Improved aboveground biomass estimation and regional assessment with aerial lidar in California's subalpine forests.

Background: Understanding the impacts of climate change on forest aboveground biomass is a high priority for land managers. High elevation subalpine forests provide many important ecosystem services, including carbon sequestration, and are vulnerable to climate change, which has altered forest structure and disturbance regimes. Although large, regional studies have advanced aboveground biomass mapping with satellite data, typically using a general approach broadly calibrated or trained with available field data, it is unclear how well these models work in less prevalent and highly heterogeneous forest types such as the subalpine.

Changes in Homelessness Among US Veterans After Implementation of the Ending Veteran Homelessness Initiative.

Importance: Homelessness is a persistent and growing problem. What role health systems should play and how that role is incorporated into larger strategic efforts are not well-defined.

Objective: To compare homelessness among veterans with that in the general population during a 16-year study period before and after implementation of the Ending Veteran Homelessness Initiative, a program to rehouse veterans experiencing homelessness.

Sierra Nevada reference conditions: A dataset of contemporary reference sites and corresponding remote sensing-derived forest structure metrics for yellow pine and mixed-conifer forests.

Contemporary reference sites in California's Sierra Nevada represent areas where a frequent, low-intensity fire regime - an integral ecological process in temperate dry forests - has been reintroduced after several decades of fire suppression. Produced by an intact fire regime, forest structural patterns in these sites are likely more resilient to future disturbances and climate, and thus can provide reference conditions to guide management and ecological research. In this paper, we present a set of 119 delineated contemporary reference sites in the Sierra Nevada yellow pine and mixed-conifer zone along with a suite of key remote sensing-derived forest structure metrics representing conditions within these sites.

Low-dose aspirin and racial disparities in spontaneous preterm delivery in low-risk individuals.

Background: Preterm birth is a leading cause of perinatal morbidity and mortality. There are significant racial disparities in the rates of preterm delivery in the United States, with Black individuals at disproportionately higher risk than their White counterparts. Although low-dose aspirin is currently under investigation for reducing the rates of preterm delivery, limited data are available on how the use of low-dose aspirin might affect racial and ethnic disparities in the rates of preterm delivery.

Neuroimaging biomarkers of cognitive recovery after ischemic stroke.

Post-stroke cognitive impairment affects more than one-third of patients after an ischemic stroke (IS). Identifying markers of potential cognitive recovery after ischemic stroke can guide patients' selection for treatments, enrollment in clinical trials, and cognitive rehabilitation methods to restore cognitive abilities in post-stroke patients. Despite the burden of post-stroke cognitive impairment, biomarkers of cognitive recovery are an understudied area of research.

Estimating Fuel Moisture in Grasslands Using UAV-Mounted Infrared and Visible Light Sensors.

Predicting wildfire behavior is a complex task that has historically relied on empirical models. Physics-based fire models could improve predictions and have broad applicability, but these models require more detailed inputs, including spatially explicit estimates of fuel characteristics. One of the most critical of these characteristics is fuel moisture.

Veteran Patient Experience Academy: Putting Veterans First.

With a national priority to make the Veteran Health Administration (VA) a leading customer service organization and provide patient-centric services to veterans and their families, the Wilmington VA Medical Center (W VAMC) partnered with the University of Delaware's Department of Hospitality and Sport Business Management at the Learner College of Business & Economics to develop The program focused on employee training and provided tools to enhance the veterans' experience, operationalized the VA Way (VA Core Values, Service Behaviors, Service Recovery), and Own the Moment. Phase 1 of the VA Patient Experience Academy launched with 25 managers in February 2019 and were followed by 5 cohorts including physicians, nurse practitioners, registered nurses, licensed practical nurses, medical staff assistants, and staff. The participants were selected from the W VAMC and 5 Community-Based Outpatient Clinics.

Adapting western North American forests to climate change and wildfires: 10 common questions.

