bluuebunny/crossref_metadata_2025 huggingface dataset:
An Approach to Improving Student Success in Science, Technology, Engineering, and Mathematics (STEM ) Career Pathways
Authors: Oppenheimer Steven B. , Mills Jack I. , Zakeri Ali , Payte Trista R. , Lidgi Avi , Zavala MariaElena
Published: January 2020

In this article, we report on an 11-year study that explores approaches to improve student success in college by a five-week summer program in Mathematics and Lan­guage Arts for entering freshmen. To recruit students into the program, we invited stu­dents accepted at the university and listed as underrepresented and economically disadvantaged (Pell-eligible) by the Office of Institutional Research at California State University, Northridge. The program con­sisted of all-day Math and English enhance­ment in mixed ability groups. Results of this program examining Math and English performance at California State University, Northridge showed that students com­pleting the summer programs during the 11-year study period had improved pass rates in Math and English at California State University, Northridge compared with students in a control group who did not participate in the summer program. The results show that intensive pre-college enhancement for entering freshmen can improve student success in college. Student graduation data from the early cohorts (2010, 2011, 2012) were obtained from Institutional Research. The summary results showed that students from the accepted/ attending group had substantially increased GPAs and graduation rates, essentially clos­ing the achievement gap. Increased interest in biomedical research careers was also de­veloped by the program, as demonstrated by a five-fold number of summer enrich­ment participants entering the PhD, MARC (Minority Access to Research Careers) and RISE (Research Initiative for Scientific Enhancement) programs than students who did not attend summer enrichment. Ethn Dis.2020;30(1):33-40; doi:10.18865/ed.30.1.33
The Role of Public Health Partnerships in the Success of the Jackson Heart Study Undergraduate Training and Education Center
Authors: White Wendy B. , Henderson Frances , Harris Kisa K. , Mohamed Amel , Srinivasan Asoka
Published: January 2020

Background: The Jackson Heart Study (JHS) is a single-site prospective epidemiologic investigation of cardiovascular disease (CVD) among African Americans from the central Jackson, Mississippi area. The study is a collaboration between Jackson State University (JSU), University of Mississippi Medical Center (UMMC), Tougaloo College (TC), and the Mississippi State Department of Health (MSDH). The JHS Undergraduate Training and Education Center (JHSUTEC) at TC was developed to increase the numbers of college-aged African American students entering public health and health-related fields. To achieve this goal, the UTEC designed the Jackson Heart Study (JHS) Scholars program.Methods: JHS Scholars are required to take additional classes and participate in public health and/or biomedical research. The scholars engage in research locally during the academic year. However, many scholars participate in research outside of the Jack­son Metropolitan area during the summer. Because of this, national collaborators were needed to act as mentors and hosts.Results: Since the inception of the JHSUTEC, more than 15 collaborations have been formed that have shared resources and student successes. As of May 2018, more than150 students have successfully completed the JHS Scholars program and many have continued into careers in public health, biomedical research, and medicine. Since 2004, JHS scholars have published 29 papers and 15 scholars have received diversity supplements.Conclusion: Collaborative activities and public health partnerships have contributed to the success of the JHSUTEC program and have served as a pathway of entry into STEM fields for minority students.Ethn Dis. 2020;30(1):41-46; doi:10.18865/ed.30.1.41
Conversation Cafés and Conceptual Framework Formation for Research Training and Mentoring of Underrepresented Faculty at Historically Black Colleges and Universities: Obesity Health Disparities (OHD) PRIDE Program
Authors: Beech Bettina M. , Norris Keith C. , Thorpe, Jr Roland J. , Heitman Elizabeth , Bruce Marino A.
Published: January 2020

The development of research training opportunities for investigators from the untapped pool of traditionally underrep­resented racial/ethnic groups has gained intense interest at the National Institutes of Health (NIH). The significant and persistent disparity in the likelihood of R01 funding between African American and Whites was highlighted in the groundbreaking 2011 report, Race, Ethnicity, and NIH Research Awards. Disparities in funding success were also shown to exist at the institutional level, as 30 institutions receive a disproportion­ate share of federal research funding. Historically Black Colleges and Universities (HBCUs) have a dual commitment to edu­cation and research; however, the teaching loads at HBCUs may present challenges for research-oriented faculty. Few research training and mentoring programs have been specifically designed for this group.During 2015 and 2016, we held three conversation cafés with 77 participants in Jackson, Mississippi and Baltimore, Maryland. The purpose of this article is to describe findings from these conversation cafés regarding barriers and facilitators to building robust research careers at HBCUs, and to illustrate how these data were used to adapt the conceptual framework for the NHLBI-funded Obesity Health Disparities (OHD) PRIDE program. Identified barri­ers included teaching and advising loads, infrastructures, and lack of research mentors on campus. The benefit of incorporating re­search into classroom teaching was a noted facilitator. Ethn Dis. 2020;30(1):83-90; doi:10.18865/ed.30.1.83
Racial Differences in Mechanical Thrombectomy Utilization for Ischemic Stroke in the United States
Authors: Esenwa Charles , Lekoubou Alain , Bishu Kinfe G. , Small Kemar , Liberman Ava , Ovbiagele Bruce
Published: January 2020

