When Families, Organizational Culture, and Policy Collide: A Mixed Method Study of Alternative Response

Objective Alternative response (AR) is a family-centered, preventative approach for child protection systems. This study first examined what family and case factors predicted re-investigation and then explored which organizational factors influence caseworker and agency implementation of AR. Method Using administrative data from child protection reports, AR families (N = 9,959) and traditional response (TR) families (N = 13,974) were followed for 18 months to determine re-investigation rates using multilevel modeling where families were nested in county of residence. Four focus groups with 14 participants were conducted to discuss the quantitative findings, organizational culture, and implementation of AR. Results AR families had lower odds of re-investigation; males and younger children also had lower odds. Families with multiple children, prior investigations, receipt of Medicaid, and medium/high risk had higher odds of re-investigation. AR caseworkers provided insights regarding the intersection of family factors, organizational culture and support, and agency implementation of AR. Although participants supported AR, their ability to implement it was influenced by agency support and availability of resources to carry out the basic requirements of the policy. A clear distinction in responses emerged between those who held dual cases versus those holding only AR cases. Conclusion Although AR reduces the odds of re-investigation for low-risk families and was endorsed by caseworkers, AR policy in practice is complex and requires further evaluation, particularly from the perspective of AR caseworkers who faced implementation hurdles

Perturbative framework for the pi(+)pi(-) atom

The perturbative framework is developed for the calculation of the pi(+)pi(-) atom characteristics on the basis of the field-theoretical Bethe-Salpeter approach. A closed expression for the first-order correction to the pi(+)pi(-) atom lifetime has been obtained.Comment: 8 pages, LaTeX-fil

Direct calculation of the probability of pionium ionization in the target

We performed the first direct calculation of the probability of pionium (pi+pi- atom) ionization in the target. The dependence of the probability of pionium ionization in the target as a function of the pionium lifetime is established. These calculations are of interest of the DIRAC experiment at CERN, which aims to measure the pionium lifetime with high precision.Comment: 11 pages, 4 figures; submitted to "Physics of Atomic Nuclei" ("Yadernaya Fizika"

Quantification of left ventricular remodeling in response to isolated aortic or mitral regurgitation

<p>Abstract</p> <p>Background</p> <p>The treatment of patients with aortic regurgitation (AR) or mitral regurgitation (MR) relies on the accurate assessment of the severity of the regurgitation as well as its effect on left ventricular (LV) size and function. Cardiovascular Magnetic Resonance (CMR) is an excellent tool for quantifying regurgitant volumes as well as LV size and function. The 2008 AHA/ACC management guidelines for the therapy of patients with AR or MR only describe LV size in terms of linear dimensions (i.e. end-diastolic and end-systolic dimension). LV volumes that correspond to these linear dimensions have not been published in the peer-reviewed literature. The purpose of this study is to determine the effect of regurgitant volume on LV volumes and chamber dimensions in patients with isolated AR or MR and preserved LV function.</p> <p>Methods</p> <p>Regurgitant volume, LV volume, mass, linear dimensions, and ejection fraction, were determined in 34 consecutive patients with isolated AR and 23 consecutive patients with MR and no other known cardiac disease.</p> <p>Results</p> <p>There is a strong, linear relationship between regurgitant volume and LV end-diastolic volume index (aortic regurgitation r²= 0.8, mitral regurgitation r²= 0.8). Bland-Altman analysis of regurgitant volume shows little interobserver variation (AR: 0.6 ± 4 ml; MR 4 ± 6 ml). The correlation is much poorer between regurgitant volume and commonly used clinical linear measures such as end-systolic dimension (mitral regurgitation r²= 0.3, aortic regurgitation r²= 0.5). For a given regurgitant volume, AR causes greater LV enlargement and hypertrophy than MR.</p> <p>Conclusion</p> <p>CMR is an accurate and robust technique for quantifying regurgitant volume in patients with AR or MR. Ventricular volumes show a stronger correlation with regurgitant volume than linear dimensions, suggesting LV volumes better reflect ventricular remodeling in patients with isolated mitral or aortic regurgitation. Ventricular volumes that correspond to published recommended linear dimensions are determined to guide the timing of surgical intervention.</p

Social Determinants of Health and Parenting Self-Efficacy Among Mothers of Preterm Infants

Objective: To explore the relationships between social and environmental factors and parenting self-efficacy (PSE) among mothers of preterm infants hospitalized in neonatal intensive care units (NICUs) using a social determinants of health (SDoH) framework. Method: We analyzed data from a prospective cohort study that included 187 mother-infant dyads admitted to four NICUs in the Mountain West region between June 2017 and December 2019. We used multivariable linear regression models to assess the independent associations between maternal and infant characteristics and PSE. Results: Our final multiple linear regression model predicting the efficacy score including maternal race/ethnicity, age, insurance, employment status before giving birth, gestational age, depression, and having other children was significant (F(12,160) = 3.17, p = .0004, adjusted R¬2 = .131). Significant predictors of PSE were race/ethnicity (β= 3.3, p = .022), having another child/children (β= 4.2, p = .005), and depression (β= -4.2, p = .004). Conclusions: Findings suggest that social workers and medical practitioners should consider SDoH, such as insurance type, household income, and employment, along with traditional clinical indicators when assessing families’ infant care needs. Social workers, medical practitioners, and researchers should be mindful of how implicit bias may influence the allocation of care and parental supports

Energy and decay width of the pi-K atom

The energy and decay width of the pi-K atom are evaluated in the framework of the quasipotential-constraint theory approach. The main electromagnetic and isospin symmetry breaking corrections to the lowest-order formulas for the energy shift from the Coulomb binding energy and for the decay width are calculated. They are estimated to be of the order of a few per cent. We display formulas to extract the strong interaction S-wave pi-K scattering lengths from future experimental data concerning the pi-K atom.Comment: 37 pages, 5 figures, uses Axodra

\pi\pi, K\pi and \pi N potential scattering and a prediction of a narrow \sigma meson resonance

Low energy scattering and bound state properties of the \pi N, \pi\pi and K\pi systems are studied as coupled channel problems using inversion potentials of phase shift data. In a first step we apply the potential model to explain recent measurements of pionic hydrogen shift and width. Secondly, predictions of the model for pionium lifetime and shift confirm a well known and widely used effective range expression. Thirdly, as extension of this confirmation, we predict an unexpected medium effect of the pionium lifetime which shortens by several orders of magnitude. The \sigma meson shows a narrow resonance structure as a function of the medium modified mass with the implication of being essentially energy independent. Similarly, we see this medium resonance effect realized for the K\pi system. To support our findings we present also results for the \rho meson and the \Delta(1232) resonance.Comment: 42 pages, 17 PS figures, REFTeX, epsfig.sty needed, submitted to Phys. Re

A Study of Cosmic Ray Composition in the Knee Region using Multiple Muon Events in the Soudan 2 Detector

Deep underground muon events recorded by the Soudan 2 detector, located at a depth of 2100 meters of water equivalent, have been used to infer the nuclear composition of cosmic rays in the "knee" region of the cosmic ray energy spectrum. The observed muon multiplicity distribution favors a composition model with a substantial proton content in the energy region 800,000 - 13,000,000 GeV/nucleus.Comment: 38 pages including 11 figures, Latex, submitted to Physical Review