bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Opioid Treatment Programs on Child Well-Being
Authors: Bullinger Lindsey Rose , Wang Vivian , Feder Kenneth A.
Published: March 2023

Children exposed to parental opioid use disorder are at an elevated risk of maltreatment. We study whether parents’ access to medication-assisted opioid treatment programs (OTPs) affects the well-being of their children. An administrative decision to lift a moratorium on access to these programs in Indiana created the opportunity for this study. We show that after a county opened an OTP, methadone dispensing increased and emergency department visits related to opioid overdose decreased there, offering evidence of the success of these programs. We also show that the opening of these OTPs did not have significant effects on reports of child maltreatment, but that out-of-home foster care placements were reduced by 22 percent. Our findings are consistent with past research showing that child welfare cases involving parental substance use tend to be complex and tend to have longer times to parent/child reunification than child welfare cases in which substance use is not present. We argue that expanding access to opioid treatment programs may help reduce foster care placements.
The Opioid Epidemic and Children’s Living Arrangements in the United States, 2000–2018
Authors: Caudillo Mónica L. , Villarreal Andrés , Cohen Philip N.
Published: March 2023

Although the detrimental effects of the opioid epidemic on individuals’ health and well-being have been well documented, we know little about how it has affected the family contexts in which children live. We assess how the opioid epidemic, as measured by a rise in the opioid overdose death rate, has affected the rates at which children live in different family arrangements: two married parents, two cohabiting parents, single mother, single father, or another configuration. Our local fixed-effects models show that higher local overdose death rates are associated with fewer children living with two married parents and with an increase in children living in family structures that tend to be less stable, such as those led by cohabiting parents or a single parent. These changes in family arrangements have potential long-term implications for the well-being of future generations.
The Opioid Crisis, Health, Healthcare, and Crime: A Review of Quasi-Experimental Economic Studies
Authors: Maclean Johanna Catherine , Mallatt Justine , Ruhm Christopher J. , Simon Kosali
Published: March 2023

We review quasi-experimental studies that examine the relationship of opioids to health, healthcare, and crime in the U.S. Our findings align with the general perception that the opioid crisis has negatively impacted health and increased healthcare costs; we find limited evidence that appropriate opioid use enhances work capacity or carries other benefits. Extant studies suggest that opioids also increase crime, although the link is not as strong as has been observed in previous drug epidemics. This finding is consistent with the fact that opioids are pharmacologically different than stimulant substances like cocaine that have dominated earlier drug epidemic periods. We argue that the healthcare system has a potentially important role to play in combatting the opioid crisis, largely through the provision of treatments that address underlying addiction, and through the development of strategies to effectively curtail access to the drugs.
Food Insecurity and the Opioid Crisis
Authors: Heflin Colleen , Sun Xiaohan
Published: March 2023

The opioid epidemic has increased adult mortality, disrupted families, and changed labor supply—all factors that are independently associated with poverty and food insecurity. We explore the relationship between the opioid crisis and food insecurity at the state level, first by examining the relationship of drug-related mortalities to food insecurity, and then by exploiting cross-state variations in OxyContin misuse prior to reformulation of the drug to investigate whether food insecurity increased as individuals with opioid use disorder transitioned from prescription to street drugs such as heroin. Results provide further evidence of the presence and size of the social consequences of the opioid crises and the negative consequences associated with drug reformulation for food security.
Do Federal Grants for Medication-Assisted Opioid Treatment Reduce Homelessness?
Authors: Sullivan Andrew , Park Changwe
Published: March 2023

The federal government awarded $115 million to local entities between 2015 and 2018 for medication-assisted treatment (MAT) programs to treat opioid use disorder. These programs integrate the use of medications with counseling and behavioral therapies to reduce withdrawal symptoms and other adverse, individual-level effects of opioid misuse. Mounting evidence shows the benefits of MAT interventions among individuals, but little is known of whether these programs have prosocial, community-level effects. We examine the effect of MAT programs on one such community-level outcome: homelessness. Our event study design shows that MAT grants did not have a discernable relationship to homelessness at the community level; and we argue that while MAT may be an effective approach to treating opioid use disorder among individuals, more must be done to scale up its effects of these programs on community-level outcomes like homelessness.
Teaching Small Bite Fascial Closure Technique: Improved Accuracy and Consistency Through Simulation
Authors: Cuevas Natalie , Beeson Seth T. , Faulkner Justin D. , Edgerton Colston , Hope William W.
Published: March 2023

