Colorectal cancer community engagement: a qualitative exploration of American Indian voices from North Dakota.

BACKGROUND: American Indians (AI) in North Dakota present with higher rates of advanced-stage disease for screening detectable colorectal cancers and have lower overall baseline colorectal cancer screening rates than non-AIs. We sought to identify the perceived barriers and facilitators for the engagement with colorectal cancer prevention within North Dakota tribal communities. METHODS: Twelve semi-structured interviews were carried out across four tribal reservation communities in the state of North Dakota with American Indian adults between the ages of 30 and 75 years. We utilized purposive sampling to ensure maximum variation in age, sex, and tribal community until data saturation was achieved. The interviews were transcribed, and thematic analysis was carried out to identify consistent themes rooted within the data. Ethical approval was gained for this project from all relevant institutional review boards. RESULTS: Four main themes were identified as barriers for the engagement with colorectal cancer prevention, including: colorectal cancer screening barriers, focused on other health problems, lack of colorectal cancer tailored health promotion, and socio-cultural factors affecting colorectal cancer prevention. Three main themes were identified as facilitators for the engagement with colorectal cancer prevention, including: reasons for getting colorectal cancer screening, role of culture, and getting out into the community. CONCLUSION: There is need for more community-rooted, strengths-based approaches to colorectal cancer prevention activities in AI communities in North Dakota. Socio-cultural factors, such as the use of storytelling, and the use of traditional knowledge have been demonstrated to be an important element of consideration for colorectal cancer tribal community engagement and prevention planning in the state.

Association of Prenatal Exposure to Maternal Drinking and Smoking With the Risk of Stillbirth.

Importance: Prenatal smoking is a known modifiable risk factor for stillbirth; however, the contribution of prenatal drinking or the combination of smoking and drinking is uncertain. Objective: To examine whether prenatal exposure to alcohol and tobacco cigarettes is associated with the risk of stillbirth. Design, Setting, and Participants: The Safe Passage Study was a longitudinal, prospective cohort study with data collection conducted between August 1, 2007, and January 31, 2015. Pregnant women from Cape Town, South Africa, and the Northern Plains region of the US were recruited and followed up throughout pregnancy. Data analysis was performed from November 1, 2018, to November 20, 2020. Exposure: Maternal consumption of alcohol and tobacco cigarettes in the prenatal period. Main Outcomes and Measures: The main outcomes were stillbirth, defined as fetal death at 20 or more weeks' gestation, and late stillbirth, defined as fetal death at 28 or more weeks' gestation. Self-reported alcohol and tobacco cigarette consumption was captured at the recruitment interview and up to 3 scheduled visits during pregnancy. Participants were followed up during pregnancy to obtain delivery outcome. Results: Of 11663 pregnancies (mean [SD] gestational age at enrollment, 18.6 [6.6] weeks) in 8506 women for whom the pregnancy outcome was known by 20 weeks' gestation or later and who did not terminate their pregnancies, there were 145 stillbirths (12.4 per 1000 pregnancies) and 82 late stillbirths (7.1 per 1000 pregnancies). A total of 59% of pregnancies were in women from South Africa, 59% were in multiracial women, 23% were in White women, 17% were in American Indian women, and 0.9% were in women of other races. A total of 8% were older than 35 years. In 51% of pregnancies, women reported no alcohol or tobacco cigarette exposure (risk of stillbirth, 4 per 1000 pregnancies). After the first trimester, 18% drank and smoked (risk of stillbirth, 15 per 1000 births), 9% drank only (risk of stillbirth, 10 per 1000 pregnancies), and 22% smoked only (risk of stillbirth, 8 per 1000 pregnancies). Compared with the reference group (pregnancies not prenatally exposed or without any exposure after the first trimester), the adjusted relative risk of late stillbirth was 2.78 (98.3% CI, 1.12-6.67) for pregnancies prenatally exposed to drinking and smoking, 2.22 (98.3% CI, 0.78-6.18) for pregnancies prenatally exposed to drinking only after the first trimester, and 1.60 (98.3% CI, 0.64-3.98) for pregnancies prenatally exposed to smoking only after the first trimester. The adjusted relative risk for all stillbirths was 1.75 (98.3% CI, 0.96-3.18) for dual exposure, 1.26 (98.3% CI, 0.58-2.74) for drinking only, and 1.27 (98.3% CI, 0.69-2.35) for smoking only compared with the reference group. Conclusions and Relevance: These results suggest that combined drinking and smoking after the first trimester of pregnancy, compared with no exposure or quitting before the end of the first trimester, may be associated with a significantly increased risk of late stillbirth.

