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Data suggest poorer bereavement outcomes for lesbian, gay and bisexual people, but this has not been estimated in population-based research. This study compared bereavement outcomes for partners of same-gender and different-gender decedents.
Methods
In this population-based, cross-sectional survey of people bereaved of a civil partner or spouse 6–10 months previously, we used adjusted logistic and linear regression to investigate outcomes of interest: (1) positive screen on Inventory of Complicated Grief (ICG), (2) positive screen on General Health Questionnaire (GHQ), (3) grief intensity (ICG) and (4) psychiatric symptoms (GHQ-12).
Results
Among 233 same-gender partners and 329 of different-gender partners, 66.1% [95% confidence interval (CI) 60.0–72.2] and 59.2% [95% CI (53.9–64.6)] respectively screened positive for complicated grief on the ICG, whilst 76.0% [95% CI (70.5–81.5)] and 69.3% [95% CI (64.3–74.3)] respectively screened positive on the GHQ-12. Same-gender bereaved partners were not significantly more likely to screen positive for complicated grief than different-gender partners [adjusted odds ratio (aOR) 1.56, 95% CI (0.98–2.47)], p = 0.059, but same-gender bereaved partners were significantly more likely to screen for psychiatric caseness [aOR 1.67 (1.02, 2.71) p = 0.043]. We similarly found no significant association of partner gender with grief intensity [B = 1.86, 95% CI (−0.91to 4.63), p = 0.188], but significantly greater psychological distress for same-gender partners [B = 1.54, 95% CI (−0.69–2.40), p < 0.001].
Conclusions
Same-gender bereaved partners report significantly more psychological distress. In view of their poorer sub-clinical mental health, clinical and bereavement services should refine screening processes to identify those at risk of poor mental health outcomes.
Something about the way the South looks has long fascinated outsiders and southerners alike. It seems to invite the stunning cover of William Eggleston's The Beautiful Mysterious, which is a blue-tinged, illuminated, nearly empty, parking lot. Another example: the “rust aesthetic” associated with the banged-up signs so common in William Christenberry's photographs seems like an authentic southern thing. In fact, a certain orange-brown, rustlike color permeates many of the photographs in The Beautiful Mysterious. A more shocking visual signifier of southernness has historically been the lynched black body, as, for example, that of Emmett Till in 1955. As it turns out, Eggleston (b. 1939) grew up in Sumner, MS where the murderers of the Chicago teenager were put on trial – and acquitted.
On March 28, 2019, less than two weeks after the Christchurch, New Zealand massacre, the United Nations Security Council unanimously adopted Resolution 2462. It stands as a signal of the United Nations' continued recognition of the critical importance of finance in combatting and countering global terrorism. Unfortunately, it may also be an indication that states are not doing what they have been urged to do in previous resolutions. The text of 2462 and its preamble are riddled with language like “Reminding,” “Reaffirming,” “Encouraging,” and “Noting with Concern,” rather than with language and ideas that break new ground.
We show that propensity score matching (PSM), an enormously popular method of preprocessing data for causal inference, often accomplishes the opposite of its intended goal—thus increasing imbalance, inefficiency, model dependence, and bias. The weakness of PSM comes from its attempts to approximate a completely randomized experiment, rather than, as with other matching methods, a more efficient fully blocked randomized experiment. PSM is thus uniquely blind to the often large portion of imbalance that can be eliminated by approximating full blocking with other matching methods. Moreover, in data balanced enough to approximate complete randomization, either to begin with or after pruning some observations, PSM approximates random matching which, we show, increases imbalance even relative to the original data. Although these results suggest researchers replace PSM with one of the other available matching methods, propensity scores have other productive uses.
To investigate the relative importance of 10 attributes identified in prior studies as essential for effective disaster medical responders and leaders.
Methods
Emergency and disaster medical response personnel (N=220) ranked 10 categories of disaster worker attributes in order of their importance in contributing to the effectiveness of disaster responders and leaders.
