Victimization in Unethical Unlicensed Small Residential Care Homes in the United States: The Case for Whole System Disruption.

In the United States, small residential care homes provide affordable community-based care for disabled older adults. Also called adult foster care homes, residential care facilities, group homes, or board and care homes, small residential care homes are typically private, small businesses operating in single-family dwellings that provide round-the-clock care in a home-like setting in residential neighborhoods. While most states license small residential care homes they also exist, legally and illegally, as unlicensed and unregulated operations. The quality of care in some unlicensed and unregulated small residential care homes can be questionable. Disabled older adults are targeted and victimized by unethical small residential care home operators for financial gain. This commentary highlights the need for whole system disruption to end victimization in unethical unlicensed and unregulated small residential care homes through case studies of the abuse and neglect of residents living in unethical unlicensed operations and recommends ambitious goals centered on reducing secondary financial gains and medically neglectful practices. These recommendations are at federal, state, and local levels, and include creating a federal definition of small residential care homes, increasing and coupling government incomes with state registration and employee misconduct registry checks, increasing oversight and assessment, improving temporary guardianship processes, providing avenues for reporting abuse, and developing older adult fatality review teams.

Mental health-related hospitalizations among adolescents and emerging adults with autism in the United States: A retrospective, cross-sectional analysis of national hospital discharge data.

LAY ABSTRACT: Autistic young people are more likely to have mental health conditions, like depression and bipolar disorder, than people without autism. These mental health issues sometimes lead to hospitalizations, which can be expensive and traumatic. Because of this, we wanted to understand mental health-related hospitalizations among autistic young people aged 10-20. We found that the main mental health reasons for the hospitalization of autistic young people were neurodevelopmental, disruptive, depressive, and bipolar disorders. These hospitalizations cost an average of US$7401.23 per stay, for a total of US$106 million in service delivery costs in 2016. Mental health-related hospitalizations were compared between young people with autism, young people with complex and chronic conditions, and young people with no chronic conditions. Autistic young people were almost 11 times more likely to be hospitalized for mental health reasons than young people with complex and chronic conditions, and two times more likely than young people with no complex and chronic conditions. We believe the United States needs better community-based mental health care for young people with autism.

Hospitalizations Among Children and Youth With Autism in the United States: Frequency, Characteristics, and Costs.

National estimates of hospitalization diagnoses and costs were determined using the 2016 HCUP Kids' Inpatient Database. Children and youth with autism were hospitalized over 45,000 times at over $560 million in costs and 260,000 inpatient days. The most frequent principal diagnoses for hospitalizations of children and youth with autism were epilepsy, mental health conditions, pneumonia, asthma, and gastrointestinal disorders, which resulted in almost $200 million in costs and 150,000 inpatient days. Mental health diagnoses accounted for 24.8% of hospitalizations, an estimated $82 million in costs, and approximately 94,000 inpatient days. Children and youth with autism were more likely hospitalized for epilepsy, mental health diagnoses, and gastrointestinal disorders, and less likely for pneumonia and asthma compared to other children and youth.

The Role of Optimism on the Relationship Between Activity Limitations and Life Satisfaction Among Middle-Aged and Older Adults in the United States: A Growth Curve Model of Changes Over Time.

Activity limitations can diminish life satisfaction. This study explored the role of optimism on the relationship between changes in activities of daily living and instrumental activities of daily living (ADL/IADL) limitations and life satisfaction over time among middle-aged and older adults. Growth curve modeling accounting for intra- and inter-individual changes in life satisfaction was applied to the 2008-2018 waves of the Health and Retirement Study Leave Behind Survey subsample (n = 39,122 person-years). After controlling for sociodemographic factors, physical functioning decline adversely affected life satisfaction (ßADL = -0.12, ßIADL = -0.13, p < 0.001), but the negative consequences reduced slightly through optimism (ßADL = -0.11, ßIADL = -0.12, ßoptimism = 0.47, p < 0.001). Increasing optimism could reduce the negative consequences of ADL/IADL limitations on life satisfaction among middle-aged to older adults.

Evaluation of Surface Enthalpy of Porous Aluminosilicates of the MCM-41 Type Using Immersional Calorimetry: Effect of the Pore Size and Framework Si:Al Ratio.

Surface properties of porous aluminosilicates of the MCM-41 type have been tested by immersional calorimetry. Two series of materials, referred to as SiAlxCn, where x is the Si : Al mole ratio and n the chain length of the surfactant template, having (1) x=32 and n=8, 12, 14, 16, 18 and (2) n=14 and x=8, 32, infinity, were used. The results of thermogravimetric analysis on these samples served to evaluate the surface density of hydroxyl groups. This parameter is rather sensitive to the pore size than to the aluminium content in the solid matrix. Based on the experimentally measured enthalpies of immersion in n-heptane, water, and formamide per unit BET specific surface area, estimates could be made of the apolar, Lewis acid, and Lewis base contributions to the total surface enthalpy of MCM-41 materials. The samples studied have a predominant surface acidic character, which is markedly enhanced by incorporating aluminium into the silica matrix. Surface acidity is also modified by changes in the porous structure, although the trends are less noticeable here. Nevertheless, the total surface enthalpy of MCM-41 aluminosilicates appears to be small in comparison with typical inorganic oxides, such as silica or alumina. Copyright 2001 Academic Press.

Direct link between microwave and optical frequencies with a 300 THz femtosecond laser comb

We demonstrate a great simplification in the long-standing problem of measuring optical frequencies in terms of the cesium primary standard. An air-silica microstructure optical fiber broadens the frequency comb of a femtosecond laser to span the optical octave from 1064 to 532 nm, enabling us to measure the 282 THz frequency of an iodine-stabilized Nd:YAG laser directly in terms of the microwave frequency that controls the comb spacing. Additional measurements of established optical frequencies at 633 and 778 nm using the same femtosecond comb confirm the accepted uncertainties for these standards.

Carrier-envelope phase control of femtosecond mode-locked lasers and direct optical frequency synthesis

We stabilized the carrier-envelope phase of the pulses emitted by a femtosecond mode-locked laser by using the powerful tools of frequency-domain laser stabilization. We confirmed control of the pulse-to-pulse carrier-envelope phase using temporal cross correlation. This phase stabilization locks the absolute frequencies emitted by the laser, which we used to perform absolute optical frequency measurements that were directly referenced to a stable microwave clock.