Screening at a Federally Qualified Health Center in the Midwest for Hepatitis C Among People Who Inject Drugs, 2019-2020.

INTRODUCTION: Hepatitis C virus (HCV) infection is a public health epidemic. People who inject drugs (PWID) are at high risk for transmitting and contracting HCV. The objective of this study was to assess the effectiveness of a multifaceted intervention at a federally qualified health center in the US Midwest to improve HCV screening rates among PWID. METHODS: A prospective quality improvement initiative was conducted to increase the proportion of PWID screened for HCV. Inclusion criteria consisted of being seen by a primary care provider from April 16, 2019, through February 28, 2020, being aged 18 years or older, and confirmation of intravenous drug use. PWID status was confirmed by reviewing electronic health records. The multifaceted intervention consisted of educational sessions for the health care team and workflow changes. We analyzed the proportion of patients screened preintervention and postintervention by using χ2 tests. RESULTS: Of 742 patients who met the inclusion criteria, the proportion of PWID screened preintervention was 59.6% (n = 329) and the proportion of PWID screened postintervention was 65.1% (n = 283), increasing the screening rate by 5.5 percentage points. A χ2 test of homogeneity indicated a significant relationship between the preintervention and postintervention periods, and screening outcomes (P < .001). CONCLUSION: This multifaceted intervention to increase HCV screening resulted in a modest increase in the proportion of PWID screened. Consistent and health care system-wide screening approaches are needed to optimize the potential of HCV treatment and cure options now available.

Preoperative and Intraoperative Blood Pressure Variability Independently Correlate with Outcomes.

BACKGROUND: Blood pressure variability (BPV) describes visit-to-visit blood pressure (BP) changes independent of hypertension. Preoperative BPV and intraoperative BPV are associated with increased postoperative outcomes. We investigated the impact of both preoperative BPV and intraoperative BPV on elective surgical outcomes, specifically whether preoperative BPV and intraoperative BPV were independent risk factors for surgical complications. MATERIALS AND METHODS: We investigated 600 patients undergoing elective surgery lasting more than two h and who had ≥8 outpatient BP recordings over three preoperative years. Age, sex, ethnicity, BMI, current medical problems, and medications at time of surgery were recorded. BPV was calculated as the standard deviation (SD) of systolic or diastolic BP for the 369 valid patients. Average BPV were compared between adverse outcomes of readmission, wound infection, acute kidney injury, death, myocardial infarction, and cerebral vascular accident. RESULTS: Three-hundred-sixty-nine (52.6% male, 47.4% female, 98.1% non-Hispanic) patients (mean age 62.5) were included in the study. Preoperative systolic (P = 0.043) and diastolic (P = 0.009) BPV were higher for patients with the combined endpoint of all adverse events. Preoperative systolic BPV was correlated with intraoperative BPV (P = 0.010). Both systolic and diastolic preoperative BPV was found to be independent from intraoperative BPV. Otolaryngology procedures were associated with less adverse outcomes (P = 0.034), whil antimicrobials (P = 0.022), autonomic drugs (P < 0.001), or respiratory drugs (P = 0.032) was associated with an increased likelihood of adverse outcome. CONCLUSION: Preoperative DBPV is associated with increased risk of readmission, wound infection and the combined endpoint of all adverse events. Intraoperative systolic blood pressure variability (SPBV) is associated with increased risk of acute kidney injury and the combined endpoint of all adverse events. Preoperative DBPV and intraoperative SBPV are independent risk factors for ninety-d postoperative outcomes. BPV should be considered in individualized risk assessment when assessing patient eligibility for elective procedures.