Background: Compared with non-Hispanic Whites (NHW), racial-ethnic minorities bear a disproportionate burden of stroke and receive fewer evidence-based stroke care processes and treatments. Since 2015, me­chanical thrombectomy (MT) has become standard of care for acute ischemic stroke (AIS) patients with proximal anterior circula­tion large vessel occlusion (LVO).Objectives: Our objectives were to: assess recent trends in nationwide MT utilization among patients with AIS; determine if there were racial differences; and identify what factors were associated with such differ­ences.Methods: We performed a retrospective cohort study using nationally representative data of a non-institutionalized population sample from 2006 to 2014 obtained from the Nationwide Inpatient Sample (NIS). We identified a total of 889,309 observations of AIS, of which there were 5,256 MT observa­tions.Results: In the fully adjusted model, rate of thrombectomy utilization was significantly lower in African Americans (AA) (OR .67, CI .58-.76, P<.001) compared with NHW and Hispanics (OR .94, CI .78-1.13, P=.5).Conclusion: We found a significant dispar­ity in MT utilization for AA compared with NHW and Hispanics. More work is needed to understand the drivers of this racial disparity in stroke treatment. Ethn Dis. 2020;30(1):91-96; doi:10.18865/ed.30.1.91
Temporal Associations Between Psychological and Physical Intimate Partner Violence: A Cross-Lag Analysis
Authors: Saint-Eloi Cadely Hans , Pittman Joe F. , Pettit Gregory S. , Lansford Jennifer E. , Bates John E. , Dodge Kenneth A. , Holtzworth-Munroe Amy
Published: January 2020

The present study examined the relationship between psychological and physical forms of intimate partner violence (IPV) across four waves of data during the developmental period of young adulthood. The links from early psychological aggression to later physical aggression and from early physical aggression to later psychological aggression across waves were tested while controlling for their cross-time stabilities and concurrent associations. IPV data were collected annually from 434 young adult respondents involved in a romantic relationship at least once during the respective years from the ages of 22–25. On average, participants provided IPV data for 3 out of the 4 years covered by the study (M= 2.82; standard deviation [SD] = 1.14). Results of a cross-lagged structural equation model (SEM) model indicated significant cross-time stabilities as well as significant, positive concurrent associations for both forms of aggression. Most important to this study were the findings that, controlling for these stabilities and concurrent associations, early psychological aggression was a consistent positive predictor of later physical aggression across waves whereas the opposite direction from early physical aggression to later psychological aggression was either non-significant or significant and negative.
The Process of Empowerment Reflected in Women's Narratives of Their Stay in a Domestic Violence Shelter
Authors: Kenyon Katherine M. , Hiebert-Murphy Diane , Ristock Janice , Medved Maria I.
Published: January 2020

Domestic violence shelters can provide services that are key to ending intimate partner violence. Yet, little is known about the process through which a stay in shelter increases women's ability to move toward the lives they want. The construct of empowerment has been used to gauge the effectiveness of intimate partner violence interventions and has been linked to a variety of positive outcomes. The present qualitative study analyzed nine in-depth interviews with women in domestic violence shelters to explore processes that occurred within the shelter stay that enhanced their sense of empowerment. A narrative methodology that situates personal stories within the broader social context was used. Four interrelated empowerment storylines were identified and involved self-reflection, gaining clarity, acquiring knowledge, and building community. Implications of these processes for shelter services are discussed.
Problem Drinking and Marijuana Use as Risks for Unidirectional and Bidirectional Partner Violence
Authors: Cunradi Carol B. , Dellor Elinam , Alter Harrison J. , Caetano Raul , Mair Christina
Published: January 2020

Despite evidence that most who perpetrate intimate partner violence (IPV) also report victimization, little is known about bidirectional IPV among Emergency Department patients and its association with problem drinking and marijuana use. We conducted an observational, cross-sectional survey among low- and moderate-acuity patients at a Northern California safety-net ED. Physical IPV was measured with the Revised Conflict Tactics Scale (CTS2). We recorded patient's frequency of intoxication and marijuana use. Spouse/partner's problem drinking and marijuana use were measured dichotomously. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multinomial logistic regression models of unidirectional and bidirectional IPV. Among 1,037 patients (53% female), perpetration only, victimization only, and bidirectional IPV were reported by 3.8%, 6.2%, and 13.3% of the sample, respectively. Frequency of intoxication was associated with perpetration (OR = 1.50; 95% CI 1.18–1.92) and bidirectional IPV (OR = 1.34; 95% CI 1.13–1.58). Days of marijuana use were associated with bidirectional IPV (OR = 1.15; 95% CI 1.03–1.28). Patients whose partners were problem drinkers were at risk for victimization (OR = 2.56; 95% CI = 1.38, 4.76) and bidirectional IPV (OR = 1.97; 95% CI 1.18, 3.27). Among patients who reported any past-year IPV, most experienced bidirectional aggression. ED staff should consider asking patients who are married, cohabiting, or in a dating relationship about their experience with past-year IPV and inquire about their substance use patterns and those of their romantic partner, to share information about potential linkages. Medical and recreational marijuana legalization trends underscore the importance of further research on IPV and marijuana.
Using Dyadic Concordance Types to Understand Frequency of Intimate Partner Violence
Authors: Hines Denise A. , Straus Murray A. , Douglas Emily M.
Published: January 2020

