Background The effects of economic instability and the role of economic conditions preceding child protective services (CPS) involvement have not been fully considered in the child welfare ...literature. Objective This paper investigates the link between earnings instability and CPS involvement. Specifically, it examines whether adequate access to safety net programs mitigates the likelihood of child welfare involvement when families encounter negative earnings shocks. Methodology The study used quarterly administrative data from a sample of at-risk families for CPS involvement in Wisconsin. Event history analysis was employed to estimate the relationship between earnings instability and subsequent child maltreatment investigations. Result Experiencing a negative earnings shock of 30% or more increases the likelihood of CPS involvement by approximately 18%. The effect diminishes and becomes nonsignificant when an earnings decline is compensated by benefit receipt. Each additional earnings drop is associated with a 15% greater likelihood of CPS involvement. Each consecutive quarter with stable income is associated with 5% lower probability of a CPS report. The results are more pronounced for abuse than neglect and are marginally significant for neglect reports. Conclusion Unfavorable economic instability is linked to greater CPS-involvement risk, particularly for child abuse. Moreover, accessing sufficient social benefits as supplemental income when negative earnings shocks occur serves to effectively buffer against the risk of child maltreatment, particularly among families with young children (ages 0–4).
•Stably nonemployment is most strongly associated with low income and poverty but not material hardship.•Unstably employed households, particularly those that experience only job losses are more ...likely to have material hardship than consistently employed households.•The safety net as a whole appears to be more effective for nonworking households than for unstably working households.•In-kind transfers appear more important for unstably employed households, particularly those that are single-adult headed households facing job losses.•Cash transfers effectively buffer against the negative impact of stably nonemployment.
Labor market structures and job characteristics have changed in the United States over the last few decades – often making work more unpredictable. Employment instability, or job churning, may have distinct consequences for households’ economic well-being. Meanwhile, American social policies have shifted from cash-based benefits toward in-kind and work-conditioned programs. Yet, we know little about how social programs buffer the financial hardships imposed by economic shocks due to job churning. This paper harnesses novel data collected at 3-month intervals to study the associations between household members’ employment trajectories and (1) household income packages, (2) poverty status, and (3) material hardships, paying particular attention to whether government benefit receipt buffers against the adverse financial consequences of unstable employment. We find that consistent unemployment is most strongly associated with low income and poverty but not material hardship. Unstably employed households, particularly those that are single-adult headed households and experienced only job losses are significantly more likely to experience material hardship than consistently employed households. Our results also suggest that cash transfers effectively buffer against the negative impact of persistent unemployment, while in-kind transfers appear more important for unstably employed households, particularly those that are single-adult headed households. Together, these results highlight the roles and extent of impacts of cash, in-kind benefits, and the tax system, which can inform future policy recommendations in an age of high levels of economic insecurity.
•Families with screened out child maltreatment reports can be engaged in prevention services.•Case management services reduce re-reports to child protection systems among some families.•Prevention ...services for families screened out of child protection systems vary in effectiveness.
In the mid-2000s, the Wisconsin Child Abuse and Neglect Prevention Board developed an intervention called the Community Response Program (CRP), intended to fill an important gap in the continuum of services to address child maltreatment. Specifically, families reported to child protective services (CPS) for alleged child maltreatment, but diverted (i.e., their cases were screened out at the hotline call stage or closed following an investigation), were offered voluntary case management services tailored to each family’s unique circumstances and self-determined needs. The goal of CRP was to significantly reduce future contacts with the child welfare system within this population.
Beginning in late 2016, seven CRP sites representing 16 Wisconsin counties participated in a randomized control trial to determine the effectiveness of the intervention for reducing CPS involvement. The sample involved families (N = 12,373) diverted from CPS across the program sites. Findings include that CRP staff were able to contact 38% of families in the treatment group, and 12% of families (32% of those contacted) enrolled in the program. CRP participants identified a range of service needs, but over half identified one or more economic needs as service priorities. Just over one-third identified needs related to parenting, and about one quarter identified mental and behavioral health needs. Among participants, over half attained at least one self-determined service goal, and approximately one-quarter attained all of their service goals.
