Perspectives on Working with Immigrants Held in Detention Using Photovoice.

Those who work with immigrants in detention centers may be at increased risk of secondary trauma. This study used Photovoice to capture reflections on how the lives of volunteers are affected by their work on behalf of immigrant family detainees. Participants were recruited over a two-month period in 2018 from amongst the volunteers of a non-governmental organization that provides legal services to the detainees at one immigration detention center. Participants submitted photos and captions that explored their experiences with their work. Thirteen volunteers consented to participate and submitted 44 photos with captions to the project. Major themes included emotional challenges of the work, frustrations with the U.S. government, comparison of their experiences to those of their clients', and finding uplifting moments. Our findings regarding the significant emotional challenges of this work are of particular importance given the increasing coverage of immigration detention in the media and the increased interest in volunteer opportunities to support this population.

A century of climate and land-use change cause species turnover without loss of beta diversity in California's Central Valley.

Climate and land-use changes are thought to be the greatest threats to biodiversity, but few studies have directly measured their simultaneous impacts on species distributions. We used a unique historic resource-early 20th-century bird surveys conducted by Joseph Grinnell and colleagues-paired with contemporary resurveys a century later to examine changes in bird distributions in California's Central Valley, one of the most intensively modified agricultural zones in the world and a region of heterogeneous climate change. We analyzed species- and community-level occupancy using multispecies occupancy models that explicitly accounted for imperfect detection probability, and developed a novel, simulation-based method to compare the relative influences of climate and land-use covariates on site-level species richness and beta diversity (measured by Jaccard similarity). Surprisingly, we show that mean occupancy, species richness and between-site similarity have remained remarkably stable over the past century. Stability in community-level metrics masked substantial changes in species composition; occupancy declines of some species were equally matched by increases in others, predominantly species with generalist or human-associated habitat preferences. Bird occupancy, richness and diversity within each era were driven most strongly by water availability (precipitation and percent water cover), indicating that both climate and land-use are important drivers of species distributions. Water availability had much stronger effects than temperature, urbanization and agricultural cover, which are typically thought to drive biodiversity decline.

Health Information Seeking Behavior Among College Students.

Individuals have a wide range of resources when searching for health topics. The aim of this research was twofold: (1) to identify and assess the resources college students use when exercising health information seeking behavior (HISB); and (2) to examine perceptions and behaviors regarding adoption of online tools. A questionnaire was developed to assess HISB in a sample of college students. Items pertaining to HISB were adapted from a Health Information National Trends Survey with permission from the National Cancer Institute at the National Institutes of Health. During Spring 2018, 258 students in 9 sections of a personal health class at a public university in NJ completed the questionnaire. Students were most likely to often or always use the Internet for health information (n = 74%) over other sources. Females were more likely to use the Internet for health information (p = .030), to consult a health or medical professional (p = .042) and to confirm the health information they find with a health or medical professional (p = .028). Females also reported spending significantly more time on social media (mean 4.96 h/day) compared to males (4.00 h/day, p = .041). Non-white students were significantly more likely to often use the Internet to find health information (p = .039), while white students reported spending significantly less time on the Internet (p < .001) and on social media (p < .001). Future research is needed to understand motivating factors for HISB, and to tailor interventions accordingly to assure that college students who exhibit HISB have appropriate levels of e-health literacy.

Glove Changing Practices of Mall Food Vendors in New Jersey.

Gloves can serve as barriers to decrease the transfer of microorganisms from hands to food. Glove changing by food vendors is particularly important when handling paper currency, as bills can carry and transmit microbes from person to person. The purpose of this study was two-fold: (1) To ascertain the extent to which gloves are changed after monetary transactions in food vendors at a major mall in New Jersey; and (2) to document the level of bacterial contamination and the presence of coliform bacteria on paper currency handled by these vendors. This study was conducted with two phases: Phase 1, in which 10 min of observation of food workers was completed followed by a monetary sample collection and testing, and Phase 2, in which 1 h of observations were conducted. During Phase 1, gloves were changed after 4 (2.3%) of the 174 transactions. All the dollar bills collected from all 17 vendors during Phase 1 exhibited bacterial contamination. The number of CFUs ranged from 1.18 × 107 to 1.13 × 1010, and bills collected from 6 of the 17 vendors (35.3%) tested positive for coliform bacteria. In Phase 2, gloves were changed after 3.35% of the 1193 transactions observed. This study makes the critical connection between the lack of compliance by food workers with the health code, and the contaminated money they may be handling while dispensing food.