Findings regarding women's perpetration of physical partner violence (PV) and bidirectional PV are a major source of controversy in the family violence literature. Questions remain as to how frequently women use PV, in comparison to men, when they are the sole perpetrators of PV and when involved in bidirectionally violent relationships. We also do not know much about women's perpetration and the bidirectionality of nonphysical forms of PV. To answer these questions, we used dyadic concordance types to categorize couples into bidirectionally violent, male-only violent, and female-only violent, and then analyzed the frequency with which the men and women used violence. We conducted these analyses for physical PV, verbal sexual PV, severe psychological PV, and controlling behaviors, among a population-based sample of 1,601 men, ages 18–59, who reported ever having a romantic relationship with a woman. Results indicated that for physical PV, severe psychological PV, and controlling behaviors, bidirectional PV was the most common, followed by female-only perpetration. Within bidirectionally aggressive relationships, women committed significantly more physical PV and controlling behaviors; there were no sex differences in frequency of PV perpetration for these three forms of PV for male-only versus female-only PV. The exception to this pattern was verbal sexual aggression, with men committing significantly more of these acts and male-only perpetration just as common as bidirectional aggression. Bidirectionally aggressive relationships were also the most aggressive. These findings lend support to a family systems perspective when seeking to understand PV and for assessing both victimization and perpetration when investigating PV.
VIOLENCE AGAINST WOMEN IN INTIMATE PARTNER RELATIONSHIPS AND INSTITUTIONAL RESPONSE TO WOMEN’S NEEDS
Authors: Ignjatović Tanja
Published: January 2020

Although there are tendencies to portray women in partner relationships as physically equally aggressive as men, initiating violence, revenge, and using deadly force almost as much as men, men’s violence against women is more pernicious, characterized by more severe and frequent acts of greater range, manifestations, and with more severe consequences. It is therefore unjustified to speak of gender symmetry, and present this type of violence in gender-neutral terms. This paper provides an overview of the most important features of the observed phenomenon, focusing on psychological violence, which plays a key role in “breaking the resistance”, and in providing a “voluntary sacrifice”, i.e., coercive control, structural in nature and extending to all aspects of a woman’s life. Paradoxically, leaving a violent partner is a risk factor for violence and is considered to be potentially more dangerous than staying in a relationship. In the literature, help seeking and coping strategies used by women who have experienced violence are conceptualized in various ways, and research confirms that they depend on the features of violence and the resources available. It is shown that the crucial precondition for women who want to break out of the circle of violence and begin a new life is a fact that professionals understand the gender nature of violence, that effective social control of violent behaviour is established, that women are lent support through specialized independent programs over a longer period, which should be multidimensional and well synchronized, so as to include women, and take into account their needs, reinforcing their sense of security and space for action.
CONTACT, CONFLICT AND INTERETHNIC ATTITUDES AMONG CHILDREN IN NORTH MACEDONIA
Authors: Tomovska Misoska Ana , Taylor Laura , Dautel Jocelyn , Rylander Risa
Published: January 2020

Improving interethnic relations in conflict-affected societies is a difficult task, as a complex repertoire of mutual views and reactions is developed. Furthermore, the experiences of the children in such situations have rarely been taken into perspective. Therefore, this study tries to address this research gap by using data from the Republic of North Macedonia, where interethnic tensions are still present between ethnic Macedonians and ethnic Albanians, although the violent outburst of the conflict ended in 2001. The paper is focused on perceptions of contact and conflict among primary aged children, and their relations with the outgroup attitudes such as liking, trusting, and wanting to play with children from the outgroup. A total of 194 children aged 6 to 11 (M = 8.4) participated in the research, filling play-like items using Qualtrics. The sample was taken from two schools with a mixed language of instruction and was balanced for ethnicity (45.9% Macedonian, 54.1% Albanian) as well as gender (57.7% female, 42.3% male). The results of the series of regression analyses show that the contact quality and a number of outgroup friends are significantly correlated with outgroup liking, willingness to play, and outgroup trust, while the perception of conflict is negatively correlated with outgroup trust. The interaction between age and the contact quantity is a significant predictor of willingness to play with the outgroup, while the interaction between majority status and contact quantity is a significant predictor of outgroup trust. The study highlights the need for a meaningful contact between children from both ethnic groups for improvement of interethnic relations.
Orhangazi Yöresi Kivi (Actinidia deliciosa Hayward) Bahçelerinin Beslenme Durumlarının Toprak, Yaprak ve Meyve Analizleri ile Değerlendirilmesi
Authors: ÇELİK Hakan , BATMAZ Oğuz
Published: January 2020

