Western US States Research Articles

State-Level Social and Economic Policies and Their Association With Perinatal and Infant Outcomes.

Rates of preterm birth and infant mortality are alarmingly high in the United States. Legislated efforts may directly or indirectly reduce adverse perinatal and infant outcomes through the enactment of certain economic and social policies. We conducted a narrative review to summarize the associations between perinatal and infant outcomes and four state-level US policies. We then used a latent profile analysis to create a social and economic policy profile for each state based on the observed policy indicators. Of 27 articles identified, nine focused on tax credits, eight on paid parental leave, four on minimum wages, and six on tobacco taxes. In all but three studies, these policies were associated with improved perinatal or infant outcomes. Thirty-three states had tax credit laws, most commonly the earned income tax credit (n = 28, 56%). Eighteen states had parental leave laws. Two states had minimum wage laws lower than the federal minimum; 14 were equal to the federal minimum; 29 were above the federal minimum; and 5 did not have a state law. The average state tobacco tax was $1.76 (standard deviation = $1.08). The latent profile analysis revealed three policy profiles, with the most expansive policies in Western and Northeastern US states, and the least expansive policies in the US South. State-level social and economic policies have the potential to reduce adverse perinatal and infant health outcomes in the United States. Those states with the least expansive policies should therefore consider enacting these evidence-based policies, as they have shown a demonstratable benefit in other states.

Wine market segmentation by age generations in the Western US: expectations after the COVID-19 pandemic

PurposeThe purpose of this paper is to investigate if differences exist between the four wine-consuming generations in wine purchasing behavior, the desirability of wine attributes when making a purchase decision and information sources used. It examines if generational market segmentation is an actionable and valuable strategy for the wine industry. Generation Z, Millennials, Generation X and Baby-Boomers are the four generations examined. This research also investigates if the generations behaved differently concerning wine consumption during the COVID-19 pandemic. Further, expectations concerning future wine purchasing behavior are examined.Design/methodology/approachAn online survey was conducted between April 29, 2020 and May 7, 2020, with a sample size of 944 consumers from Western US States (California, Washington, Idaho, Oregon and Nevada). One-way analysis of variance technique and Chi-square tests were used to examine differences.FindingsSegmentation by generation is appropriate when creating products, pricing, determining channels of distribution and creating messaging for a specific wine brand. The COVID-19 pandemic caused channel shifting that is expected to continue after the pandemic.Originality/valueThis is the second academic paper that examines differences in wine purchasing behavior between generations including Generation Z and the only study that examines the purchasing behavior changes and expectations for the future by generation concerning the COVID-19 pandemic.Research limitations/implicationsA national survey should be conducted to confirm that the results from the sample that was mostly from California and neighboring states reflect the national wine consumer in the USA.Practical implicationsThe research identifies the products, prices, channels of distribution and messaging that are appropriate to target each generation.

Positive Engagement with Pets Buffers the Impact of Intimate Partner Violence on Callous-Unemotional Traits in Children.

Childhood exposure to intimate partner violence (IPV) is associated with serious psychological outcomes including increased odds of developing callous-unemotional (CU) traits and behaviors. Recent studies suggest that concomitant exposure to animal cruelty (AC) may increase this risk. However, even under these circumstances, bonds with companion animals may still be a protective factor that buffers the deleterious impact of IPV on child adjustment. This cross-sectional study evaluates whether, and to what extent, the association between exposure to IPV and children's CU and empathic-prosocial (EP) traits vary as a function of children's positive engagement with pets and exposure to AC. Participants included 204 children (aged 7-12 years; 57% Latinx) and their maternal caregiver who were recruited from domestic violence agencies in a western US state. We conducted multiple moderation analyses to evaluate each outcome individually (i.e., CU traits, EP traits), adjusting for the effects of child age, gender, and Hispanic ethnicity. Positive engagement with pets significantly moderated the relationship between IPV and CU traits, ∇R = 0.03, F (1, 195) = 7.43, β = -0.17, t(195) = -2.73, p = .007. Specifically, when high levels of positive engagement with pets is present, IPV is negatively associated with CU traits, whereas the reverse was true at low levels of positive engagement with pets. Evidence of moderation by AC was not supported. Our findings suggest that children who form close relationships with their pets in the context of IPV appear to derive important support from these animals; safeguarding the well-being of these animals may be critical to their long-term emotional health.