Despite evidence that small bite closure is beneficial, it is not well documented how accurately and consistently surgeons employ this technique. We created a felt model to simulate fascial closure and educate residents regarding small bites. This study aims to gauge accuracy and consistency of bite size in fascial closure and assess if utilizing a templated model could improve technique. Two 10 cm incisions were made in different pieces of felt. Residents were instructed to suture the incisions to simulate fascial closure by running the incisions closed with 1 cm and 5 mm bites respectively. The process was repeated with templated pieces of felt marking 1 and 0.5 cm to guide bite size. Residents were timed for each closure. The travel and distance from the midline for each bite was measured and analysis performed. 14 residents participated. Paired T-test compared means and standard deviations of bite size. Taking 5 mm bites took more time. Standard deviation of travel and right sided distance from midline were significantly smaller when a template was utilized. Standard deviation of travel as well as right sided distance was also improved when instructed to take 5 mm bites. This study demonstrates that a small bite technique results more closure and that when residents are instructed to take smaller bites. The adage, “aim small, miss small,” holds true in fascial closure and may be one reason why small bites improve hernia rates. This study also suggests that the use of a template improves accuracy and consistency of closure regardless of bite size intention.
Management of Chronic Pain by Occupational Therapist: A Description of Practice Profile
Authors: Lagueux Émilie , Masse Julie , Pagé Raphaël , Marin Béatrice , Tousignant-Laflamme Yannick
Published: March 2023

Background. Current state of knowledge regarding occupational therapy's contribution to chronic pain (CP) management has evolved over the past decade. Yet, has this been transferred to clinical practice? Purpose. Describe the current state of practice of CP management-specific occupational therapy. Method. An online survey was sent to occupational therapists working with CP patients. Findings. Of the 90 respondents (11.9%), 42.2% worked in primary care and 52.2% in secondary care. They reported that their primary role aimed at enabling occupation and providing vocational rehabilitation. The Canadian Model of Occupational Performance and Engagement (CMOP-E) (87.8%), semi-structured interview (86.7%), and education on energy conservation (65.6%) and postural hygiene (60.0%) were the most frequently reported conceptual model, assessment, and intervention methods. Implications. Results illustrate the diversity of current occupational therapy practice in CP management and suggest opportunities for improvement to ensure best practices are adopted, by emphasizing an occupation-based vision of health and well-being.
Double stigma in mental health service use: Experience from ethnic minorities in Hong Kong
Authors: Yi Nam Suen , Yik Chun Wong , Tak Hing Michael Wong , Kit Wa Sherry Chan , Lai Ming Christy Hui , Ho Ming Edwin Lee , Yu Hai Eric Chen
Published: March 2023

Background:

Ethnic minorities (EMs) typically underutilise mental health services (EMs) with issues that are not shared by the local population. Understanding the underlying perceived factors could help reduce their mental health disparities.

Aims:

This is a qualitative study aiming to examine the barriers that prevent EMs from seeking mental health services in Hong Kong.

Methods:

Six semistructured focus groups with 31 EMs who resided in Hong Kong were conducted from May 31 to June 26, 2021. The outcome measures were the themes and subthemes of perspectives on mental health service use.

Results:

Among 31 adults (20 [64.5%] women, 11 [35.5%] men; 17 [54.8%] aged 25–39 years) who participated, most participants self-identified as Indian (13 [41.95]) or Pakistani (10 [32.3]). There were 16 individuals (51.6%) who reported severe or higher levels of anxiety or depressive symptoms, while 12 individuals (38.7%) reported moderate levels. Three emerging themes identified for the barriers to help-seeking for psychiatric intervention were (1) preexisting problems, (2) psychaitric service lacks cultural sensitivity and (3) personal or family limitation, while that for the recommendations to improve help-seeking had six themes: (1) improve cultural sensitivity, (2) make EM mental health practitioners available, (3) improve professional conduct, (4) improve on-site support, (5) improve financial support and (6) improve mental health promotion in schools.

Conclusion:

This study found that EMs in Hong Kong experience double stigma, which keeps them away from seeking professional mental health care. There were also disparities in the use of mental health services by ethnicity. The study also made recommendations for promoting EM help-seeking at the individual, governmental and community levels.
Sequence Processing in Music Predicts Reading Skills in Young Readers: A Longitudinal Study
Authors: Andrade Paulo E. , Müllensiefen Daniel , Andrade Olga V. C. A. , Dunstan Jade , Zuk Jennifer , Gaab Nadine
Published: March 2023

Musical abilities, both in the pitch and temporal dimension, have been shown to be positively associated with phonological awareness and reading abilities in both children and adults. There is increasing evidence that the relationship between music and language relies primarily on the temporal dimension, including both meter and rhythm. It remains unclear to what extent skill level in these temporal aspects of music may uniquely contribute to the prediction of reading outcomes. A longitudinal design was used to test a group-administered musical sequence transcription task (MSTT). This task was designed to preferentially engage sequence processing skills while controlling for fine-grained pitch discrimination and rhythm in terms of temporal grouping. Forty-five children, native speakers of Portuguese ( Mage = 7.4 years), completed the MSTT and a cognitive-linguistic protocol that included visual and auditory working memory tasks, as well as phonological awareness and reading tasks in second grade. Participants then completed reading assessments in third and fifth grades. Longitudinal regression models showed that MSTT and phonological awareness had comparable power to predict reading. The MSTT showed an overall classification accuracy for identifying low-achievement readers in Grades 2, 3, and 5 that was analogous to a comprehensive model including core predictors of reading disability. In addition, MSTT was the variable with the highest loading and the most discriminatory indicator of a phonological factor. These findings carry implications for the role of temporal sequence processing in contributing to the relationship between music and language and the potential use of MSTT as a language-independent, time- and cost-effective tool for the early identification of children at risk of reading disability.
Review of State Policies and Guidance for the Identification of Culturally and Linguistically Minoritized Students With Specific Learning Disabilities
Authors: Harris Bryn , Kulkarni Tara , Sullivan Amanda L.
Published: March 2023

