Barriers and Facilitators Impacting Lung Cancer Screening Uptake Among Black Veterans: A Qualitative Study.

BACKGROUND: Racial disparities in lung cancer screening (LCS) are well established. Black Veterans are among those at the highest risk for developing lung cancer but are less likely to complete LCS. We sought to identify barriers and facilitators to LCS uptake among Black Veterans. PATIENTS AND METHODS: A qualitative study using semistructured interviews was conducted with 32 Black Veterans to assess for barriers, facilitators, and contextual factors for LCS and strategies to improve screening. Veterans were purposively sampled by age, sex, and LCS participation status (ie, patients who received a low-dose CT [LDCT], patients who contacted the screening program but did not receive an LDCT, and patients who did not connect with the screening program nor receive an LDCT). Interview guides were developed using the Theoretical Domains Framework and Health Belief Model. Data were analyzed using rapid qualitative analysis. RESULTS: Barriers of LCS uptake among Black Veterans include self-reported low LCS knowledge and poor memory, attention, and decision processes associated with the centralized LCS process. Facilitators of LCS uptake among Black Veterans include social/professional role; identity and social influences; perceived susceptibility, threat, and consequences due to smoking status and military or occupational exposures; emotion, behavioral regulation, and intentions; and high trust in providers. Environmental context and resources (eg, transportation) and race and racism serve as contextual factors that did not emerge as having a major impact on LCS uptake. Strategies to improve LCS uptake included increased social messaging surrounding LCS, various forms of information dissemination, LCS reminders, balanced and repeated shared decision-making discussions, and streamlined referrals. CONCLUSIONS: We identified addressable barriers and facilitators for LCS uptake among Black Veterans that can help focus efforts to improve disparities in screening. Future studies should explore provider perspectives and test interventions to improve equity in LCS.

Therapist Participation in a Learning Collaborative on Trauma-Focused Cognitive Behavioral Therapy: Impact of COVID-related Stressors and Challenges.

The rise in mental health problems during the COVID-19 pandemic amplified the need to improve access to evidence-based treatments (EBT) and necessitated changes in treatment delivery and training of mental health providers (MHPs). There is limited information on how the pandemic may have impacted MHPs' participation in training and treatment delivery. This study included 269 MHPs who participated in a Learning Collaborative (LC) focused on an EBT. Qualitative interviews conducted with 15 MHPs who participated in the LC during the pandemic identified facilitators and barriers to training participation and EBT delivery that included social support, technology challenges, and difficulty completing cases following the transition to telehealth. Quantitative results showed that MHPs in the peri-COVID cohorts completed significantly fewer cases and fewer consultation calls compared to those prior to the pandemic. Findings suggest that providing support to train MHPs and promote EBT delivery may be beneficial during times of heightened stress.

Tractor Injuries in the Upper Midwestern United States: a retrospective analysis of four trauma centers.

OBJECTIVES: The purpose of the present study was to characterize the incidence, injury characteristics, and outcomes of patients presented to four trauma facilities located in the upper Midwest with tractor-related agricultural injuries. METHODS: We performed a retrospective review of the facility level trauma registries of four trauma centers located in North Dakota, South Dakota, and Minnesota between January 1, 2010 and December 31, 2021. We characterized the incidence, severity and outcomes of traumatic tractor-related agricultural injuries for pediatric and adult patients. We described the nature of these injuries by severity, anatomical site, type, age, sex, and length of stay (LoS). Injury severity was evaluated using Injury Severity Score (ISS) and Abbreviated Injury Scale (AIS). RESULTS: Findings indicated that farmers aged 65 and older experience polytraumatic, severe tractor-related agricultural injuries and fatalities. Of the 177 tractor patients analyzed, 40 patients were between the ages of 65 and 74 years and 45 patients were 75 and over. Male farmers aged 65 and older are injured year-round, many are discharged to skilled nursing facilities for additional care, are spending more time in the hospital, and have the highest rate of critical injuries out of all age groups. Moreover, the patients who died as a result of tractor-related agricultural injuries were men over 65 years. The most common tractor-related agricultural injuries include falls from tractors (n = 53), struck by object falling/propelled from tractor (n = 25), rollovers (n = 26), and runovers (n = 24). Falls from tractors accounted for 33% of all tractor-related upper extremity fractures, 36% of head injuries and 29% of chest injuries. CONCLUSION: The findings from this study indicate that tractor-related agricultural injuries represent a significant problem in the upper Midwest. Older, male farm workers experience a higher incidence of tractor-related agricultural injuries, and all tractor-related fatalities occurred in individuals 65 years of age and older. These results underscore the need for further investigation into aging-related farm safety issues.

