at 10 and 20 min was investigated. The regression equation, log reduction (biofilm) = 0.64 + 0.59×(C - 2) + 0.33×(T - 10), described the dependence of biofilm inactivation on the dissolved ozone concentration (C, ppm) and contact time (T, min). The predicted D-values were 11.1, 5.7 and 2.2 min at 2, 5 and 7 ppm, respectively. Inactivation of biofilms grown on various surfaces was tested at a single dissolved ozone concentration of 5 ppm and a single exposure time of 20 min. Biofilms grown on plastic materials showed inactivation results similar to that of biofilms on glass, while biofilms grown on ceramics were statistically significantly more difficult to inactivate, suggesting the importance of utilizing non-porous materials in industrial and clinical settings.

Background: Combination medicines including an artemisinin are the mainstay of antimalarial therapy. Artemisinins are potent embryotoxicants in animal species due to their trioxane moiety., Methods: As part of its development, the new synthetic trioxolane antimalarial artefenomel (OZ439) was tested in rat whole embryo culture and in rat embryo-fetal toxicity studies with dosing throughout organogenesis or with a single dose on Gestational Day (GD) 12. The single-dose studies included groups treated with artesunate to allow a direct comparison of the embryotoxicity of the two antimalarials and included toxicokinetics hematology and histological examination of embryos. In addition, the distribution of artefenomel-related material in plasma was determined after the administration of 14 C-artefenomel., Results: Artefenomel and artesunate showed similar patterns of embryotoxicity including cardiovascular defects and resorption with a steep dose-response. They both also caused a depletion of circulating embryonic erythroblasts both in vitro and in vivo and decreases in maternal reticulocyte count. However, artefenomel was ∼250-fold less potent than the active metabolite of artesunate (dihydroartemisinin) as an embryotoxicant in vitro. The safety margin (based on AUC) for artefenomel administered on GD 12 was approximately 100-fold greater than that for artesunate. Also, unlike artesunate, artefenomel was not a selective developmental toxicant., Conclusions: The lesser embryotoxicity of artefenomel is likely linked to its original design which included two blocking side groups that had been introduced to lower the reactivity with ferrous iron. Our data support the hypothesis that artefenomel's improved safety margin is linked to a lower potential for inhibiting heme biosynthesis in embryonic erythroblasts., (© 2017 The Authors. Birth Defects Research Published by Wiley Periodicals, Inc.)

Background: The aging process is often associated with the presence of sarcopenia. Although changes in the plasma concentration of several amino acids have been observed in older adults, it remains unclear whether these changes are related to disturbances in whole body production and/or interconversions., Methods: We studied 10 healthy young (~22.7y) and 17 older adults (~64.8y) by administering a mixture of stable amino acid tracers in a pulse and in a primed constant infusion. We calculated whole body production (WBP) and metabolite to metabolite interconversions. In addition, we measured body composition, muscle function, and provided questionnaires to assess daily dietary intake, physical activity, mood (anxiety, depression) and markers of cognitive function. Plasma enrichments and metabolite concentrations were measured by GC- and LC-MS/MS and statistics were performed by student t-test., Results: Older adults had a 11% higher body mass index (p=0.04) and 27% reduced peak leg extension force (p=0.02) than the younger group, but comparable values for muscle mass, mood and cognitive function. Although small differences in several plasma amino acid concentrations were observed, we found older adults had about 40% higher values of WBP for glutamine (221±27 vs. 305±21μmol/kgffm/h, p=0.03) and tau-methylhistidine (0.15±0.01 vs. 0.21±0.02μmol/kgffm/h, p=0.04), 26% lower WBP value for arginine (59±4 vs. 44±4μmol/kgffm/h, p=0.02) and a reduction in WBP (50%; 1.23±0.15 vs. 0.69±0.06μmol/kgffm/h, p=0.001) and concentration (25%; 3.5±0.3μmol/l vs. 2.6±0.2μmol/l, p=0.01) for β-Hydroxy β-Methylbutyrate. No differences were observed in protein catabolism. Clearance of arginine was decreased (27%, p=0.03) and clearance of glutamine (58%, p=0.01), leucine (67%, p=0.001) and KIC (76%, p=0.004) were increased in older adults., Conclusions: Specific differences exist between young and older adults in amino acid metabolism., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Women are inundated with advertisements for products promising younger-looking, healthier skin. The truth is that many of these products can be expensive and produce results that do not live up to the claims. Health care providers can educate women about proven best practices and how to evaluate products' claims of benefits. The best advice is that a well-balanced diet, adequate hydration, use of a topical moisturizer, protection from the sun, and avoiding smoking and tobacco are the most effective measures to not only healthy skin but a healthful life., (© 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.)

