bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternity Leave and Paternity Leave: Evidence on the Economic Impact of Legislative Changes in High-Income Countries
Authors: Canaan Serena , Lassen Anne Sophie , Rosenbaum Philip , Steingrimsdottir Herdis
Published: July 2022

Labor market policies for expecting and new mothers emerged at the turn of the 19th century. The main motivation for these policies was to ensure the health of mothers and their newborn children. With increased female labor market participation, the focus has gradually shifted to the effects that parental leave policies have on women’s labor market outcomes and gender equality. Proponents of extending parental leave rights for mothers in terms of duration, benefits, and job protection have argued that this will support mothers’ labor market attachment and allow them to take time off from work after childbirth and then safely return to their pre-birth jobs. Others have noted that extended maternity leave can work as a double-edged sword for mothers: If young women are likely to spend months, or even years, on leave, employers are likely to take that into consideration when hiring and promoting their employees. These policies may therefore end up adversely affecting women’s labor market outcomes. This has led to an increased focus on activating fathers to take parental leave, and in 2019, the European Parliament approved a directive requiring member states to ensure at least 2 months of earmarked paternity leave.

The literature on parental leave has proliferated during the past two decades. The increased number of studies on the topic has brought forth some consistent findings. First, the introduction of short maternity leave is beneficial for both maternal and child health and for mothers’ labor market outcomes. Second, there appear to be negligible benefits from a leave extending beyond 6 months in terms of health outcomes and children’s long-term outcomes. Furthermore, longer leaves have little, or even adverse, influence on mothers’ labor market outcomes. However, evidence suggests that there may be underlying heterogeneous effects from extended leave among different socioeconomic groups. The literature on the effect of earmarked paternity leave indicates that these policies are effective in increasing fathers’ leave-taking and involvement in child care. However, the evidence on the influence of paternity leave on gender equality in the labor market remains scarce and is somewhat mixed. Finally, recent studies that focus on the effect of parental leave policies for firms find that in general, firms are able to compensate for lost labor when their employees go on leave. However, if firms face constraints when replacing employees, it could negatively influence their performance.
Community Resilience and Earthquakes: The Role of Neighborhood—A Case Study From Christchurch, Aotearoa New Zealand
Authors: Banwell Karen
Published: July 2022

It is well recognized that preexisting social connections and networks help people adapt and provide for more positive outcomes in the aftermath of a disaster. The role of place, of local neighborhood, in helping people to adapt and manage through the difficult times is developing. Neighborhood, the place where people live, can help facilitate the important informal response to disasters—where residents come together and provide mutual support. Features such as well-defined geography, intimate streets, walkable access to social infrastructure and natural spaces, and central meeting places all help to build the social connections that foster community resilience. Another important element is the community-focused groups that are already in place, especially ones with people who know their areas and who to support. Community resilience is a consequence of having good social connections, with social infrastructure helping to facilitate those connections; these are the same social and physical characteristics of neighborhoods that influence local health and well-being. The main message is that it is possible to develop urban environments in a way that provides multiple benefits. Social connections make people happier and healthier; they can learn from village life that can improve their future living environments, ones that are healthy and resilient. A vibrant well-connected neighborhood community with walkable access to natural spaces, to local shops and schools, and to places for locals to gather is healthy, self-reliant, and more resilient.
Sangoan
Authors: Taylor Nicholas
Published: July 2022

The Sangoan is a stone tool industry associated with the transition from the Early Stone Age (ESA) to the Middle Stone Age (MSA) in sub-Saharan Africa. The Sangoan overlies the Acheulean at sites including Nsongezi (Uganda) and Kalambo Falls (Zambia), and across much of Africa is the earliest technological marker for the shift from iconic Acheulean handaxes to the hafted points, blades, and smaller bifaces that characterize the MSA. Given its chronological position and status as an immediate post-Acheulean technology, the industry is pertinent to evolutionary questions about the origins of Homo sapiens in the late Middle Pleistocene.

The Sangoan was named after the site of Sango Bay on the western shore of Lake Victoria in Uganda and was first described based on an assemblage of rugged tools dominated by thick, heavy-duty bifaces, choppers, and core scrapers. It was historically observed to cluster in and around the central African forest belt, but recent claims of Sangoan tools in North, West, and Southern Africa indicate that it may have a far wider distribution. These findings, along with the recovery of Sangoan artefacts in an open paleohabitat at Simbi (Kenya), have queried the long-standing association of the industry with woodland and rain forest ecosystems. Identifying and correlating Sangoan occurrences is made harder by the fact it has rarely been recovered from undisturbed archaeological contexts and it thus remains loosely defined and poorly dated. The few sites that have been dated are widely dispersed and broadly coalesce on a time frame of 250,000 to 300,000 years ago (ka BP), but these are likely to be significant underestimates.

