Racial Resentment And Administrative Burden Tolerance: The Case Of Expanded SNAP Work Requirements.

Administrative burdens-onerous experiences with policy implementation-can deter access to crucial safety-net programs. New research finds that racial resentment boosts support for one form of administrative burden: work requirements. I discuss these findings and how expanded work requirements under the Fiscal Responsibility Act of 2023 may affect members of racial and ethnic minority groups. I argue that the racial implications may depend on how states and counties apply for hardship exemptions, use time-limit waivers, and implement work requirements as they adjust to the winding down of the COVID-19 public health emergency measures. As demonstrated in other policy domains, racial and ethnic minority populations may be disproportionately harmed by expanded work requirements, especially if they reside in conservative, high-poverty, rural communities.

Parameters for Orally Feeding Neonates Who Require Noninvasive Ventilation: A Systematic Review.

PURPOSE: Infants hospitalized in the neonatal intensive care unit (NICU) may be orally fed while receiving noninvasive ventilation (NIV), but the practice is variable and decision criteria are not well understood. This systematic review examines the evidence regarding this practice, including type and level of NIV used during NICU oral feeding, protocols, and safety of this practice. METHOD: The PubMed, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched to identify publications relevant to this review. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to ensure the appropriate inclusion of articles. RESULTS: Fourteen articles were included. Seven studies (50%) were retrospective. Two were quality improvement projects, and the remaining five (35.7%) were prospective. Continuous positive airway pressure and high-flow nasal cannula were commonly used. Levels of respiratory support were variable between studies, if reported at all. Three studies (21.4%) included feeding protocols. Six studies (42.9%) identified use of feeding experts. While many studies commented that orally feeding neonates on NIV is safe, the only study to instrumentally assess swallow safety found that a significant number of neonates silently aspirated during feeding on continuous positive airway pressure. CONCLUSIONS: Strong data supporting practices related to orally feeding infants in the NICU who require NIV are scarce. The types and levels of NIV, and decision-making criteria, are variable across studies and preclude clinically useful conclusions. There is a pressing need for additional research pertaining to orally feeding this population so that an evidence-based standard of care can be established. Specifically, this research should elucidate the impact of different types and levels of NIV on the mechanistic properties of swallowing as defined via instrumental assessment.

"I Used to Get WIC But Then I Stopped": How WIC Participants Perceive the Value and Burdens of Maintaining Benefits.

This study examines how individuals assess administrative burdens and how these views change over time within the context of the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC), which provides food to pregnant and breastfeeding women and children under age five. Using interview data from the Baby's First Years: Mothers' Voices study (n. = 80), we demonstrate how the circumstances of family life, shifiing food needs and preferences, and the receipt of other resources shape how mothers perceive the costs and benefits of program participation. We find that mothers' perceptions of WIC's costs and benefits vary over time and contribute to program participation trajectories, so many eligible people do not participate; need alone does not drive participation decisions.

Staff perceptions of COVID-19 impacts on wildlife conservation at a zoological institution.

Coronavirus Disease 2019 (COVID-19) has impacted virtually all aspects of a global society. By using a transdisciplinary team and methodology, our study highlights the importance of utilizing a One Health approach to address global health and conservation challenges in tandem. We examined how conservation conducted by an accredited zoological institution was altered by the pandemic. In July 2020, we surveyed a select subset of Saint Louis Zoo employees to understand how these staff members perceived their conservation work to be affected during this time. Additionally, in November and December 2020, seven survey respondents were interviewed virtually for qualitative data. Our hypothesis was that lack of funding, reduced ability to travel, and shifting priorities among conservation professionals, as well as their respective institutions, would be significant barriers to conservation efforts. Our survey results revealed that the top three perceived challenges to conservation projects at the Saint Louis Zoo due to the COVID-19 pandemic were lack of funding (83.9%), reductions in Zoo visitors (56.3%), and inability/lack of ability to access field sites and laboratories (55.2%). Respondents also indicated that the top three most important Zoo conservation activities before the COVID-19 pandemic were (1) local/national/global wildlife management and recovery programs, (tie 2) caring for animals in the Zoo's collection, and (tie 2) genetic breeding programs. At least half of respondents indicated that the pandemic had significantly or slightly decreased the ability of staff to perform all three activities. Results supported our hypothesis that reduced funding, limited travel, and shifting priorities were challenges to zoological conservation at this institution. Although travel restrictions will likely persist, continual funding will be critical for maintaining conservation. Our results also indicate that reductions in Zoo visitors were another perceived barrier to conservation and that staff needed to find novel ways to connect with the public. Results from this study may help zoos and aquariums better understand the unique pandemic-associated challenges that threaten conservation at their institutions and may be helpful in designing programs and projects in a post-pandemic world.