Amaç:
Bu çalışma Bursa ili Orhangazi ilçesinde kivi (Actinidia
deliciosa Hayward) yetiştiriciliği yapılan toprakların verimlilik durumlarının
belirlenmesi amacıyla yapılmıştır. Materyal ve Metot: Çalışma amacı
doğrultusunda Orhangazi ilçesinden farklı lokasyonlarda yer alan yedi bahçeden 0-30
cm derinlikten toprak örnekleri yanı sıra bitkilerden yaprak ve meyve örnekleri
alınarak besin elementi analizleri yapılmıştır. Yapılan yaprak, meyve ve toprak
analiz sonuçları referans değerlerle karşılaştırılarak bitkilerin beslenme
sorunları tespit edilmeye çalışılmıştır. Bulgular: Elde edilen bulgulara göre, kivi yetiştiriciliği yapılan toprakların genel
olarak orta bünyeye, hafif alkali pH’ya, düşük tuz, az kireç ve yetersiz organik
maddeye sahip oldukları belirlenmiştir. Topraklar arasında besin elementlerinin
yetersiz, sınırlar içinde ve fazla olduğu alanlar tespit edilmiştir. Bitkilerin
azot, fosfor, potasyum, magnezyum ve mikro element içerikleri sınır değerlerin altında
ve sınıra yakın bulunurken, kalsiyum içerikleri sınırın üzerinde belirlenmiştir.
Bitki ve toprak özellikleri yanı sıra elementler arasındaki interaksiyonlar, yaprak
ve meyvedeki besin elementi konsantrasyonlarında farklılığa neden olmuştur.

Sonuç: Yapılan çalışmanın sonuçlarından yöredeki üreticilerin toprak ve bitki
analizine dayalı olmayan bir gübreleme programı izlediği, organik gübre
kullanımlarının yetersiz olduğu ve kivi üretiminin de bilinçsiz olarak
yapıldığı görülmüştür. Bilinçsiz üretimin devam etmesi durumunda yörede
yetiştirilen diğer ürünlerde yaşanan sorunların yakın zamanda kivi üretimi
yapılan alanlarda da görülebileceği sonucuna varılmıştır.
Şiraz Üzüm Çeşidinde Yaprak Alma ve Salkım Seyreltme Uygulamalarının Verim ve Kalite Üzerine Etkileri
Authors: ÇELİK Mustafa , ILGAZ Fatih
Published: January 2020

Bu araştırmada Şiraz üzüm çeşidinde yaprak alma ve salkım seyreltme uygulamalarının verime, kaliteye ve tane bileşimine olan etkilerini belirlemek amaçlanmıştır. Seyreltme seviyelerini seyreltme yapılmamış ve ben düşme döneminde 20 salkım/asma düzeyinde seyreltme yapılmış oluşturmaktadır. Yaprak alma seviyelerini ise yaprak alınmamış ve ince koruk döneminde salkım bölgesindeki dipten itibaren ilk 6 boğumdan tüm yaprakların ve koltukların alınması meydana getirmiştir. Deneme bölünmüş parsellerde, tesadüf blokları deneme desenine göre planlanmıştır. Yaprak alma ile yaş üzüm verimi, salkım özellikleri, olgunluk ve fenolik maddeler etkilenmemiştir. Tane özelliklerinden sadece chroma ve ‘a’ renk değeri etkilenmiştir. Kırmızılık artarken, renk doygunluğu azalmıştır. Salkım seyreltme ise yaş üzüm verimini ve salkım sayısını azaltırken, salkım ağırlığını ve salkım boyunu artırmıştır. Salkım seyreltme, salkım eni ve salkım sıklığı, 100 tane ağırlığı, tane eni, tane boyu, meyve kabuğu rengi ‘L’, ‘a’, chroma ve hue açı değerlerini etkilemezken, meyve kabuğu rengi ‘b’ değerini 0’a yaklaştırarak, mavi rengi azaltmıştır. Salkım seyreltme ile rakamsal olarak % SÇKM ve olgunluk indisi artarken, % asitlik azalmıştır. Salkım seyreltme ile toplam fenoller ve antioksidant içerikleri değişmez iken, toplam flavonoidler azalmıştır. Salkım seyreltme ile bir yıllık budama artığı ağırlığı etkilenmez iken Ravaz indeksi azalmıştır.
Utilization of Waste Corncobs as Mushroom Cultivication Media in The Pataan Village, Lamongan District
Authors: Aly M Nilzam , Susilawati Ruyawari Marlin Pernilawati
Published: January 2020

Background: Waste is part of environmental problems because the increase in volume of waste correlates with population growth and efforts to reduce waste are still limited. Pataan Village which is one of the villages in Sambeng Subdistrict is also inseparable from the garbage problem. Most of the household waste will be collected in the yard and then burned, both organic and inorganic waste. In Pataan Village, there is already a 3R Waste Disposal Site (TPS) which functions as a place to collect garbage and a place to sort waste, unfortunately it is not functioned optimally due to various obstacles. Purpose: Solve the problem of managing organic waste especially corncobs by maximizing it as a mushroom planting media. Method: Socialization, training and assistance of mushroom cultivation using corncobs media to youth groups who are members of the Karang Taruna Organizations in Pataan Village. Results: The results of training and assistance for 25 days, it can be noted that the optimization of corncobs as a medium for mushroom cultivation can be an effective solution in handling the waste problem in Pataan Village and has the potential to bring up new commodities in Pataan Village in the form of janggel mushrooms. Conclusion:Partners get increased knowledge and skills in utilizing corncobs as a medium for cultivating janggel mushrooms. So that in the next period can be given about how the processing of the janggel mushroom in order to have added value.
Community Empowerment Through Sulfur Soap Preparation for Dermatitis Prevention
Authors: Adlia Amirah , Aljuffrie Sakinah , Adi Annis Catur , Regitasari Deandra Ardya , Rahmasari Vidya Anggarini , Rachmawati Heni
Published: January 2020