The paucity of well-stratified intact sequences that sample the Sangoan means that critical questions remain about its technological content, variability, and behavioral significance. The absence of any significant small tool component within many Sangoan assemblages has led to questions over whether this often bulky technology is suitable for hafting and whether, therefore, it may be better understood as a functional variant of the late Acheulean than as an MSA technocomplex. Recent use-wear analysis on Sangoan core axes at Sai Island (Sudan), however, has confirmed that many of the industry’s bifaces did serve as composite implements. At Kalambo Falls (Zambia), the presence of a small tool component, some with typical MSA characteristics, reinforces the Sangoan’s characterization as a mosaic technology that falls comfortably into neither the ESA nor the MSA.
Phenomenological Arguments and Concepts for Anthropology
Authors: Leistle Bernhard
Published: July 2022

Phenomenology is an important branch of 20th century philosophy, which originated in Germany but has been taken up in many countries all over the world. In cultural anthropology, it has informed theoretical as well as methodological perspectives and approaches and has led some anthropologists to proclaim a subdiscipline of “phenomenological anthropology.” The definitions of this subdiscipline and, consequently, the criteria for inclusion in it, however, vary widely and work that is labeled “phenomenological” sometimes shows a lack of acquaintance with philosophical phenomenology. This is typical for interdisciplinary projects, which face the difficulty of formulating the basis for a dialogue between intellectual disciplines with different orientations and traditions.

In contrast to a common misunderstanding, phenomenology is not a first-person description of experience but a systematic inquiry into the structures and processes of experience and their philosophical significance. In this effort, the concept of the “intentionality of consciousness” is often described as phenomenology’s major theoretical discovery. This key notion of an essential relation between mind and world can serve as point of access and touchstone for cultural anthropologists to gain a working understanding of other phenomenological concepts like epoché, being-in-the-world, life-world, or otherness. As a philosophy, phenomenology stresses open-endedness, indeterminacy, and in-betweenness of experience and human existence; in this capacity it suggests to cultural anthropologists paradigmatic ways in which to think about their discipline and its relationship to its object of study, the “culturally Other.” But anthropology’s relationship to phenomenology need not necessarily be dogmatic, and phenomenological anthropology can be carried out within the conventional paradigm of a hermeneutic science. In this context, phenomenology provides a wealth of theoretical concepts like embodiment, intersubjectivity, intercorporeality, which enable anthropologists to perform innovative empirical analyses on a wide variety of topics including, but not limited to, cultural differences in sensory experience, cultural contagion of health and illness, immigration, and transnationalism.
The Stone Age of the Middle Nile Valley
Authors: Garcea Elena A.A.
Published: July 2022

The stretch of the Nile River upstream from the First Cataract corresponds to the Middle Nile and extends from southern Egypt to the confluence of the White Nile and the Blue Nile in central Sudan. Its water basin is wider than that of the Lower Nile Valley and includes considerable tributaries and groundwater outlets springing in oases, wells, or boreholes, which could support human populations in otherwise uninhabitable arid and semi-arid lands. The Middle Nile Valley and the adjacent western and eastern deserts feature a range of significant sites belonging to the Early Stone Age (ESA), the Middle Stone Age (MSA), and the Later Stone Age (LSA). The earliest hominin occupation goes back to the Oldowan. Sites dating to this period are not numerous but are dispersed in different areas and suggest that some may have been lost due to taphonomic agents. Acheulean techno-complexes attest to a more consistent human presence in northern Sudan, western Sudan, and eastern Sudan. Research along the Red Sea coast and inland has provided strong evidence on green corridors for hominin dispersals connecting East Africa to the eastern desert. A variety of MSA techno-complexes appear in different territories. The most frequent industries have been assigned to the Sangoan, Lupemban, Nubian Complex, Aterian, and Khormusan. Early MSA Sangoan and Lupemban sites concentrate in the main Nile and White Nile areas, whereas Middle MSA Nubian Complex sites also appear in the eastern desert. Almost unknown in the Egyptian Nile Valley, the Aterian is well attested to in the Middle Nile Valley, as well as in the western desert. Finally, the Late MSA Khormusan and the LSA are mostly restricted to northern Sudan, with the exception of an LSA evidence in eastern Sudan, at Khashm el-Girba. The renowned LSA cemetery at Jebel Sahaba with signs of interpersonal violence is located in northern Sudan. Thanks to their favorable intermediary position, the Middle Nile Valley and the adjacent western and eastern areas likely contributed to both the northern and the southern routes of out-of-Africa hominin dispersals. The northern route that led East African hominins into Southwest Asia and onward almost inevitably traversed Sudan. At the same time, Sudanese technological traditions also appear across the Red Sea, in the Arabian Peninsula and seemingly spread via the southern route.
The Populist Movement in the 19th Century
Authors: Postel Charles
Published: July 2022