Fetal growth restriction is commonly defined as an estimated fetal weight (EFW) that is below the 10th percentile for gestational age. It is associated with an increased risk of intrauterine demise, neonatal morbidity, and neonatal death; therefore, antenatal detection and surveillance with the optimization of delivery timing are necessary to improve pregnancy outcomes. If the estimated due date has been verified and the EFW is below the 10th percentile for gestational age, the underlying cause should be investigated, since the clinical management, outcome, and counseling options are largely dependent on the cause of the growth restriction. Serial ultrasonography (US) for the evaluation of fetal growth and umbilical artery Doppler velocimetry are used to guide pregnancy management decisions. This article describes the accurate US detection and surveillance of fetal growth restriction, discusses the current obstetric and radiology literature regarding the use of Doppler velocimetry in the setting of fetal growth restriction, and describes the techniques for performing umbilical artery Doppler velocimetry. Although various Doppler techniques have been described in the setting of fetal growth restriction, only umbilical artery Doppler assessment is recommended to identify fetuses most at risk for poor outcome and to guide the timing of delivery. The use of other Doppler waveforms in this setting remains investigational. © RSNA, 2017.

A conical cavity has been designed and fabricated for use as a broadband passive microwave calibration source, or blackbody, at the National Institute of Standards and Technology. The blackbody will be used as a national primary standard for brightness temperature and will allow for the prelaunch calibration of spaceborne radiometers and calibration of ground-based systems to provide traceability among radiometric data. The conical geometry provides performance independent of polarization, minimizing reflections, and standing waves, thus having a high microwave emissivity. The conical blackbody has advantages over typical pyramidal array geometries, including reduced temperature gradients and excellent broadband electromagnetic performance over more than a frequency decade. The blackbody is designed for use between 18 and 230 GHz, at temperatures between 80 and 350 K, and is vacuum compatible. To approximate theoretical blackbody behavior, the design maximizes emissivity and thus minimizes reflectivity. A newly developed microwave absorber is demonstrated that uses cryogenically compatible, thermally conductive two-part epoxy with magnetic carbonyl iron (CBI) powder loading. We measured the complex permittivity and permeability properties for different CBI-loading percentages; the conical absorber is then designed and optimized with geometric optics and finite-element modeling, and finally, the reflectivity of the resulting fabricated structure is measured. We demonstrated normal incidence reflectivity considerably below -40 dB at all relevant remote sensing frequencies.

As the global cancer burden grows, so too will global inequities in access to cancer and palliative care increase. This paper will describe the cancer and palliative care landscape relative to nursing practice, education, and research, and emerging global collaborations in the United States (U.S.), Turkey, and Malawi. It is imperative that nurses lead efforts to advance health and strengthen education in these high-need areas. Leaders within the University of Alabama at Birmingham School of Nursing, through a Pan American Health Organization/World Health Organization Nursing Collaborating Center, have initiated collaborative projects in cancer and palliative care between the U.S., Turkey, and Malawi to strengthen initiatives that can ultimately transform practice. These collaborations will lay a foundation to empower nurses to lead efforts to reduce the global inequities for those with cancer and other serious and life-limiting illnesses., Competing Interests: There are no conflicts of interest.

Objectives: Infant mortality remains a significant public health problem in the U.S. The Collaborative Improvement & Innovation Network (CoIIN) model is an innovative approach, using the science of quality improvement and collaborative learning, which was applied across 13 Southern states in Public Health Regions IV and VI to reduce infant mortality and improve birth outcomes. We provide an in-depth discussion of the history, development, implementation, and adaptation of the model based on the experience of the original CoIIN organizers and participants. In addition to the political genesis and functional components of the initiative, 8 key lessons related to staffing, planning, and implementing future CoIINs are described in detail., Methods: This paper reports the findings from a process evaluation of the model. Data on the states' progress toward reducing infant mortality and improving birth outcomes were collected through a survey in the final months of a 24-month implementation period, as well as through ongoing team communications., Results: The peer-to-peer exchange and platform for collaborative learning, as well as the sharing of data across the states, were major strengths and form the foundation for future CoIIN efforts. A lasting legacy of the initiative is the unique application and sharing of provisional "real time" data to inform "real time" decision-making., Conclusion: The CoIIN model of collaborative learning, QI, and innovation offers a promising approach to strengthening partnerships within and across states, bolstering data systems to inform and track progress more rapidly, and ultimately accelerating improvement toward healthier communities, States, and the Nation as a whole.

