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Objectives The majority of patients with head and neck squamous cell carcinoma (HNSCC) do not commence postoperative radiation treatment (PORT) within the recommended 6 weeks. We explore how delayed PORT affects survival outcomes, what factors are associated with delayed PORT initiation, and what interventions exist to reduce delays in PORT initiation. Methods We conducted a PubMed search to identify articles discussing timely PORT for HNSCC. We performed a narrative review to assess survival outcomes of delayed PORT as well as social determinants of health (SDOH) and clinical factors associated with delayed PORT, using the PROGRESS‐Plus health equity framework to guide our analysis. We reviewed interventions designed to reduce delays in PORT. Results Delayed PORT is associated with reduced overall survival. Delays in PORT disproportionately burden patients of racial/ethnic minority backgrounds, Medicaid or no insurance, low socioeconomic status, limited access to care, more comorbidities, presentation at advanced stages, and those who experience postoperative complications. Delays in PORT initiation tend to occur during transitions in head and neck cancer care. Delays in PORT may be reduced by interventions that identify patients who are most likely to experience delayed PORT, support patients according to their specific needs and barriers to care, and streamline care and referral processes. Conclusions Both SDOH and clinical factors are associated with delays in timely PORT. Structural change is needed to reduce health disparities and promote equitable access to care for all. When planning care, providers must consider not only biological factors but also SDOH to maximize care outcomes.

Introduction: The decision to discharge a patient from the hospital with confirmed or suspected coronavirus 2019 (COVID-19) is fraught with challenges. Patients who are discharged home must be both medically stable and able to safely isolate to prevent disease spread. Socioeconomically disadvantaged patient populations in particular may lack resources to safely quarantine and are at high risk for COVID-19 morbidity. Methods: We developed a telehealth follow-up program for emergency department (ED) patients who received testing for COVID-19 from April 24–June 29, 2020 and were discharged home. Patients who were discharged with a pending COVID-19 test received follow-up calls on Days 1, 4, and 8. The objective of our program was to screen and provide referrals for health-related social needs (HRSN), conduct clinical screening for worsening symptoms, and deliver risk-reduction strategies for vulnerable individuals. We conducted retrospective chart reviews on all patients in this cohort to collect demographic information, testing results, and outcomes of clinical symptom and HRSN screening. Our primary outcome measurement was the need for clinical reassessment and referral for an unmet HRSN. Results: From April 24–June 29, 2020, we made calls to 1,468 patients tested for COVID-19 and discharged home. On Day 4, we reached 67.0% of the 1,468 patients called. Of these, 15.9% were referred to a physician’s assistant (PA) out of concern for clinical worsening and 12.4% were referred to an emergency department (ED) patient navigator for HRSNs. On Day 8, we reached 81.8% of the 122 patients called. Of these, 19.7% were referred to a PA for clinical reassessment and 14.0% were referred to an ED patient navigator for HRSNs. Our intervention reached 1,069 patients, of whom 12.6% required referral for HRSNs and 1.3% (n = 14) were referred to the ED or Respiratory Illness Clinic due to concern for worsening clinical symptoms. Conclusion: In this patient population, the demand for interventions to address social needs was as high as the need for clinical reassessment. Similar ED-based programs should be considered to help support patients’ interdependent social and health needs beyond those related to COVID-19.

RationaleADHD is a prevalent and morbid neurobiological disorder affecting up to 5% of adults. While stimulants have been documented to be safe and effective in adults with ADHD, uncertainties remain about adherence to these treatments.ObjectivesThe main aim of this article was to evaluate contemporaneous rates and correlates of adherence to stimulants in adults with ADHD using data from electronic medical records from a large healthcare organization focusing on timely renewal of an initial prescription.MethodsSubjects were patients 18 to 44 years of age who had been prescribed a stimulant between January 1, 2015, and December 31, 2016. Prescription and sociodemographic data were extracted from the Partners HealthCare Research Patient Data Registry (RPDR). Our outcome metric was renewal of the index stimulant prescription defined as the first prescription recorded in the electronic record for the period under investigation.ResultsWe identified 2689 patients with an index prescription for a stimulant medication. Results showed that only 42% of patients renewed their prescriptions in a timely enough fashion to be considered consistently medicated.ConclusionsResults indicate that adults with ADHD have a low rate of renewal of their initial stimulant prescription indicating poor patient engagement in their treatment for ADHD.