Research Note: Reducing food loss in the manufacturing process of chickens by reconditioning dropped raw poultry carcasses with peroxyacetic acid and sodium hypochlorite (chlorine) solution.

Food waste and food loss has been a growing concern in the manufacturing industry with a gap between identifying the problem and implementing a solution. The manufacturing process of chicken is largely automated by conveyor belts and machines in which initial application of either peroxyacetic acid (PAA) or sodium hypochlorite (chlorine) solution is utilized to reduce the microbial load and prevent food borne illnesses on the chicken products as they are processed and packaged for distribution. However, during this automated process whole chickens can drop from the manufacturing line and become contaminated leading to the disposal and waste of the product. A solution to reduce food waste was to analyze a reconditioning procedure within the manufacturing process. The study evaluated the aerobic microbial growth on salvaged marinated deli raw whole chickens without giblets (WOGs) from conveyor belt loss reconditioned in either PAA or sodium hypochlorite (chlorine) solution to undropped chicken WOGs. Chicken rinsate and segmented samples were collected from each parameter and tested for microbial growth using Petrifilm aerobic plate count (APC) plates and converting results into log colony forming units (CFU). A difference (P < 0.05) was observed with the reconditioning of the WOGs in PAA (0.71 log10 CFU/mL) compared to the control (1.45 ± 0.26 log10 CFU/mL), for rinses. Of the segmented samples, the trussing strings displayed a significant decrease in APC counts for both chlorine (2.30 ± 0.49 log10 CFU/g) and PAA (2.3 ± 0.49 log10 CFU/g) reconditioning compared to the control (2.72 ± 0.39 log10 CFU/g). Reconditioning of salvaged deli chicken WOGs in chlorine or PAA is comparable to or better than the conventional process for the reduction of APC, it is an effective strategy to reintroduce dropped marinated deli chicken WOGs to the manufacturing line and can reduce food waste at a manufacturing level.

Using Partnerships and Multiple Data Sources to Surveil Agricultural Injuries: Considerations and Recommendations.

This article describes an interprofessional collaboration between Sanford Health and North Dakota State University that strengthens agricultural injury surveillance in the upper Midwest by using multiple sources of health data and geographic information systems (GIS) technology. We provide methodological insights and considerations for using and combining facility-level trauma registry (FLTR) data, national data sets, and GIS to identify areas with disproportionate agricultural injury prevalence. Additionally, we discuss the benefits of FLTR data, how and why it is collected, the data it contains, and how it can be combined with national datasets to fill-in surveillance gaps. Lastly, we offer recommendations for building cross-institutional and interprofessional partnerships.

Physiological Arousal, Attentiveness, Emotion, and Word Retrieval in Aphasia: Effects and Relationships.

PURPOSE: This study aimed to (a) compare physiological arousal and attentiveness during a confrontational naming task between participants with aphasia and a control group across four conditions that varied according to emotionality of presented stimuli and (b) explore relationships among physiological arousal, attentiveness, perceived arousal, and naming performance. We hypothesized that participants with aphasia would show lower levels of arousal and attentiveness than control participants and that emotional conditions would lead to increased physiological arousal and attentiveness. METHOD: Eight participants with aphasia and 15 control participants completed a confrontational naming task under positive, negative, and neutral conditions and rated their perceived arousal after each. Electrophysiological recordings were taken during the entire experiment to obtain measures of heart rate (HR), HR variability, and skin conductance (SC). Videos of confrontational naming trials were rated based on visual signs of participant attentiveness during each trial. RESULTS: Statistically significant group differences were found for HR, SC, and attentiveness ratings, but no differences were found in these measures among conditions. Correlational analyses revealed statistically significant relationships between attentiveness and response time, HR, and naming accuracy. Significant correlations were also found for HR and naming accuracy as well as perceived arousal and naming accuracy. CONCLUSIONS: Findings suggest that decreased physiological arousal or attentiveness may contribute to naming deficits for people with aphasia (PWA). Assisting PWA to fully attend to and engage in therapy tasks may be important for accurate assessment of language functions and for achieving optimal benefit in treatment.