Essential amino acid (EAA) ingestion enhances postexercise muscle protein synthesis, and, in particular, the anabolic response of older adults appears sensitive to the quantity of ingested leucine. The effect of leucine ingestion on muscle breakdown following resistance exercise (RE) is less understood. The purpose of this study was to identify the impact of postexercise leucine ingestion on the ubiquitin proteasome and autophagosomal-lysosomal systems following acute RE in older men. Subjects (72 ± 2 yr) performed RE and 1 h postexercise ingested 10 g of EAA containing a leucine quantity similar to quality protein (control, 1.8 g leucine, n = 7) or enriched in leucine (leucine, 3.5 g leucine, n = 8). Stable isotope infusion and muscle biopsies (vastus lateralis) obtained at rest and 2, 5, and 24 h postexercise were used to examine protein content (Western blot), mRNA expression (RT-quantitative PCR), and muscle protein fractional breakdown rate (FBR). Muscle-specific RING finger 1 mRNA increased in both groups at 2 and 5 h ( P < 0.05). LC3 mRNA increased, and the LC3BII-to-LC3BI ratio decreased at all postexercise time points in control ( P < 0.05). Conversely, LC3 mRNA only increased at 2 h, and the LC3BII-to-LC3BI ratio only decreased at 2 and 5 h in leucine ( P < 0.05). Tumor necrosis factor receptor-associated factor-6 mRNA increased ( P < 0.05) in control at 5 h. FBR was not statistically different between groups or from basal 24 h postexercise ( P > 0.05). These data indicate that ingesting a larger quantity of leucine following RE may further reduce postexercise skeletal muscle autophagy in older men; however, it does not appear to influence the acute postexercise elevation in markers of the ubiquitin proteasome system or the breakdown of intact proteins. NEW & NOTEWORTHY The impact of postexercise leucine ingestion on processes of skeletal muscle breakdown in older adults is not well understood. Additional postexercise leucine ingestion appears to further reduce autophagy, but it does not interfere with the increase in ubiquitin proteasome system markers or the breakdown of intact proteins in skeletal muscle of older men. Postexercise leucine ingestion may promote a healthier protein pool and favorable muscle adaptations in older adults through greater accretion of myofibrillar proteins., (Copyright © 2017 the American Physiological Society.)

Our objective was to develop a quick and simplified method for the determination of β-Hydroxy-β-methylbutyrate (HMB) and ɑ-ketoisocaproic acid (KIC) concentrations and enrichments by GC/MS/MS to determine the turnover rate of HMB in humans. In experiment 1, we provided a pulse of L-[5,5,5- 2 H 3 ]leucine to younger adults in the postabsorptive state then collected blood samples over a 4h time period. In experiment 2, we provided a pulse of [3,4,methyl- 13 C 3 ]HMB to older adults in the postabsorptive state then collected blood samples over a 3h time period. Plasma concentrations of KIC and HMB and MPE of KIC and HMB were determined by GC/MS/MS. Plasma enrichment of leucine was determined by LC/MS/MS. To determine plasma enrichment of [5,5,5- 2 H 3 ]HMB and [3,4,methyl- 13 C 3 ]HMB, samples were derivatized using pentafluorobenzyl bromide and analyzed using chemical ionization mode. The final methods used included multiple reaction monitoring of transitions 117.3>59.3 for M+0 and 120.3>59.3 for M+3. In experiment 1, peak MPE of Leu peaked at 9.76% generating a peak MPE of KIC at 2.67% and a peak HMB MPE of 0.3%. In experiment 2, the rate of appearance for HMB was  0.66μmol/kg ffm/h. We calculated that production of HMB in humans accounts for 0.66% of total leucine turnover., (Copyright © 2016 Elsevier B.V. All rights reserved.)