Privilege and Place: an exploratory study about healthcare bypass behavior.

Bypass, or utilizing healthcare outside of one's community rather than local health care, can have serious consequences on rural healthcare availability, quality, and outcomes. Previous studies of the likelihood of healthcare bypass used various individual and community characteristics. This study includes measures for individuals and communities, as well as place-based characteristics. The authors introduce the Social Vulnerability of Place Index (SoVI) - a well-established measure in disaster literature - into healthcare studies to further explain the impact of place on healthcare selection behavior. Additionally, with the use of open-ended questions, this study explains why people choose to bypass. By including each of these measures, this study provides a more nuanced and detailed understanding of how individual healthcare selection is affected by the privilege of the individual, community ties, place of residence, and primary motivator for bypass. A systematic random sample of residents from 25 rural towns in the western US state of Utah were surveyed in 2017 in the Rural Utah Community Survey. After accounting for missing data, the total sample size was 1061. This study used logistic regression to better predict the likelihood of rural healthcare bypass behavior. Measures associated with community push factors (dissatisfaction with various local amenities), community pull factors (friends in community and length of residence), individual ability (demographics, self-reported health, and distance to a hospital), and SoVI, were added to the models to examine their impact on the likelihood of bypass. The SoVI was made using census data with variables that measure both social and place inequality. Each town in the study received a SoVI score and was then categorized as having low, mean, or high social vulnerability. Qualitative open-ended responses about healthcare selection were coded for explanations given for bypassing. The pooled model showed that bypass was more likely amongst residents who were dissatisfied with local health care and more likely for females. Breaking bypass down, according to SoVI, provides a more nuanced understanding of bypass. For people living in low socially vulnerable areas, privileges such as graduating college made them more likely to bypass. For high socially vulnerable areas, privilege did not help people bypass, but disadvantages such as aging made residents less likely to bypass. Thus, by introducing the SoVI into healthcare literature, this study can compare healthcare selection behaviors of residents in low vulnerable towns, average vulnerable towns, and highly vulnerable towns. Additionally, the analysis of open-ended responses showed patterns explaining why people bypass. Policymakers and public health workers can use the SoVI to better target their healthcare outreach. Reasons for bypass include quality, selection, consistency, cost of insurance, one-stop shop, and confidentiality. Rural clinics can help residents avoid the need to bypass by improving in these areas and thus gaining patients and minimizing the risk of closure. Healthcare policymakers should focus resources on high socially vulnerable places as well as underprivileged people in low socially vulnerable places.

Moral frameworks of commercial surrogacy within the US, India and Russia

In this paper, we draw on three ethnographic studies of surrogacy we carried out separately in different contexts: the western US state of California, the south Indian state of Karnataka, and the western Russian metropolis of St Petersburg. In our interviews with surrogate mothers, intended parents, and surrogacy professionals, we traced the meanings and ideologies through which they understood the clinical labour of surrogacy. We found that in the US, interviewed surrogates, intended parents and professionals understood surrogacy as an exchange of both gifts and commodities, where gift-giving, reciprocity, and relatedness between surrogates and intended parents were the major tropes. In India, differing narratives of surrogacy were offered by its different parties: whilst professionals and intended parents framed it as a win-win exchange with an emphasis on the economic side, the interviewed surrogate mothers talked about surrogacy as creative labour of giving life. In Russia, approaches to surrogacy among the interviewed surrogate mothers, professionals and intended parents overlapped in framing it as work and a businesslike commodity exchange. We suggest these three different ways of ethical reasoning about the clinical labour of surrogacy, including justifications of women’s incorporation into this labour, were situated in local moral frameworks. We name them “repro-regional moral frameworks”, inspired by earlier work on moral frameworks as well as on reproductive nationalisms and transnational reproduction. Building on these findings, we argue that any international or global regulation of surrogacy, or indeed any moral stance on it, needs to take these local differences into account.

Women and the weight of a pandemic: A survey of four Western US states early in the Coronavirus outbreak.

