Latino Parents' Perspectives on the Life Trajectories of Mixed-Status Children.

Many immigrant Latino families have one or more U.S. -born children and at least one foreign-born non-citizen child. Contextual theories of human development would argue that these siblings would have very different life trajectories by virtue of their citizenship status or lack thereof. However, researchers and policy-makers know very little about the home environment of mixed-status siblings. Using data from in-depth personal interviews, this study examined parental perceptions of the life trajectories of mixed-status youth. Participants were 18 parents with at least one adolescent between the ages of 10-18 residing at home. Using grounded theory, two broad themes emerged. First, parental perceptions of children's life trajectories based on citizenship and parental concerns' regarding their children's mixed legal status. Within this first theme, parents discussed youth's educational opportunities, job prospects, health care access, and travel restrictions. The second theme was parental concerns' about their children's citizenship status; ambivalence about migrating to the United States; and coping with fear and anxiety. Results of this study highlight the pervasive influence of immigration policies and practices on family dynamics and child development, the risk they posit to youth development and individual family resilience.

Equivocal associations between small-scale shoreline restoration and subtidal fishes in an urban estuary.

Restoration of degraded coastal and estuarine habitats owing to human activities is a major global concern. In Puget Sound, Washington, U.S.A., removal of hard armor from beaches and intertidal zones has become a priority for state and local agencies. However, the effectiveness of these shoreline restoration programs for subtidal habitats and fish is unknown. We surveyed six restoration sites in Puget Sound over 2 years to evaluate associations between shoreline restoration and subtidal fish abundance. We measured the abundance of juvenile salmonids and forage fishes along armored, restored, and reference shorelines. Bayesian generalized linear models showed limited support for associations between shoreline restoration and these fishes in the 3-7 years since armor removal. Pacific herring were more abundant at reference shorelines; the shoreline effect for surf smelt varied by survey site. Shoreline restoration was not an important predictor of salmonid abundance; the best models for Chinook and chum salmon included predictors for survey site and eelgrass, respectively. The retention of survey site in several species' top models reveals the influence of the broader landscape context. We also found seasonal variation in abundance for chum salmon and surf smelt. Our results suggest that juvenile forage fish and salmonids in estuaries likely have unique responses to shoreline features, and that the positive effects of armor removal either do not extend into subtidal areas or are not detectable at local scales. To be most effective, coastal restoration programs should consider broader landscape patterns as well as species-specific habitat needs when prioritizing investments.

Describing Maternal Knowledge of Infant Feeding Practices.

INTRODUCTION: This qualitative study aimed to describe first-time mothers' knowledge of infant feeding practices, including the responsive feeding approach. METHOD: This descriptive, qualitative study enrolled first-time mothers in the third trimester of pregnancy. Participants were asked plans for infant feeding and knowledge of infant feeding cues and responsive feeding. NVivo version 11 was used to analyze data using thematic analysis. RESULTS: All mothers (n = 30) intended to breastfeed. Hunger cues such as rooting were described; cessation of eating was consistently mentioned as a fullness cue. Mothers were unfamiliar with responsive feeding yet deduced the meaning of feeding in response to infant cues. Readiness for complementary foods was described by infant age and/or health care provider recommendation; developmental readiness was not described. DISCUSSION: Findings suggest future education and research should focus on responsive feeding and readiness for complementary foods. Finding ways to assist mothers to adhere to recommendations may promote healthy infant growth and prevent childhood obesity.

From the predictable to the unexpected: kelp forest and benthic invertebrate community dynamics following decades of sea otter expansion.

The recovery of predators has the potential to restore ecosystems and fundamentally alter the services they provide. One iconic example of this is keystone predation by sea otters in the Northeast Pacific. Here, we combine spatial time series of sea otter abundance, canopy kelp area, and benthic invertebrate abundance from Washington State, USA, to examine the shifting consequences of sea otter reintroduction for kelp and kelp forest communities. We leverage the spatial variation in sea otter recovery to understand connections between sea otters and the kelp forest community. Sea otter increases created a pronounced decline in sea otter prey-particularly kelp-grazing sea urchins-and led to an expansion of canopy kelps from the late 1980s until roughly 2000. However, while sea otter and kelp population growth rates were positively correlated prior to 2002, this association disappeared over the last two decades. This disconnect occurred despite surveys showing that sea otter prey have continued to decline. Kelp area trends are decoupled from both sea otter and benthic invertebrate abundance at current densities. Variability in kelp abundance has declined in the most recent 15 years, as it has the synchrony in kelp abundance among sites. Together, these findings suggest that initial nearshore community responses to sea otter population expansion follow predictably from trophic cascade theory, but now, other factors may be as or more important in influencing community dynamics. Thus, the utility of sea otter predation in ecosystem restoration must be considered within the context of complex and shifting environmental conditions.

SU-E-T-403: Delivery Efficiency of StereoArc Stereotactic Body Radiotherapy (SBRT).

PURPOSE: Traditional SBRT employs approximately 10 static beams with up to 20 Gy per fraction, requiring lengthy treatments which can be difficult for patients to tolerate, increasing the risk of movement, and causing discrepancies in the reproducibility of the breathing cycle. Commercial VMAT systems offer shorter treatment times with modulated beams; however, modulation is often not necessary or desired for small fields. Conformai arc therapy offers efficient beam delivery, but with only one aperture shape and constant beam weighting over all gantry angles. This study evaluates the efficiency of a new SBRT delivery Method: a conformai arc with multiple aperture shapes and variable dose rate. METHODS: Three clinical SBRT cases were chosen for this study. Each static field was converted into an arc segment to create a StereoArc plan. Gantry angle ranges were determined from the clinical monitor units, with the MU/degree chosen to maximize the dose rate. All segments were merged into a single arc with variable dose rate. Dose distributions from the StereoArc plans were compared to the clinical static field plans using Pinnacle. Delivery times were compared between the static SBRT plans, both with and without Beam Automation, and equivalent StereoArc plans. All plans were delivered on a Varian TrueBeam using a dose rate of 1000 MU/min. RESULTS: Dose differences between StereoArc and static plans were minimal. Delivery times for the static plans were 5-8 minutes, while delivery time with StereoArc was less than 3 minutes for all cases, which was equivalent to delivering the static plans with Beam Automation. CONCLUSIONS: Delivery efficiency was improved up to 60%: from 8 minutes for static fields, to less than 3 minutes for StereoArc. StereoArc appears to be both an effective and efficient way of delivering SBRT for centers not wishing to modulate SBRT and without access to Beam Automation. This study is partially supported by NIH grant 1R01CA133539-01A2.

Writing a coding success story: best practices and beyond. Panel discussion.

What are the cornerstones of a thriving coding department? How can you ensure your coding team is built on a foundation of education, compliance, and satisfaction? We spoke with several coding managers to collect solutions and guidance for common coding challenges.