American Populism of the 1880s and 1890s marked the political high-water mark of the social movements of farmers, wage earners, women, and other sectors of society in the years after the Civil War. These movements forged the People’s Party, also known as the Populist Party, which campaigned against corporate power and economic inequality and was one of the most successful third parties in US history. Populist candidates won gubernatorial elections in nine states and gained some forty-five seats in the US Congress, including six seats in the Senate, and in 1892 the Populist presidential candidate, James B. Weaver of Iowa, received over a million votes, more than 8 percent of the total. The Populist Party was not a conventional political party but a coalition of organizations, including the Farmers’ Alliances, the Knights of Labor, and other reform movements, in what the Populists described as a “congress of industrial orders.” These organizations gave the People’s Party its strength and shaped its character as a party of working people with a vision of egalitarian cooperation and solidarity comparable to the labor, farmer-labor, and social-democratic parties in Europe and elsewhere that took shape in the same decades. Despite their egalitarian claims, however, the Populists had at best a mixed attitude towards the struggles for racial equality, and at worst accommodated Indian dispossession, Chinese exclusion, and Jim Crow segregation. In terms of its legacy, veterans of the Populist movement and many of its policy proposals would shape progressive and labor-farmer politics deep into the 20th century, partly by way of the Socialist Party, but mainly by way of the progressive or liberal wings of the Democratic and Republican Parties. At the same time, the adjective “populist” has come to describe a wide variety of political phenomena, including right-wing and nationalist movements, that have no particular connection to the late 19th-century Populism.
Greek Myth
Authors: Hawes Greta
Published: July 2022

Myths frequently intersect Greek religion, but Greek myth is neither coterminous with ancient ritual nor merely an appendix to it. The ancient poets and writers who took up the tasks of narrating, explaining, and expanding it did so with considerations which went far beyond the strictly religious. In antiquity myths were a repertoire of narratives which took place in a story-world located in a distant past which stretched from the beginnings of the universe to several generations after the return of the Heraclids to the Peloponnese. This repertoire featured episodes, events, genealogies, gods, and heroes that were shared across the Greek world, but within this common cultural paradigm there was broad tolerance for continual invention and improvisation: contingent local concerns fueled constant creation and manipulation of these stories. This apparent contradiction between a common canon and the mass of mutually contradictory variants and versions that it comprised is paralleled by the way that these myths could be simultaneously held up as paramount expressions of Hellenic culture while intersecting in significant ways with the traditions of the Greeks’ neighbors.

Myths were used among ancient Greek communities in broadly etiological ways: they explained why the world of the present was as it was. Myths existed to explain landscape features, political structures, regional alliances, ethic affiliations, cultic rituals, and theological principles. Myths could also be used in rationalistic modes to offer up a historicist vision of the past and in allegorical modes to illustrate philosophical paradigms. Greek myth remains a rich and varied body of stories with an intricate reception history. Nonetheless, what we know of it in antiquity is limited by the patterns of its survival. For the most part, preservation was through written sources (extant poetic and prose literature, documents from epigraphy, and papyri) and material evidence (statuary, votives, vase painting, wall painting, coins, and decorative objects). Although the context of these sources can offer radically different perspectives on myths, the viewpoint is most typically that of the elites.
“Whosoever Sees an Evil”: Muslim Americans’ Human Rights Advocacy
Authors: Aziz Sahar
Published: July 2022

The quintessential foil to liberalism in the Western imagination continues to be Islam. Orientalist stereotypes of Muslims as uncivilized and savage justified European conquest that led to centuries of colonialism. The United States followed suit when it replaced Britain and France as the new “Great Power” in Muslim majority countries, but this time through political and military hegemony.

International human rights, formally developed after World War II by Western nations, became a soft power tool that perpetuated Orientalist portrayals of Muslim societies as illiberal, misogynist, and violent on account of their Islamic values. As a result, some Western lawyers and scholars frame Islam as the cause of international human rights violations, thereby making military and political interventions necessary to protect Muslims’ human rights. That is, Islam is antithetical to universal human rights. Meanwhile, insufficient attention is paid to Western nation’s support for the despots that violate their Muslim citizens’ human rights.

To the extent explorations of human rights and Islam are conducted in good faith, the lived experiences of Muslims offer more insights than abstract debates infected by Orientalist academic training. Accordingly, this article looks to Muslims in America as a case study to show how Islamic principles can and do inform Muslim leaders’ defense of human rights. Muslim elected officials, human rights lawyers, and religious leaders explicitly reference their Islamic beliefs as the basis for their social justice work in the United States. The political environment in which Muslims live, rather than their religion per se, is thus more predictive of compliance with international human rights norms.
Muslims and Social Media in North America
Authors: Kamal Rabia
Published: July 2022