Compliance with North Dakota's smoke-free law among vape and tobacco specialty shops.

OBJECTIVE: To determine compliance with North Dakota's smoke-free law in vape shops and other tobacco specialty shops selling electronic nicotine delivery systems (ENDS) or e-liquids. DESIGN: In this 2019 descriptive study, shops (n = 35) were assessed for compliance with the smoke-free law by observation of indoor and outdoor areas for smoking or vaping, or evidence of such activity in prohibited areas, and the presence of required no-smoking signs. RESULTS: Only two shops (5.7%) were fully compliant with the smoke-free law. Full compliance for indoor and outdoor environments was 8.5% and 42.8%, respectively. Vaping occurred inside five shops (14.3%), and smoking occurred outdoors within required smoke-free areas in two (5.7%) shops. Four (11.4%) and 17 (48.6%) shops complied with indoor and outdoor signage requirements, respectively. CONCLUSIONS: Overall compliance remained low, although much of the noncompliance was related to signage. Use or evidence of ENDS use occurred both indoors and outdoors where prohibited by law. Classifying ENDS as tobacco products would require tobacco licensure of shops selling ENDS and e-liquids, aiding in identification of the shops for education and enforcement efforts to ensure compliance with the law and to improve public health protection.

Characterization of Virulence Phenotypes of Soybean Cyst Nematode (Heterodera glycines) Populations in North Dakota.

Soybean cyst nematode (SCN; Heterodera glycines) continues to be the greatest threat to soybean production in the United States. Because host resistance is the primary strategy used to control SCN, knowledge of SCN virulence phenotypes (HG types) is necessary for choosing sources of resistance for SCN management. To characterize SCN virulence phenotypes in North Dakota, a total of 419 soybean fields across 22 counties were sampled during 2015, 2016, and 2017. SCN was detected in 42% of the fields sampled, and population densities in these samples ranged from 30 to 92,800 eggs and juveniles per 100 cm3 of soil. The SCN populations from some of the infested fields were virulence-phenotyped with seven soybean indicator lines and a susceptible check ('Barnes') using the HG type tests. Overall, 73 SCN field populations were successfully virulence-phenotyped. The HG types detected in North Dakota were HG types 0 (frequency rate: 36%), 7 (27%), 2.5.7 (19%), 5.7 (11%), 1.2.5.7 (4%), and 2.7 (2%). However, before this study only HG type 0 was detected in North Dakota. The designation of each of these HG types detected was also validated by repeating the HG type tests for 33 arbitrarily selected samples. This research for the first time reports several new HG types detected in North Dakota and confirms that the virulence of SCN populations is shifting and overcoming resistance, highlighting the necessity of using different resistance sources, rotating resistance sources, and identifying novel resistance sources for SCN management in North Dakota.

Effects of Cover Crops on Population Reduction of Soybean Cyst Nematode (Heterodera glycines).

Microplot experiments were conducted to evaluate the effects of cover crops on population reduction of a major soybean pest, soybean cyst nematode (SCN; Heterodera glycines Ichinohe) in 2016 and 2017. Ten crop species, including annual ryegrass (Lolium multiflorum L.), Austrian winter pea (Pisum sativum L. subsp. arvense), carinata (Brassica carinata A. Braun), faba bean (Vicia faba Roth), foxtail millet (Setaria italica (L.) P. Beauvois), daikon radish (Raphanus sativus L.), red clover (Trifolium pratense L.), sweetclover (Melilotus officinalis L.), turnip (Brassica rapa subsp. rapa L.), and winter rye (Secale cereale L.), were planted along with susceptible soybean (Glycine max (L.) Merr. 'Barnes') in soil naturally infested with each of two SCN populations (SCN103 and SCN2W) from two North Dakota soybean fields. Crops were grown in large plastic pots for 75 days in an outdoor environment (microplot). Soil samples were collected from each pot for nematode extraction and SCN eggs were counted to determine the final SCN egg density. The population reduction was determined for each crop and nonplanted natural soil (fallow). All of the tested crops and nonplanted natural soil had significantly (P < 0.0001) lower final population densities compared with susceptible soybean (Barnes). Also, a significant difference (P < 0.0001) was observed between the SCN population suppressions caused by cover crops versus the fallow treatment. All cover crops except Austrian winter pea, carinata, faba bean, and foxtail millet had consistently lower SCN egg numbers than in fallow in both years of the experiments. The average population reductions of SCN by the cover crops ranged from 44 to 67% in comparison with the initial population density, while the fallow had natural reductions from 4 to 24%. Annual ryegrass and daikon radish reduced SCN egg numbers to a greater extent than the other cover crops, with an average of 65 and 67% reduction of initial population density, respectively, from 2 years. The results suggested that cover crops reduced the SCN populations in external microplot conditions, and their use has great potential for improving SCN management in infested fields.