Results
Attributes of disaster medical leaders and responders were rank ordered, and the rankings differed for leaders and responders. For leaders, problem-solving/decision-making and communication skills were the highest ranked, whereas teamwork/interpersonal skills and calm/cool were the highest ranked for responders.
Conclusions
The 10 previously identified attributes of effective disaster medical responders and leaders include personal characteristics and general skills in addition to knowledge of incident command and disaster medicine. The differences in rank orders of attributes for leaders and responders suggest that when applying these attributes in personnel recruitment, selection, and training, the proper emphasis and priority given to each attribute may vary by role. (Disaster Med Public Health Preparedness. 2019;13:700–703)
During the Obama presidency, Republicans made major gains in state legislative elections, especially in the South and the Midwest. Republicans’ control grew from 13 legislatures in 2009 to 32 in 2017. A major but largely unexamined consequence of this profound shift in state-level partisan control was the resurgence of efforts to re-segregate public education. We examine new re-segregation policies, especially school district secession and anti-busing laws, which have passed in these states. We argue that the marked reversal in desegregation patterns and upturn in re-segregated school education is part of the Republican Party's anti-civil rights and anti-federal strategies, dressed up in the ideological language of colour-blindness.
Objectives: The aim of this study was to investigate alterations in functional connectivity, white matter integrity, and cognitive abilities due to sports-related concussion (SRC) in adolescents using a prospective longitudinal design. Methods: We assessed male high school football players (ages 14–18) with (n=16) and without (n=12) SRC using complementary resting state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) along with cognitive performance using the Immediate Post-Concussive Assessment and Cognitive Testing (ImPACT). We assessed both changes at the acute phase (<7 days post-SRC) and at 21 days later, as well as, differences between athletes with SRC and age- and team-matched control athletes. Results: The results revealed rs-fMRI hyperconnectivity within posterior brain regions (e.g., precuneus and cerebellum), and hypoconnectivity in more anterior areas (e.g., inferior and middle frontal gyri) when comparing SRC group to control group acutely. Performance on the ImPACT (visual/verbal memory composites) was correlated with resting state network connectivity at both time points. DTI results revealed altered diffusion in the SRC group along a segment of the corticospinal tract and the superior longitudinal fasciculus in the acute phase of SRC. No differences between the SRC group and control group were seen at follow-up imaging. Conclusions: Acute effects of SRC are associated with both hyperconnectivity and hypoconnectivity, with disruption of white matter integrity. In addition, acute memory performance was most sensitive to these changes. After 21 days, adolescents with SRC returned to baseline performance, although chronic hyperconnectivity of these regions could place these adolescents at greater risk for secondary neuropathological changes, necessitating future follow-up. (JINS, 2018, 24, 781–792)
Retrospective data evaluated increases in advanced medical support for children with medically attended acute respiratory illness (MAARI) during influenza outbreak periods (IOP). Advanced support included hospitalisation, intensive care unit admission, or mechanical ventilation, for children aged 0–17 years hospitalised in Maryland's 50 acute-care hospitals over 12 influenza seasons. Weekly numbers of positive influenza tests in the Maryland area defined IOP for each season as the fewest consecutive weeks, including the peak week containing at least 85% of positive tests with a 2-week buffer on either side of the IOP. Peak IOP (PIOP) was defined as four consecutive weeks containing the peak week with the most number of positive influenza tests. Off-PIOP was defined as the ‘shoulder’ weeks during each IOP. Non-influenza season (NIS) was the remaining weeks of that study season. Rate ratios of mean daily MAARI-related admissions resulting in advanced medical support outcomes during PIOP or Off-PIOP were compared with the NIS and were significantly elevated for all 12 study seasons combined. The results suggest that influenza outbreaks are associated with increased advanced medical support utilisation by children with MAARI. We feel that this data may help preparedness for severe influenza epidemics or pandemic.
