Advancing Maternal Health Equity in Southern States: What Are Medicaid Programs Doing and What More Could They Do?

The US is facing a severe maternal morbidity and mortality crisis, and Black women and other women of color are at particularly high risk. Maternal mortality is also higher in the South than in other regions. Given evidence that abortion restrictions are associated with higher maternal mortality, such risks could grow under the recent Supreme Court ruling overturning Roe v. Wade, especially in the South, where in many states abortion is now severely restricted. With more than 40 percent of all births nationally, 65 percent of births among Black women, and 59 percent of births among Hispanic women covered by Medicaid, state Medicaid policies and practices have the potential to improve maternal health and reduce racial and ethnic inequities in maternal health outcomes.For this study on Medicaid and maternal health, we conducted interviews with national experts, a national policy scan, and case studies in three Southern states (Georgia, Louisiana, and Texas) that are using various approaches to promote improvements in maternal health care for their Medicaid populations. We sought to identify facilitators of and barriers to maternal health equity and promising programs and policy levers that could advance maternal health equity to inform approaches in other Southern states

The adaptation of the Affective Norms for English Words (ANEW) for European Portuguese

This study presents the adaptation of the Affective Norms for English Words (ANEW; Bradley & Lang, 1999a) for European Portuguese (EP). The EP adaptation of the ANEW was based on the affective ratings made by 958 college students who were EP native speakers. Participants assessed about 60 words by considering the affective dimensions of valence, arousal, and dominance, using the Self-Assessment Manikin (SAM) in either a paper-and-pencil and a web survey procedures. Results of the adaptation of the ANEW for EP are presented. Furthermore, the differences between EP, American (Bradley & Lang, 1999a), and Spanish (Redondo, Fraga, Padrón, & Comesaña, 2007) standardizations were explored. Results showed that the ANEW words were understood in a similar way by EP, American, and Spanish subjects, although some sex and cross-cultural differences were observed. The EP adaptation of the ANEW is shown to be a valid and useful tool that will allow researchers to control and/or manipulate the affective properties of stimuli as well as to develop cross-linguistic studies. The normative values of EP adaptation of the ANEW can be downloaded at http://brm.psychonomic-journals.org/content/supplemental.COMPETE - Programa Operacional Factores de CompetitividadeFundo Europeu de Desenvolvimento Regional - FEDERQuadro de Referência Estratégico Nacional - QRENFundação para a Ciência e a Tecnologia (FCT) - research project “Procura Palavras (P-Pal ): A software program for deriving objective and subjective psycholinguistic indices for European Portuguese words

Current Wildland Fire Patterns and Challenges in Europe : A Synthesis of National Perspectives

Changes in climate, land use, and land management impact the occurrence and severity of wildland fires in many parts of the world. This is particularly evident in Europe, where ongoing changes in land use have strongly modified fire patterns over the last decades. Although satellite data by the European Forest Fire Information System provide large-scale wildland fire statistics across European countries, there is still a crucial need to collect and summarize in-depth local analysis and understanding of the wildland fire condition and associated challenges across Europe. This article aims to provide a general overview of the current wildland fire patterns and challenges as perceived by national representatives, supplemented by national fire statistics (2009-2018) across Europe. For each of the 31 countries included, we present a perspective authored by scientists or practitioners from each respective country, representing a wide range of disciplines and cultural backgrounds. The authors were selected from members of the COST Action "Fire and the Earth System: Science & Society" funded by the European Commission with the aim to share knowledge and improve communication about wildland fire. Where relevant, a brief overview of key studies, particular wildland fire challenges a country is facing, and an overview of notable recent fire events are also presented. Key perceived challenges included (1) the lack of consistent and detailed records for wildland fire events, within and across countries, (2) an increase in wildland fires that pose a risk to properties and human life due to high population densities and sprawl into forested regions, and (3) the view that, irrespective of changes in management, climate change is likely to increase the frequency and impact of wildland fires in the coming decades. Addressing challenge (1) will not only be valuable in advancing national and pan-European wildland fire management strategies, but also in evaluating perceptions (2) and (3) against more robust quantitative evidence.Peer reviewe

Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago

Background: Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann's procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods: This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results: 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P < 0.001). 30-day mortality was higher in HP patients (13.7%), especially in case of bowel perforation and diffused peritonitis. 1-year follow-up showed no differences on ostomy reversal rate between HP and RPA. (P = 0.127). A backward likelihood logistic regression model showed that RPA was preferred in younger patients, having low ASA score (≤ 3), in case of large bowel obstruction, absence of colonic ischemia, longer time from admission to surgery, operating early at the day working hours, by a surgeon who performed more than 50 colorectal resections. Conclusions: After 100 years since the first Hartmann's procedure, HP remains the most common treatment for left-sided colorectal emergencies. Treatment's choice depends on patient characteristics, the time of surgery and the experience of the surgeon. RPA should be considered as the gold standard for surgery, with HP being an exception

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

What imagination teaches

Thesis: Ph. D., Massachusetts Institute of Technology, Department of Linguistics and Philosophy, 2016.Cataloged from PDF version of thesis.Includes bibliographical references.An investigation of the imagination, as both a mental process and a capacity to acquire knowledge about the world and other minds. It is argued that imagination is a unique mental process, whose primary feature is the capacity to construct and manipulate sets of mental representations. This feature unifies the diverse activities we call imaginings into a single class. In addition, use of this capacity in a rule-based way, under the constraint of prior beliefs, can help us acquire knowledge of everyday facts. An examination is then made into the limitations of such a capacity. It is argued that imagination can aid in rational decision-making, even in cases which may involve substantial transformation of the agent. Finally, a case is made that we can improve our capacity to gain knowledge of the mental states of others by careful application of imagination.by Sofia Ortiz-Hinojosa.Ph. D

Environmental management and environmental awareness in students of the Professional school of Business Administration of a private university of Lima Sur – 2020

El objetivo de este estudio fue establecer la relación entre la gestión ambiental y la conciencia ambiental en los estudiantes de la Escuela Profesional de Administración de Empresas de una Universidad Privada de Lima Sur. El estudio realizado fue de tipo aplicado, nivel correlacional, diseño no experimental y enfoque cuantitativo, desarrollada en una muestra conformada por 100 estudiantes. Los instrumentos utilizados fueron dos cuestionarios conformados por 20 ítems para la prueba de gestión ambiental y 19 ítems para la prueba de conciencia ambiental. Los cuestionarios presentaron niveles excelentes de consistencia interna cuyos resultados alfa de Cronbach fue de 0.963 para el cuestionario de gestión ambiental y 0.971 para el cuestionario de conciencia ambiental. Los resultados de la prueba de correlación de Pearson permitieron afirmar que existe relación considerable entre gestión ambiental y conciencia ambiental demostrado mediante un resultado de 0.627 y un nivel de significación bilateral de 0.000, entendiéndose que mientras se realice una gestión ambiental adecuada los estudiantes desarrollan su conciencia ambiental de manera eficiente durante su formación profesional

Multimodal Associations (Network for Sensory Research Toronto Workshop on Perceptual Learning: Question Two)

This is an excerpt from a report that highlights and explores five questions which arose from the workshop on perceptual learning and perceptual recognition at the University of Toronto, Mississauga on May 10th and 11th, 2012. This excerpt explores the question: What are the origins of multimodal associations

Cognitive Penetration? (Network for Sensory Research Toronto Workshop on Perceptual Learning: Question Four)

This is an excerpt from a report that highlights and explores five questions which arose from the workshop on perceptual learning and perceptual recognition at the University of Toronto, Mississauga on May 10th and 11th, 2012. This excerpt explores the question: What counts as cognitive penetration

Philosophy/Psychology Collaboration (Network for Sensory Research Toronto Workshop on Perceptual Learning: Question Five)

This is an excerpt from a report that highlights and explores five questions which arose from the workshop on perceptual learning and perceptual recognition at the University of Toronto, Mississauga on May 10th and 11th, 2012. This excerpt explores the question: How can philosophers and psychologists most fruitfully collaborate