To address selection into treatment, we used propensity score matching techniques to conduct treatment-on-the-treated analyses. Results showed that in some program sites, modest to large declines in child welfare system involvement were observed for the treatment versus the control group, and these declines were much more pronounced and consistent in the subgroup that had a screened-out index report compared to those with an investigated index report. However, in some sites, increases in child welfare system involvement occurred in the treatment group relative to the control group, suggesting that the CRP intervention may not be equally helpful to all families, or requires modifications to enhance success in some sites. The implications of these findings for child maltreatment prevention are discussed.
Patients with non–small-cell lung cancer were randomly assigned to three cycles of chemotherapy with or without nivolumab, an anti–PD-1 antibody. Event-free survival was longer with nivolumab than ...without it (31.6 months vs. 20.8 months), and the percentage of patients with a pathological complete response was 24.0% and 2.2%, respectively.
The diversity of MTOR-regulated mRNA translation remains unresolved. Whereas ribosome-profiling suggested that MTOR almost exclusively stimulates translation of the TOP (terminal oligopyrimidine ...motif) and TOP-like mRNAs, polysome-profiling indicated that MTOR also modulates translation of mRNAs without the 5' TOP motif (non-TOP mRNAs). We demonstrate that in ribosome-profiling studies, detection of MTOR-dependent changes in non-TOP mRNA translation was obscured by low sensitivity and methodology biases. Transcription start site profiling using nano-cap analysis of gene expression (nanoCAGE) revealed that not only do many MTOR-sensitive mRNAs lack the 5' TOP motif but that 5' UTR features distinguish two functionally and translationally distinct subsets of MTOR-sensitive mRNAs: (1) mRNAs with short 5' UTRs enriched for mitochondrial functions, which require EIF4E but are less EIF4A1-sensitive; and (2) long 5' UTR mRNAs encoding proliferation- and survival-promoting proteins, which are both EIF4E- and EIF4A1-sensitive. Selective inhibition of translation of mRNAs harboring long 5' UTRs via EIF4A1 suppression leads to sustained expression of proteins involved in respiration but concomitant loss of those protecting mitochondrial structural integrity, resulting in apoptosis. Conversely, simultaneous suppression of translation of both long and short 5' UTR mRNAs by MTOR inhibitors results in metabolic dormancy and a predominantly cytostatic effect. Thus, 5' UTR features define different modes of MTOR-sensitive translation of functionally distinct subsets of mRNAs, which may explain the diverse impact of MTOR and EIF4A inhibitors on neoplastic cells.
There is limited information on how patient outcomes have changed during the COVID-19 pandemic. This study characterizes changes in mortality, intubation, and ICU admission rates during the first 20 ...months of the pandemic.
University of Wisconsin researchers collected and harmonized electronic health record data from 1.1 million COVID-19 patients across 21 United States health systems from February 2020 through September 2021. The analysis comprised data from 104,590 adult hospitalized COVID-19 patients. Inclusion criteria for the analysis were: (1) age 18 years or older; (2) COVID-19 ICD-10 diagnosis during hospitalization and/or a positive COVID-19 PCR test in a 14-day window (+/- 7 days of hospital admission); and (3) health system contact prior to COVID-19 hospitalization. Outcomes assessed were: (1) mortality (primary), (2) endotracheal intubation, and (3) ICU admission.
The 104,590 hospitalized participants had a mean age of 61.7 years and were 50.4% female, 24% Black, and 56.8% White. Overall risk-standardized mortality (adjusted for age, sex, race, ethnicity, body mass index, insurance status and medical comorbidities) declined from 16% of hospitalized COVID-19 patients (95% CI: 16% to 17%) early in the pandemic (February-April 2020) to 9% (CI: 9% to 10%) later (July-September 2021). Among subpopulations, males (vs. females), those on Medicare (vs. those on commercial insurance), the severely obese (vs. normal weight), and those aged 60 and older (vs. younger individuals) had especially high mortality rates both early and late in the pandemic. ICU admission and intubation rates also declined across these 20 months.
Mortality, intubation, and ICU admission rates improved markedly over the first 20 months of the pandemic among adult hospitalized COVID-19 patients although gains varied by subpopulation. These data provide important information on the course of COVID-19 and identify hospitalized patient groups at heightened risk for negative outcomes.
ClinicalTrials.gov Identifier: NCT04506528 (https://clinicaltrials.gov/ct2/show/NCT04506528).