Background: As a country with a tropical climate, Indonesia has the risk to have many disease problems, such as skin disorder or dermatitis. Dermatitis is an either acute, sub-acute, or chronic inflammatory skin disease. One of therapies is using sulfur compound. Purpose: The objective of this program was to improve public awareness of Tulungagung Regency on the importance of health care, to train people preparing soap containing sulfur, and to help the people to empower the economic community through home industry initiation. Methods: This program was done by motivation generating, counseling, advocacy, and education. The activities were performed through counseling about skin diseases, causes, the prevention and treatment of the disease with sulfur soap, demonstration and providing training to the community about sulfur soap. Results: The training on handmade soap preparation was conducted at the Village Hall of Mojosari, Kauman, Tulungagung, on July 28-29th 2019 and was attended by 20 female participants. The socialization programme was carried out by providing technical guidance, visual exposure of materials, packaging training through small groups. Conclusion:  This training program of soap containing sulfur preparation attracted public attention to gain the science, knowledge, and skill increase business motivation, knowledge, and community skills as well as motivation generation to apply a simple technology of soap containing sulfur manufacturing.
Line Follower Robot Training and Introduction of Internet of Things (IoT) for Students in Jombang City
Authors: Agustin Eva Inaiyah , Yunardi Riky Tri , Winarno Winarno
Published: January 2020

Background: During the Industrial Revolution 4.0, the Internet of Things (IoT) is the main pillar of people and machines connected to each other. It can be an intelligent system when combined with a robot. This is what underlies the importance of robotics and IoT training, especially to be introduced early on. Purpose: This activity aimed to improve students' knowledge and skills in technology. The target of this activity is high school students in Jombang City. Methods: It starts from the planning, implementation, and evaluation stages. Auditory, visual and kinesthetic techniques are used in this activity, which is in the form of interesting learning media such as power points, videos, as well as demonstrations and practices. Data collection techniques such as questionnaires, pre-test, and post-test, and running tests were carried out to measure the level of skills, knowledge, and satisfaction of participants. Results: A total of 85% of participants did not know about IOT and 83% of the participants already know what the robot. But only 17% ever make robots. Conclusion:  After this activity the participants' understanding increased by 20%. Their skills also increased as evidenced by the participants programming themselves so that the robot can run well on the track.
Ultrasound-Guided Nerve Hydrodissection for Pain Management: An Updated Review of Anatomy and Techniques
Authors: Lam King Hei Stanley , Hung Chen-Yu , Chiang Yi-Pin , Onishi Kentaro , Clark Thomas B. , Reeves Dean K , Daniel Su
Published: January 2020

Nerve hydrodissection (HD), a technique used when treating nerve entrapments, involves using an anesthetic or solution such as saline or 5% dextrose solution to separate the nerve from the surrounding tissue, fascia, or adjacent structures. This technique aims to treat neuropathic pain, or pain caused by the nerve. Ultrasound-guided HD of peripheral nerves has gained significant attention in the medical profession and pain management fields in recent years. This is due to a number of high impact publications of randomized control trials demonstrating the efficacy and safety of this technique for the treatment of carpal tunnel syndrome. Even the 20th edition of Harrison’s Principles of Internal Medicine textbook lists injection of 5% dextrose as an alternative local treatment that does not have the side effects of corticosteroids. At present, there is no review of the current literature on this technique. This manuscript will summarize and discuss the following: 1) the different approaches to doing ultrasound-guided HD of nervous structures, 2) its usages in different clinical situations, 3) its clinical pearls, 4) the solution used, and 5) the postulated mechanisms of action.
Eliminating Gaps in Medicaid Coverage During Reentry After Incarceration
Authors: Albertson Elaine Michelle , Scannell Christopher , Ashtari Neda , Barnert Elizabeth
Published: January 2020

This commentary explores the health and social challenges associated with gaps in Medicaid health insurance coverage for adults and youths exiting the US criminal justice system, and highlights some potential solutions.

Because a high proportion of recently incarcerated people come from low-income backgrounds and experience a high burden of disease, the Medicaid program plays an important role in ensuring access to care for this population. However, the Medicaid Inmate Exclusion Policy, or “inmate exclusion,” leads to Medicaid being terminated or suspended upon incarceration, often resulting in gaps in Medicaid coverage at release. These coverage gaps interact with individual-level and population-level factors to influence key health and social outcomes associated with recidivism.

Ensuring Medicaid coverage upon release is an important, feasible component of structural change to alleviate health inequities and reduce recidivism. High-yield opportunities to ensure continuous coverage exist at the time of Medicaid suspension or termination and during incarceration prior to release.
Identifying Needs for Advancing the Profession and Workforce in Environmental Health
Authors: Gerding Justin A. , Brooks Bryan W. , Landeen Elizabeth , Whitehead Sandra , Kelly Kaitlyn R. , Allen Amy , Banaszynski David , Dorshorst Michael , Drager Lane , Eshenaur Tannie , Freund Jeff , Inman Adam , Long Sandra , Maloney Jessica , McKeever Tammy , Pigman Tyler , Rising Nancy , Scanlan Sarah , Scott Jennifer , Shukie Colin , Stewart Gary , Tamekazu Darren , Wade Valerie , White Carolyn , Sarisky John
Published: January 2020

An ever-changing landscape for environmental health (EH) requires in-depth assessment and analysis of the current challenges and emerging issues faced by EH professionals. The Understanding the Needs, Challenges, Opportunities, Vision, and Emerging Roles in Environmental Health initiative addressed this need.