In the initial months of the COVID‐19 outbreak in the United States, people struggled to adjust to the new normal. The burden of managing changes to home and work life seemed to fall disproportionately to women due to the nature of women's employment and gendered societal pressures. We surveyed residents of four western states in the first months of the outbreak to compare the experiences of women and men during this time. We found that women were disproportionately vulnerable to workplace disruptions, negative impacts on daily life, and increased mental load. Women with children and women who lost their jobs were particularly impacted. These results contribute to the growing body of findings about the disproportionate impacts of crises on women and should inform organizational and government policies to help mitigate these impacts and to enhance societal resilience in future emergencies.

Genetic analysis of invasive populations of Ventenata dubia (Poaceae): an assessment of propagule pressure and pattern of range expansion in the Western United States

Molecular markers prove to be an invaluable tool in assessing the introduction dynamics, pattern of range expansion, and population genetics of an invasive species. Ventenata dubia (Leers) Coss. (Aveneae; ventenata) is a diploid, primarily self-pollinating, annual grass native to Eurasia and Northern Africa. The grass has a detailed herbarium collection history in the western United States since its discovery in eastern Washington in 1952. Genetic analysis of 51 invasive populations (1636 individuals) of V. dubia, coupled with historical records, suggests moderate propagule pressure from multiple introductions, followed by local or regional range expansion. Allozyme analysis detected nine multilocus genotypes (MLGs) across eight western US states. A single MLG, referred to as the most common genotype, was detected in 37 of 51 (72.5%) invasive populations across all states. The other eight MLGs were generally found in fewer populations, with limited geographic distributions. Despite multiple introductions, invasive populations exhibit low levels of genetic admixture, low levels of genetic diversity within populations (A = 1.03, %P = 2.94, Hexp = 0.007) and high genetic differentiation among populations (GST= 0.864). The apparent reduced evolutionary potential of most V. dubia populations did not preclude the initial establishment and rapid spread of this species across its new range in the western US.

Valuing whole complex lives: Young adults' experiences of recovery-related principles in mental healthcare in the United States.

One in five young adults (aged 18–25 years) in the United States experiences a past year mental disorder, commonly including depression or anxiety. Yet, 1.5 million each year do not receive needed mental health services and are unlikely, in general, to seek formal mental healthcare. We aimed to inform the development of a novel programme for young adult mental health by first eliciting their positive and negative prior experiences with mental health providers. Four focus groups with 19 young adults (aged 19–26 years) recruited from the community and with moderate to severe depression and/or anxiety were conducted in 2018 in a western US state. Participants’ prior experiences with services/providers were elicited along six pre‐defined recovery‐related concepts: feeling listened to and validated, inclusivity, full information and consent, hope and optimism, connectedness, and change. Focus groups were audio‐recorded, transcribed verbatim and uploaded into NVivo version 12 software. Two independent coders used deductive thematic analysis to identify patterned responses. Feeling listened to and validated appeared as a cornerstone of other recovery concepts. Participants discussed past negative experiences with psychiatrists and regret for being put on medications in their teenage years without information or options. Hope and optimism were low because of a general focus by professionals to address immediate symptom‐based issues, rather than on improving their overall lives. Service providers’ focus on medication‐taking, and other one‐size‐fits‐all tools, was interpreted as lacking a sincere desire to help. Young adults were particularly sensitive to inauthentic interactions and superficial strategies, which left them craving care that incorporated their whole lives, acknowledged biopsychosocial interconnections and prioritised improving their lives over ‘feeling better’ in a given moment. Mental health providers should consider developing programmes that shift focus away from an exclusively medical understanding of distress and towards holistic, educational or relational approaches that value body, mind, self‐exploration and authentic connection.

Wildfire exposure to the wildland urban interface in the western US

Predicting wildfire disasters presents a major challenge to the field of risk science, especially when fires propagate long distances through diverse fuel types and complex terrain. A good example is in the western US where large tracts of public lands routinely experience large fires that spread from remote wildlands into developed areas and cause structure loss and fatalities. In this paper we provide the first comprehensive assessment of where public wildlands potentially contribute wildfire exposure to communities in the 11 western US states. We used simulation modeling to map and characterize the composition of the source landscapes (firesheds) and recipient communities in terms of fuels, fire behavior and forest management suitability. The information was used to build a prototype investment prioritization framework that targets highly exposed communities where forest and fuel management activities are feasible. We found that simulated wildfires ignited on national forests can potentially affect about half of the communities in the western US (2560 out of 5118), with 90% of exposure affecting the top 20% of the communities (n = 516). Firesheds within national forests, defined as areas that have the potential to expose communities to fire, were estimated at 35 million ha (62% of the total national forest area), and were almost three times larger than the affected community lands. Large contiguous areas of wildfire transmission were evident on a number of national forests. Only 22% of the fireshed area is forested, fire-adapted, and lies within land management designations that allow mechanical fuels management. The methods demonstrate how cross-boundary exposure can be factored into prioritizing federal investments in hazardous fuels reduction on national forests in concert with community protection measures. The results can also help scale wildfire governance systems to match the geography of risk from large wildfire events, which augments existing assessments that do not explicitly identify the source of risk to communities.