Dynamic stabilization home exercise program for treatment of thumb carpometacarpal osteoarthritis: A prospective randomized control trial.

STUDY DESIGN: Randomized control trial. INTRODUCTION: Thumb carpometacarpal (CMC) osteoarthritis (OA) is a common cause of hand pain and disability. Standard conservative therapy (SCT) for thumb CMC OA includes an orthosis and instruction in joint protection, adaptive equipment, and pain relieving modalities. The dynamic stability home exercise (HE) program is complementary conservative therapy designed to strengthen the stabilizing muscles of the thumb CMC. PURPOSE OF THE STUDY: To investigate whether the addition of HE to SCT (SCT+HE) was more effective at reducing pain and disability in thumb CMC OA compared to SCT alone. METHODS: The study compared 2 groups: SCT and SCT+HE. The SCT group received SCT with in-home pain management instructions, joint protection strategies with adaptive equipment, and a hand-based thumb-spica orthosis. The SCT+HE group received HE program instructions for adductor stretching and opponens and first dorsal interosseous strengthening in addition to SCT. Our primary outcome measure was the numerical rating scale (NRS) with secondary outcome measures of QuickDASH (shortened Disabilities of the Arm, Shoulder and Hand questionnaire), range of motion, grip strength, and pinch strength. Outcome measurements were assessed at first visit, 6 weeks, and 6 months. RESULTS: There was no statistical difference between the 2 groups for NRS and QuickDASH at 6 weeks (P = .28 and P = .36, respectively) or 6 months (P = .52 and P = .97, respectively). However, there was a statistically significant decrease in NRS and QuickDASH scores at 6 weeks and 6 months within both groups. CONCLUSIONS: Both SCT and SCT+HE are effective at reducing pain and disability in OA of the thumb CMC joint. Neither therapy program was superior to the other at improving NRS or QuickDASH scores at 6-week or 6-month follow-up.

"It Was Actually Pretty Easy": COVID-19 Compliance Cost Reductions in the WIC Program.

In recent years, scholars have examined the barriers to accessing public assistance benefits. Research identifies learning, compliance, and psychological costs as deterring program use. Compliance costs reflect the burdens of following program rules, which may entail providing documentation, responding to discretionary demands of bureaucrats, or attending appointments to maintain benefits. Studies identify one element of compliance costs-quarterly appointments-as a barrier to continued WIC participation. This article draws on 44 in-depth qualitative interviews with participants in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC). We examine how WIC participants perceive the reduction of compliance costs following the implementation of remote appointments in response to the COVID-19 pandemic. WIC participants report satisfaction with remote appointments and a reduction in the compliance costs of accessing and maintaining benefits. We conclude by recommending longer term changes to policy and practices to increase access and continuity in WIC receipt.

Cyclodextrin dimers: A versatile approach to optimizing encapsulation and their application to therapeutic extraction of toxic oxysterols.

We have developed a novel class of specifically engineered, dimerized cyclodextrin (CD) nanostructures for the encapsulation of toxic biomolecules such as 7-ketocholesterol (7KC). 7KC accumulates over time and causes dysfunction in many cell types, linking it to several age-related diseases including atherosclerosis and age-related macular degeneration (AMD). Presently, treatments for these diseases are invasive, expensive, and show limited benefits. CDs are cyclic glucose oligomers utilized to capture small, hydrophobic molecules. Here, a combination of in silico, in vitro, and ex vivo methods is used to implement a synergistic rational drug design strategy for developing CDs to remove atherogenic 7KC from cells and tissues. Mechanisms by which CDs encapsulate sterols are discussed, and we conclude that covalently linked head-to-head dimers of ßCDs have substantially improved affinity for 7KC compared to monomers. We find that inclusion complexes can be stabilized or destabilized in ways that allow the design of CD dimers with increased 7KC selectivity while maintaining an excellent safety profile. These CD dimers are being developed as therapeutics to treat atherosclerosis and other debilitating diseases of aging.