After receiving responses from more than 1700 practitioners, during an in-person workshop, focus groups identified and described priority problems and supplied context on addressing the significant challenges facing EH professionals with state health agencies and local health departments. The focus groups developed specific problem statements detailing the EH profession and workforce’s prevailing challenges and needs according to 6 themes, including effective leadership, workforce development, equipment and technology, information systems and data, garnering support, and partnerships and collaboration.

We describe the identified priority problems and needs and provide recommendations for ensuring a strong and robust EH profession and workforce ready to address tomorrow’s challenges.
Older Americans’ Preferences Between Lower Drug Prices and Prescription Drug Plan Choice, 2019
Authors: Socal Mariana P. , Anderson Gerard F.
Published: January 2020

Objectives. To assess older Americans’ willingness to trade off the possibility of choosing or changing their prescription drug plan for lower drug spending.

Methods. We used data from the Kaiser Family Foundation Health Tracking Poll on prescription drugs carried out in February 2019. This nationwide telephone survey oversampled participants aged 65 years and older who, when weighted, were representative of the US older adult population.

Results. Older adults were strongly in favor of the government negotiating drug prices in Medicare Part D (82% support); 60% of older adults would trade off the possibility of choosing or switching their drug plan in favor of lower drug prices. All groups preferred lower spending over plan choice, but this preference was stronger among individuals who were in poorer health, had lower education and income, and found it very difficult to afford the drugs they needed.

Conclusions. The results suggest that Medicare beneficiaries could support policies that limit plan choice, as long as drug prices actually decrease.
Marijuana Decriminalization, Medical Marijuana Laws, and Fatal Traffic Crashes in US Cities, 2010–2017
Authors: Cook Amanda C. , Leung Gregory , Smith Rhet A.
Published: January 2020

Objectives. To determine the impact of city-level cannabis decriminalization and medical marijuana laws (MMLs) on fatal traffic crashes in US cities.

Methods. Using a census of fatal traffic crashes from the 2010 to 2017 Fatality Analysis Reporting System, we examined MMLs and cannabis decriminalization on fatal crashes by age and sex of driver. We used a Poisson difference-in-differences approach, exploiting temporal and geographic variation in marijuana decriminalization laws.

Results. Cities experienced a 13% increase in fatal crashes involving 15- to 24-year-old male drivers following decriminalization (incidence rate ratio = 1.125; 95% confidence interval = 1.014, 1.249). This effect was immediate and strongest on weekend nights. We found no effect on female drivers or older males. Conversely, we found that MMLs were associated with fewer fatal crashes for both males and females, which was most pronounced in 15- to 24-year-old drivers.

Conclusions. Unlike MMLs, which are associated with fewer fatal crashes, cities experienced a relative increase in fatal crashes involving young male drivers following marijuana decriminalization.

Public Health Implications. MMLs stipulate consumption occurs at home, whereas decriminalization only lessens the penalty for marijuana possession. Therefore, travel incentives of such laws have heterogeneous effects on traffic safety.
Human Papillomavirus Vaccination Schedule: Adherence Among Commercially Insured Adolescents and Young Adults in the United States, 2011–2017
Authors: Hubbard Demetria , Shrestha Sadeep , Levitan Emily B. , Yun Huifeng
Published: January 2020

Objectives. To determine rates of human papillomavirus (HPV) vaccine adherence to the 2011 and 2016 Advisory Committee for Immunization Practices (ACIP) recommendations in the United States.

Methods. We conducted a retrospective cohort study by using the 2011 to 2017 Marketscan data for beneficiaries aged 9 to 26 years who had at least 1 claim for HPV vaccination between January 1, 2011, and January 1, 2017. According to the 2011 ACIP recommendation, adherence is defined as 30 to 90 days between the first and second vaccination and 168 to 212 days between the first and third vaccination. According to the 2016 recommendation, preadolescents are classified as adherent if they had 2 claims of vaccination within 168 to 212 days. We calculated proportions of completion and adherence by recommendation.

Results. Among patients classified under the 2011 ACIP recommendation (n = 2 164 096), 8.3% completed all 3 doses of the vaccine series. Of those who completed, 69.6% were considered adherent to the recommended schedule. Completion and adherence increased to 9.6% and 70.8%, respectively, among patients who were classified under the 2016 ACIP recommendation.

Conclusions. Simpler recommendations lead to better adherence to the HPV vaccination schedule.
Health and Health-Related Resources in Newly Designated Federally Qualified Opportunity Zones: United States, 2012–2016
Authors: Hirsch Jana A. , Zhao Yuzhe , Bilal Usama , Neckerman Kathryn M. , Michael Yvonne L.
Published: January 2020

Objectives. To characterize health and health-related resources in the new qualified opportunity zones (QOZs) relative to tracts not selected or not eligible for this federal investment incentive.

Methods. We used tract-level data from the 498 largest cities in the contiguous United States (n = 24 409), categorized using designations from the Department of Treasury. We compiled data on population characteristics, health-related resources, and health from the American Community Survey, the National Establishment Time Series, the National Land Cover Dataset, and the US Small-Area Life Expectancy Estimates Project and the 500 Cities projects. We calculated means and SDs for ineligible, eligible (but not designated), and designated QOZ tracts.