Children and youth agricultural injuries: A retrospective analysis of pediatric trauma admissions in North Dakota.

Introduction: Farm children and youths face unique health risks, including increased risk of agricultural injuries (AI), due to the hazardous machinery, structures and animals on their residential environment. As a result, they experience more severe and complex polytraumatic injuries and longer hospital stays compared to those children injured in homes or residences. A major barrier to the prevention of AI among children and youth residing on farms is a lack of analytic studies about the magnitude and characteristics of these injuries, especially in North Dakota. Methods: We performed a retrospective review of the Sanford Medical Center Fargo trauma registry for pediatric patients (aged 0-19 years) who received care between January 2010 and December 2020 for AI. Patients were grouped for analysis by the age categories of the Agricultural Youth Work Guidelines (AYWG) to compare the mechanisms of injury with the recommended minimum age requirements for specific farm tasks. Results: Of the 41 patients, 26 were male. Mean age was 11 years and one death was reported. The most common mechanism of injury was animals (37%), followed by falls (20%) and machinery (17%). Children under 6 years and youth aged 16 to 19 had the highest number of injuries. Females experienced 53% of animal-related injuries and males accounted for all vehicle-related injuries. Conclusion: The incidence and severity of polytraumatic AI among young children in North Dakota is concerning. Our results underscore the continued need to pursue pediatric injury prevention on farms through educational resources and programs, including the AWYG. Practical applications: Parents require more training on age and ability appropriate farm tasks, especially animal-related interactions. It is imperative that families are given the education and training necessary to integrate children into the farm life while protecting them from injury.

A Scoping Review on Resources, Tools, and Programs to Support Women's Leadership in Global Health: What Is Available, What Works, and How Do We Know?

Background: The unequal representation of women in global health leadership is a prevalent issue laterally across global health fields and vertically down experience levels. Although women compose much of the workforce, gender-based barriers prevent female talent from filling their appropriate leadership roles, which funnels unique expertise and problem-solving skills on a diversity of health topics out of positions of leadership. Currently, many calls to action have been proposed to raise awareness of the lack of women's global health leadership, with Women in Global Health as one of the more prominent movements. This paper evaluates how the priorities and strategies for leadership training and development set forth by such movements have changed the landscape of available programs and resources for women in global health, based on availability, success, and evaluation. Objectives: This manuscript maps existing programs and resources that support women's leadership in global health and describes available evaluations and documented outcomes. Methods: We used a dual approach of a peer-reviewed and gray literature search to build a comprehensive list of existing programs and resources designed to support women's leadership in global health. Out of 54 items included for full-text review and 22 gray literature items screened for inclusion, a total of 31 resources were processed in the final extraction. We used descriptive quantitative analysis for categorical and binary variables, while qualitative data from evaluations were analyzed for outcomes. Findings: Resources were in the form of conferences, supplemental resources to conferences, certificate programs, coursework, stand-alone documents, single-focus programs, and mostly multicomponent programs. Most resources did not have a global health focus area, and a third of the total resources identified women first authors from predominantly high-income countries. About half of the resources mention mentorship and networking as activities incorporated as part of the resource. Over half of the resources did not have a target audience, and most resources were free to users.While there is a lack of consistent and meaningful evaluation of the resources, the available captured metrics of success were described as the number of career-advancing opportunities after using the resources. Examples of opportunities include enrollment in graduate school, receiving academic promotions, participating in internships, presenting at conferences, and publications. Conclusion: While the supply of existing programming and resources to advance women's leadership in the global health field is limited in terms of quantity, it is rich in diverse formats, content, and implementation. This scoping review supports the notion that empowered female leadership in global health requires a complementary support system that encourages the unique needs and talents of female leaders. Such a support system needs inclusive targeting regardless of experience level, academic degree, or location. Furthermore, evaluations of resources will be critical in maintaining meaningful interventions that effectively dismantle the infrastructures that continue to limit the success of women leaders in global health.

Associations between perceived everyday discrimination and health among college students at a Hispanic-serving institution.