Philip Rieff's (1922– 2006) intellectual and cultural inheritance derives from a variety of sources. For example, he was not a religious Jew and mentions of the Holocaust hardly make an appearance in his early work. Yet increasingly “Auschwitz” takes on great moral and cultural significance in his late writings. Rieff made his intellectual name with an intellectual biography of Sigmund Freud, co- written with his first wife Susan Sontag. It still stands as a major achievement, even if his own attitude toward Freud moved from admiration to disapproval over the years. As a sociologist, Rieff was influenced by Emile Durkheim's emphasis on the relationship between a society's cohesion and its religious ethos, not to mention Max Weber's writings on authority and his idea of modernity as intertwined with secularization, a special preoccupation of modern German thought. The philosophy of culture hammered out by Friedrich Nietzsche was also of fundamental importance for Rieff's later work, particularly, of course, for his “death of God” anti- theology. Besides that Rieff was steeped in the advanced art and culture of the twentieth century. In this he was a product of an eclectic and pluralist modernist culture.
But as a theorist of culture, Rieff was indifferent to the philosophical tradition of Greece as it has shaped modern thought, particularly German thought. There's no evidence that Rieff accepted Martin Heidegger's version of Western thought as Seinsvergessenheit (the forgetting of Being). Though he admired Hannah Arendt as “one of the most trustworthy guides to our time and its past,” he never really responded to her claim that the history of Western political ideas was the story of the loss of authentic political thinking. And unlike another (adopted) American conservative, Leo Strauss, with whom he is sometimes compared, Rieff did not choose Athens over Jerusalem, rationality over revelation, natural law over God's commandments. Unlike both Strauss and Arendt, he was largely dismissive of politics, which he considered to be the pursuit of crass material interests and power grabbing. Still, in his late writings, he identified the Hellenic origins of the West with what he called the “first world,” one founded on “taboo” and guided by “fate.” The third world, which we the living allegedly now inhabit, sees the world in terms of the “primacy of possibility” (aka POP), and it is guided by “rules” that regulate the roles the self continually tries on and sheds.
Integration of the III–V material systems on Si is an enabling technology for achieving high efficiency heterojunction Si-based photovoltaic devices. Gallium phosphide (GaP) offers numerous potential electrical, optical, and material advantages over amorphous silicon (a-Si) for the realization of several heterojunction solar cell designs. In this paper, details are given for the growth, fabrication, and characterization of different n-GaP/n-Si heterojunction solar cells to explore the effect of GaP as a carrier-selective contact. The cell performance is promising with high Si bulk lifetime (∼2.2 ms at the injection level of 1015 cm−3) and an open-circuit voltage of 618 mV and an efficiency of 13.1% in this new solar cell design. In addition to GaP as an electron-selective contact, MoOx was successfully implemented as a hole-selective contact in the n-GaP/n-Si heterojunction solar cell, increasing efficiency to 14.1% by improving the short wavelength response. The Si bulk lifetime is maintained during growth of GaP on Si by two different approaches and their effects on GaP/Si solar cell performance are also presented.
The aging population means more men are diagnosed with prostate cancer, resulting in greater demand for treatment. Robot-assisted radical prostatectomy (RARP) claims to offer additional benefits to patients and providers. The independent Victorian Health Technology Program Advisory Committee assessed safety, clinical effectiveness and cost effectiveness evidence and financial impact to inform policy, access and reimbursement decision-making by state government policy makers and public hospital providers.
Methods:
Public and private hospital activity and costs for 2008–09 to 2012–13 from the Victorian Admitted Episodes Database (VAED) and the Victorian Cost Data Collection (VCDC) were identified. Data were extracted and reviewed based on (i) DRGs M01A and B, (ii) primary diagnostic code C61 (ICD-10-AM), and (iii) Australian Classification of Health Interventions procedure codes for open (ORP), laparoscopic (LRP) and RARP, supplemented by Victorian Prostate Cancer Clinical Registry data. English language Health Technology Assessments (HTAs)/systematic reviews published January 2009 to January 2015 were identified and analysed with comparative clinical outcomes data for RARP vs. ORP and RARP vs. LRP analysed. Not all reported the same data and most outcomes data presented were odds ratios and risk ratios.