Results. In general, designated QOZ tracts had lower access to health care facilities, physical activity resources, and healthy food. They had a higher prevalence of unhealthy behaviors and worse health outcomes across most measures.

Conclusions. By benchmarking conditions, we facilitate tracking and assessment of QOZ impacts.

Public Health Implications. QOZ could spur unprecedented neighborhood change with substantial influence on health resources and outcomes. Public health collaboration and strategic local governance of QOZ will be crucial for yielding health benefits for existing residents.
Understanding Family Caregivers’ Needs to Support Relatives with Advanced Progressive Disease at Home: An Ethnographic Study in Rural Portugal
Authors: Teixeira Maria Joao Cardoso , Abreu Wilson , Costa Nilza , Maddocks Matthew
Published: January 2020

Background: Family caregivers play an important role supporting their relatives with advanced progressive disease to live at home. There is limited research to understand family caregiver needs over time, particularly outside of high-income settings. The aim of this study was to explore family caregivers’ experiences of caring for a relative living with advanced progressive disease at home, and their perceptions of met and unmet care needs over time. Methods: An ethnographic study comprising observations and interviews. A purposive sample of 10 family caregivers and 10 relatives was recruited within a rural area in the north of Portugal. Data were collected between 2014-16 using serial participant observations (n=33) and in-depth interviews (n=11). Thematic content analysis was used to analyse the data. Results: Five overarching themes were yielded: (1) provision of care towards independence and prevention of complications; (2) perceived and (3) unknown caregiver needs; (4) caregivers’ physical and emotional impairments; and (5) balancing limited time. An imbalance towards any one of these aspects may lead to reduced capability and performance of the family caregiver, with increased risk of complications for their relative. However, with balance, family caregivers embraced their role over time. Conclusions: These findings enhance understanding around the needs of family caregivers, which are optimally met when professionals and family caregivers work together with a collaborative approach over time. Patients and their families should be seen as equal partners. Family-focused care would enhance nursing practice in this context and this research can inform nursing training and educational programs.
Prognostic factors for ARDS: clinical, physiological and atypical immunodeficiency
Authors: Song Min , Liu Yijie , Lu Zhiwen , Luo Hong , Peng Hong , Chen Ping
Published: January 2020

Background: The risk factors affecting the prognosis of acute respiratory distress syndrome (ARDS) in adults were investigated. The aim was to identify new predictors of prognosis in ARDS patients, including those with clinical, pathophysiological, and atypical immunodeficiency.
Methods: ARDS patients were retrospectively included. Patients were grouped and analysed according to different oxygenation index grades and prognosis, and the factors influencing prognosis and survival were analysed. Adolescent patients, patients with typical immunodeficiency and patients who died within 24 hours after being diagnosed with ARDS were excluded. The predictive value for mortality was determined by Cox proportional hazard analysis.
Results: In total, 201 patients who fulfilled the Berlin definition of ARDS were included. The severity of critical illness on the day of enrolment, as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) II score (P=0.016), Sequential Organ Failure Assessment (SOFA) score (P=0.027), and PaO 2 /FiO 2 (P=0.000), worsened from mild to severe ARDS. Compared with survivors, non-survivors had significantly older age and higher APACHE II and SOFA scores. Moreover, significantly lower lymphocyte/neutrophil ratios and leukocyte counts were found in non-survivors than in survivors (P=0.008, P=0.012). Furthermore, there was a moderate positive correlation between the lymphocyte/neutrophil and PaO 2 /FiO 2 ratios (P=0.023). The area under the curve (AUC) for the lymphocyte/neutrophil ratio was significantly greater than those for the body mass index (BMI) alone, PaO 2 /FiO 2 ratio alone, and lymphocyte/neutrophil ratio alone for predicting 100-day survival in patients with ARDS (P=0.0062, 0.0001, and 0.0154). Age (per log 10 years), BMI<24, the SOFA score, leukocyte count, and the lymphocyte/neutrophil ratio were independent predictors of 28-day mortality in ARDS patients. Moreover, ARDS patients with a lymphocyte/neutrophil ratio <0.0537 had elevated 28-day mortality (P=0.0283). Old age affected both 28-day and 100-day mortality (P=0.0064,0.0057).
Conclusions: Age (per log 10 years), BMI<24, SOFA score, lymphocytes, and the lymphocyte/neutrophil ratio were independent predictors of 100-day mortality in patients with ARDS. The lymphocyte/neutrophil ratio may represent a potential molecular marker to evaluate atypical immunosuppression or impairment in patients with ARDS.
The combination of transversus abdominis plane block and rectus sheath block reduced postoperative pain after splenectomy: a randomized trial
Authors: Zhu Jingli , Wang Xue-ting , Gong Jing , Sun Hai-bin , Zhao Xiao-qing , Gao Wei
Published: January 2020