The identification of specific learning disabilities (SLD) remains fraught with controversy and uncertainty about professionals’ capacity to appropriately identify special education eligibility. For students from linguistically minoritized backgrounds, the exclusionary clause prohibits the identification of learning difficulties primarily attributable to contextual or linguistic factors. Yet the ambiguity of the federal language may hinder application, making critical states’ interpretation and corresponding guidance for professional practice in eligibility determination. In this archival study, we systematically reviewed state departments’ education policies and related guidance on the identification of multilingual learners with SLD, with a focus on how states have articulated policies and procedures related to the federal exclusionary clause. Our findings demonstrate variability and depth of information across states pertaining to guidance regarding the exclusionary clause. Implications for practice and policy are provided.
Combatting Election Stress: Anticipatory Coping and Daily Self-Reported Physical Health
Authors: Johnson Brittany K. , Neupert Shevaun D.
Published: March 2023

This study’s purpose is to evaluate the effectiveness of anticipatory coping as a possible mechanism to reduce daily self-reported physical health consequences of forecasting election-related stress. Elections are often stressful for people. However, the research on possible physical consequences of anticipated election-related stress and ways to counter its impact is limited. We used data from the 2018 U.S. Midterm Election Stress Coping and Prevention Every Day (ESCAPED) study, which provided daily diary responses from 140 participants across the U.S. and American Samoa, ages 19–86. Participants were recruited using Amazon’s Mechanical Turk (mTurk) and were asked to fill out an online survey each day for 22 days before, the day of, and 7 days after the 2018 U.S. midterm election, which fell on November 6, 2018. Questions involved forecasting election-related stress, four forms of anticipatory coping, and daily self-reported physical health. Results from multilevel models suggested that on days when participants experienced an increase in their forecasting of election-related stressors and also experienced a decrease in their anticipatory coping related to problem analysis, their daily self-reported physical health decreased. These results highlight the role that future-oriented tactics could play in managing the physical consequences of election-related stress.
Fear and loathing in north London: Experiencing estate regeneration as psychosocial degeneration
Authors: Watt Paul
Published: March 2023

This article analyses residents’ emotional responses to the regeneration – involving demolition and rebuilding – of West Hendon council housing estate in north London. Based on ethnographic research, the article outlines what living on the estate meant for its working-class residents in terms of providing ontological security and place belonging prior to regeneration. The reality of regeneration for residents involved multiple layers of physical, social, symbolic and psychosocial ‘degeneration’. The article’s focus is psychosocial degeneration, which is illustrated through three emotional dimensions: frustration, anger and betrayal arising from broken promises; stress resulting from living near a building site; and displacement anxiety regarding the uncertainties of where and when they would be relocated. The article highlights how residents are emotionally scarred by the protracted, opaque, ever-changing regeneration process. The reality of regeneration/degeneration for residents – involving state-led gentrification – is at stark variance to the official narrative that regeneration entails a smooth, unidirectional trajectory of improving homes and communities.
Self-initiated expatriates in menial jobs: Destructive psychological contracts in the hospitality sector
Authors: Kraak Johannes M , Griep Yannick , Altman Yochanan
Published: March 2023

This qualitative research explores the psychological contract (PC) of a sample of self-initiated expatriates (SIEs) working in the French hospitality sector, focusing on PC evaluation as well as reactions to PC breach and feelings of violation. The authors found evidence of a psychological contract type not discussed before in empirical studies. The employer in this research intentionally disrupts the exchange relationship, creating a destructive PC. In these cases, it is assumed that employees would exit such an employment relationship, but instead the study found a mix of dysfunctional behavior in the form of neglect, workplace deviance and revenge cognitions. Accounting for the limitations of the study the authors highlight the implications of the findings for theory, practice and future research.
A Socio-Cognitive Explanation of Organizational Grouping Decisions: Multidivisional Firms and the Formation of Their Divisions
Authors: Sengul Metin , Yu Tieying
Published: March 2023

We advance a socio-cognitive explanation of the grouping of a firm's activities into distinct divisions, each responsible for a specific set of activities. We argue that categorization creates expectations regarding which activities should be bundled, and grouping decisions that are inconsistent with these expectations are sanctioned. Hence, organizational grouping and reconfiguration decisions of multidivisional firms are influenced by categorical expectations, in addition to the interdependencies and shared external contingencies underlying a firm's activities and their perceptions and interpretations among managers. We also expect that the illegitimacy discount and associated performance penalty resulting from a firm's divergence in organizational grouping choices from categorical expectations will be lower for firms that span multiple categories or belong to an incoherent category. The socio-cognitive explanation we develop informs four theoretically relevant topics—labelling of organizational units, analogical reasoning, organizational identity, and categorical expectation violations—and has implications for future empirical research on organization design.
Rival monarchs: The two versions of 2 Henry VI and 3 Henry VI
Authors: Chernaik Warren
Published: March 2023