Current Trends in Surgical Procedures Performed in Rural General Surgery Practice.

BACKGROUND: The procedures that rural general surgeons perform may be changing. It is important to recognize the trends and practices of the current rural general surgeon in efforts to better prepare general surgeons who desire to enter a practice in a rural environment. The aim of this review is to detail the recent operative case volumes of 6 rural locations in the upper Midwest where general surgery is practiced. METHODS: The Enterprise Data and Analytics department of Sanford Health compiled all surgical procedures performed within the Sanford Health System between January 1, 2013 and August 31, 2018. Procedures performed by a total of 58 general surgeons in locations of under 50 000 people are included in this review. RESULTS: From January 1, 2013 to August 31, 2018, 38 958 surgical procedures were performed in rural locations. Endoscopic procedures made up 61.6% of a rural general surgeon's practice. Cholecystectomy (6.3%), hernia repair (6.3%), and appendectomy (3.7%) were the principle nonendoscopic procedures performed by rural surgeons, comprising 16.3% of the case volume. Added together, endoscopy, cholecystectomy, hernia repair, and appendectomy made up 77.9% of the rural general surgeon's caseload. Vascular procedures (2.5%), breast procedures (1.8%), obstetrics (0.4%), and urology procedures (0.2%) are also included in this review. CONCLUSIONS: Rural general surgeons are vital to the surgical workforce in the United States. Recognizing a trend that rural general surgeons perform less subspecialty procedures and more endoscopic procedures will provide direction for those interested in pursuing a career in rural general surgery.

Associations between oil development and sexually transmitted infections: Public health nurse perspectives.

BACKGROUND: Oil development (OD) has been associated with increased sexually transmitted infection (STI) rates, with limited focus on the North Dakota (ND) oil boom. Public health (PH) nurse experiences can provide context related to health challenges during OD-related population booms. OBJECTIVE: To compare reported STI rates in ND oil-producing (OP) and non-oil-producing (NOP) counties before, during, and after the oil boom and describe PH nurse experiences during this time. DESIGN: We conducted secondary data analysis of oil production data and reported rates for chlamydia and gonorrhea, and conducted interviews with ND PH nurses. SAMPLE: PH nurses within ND counties geographically located in or near OD in the state. MEASUREMENTS: ND county-level OD data trends were compared to similarly timed reported rates of chlamydia and gonorrhea in OP and NOP counties. PH nurse interviews were conducted addressing their STI-related experiences working in PH during the oil boom. RESULTS: Significant findings include a correlation between OD and gonorrhea rates. PH nurses described a limited PH infrastructure to meet the health needs of a transient, increasing population. CONCLUSIONS: Expanding the role of PH nurses in ND to implement STI screening and treatment would improve access to STI testing allowing for comprehensive reporting of STIs.

Comparison of Anticoagulants for Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting: A Pilot Study.