Socioecological Factors Related to Hazardous Alcohol use among Female Sex Workers in Lilongwe, Malawi: A Mixed Methods Study.

BACKGROUND: Alcohol use is pervasive among female sex workers (FSW) placing them at increased risk of violence and sexual risk behaviors. FSW often live and work where alcohol is highly normative. OBJECTIVE: To understand the socioecological influences on hazardous alcohol use among FSW in Malawi. METHODS: In 2014, 200 FSW identified through venue-based sampling in Lilongwe, Malawi, completed a quantitative behavioral survey, with a sub-sample participating in qualitative interviews. Multivariable log-binomial regression was used to identify associations between hazardous alcohol use (AUDIT score ≥ 7) and time in sex work, clients per week, unprotected sex, alcohol use with clients, and living environment. Qualitative interviews enhanced findings from quantitative data and identify emergent themes around socioecological influences on alcohol use. RESULTS: Over 50% reported hazardous alcohol use and lived in an alcohol-serving venue. Hazardous alcohol use was associated with sex work duration of ≥2 years (aPR: 1.30; 95%CI: 1.02,1.65) and alcohol use at last sex with a client (aPR: 1.29; 95%CI: 1.06,1.57). FSW perceived alcohol as a facilitator for sex work by reducing inhibitions and attracting clients, but acknowledged alcohol leads to violence and/or unprotected sex. Despite these risks and a motivation to reduce use, FSW feared that refusing to drink would be tantamount to turning away clients. CONCLUSIONS: Although FSW recognized alcohol-related risks, the norms and power dynamics of sex work perpetuated hazardous alcohol use. Multilevel interventions are needed to collectively change norms around drinking and sex work that will enable FSW to reduce alcohol consumption when engaging in their work.

Species' traits as predictors of range shifts under contemporary climate change: A review and meta-analysis.

A growing body of literature seeks to explain variation in range shifts using species' ecological and life-history traits, with expectations that shifts should be greater in species with greater dispersal ability, reproductive potential, and ecological generalization. Despite strong theoretical support for species' traits as predictors of range shifts, empirical evidence from contemporary range shift studies remains limited in extent and consensus. We conducted the first comprehensive review of species' traits as predictors of range shifts, collecting results from 51 studies across multiple taxa encompassing over 11,000 species' responses for 54 assemblages of taxonomically related species occurring together in space. We used studies of assemblages that directly compared geographic distributions sampled in the 20th century prior to climate change with resurveys of distributions after contemporary climate change and then tested whether species traits accounted for heterogeneity in range shifts. We performed a formal meta-analysis on study-level effects of body size, fecundity, diet breadth, habitat breadth, and historic range limit as predictors of range shifts for a subset of 21 studies of 26 assemblages with sufficient data. Range shifts were consistent with predictions based on habitat breadth and historic range limit. However, body size, fecundity, and diet breadth showed no significant effect on range shifts across studies, and multiple studies reported significant relationships that contradicted predictions. Current understanding of species' traits as predictors of range shifts is limited, and standardized study is needed for traits to be valid indicators of vulnerability in assessments of climate change impacts.

Attitudes and Behaviors Related to Sun-Safety in College Students.

The purpose of this study was to determine the level of sun safe behaviors, as well as to measure knowledge and attitudes toward being tan in a sample of college students. The sample was comprised of 315 college students attending a personal health course. During Fall of 2016, a survey was distributed to assess knowledge, attitudes, and behaviors of university students regarding skin cancer related behaviors. Students with a friend or family member with skin cancer more often reported thinking that they were at risk for developing skin cancer (48.6 vs. 21.2%, p < 0.001). Despite this opinion, they more often sunbathed (p = 0.008) and had a sunburn (p < 0.001) in the past year. Being in a health-related major did not significantly impact attitudes or behaviors. Future studies can focus further on raising awareness about skin cancer, specifically in college aged populations.

Concordant and opposing effects of climate and land-use change on avian assemblages in California's most transformed landscapes.