The coronavirus disease 2019 (COVID-19) pandemic has challenged the ability of harm reduction programs to provide vital services to adolescents, young adults, and people who use drugs, thereby increasing the risk of overdose, infection, withdrawal, and other complications of drug use. To evaluate the effect of the COVID-19 pandemic on harm reduction services for adolescents and young adults in Boston, we conducted a quantitative assessment of the Community Care in Reach (CCIR) youth pilot program to determine gaps in services created by its closure during the peak of the pandemic (March 19–June 21, 2020). We also conducted semistructured interviews with staff members at 6 harm reduction programs in Boston from April 27 through May 4, 2020, to identify gaps in harm reduction services, changes in substance use practices and patterns of engagement with people who use drugs, and how harm reduction programs adapted to pandemic conditions. During the pandemic, harm reduction programs struggled to maintain staffing, supplies, infection control measures, and regular connection with their participants. During the 3-month suspension of CCIR mobile van services, CCIR missed an estimated 363 contacts, 169 units of naloxone distributed, and 402 syringes distributed. Based on our findings, we propose the following recommendations for sustaining harm reduction services during times of crisis: pursuing high-level policy changes to eliminate political barriers to care and fund harm reduction efforts; enabling and empowering harm reduction programs to innovatively and safely distribute vital resources and build community during a crisis; and providing comprehensive support to people to minimize drug-related harms.

This study by Starnes and Noyes was immediately recognized as a unique and pioneering work of scholarship and has long been the standard work on the emergence and early flowering of English lexicography. Within the last 20 years we have been witnessing a remarkable scholarly interest in the study of dictionary-making and the role played by dictionaries in the transmission and preservation of knowledge and learning. It is therefore essential to have this classic work available again to all students of linguistic history. In its new edition the book has been vastly enhanced by a lengthy and invaluable introduction by Gabriele Stein, Professor of English Linguistics in Heidelberg and author of The English Dictionary before Cawdrey (1985). In her introduction to the present volume she sets out in scholarly detail the work that has emerged since 1946, which makes this study of the English dictionary from Cawdrey to Johnson as complete as the original authors themselves would have wished.

Background: Rural African American (AA) seniors may experience significant challenges during cancer treatment. Previous research suggests community health workers (CHWs) can provide effective cancer patient navigation (CPN) support. Objectives: To develop a Train the Trainers (TTT) program for CHWs in rural Central Virginia who would navigate local AA seniors with cancer and train their support persons to provide similar types of assistance. Methods: We conducted focus groups with rural AA seniors, consulted with experienced CHW trainers, recruited and trained CHWs through a combination of online learning and distance education, evaluated the TTT via surveys and focus groups, and hired CHWs to the study team. Results/Lessons Learned: Lessons learned from our TTT experience include the value of incorporating CHW trainers and trainees as full members of the research team. Conclusions: Training should be accessible and flexible, providing trainees community-level resources and enriched educational experiences. Findings have informed a culturally tailored support CHW intervention to address cancer diagnosis and treatment needs for older rural AAs.

This thesis investigates the accuracy of operational sea surface temperature (SST) and land surface temperature (LST), data from the Advanced Along-Track Scanning Radiometer (AATSR). The study includes some of the first in situ validation results for these data sets, and forms an integral part of the overall AATSR validation programme. In addition, a comprehensive sensitive study of the response of these retrievals to changes in atmospheric and surface conditions is also presented as in aid to interpreting validation results.AATSR SSTs recorded during 2003 have been validated over the Caribbean sea, using in situ observations of SST from the Marine-Atmosphere Emitted Radiance Interferometer (M-AERI). This validation experiment, which extends over a full year, is the most extensive yet performed for any of the ATSR instruments (ATSR-1, ATSR-2 and AATSR) using in situ SSTs derived from radiometric measurements. These data also provide a first opportunity to study seasonal biases using observations of this type. The results demonstrate that clear-sky SSTs obtained using the unique dual-viewing geometry of the AATSR agree with the in situ data to within 0.3 K. Nadir-only retrievals performed using three channels also provide SSTs that approach this accuracy, but the split-window retrievals are found to be warm-biased by ∼0.6 K. When tropospheric dust aerosol is present, the accuracy of the retrieved SSTs is reduced, with the nadir-view SSTs becoming cold biased and the dual-view SSTs, warm biased.For the first time, the potential for validation of LST over heterogeneous land sites is also explored. Two methodologies are presented for upscaling point in situ LSTs to the 1-km spatial scale of the AATSR, together with initial validation results over a field site in Morocco, which suggest that the AATSR LSTs are warm-biased by at least 0.6 K over this site. The findings of this study suggest that validation over heterogeneous sites is possible for situations where the variation of LST is characterised by several in situ point observations of LST.