Islam in North America is an incredibly diverse phenomenon with a long history and a range of different perspectives on what “American/Canadian Islam” is or should be. While the presence of Islam in the United States dates back to the transatlantic slave trade, Muslim identity in the region is often linked to an immigrant presence and became synonymous with a sense of violent foreignness after the 9/11 attacks. Mainstream Western media has played a fundamental role in the configuration of Islam as the ultimate cultural “other,” leaving Muslims who strongly identify as Muslim and American or Canadian in a precarious position. Representation and debates around Muslim identity have recently shifted to online platforms. Social media has not only impacted how Islam is practiced in the United States and Canada but has also influenced self-presentation, community building, and activism among Muslims across ethnicity, race, generation, and class. From Quranic websites and Muslim dating apps to blogs, Instagram influencers, and Snapchat fatwas, North American Islam has developed a burgeoning presence across the digital landscape. Furthermore, social media provides a central space through which national politics and policies play out, and Muslims in particular have faced challenges ranging from Islamophobia and religious persecution to digital surveillance and censorship. Such phenomena have impacted the online activities of Muslims and deeply inform the day-to-day lives of Muslim communities across the region. Through exploring the various ways in which Muslims in these minority contexts experience the growing interrelationship between their on- and offline lives, we approach the digital as a space where culture is continually produced, performed, and contested.
Exhibitions and Displays of Religious Art
Authors: Gahtan Maia Wellington
Published: July 2022

Exhibitions and displays of religious art have been an integral part of religion since the manufacture of the first religious objects and the adornment of the first sacred places. Growing more complex and varied with time, such manifestations within religions provided models for art exhibitions associated with academies, galleries, museums, and other institutions with secular purposes by the mid-18th and 19th centuries. Typically organized around the works of an artist, a group of artists, art academies, or the holdings of private lenders, such exhibitions included works with both sacred and secular subjects. Exhibition design drew on the shapes and materials of the works, privileging formal qualities over meanings, including any religious content, even for works that had once belonged to sacred settings but had migrated to private collections. The final decades of the 19th and early 20th centuries were characterized by both exhibitions organized by religious authorities for the general public and exhibitions of specific genres of sacred art organized by museums and galleries. These, together with international exhibitions and World’s Fairs which showcased non-Western religious objects, helped form the modern notions of material religion that would find voice in the exhibitions of recent decades which have focused on particular faiths in geographical, historical, cultural, and iconological terms. These exhibitions have addressed the major religions of the world, especially Christianity and Islam, in both multi-faith and single-faith contexts. Input from practitioners and source communities at the planning and installation stages, as well as for public programming and events, has helped ensure greater authenticity in the displays and encouraged a movement away from considering religious objects exclusively in terms of art.
African Slavery and the Slave Trade in the Rio de la Plata Region
Authors: Secreto María Verónica
Published: July 2022

Historiography has traditionally divided the policy of introducing enslaved people to Spanish America into three periods based on the legal framework in effect at the time. These divisions are: the period of licensing from 1493 to 1595; the period of asientos from 1595 to 1789: and the period of free trade in enslaved people from 1789 to 1812. However, Spanish enslaved traffic did not end in 1812; it remained for decades thereafter, with the main destinations being Cuba and Puerto Rico. Spanish colonial expeditions to the Americas included enslaved Black people from the outset. The Instructions to Comendador Fray Nicolás de Ovando, published in 1501, contain the earliest reference to Black slavery in the West Indies. Supply was seen as an increasingly important problem as demand grew. Systematic mechanisms were needed to ensure a regular supply of enslaved people.

The joining of the Portuguese and Spanish crowns under Phillip II, known as the Iberian Union (1580–1640), seemed to solve the problem of supplying enslaved labor to Spanish possessions throughout the world. The Rio de la Plata played an important role in the extensive route linking Angola to Potosí, which, together with its hinterland, constituted a rich market made enormously attractive by the silver mined from the mountain for which the city was named. The lure of Peruvian silver hung over the slave trade and the institution of slavery in the Rio de la Plata region throughout the entire slaveholding period. During the 1789–1812 period, local merchants and traders in leather, tallow, and timber vied for position in this profitable market.
The Green Revolution in Latin America
Authors: Lorek Timothy W.
Published: July 2022

Latin America and Latin Americans played a pivotal role in the 20th-century reconstruction of the global food system. This process is often remembered as the “Green Revolution,” a loaded phrase forged in the Cold War furnace of 1968 and referring to the adoption of high-yielding and disease-resistant seeds, petrochemical inputs, and mechanization in the agriculture of what was then referred to as the “Third World.” Here, the purpose is to introduce this process and the contentious politics of historical narrative that are inseparable from material stories about plant breeding. The Green Revolution in Latin America has a deeper and more complex history than the US-centric post–World War II narrative that long set the terms of the field. Beginning in the late 19th century, “creole pre-histories” set the intellectual and material principles for the later growth and internationalization of agricultural development work. An important shift occurred in the 1940s as the Rockefeller Foundation in particular turned to these preexisting sites of agricultural science and linked them via state partnerships in a new era of “coordinated country programs.” As the international Cold War matured, these country programs offered a network upon which to further globalize research agendas, in many cases disassociating agricultural research from the specific regional and political contexts at the sites of the scientific institutions. The resultant network of “placeless” agricultural research is perhaps best understood through the creation of the Consultative Group for International Agricultural Research (CGIAR) in 1971, which at its 50th anniversary in 2021 maintained three important research centers with Latin American addresses, oriented toward the goals and funding mechanics of agricultural science on a global scale.
Animal Perspectives: Nonhuman Creatures’ Roles in Modern Latin America
Authors: Neufeld Stephen
Published: July 2022