In-Depth Qualitative Interviews to Explore Healthy Environment Strategies in Food Pantries in the Western United States

BackgroundFood insecurity and chronic disease are compounded by poverty. A growing number of low-income Americans obtain food regularly from food pantry agencies to combat food insecurity. Evidence demonstrates that food environments may affect healthy dietary behaviors. Food pantry environmental interventions may improve diet quality of low-income, food insecure populations by encouraging healthy food choices. ObjectiveThe two a priori exploratory research questions were: What strategies do food pantries and food banks undertake to implement healthy environments affecting the physical space or how clients are treated; and, What challenges do pantries and food banks face during these efforts? DesignInterview data were collected March through May 2016 via in-depth telephone interviews and respondents were recruited by purposive and snowball sampling. Participants and settingsRespondents were 43 key informants who represented food bank distributors (n=16), food pantries (n=14), community partners (n=6), and antihunger advocates (n=2) within the 13 western US states. Main outcome measuresStrategies to improve the healthfulness of food pantry environments were defined and their corresponding processes described. Statistical analyses performedA thematic and descriptive analysis approach was used to elucidate healthy environment strategies. Data were analyzed by inductive modeling and network application of descriptive process codes to address the research question. ResultsSeven strategies to address the emotional and physical dimensions of a food pantry environment were identified and described. Associated challenges (n=12), characteristics of initiation (n=9), and evaluation methods (n=7) were revealed. ConclusionsFindings indicate that these strategies overlap in novel ways and further examination is warranted. Future quantitative research should assess the prevalence of these strategies in a larger sample of food pantries.

Organic farms conserve a dung beetle species capable of disrupting fly vectors of foodborne pathogens

Produce can be contaminated with enteric bacteria when livestock or wildlife feces are deposited in vegetable fields. Coprophagous beetles and flies might mitigate this threat as they feed but could also transmit pathogens if they contact plants. Improved food safety will result only from farming practices that enhance coprophage benefits and limit harms. On 49 mixed-vegetable farm fields across the western US states of Oregon and California, we found differences in coprophagous fly community composition under organic versus conventional management practices. While dung beetle (Coleoptera: Scarabaeidae) community assemblages did not differ significantly based on farm management system, organic farms fostered populations ofOnthophagus taurus, a dung beetle species that is a known antagonist of human-pathogenicEscherichia coli. We examined the possible implications for food safety of interactions between O. taurus and a common fly species on the farms, Calliphora vomitora, in microcosms containing pig (Sus scrofa) feces inoculated with human pathogenicE. coliO157:H7 and placed near broccoli (Brassica oleracea) plants. In the absence of dung beetles, Calliphora vomitorareadily acquired the bacteria and transmitted them to broccoli foliage. In the presence of the dung beetleO. taurus, however,E. coliin the soil and fly survivorship were reduced, and the pathogen was rarely recovered from foliage. Altogether, our results suggest the potential for O. taurus to both directly suppress enteric pathogens in vertebrate feces and to indirectly reduce the spread of these bacteria by co-occurring flies. The beneficial beetle O. tauruswas common only on organic farms, suggesting these benefits of beetle-fly interference for food safety could be more likely under this farming regime. Future research that investigates interactions between the many other common dung beetle and fly species on these farms would help fully delineate any net benefit of these species-rich coprophage communities, and the farming systems that shape them, for food safety.

