Facility design and worker justice: COVID-19 transmission in meatpacking plants.

BACKGROUND: Meatpacking plants were major sources of COVID-19 outbreaks, posing unprecedented risks to employees, family members, and local communities. The effect on food availability during outbreaks was immediate and staggering: within 2 months, the price of beef increased by almost 7% with documented evidence of significant meat shortages. Meatpacking plant designs, in general, optimize on production; this design approach constrains the ability to enhance worker respiratory protection without reducing output. METHODS: Using agent-based modeling, we simulate the spread of COVID-19 within a typical meatpacking plant design under varying levels of mitigation measures, including combinations of social distancing and masking interventions. RESULTS: Simulations show an average infection rate of close to 99% with no mitigation, 99% with the policies that US companies ultimately adopted, 81% infected with the combination of surgical masks and distancing policies, and 71% infected with N95 masks and distancing. Estimated infection rates were high, reflecting the duration and exertion of the processing activities and lack of fresh airflow in an enclosed space. CONCLUSION: Our results are consistent with anecdotal findings in a recent congressional report, and are much higher than US industry has reported. Our results suggest current processing plant designs made rapid transmission of the virus during the pandemic's early days almost inevitable, and implemented worker protections during COVID-19 did not significantly affect the spread of the virus. We argue current federal policies and regulations are insufficient to ensure the health and safety of workers, creating a justice issue, and jeopardizing food availability in a future pandemic.

Maternal, Paternal, and Peer Relationships Differentially Predict Adolescent Behavioral Problems.

The current study investigated how maternal, paternal, and peer social relationships predict adolescent behavioral problems using secondary data analyses of the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN). We aimed to examine differences between maternal and paternal relationships in predicting adolescent behavioral problems, and we hypothesized that parental relationships would more strongly predict adolescent behavioral problems than peer relationship in mid-adolescence. Participants were 929 adolescents at their 14-year-old visit. Hierarchical multiple regressions and multiple regression models revealed the following: Maternal relationship quality predicted fewer adolescent externalizing and total behavioral problems; paternal relationship quality predicted fewer internalizing problems; and peer popularity predicted fewer externalizing and total behavioral problems. In conclusion, mother-adolescent relationship may be more important for externalizing behavioral problems and father-adolescent relationship may be more important for internalizing behavioral problems. In middle adolescence, parental relationships are still more important than peer relationship in predicting adolescent behavioral problems. Study limitations and implications for research, policy, and practice were discussed.

Disparate healthcare access and telehealth-based hybrid consultations during the COVID-19 pandemic.

BACKGROUND: The coronavirus disease-2019 pandemic led to rapid expansion of telehealth services. This was speculated to improve healthcare access among underserved populations, including individuals unable to take time off work or arrange transportation. OBJECTIVE: We completed a quality improvement project to evaluate the feasibility of hybrid consultations that combined televisits and abbreviated in-person visits for neuromuscular referrals. METHODS: Using a censoring date of August 5, 2021, we reviewed all outpatient neuromuscular consultations from August 5, 2020 to February 5, 2021. For both hybrid and traditional in-person consultations, we reviewed no-show rates, completion rates of ordered diagnostic workup, and billing codes. For hybrid consultations only, we also reviewed intervals between initial televisit and subsequent examination and rates of video-enhanced versus audio-only televisits. RESULTS: During the study period, we completed 153 hybrid and 59 in-person new-patient consultations (no-show rates 9% and 27% respectively.) For hybrid consultations, 77% and 73% of laboratory and imaging studies were completed respectively, compared to 89% and 91% for in-person consultations. For hybrid visits, average RVUs (a marker for reimbursement) per consultation depended on whether audio-only televisits were billed as telephone calls or E/M visits per insurance payer rules, while video-enhanced televisits were uniformly billed as E/M visits. This resulted in average RVUs between 2.09 and 2.26, compared to 2.30 for in-person consultations. CONCLUSIONS: Telehealth-based hybrid neuromuscular consultations are feasible with minor caveats. However, the future of telehealth may be restricted by decreasing reimbursement rates particularly for audio-only televisits, limiting its potential to improve healthcare access.

Optimizing the operation of an electrodiagnostic laboratory during the COVID-19 pandemic: A 6-month single-center experience.

INTRODUCTION/AIMS: The initial surge of the coronavirus disease-2019 (COVID-19) pandemic in early 2020 led to widespread cancellation of elective medical procedures in the United States, including nonurgent outpatient and inpatient electrodiagnostic (EDx) studies. As certain regions later showed a downtrend in daily new cases, EDx laboratories have reopened under the guidance of the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM). In our reopening experience guided by the AANEM, we measured relevant outcomes to determine further workflow adaptations. We aimed to detail our experience and share the lessons learned. METHODS: We reviewed the clinical volumes, billing data, diagnosis distributions, and rates of COVID-19 exposure and transmission among patients and staff in our EDx laboratory during the first 6 months of reopening, starting on June 1, 2020. For context, we detailed the recent AANEM guidelines we adopted at our laboratory, supplemented by other consensus statements. RESULTS: We completed 816 outpatient studies from June 1 to December 1, 2020, reaching 97% of the total volume and 97% of total billing compared with the same time period in 2019. The average relative value units per study were similar. There were no major shifts in diagnosis distributions. We completed 10 of 12 requested inpatient studies during this period. There were no known COVID-19 transmissions between patients and staff. DISCUSSION: Our experience suggests that it is possible to safely operate an EDx laboratory under the guidance of the AANEM and other experts, with clinical volume and billing rates comparable to pre-pandemic baselines.

