Wildfire particulate exposure and risks of preterm birth and low birth weight in the Southwestern United States.

OBJECTIVES: Wildfire air pollution is a growing concern on human health. The study aims to assess the associations between wildfire air pollution and pregnancy outcomes in the Southwestern United States. STUDY DESIGN: This was a retrospective cohort study. METHODS: Birth records of 627,404 singleton deliveries in 2018 were obtained in eight states of the Southwestern United States and were linked to wildfire-sourced fine particulate matter (PM2.5) and their constituents (black carbon [BC] and organic carbon [OC]) during the entire gestational period. A double-robust logistic regression model was used to assess the associations of wildfire-sourced PM2.5 exposures and preterm birth and term low birth weight, adjusting for non-fire-sourced PM2.5 exposure and individual- and area-level confounder variables. RESULTS: Wildfire-sourced PM2.5 contributed on average 15% of the ambient total PM2.5 concentrations. For preterm birth, the strongest association was observed in the second trimester (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.05-1.07 for PM2.5; 1.06, 95% CI: 1.05-1.07 for BC; 1.04, 95% CI: 1.03-1.05 for OC, per interquartile range increment of exposure), with higher risks identified among non-smokers or those with low socio-economic status. For term low birth weight, the associations with wildfire-sourced PM2.5 exposures were consistently elevated for all trimesters except for the exposure averaged over the entire gestational period. Overall, the associations between wildfire-sourced PM2.5 and pregnancy outcomes were stronger than those with total PM2.5. CONCLUSIONS: Wildfire-sourced PM2.5 and its constituents are linked to higher risks of preterm birth and term low birth weight among a significant US population than the effects of ambient total PM2.5.

A Person-Centered Analysis of Adolescent Multicultural Socialization Niches and Academic Functioning.

Despite the growing cultural diversity worldwide, there is scarce research on how socialization processes prepare youth to respond to increasing multicultural demands and the degree to which these socialization opportunities inform youth academic functioning. This study used a person-centered approach to identify profiles or niches based on the degree and consistency of multicultural socialization experiences across school, peer, and family settings and to examine the associations between identified niches and markers of academic functioning (i.e., emotional and behavioral academic engagement, academic aspirations and expectations) in a sample of adolescents (N = 717; Mage = 13.73 years). Participants (49.9% girls) were from the U.S. Southwest and represented multiple ethno-racial backgrounds (31.8% Hispanic/Latinx, 31.5% Multiethnic, 25.7% White, 7.3% Black or African American, 1.4% Asian American or Pacific Islander, 1.4% American Indian or Alaska Native, and 1% Arab, Middle Eastern, or North African). Six distinct multicultural socialization niches were identified. Three niches had similar patterns across school-peer-family but ranged in the degree of socialization. The cross-setting similar higher socialization niche (Niche 6) demonstrated greater socialization than the cross-setting similar moderate (Niche 5) and lower socialization (Niche 4) niches, which had moderate and lower socialization, respectively. Three niches demonstrated cross-setting dissimilarity which ranged in the type of cross-setting contrast and the degree of socialization. The cross-setting dissimilar school contrast socialization niche (Niche 3) had greater dissimilarities between socialization opportunities in the school setting compared to the peer and family settings and demonstrated the lowest levels of socialization of all niches. The other two niches, the cross-setting dissimilar peer contrast (Niche 1) and greater peer contrast socialization (Niche 2) niches had larger dissimilarities between socialization opportunities in the peer setting than the school and family settings. In the former, however, the contrast was lower, and socialization ranged between very low to low. In the latter, the contrast was higher and socialization ranged from very low to moderate. Most adolescents were in the cross-setting similar lower socialization niche or in the cross-setting dissimilar niches. Adolescents in the cross-setting similar higher multicultural socialization demonstrated greater emotional and behavioral academic engagement than adolescents in most of the other niches. Adolescents in the cross-setting dissimilar school contrast niches demonstrated lower emotional and behavioral academic engagement and lower academic expectations than adolescents in some of the other niches. The results emphasize the collective role of school, peer, and family multicultural socialization on emotional and behavioral academic engagement.

Pain, obesity, and physical function in Mexican American older adults during 20 years of follow-up.