Two early plays in the Shakespeare canon, 2 Henry VI and 3 Henry VI, exist in widely different versions. For many years, the standard explanation for the discrepancy was that Contention and True Tragedie were untrustworthy texts contaminated by memorial reconstruction. In this essay, I will argue that each needs to be treated in its own terms as an internally consistent play; that anomalies in the text of Contention and True Tragedie are not convincing evidence of memorial reconstruction; and that significant differences in the alternative versions can best be explained as revision and expansion, rather than as abridgement.
Addressing the Catch-22 of Using Mixed Methods in Behavior Disorders Intervention Research
Authors: Hitchcock John H. , Houchins David E. , Onwuegbuzie Anthony J.
Published: March 2023

Limited emotional and behavioral disorders (EBD)–focused intervention mixed methods research (MMR) has been published, particularly in top-tier EBD journals (i.e., Behavior Disorders and Journal of Emotional and Behavioral Disorders). The lack of published MMR creates what could be perceived as a Catch-22 situation wherein those who conduct EBD intervention research are not encouraged to conduct MMR because they do not see published examples in the journals that they read. The purpose of this article is to demonstrate how the routine use of MMR should be considered and suggest why doing so is a worthwhile endeavor. An overview of potential barriers to conducting intervention MMR in the field of EBD is provided. Examples of the use of MMR with Functional Behavior Analysis and Multi-tiered Systems of Support for students with Tier 2 needs are discussed. Details regarding the use of a mixed methods profile analysis to understand treatment successes and challenges are provided. Our hope is that this article will inspire EBD researchers to consider MMR as they develop interventions for children with EBD.
Effect of a controlled lifestyle intervention on medication use and costs: The Healthy Lifestyle Community Program (cohort 2)
Authors: Kranz Ragna-Marie , Kettler Carmen , Anand Corinna , Koeder Christian , Husain Sarah , Schoch Nora , Buyken Anette , Englert Heike
Published: March 2023

Background: Establishing a healthy lifestyle has a great potential to reduce the prevalence of non-communicable diseases (NCDs) and their risk factors. NCDs contribute immensely to the economic costs of the health care system arising from therapy, medication use, and productivity loss. Aim: The aim of this study was to evaluate the effect of the Healthy Lifestyle Community Program (cohort 2; HLCP-2) on medication use and consequently on medication costs for selected NCDs (diabetes, hypertension, and dyslipidemia). Methods: Data stem from a 24-month non-randomised, controlled intervention trial aiming to improve risk factors for NCDs. Participants completed questionnaires at six measurement time points assessing medication use, from which costs were calculated. The following medication groups were included in the analysis as NCD medication: glucose-lowering medications (GLM), antihypertensive drugs (AHD) and lipid-lowering drugs (LLD). Statistical tests for inter- and intra-group comparison and multiple regression analysis were performed. Results: In total, 118 participants (intervention group [IG]: n = 79; control group [CG]: n = 39) were considered. Compared to baseline medication use decreased slightly in the IG and increased in the CG. Costs for NCD medication were significantly lower in the IG than in the CG after 6 ( p = 0.004), 12 ( p = 0.040), 18 ( p = 0.003) and 24 months ( p = 0.008). After multiple regression analysis and adjusting for confounders, change of costs differed significantly between the groups in all final models. Conclusion: The HLCP-2 was able to moderately prevent an increase of medication use and thus reduce costs for medication to treat NCDs with the greatest impact on AHD.

Trial registration

German Clinical Trials Register DRKS ( www.drks.de ; reference: DRKS00018775).
Urban orientalism and the informal city in Rio de Janeiro, Brazil
Authors: Garmany Jeff , Almeida Rafael Gonçalves
Published: March 2023

In this article, we scrutinize the concept of ‘urban informality’ in Rio de Janeiro, Brazil. By unpacking key moments in Rio’s history when conceptualizations of informal housing (i.e., favelas) changed, we explain why favelas have been understood in different ways over the last century. Our argument is that the concept of informality, while signaling an important shift in how favelas were understood, also perpetuated orientalist epistemologies in theories of urban development. This helps to explain why the term gained traction when it did, as well as why it remains salient today. In Rio, this means that changing understandings of favelas over the last century reveal little about actual changes within favelas, and more about how different geographic imaginaries were projected onto them, reflecting specific ‘problems’ confronting the city at different moments in history. This is important for seeing how conceptualizations of favelas – including the ways we understand urban informality – tend to mirror a host of latent social and political anxieties connected to urban development, including attempts to govern and control informal space.
‘If you don’t “pass” as cis, you don’t exist’. The trans audience's reproofs of ‘Cis Gaze’ and transnormativity in TV series
Authors: Villegas Simón Isabel , Sánchez Soriano Juan José , Ventura Rafael
Published: March 2023