BACKGROUND: Direct-acting oral anticoagulants are indicated for the treatment of nonvalvular atrial fibrillation, but their use in patients after undergoing cardiac surgery is poorly defined despite a high prevalence of postoperative atrial fibrillation in this population. METHODS: Patients diagnosed with postoperative atrial fibrillation were prospectively randomized to warfarin or apixaban. Safety, efficacy, and economic outcomes were evaluated until their 4- to 6-week postoperative appointment. RESULTS: While this pilot study was not powered to determine a difference in safety or efficacy, adverse event rates were similar to the published literature. It was noted that a patient's course of therapy when utilizing apixaban was significantly less costly than warfarin when including medication, bridging, and laboratory expenses. CONCLUSION: Apixaban and warfarin both appeared to be safe and effective for anticoagulation throughout the duration of this pilot study in treating postoperative atrial fibrillation after coronary artery bypass grafting. Apixaban was associated with significantly less expense when bridging and monitoring costs were included in addition to medication expense.

The shale gas production and economic growth in local economies across the US.

Recently, several seminal works have been drawing attention to the revolution of shale gas production technology of the USA, the impact of shale gas on energy sectors, as well as the influences of shale gas on macroeconomic variables of employment, economic growth, etc. Nevertheless, one may claim that two gaps appear in literature. The first gap is the absence of an econometric study estimating the effect of shale oil/gas on national economies. The more considerable second gap is the absence of econometric analyses revealing the impulses of shale gas on local economies. Therefore, this paper observes the possible causalities between the shale gas and local gross domestic product (GDP) employing quarterly data covering the period 2007-2016 for 12 states in the US. After performing the tests of cross-sectional dependence, heterogeneity, stationarity, and cointegration, the paper conducts the panel Granger causality analyses. The empirical findings depict that (i) there is available unidirectional relationship from local shale gas production to local GDP in Colorado, Ohio, and West Virginia; (ii) there occurs an impulse from GDP to local shale gas production for Louisiana, North Dakota, and Oklahoma; (iii) a bidirectional causality coexists between local shale gas production and GDP in Arkansas, California, and Texas; and (iv) there exists no association between local GDP and local shale gas extraction in Montana, New Mexico, and Wyoming.

Thyroid Cancer Incidence Rates in North Dakota are Associated with Land and Water Use.

Objective: The increasing rate of thyroid cancer diagnoses in the U.S. reflects the increasing use of ultrasonography and of specialist medical care. North Dakota is a rural state with limited access to specialist care, yet its incidence of thyroid cancer is significantly greater than that of the U.S. overall. We sought to identify factors responsible for the high incidence of thyroid cancer in North Dakota. Methods: We examined county-specific incidence rates for thyroid cancer in North Dakota in relation to demographic and geographic factors, including median household income, percent of land fertilized, cattle density per capita, and source of drinking water (city or well water), using structural equation modeling. We included county level data on residential radon levels and estimates of radioactive iodine in milk following nuclear weapons testing in the 1950s. Results: Thyroid cancer incidence rates were significantly associated with median income (p < 0.05); percent of land fertilized (p < 0.05); the use of city water (p < 0.01), and cattle density per capita (p < 0.001). Conclusions: The risk of thyroid cancer in North Dakota is positively associated with income and with factors related to land and water use. Our finding that thyroid cancer incidence rates are associated with the use of city water was unexpected and merits examination in other locations with a mix of city and well water use.

Youth smoking and anti-smoking policies in North Dakota: a system dynamics simulation study.

BACKGROUND: The current study utilizes system dynamics to model the determinants of youth smoking and simulate effects of anti-smoking policies in the context of North Dakota, a state with one of the lowest cigarette tax rates in the USA. METHODS: An explanatory model was built to replicate historical trends in the youth smoking rate. Three different policies were simulated: 1) an increase in cigarette excise taxes; 2) increased funding for CDC-recommended comprehensive tobacco control programs; and 3) enforcement of increased retailer compliance with age restrictions on cigarette sales. RESULTS: The explanatory model successfully replicated historical trends in adolescent smoking behavior in North Dakota from 1992 to 2014. The policy model showed that increasing taxes to $2.20 per pack starting in 2015 was the most effective of the three policies, producing a 32.6% reduction in youth smoking rate by 2032. Other policies reduced smoking by a much lesser degree (7.0 and 3.2% for comprehensive tobacco control program funding and retailer compliance, respectively). The effects of each policy were additive. CONCLUSIONS: System dynamics modeling suggests that increasing cigarette excise taxes are particularly effective at reducing adolescent smoking rates. More generally, system dynamics offers an important complement to conventional analysis of observational data.