Experiences of Hispanic Families with Social Services in the Racially Segregated Southeast: Views from Administrators and Workers in North Carolina.

North Carolina-as a state in the racially segregated Southeast-offers a unique context to understand access to social services for Hispanic families and children. Theories of administrative burden posit that Hispanic families likely face high learning, compliance, and psychological costs. Hispanic families face challenges that compound these costs: limited English language and literacy proficiency, complex household composition, and citizenship status of family members and other household members. With new survey results and qualitative data on social service administrators and front-line workers, we examine how these costs may affect access to programs for Hispanic families who reside in a state with a history of racial divisions that have shaped local policy implementation. Some workers noted transportation barriers and complex application processes as limiting access. While we expected to find that Hispanic families may be disadvantaged by decentralized service delivery in a manner that is similar to the experiences of African American families, workers instead note significant resources that help facilitate Hispanic families' access to programs. Workers view national anti-immigrant policies and rhetoric, rather than state and local policy rules or resource constraints, as limiting their capacity to serve Hispanic families.

Reversible spatial and temporal control of lipid signaling.

Herein, we introduce versatile molecular tools that enable specific delivery and visualization of photoswitchable lipids at cellular membranes, namely at the plasma membrane and internal membranes. These molecules were prepared by tethering ortho-nitrobenzyl-based fluorescent cages with a signaling lipid bearing an azobenzene photoswitch. They permit two sequential photocontrolled reactions, which are uncaging of a lipid analogue and then its repeated activation and deactivation. We used these molecules to activate GPR40 receptor transiently expressed in HeLa cells and demonstrated downstream modulation of intracellular Ca2+ levels.

WIC Recipients in the Retail Environment: A Qualitative Study Assessing Customer Experience and Satisfaction.

BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program is an important intervention for prevention and treatment of obesity and food insecurity, but participation has dropped among eligible populations from 2009 to 2015. Program satisfaction is integral to participant retention, and the retail experience is a vital component of program satisfaction. OBJECTIVE: This article applies behavioral economics principles to explore the retail experience of WIC participants and ways in which it may be improved. DESIGN: The authors designed and conducted semistructured interviews and focus groups with WIC participants. PARTICIPANTS/SETTING: A convenience sample of WIC participants aged 18 years and older were recruited through WIC clinics in Texas, North Carolina, Oregon, and Illinois (n=55, 27 participants from four focus groups and 28 individual interviews). STATISTICAL ANALYSIS CONDUCTED: Responses were analyzed qualitatively using principles of content analysis. RESULTS: Challenges in identifying WIC-allowable items throughout the store as well as perceived stigmatization during the checkout process were the chief complaints. Study participants described a learning curve in successful use of WIC in retail environments over time. Study participants also reported acceptance of restrictions, such as a requirement to purchase the least expensive brand. CONCLUSIONS: Dissatisfaction with the retail experience may lead to the underutilization of WIC benefits or program exit. Behavioral economics strategies that facilitate a better shopping experience, such as creating a section for WIC items in the store or improving in-store education, may improve the retail experience for WIC customers. Further research is needed to ensure such strategies are effective and do not contribute to stigma.

Fractionated Proton Beam Therapy for Acoustic Neuromas: Tumor Control and Hearing Preservation.