Despite efforts by universities to promote racial/ethnic, gender, and socioeconomic diversity, college students continue to report discrimination. In two studies, we examined the frequency, predictors, and health consequences of experiencing everyday discrimination at a Hispanic-Serving Institution. Findings show the majority of students reported experiencing discrimination at the university, with most experiences attributed to their gender and aspects of their physical appearance. More frequent discrimination was associated with poorer physical and psychological health. Furthermore, most participants cited other students as the source of their discrimination. These findings offer important insight into students' experiences of everyday discrimination at a diverse setting.

Regression discontinuity designs in a latent variable framework.

When randomized control trials are not available, regression discontinuity (RD) designs are a viable quasi-experimental method shown to be capable of producing causal estimates of how a program or intervention affects an outcome. While the RD design and many related methodological innovations came from the field of psychology, RDs are underutilized among psychologists even though many interventions are assigned on the basis of scores from common psychological measures, a situation tailor-made for RDs. In this tutorial, we present a straightforward way to implement an RD model as a structural equation model (SEM). By using SEM, we both situate RDs within a method commonly used in psychology, as well as show how RDs can be implemented in a way that allows one to account for measurement error and avoid measurement model misspecification, both of which often affect psychological measures. We begin with brief Monte Carlo simulation studies to examine the potential benefits of using a latent variable RD model, then transition to an applied example, replete with code and results. The aim of the study is to introduce RD to a broader audience in psychology, as well as show researchers already familiar with RD how employing an SEM framework can be beneficial. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Farm Machinery Injuries: A Retrospective Analysis of Admissions at a Level I Trauma Center in North Dakota.

OBJECTIVES: The purpose of the present study was to characterize the incidence, injury characteristics, and outcomes of patients presented to a Level I adult trauma center in Fargo, North Dakota, with farm machinery injuries (FMI). METHODS: We performed a retrospective review of the trauma registry of Sanford Medical Center Fargo (SMCF) between January 2010 and December 2020. We compared admission characteristics of FMI admissions to non-FMI admissions, identified the types of machinery that are most commonly associated with FMI, and described the nature of these injuries by severity, anatomical site, type, age, sex, and length of stay (LoS). Injury severity was evaluated using Injury Severity Score (ISS). RESULTS: Findings indicated that FMI admissions had a higher mean ISS, longer ICU LoS, and a higher mortality rate than non-FMI admissions. The leading cause of fatal and non-fatal FMI in this region are tractors. Males experience 91.2% of tractor injuries, and individuals 65 and over account for nearly 53% of all tractor injuries (n = 18). Males accounted for all deaths, tractor and otherwise. The "other machinery" category was the second most common category and accounted for 50% of female patients. Additionally, 24.5% of all FMI are related to machine maintenance. CONCLUSION: The findings from this study indicate that FMI injuries represent a significant problem in the upper Midwest. Older, male farm workers experience a higher incidence of tractor-related injuries, and all tractor-related deaths occurred in individuals 65 years of age and older. These results underscore the need for further investigation into aging-related farm safety issues.

The role of uncertainty, worry, and control in well-being: Evidence from the COVID-19 outbreak and pandemic in U.S. and China.

Uncertainty about the future often leads to worries about what the future will bring, which can have negative consequences for health and well-being. However, if worry can act as a motivator to promote efforts to prevent undesirable future outcomes, those negative consequences of worry may be mitigated. In this article, we apply a novel model of uncertainty, worry, and perceived control to predict psychological and physical well-being among four samples collected in China (Study 1; during the early COVID-19 outbreak in China) and the United States (Studies 2-4, during 4 weeks in May 2020, 4 weeks in November 2020, and cross-sectionally between April and November 2020). Grounded in the feeling-is-for-doing approach to emotions, we hypothesized (and found) that uncertainty about one's COVID-19 risk would predict greater worry about the virus and one's risk of contracting it, and that greater worry would in turn predict poorer well-being. We also hypothesized, and found somewhat mixed evidence, that perceptions of control over 1's COVID-19 risk moderated the relationship between worry and well-being such that worry was related to diminished well-being when people felt they lacked control over their risk for contracting the virus. This study is one of the first to demonstrate an indirect path from uncertainty to well-being via worry and to demonstrate the role of control in moderating whether uncertainty and worry manifest in poor well-being. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effectiveness of a Patient-Centered Dietary Educational Intervention.