An exploration of colorectal cancer incidence rates in North Dakota, USA, via structural equation modeling.

PURPOSE: The state of North Dakota has one of the highest incidence rates for colorectal cancer in the USA. Its high incidence rate, coupled with a large variation in incidence rates among counties within the state, makes North Dakota a "natural laboratory" in which to investigate environmental clues to colorectal cancer. We conducted a hypothesis-generating study to explore potential determinants of colorectal cancer in North Dakota. METHODS: We obtained county-specific incidence rates for North Dakota's 53 counties from the statewide cancer registry and corresponding data on county demographic, agricultural, and geophysical features from population-based sources. Candidate demographic/agricultural variables included median household income, population density, colorectal cancer screening rates, average farm size (in acres), and the percent of county fertilized. Geophysical variables included the uranium content of soil, residential radon levels, and source of drinking water (municipal or well water). Statistical analyses were performed via multivariate regression and structural equation modeling. RESULTS: Colorectal cancer incidence rates across North Dakota counties varied 3-fold. The structural equation model identified a significant role for well water use (p < 0.05). This finding is consistent with studies that implicate well water in colorectal cancer. CONCLUSIONS: Well water contains several agents, e.g., bacteria, disinfection by-products, and nitrates that are potent colorectal carcinogens. Studies of well water use and colorectal cancer risk at the individual level in North Dakota are warranted.

Spatial Distribution of Soybean Cyst Nematode in Research Plots.

Soybean cyst nematode (SCN; Heterodera glycines Ichinohe) is a major pathogen of soybean [Glycine max (L.) Merr.] in the United States. The spatial distribution of SCN in 10 naturally infested research sites in North Dakota was examined between 2006 and 2009. Egg densities were measured in plots and expressed as arithmetic means or grouped into classes using two categorical scales based on the effect of SCN on yield. Data were used to determine spatial distribution, egg cluster sizes, minimum plot sizes, and replications in field experiments. SCN populations varied among plots from undetected to 25,800 eggs/100 cm3 of soil, and differences between adjacent plots were as high as sixfold. Mean to median ratios and Lloyd's index of patchiness suggested an aggregated distribution in nine of the 10 sites. SCN cluster sizes varied in five of the 10 sites and optimum plot size over all sites varied depending on calculation methods. The minimum number of replications needed to detect specific differences among plots varied between field sites. Grouping data into either of the two categories generally increased the ability to detect differences between plots. The spatial distribution of SCN can be a critical factor affecting design and outcomes of field experiments.

Loss of Control Eating and Binge Eating in the 7 Years Following Bariatric Surgery.

BACKGROUND: Although bariatric surgery is an effective intervention for severe obesity, a subset of patients demonstrates suboptimal weight outcomes. Postoperative loss of control eating (LOCE) and binge eating may influence weight outcomes, though research has not examined differences by surgical procedure, or factors that predict postoperative LOCE. This study aimed to [1] characterize LOCE and binge eating disorder (BED) over a 7-year period following bariatric surgery; [2] examine concurrent, prospective, and cumulative relationships between LOCE and weight loss; [3] assess whether these associations are moderated by surgery type; and [4] evaluate predictors of LOCE. METHODS: Participants were 2156 patients who underwent laparoscopic adjustable gastric banding (LAGB) or Roux-n-Y gastric bypass (RYGB) in the multi-center Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study. Generalized linear mixed models examined relationships between LOCE and percent weight loss and predictors of LOCE. RESULTS: LOCE and BED initially declined then increased after surgery, with a notable number of de-novo cases (25.6% and 4.8%, respectively). LOCE was related to less concurrent but not prospective or cumulative percent weight loss. Self-monitoring of eating, higher daily eating frequency, older age, male gender, and higher self-esteem were associated with a lower likelihood of LOCE. CONCLUSIONS: Results suggest that LOCE and binge eating are clinically relevant behaviors that may impede weight loss, and findings highlight the importance of ongoing assessment of maladaptive eating following surgery.