PURPOSE: This prospective cohort evaluated patients with acoustic neuroma treated with proton irradiation at Loma Linda University Medical Center. A dose of 50.4 Gy in 28 fractions was given to improve hearing preservation while maintaining tumor control. PATIENTS AND METHODS: Ninety-five patients were treated from March 1991 to March 2008. Fractionated proton radiotherapy at daily doses of 1.8 Gy was employed. Patients were treated to 1 of 3 total doses: 59.4 Gy, used initially for patients without serviceable hearing; 54 Gy, used for patients with serviceable hearing through October 2000; and 50.4 Gy used since 2001 for patients with serviceable hearing. Survival and local control were calculated using the Kaplan-Meier method. Logistic regression analysis was preformed comparing dose, tumor size, and tumor location with hearing preservation. RESULTS: Ninety-four patients were assessable; the median follow-up was 64 months. Five-year local control rates for the 59.4 Gy, 54 Gy, and 50.4 Gy groups were 95%, 97%, and 92%, respectively (P = .80); the overall 10-year actuarial control rate was 90%. Cranial nerve injuries occurred in <5% in all groups. Four-year actuarial rates of hearing preservation were maintained in 44% of patients treated with 54 Gy and 64% treated with 50.4 Gy (P = .284). On multivariate analysis, initial tumor diameter (≤1.5 cm) was found to be a prognostic factor for maintaining serviceable hearing in both groups (P = .011). CONCLUSIONS: Fractionated proton therapy of 50.4 Gy offers excellent local control and minimal cranial nerve toxicities. Improved rates of hearing preservation that are comparable with radiosurgery were seen with 50.4 Gy compared with higher doses, although this did not reach significance. Maintaining hearing was found to be associated with smaller initial tumor size.

Means-Tested Public Assistance Programs and Adolescent Political Socialization.

In recent years, scholars have pointed to the politically demobilizing effects of means-tested assistance programs on recipients. In this study, we bridge the insights from policy feedback literature and adolescent political socialization research to examine how receiving means-tested programs shapes parent influence on adolescent political participation. We argue that there are differences in pathways to political participation through parent political socialization and youth internal efficacy beliefs for adolescents from households that do or do not receive means-tested assistance. Using data from a nationally representative sample of 536 Black, Latino, and White adolescents (50.8% female), we find that adolescents from means-tested assistance households report less parent political socialization and political participation. For all youth, parent political socialization predicts adolescent political participation. Internal political efficacy is a stronger predictor of political participation for youth from a non-means-tested assistance household than it is for youth from a household receiving means-tested assistance. These findings provide some evidence of differential paths to youth political participation via exposure to means-tested programs.

The marine diversity spectrum.

Distributions of species body sizes within a taxonomic group, for example, mammals, are widely studied and important because they help illuminate the evolutionary processes that produced these distributions. Distributions of the sizes of species within an assemblage delineated by geography instead of taxonomy (all the species in a region regardless of clade) are much less studied but are equally important and will illuminate a different set of ecological and evolutionary processes. We develop and test a mechanistic model of how diversity varies with body mass in marine ecosystems. The model predicts the form of the 'diversity spectrum', which quantifies the distribution of species' asymptotic body masses, is a species analogue of the classic size spectrum of individuals, and which we have found to be a new and widely applicable description of diversity patterns. The marine diversity spectrum is predicted to be approximately linear across an asymptotic mass range spanning seven orders of magnitude. Slope -0.5 is predicted for the global marine diversity spectrum for all combined pelagic zones of continental shelf seas, and slopes for large regions are predicted to lie between -0.5 and -0.1. Slopes of -0.5 and -0.1 represent markedly different communities: a slope of -0.5 depicts a 10-fold reduction in diversity for every 100-fold increase in asymptotic mass; a slope of -0.1 depicts a 1.6-fold reduction. Steeper slopes are predicted for larger or colder regions, meaning fewer large species per small species for such regions. Predictions were largely validated by a global empirical analysis. Results explain for the first time a new and widespread phenomenon of biodiversity. Results have implications for estimating numbers of species of small asymptotic mass, where taxonomic inventories are far from complete. Results show that the relationship between diversity and body mass can be explained from the dependence of predation behaviour, dispersal, and life history on body mass, and a neutral assumption about speciation and extinction.

Global patterns in predator-prey size relationships reveal size dependency of trophic transfer efficiency.