There are currently more trans characters than ever in television series, while at the same time scrutiny of trans people is intensifying in social and public debate, and the correspondence between this increased presence in the media and improvements in the trans community's rights is in dispute. This research aims to find out how trans audiences relate to their portrayal in TV series, to learn about their perceptions and opinions, and to understand how these depictions affect their everyday lives. A qualitative analysis was conducted of 19 trans people in two focus groups and nine semi-structured interviews. The findings show that the participants perceive a clear distance between their realities and the most popular narratives about trans lives. They identify cispassing as a transversal element that drives the production, creation, and distribution of media narratives, leading to a transnormative representation. Consequently, the trans audience demands the inclusion of trans people in the (audiovisual) cultural circuit in order to combat the ‘cis gaze’ and to create more diverse narratives.
Predicting the mortality of patients with cardiogenic shock after coronary artery bypass grafting
Authors: Zhou Xiaozheng , Tan Wen , Liu Maomao , Liu Nan
Published: March 2023

Introduction

Cardiogenic shock (CS) is a critical condition and the leading cause of mortality after coronary artery bypass grafting (CABG). To define the risk factors for CS in patients who undergo CABG and create a risk-predictive model is crucial.

Methods

In this observational study, we retrospectively evaluated consecutive patients who underwent CABG between January 2018 and October 2022 at Beijing Anzhen Hospital. A total of 496 patients were enrolled and categorized into the training (396 cases) and internal test (100 cases) sets. The variables significantly associated with mortality ( p < 0.05) were analyzed using logistic regression analyses.

Results

The E/A ratio at admission, postoperative brain natriuretic peptide, postoperative arterial lactate, two or more arrhythmias at the same time after CABG, and carotid artery stenosis at admission were identified as independent prognostic factors for in-hospital mortality after multivariate logistic regression analysis. The CS after CABG score (ACCS) was established and three classes of ACCS, named classes I (ACCS, <20), II (ACCS, 20–30), and III (ACCS, >30), made up the risk model. The ACCS showed better discrimination with an AUROC of 0.937 (95% confidence interval, 0.982–0.892) and calibration with the Hosmer–Lemeshow test (X2 = 5.854 with 8 df; p = 0.664). In addition, tenfold cross-validation demonstrated that the mean misdiagnosis rate was 5.56% and the lowest misdiagnosis rate was 6.38%.

Conclusion

The ACCS score represents a risk-predictive model for in-hospital mortality of patients with CS after CABG in acute care settings. Patients identified as class III may have a worse prognosis.
Two Responsibilities to Protect
Authors: Quinton-Brown Patrick
Published: March 2023

The purpose of this paper is to re-theorize the evolution of the Responsibility to Protect (RtoP) in the UN through to 2011, the apogee of liberal interventionism in the post-Cold War period. Contrary to a common argument in existing literature, and notwithstanding the adoption of the concept as an annual agenda item of the General Assembly, international contestation is not about implementation as neatly separated from meaning, but rather definition or interpretation. To better understand the boundaries of intergovernmental understanding, we need to interrogate the language or terms of the debate, particularly the ways in which those terms have been practiced. There have been two Responsibilities to Protect in international society. A discursive practice called Southern RtoP, traced through UN-based political dialogue, contests a meaning that has been prevalent for 20 years at least: that of Northern RtoP. This article shows evaluative nuance and data from the perspective of the Global South and provides a discursive history of an ongoing non-aligned protest against a NATO-associated theory of defeasible sovereignty.

Deux responsabilités de protéger
Active learning approach to enhance rotor dynamics understanding: A classroom demonstration
Authors: Bernardini Lorenzo , Di Gialleonardo Egidio
Published: March 2023

In the last decades, novel teaching strategies have been increasingly adopted to improve and enhance the students learning process by promoting their involvement and engagement during classes. In this context, this work presents a laboratory experience proposed to the third-year bachelor students of the course of ‘Mechanics of Vibrations’, held at the faculty of mechanical engineering of Politecnico di Milano. The experience consisted in the presentation of a rotor test bench specifically designed for educational purposes. Main concepts of rotor dynamics were analysed and showed, together with a critical discussion on the discrepancies between the Jeffcott–Laval model and experimental results. This project, that is one of the outcomes of an educational project for post-covid teaching promoted by Politecnico di Milano, involved almost 200 students in total. An anonymous evaluation survey proposed to students revealed a general appreciation of the experience, especially for the possibility of visualising important theoretical concepts. Given the positive feedback, the demonstration will be repeated in the next academic year, with some changes according to students’ suggestions.
Time for a Left-Turner to Block a Shared Lane of a Signalized Intersection
Authors: Troutbeck Rod , Kyte Michael
Published: March 2023