We review science-based adaptation strategies for western North American (wNA) forests that include restoring active fire regimes and fostering resilient structure and composition of forested landscapes. As part of the review, we address common questions associated with climate adaptation and realignment treatments that run counter to a broad consensus in the literature. These include the following: (1) Are the effects of fire exclusion overstated? If so, are treatments unwarranted and even counterproductive? (2) Is forest thinning alone sufficient to mitigate wildfire hazard? (3) Can forest thinning and prescribed burning solve the problem? (4) Should active forest management, including forest thinning, be concentrated in the wildland urban interface (WUI)? (5) Can wildfires on their own do the work of fuel treatments? (6) Is the primary objective of fuel reduction treatments to assist in future firefighting response and containment? (7) Do fuel treatments work under extreme fire weather? (8) Is the scale of the problem too great? Can we ever catch up? (9) Will planting more trees mitigate climate change in wNA forests? And (10) is post-fire management needed or even ecologically justified? Based on our review of the scientific evidence, a range of proactive management actions are justified and necessary to keep pace with changing climatic and wildfire regimes and declining forest heterogeneity after severe wildfires.

Impact of an unannounced standardized veteran program on access to community-based services for veterans experiencing homelessness.

Background: The United States Department of Veterans Affairs established a program in which actors incognito portray veterans experiencing homelessness with pre-determined needs to identify barriers to access and services at community-based organizations.

Methods: From 2017 to 2019, actors who varied in gender, skin color and age portrayed one of three scripts at all VA Community-Based Resource and Referral Centers (CRRCs) serving veterans experiencing homelessness in 30 cities and completed an evaluative survey. They carried authentic VA identification and were registered in a VA patient database for each identity.

Three-dimensional partitioning of resources by congeneric forest predators with recent sympatry.

Coexistence of ecologically similar species can be maintained by partitioning along one or more niche axes. Three-dimensional structural complexity is central to facilitating resource partitioning between many forest species, but is underrepresented in field-based studies. We examined resource selection by sympatric northern spotted owls (Strix occidentalis caurina), a threatened species under the US Endangered Species Act, and nonnative barred owls (S.

Multiscale divergence between Landsat- and lidar-based biomass mapping is related to regional variation in canopy cover and composition.

Background: Satellite-based aboveground forest biomass maps commonly form the basis of forest biomass and carbon stock mapping and monitoring, but biomass maps likely vary in performance by region and as a function of spatial scale of aggregation. Assessing such variability is not possible with spatially-sparse vegetation plot networks. In the current study, our objective was to determine whether high-resolution lidar-based and moderate-resolution Landsat-base aboveground live forest biomass maps converged on similar predictions at stand- to landscape-levels (10 s to 100 s ha) and whether such differences depended on biophysical setting.

Evidence of fuels management and fire weather influencing fire severity in an extreme fire event.

Following changes in vegetation structure and pattern, along with a changing climate, large wildfire incidence has increased in forests throughout the western United States. Given this increase, there is great interest in whether fuels treatments and previous wildfire can alter fire severity patterns in large wildfires. We assessed the relative influence of previous fuels treatments (including wildfire), fire weather, vegetation, and water balance on fire-severity in the Rim Fire of 2013.

A Hybrid III stepped wedge cluster randomized trial testing an implementation strategy to facilitate the use of an evidence-based practice in VA Homeless Primary Care Treatment Programs.

Background: Homeless veterans often have multiple health care and psychosocial needs, including assistance with access to housing and health care, as well as support for ongoing treatment engagement. The Department of Veterans Affairs (VA) developed specialized Homeless Patient Alignment Care Teams (HPACT) with the goal of offering an integrated, "one-stop program" to address housing and health care needs of homeless veterans. However, while 70% of HPACT's veteran enrollees have co-occurring mental health and substance use disorders, HPACT does not have a uniform, embedded treatment protocol for this subpopulation.

Unprecedented remote sensing data over King and Rim megafires in the Sierra Nevada Mountains of California.

Megafires have lasting social, ecological, and economic impacts and are increasing in the western contiguous United States. Because of their infrequent nature, there is a limited sample of megafires to investigate their unique behavior, drivers, and relationship to forest management practices. One approach is to characterize critical information pre-, during, and post-fire using remote sensing.

