Ban, Fee, Take-Back/Recycle: Which Approach Wins Out in the End?

Plastic bags provide cost-effective, ease of use utility to communities, while also producing disposal and blight costs in the United States. The role of policies to target their usage has not been fully considered, partially due to the state-centric model of waste policy implementation, independent local government actors, and the absence of an overarching model for assessing effectiveness of plastic bag policies. Due to this oversight, this study examines the plastic bag policy process. Existing literature ignores the emergence of plastic bag take-back programs, recycling programs, and much of the action taken in states, other than New York and California, to combat plastic bag pollution. Furthermore, there are no clear lines showing the motivation for plastic bag policy action. The main objectives of this thesis are to 1) understand the effectiveness of bans, levies, take-back programs, and recycling programs; and 2) establish the groundwork for when bans, levies, take-back/recycling programs are useful, so communities can use this information as a framework for plastic bag policies. In order to examine these objectives the following research question will be addressed: Under what conditions is a ban, fee, or a take-back/recycling program best to address the end of life attributes of plastic bags in the waste stream

An Exploration into Effective Pedagogies in Occupational Therapy Education for the Safe and Effective Use of Physical Agents

Occupational therapy educational standards, established by the Accreditation Council for Occupational Therapy Education (ACOTE), require students to demonstrate knowledge and use of the safe and effective application of physical agents. A recent change requires educators to reflect on pedagogical approaches for electrotherapeutic and deep thermal agents. With a lack of research on pedagogical approaches to teaching physical agents, research on this important topic is essential. The purpose of this study was to identify education and training methods that facilitate the development of competence with complex physical agents. This study used a mixed-methods survey design with follow-up interviews. The survey sample included 98 occupational therapists/Certified Hand Therapists with six follow-up semi-structured interviews. Descriptive statistics and one-way ANOVAs were used to analyze quantitative data. Inductive coding and deductive coding guided by Miller’s Pyramid and Bloom’s Taxonomy were used to analyze qualitative data. One-way ANOVAs indicated continuing education and fieldwork resulted in higher levels of independence when compared with manufacturer’s sales representative training (p

Systematic and Stochastic Variations in Pulsar Dispersion Measures

We analyze deterministic and random temporal variations in dispersion measure (DM) from the full three-dimensional velocities of pulsars with respect to the solar system, combined with electron-density variations on a wide range of length scales. Previous treatments have largely ignored the pulsar's changing distance while favoring interpretations involving the change in sky position from transverse motion. Linear trends in pulsar DMs seen over 5-10~year timescales may signify sizable DM gradients in the interstellar medium (ISM) sampled by the changing direction of the line of sight to the pulsar. We show that motions parallel to the line of sight can also account for linear trends, for the apparent excess of DM variance over that extrapolated from scintillation measurements, and for the apparent non-Kolmogorov scalings of DM structure functions inferred in some cases. Pulsar motions through atomic gas may produce bow-shock ionized gas that also contributes to DM variations. We discuss possible causes of periodic or quasi-periodic changes in DM, including seasonal changes in the ionosphere, annual variation of the solar elongation angle, structure in the heliosphere-ISM boundary, and substructure in the ISM. We assess the solar cycle's role on the amplitude of ionospheric and solar-wind variations. Interstellar refraction can produce cyclic timing variations from the error in transforming arrival times to the solar system barycenter. We apply our methods to DM time series and DM gradient measurements in the literature and assess consistency with a Kolmogorov medium. Finally, we discuss the implications of DM modeling in precision pulsar timing experiments.Comment: 24 pages, 17 figures, published in Ap

The Rights of Parents with Children in Foster Care: Removals Arising from Economic Hardship and the Predicative Power of Race

The following symposium at the Association of the Bar of the City of New York explores the predicament posed by the surge of child removals through neglect petitions, and the subsequent placement of those children in foster care. The panel, whose comments are published here, offer some poignant reflections on the crisis of the child welfare system

USE OF PERIPHERAL VASOPRESSORS IN EARLY SEPSIS-INDUCED HYPOTENSION ACROSS MICHIGAN HOSPITALS

INTRODUCTION: Recent data suggest it may be safe to administer vasopressors via peripheral IV (PIV), challenging convention that vasopressors must be delivered centrally. Surviving Sepsis Campaign 2021 guidelines suggest using peripheral vasopressors as a bridge to central access. However, little is known about vasopressor initiation in practice. METHODS: Cohort study of patients hospitalized with community-onset sepsis at 12 hospitals in the Hospital Medicine Safety Consortium (HMS) sepsis initiative. HMS is a Collaborative Quality Initiative sponsored by Blue Cross Blue Shield of Michigan. A random sample of adult sepsis hospitalizations between 11/2020-1/2022 were included. Data were abstracted by trained abstractors. We sought to determine how commonly vasopressors were initiated via PIV vs central access across hospitals. HMS-Sepsis is expanding to 69 hospitals. Here we present pilot data; full cohort analysis is in process. RESULTS: of 1,901 patients in the HMS-Sepsis registry at the time of pilot data analysis, 440 (23.1%) had hypotension (defined by mean arterial pressure\u3c 65mmHg, systolic blood pressure\u3c 90mmHg, and/or vasopressor initiation) within 3 hours of hospital arrival. of these, 160 (36.4%) received vasopressors within 6 hours of hospital arrival. Route of initial vasopressor was PIV in 122 (76.3%), central access in 30 (18.8%), midline catheter in 1 (0.6%), oral (ie, midodrine) in 5 (3.1%), and unknown in 2 (1.3%). Across all hospitals, 50.0% to 91.7% of vasopressor initiation was via PIV (median 83.3%). Among 122 patients with vasopressor initiation via PIV, 66 (54.1%) received a 2nd vasopressor, after a median of 2.8 hrs [IQR 1, 8] from 1st vasopressor. Route of 2nd vasopressor was PIV in 27 (40.9%) and central access in 30 (45.4%). Time from hypotension to vasopressor initiation did not differ between patients receiving initial vasopressor via PIV vs central access (median 1.9 vs 2.1 hrs, p=0.79). Likewise, IV fluids within 6 hrs (median 2.0 vs 2.1L, p=0.78), hospitalization length (median 7 vs 6 days, p=0.31), and inhospital mortality (33.6% vs 40.0%, p=0.51) were similar. CONCLUSIONS: In this 12-hospital cohort, vasopressors were most frequently initiated peripherally. Outcomes were similar between patients in whom vasopressors were initiated via peripheral vs central access