INTRODUCTION: Pain remains largely undertreated in older adults irrespective of health care setting. Mexican American adults in the United States have a high age-adjusted prevalence of obesity. However, the association of pain and obesity with physical function is understudied in this population. OBJECTIVE: To examine the association of co-occurring pain and obesity with physical function over 20 years of follow-up in a cohort of older Mexican Americans who scored ≥7 (moderate to high) in the Short Physical Performance Battery (SPPB) test and were nondisabled at baseline. DESIGN: Longitudinal population-based study. SETTING: Community-dwelling older adults from Southwestern United States. PARTICIPANTS: Mexican American adults age 65 years and older. INTERVENTIONS: Not Applicable. MAIN OUTCOME MEASURES: Physical function was assessed with the SPPB test (standing balance, timed 8-ft walk, and five repeated timed chair stands). Participants at baseline were divided into four groups: no pain-no obesity (n = 869), obesity only (n = 282), pain only (n = 216), and pain-obesity (n = 159). Generalized Estimating Equation models were used to estimate the odds ratio (OR) and 95% confidence interval (CI) of lower performance in physical function over 20 years as a function of pain-obesity grouping. RESULTS: Participants with pain only (OR = 1.61, 95% CI = 1.34-1.95) and with co-occurring pain and obesity (OR = 2.32, 95% CI = 1.83-2.95) had significantly greater odds of physical function impairment over those with no pain-no obesity or obesity only, after controlling for all covariates. CONCLUSION: Older Mexican American adults were at high risk for physical function impairment over time if they had pain or co-occurring pain and obesity. Early assessment and proper pain management as well as maintaining a healthy weight may reduce declines in physical function in older Mexican American adults.

Phylogenetic diversity of two common Trypanosoma cruzi lineages in the Southwestern United States.

Trypanosoma cruzi is the causative agent of Chagas disease, a devastating parasitic disease endemic to Central and South America, Mexico, and the USA. We characterized the genetic diversity of Trypanosoma cruzi circulating in five triatomine species (Triatoma gerstaeckeri, T. lecticularia, T.indictiva, T. sanguisuga and T. recurva) collected in Texas and Southern Arizona using multilocus sequence typing (MLST) with four single-copy loci (cytochrome oxidase subunit II- NADH dehydrogensase subunit 1 region (COII-ND1), mismatch-repair class 2 (MSH2), dihydrofolate reductase-thymidylate synthase (DHFR-TS) and a nuclear gene with ID TcCLB.506529.310). All T. cruzi variants fall in two main genetic lineages: 75% of the samples corresponded to T. cruzi Discrete Typing Unit (DTU) I (TcI), and 25% to a North American specific lineage previously labelled TcIV-USA. Phylogenetic and sequence divergence analyses of our new data plus all previously published sequence data from those four loci collected in the USA, show that TcIV-USA is significantly different from any other previously defined T. cruzi DTUs. The significant level of genetic divergence between TcIV-USA and other T. cruzi DTUs should lead to an increased focus on understanding the epidemiological importance of this DTU, as well as its geographical range and pathogenicity in humans and domestic animals. Our findings further corroborate the fact that there is a high genetic diversity of the parasite in North America and emphasize the need for appropriate surveillance and vector control programs for Chagas disease in southern USA and Mexico.

Pediatric Snakebites: Comparing Patients in Two Geographic Locations in the United States.

BACKGROUND: Management of children with snakebites may vary based on subjective criteria, geographic, and climatic factors. We reviewed the incidence and management of snakebite injuries in children at two tertiary referral centers in separate geographic and climatic location to assess differences in management and outcomes of these patients. METHODS: After institutional review board approval, a retrospective chart review was performed for patients ≤18 years with snakebite injuries at emergency departments (ED) of two American College of Surgeons verified trauma centers (2006-2013). One center is in southeast US and experiences a sub-tropical climate whereas the other is in southwest US and experiences a semi-arid climate. Demographic and clinical parameters were extracted. RESULTS: A total of 108 patients (59% male), median age of 9 y (1 y-17 y), were included. Snake type was identified by bystanders in 55.5% cases; copperhead was the most common (37%) subtype. Approximately 30% of patients received antivenom. One quarter of all patients were discharged from the ED. Two patients received surgical intervention in the first 48 hours after presentation. Compared to patients who sustained a snakebite in semi-tropical regions, patients in semi-arid areas had shorter bite-to-ED time, presented directly to the referral center, were more frequently bitten by a rattlesnake, had longer lengths of hospital stay, required antivenom more frequently and at higher doses, and were more frequently admitted to the ICU. No differences were seen in gender, age at presentation, severity of wound, location of bite, abnormalities in coagulation profile or rate of admission to hospital amongst the two sites. CONCLUSIONS: Patients sustaining snakebites in semi-arid climates were more commonly exposed to dangerous snake types, resulting in higher antivenom requirement, as well as longer hospital stays and need for intensive monitoring. Although no fatalities were reported in our study, our data supports early transfer of snakebite victims to higher levels of care, especially in semi-arid or high-risk areas.