In the national era of Latin American history, animals played various and significant roles. The 19th century brought to bear forces of industrialization and urbanization that altered how humans and animals interacted. While humans continued to rely on animals through the 20th century, the changes spurred during the 19th century Anthropocene (the period during which human activity has been the dominant influence on climate and the environment) led to new human–animal relations and reshaped traditional ones. Animals represented a driving economic force as a commodity, as transport, as labor, and as raw capital in the growing national republics. In and of themselves, they embodied the nation as symbols and as a part of the broader discourses that marked rural lifeways. As companions and pets, they enjoyed human protection and care, yet as prey and props, they also faced cruel destruction through hunting, blood sports, and vermin control. They caused disease and carried vaccines. And so, from the deepest wilderness of the region to the busiest city boulevard, the human history of Latin America took form in venues inhabited by fauna whose uses, and presence, shaped human life. A better understanding of these nonhuman animals’ histories changes our focus and situates animals as a vital element in Latin American societies.
German Assistance in Cold War Policing in Paraguay
Authors: Contreras Saiz Mónika
Published: July 2022

Between 1962 and 1989 the Federal Republic of Germany (FRG) provided policing assistance projects for the Paraguayan police. After the United States, the FRG was the country in which most Paraguayan police officers completed their training. German policing assistance, called Polizeihilfe, was based on the idea that the transfer of models and principles of constitutional and democratic policing would lead to the stabilization of politics and the reduction of violence and delinquency in the beneficiary countries. The study of policing cooperation and assistance between countries from the Western hemisphere during the Cold War reveals processes of transfer, translation, and appropriation of a set of practices and knowledge which affected the local security of beneficiary countries and the professional careers of those who carried out that training. Also important were the tensions and criticisms that arose when the FRG, a democratic state, gave assistance to the police of Alfredo Stroessner’s dictatorial regime.
Spanish-Based Creole Languages
Authors: Schwegler Armin , Jacobs Bart , Quint Nicolas
Published: July 2022

We offer a global overview of Spanish-based Creoles and the state of the art of the discipline. First, we present what is generally considered “the group” of Spanish-based Creoles. Two Creoles are then discussed in some detail, Palenquero and Papiamentu, providing sketches of their (a) sociolinguistic history and (b) linguistic structure. Completing this overview, we cover Chabacano (spoken in the Philippines), albeit in briefer fashion due to limitations of space. Attention is then turned to several Latin American areas that once may have been Creole speaking (these include Highland Bolivia, Peru, and western Colombia). We also make reference to Bozal Spanish, that is, the L2 Spanish formerly spoken in the Caribbean and elsewhere by slaves born in Africa.
The Problem of Water Markets
Authors: Hanemann Michael
Published: July 2022

Water marketing and property right reform are intertwined. Water markets are advocated as a solution for water scarcity, but changes in water rights are often required if the scope of water marketing is to expand. This is true in many countries, including (but not limited to) the United States and Australia. The focus here is on the United States. So far, water marketing in the Western United States is not producing long-run reallocation on the scale expected. The chief impediment is the complexities in existing water rights. An important distinction is between a property right to extract water and put it to use versus a contractual right to receive water from a supply organization. In the United States, the property right to water is a unique form of property. Unlike land, it is a right of use, not ownership; the quantity afforded by the right is incompletely specified; and the ability to transfer it is constrained by the obligation to avoid harm through the externality of return flows and also by unreliable historical records of rights. These constraints are often relaxed for short-term transfers (leases) of a property right lasting only a year or two. Also, these constraints generally do not apply to a contract right to receive water. Thus, most of the surface water transferred in the United States is either contract water moving within supply system boundaries or short-term leases of appropriative rights. These transfers tend to provide short-run flexibility for water users rather than long-run reallocation. For more significant long-run reallocation of water, some modification of the property right to water is essential. Devising a politically acceptable way to make the needed changes is the ultimate constraint on water marketing.
Locating School Social Work in the Reconstruction Period
Authors: Guz Samantha
Published: July 2022

The origin of school social work in the United States is frequently traced back to the early 20th century’s visiting teachers movement. To expand on previous scholarship, school social work can be situated in the 19th century by focusing on the organizing impact of Black communities on public education during Reconstruction. First, history provides context for public education during chattel slavery and for the formation of racialized politics in education. This historical context primarily focuses on how access to education was used as a tool to stratify citizenship in the South. Next, the work of Southern Black communities, the Freedmen’s Bureau, and Northern abolition organizations advanced efforts during Reconstruction, specifically the coalition-building to establish Freedmen’s Schools and the advocacy to make education a publicly funded institution. Thus, coalition-building and policy advocacy within school social work’s practice history have the potential to impact contemporary school social work practice.
Providing Low-barrier Addiction Treatment Via a Telemedicine Consultation Service During the COVID-19 Pandemic in Los Angeles, County: An Assessment 1 Year Later
Authors: Kennedy Amy J. , George James S. , Rossetti Gina , Brown Christopher O. , Ragins Kyle , Dadiomov David , Trotzky-Sirr Rebecca , Sanchez Gloria , Llamas Herman , Hurley Brian
Published: July 2022