Background: A healthy diet is an important component of preventive medicine. With the changing landscape of medicine, physicians are encountering more challenges in educating patients about a healthy diet, so finding innovative ways to educate patients is imperative. This study investigated the effectiveness of an innovative educational intervention based on the United States Department of Agriculture-recommended MyPlate diet. Methods: Based on the assessed need for dietary education, patients were exposed to an educational video and received a handout on the MyPlate diet. The educational video was created to be culturally relevant with patient-informed edits. The handout was taken from www.ChooseMyPlate.gov. The patients who received the intervention were compared to those who were not exposed to the intervention. Data were collected in a primary care clinic for an underserved population in fall 2018 and analyzed in spring 2019 through patient-completed surveys and physician reporting on patient interactions. Data were analyzed using descriptive statistics, t tests, chi-squared models, and repeated measures analysis of variance. Results: Among 320 patients, 169 patients were exposed to the educational intervention. Intervention patients had better knowledge of the MyPlate diet (P=0.009), felt it would be easier to change their diet (P=0.03), and were more motivated to have conversations about diet with their physician (P=0.04) compared to those who were not exposed. Patients also enjoyed the video overall. Conclusion: This study shows that using multiple modalities including a patient-centered video and handouts to educate patients about diet is enjoyable to patients and effective in teaching, motivating change, and encouraging communication between patients and physicians.

Individual-Level and Neighborhood-Level Factors Associated with Longitudinal Changes in Cardiometabolic Measures in Participants of a Clinic-Based Care Coordination Program: A Secondary Data Analysis.

Background: Identifying individual and neighborhood-level factors associated with worsening cardiometabolic risks despite clinic-based care coordination may help identify candidates for supplementary team-based care. Methods: Secondary data analysis of data from a two-year nurse-led care coordination program cohort of Medicare, Medicaid, dual-eligible adults, Leveraging Information Technology to Guide High Tech, High Touch Care (LIGHT2), from ten Midwestern primary care clinics in the U.S. Outcome Measures: Hemoglobin A1C, low-density-lipoprotein (LDL) cholesterol, and blood pressure. Multivariable generalized linear regression models assessed individual and neighborhood-level factors associated with changes in outcome measures from before to after completion of the LIGHT2 program. Results: 6378 participants had pre-and post-intervention levels reported for at least one outcome measure. In adjusted models, higher pre-intervention cardiometabolic measures were associated with worsening of all cardiometabolic measures. Women had worsening LDL-cholesterol compared with men. Women with pre-intervention HbA1c > 6.8% and systolic blood pressure > 131 mm of Hg had worse post-intervention HbA1c and systolic blood pressure compared with men. Adding individual's neighborhood-level risks did not change effect sizes significantly. Conclusions: Increased cardiometabolic risks and gender were associated with worsening cardiometabolic outcomes. Understanding unresolved gender-specific needs and preferences of patients with increased cardiometabolic risks may aid in tailoring clinic-community-linked care planning.

Acculturation and drinking behavior among Latinxs: a narrative review.

Research suggests that acculturation is associated with increased alcohol consumption among Latinxs. The purpose of this narrative review is to contribute to this literature by examining the association between acculturation and alcohol use within current theoretical and etiological frameworks on cultural norms, acculturative stress, and acculturative gaps. This review also compares the utility of these explanatory frameworks for guiding future research. Two databases (PubMed and PsycInfo) were used to identify peer-reviewed studies pertaining to the associations between acculturation and alcohol use among Latinxs. Studies that examined drinking norms, acculturative stress, acculturation gaps, and drinking behavior in Latinxs were included. The types of study approaches and designs included quantitative, qualitative, cross-sectional, cohort, and longitudinal studies published between January 2000 and December 2021. Quality assessment and data synthesis were conducted by two reviewers. A total of 65 articles reporting empirical studies were included in the final review. Eighteen studies did not utilize a specific framework, but generally supported that acculturation is associated with increased alcohol consumption and alcohol related consequences among Latinxs. Additionally, sixteen studies examined cultural norms, twenty-two examined acculturative stress, while only nine utilized a gap discrepancy framework. Studies examining drinking norms appeared to largely explain changes in drinking behavior among Latinas, while studies examining acculturative stress seemed to be better equipped to explain changes in drinking behavior among Latino men. Meanwhile, the Gap Discrepancy Model articulates the gap between old and new cultural influences and can be conceptualized as an additional dimension of acculturative stress.