Resilience and Function in Adults With Chronic Physical Disabilities: A Cross-Lagged Panel Design.

BACKGROUND: Resilience is a psychological construct referring to one's positive adaptation in response to adversity. Evidence suggests that resilience may contribute to various function domains in adults with chronic physical disabilities. PURPOSE: To test hypothesized temporal associations between resilience and four function domains (anxiety, depression, social role satisfaction, and physical function) in individuals with chronic physical disabilities. METHODS: Participants were 1,574 adults with one of four chronic physical disabilities (spinal cord injury, muscular dystrophy, multiple sclerosis, or postpolio myelitis syndrome) who were participating in a large, ongoing USA-based longitudinal survey study. Three surveys were mailed on an approximately yearly basis. Resilience was assessed using the Connor-Davidson Resilience Scale 10-item (CDRSC-10) and each function domain was assessed using the respective Patient Reported Outcome Measurement System (PROMIS) short-form. RESULTS: Cross-lagged path models evidenced statistically significant reciprocal relationships between resilience and each function domain except physical function. The standardized lagged coefficients corresponding to resilience predicting social role satisfaction (T1-T2 = 0.09, T2-T3 = 0.09) had similar effect sizes as those corresponding to social role satisfaction predicting resilience (T1-T2 = 0.11, T2-T3 = 0.04), although resilience was a slightly stronger predictor in the second lag. In models assessing psychological function, resilience was a stronger predictor of later psychological function (resilience-to-anxiety, T1-T2 = -0.15, T2-T3 = -0.11; resilience-to-depression, T1-T2 = -0.21, T2-T3 = -0.13) than the inverse (anxiety-to-resilience, T1-T2 = -0.11, T2-T3 = -0.06; depression-to-resilience, T1-T2 = -0.12, T2-T3 = -0.05). CONCLUSIONS: The study findings suggest that resilience is a significant prospective predictor of psychological and social function over time in individuals with chronic physical disabilities.

1,1-Hydroboration and a Borane Adduct of Diphenyldiazomethane: A Potential Prelude to FLP-N2 Chemistry.

Diphenyldiazomethane reacts with HB(C6 F5 )2 and B(C6 F5 )3 , resulting in 1,1-hydroboration and adduct formation, respectively. The hydroboration proceeds via a concerted reaction involving initial formation of the Lewis adduct Ph2 CN2 BH(C6 F5 )2 . The highly sensitive adduct Ph2 CN2 (B(C6 F5 )3 ) liberates N2 and generates Ph2 CB(C6 F5 )3 . DFT computations reveal that formation of Ph2 CN2 B(C6 F5 )3 from carbene, N2 , and borane is thermodynamically favourable, suggesting steric frustration could preclude carbene-borane adduct formation and affect FLP-N2 capture.

Stoichiometric reductions of alkyl-substituted ketones and aldehydes to borinic esters.

A series of alkyl-substituted ketones are shown to activate hydrogen in the presence of B(C6F5)3, affording the corresponding borinic esters RR'CHOB(C6F5)2. The mechanism is shown to proceed via H2 activation, hydride delivery and protonation of a C6F5 group. The aliphatic aldehyde Et2CHCHO reacts with B(C6F5)3 or BPh3 to give boron enolates Et2C[double bond, length as m-dash]CH(OBAr2) (Ar = C6F5, Ph). These latter species are amenable to FLP-catalyzed reduction to the corresponding borinic esters.

Membership in fraternities and sororities, depression, and suicidal ideation.

College student membership in fraternities/sororities may have positive or negative effects on their behavior. This study investigated the relationships between fraternity/sorority membership, depression, and suicidal behavior. 293 undergraduate students (232 women, 61 men; M age = 22.6 yr., SD = 1.5, range = 18-24; 127 sorority sisters, 35 fraternity brothers) from a rural state college participated in the study. Depression, self-esteem and perceived social support were measured with the Beck Depression Inventory, the Rosenberg Self-esteem Scale, and the Multidimensional Scale of Perceived Social Support, respectively. Depression and suicidal ideation correlated negatively with self-esteem and perceived social support, but were not correlated with membership in fraternities/sororities.

Working toward a conceptual definition of child neglect.

The phenomenon of child neglect has been nebulous due to limited research on child neglect and the meshing of child neglect with child abuse. There are disagreements among neglect researchers about several important issues, such as whether to frame child neglect as a child's unmet needs or as omissions in parental behavior. It has therefore been difficult to develop a standard conceptual definition of child neglect. In this article, a conceptual definition of child neglect is proposed. The definition's stand on a few important issues is discussed. Finally, how the conceptual definition can guide the formulation of operational definitions for both research and practice is described.

Young children's reports of when learning occurred.

This study investigated young children's reports of when learning occurred. A total of 96 4-, 5-, and 6-year-olds were recruited from suburban preschools and elementary schools. The children learned an animal fact and a body movement. A week later, children learned another animal fact and another body movement and then answered questions about when the different learning events occurred. Responses of children who responded correctly to control questions about time supported the hypothesis that temporal distance questions would elicit more correct responses than would temporal location questions. Partial support was also found for the hypothesis that behavior learning would generate more correct reports than would fact learning. Implications for characterizations of children's developing understanding of knowledge and for applications of those characterizations in education and eyewitness testimony are discussed.