Frequently, signalized intersections have a single lane for both left-turners and through traffic. If the vehicles leaving this lane are opposed by through traffic, then no vehicles can depart after a left-turner reaches the head of the queue. This paper evaluates a single lane of left-turning and through vehicles in the subject stream and a single lane of through vehicles in the opposing stream. The first left-turning vehicle is delayed if the opposing flow is high and this further delays other vehicles in the subject stream. The time for the first left-turning vehicle to arrive at the stop line ( gf) and block the through vehicle is important when evaluating the queue accumulation polygon (QAP). If the process to determine the gf term is not well established and accurate, then all other aspects of QAP will not be accurate and the prediction of both capacity and delay will also be inaccurate. gf was determined through a theoretical evaluation to establish the form of the equation and simulation to establish empirical values for the parameters. The resultant equation had a standard error of 0.83 s. The proposed equation was compared with other expressions for gf, including the equation currently in use in the Highway Capacity Manual, and found to have a much lower standard error than those of other methods.
Evaluation of Pavement Performance Models Using Historical Condition Data for the U.S. National Parks Pavement Network
Authors: Bryce James , Nichols Andrew , Elias Mohammed , Maloche Anthony , Sivaneswaran Nadarajah , Canick Thomas
Published: March 2023

Pavement management, a subdivision of transportation asset management, seeks to use finite and limited resources to maintain or improve the condition of a pavement network for a defined time horizon. Pavement performance prediction is integral to pavement management, and among other uses, it contributes to budget projections and allows scenario analyses to be conducted. This paper documents the evaluation of the original pavement performance models developed for the U.S. National Park Service (NPS) pavement network using historical condition data. The Federal Lands Highway Program began to use a pavement management system for NPS pavements in 2005, and the results in this paper represent an evaluation of those models with an emphasis on developing recommendations for improvement. The main finding of the work presented in this paper is that the current NPS models result in significant overprediction of deterioration in practically all cases, although the effect is more pronounced for those measures associated with structural failure. This means that the NPS pavement network is in better condition than the models predict. The performance prediction models for those segments that received preservation treatments are also investigated in this paper, and it is found that the model bias is less for these than for the models predicting condition without a preservation treatment. However, this is attributed to the segments that received preservation treatments being in good condition. Overall, the findings point to a need to recalibrate or redevelop the models to improve their prediction capabilities.
Benefits of the PRISM Shelter-Based Program for Attainment of Stable Housing and Functional Outcomes by People Experiencing Homelessness and Mental Illness: A Quantitative Analysis
Authors: Soufi Ghassen , Voisard Brigitte , Latimer Eric A. , Matai Lavina , Moodie Erica E. M. , Laliberté Vincent
Published: March 2023

Objective

To explore the housing trajectory, personal recovery, functional level, and quality of life of clients at discharge and 1 year after completing Projet Réaffiliation Itinérance Santé Mentale (PRISM), a shelter-based mental health and rehabilitation program intended to provide individuals experiencing homelessness and severe mental illness with transition housing and to reconnect them with mental health and social services.

Method

Housing status, psychiatric follow-up trajectory, personal recovery (Canadian Personal Recovery Outcome Measure), functional level (Multnomah Community Ability Scale), and quality of life (Lehman Quality of Life Interview) were assessed at program entry, at program discharge and 1 year later.

Results

Of the 50 clients who participated in the study from May 31, 2018, to December 31, 2019, 43 completed the program. Of these, 76.7% were discharged to housing modalities and 78% were engaged with psychiatric follow-up at the program's end. Housing stability, defined as residing at the same permanent address since discharge, was achieved for 62.5% of participants at 1-year follow-up. Functional level and quality of life scores improved significantly both at discharge and at 1-year follow-up from baseline.

Conclusions

Admission to PRISM helped clients secure long-term stable housing and appropriate psychiatric follow-up. Stable housing was maintained for most clients at 1-year follow-up, and they benefited from sustained functional and quality of life outcomes in long-term follow-up.
Clinical manifestation score and characterization of cytokines and lymphocytes of dimethylacetamide-induced toxic hepatitis in spandex workers
Authors: Wang Jinglei , Tang Kai , Wang Caiping , Xu Shengzhi , Wang Yaqin , Zhu Qinya
Published: March 2023

Occupational exposure to dimethylacetamide (DMAc) has been reported to cause toxic hepatitis. Sixty spandex workers were included in this study to research the clinical manifestations and expression of cytokines and lymphocytes in DMAc-induced toxic hepatitis. Chinese drugs (reduced glutathione and Hugan tablets) were used to treat them. The manifestations including jaundice, asthenia, appetite, nausea, emesis, abdominal distension, yellow urine, and dizziness were scored. The percentages of patients rated as 0–3, 4–6, 7–9, and 10–12 points were 33.3%, 43.3%, 21.7%, and 1.7%, respectively, before treatment, and all patients showed 0–3 points after the treatment. The ultrasonic and CT imaging revealed diffuse intrahepatic hypodensity, intrahepatic calcification, signs of liver injury, and splenomegaly, which improved after therapy. Blood analysis showed that ALT, AST, TBIL, IL-6, IL-10, TNF-α, IFN-γ, CD3+%, and CD4+/CD8+ statistically decreased after drug treatment. Correlation analysis demonstrated positive linear correlations between ALT and TBIL, AST and TBIL, IL-10 and ATL, IL-10 and AST, IL-10 and TBIL, IFN-γ and IL-6, IFN-γ and TNF-α, and CD3+% and ALT. Pro-inflammatory cytokines and lymphocytes in DMAc-induced toxic hepatitis reflected an active immune state that decreased after treatment. IL-10 may inhibit the immune response in this disease, as a protective mechanism.
Improvements in Accuracy and Confidence in Rhythm Identification After Cardiac Surgery Using the AtriAmp Signals
Authors: Brown Diane H. , Zhang Xiao , Al-Subu Awni M. , Von Bergen Nicholas H.
Published: March 2023