Climate and land-use change could exhibit concordant effects that favor or disfavor the same species, which would amplify their impacts, or species may respond to each threat in a divergent manner, causing opposing effects that moderate their impacts in isolation. We used early 20th century surveys of birds conducted by Joseph Grinnell paired with modern resurveys and land-use change reconstructed from historic maps to examine avian change in Los Angeles and California's Central Valley (and their surrounding foothills). Occupancy and species richness declined greatly in Los Angeles from urbanization, strong warming (+1.8°C), and drying (-77.2 millimeters) but remained stable in the Central Valley, despite large-scale agricultural development, average warming (+0.9°C), and increased precipitation (+11.2 millimeters). While climate was the main driver of species distributions a century ago, the combined impacts of land-use and climate change drove temporal changes in occupancy, with similar numbers of species experiencing concordant and opposing effects.

Characterization of the mental health of immigrant children separated from their mothers at the U.S.-Mexico border.

Immigrant children who faced forced separation from their parents may be at heightened risk of developing mental health disorders, including depression, post-traumatic stress disorder (PTSD), and anxiety disorders. This cross-sectional study assessed the mental health of children being held in U.S. immigration detention who had been previously separated from their mothers. We interviewed 73 mothers about their eldest child age 5-17 using the Parent-Report version of the Strengths and Difficulties Questionnaire (SDQ). Among these children, many had elevated scores for emotional problems (49%), peer problems (21%), and total difficulties (15%). Male children demonstrated significantly higher rates of abnormal peer problems compared to females. Younger children (age 5-11 years) also demonstrated significantly higher rates of abnormal conduct problems, hyperactivity, and total difficulties. Scores did not differ significantly based on length of separation. Results reveal that children who had been separated from their parents experience high levels of mental health distress, which are especially high in younger children. Regardless of length of separation, these children would benefit from comprehensive mental health treatment with a culturally-responsive and trauma-informed lens.

Breast Cancer on Instagram: A Descriptive Study.

BACKGROUND: Breast cancer has an impact not only on those who are diagnosed, but also on their social network, creating an even greater need for the availability of reliable information and support. METHODS: The purpose of this study was to document the content of posts on the highly popular social media platform, Instagram. Posts were garnered and analyzed from Instagram using the hashtag #breastcancer. Data were collected at three different points in time in 2018 and were then aggregated. RESULTS: The most common attributes were highlighting an individual story (n = 76), discussing support for those with breast cancer (n = 75), discussing treatment (n = 55), or promoting an alternative treatment or product (n = 24). Posts that contained images of people were more likely highlight an individual story (P = 0.001) and discuss treatment (P = 0.046). CONCLUSIONS: Future research can focus on best practices for developing breast cancer-related information on social media.

A content analysis of HPV related posts on instagram.

Human papillomavirus, or HPV, is the most common sexually transmitted disease in the United States. Despite the potential deleterious effects of HPV, vaccine uptake remains suboptimal. One potential venue for educating the public about HPV and vaccinations is through social media such as the widely used Instagram platform. Given the widespread reach of a platform with such a vast user base, the aim of this study was to describe posts related to HPV on Instagram. Content categories were established using fact sheets from the Centers for Disease Control HPV index page. Important content categories were created and the resultant coding sheet was used to analyze posts from the hashtag #HPV. Of the 150 posts analyzed, 53 posts (35%) mentioned the HPV vaccine. More were pro-vaccine (28%) versus anti-vaccine (7%). Posts mentioned the association of HPV with cancer (35%) and prevention of HPV (32%). Posts with a higher number of likes were more likely to mention cancer (p = 0.016) and HPV screening (p = 0.041). Among those that mentioned the HPV vaccine, posts that were anti-vaccine were more likely to mention prevention (p < 0.001) and cancer (p < 0.001). As new technology emerges and is widely adopted, health professionals should be aware and adept at using what is popular to influence given audiences. This applies to adolescents in particular, who, by and large are frequent users of technology for communication.

Readability of online information about HPV Immunization.

The human papillomavirus (HPV) vaccine is highly effective in preventing anogenital cancers, but vaccination rates in the United States remain low. In deciding whether to vaccinate their children, parents are increasingly using the internet to gather information. This study aimed to examine the level of readability of information on HPV vaccines written on 100 websites that were found via an internet search. To create the website sample, the first 50 websites from the search "HPV immunization" were recorded, followed by the first 50 non-duplicated websites from the search "Gardasil." The content of the sites was analyzed using established readability scales. Websites were compared based on keyword search and on whether they had a commercial or non-commercial URL extension. The majority of websites were found to have information of a difficult reading level. Websites with commercial URL extensions and websites found using the search "Gardasil" had higher mean readability scores. These results suggest that many parents may not understand the information currently presented on the internet and that interventions aimed at improving the readability of online information could help to increase parental approval of the vaccine.

