Huron Consulting Group

OBJECTIVE:Childhood anxiety disorders are prevalent and impair children's socioemotional functioning. Abnormalities in sensory processing may play a role in the presentation of anxiety disorders. One important domain of sensory processing is sensory sensitivity, referring to heightened or diminished responses to sensory stimuli. While anxiety and sensory sensitivity frequently co-occur, research thus far has primarily focused on associations among autistic children, with limited investigation in anxious children. This study examined the associations between sensory sensitivity and anxiety symptom severity, externalizing problems, emotion dysregulation, and quality of peer and family relationships in children with elevated anxiety symptoms without neurodevelopmental disorders. METHOD:Ninety-four children aged 8 to 17 years (mean age=12.41, SD=2.55 y) with elevated anxiety symptoms but without neurodevelopmental disorders completed self-report assessments of sensory sensitivity, anxiety symptom severity, externalizing behaviors, emotion dysregulation, and quality of peer and family relationships. Participants' parents completed a parent-report assessment of children's externalizing behaviors. RESULTS:Sensory sensitivity and anxiety symptom severity were not statistically significantly associated. Controlling for anxiety symptom severity and relevant sociodemographic covariates, sensory sensitivity explained a statistically significant amount of variance in youth-reported (but not parent-reported) externalizing symptoms, emotion dysregulation, and quality of family but not peer relationships. CONCLUSION:Anxious youth with sensory sensitivity may experience externalizing symptoms, emotion dysregulation, and difficulties with family relationships. Study limitations included a racially/ethnically homogeneous sample and a cross-sectional design. Further research is necessary to better understand the causal impact of sensory sensitivity on behavioral difficulties and quality of life, identify potential protective factors, and test intervention strategies for this population.

This study investigates the impact of geographic and socioeconomic barriers on access to transcatheter aortic valve replacement (TAVR). Utilizing Medicare data from the US Centers for Medicare and Medicaid Services, this study analyzed TAVR and surgical aortic valve replacement (SAVR) procedures among beneficiaries from 2017 to 2022. Geographic units were defined by 5-digit zip codes, categorized on the basis of TAVR/SAVR volume into four categories: (1) no TAVR or SAVR, (2) no-TAVR zone (SAVR present, no TAVR), (3) low-TAVR zone (TAVR/SAVR ratio ≤ 0.5), and (4) TAVR accessible (TAVR/SAVR ratio > 0.5). The differential distance index (DDI) was developed to measure travel hurdles, calculated as the difference in miles from a patient’s zip code center to the treatment hospital (TAVR versus SAVR, CABG (coronary artery bypass grafting), and PCI (percutaneous coronary intervention) comparators). This study maintained a continuous access variable to model outcomes such as the ratio or volume of TAVR/SAVR and the percentage share of TAVR/AVR within each zip code over biennial periods (2017–2018, 2019–2020, 2021–2022). Covariates in the model included population density, area deprivation index (ADI), and calendar time, with an exploration of the interaction between DDI and ADI. The analysis revealed significant geographic disparities in TAVR access across the USA, with no-TAVR zone and low-TAVR zone areas often featuring lower population densities, higher ADIs, and more rural settings. Increased travel distance (DDI) significantly correlated with lower TAVR utilization, emphasizing distance as a critical barrier. Furthermore, both ADI and DDI emerged as significant predictors of TAVR volume and share, underlining the compound effect of socioeconomic status and geographic distance on healthcare access. This study highlights the critical role of geographic and socioeconomic barriers in accessing advanced medical treatments like TAVR. Addressing these barriers may ensure equitable healthcare distribution, guiding policymakers and providers towards more accessible healthcare solutions for all populations.

We present the first fully explicit, continuous, analytically derived warp–drive spacetime within General Relativity whose shift–vector flow is kinematically irrotational. Building on Santiago et al. that scalar–potential, zero–vorticity warp fields are Hawking–Ellis Type I for unit lapse and flat spatial slices, we supply a closed–form scalar potential and smooth shift components with proper boundary behavior, together with a Cartan–tetrad analytic pipeline and high–precision eigenanalysis. Compared with the Alcubierre and Natário models (evaluated at identical (ρ ,σ ,v/c) ), our irrotational solution exhibits significantly reduced local NEC/WEC stress: its peak proper–energy deficit is reduced by a factor of ≈ 38 relative to Alcubierre and ≈ 2.6× 10^3 relative to Natário, and its peak NEC violation is more than 60× smaller than Natário. Crucially, the stress–energy is globally Hawking–Ellis Type I, with a well–defined timelike eigenvalue (proper energy density) everywhere. A fixed–smoothing vortical ablation confirms that this improvement is causally due to irrotational, curl–free kinematics rather than profile shaping: adding modest vorticity collapses the E_+/E_- balance and drives large increases in the negative–energy magnitude E_- . We quantify the negative–energy requirement via a slice-integrated (on Σ _t ) negative–energy volume and tabulate global measures. A far–field extrapolation to R→∞ yields tail–corrected totals |E_+-E_-|/(E_++E_-)=0.04% . Thus the net proper energy is consistent with zero to four decimal places (in fractional units). We also establish regularity at r=0 for the irrotational construction.

We report on an experience with impostor research participants, people who misrepresent themselves, and identify characteristics that can be used by investigators to screen out such participants. We compare the responses of impostor and valid participants, showing that impostors meaningfully change qualitative study findings with implications for policy interventions or follow-on research informed by the study. It is important for investigators to be alert to the potential for impostor participants and plan their research accordingly.

BackgroundThe Nepal Stroke Project (NSP) aims to improve stroke care in a resource-limited setting. This qualitative study explores healthcare professionals’ experiences and perceptions of barriers and success factors in implementing stroke care in Nepal.MethodsSemi-structured interviews were conducted with eight healthcare professionals (six physicians, two nurses) involved in the NSP. Interviews were analyzed using qualitative content analysis, following a constructivist approach.ResultsSuccess factors encompassed the dedication of healthcare professionals, involvement of hospital boards, effective training initiatives, and the formation of stroke teams. Positive developments noted were increased thrombolysis availability, improved stroke awareness, and growing interest in stroke care among medical professionals. Key barriers identified included lack of government ownership in stroke care advocacy, financial constraints for patients, inadequate public awareness, and challenges in implementing quality monitoring.ConclusionWhile the NSP has initiated positive changes in Nepal’s stroke care landscape, significant barriers persist. The study highlights the importance of addressing systemic issues such as government involvement and financial accessibility of treatments. Success factors, particularly the motivation of healthcare professionals and local ownership of the project, provide a foundation for future improvements. These findings can inform strategies for enhancing stroke care delivery in other resource-limited settings and guide ongoing initiatives within the NSP.