Background

Los Angeles County Department of Health Services provides medical care to a diverse group of patients residing in underresourced communities. To improve patients' access to addiction medications during the COVID-19 pandemic, Los Angeles County Department of Health Services established a low-barrier telephone service for DHS providers in March 2020, staffed by DATA-2000–waivered providers experienced with prescribing addiction medications. This study describes the patient population and medications prescribed through this service during its initial 12 months.

Methods

We performed a retrospective evaluation of a provider-entered call registry for the telephone consult line. Information was collected between March 31, 2020, and March 30, 2021. The registry includes information related to patient demographics, the reason for visit, and which addiction medications were prescribed. We conducted descriptive statistics in each of these domains.

Results

During the study period, 11 providers on the MAT telephone service logged 713 calls. These calls represented a total of 557 unique patients (mean age of 40 years, 75% male, 41% Latino, 49% experiencing homelessness). Most patients either had Medicaid insurance (77%) or were uninsured (20%). The most prescribed addiction medication was buprenorphine-naloxone (90%), followed by nicotine replacement therapy (5.3%), naltrexone (4.2%), and buprenorphine monotherapy (1.8%).

Conclusion

A telephone addiction medication service is feasible to deliver low-barrier medications to treat addiction in underresourced communities, especially to individuals experiencing homelessness. This can mitigate but does not eliminate disparities in access to addiction medications for communities of color.
Public Insurance Payment Does Not Compensate Hospital Cost for Care of Long-Bone Fractures Requiring Additional Surgery to Promote Union
Authors: Roddy Erika , von Kaeppler Ericka P. , Chan Matthew C. , Shearer David W. , Kandemir Utku , Morshed Saam
Published: July 2022

Objectives:

To quantify the total hospital costs associated with the treatment of lower extremity long-bone fracture aseptic and septic unhealed fracture, to determine if insurance adequately covers these costs, and to examine whether insurance type correlates with barriers to accessing care.

Design:

Retrospective cohort study.

Setting:

Academic Level II trauma center.

Patients:

All patients undergoing operative treatment of OTA/AO classification 31, 32, 33, 41, 42, and 43 fractures between 2012 and 2020 at a single Level II trauma center with minimum of 1-year follow-up.

Main Outcome Measures:

The primary outcome was the total cost of treatment for all hospital-based episodes of care. Distance traveled from primary residence was measured as a surrogate for barriers to care.

Results:

One hundred seventeen patients with uncomplicated fracture healing, 82 with aseptic unhealed fracture, and 44 with septic unhealed fracture were included in the final cohort. The median cost of treatment for treatment of septic unhealed fracture was $148,318 [interquartile range(IQR) 87,241–256,928], $45,230 (IQR 31,510–68,030) for treatment of aseptic unhealed fracture, and $33,991 (IQR 25,609–54,590) for uncomplicated fracture healing. The hospital made a profit on all patients with commercial insurance, but lost money on all patients with public insurance. Among patients with unhealed fracture, those with public insurance traveled 4 times further for their care compared with patients with commercial insurance (P = 0.004).

Conclusions:

Septic unhealed fracture of lower extremity long-bone fractures is an outsized burden on the health care system. Public insurance for both septic and aseptic unhealed fracture does not cover hospital costs. The increased distances traveled by our Medi-Cal and Medicare population may reflect the economic disincentive for local hospitals to care for publicly insured patients with unhealed fractures.

Level of Evidence:

Economic Level V. See Instructions for Authors for a complete description of levels of evidence.
Operative Fixation of Extra-articular Scapula Body Fracture Through a Modified Judet Approach
Authors: Konda Sanjit R. , Solasz Sara Jo , Ganta Abhishek
Published: July 2022

We present the case of a 53-year-old male laborer who slipped and fell on ice and had acute right shoulder pain. Plain radiographs and a computed tomography scan of the scapula were obtained that demonstrated a comminuted and displaced extra-articular scapula body fracture with approximately 2 cm of medialization of the glenoid. The anatomy, examination, diagnosis, and surgical approach options are reviewed. In this case, open reduction and internal fixation of the scapula is performed through a modified Judet approach. At the 3-month postoperative visit, radiographs demonstrated a healed scapula fracture. The patient was allowed to return to work as a laborer. A modified Judet approach can be performed for surgical fixation of comminuted and displaced extra-articular scapula body fractures with excellent clinical results.
Repair of a Femoral Head Fracture Dislocation With an Associated Posterior Wall Acetabular Fracture (Pipkin 4) via a Kocher–Langenbeck Approach
Authors: Konda Sanjit R. , Solasz Sara Jo , Pean Christian Alexander , Lowe Dylan T. , Ganta Abhishek
Published: July 2022