A cumulative gravity model for inter-urban spatial interaction at different scales

The classical gravity model assumes the knowledge of origin-destination (OD) flows between places. While this is reasonable for some modes of transportation such as air travel, it presents challenges to many other applications such as road travel where the observed flow on road segments, such as annual average daily traffic (AADT), may involve traffic for multiple OD pairs. This article introduces a methodology to calibrate a cumulative gravity model on a scale-specific road network. The model infers the traffic on OD pairs from the knowledge of link flows and we document its effectiveness in predicting the bidirectional volume of traffic on highways in the United States. Census data and state AADT were used to calibrate both the noncumulative and cumulative gravity models in three different regions in the western US: Arizona only, 10 western US states, and 16 western US states. The road networks were built by defining nodes as population centers of >10,000 inhabitants for Arizona and >500,000 for the other two networks. A systematic method to remove junction nodes that do not satisfy population threshold requirements but are necessary to maintain network connectivity is presented. The cumulative gravity model performed better (with a R-squared value of 0.93 in Arizona) than the standard model, but the improvement, based on two goodness-of-fit metrics (Common Part of Commuters and least squares) was above 2% only in the Arizona network. Removal of commercial traffic from the data further improved the model's calibration in the 10-state network. A thresholding method that connects the cumulative to the standard gravity model reveals that most road trips in Arizona are within the 150-mile range and that this distance increases to 500 miles in both western networks. Potential future applications of the present work are discussed.

Abstract 3331: Association of lifestyle and clinical characteristics with receipt of radiotherapy treatment among women diagnosed with DCIS in the National Institutes of Health-AARP Diet and Health Cohort Study

Abstract Introduction: The long-term risks and benefits of breast radiotherapy for the treatment of ductal carcinoma in situ (DCIS) remain unclear. A recent study using data from the Surveillance, Epidemiology and End Results (SEER) registries showed that DCIS-associated radiotherapy treatment significantly increased risks of second non-breast cancers. To help disentangle those observations and understand whether breast cancer risk factors are related to radiotherapy treatment decision making, we aimed to identify factors associated with receipt of radiotherapy treatment for DCIS. Methods: Accordingly, among 1,628 women with DCIS who participated in the large prospective National Institutes of Health (NIH)-AARP (formerly American Association of Retired Persons) Diet and Health Cohort Study, that were diagnosed between study entry and follow up (through 31st December 2011) and eligible for inclusion, we examined associations between demographic, lifestyle and clinical factors and receipt of radiotherapy treatment. Odds ratios and 95% confidence intervals (CIs) were estimated from multivariable logistic regression models, to determine associations. Results: Among women diagnosed with DCIS, 45% (n=730) received radiotherapy treatment. No relationships were observed between receipt of radiotherapy and lifestyle factors including smoking status. The strongest associations were observed for clinical factors. Receipt of radiotherapy was associated with a more recent diagnoses period (2005-2011 versus 1995-1999; OR=1.60, 95%CI: 1.14, 2.25), diagnosis within eastern (Michigan/New Jersey) versus western US states, (OR=1.44, 95%CI: 1.07, 1.93), poorly than well-differentiated tumours (OR=1.69, 95%CI: 1.16, 2.46) and receipt of endocrine therapy (OR=3.37, 95%CI: 2.56, 4.44). Discussion: Clinical characteristics of the DCIS and temporal trends in radiotherapy use were the strongest determinants of radiotherapy treatment within this population. Receipt of radiotherapy was largely unrelated to lifestyle factors suggesting that the previously observed associations in SEER between radiotherapy treatment and risk of non-breast cancers were likely not confounded by lifestyle factors including smoking status. Thus, these findings are relevant for understanding the aetiology of subsequent secondary cancers among the increasing population of DCIS survivors. The lack of association observed for breast cancer family history and prior breast biopsy suggest that these risk factors do not influence radiotherapy clinical decision making. Citation Format: Maeve Mullooly, Diana R. Withrow, Rochelle E. Curtis, Shaoqi Fan, Linda M. Liao, Ruth M. Pfeiffer, Amy Berrington de Gonzalez, Gretchen L. Gierach. Association of lifestyle and clinical characteristics with receipt of radiotherapy treatment among women diagnosed with DCIS in the National Institutes of Health-AARP Diet and Health Cohort Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3331.