Information on teeth whitening from employees at establishments in New York City.

Teeth whitening (bleaching) is a popular cosmetic procedure in the United States and the potential side-effects are well-documented. Establishments offering whitening procedures in New York City were found online and 148 were successfully contacted to inquire about the benefits, side effects, and eligibility criteria of their whitening procedures. Most had no eligibility criteria and the only stated benefit was brighter teeth. Representatives from 25 businesses stated that there were no side effects. About half of the establishments used UV light and employees at these businesses were more likely to state that there were side effects. While limited in its cross-sectional design, this study demonstrates a lack of effective communication by employees regarding the side effects of teeth whitening. Future public health research on this topic would complement existing biological and clinical research.

Improving understanding about dental health issues in college students.

Good oral health has been shown to be an important facet of overall well-being. Optimal oral health is achieved through routine daily self-care, proper diet, and regular prevention visits to a dental professional. Adolescence and early adulthood may be a time where these self-care routines change for a variety of reasons, including newfound independence, changes in one's financial status, or transportation difficulties. Therefore, the aim of this study was to describe the dental health status and behaviors of a sample of college students, as well as identify barriers to oral healthcare. Results from this diverse sample (n = 705, 95% response rate) revealed that nearly a third (31.3%) of the students had a current untreated dental health issue, with the most common barriers reported by these students being cost (n = 92) and lack of time (n = 89). Daily self-care behaviors (brushing and flossing) were more prevalent in the morning rather than evening hours.

Physician Characteristics and Decisions Regarding Cancer Screening: A Systematic Review.

The guidelines provided by experts regarding various cancer screening tests are not universally accepted by physicians or patients. This systematic review describes the literature regarding the associations of physician characteristics with the implementation of and referral of patients for selected cancer screening tests. In October 2016, the authors conducted a thorough search of articles found in 4 databases, using keywords describing physician characteristics and cancer screening. English-language articles reporting on patient surveys or records of patients' screening history, and surveys of physicians' practices or opinions, in the United States were included. The physician characteristics most commonly analyzed were specialty and sex. The screening tests most commonly analyzed were those for cervical and colorectal cancers. Female and white physicians were found to screen more patients than male and nonwhite physicians. Obstetrician-gynecologists screened more for breast and cervical cancer than internists, who screened more than family or general practitioners. Physician sex, race, and specialty were consistently associated with cancer screening practices and should be the focus of efforts to harmonize practices with recommendations.

Escherichia coli on the internet: The power of YouTube to educate and influence consumer behavior regarding pathogenic bacteria.

BACKGROUND: Proper education about food safety and hand hygiene helps to reduce the risk of exposure to Escherichia coli associated disease. The purpose of this study was to describe the 100 most widely viewed YouTube videos on the subject of E. coli to determine what consumers are viewing related to the hazards of, and reducing risk of exposure to, bacteria such as E. coli. METHODS: The search term was conducted using the keywords "E. coli." The 100 videos with the top view counts were included in this study. The sampling frame for this study included only videos that were in English. The source of the upload of each video was determined to be one of the following: (1) consumer, (2) professional (MD, RN)/government, (3) any news (television-based, internet-based, or print/radio). Content categories were created using a fact sheet from the Centers for Disease Control and Prevention. RESULTS: Videos uploaded by a news source tended to have been uploaded more recently (2015-2018) compared to other sources (p < 0.001). Videos uploaded by consumers or news sources tended to have more views than professional/government-uploaded videos (p = 0.044). Videos uploaded by news sources were more likely to mention a specific outbreak (p < 0.001), statistics (p = 0.004), and transmission via raw meat (p = 0.036), feces (p = 0.006), vegetables or produce (p = 0.006), and processing techniques (p = 0.005). CONCLUSIONS: YouTube videos on the topic were widely divergent, and varied in content, emphasizing different aspects of concern over hazards associated with E. coli. Consumer sources, rather than experts, were the most common source of upload of the most highly viewed videos. Government agencies, which collect and analyze public health data, do not appear to use YouTube effectively to disseminate information. This underscores the need for media to work with government agencies to provide accurate, timely information to the public.