Results:
RARP offers patients a shorter length of stay (LOS) compared with ORP or LRP, but the procedure takes longer to perform. While RARP has similar safety and clinical effectiveness profiles compared with ORP and LRP, published data do not unequivocally demonstrate that RARP is superior to ORP or LRP in terms of clinical outcomes. RARP is more expensive than ORP and LRP. The cost differential increases when capital costs are taken into account. Cost offsets from a reduced LOS are insufficient to justify the higher cost.
Conclusions:
Since RARP produces similar clinical outcomes to ORP and LRP but at a higher cost, the Victorian Health Technology Program Advisory Committee considered the case for public sector support of RARP is weak and provided two recommendations: (i) State Government resources are not used to procure RARP capital equipment; (ii) public hospitals can refer patients to a RARP provider, provided costs are negotiated prior to patient transfer and fully covered by the referring hospital.
The Yellow Chat Epthianura crocea is comprised of three disjunct subspecies. Subspecies E. c. macgregori (Capricorn Yellow Chat) is listed as Critically Endangered under the EPBC Act and has a distribution that also appears to be disjunct, with a limited geographic area of less than 7,000 ha. Some populations are threatened by rapid industrial development, and it is important for conservation of the subspecies to determine the extent to which the putative populations are connected. We used 14 microsatellite markers to measure genetic diversity and to determine the extent of gene flow between two disjunct populations at the northern and southern extremes of the subspecies’ range. No significant differences in genetic diversity (number of alleles and heterozygosity) were observed, but clear population structuring was apparent, with obvious differentiation between the northern and southern populations. The most likely explanation for reduced gene flow between the two populations is either the development of a geographic barrier as a consequence of shrinkage of the marine plains associated with the rise in sea levels following the last glacial maxima, or reduced connectivity across the largely unsuitable pasture and forest habitat that now separates the two populations, exacerbated by declining population size and fewer potential emigrants. Regardless of the mechanism, restricted gene flow between these two populations has important consequences for their ongoing conservation. The relative isolation of the smaller southern groups (the Fitzroy River delta and Curtis Island) from the much larger northern group (both sides of the Broad Sound) makes the southern population more vulnerable to local extinction. Conservation efforts should focus on nature refuge agreements with land owners agreeing to maintain favourable grazing management practices in perpetuity, particularly in the northern area where most chats occur. Supplemental exchanges of individuals from northern and southern populations should be explored as a way of increasing genetic diversity and reducing inbreeding.
To identify key attributes of effective disaster/mass casualty first responders and leaders, thereby informing the ongoing development of a capable disaster health workforce.
Methods
We surveyed emergency response practitioners attending a conference session, the EMS State of the Science: A Gathering of Eagles. We used open-ended questions to ask participants to describe key characteristics of successful disaster/mass casualty first responders and leaders.
Results
Of the 140 session attendees, 132 (94%) participated in the survey. All responses were categorized by using a previously developed framework. The most frequently mentioned characteristics were related to incident command/disaster knowledge, teamwork/interpersonal skills, performing one’s role, and cognitive abilities. Other identified characteristics were related to communication skills, adaptability/flexibility, problem solving/decision-making, staying calm and cool under stress, personal character, and overall knowledge.
Conclusions
The survey findings support our prior focus group conclusion that important characteristics of disaster responders and leaders are not limited to the knowledge and skills typically included in disaster training. Further research should examine the extent to which these characteristics are consistently associated with actual effective performance of disaster response personnel and determine how best to incorporate these attributes into competency models, processes, and tools for the development of an effective disaster response workforce. (Disaster Med Public Health Preparedness. 2016;page 1 of 4)