Background: Splenectomy performed with a curved incision results in severe postoperative pain. The aim of this study was to evaluate the effect of transversus abdominis plane block and rectus sheath block on postoperative pain relief and recovery.
M ethods: A total of 150 patients were randomized into the control (C), levobupivacaine (L) and levobupivacaine / morphine (LM) groups. The patients in the C group received only patient-controlled analgesia. The patients in the L and LM groups received transversus abdominis plane block and rectus sheath block with levobupivacaine or levobupivacaine plus morphine. The intraoperative opioid consumption; postoperative pain score; time to first analgesic use; postoperative recovery data, including the times of first exhaust, defecation, oral intake and off-bed activity; the incidence of postoperative nausea and vomiting and antiemetics use; and the satisfaction score were recorded.
Results: Transversus abdominis plane block and rectus sheath block reduced intraoperative opioid consumption. The patients in the LM group showed lower postoperative pain scores, opioid consumption, postoperative nausea and vomiting incidence and antiemetic use and presented shorter recovery times and higher satisfaction scores.
Conclusions: The combination of transversus abdominis plane block and rectus sheath block with levobupivacaine and morphine can improve postoperative pain relief, reduce the consumption of analgesics, and partly accelerate postoperative recovery.
Psychometric Evaluation of Two Short Versions of the Revised Child Anxiety and Depression Scale
Authors: Klaufus Leonie , Verlinden Eva , Wal Marcel van der , Kösters Mia , Cuijpers Pim , Chinapaw Mai
Published: January 2020

Background
Anxiety and depression are common in children and adolescents, which can be detected via self-report questionnaires in non-clinical settings like the school environment. Two short versions of the Revised Child Anxiety and Depression Scale (i.e., RCADS-25 and RCADS-20) seem to be feasible for administering at schools. The present study evaluated the psychometric properties of the RCADS-25 and RCADS-20 used as screening instruments for anxiety and depression in a general population of schoolchildren and adolescents.
Methods
The RCADS-25 was completed by 69,487 schoolchildren and adolescents aged 8 to 18. The RCADS-25 and RCADS-20 broad anxiety scales are equal (15 items), but there are two versions of the major depressive disorder (MDD) scale: the RCADS-25 MDD scale (10 items) and the RCADS-20 MDD scale (5 items). The three scales were assessed on structural validity, internal consistency, test-retest reliability, criterion validity, and hypotheses for construct validity.
Results
The RCADS-25/RCADS-20 broad anxiety scale demonstrated a sufficient structural validity (CFI = 0.98, TLI = 0.99, RMSEA = 0.03, SRMR = 0.03), internal consistency (alpha = 0.82), test-retest reliability (ICC = 0.73), criterion validity (AUC = 0.79), and all four hypotheses concerning construct validity were confirmed. The RCADS-25 MDD scale demonstrated a sufficient test-retest reliability (ICC=0.70) and three out of four hypotheses concerning construct validity were confirmed, but its structural validity was suspect (CFI = 0.89, TLI = 0.94, RMSEA = 0.09, SRMR = 0.06). The RCADS-20 MDD scale demonstrated a sufficient structural validity (CFI = 0.97, TLI = 0.97, RMSEA = 0.08, SRMR = 0.04) and internal consistency (alpha = 0.72). Two out of four hypotheses concerning construct validity were confirmed. The test-retest reliability (ICC = 0.60) was insufficient. Since both MDD scales showed shortcomings, the shortening of the RCADS-25 MDD scale was re-examined post hoc by principal component and reliability analyses. The result was an MDD scale with seven items.
Conclusions
The RCADS-25/RCADS-20 broad anxiety scale is valid and reliable for screening schoolchildren and adolescents, but the RCADS-25 and RCADS-20 MDD scales showed shortcomings. An MDD scale of seven items showed acceptable psychometric properties.
Endoscopic treatment of early leaks and strictures after laparoscopic one anastomosis gastric bypass
Authors: Younis Fadi , Shnell Mati , Gluck Nathan , Abu-Abeid Subhi , Eldar Shai , Fishman Sigal
Published: January 2020

Background: Laparoscopic one anastomosis gastric bypass has become a prominent bariatric procedure. Yet, early and late complications, primarily leaks and strictures, are not uncommon. This study summarizes our experience with endoscopic treatment of laparoscopic one anastomosis gastric bypass complications.
Methods: This is a retrospective study of consecutive patients referred to our hospital from 2015 to 2017 with post laparoscopic one anastomosis gastric bypass complications. Therapy was tailored to each case, including fully covered self-expandable metal stents, fibrin glue, septotomy, internal drainage with pigtail stents, through-the-scope and pneumatic dilation. Success was defined as resuming oral nutrition without enteral or parenteral support or further surgical intervention.
Results : Nine patients presented with acute or early leaks: 5 (56%) had staple-line leaks, 3 (33%) had anastomotic leaks and 1 (11%) had both. All were treated with stents. Adjunctive endoscopic drainage was applied in 4 patients (44%). Overall 5 patients (56%) with acute/ early leaks recovered completely, including all 3 patients with anastomotic leak and the patient with both leaks but only 1/5 with staple line leak (20%). Complication rate in the leak group reached 22%. Eight patients presented with strictures, 7 at the anastomosis and one due to remnant stomach misalignment. All anastomotic strictures were dilated successfully. However, the patient with the pouch stricture required conversion to Roux-en-Y gastric bypass after 3 failed attempts of dilation.
Conclusion: Endoscopic treatments of laparoscopic one anastomosis gastric bypass complications are relatively effective and safe. Anastomosis-related complications are more amenable to endoscopic treatment compared to staple line leaks.