Objectives: Following cardiac surgery, 50% to 60% of patients with congenital heart disease will experience an arrhythmia. These arrhythmias are associated with increased morbidity and mortality. Therefore, rapid and accurate identification is paramount to the improvement of patient outcome. We hypothesize that the AtriAmp, a device which allows atrial electrogram (AEG) display on the bedside monitors, will increase provider accuracy and confidence in arrhythmia diagnosis. Design: A prospective observational study. Electrograms were collected from post-operative patients from the bedside monitors surface ECG and an AEG using the AtriAmp. A 12-question online survey was given to critical care and cardiology providers at 9 different programs across the country as well as being posted to the AAP SOCC fall newsletter. Six questions displayed signals from only the surface leads, while the other 6 showed the same arrhythmias with an AEG obtained from the AtriAmp. Answers were then evaluated for confidence and accuracy. A paired t-test along with mixed method modeling was used to assess the data. Setting: Cardiac pediatric ICU. Subjects: Providers in pediatric cardiology and pediatric critical care were evaluated on their ability to diagnose arrhythmias on surface ECG and AEG obtained from bedside monitor. Interventions: The accuracy and confidence of diagnosis of both surface and AEG signals were evaluated through an on-line survey. Results: Eighty-eight providers completed the survey. The study showed that interpreting with the AtriAmp signal, compared to the surface ECG only, significantly increased the accuracy ( P = .002) and confidence in provider rhythm diagnosis ( P < .001). Junctional ectopic tachycardia, sinus tachycardia, and complete heart block had the most significant increase in accuracy of diagnose when using the AtriAmp signal ( P < .001, P = .002, P = .010, respectively). Conclusion: Use of the AtriAmp increased provider accuracy and confidence in post-operative rhythm diagnosis when compared to diagnosis using the surface electrograms only.
Bank Types, Inclusivity, and Paycheck Protection Program Lending During COVID-19
Authors: Cassell Mark K. , Schwan Michael , Schneiberg Marc
Published: March 2023

How do differences in bank or lending institution type shape access to credit for small businesses in poor and/or minority communities in the United States? Banking systems are populated by lenders that differ qualitatively in their organizational forms, business models and missions, and that connect—or fail to connect—to small business borrowers and local communities in divergent ways. The authors analyze data on the Paycheck Protection Program and its over 11 million loans made to businesses across the United States to trace how these differences shaped the flow of credit to poor and minority communities. The authors find substantial differences across seven lender types, both in their propensities to avoid or lend to firms in traditionally marginalized communities, and in how much they lend to poor and majority–minority communities relative to their nonpoor and majority White counterparts. From this variety within American banking, the authors identify two potential pathways for more inclusive lending.
The Relationship Between Pharmacist Resilience, Burnout, and Job Performance
Authors: Weiss Sandra S. , Weiss Laurence , Clayton Russell , Ruble Melissa J. , Cole Jaclyn D.
Published: March 2023

Background: Resilience aids healthcare professionals in navigating through and bouncing back from stressful situations in the workplace. Resilience can increase job satisfaction, work motivation, and professional commitment while decreasing burnout, and ultimately job turnover. More resilient employees experience lower instances of burnout and greater life satisfaction. Objective: The primary study objective is to determine the relationship that pharmacist resilience has on burnout and job performance. Methods: Licensed pharmacists in Florida were sent a Qualtrics survey (Qualtrics, Provo, UT) via email, which included demographics data, and valid and reliable assessment tools for resilience, burnout, and job performance. Linear regressions were used to test if resilience significantly predicted each of the output variables: burnout and job performance. Results: Survey responses were received from 942 pharmacists. The regressions showed that resilience significantly predicted both burnout (β1 = −.701, P < .001) and job performance (β1 = .35, P < .001). As resilience increased, the levels of burnout decreased, and job performance increased. Resilience explained 29% of the variance in burnout, and 11% of the variance in job performance. Conclusion: The results of this study suggest that resilience significantly predicts both pharmacist work-related burnout and job performance. The more resilient the pharmacist, the lower the chances of work-related burnout and the higher the likelihood of better job performance. Organizations should pursue opportunities to educate healthcare workers on methods to increase resilience and to bring attention to the importance of this topic.
Fabrication and characterization of light weight PVC foam based E-glass reinforced polyester sandwich composites
Authors: Ojha Somanath , Bisaria Himanshu , Mohanty Smita , Kanny Krishnan
Published: March 2023