Oil Development and Intimate Partner Violence: Implementation of Section 8 Housing Policies in the Bakken Region of North Dakota and Montana.

One of the challenges survivors of intimate partner violence (IPV) often face is securing safe and affordable housing. Many survivors qualify for public housing programs such as the Section 8 Project-Based Rental Assistance (PBRA) program and tenant-based Housing Choice Voucher Program (HCVP). These programs can be vital for survivors fleeing abuse and trying to rebuild their lives. But how might regional conditions such as rapid population growth resulting from an oil boom affect the implementation of such programs for survivors? In addition, what role might such policies play in preventing future violence in resource boom communities? Analyzing existing policies and qualitative data collected from in-depth interviews with survivors, community members, and service providers in the Bakken region of North Dakota and Montana, we evaluate the implementation of Section 8 housing programs in oil-affected communities for survivors of IPV. We find that survivors of IPV often had a difficult time accessing affordable housing in the Bakken. Eligibility restrictions prevented some survivors from utilizing Section 8 housing programs, some landlords opted out of Section 8 program participation at the height of the oil boom, and the housing crisis may have simultaneously contributed to low utilization of housing vouchers. These conditions increased vulnerability for IPV survivors. We conclude by exploring the impact of the Violence Against Women Act (VAWA), state, and local initiatives on housing access and affordability, and the efficacy of Section 8 housing programs during the oil boom. Understanding the relationship between natural resource development, rapid population increases, housing inflation, and Section 8 housing programs should be considered as policy makers prioritize social programs in boomtown communities that may affect the well-being and safety of IPV survivors.

Detection and quantitation of immunogenic epitopes related to celiac disease in historical and modern hard red spring wheat cultivars.

Celiac disease (CD) develops in genetically susceptible individuals as a result of ingesting gluten-forming proteins found in cereals, such as wheat (Triticum aestivum L.), rye (Secale cereale L.) and barley (Hordeum sativum L.). There are claims that breeding practices have changed wheat protein chemistry over the years and this has resulted in modern wheat being more antigenic in terms of CD as opposed to historical wheat. The aim of this study was to detect and quantify celiac-disease-initiating peptides of α-gliadin proteins in historical and modern spring wheat cultivars. The results indicate that immunogenic epitopes are detected in both historical and modern spring wheat cultivars irrespective of release year. Quantitation indicated that the amount of immunogenic epitopes glia-α9 (PFPQPQLPY) and glia-α20 (FRPQQPYPQ), and total α-gliadin varied randomly across the cultivars that were analyzed, suggesting there is no association between cultivar release year and amounts of immunogenic epitopes and α-gliadin.

Disparities in Risk Factors and Birth Outcomes Among American Indians in North Dakota.

Objectives High infant mortality rates among American Indians in North Dakota contribute to a 20-year gap in average age at death compared to whites. Geographic- and race-specific health disparities data to drive policy making and interventions are not well disseminated. The current study examines prenatal risk factors and birth outcomes between American Indian and whites in North Dakota. Methods A retrospective descriptive analysis of North Dakota live births from 2007 to 2012 was conducted. Period prevalence and prevalence ratios were calculated. Results The infant mortality rate from 2010 to 2012 for infants born to American Indian women was 3.5 times higher than whites. Racial disparities existed in education, teen births, tobacco use during pregnancy, and breastfeeding initiation. Disparities widened for inadequate prenatal care, illegal drug use during pregnancy, and infant mortality from 2007-2009 to 2010-2012 and narrowed for sexually transmitted infections and alcohol use during pregnancy. Conclusions for Practice American Indians are disproportionately affected by poor pregnancy and birth outcomes in North Dakota. Future geographic-specific American Indian research is warranted to aid current and future public health interventions.