NIHILISTIC DELUSION IN THE CONTEXT OF MAJOR DEPRESSIVE DISORDER WITH CATATONIC FEATURES IN A GERIATRIC PATIENT: A CASE REPORT AND REVIEW OF LITERATURE

NIHILISTIC DELUSION IN THE CONTEXT OF MAJOR DEPRESSIVE DISORDER WITH CATATONIC FEATURES IN A GERIATRIC PATIENT: A CASE REPORT AND REVIEW OF LITERATURE

Why are Proposed Public Land Transfers a Source of Extreme Conflict and Resistance?

On the Ground The United States Federal Government owns and manages one-third of the land in the United States, primarily in western US states. There is fierce debate on whether the federal government should transfer management of public lands to state control. We reviewed a variety of agency periodicals/ websites, contemporary articles, and/or rangeland textbooks and articles to better understand the key ecologic and socioeconomic processes on public rangelands. Using a systems thinking approach, we identified a number of system archetype structures, including Fixes-that-Backfire, Success-to-the-Successful, and Escalation, in the event that public land is transferred from federal to state control. Transferring management of public lands to state control would affect rangelands from an ecological perspective (e.g., over- or undergrazing) and would have potential socioeconomic impacts on urban and rural communities in the western states through increased friction at the state legislative level rather than ...

Western US high June 2015 temperatures and their relation to global warming and soil moisture

The Western US states Washington (WA), Oregon (OR) and California (CA) experienced extremely high temperatures in June 2015. The temperature anomalies were so extreme that they cannot be explained with global warming alone. We investigate the hypothesis that soil moisture played an important role as well. We use a land surface model and a large ensemble from the weather@home modelling effort to investigate the coupling between soil moisture and temperature in a warming world. Both models show that May was anomalously dry, satisfying a prerequisite for the extreme heat wave, and they indicate that WA and OR are in a wet-to-dry transitional soil moisture regime. We use two different land surface–atmosphere coupling metrics to show that there was strong coupling between temperature, latent heat flux and the effect of soil moisture deficits on the energy balance in June 2015 in WA and OR. June temperature anomalies conditioned on wet/dry conditions show that both the mean and extreme temperatures become hotter for dry soils, especially in WA and OR. Fitting a Gaussian model to temperatures using soil moisture as a covariate shows that the June 2015 temperature values fit well in the extrapolated empirical temperature/drought lines. The high temperature anomalies in WA and OR are thus to be expected, given the dry soil moisture conditions and that those regions are in the transition from a wet to a dry regime. CA is already in the dry regime and therefore the necessity of taking soil moisture into account is of lower importance.

Metronidazole for the treatment ofTritrichomonas foetusin bulls

BackgroundTritrichomonas foetusis a sexually transmitted protozoon that causes reproductive failure, among cattle, so disruptive that many western US states have initiated control programs. Current control programs are based on the testing and exclusion of individual bulls. Unfortunately, these programs are utilizing screening tests that are lacking in sensitivity. Blanket treatment of all the exposed bulls and adequate sexual rest for the exposed cows could provide a more viable disease control option. The objectives of this study were twofold. The first objective was to demonstrate effectiveness for metronidazole treatment of a bull under ideal conditions and with an optimized treatment regime. This type of study with a single subject is often referred to as an n-of-1 or single subject clinical trial. The second objective of the current study was to review the scientific basis for the banning of metronidazole for use in Food Animals by the Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA).ResultsResults from an antimicrobial assay indicated that metronidazole at a concentration of 0.5 μg/mL successfully eliminated in vitro protozoal growth of bovineTritrichomonas foetus.The estimated effective intravenous dose was two treatments with 60 mg/kg metronidazole, 24 h apart. A bull that had tested positive forTritrichomonas foetusculture at weekly intervals for 5 weeks prior to treatment was negative forTritrichomonas foetusculture at weekly intervals for five consecutive weeks following this treatment regimen. An objective evaluation of the published evidence on the potential public health significance of using metronidazole to treatTritrichomonas foetusin bulls provides encouragement for veterinarians and regulators to consider approaches that might lead to permitting the legal use of metronidazole in bulls.ConclusionThe study demonstrated successful inhibition of Tritrichomonas foetusboth in vitro and in vivo with metronidazole. The current status of metronidazole is that the Animal Medicinal Drug Use Clarification Act of 1994 prohibits its extra-label use in food-producing animals. Veterinarians and regulators should consider approaches that might lead to permitting the legal use of metronidazole in bulls.