The chemical, mechanical, thermal, and microstructural properties of Poly Vinyl Chloride (PVC) foam based E-glass reinforced polyester sandwich composites are evaluated as compared with single layer E-glass both side of PVC foam polyester composite (C1) and double layer E-galss both side of PVC foam polyester composite (C2). Fourier transform infrared (FTIR) spectroscopy was used to analyze the chemical composition of composites. The mechanical properties of fabricated composites were studied in terms of impact, flexural, and tensile strength. Thermogravimetric analysis and Dynamic mechanical analysis tests were done for examine thermal properties. Carbonyl group –C=O of the ester group, unsaturation sites of –(CH2)n–, CH, and CH3 stretching were identified in chemical analysis. The tensile strength and tensile modulus for C2 was found higher 37% and 152% more respectively as compared to C1 composite however C1 composite showed better flexural properties as compared to C2. C2 composite has a 31% higher impact strength than composite C1. Both C1 and C2 composite showed approximately equal thermal stability whereas C2 composite showed better damping properties. SEM micrograph of fractured surface divulges the fiber pullout, matrix cracking, and honeycomb structure. Fabricated light weight sandwich composites can be used for marine application.
Risk factors associated with 30-day hospital readmissions among persons living with HIV in Nantong, China
Authors: Wang Wei , Huang Hao , Cao Yuxin , Duan Xiaoyang , Li Min , Qin Gang , Zou Meiyin , Zhuang Xun
Published: March 2023

Objective

To estimate 30-day hospital readmission rates among persons living with HIV (PLWH) at the Nantong Infectious Disease Hospital in China and analyse the related risk factors.

Methods

A single-centre retrospective cohort study was conducted. There were 894 PLWH records obtained from the electronic medical record (EMR) system at the Nantong Infectious Disease Hospital in China, from October 2013 to February 2018. The 30-day readmission rates were calculated, and the risk factors were analysed by generalised estimating equations (GEEs).

Results

A total of 1153 hospitalizations from 894 patients were recorded between October 2013 and February 2018. The median time of 30-day readmissions was 13 days (interquartile range (IQR), 6–23). The reasons for all causes, acquired immunodeficiency syndrome (AIDS)-defining illnesses (ADIs), and non-AIDS-defining infections (non-ADIs) were 9.08, 13.52, and 7.91%, respectively. The results from the GEE analysis demonstrated that the risk factors associated with 30-days readmissions were as follows: no antiretroviral therapy (ART) prior to hospitalisations (odds ratio (OR) = 1.90, 95% confidence interval (CI): 1.21–3.00), low CD4 counts (OR = 2.17, 95% CI: 1.33–3.54), and multiple comorbidities (OR = 6.45, 95% CI: 1.62–25.73).

Conclusion

Early detection of HIV infection and early initiation of ART treatment are the keys to controlling 30-day readmissions.
Lupus, antiphospholipid syndrome, and stroke: An attempt to crossmatch
Authors: El Hasbani Georges , Uthman Imad
Published: March 2023

Cerebrovascular accidents (CVAs) or strokes are part of the common thrombotic manifestations of Systemic Lupus Erythematosus (SLEs) and Antiphospholipid syndrome (APS). Such neurological thrombotic events tend to occur in patients with SLE at a higher frequency when Antiphospholipid antibodies (aPLs) are present, and tend to involve the large cerebral vessels. The mechanism of stroke in SLE can be driven by complement deposition and neuroinflammation involving the blood–brain barrier although the traditional cardiovascular risk factors remain major contributing factors. Primary prevention with antiplatelet therapy and disease activity controlling agent is the basis of the management. Anticoagulation via warfarin had been a tool for secondary prevention, especially in stroke recurrence, although the debate continues regarding the target international normalized ratio (INR). The presence of either of the three criteria antiphospholipid antibodies (aPLs) and certain non-criteria aPL can be an independent risk factor for stroke. The exact mechanism for the involvement of the large cerebral arteries, especially in lupus anticoagulant (LAC) positive cases, is still to be deciphered. The data on the role of non-criteria aPL remain very limited and heterogenous, but IgA antibodies against β2GPI and the D4/5 subunit as well as aPS/PT IgG might have a contribution. Anticoagulation with warfarin has been recommended although the optimal dosing or the utility of combination with antiplatelet agents is still unknown. Minimal data is available for direct oral anticoagulants (DOACs).
Professional Development and Use of Evidence-Based Practice in Autism Early Intervention
Authors: Luskin-Saxby Sarah , Zimmer-Gembeck Melanie , Sulek Rhylee , Paynter Jessica
Published: March 2023

We investigated the experiences of Australian autism early intervention service providers, including the professional development they receive on the job and how they translate research evidence into their practice. Semi-structured interviews were conducted with 15 providers drawn from three locations. Participants described the crucial role of paraprofessionals in early intervention services, and indicated that, within multidisciplinary teams, allied health professionals, and teachers are the ones who select intervention practices and upskill paraprofessionals. Furthermore, participants reported using practices supported by research evidence, but also some emerging and unsupported practices. The use of unsupported practices is examined in light of the daily challenges faced by centers. Results may inform further professional development in early intervention services for children on the autism spectrum, to support the best possible outcomes for this population. The findings highlight the potential need for job-embedded hands-on professional development conducted in real time.