Photopolymerization systems based on hybrid monomer 3,4-epoxy-cyclohexylmethyl methacrylate (METHB) were studied to investigate water effects on conversion and polymer coating properties. METHB ...contains epoxide and methacrylate moieties, which undergo cationic and free-radical photopolymerization, respectively. The conversion of both groups was obtained by Raman spectroscopy in real time and depth. Water concentration and initiator system compositions were varied and shown to affect reaction kinetics and depth profile. With increasing water concentration, the epoxide induction period increased when only cationic initiator was present; however, the induction period disappeared when using the dual-initiator system. In addition, epoxide groups continued reacting after light was shuttered and reached a higher and more homogeneous conversion. Hybrid systems were shown to be less sensitive to water at low or intermediate concentrations. With high water concentrations, hybrid monomer systems manifested increased ring opening during illumination due to chain transfer and decreased physical properties due to loss of cross-linking.
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Abstract
Introduction
Available evidence is mixed concerning associations between smoking status and COVID-19 clinical outcomes. Effects of nicotine replacement therapy (NRT) and vaccination status ...on COVID-19 outcomes in smokers are unknown.
Methods
Electronic health record data from 104 590 COVID-19 patients hospitalized February 1, 2020 to September 30, 2021 in 21 U.S. health systems were analyzed to assess associations of smoking status, in-hospital NRT prescription, and vaccination status with in-hospital death and ICU admission.
Results
Current (n = 7764) and never smokers (n = 57 454) did not differ on outcomes after adjustment for age, sex, race, ethnicity, insurance, body mass index, and comorbidities. Former (vs never) smokers (n = 33 101) had higher adjusted odds of death (aOR, 1.11; 95% CI, 1.06–1.17) and ICU admission (aOR, 1.07; 95% CI, 1.04–1.11). Among current smokers, NRT prescription was associated with reduced mortality (aOR, 0.64; 95% CI, 0.50–0.82). Vaccination effects were significantly moderated by smoking status; vaccination was more strongly associated with reduced mortality among current (aOR, 0.29; 95% CI, 0.16–0.66) and former smokers (aOR, 0.47; 95% CI, 0.39–0.57) than for never smokers (aOR, 0.67; 95% CI, 0.57, 0.79). Vaccination was associated with reduced ICU admission more strongly among former (aOR, 0.74; 95% CI, 0.66–0.83) than never smokers (aOR, 0.87; 95% CI, 0.79–0.97).
Conclusions
Former but not current smokers hospitalized with COVID-19 are at higher risk for severe outcomes. SARS-CoV-2 vaccination is associated with better hospital outcomes in COVID-19 patients, especially current and former smokers. NRT during COVID-19 hospitalization may reduce mortality for current smokers.
Implications
Prior findings regarding associations between smoking and severe COVID-19 disease outcomes have been inconsistent. This large cohort study suggests potential beneficial effects of nicotine replacement therapy on COVID-19 outcomes in current smokers and outsized benefits of SARS-CoV-2 vaccination in current and former smokers. Such findings may influence clinical practice and prevention efforts and motivate additional research that explores mechanisms for these effects.
The major increase in atmospheric methane (CH4) concentration during the last glacial‐interglacial transition provides a useful example for understanding the interactions and feedbacks among Earth's ...climate, biosphere carbon cycling, and atmospheric chemistry. However, the causes of CH4 doubling during the last deglaciation are still uncertain and debated. Although the ice‐core data consistently suggest a dominant contribution from northern high‐latitude wetlands in the early Holocene, identifying the actual sources from the ground‐based data has been elusive. Here we present data syntheses and a case study from Alaska to demonstrate the importance of northern wetlands in contributing to high atmospheric CH4 concentration in the early Holocene. Our data indicate that new peatland formation as well as peat accumulation in northern high‐latitude regions increased more than threefold in the early Holocene in response to climate warming and the availability of new habitat as a result of deglaciation. Furthermore, we show that marshes and wet fens that represent early stages of wetland succession were likely more widespread in the early Holocene. These wetlands are associated with high CH4 emissions due to high primary productivity and the presence of emergent plant species that facilitate CH4 transport to the atmosphere. We argue that early wetland succession and rapid peat accumulation and expansion (not simply initiation) contributed to high CH4 emissions from northern regions, potentially contributing to the sharp rise in atmospheric CH4 at the onset of the Holocene.
Key PointsWetland succession process is important in controlling CH4 emissionsPeatland initiation is just one of many wetland processes affecting CH4 emissionsNorthern wetlands are a major contributor to early Holocene CH4 rise
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