The Police Officer Tacit Knowledge Inventory (POTKI): Towards Determining Underlying Structure and Applicability as a Recruit Screening Tool

SummaryThe purpose of this research was to examine the potential application of the police officer tacit knowledge inventory (POTKI) as a police recruit screening tool. The POTKI is a situational judgment test and consists of knowledge gained on the job by experienced officers that is thought to be important for problem‐solving. In the present study, four police agencies from a western US state administered the POTKI along with other screening measures to police applicants. Performance of the novice recruits was subsequently rated by their supervisors using the measure of professional expertise (MOE). Principal component analysis, multiple regression analysis, and multivariate analysis of variance were conducted on the POTKI response options. POTKI response options were found to be predictive of supervisor MOE ratings. Principal component analysis results identified intrapersonal tacit knowledge components that predicted MOE metacognitive, skill, and social recognition supervisor ratings and distinguished novice from expert police officers.Copyright © 2017 John Wiley & Sons, Ltd.

Nationwide increase in hospitalizations for heroin-related soft tissue infections: Associations with structural market conditions

IntroductionLittle is known about trends in national rates of injection-related skin and soft tissue infections (SSTI) and their relationship to the structural risk environment for heroin users. Use of Mexican-sourced “Black Tar” heroin, predominant in western US states, may have greater risk for SSTI compared with eastern US powder heroin (Colombian-sourced) due to its association with non-intravenous injection or from possible contamination. MethodsUsing nationally representative hospital admissions data from the Nationwide Inpatient Sample and heroin price and purity data from the Drug Enforcement Administration, we looked at rates of hospital admissions for opiate-related SSTI (O-SSTI) between 1993 and 2010. Regression analyses examined associations between O-SSTI and heroin source, form and price. ResultsHospitalization rates of O-SSTI doubled from 4 to 9 per 100,000 nationally between 1993 and 2010; the increase concentrated among individuals aged 20–40. Heroin market features were strongly associated with changes in the rate of SSTI. Each $100 increase in yearly heroin price-per–gram-pure was associated with a 3% decrease in the rate of heroin-related SSTI admissions. Mexican-sourced-heroin-dominant cities had twice the rate of O-SSTI compared to Colombian-sourced-heroin-dominant cities. DiscussionHeroin-related SSTI are increasing and structural factors, including heroin price and source-form, are associated with higher rates of SSTI hospital admissions. Clinical and harm reduction efforts should educate heroin users on local risk factors, e.g., heroin type, promote vein health strategies and provide culturally sensitive treatment services for persons suffering with SSTI.

Comparing US State Health Efficiencies Employing Data Envelope Analysis

Over the past several decades, there have been improvements in health outcomes such as life expectancy, infant mortality rates and maternal mortality rates. Yet, the improvements in national health indicators often have not resulted in significantly reducing burdens of chronic disease among US citizens. Burden of disease studies examining population health employ assessments to measure chronic disease and disability burdens. We used the disability-adjusted life year (DALY) as the measure for overall disease burden. Our paper evaluates the efficiency of health care resources on a state-by-state population basis in the US by examining the 50 states through the application of a non-parametric method known as data envelope analysis (DEA). DEA allows multi-input and multioutput analysis. We conducted analyses to compare each state vis-a-vis the other states to examine the efficiency of the use of health resources in relation to disease burdens. We used three input variables-the number of physicians per 100,000 residents per state, the number of hospital beds per 1000 inhabitants per state and the public health funding per capita per state and one output variable- disability adjusted life years to reflect burden of disease. The study was conducted over a six-year duration (2008-2014). Our study demonstrates that there are varying levels of efficiency in the utilization of health resources (i.e. number of physicians, number of hospital beds and public health expenditures) among the 50 US states in affecting the output of disease burden. It appears that the Western US states and the northern most Midwest regions are the most efficient relative to the other states. The least efficient states were clustered in the south Midwestern region. The states showing the most improvement include the previously least efficient south-eastern states. This indicates that these south-eastern states are “catching up” or improving relative to the other states, but still have a large gap in efficiency utilization. The Western states with high efficiency also had higher use of technology. In contrast, the North-Midwestern states with high efficiency values had lower use of technology. This finding appears to show that these North-Midwestern states are efficient with their use of health resources, but their efficiency is not due to technological improvements as in the Western states.