A case of a 27-year-old man with a right-sided largely infra-foveal femoral head fracture dislocation with posterior wall acetabular fracture repaired via a Kocher–Langenbeck approach is presented. This is an atypical approach for fixation of the femoral head and acetabulum used because of the size and displacement of both the posterior wall fracture and the femoral head fracture. Indications for fixation of both the femoral head and the acetabulum include a displaced acetabular fracture with: (1) a fracture of the weight-bearing portion of the femoral head and/or (2) a fracture of the femoral head that engages the anterior or posterior wall. Overall, midterm outcomes are expected to be excellent to good if anatomic reduction and a concentrically stable hip joint is restored.
Social Determinants of Health Associated With the Development of Sepsis in Adults: A Scoping Review
Authors: Sheikh Fatima , Douglas William , Catenacci Vanessa , Machon Christina , Fox-Robichaud Alison E.
Published: July 2022

OBJECTIVE:

Evaluating risk for sepsis is complicated due to limited understanding of how social determinants of health (SDoH) influence the occurence of the disease. This scoping review aims to identify gaps and summarize the existing literature on SDoH and the development of sepsis in adults.

DATA SOURCES:

A literature search using key terms related to sepsis and SDoH was conducted using Medline and PubMed.

STUDY SELECTION:

Studies were screened by title and abstract and then full text in duplicate. Articles were eligible for inclusion if they: 1) evaluated at least one SDoH on the development of sepsis, 2) participants were 18 years or older, and 3) the studies were written in English between January 1970 and January 2022. Systematic reviews, meta-analyses, editorials, letters, commentaries, and studies with nonhuman participants were excluded.

DATA EXTRACTION:

Data were extracted in duplicate using a standardized data extraction form. Studies were grouped into five categories according to the SDoH they evaluated (race, socioeconomic status [SES], old age and frailty, health behaviors, and social support). The study characteristics, key outcomes related to incidence of sepsis, mortality, and summary statements were included in tables.

DATA SYNTHESIS:

The search identified 637 abstracts, 20 of which were included after full-text screening. Studies evaluating SES, old age, frailty, and gender demonstrated an association between sepsis incidence and the SDoH. Studies that examined race demonstrated conflicting conclusions as to whether Black or White patients were at increased risk of sepsis. Overall, a major limitation of this analysis was the methodological heterogeneity between studies.

CONCLUSIONS:

There is evidence to suggest that SDoH impacts sepsis incidence, particularly SES, gender, old age, and frailty. Future prospective cohort studies that use standardized methods to collect SDoH data, particularly race-based data, are needed to inform public health efforts to reduce the incidence of sepsis and help clinicians identify the populations most at risk.
Mind the target: circulating tumour DNA in gastrointestinal malignancies
Authors: Fontana Elisa , Ignatova Ekaterina
Published: July 2022

Purpose of review

Circulating tumour DNA (ctDNA) is an appealing minimally invasive tool with significant theranostic potential. In this review, we highlighted recent studies evaluating three major applications of ctDNA in gastrointestinal malignancies.

Recent findings

ctDNA demonstrated a strong prognostic value in colorectal and gastroesophageal cancers in assessing minimal residual disease after radical surgery. ctDNA-guided interventional studies are ongoing.

Tracking clonal dynamics with early identification of response and resistance to therapies is of particular interest in gastrointestinal cancers especially for established targeted therapies such as antiepidermal growth factor receptor (EGFR), BRAF inhibitors and immune checkpoint inhibitors.

Early cancer detection via ctDNA approaches is encouraging and of particular relevance in gastrointestinal cancers in view of limited screening programmes and yet poor outcomes of metastatic patients.

Although feasible and powerful tool, the clinical utility of ctDNA to guide patients’ management is challenging to demonstrate and requires further investigations in large interventional clinical trials.
Updated concepts in treatment of giant cell tumor of bone
Authors: van der Heijden Lizz , Lipplaa Astrid , van Langevelde Kirsten , Bovée Judith V.M.G. , van de Sande Michiel A.J. , Gelderblom Hans
Published: July 2022

Purpose of review

Giant cell tumors of bone (GCTB) are intermediate, locally aggressive primary bone tumors. For conventional GCTB, surgery remains treatment of choice. For advanced GCTB, a more important role came into play for systemic therapy including denosumab and bisphosphonates over the last decade.

Recent findings

In diagnostics, focus has been on H3F3A (G34) driver mutations present in GCTB. The most frequent mutation (G34W) can be detected using immunohistochemistry and is highly specific in differentiating GCTB from other giant cell containing tumors. PD-L1 expression can be used as biological marker to predict higher recurrence risks in GCTB patients.