Predator-prey body size relationships influence food chain length, trophic structure, transfer efficiency, interaction strength, and the bioaccumulation of contaminants. Improved quantification of these relationships and their response to the environment is needed to parameterize food web models and describe food web structure and function. A compiled data set comprising 29582 records of individual prey eaten at 21 locations by individual predators that spanned 10 orders of magnitude in mass and lived in marine environments ranging from the poles to the tropics was used to investigate the influence of predator size and environment on predator and prey size relationships. Linear mixed effects models demonstrated that predator-prey mass ratios (PPMR) increased with predator mass. The amount of the increase varied among locations and predator species and individuals but was not significantly influenced by temperature, latitude, depth, or primary production. Increases in PPMR with predator mass implied nonlinear relationships between log body mass and trophic level and reductions in transfer efficiency with increasing body size. The results suggest that very general rules determine dominant trends in PPMR in diverse marine ecosystems, leading to the ubiquity of size-based trophic structuring and the consistency of observed relationships between the relative abundance of individuals and their body size.

Application of nitrogen stable isotope analysis in size-based marine food web and macroecological research.

Interacting human and environmental pressures influence the structure and dynamics of marine food webs. To describe and predict the effects of these pressures, theoretical advances need to be supported by a capacity to validate the underlying models and assumptions. Here, we review recent applications of nitrogen stable isotope analysis in marine food web and macroecological research, with a focus on work that has paralleled a resurgence of interest in the development and application of size-based models. Nitrogen stable isotope data have been used to estimate intra- and inter-specific variation in trophic level, predator-prey size ratios, transfer efficiency, food chain length, relationships between predator and prey species diversity and the dynamics of energy use. Many of these estimates have contributed to the development, testing and parameterisation of food web and ecosystem models, some of which have been used to establish baselines for assessing the scale of human impacts. The interpretation of results depends on assumed fractionation but, when supported by sensitivity analyses and experimental validation, nitrogen stable isotope data provide valuable insights into the structuring of marine communities and ecosystems.

The importance of quantifying inherent variability when interpreting stable isotope field data.

Stable isotope data are often used to assess diet, trophic level, trophic niche width and the extent of omnivory. Notwithstanding ongoing discussions about the value of these approaches, variations in isotopic signatures among individuals depend on inherent variability as well as differences in feeding habitats. Remarkably, the relative contributions of diet variation and inherent variability to differences in delta(15)N and delta(13)C among individuals have not been quantified for the same species at the same life history stages, and inherent variability has been ignored or assumed. We quantified inherent variability in delta(13)C and delta(15)N among individuals of a marine fish (the European sea bass, Dicentrarchus labrax) reared in a controlled environment on a diet of constant isotopic composition and compared it with variability in delta(13)C and delta(15)N among individuals from wild bass populations. The analysis showed that inherent variability among reared individuals on a controlled diet was equivalent to a large proportion of the observed variability among wild individuals and, therefore, that inherent variability should be measured to establish baseline variability in wild populations before any assumptions are made about the influence of diet. Given that inherent variability is known to be dependent on species, life history stage and the environment, our results show that it should be quantified on a case-by-case basis if diet studies are intended to provide absolute assessments of dietary habits.

Effect of temperature, ration, body size and age on sulphur isotope fractionation in fish.

Sulphur isotope analysis (delta(34)S) is increasingly identified as a valuable tool for source differentiation and the determination of trophic level in food webs, but there are still many uncertainties associated with the interpretation of delta(34)S data. To investigate the effects of temperature, ration, body size and age on sulphur trophic fractionation (Deltadelta(34)S) in fish, we reared European sea bass (Dicentrarchus labrax) on identical diets at 11 and 16 degrees C at three ration levels for over 600 days. Deltadelta(34)S was between 0 and -1 per thousand. The effect of temperature on Deltadelta(34)S was small and inconsistent, varying over the course of the experiment and depending on ration. This contrasts with temperature effects on bass Deltadelta(13)C and Deltadelta(15)N, where Deltadelta(13)C increases at warm temperatures while Deltadelta(15)N falls. Body size and age had a positive relationship with Deltadelta(34)S but the relationship with size was not significant for bass that weighed >20 g. As Deltadelta(34)S is small and the range in delta(34)S of potential diet items can be much greater than the range in delta(13)C or delta(15)N, our results show that sulphur stable isotopes are particularly useful for source differentiation in fish.