A Cross-sectional Analysis of Compassion Fatigue, Burnout, and Compassion Satisfaction in Pediatric Emergency Medicine Physicians in the United States.

OBJECTIVES: The objective was to determine the prevalence of compassion fatigue (CF), burnout (BO), and compassion satisfaction (CS) and identify potential personal and professional predictors of these phenomena in pediatric emergency medicine (PEM) physicians. METHODS: A modified Compassion Fatigue and Satisfaction Self-Test for Helpers and a questionnaire of personal and professional characteristics were distributed electronically to PEM physicians nationally. The prevalence of these phenomena was calculated. Hierarchical linear regression models for CF, BO, and CS as a function of potential risk factors were constructed. RESULTS: The final analyzable survey rate represented 22.7% of the physicians invited to participate. The prevalences of CF, BO, and CS were 16.4, 21.5, and 18.5%, respectively. BO score, distress about a "clinical situation," "physical work environment," and engaging in prayer/meditation were each significant determinants of higher CF scores, whereas "socializing with family/friends" was significantly associated with lower CF scores. CF score, emotional depletion, and distress due to "coworkers" were each significant determinants of higher BO scores, whereas CS score and "talking with a family member" as a means of self-care were significantly associated with lower BO scores. Socializing with family/friends and >20 years as PEM provider were each significant determinants of higher CS scores, whereas BO score, emotional depletion, distress about the physical work environment and "administrative issues," 10% to 24% of time spent caring for pediatric patients, and "talking with life partner" about work-related distress were each significant determinants of lower CS scores. We acknowledge that the generalizability of our findings is limited by the sample size and by the fact that participants were largely female, Caucasian, and junior faculty and worked in academic medical centers. CONCLUSIONS: PEM physicians are at risk for developing CF, BO, and low CS. Proactive awareness of these phenomena and their predictors may allow providers to better manage the unique challenges and emotional stressors of the pediatric ED to enhance personal well-being and professional performance.

Mental health of children held at a United States immigration detention center.

Rationale; Children held in immigration detention may be at risk for mental health disorders due to the impacts of pre-migration factors, including exposure to violence, their displacement from their home countries, their journey between countries, and the conditions of their detention. Limited research has demonstrated high rates of clinical depression, post-traumatic stress disorder (PTSD), and anxiety disorders among detained immigrant children. Objective; In this cross-sectional study, we assessed the mental health of children held at a US immigration detention center over two months in mid-2018. Method; We interviewed 425 mothers about their eldest child age 4-17 using the Parent-Report Strengths and Difficulties Questionnaire (SDQ). A subset of 150 children age ≥9 completed the UCLA Post-Traumatic Stress Disorder Reaction Index (PTSD-RI). Results; Among the 425 children studied, many demonstrated elevated scores for emotional problems (32%), peer problems (14%) and total difficulties (10%) on the SDQ. Younger children (age 4-8 years) demonstrated more difficulties associated with conduct, hyperactivity, and total difficulties (all p < 0.001) compared to older children. Children who had been forcibly separated from their mothers demonstrated significantly more emotional problems (49%, p = 0.003) and total difficulties (15%, p = 0.015) than those who had never been separated. Of the 150 children who completed the PTSD-RI, 17% had a probable diagnosis of PTSD. In all, nearly half (44%) of all children demonstrated at least one emotional or behavioral concern. Conclusions; These data demonstrate that children being held in immigration detention experience high levels of mental health distress. Results suggest they would benefit from more comprehensive mental health screening and release into the community, as well as culturally-responsive and trauma-informed mental health care.

Readability of Colorectal Cancer Online Information: A Brief Report.

PURPOSE: Colorectal cancer (CRC) is the third leading cause of cancer-related death in the United States. A decline in deaths caused by CRC has been largely attributable to screening and prompt treatment. Motivation, shown to influence cancer-related screening and treatment decisions, can be shaped by information from the Internet. The extent to which this information is easily readable on cancer-related websites is not known. The purpose of this study was to assess the readability levels of CRC information on 100 websites. METHODS: Using methods from a prior study, the keyword, "colorectal cancer," was searched on a cleared Internet browser. Scores for each website (n = 100) were generated using five commonly recommended readability tests. RESULTS: All five tests demonstrated difficult readability for the majority of the websites. CONCLUSIONS: Online information related to CRC is difficult to read and highlights the need for developing cancer-related online material that is understandable to a wider audience.