Integrating Permanent Supportive Housing and Co-Occurring Disorders Treatment for Individuals Who Are Homeless.

Objectives: While permanent housing, addictions, and mental health treatment are often critical needs to achieve housing stability and community reintegration, few studies have systematically integrated them into a single comprehensive approach for people experiencing chronic homelessness. This pilot study examined the feasibility and preliminary outcomes of systematically integrating permanent supportive housing and an evidence-based co-occurring disorders intervention called Maintaining Independence and Sobriety Through Systems Integration, Outreach, and Networking (MISSION).

Methods: This single-group open pilot enrolled 107 people with co-occurring disorders experiencing chronic homelessness from two Massachusetts inner-city and rural areas.

Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration's "Homeless Patient Aligned Care Team" Program.

Introduction: Although the clinical consequences of homelessness are well described, less is known about the role for health care systems in improving clinical and social outcomes for the homeless. We described the national implementation of a "homeless medical home" initiative in the Veterans Health Administration (VHA) and correlated patient health outcomes with characteristics of high-performing sites.

Methods: We conducted an observational study of 33 VHA facilities with homeless medical homes and patient- aligned care teams that served more than 14,000 patients.

Screening for Homelessness in the Veterans Health Administration: Monitoring Housing Stability through Repeat Screening.

Objective: This study examined veterans' responses to the Veterans Health Administration's (VHA's) universal screen for homelessness and risk of homelessness during the first 12 months of implementation.

Methods: We calculated the baseline annual frequency of homelessness and risk of homelessness among all veterans who completed an initial screen during the study period. We measured changes in housing status among veterans who initially screened positive and then completed a follow-up screen, assessed factors associated with such changes, and identified distinct risk profiles of veterans who completed a follow-up screen.

Factors Associated With Premature Exits From Supported Housing.

Objective: Many homeless consumers who enroll in supported housing programs--which offer subsidized housing and supportive services--disengage prematurely, before placement in permanent community-based housing. This study explored factors associated with exiting a supported housing program before achieving housing placement.

Methods: With the use of administrative data, a roster was obtained for consumers enrolled in the Veterans Affairs (VA) Greater Los Angeles supported housing program from 2011 to 2012.

Characteristics and Use of Services Among Literally Homeless and Unstably Housed U.S. Veterans With Custody of Minor Children.

Objective: The study examined the number of homeless veterans with minor children in their custody ("children in custody"), compared sociodemographic and clinical characteristics among homeless veterans with and without children in custody, and observed differences in referral and admission patterns among veterans with and without children in custody for a variety of U.S. Department of Veterans Affairs (VA) programs for homeless veterans.

Development and validation of an instrument to assess imminent risk of homelessness among veterans.

Objectives: Veterans are overrepresented within the homeless population compared with their non-veteran counterparts, particularly when controlling for poverty. The U.S.

Trauma-informed care: a paradigm shift needed for services with homeless veterans.

Purpose Of Study: Exposure to traumatic events is a highly prevalent, although often overlooked, aspect in the lives of homeless veterans. In this study, the prevalence and correlates of potentially traumatic events, including posttraumatic stress disorder, in the homeless veteran population are presented.

Findings/conclusions: Presently, there exists a lack of trauma-informed case management services for homeless veterans.

Street outreach and other forms of engagement with literally homeless veterans.

Street outreach is one of the most direct methods of engaging homeless individuals, but the characteristics of those most likely to be engaged this way is not well-understood. Data from the Department of Veterans Affairs (VA) Homeless Operations Management and Evaluation System showed that of the 70,778 literally homeless veterans engaged in VA homeless services in 2011-2012, 12% were through street outreach while the majority was through provider referrals (41%) and self-referrals (28%). Veterans engaged through street outreach had more extensive histories of recent homelessness, were more likely to be chronically homeless, and were more likely to be referred and admitted to the VA's supported housing program than other veterans.