This thesis investigates the accuracy of operational sea surface temperature (SST) and land surface temperature (LST), data from the Advanced Along-Track Scanning Radiometer (AATSR). The study includes some of the first in situ validation results for these data sets, and forms an integral part of the overall AATSR validation programme. In addition, a comprehensive sensitive study of the response of these retrievals to changes in atmospheric and surface conditions is also presented as in aid to interpreting validation results. AATSR SSTs recorded during 2003 have been validated over the Caribbean sea, using in situ observations of SST from the Marine-Atmosphere Emitted Radiance Interferometer (M-AERI). This validation experiment, which extends over a full year, is the most extensive yet performed for any of the ATSR instruments (ATSR-1, ATSR-2 and AATSR) using in situ SSTs derived from radiometric measurements. These data also provide a first opportunity to study seasonal biases using observations of this type. The results demonstrate that clear-sky SSTs obtained using the unique dual-viewing geometry of the AATSR agree with the in situ data to within 0.3 K. Nadir-only retrievals performed using three channels also provide SSTs that approach this accuracy, but the split-window retrievals are found to be warm-biased by ∼0.6 K. When tropospheric dust aerosol is present, the accuracy of the retrieved SSTs is reduced, with the nadir-view SSTs becoming cold biased and the dual-view SSTs, warm biased. For the first time, the potential for validation of LST over heterogeneous land sites is also explored. Two methodologies are presented for upscaling point in situ LSTs to the 1-km spatial scale of the AATSR, together with initial validation results over a field site in Morocco, which suggest that the AATSR LSTs are warm-biased by at least 0.6 K over this site. The findings of this study suggest that validation over heterogeneous sites is possible for situations where the variation of LST is characterised by several in situ point observations of LST.

The 96 second-graders each had three study/test trials with picture/picture or picture/word associates. With a recall test, the traditional finding that word responses are better recalled was replicated; with a four-alternative recognition task, there was no difference in retention of picture or word responses (except on the first trial, where pictures were superior to words); and with a modified recognition test, picture responses were better recalled. Children apparently do have difficulty decoding visual images to verbal representations, but the nature of the memory task itself is a critical factor in tests of that effect.

Pneumonia in swine has been studied mainly by examining lungs at slaughter or necropsy. However, when performing these slaughter or necropsy examinations, assessment of the true prevalence or lifetime extent of pneumonia is at best speculative. This is because postmortem evaluations provide only information pertaining to that particular point in time. Along with production information, endpoint measurements of pneumonia have been used to define whether or not pneumonia affected growth of pigs. This investigation, therefore, focused on gaining a better understanding of the pathogenesis of pneumonia in the growing pig from birth to market and in determining how pneumonia affects growth. In order to assess the pathogenesis of pneumonia in the growing pig, it was necessary to develop a technique that allowed evaluation of the disease in the live animal thereby allowing followup of the disease as it progresses and regresses. Radiography was used to evaluate lungs from pigs 21 to 150 days of age at 14 day intervals. Follow-up slaughter examination was performed on pigs 180 days old. Individual percentage of pneumonia observed over the life of each pig and at slaughter were added to yield lifetime pneumonia scores. A significant $(r\\sp2$ = 0.42; P = 0.0001) negative effect of lifetime pneumonia on growth rate was found. By comparison, pneumonia determined at slaughter proved to be a less significant $(r\\sp2$ = 0.14; P = 0.025) estimator for the effect pneumonia has on growth or indicator for lifetime pneumonia $(r\\sp2$ = 0.14; P = 0.05). Pneumonia was found to be a dynamic process, with lesions progressing and regressing throughout the life of the pigs. Used alone, percentage pneumonia determined at slaughter would have inaccurate information on the effects of pneumonia on growth, as some pigs had severe pneumonia during their life, but had little pneumonia apparent at slaughter. Slaughter examination is still regraded as an important diagnostic tool and as a valuable means of surveillance for evaluating prevalence and impact of disease in swine herds. However, respiratory tract disease in swine is a dynamic process that is the result of complex interactions between many factors. This should be considered when performing a slaughter examination, in order to prevent misleading conclusions about the effects of pneumonia on the swine herd.