The use of bisphosphonate-loaded bone cement is under investigation in a randomized controlled trial. A new technique consisting of percutaneous microwave ablation and bisphosphonate-loaded polymethylmethacrylate cementoplasty was proposed for unresectable (pelvic) GCTB.

Increased experience with use of denosumab raised concern on elevated recurrence rates. However, conclusions of meta-analyses should be interpreted with risk of indication bias in mind. Several small studies are published with short-course denosumab (varying from 3 to 6 doses). One small trial directly compared denosumab and zoledronic acid, with no statistical differences in radiological and clinical outcome, and nonsignificantly higher recurrence rate after denosumab. As bisphosphonates directly target neoplastic stromal cells in GCTB, larger directly comparative trials are still warranted.

Neoadjuvant denosumab is highly effective for advanced GCTB, and a short-course is advised to facilitate surgery, whereas increased recurrence rates remain of concern. Randomized controlled trials are conducted on bisphosphonate-loaded bone cement and on optimal dose and duration of neoadjuvant denosumab. PD-L1 could be a potential new therapy target in GCTB.
Use of staging for sex cord stromal tumours
Authors: Negri Serena , Grassi Tommaso , Fruscio Robert
Published: July 2022

Purpose of review

Sex cord-stromal tumours (SCSTs) are rare ovarian cancers. As in the literature, only small case series or case reports are published, gathering solid evidence about their management is challenging. Surgery plays a pivotal role, and accurate staging is one of the most important prognostic factors. This review focuses on the current evidence for surgical staging in the management of SCSTs.

Recent findings

Staging procedures have been inferred by epithelial ovarian cancers; however, they are often only partially performed, and most SCSTs therefore end up incompletely staged, raising the issue of the need for restaging or further treatments. In addition, some parts of the staging procedure have been questioned over the years, and lymphadenectomy is now considered unnecessary for SCSTs.

The generally favourable prognosis of SCSTs, the introduction of minimally invasive surgery and fertility-sparing approaches is empowering the question of which staging procedures are beneficial for these patients. We reviewed the role of each staging procedure proposed by the guidelines in light of new scientific updates.

Surgical staging should always be performed. It includes peritoneal samplings (peritoneal washing, multiple peritoneal biopsies, omental biopsy and biopsy of any suspicious area), whereas lymphadenectomy could be omitted. Laparoscopy may be considered a feasible approach.
Surgical treatment for clinical early-stage expansile and infiltrative mucinous ovarian cancer: can staging surgeries safely be omitted?
Authors: Algera Marc D. , van Driel Willemien J. , van de Vijver Koen K. , Kruitwagen Roy F.P.M. , Lok Christianne A.R.
Published: July 2022

Purpose of review

Mucinous ovarian cancers (MOCs) are categorized into infiltrative and expansile subtypes. These subtypes have different characteristics and prognoses. Patients with clinical early-stage disease of both subtypes currently undergo surgical staging (peritoneal washing, biopsies, omentectomy). Peritoneal and lymph node metastases of expansile MOC are rare, but whereas lymph node sampling (LNS) is omitted in these patients, peritoneal staging is not. Therefore, we collected all available MOC data to determine whether staging surgeries could safely be omitted in clinical early-stage expansile and infiltrative MOC.

Recent findings

Current literature confirms that peritoneal metastases are rare in expansile MOC: more than 90% of patients have early-stage disease. Only 3.4% of the patients with clinical early-stage expansile MOC had positive peritoneal washings at surgical staging. Patients with infiltrative MOC were diagnosed more frequently with advanced-stage disease (21–54%). Moreover, upstaging clinical early-stage infiltrative MOC based on positive cytology, peritoneum and omentum metastases occurred in 10.3% of the patients. Therefore, we recommend that patients with early-stage infiltrative MOC undergo peritoneal staging and LNS. However, in addition to omitting LNS, we can also safely recommend omitting peritoneal staging in patients with clinical early stage expansile MOC.

Peritoneal metastases are rare in clinical early-stage expansile MOC and peritoneal staging can therefore safely be omitted.
Radiation therapy on the axilla after neoadjuvant chemotherapy
Authors: Meattini Icro , Salvestrini Viola , Becherini Carlotta
Published: July 2022

Purpose of review

The introduction of primary systemic therapy has established a new treatment paradigm for breast cancer patients. However, recommendations for regional node irradiation after neoadjuvant chemotherapy are not supported by level I evidence, yet.

Recent findings

In addition to strategies optimising systemic treatments and surgery, current discussions focus on tailoring radiation therapy for breast cancer. Especially in view of the increasingly pivotal role of neoadjuvant chemotherapy, gauging the extent of radiation therapy in the breast and nodal volumes.

The current review focuses on recent evidence regarding radiation therapy of the breast and axilla in patients receiving neoadjuvant chemotherapy for primary breast cancer based on a PubMed and EMBASE literature search for publication years 2020–2022.