Social Threat Reduces Alcohol Consumption among College Students.

AIMS: Past research suggests that people report a greater desire to consume alcohol when they experience social threat-or threats to their social selves, such as social exclusion. Nevertheless, experimental research on the role of social threat in alcohol consumption is limited. The present study examined the causal relationship between social threat and wine consumption. METHODS: Undergraduate students (N = 83; Mage = 21.8 years old, SDage = 1.62 years old; 72.3% women; 61.4% Latinx/Hispanic) participated in a study under the pretense that they were in a focus group gauging students' opinions of a bar being constructed at their university. During the study, participants and two confederate researchers completed a group activity in which they selected design elements for the bar. Participants were randomly assigned to one of two conditions. In the social threat condition, confederates rejected participants' design choices and socially excluded them during a follow-up task. In the social acceptance condition, confederates supported participants' choices and did not socially exclude them. All participants then completed a wine taste test. RESULTS: Contrary to predictions, an independent-samples t-test revealed that participants who experienced social threat consumed significantly less wine than those who were socially accepted, t(81) = -2.22, P = 0.03, d = -0.49. Furthermore, a linear regression test revealed that this effect persisted even when controlling for typical alcohol-consumption behavior, b = 56.09, t = -2.50, P = 0.02, d = -0.61. CONCLUSION: The relationship between social threat and alcohol consumption may be more nuanced than anticipated. Discussion centers around two potential moderators including positive affect and identity.

Increasing instability of a rocky intertidal meta-ecosystem.

Climate change threatens to destabilize ecological communities, potentially moving them from persistently occupied "basins of attraction" to different states. Increasing variation in key ecological processes can signal impending state shifts in ecosystems. In a rocky intertidal meta-ecosystem consisting of three distinct regions spread across 260 km of the Oregon coast, we show that annually cleared sites are characterized by communities that exhibit signs of increasing destabilization (loss of resilience) over the past decade despite persistent community states. In all cases, recovery rates slowed and became more variable over time. The conditions underlying these shifts appear to be external to the system, with thermal disruptions (e.g., marine heat waves, El Niño-Southern Oscillation) and shifts in ocean currents (e.g., upwelling) being the likely proximate drivers. Although this iconic ecosystem has long appeared resistant to stress, the evidence suggests that subtle destabilization has occurred over at least the last decade.

The Role of Risk Perceptions and Affective Consequences in COVID-19 Protective Behaviors.

BACKGROUND: Slowing the spread of the novel coronavirus (COVID-19) requires behavioral changes such as physical distancing (e.g., staying a 6-foot distance from others, avoiding mass gatherings, reducing houseguests), wearing masks, reducing trips to nonessential business establishments, and increasing hand washing. Like other health behaviors, COVID-19 related behaviors may be related to risk representations. Risk representations are the cognitive responses a person holds about illness risk such as, identity (i.e., label/characteristics of risk), cause (i.e., factors causing condition), timeline (i.e., onset/duration of risk), consequences (i.e., intrapersonal/interpersonal outcomes), behavioral efficacy (i.e., if and how the condition can be controlled/treated), and illness risk coherence (i.e., extent to which representations, behaviors, and beliefs are congruent). The current study applies the Common-Sense Model of Self-Regulation (CSM-SR) to evaluate how risk representations may relate to COVID-19 protective and risk behaviors. METHODS: Participants include 400 workers from Amazon's Mechanical Turk aged ≥ 18 years and US residents. Participants completed an online survey measuring risk representations (B-IPQ) and COVID-19 related behaviors, specifically, physical distancing, hand washing, and shopping frequency. RESULTS: Risk coherence, consequences, timeline, emotional representation, and behavioral efficacy were related to risk and protective behaviors. CONCLUSIONS: Risk representations vary in their relationship to COVID-19 risk and protective behaviors. Implications include the importance of coherent, targeted, consistent health communication, and effective health policy in mitigating the spread of COVID-19.