Outbreak of rabbit hemorrhagic disease virus 2 in the southwestern United States: first detections in southern California.

An outbreak of rabbit hemorrhagic disease virus 2 (RHDV2)-associated disease occurred in the southwestern United States following its first detection in New Mexico in March 2020. The disease spread throughout several states and was diagnosed for the first time in California on May 11, 2020, in a black-tailed jackrabbit (Lepus californicus). The following day, the California Department of Food and Agriculture (CDFA) issued an order banning the entrance into California of several lagomorph species and their products from any state in which the disease had been detected in the last 12 mo. RHDV2 is a threat to wild lagomorph species in California, including the endangered riparian brush rabbit (Sylvilagus bachmani riparius). Therefore, the California Department of Fish and Wildlife (CDFW) started tracking any mortality event in wild lagomorph populations. As of August 9, 2020, RHDV2 had been detected in wild and domestic lagomorphs of several counties in southern California that were submitted to the California Animal Health and Food Safety laboratory system by the CDFA or the CDFW. These positive cases included 2 additional black-tailed jackrabbits and 3 desert cottontail rabbits (Sylvilagus audubonii). In addition, the infection spilled over to domestic populations, whereby it was confirmed on July 10, 2020, in a domestic rabbit (Oryctolagus cuniculus).

Sex Differences in Stroke Hospitalization Incidence, 30-Day Mortality, and Readmission in a Regional Medical Center in the Southwestern United States.

OBJECTIVES: This study explores sex differences in ischemic stroke hospitalization incidence, 30-day mortality, and 30-day readmission in a southwestern US medical center. METHODS: Ischemic stroke admissions in a regional medical center in the southwestern United States were obtained for a 6.5-year time frame (N = 1968). Logistic regression models examine the adjusted effects of sex on 30-day mortality and 30-day readmission outcomes among individuals hospitalized for ischemic stroke. RESULTS: Findings confirm that although women experience higher mortality than men (9.1% vs 6.7%), the sex disparity in mortality is explained by the age distribution of strokes. Women experience far more strokes and deaths because of stroke at older ages. No differences in principal procedure or 30-day readmission emerged. CONCLUSIONS: Men experienced higher stroke hospitalization incidence, although women exhibited higher 30-day mortality. Age composition explained sex differences in mortality, but higher male stroke hospitalization incidence represents a larger public health issue that suggests the need for behavioral change at the population level. No meaningful sex differences emerged in treatment, mortality, or readmission.

Coccidioidomycosis in patients with various inflammatory disorders treated with tumor necrosis factor α inhibitors.

Coccidioides fungi are found primarily in the southwestern United States and are the cause of coccidioidomycosis. Tumor necrosis factor α inhibitors (TNFIs) are therapies for autoimmune and inflammatory conditions; their association with coccidioidomycosis is not well characterized. We aimed to determine the prevalence and characteristics of coccidioidomycosis among TNFI recipients with different inflammatory disorders at a tertiary care center. We retrospectively reviewed the electronic health records of patients at our institution from April 4, 2010 to December 17, 2017, who received TNFIs (infliximab, etanercept, adalimumab, certolizumab pegol, or golimumab) and had positive culture, pathologic, and/or serologic results for coccidioidomycosis. Among 1770 patients identified who received TNFIs, 49 (2.8%) had proven or probable coccidioidomycosis. Of these 49, 28 (57%) were men, 47 (96%) were White, and 42 (86%) had pulmonary coccidioidomycosis. The most common TNFIs used were adalimumab, infliximab, and etanercept. Coccidioidomycosis was identified in 25 of 794 patients with rheumatologic disorders (3.1%), 18 of 783 patients with inflammatory bowel disease (IBD) (2.3%), and six of 193 patients with dermatologic disorders (3.1%) (P = .34). There was no difference in coccidioidal infections among recipients of any particular TNFI agents. A minority of patients (7/49, 14%) had an extrapulmonary infection, and the majority of these (6/7) had IBD. Our study shows a low prevalence of coccidioidomycosis in TNFI recipients, even within the Coccidioides-endemic area. Persons with IBD were disproportionately represented among those with extrapulmonary coccidioidomycosis. Treatment with azoles was effective. LAY SUMMARY: Among 1770 patients who received tumor necrosis factor α inhibitors, 49 (2.8%) had newly acquired coccidioidomycosis over a 7-year period. Dissemination occurred in 14.3%, but disproportionately among those with underlying inflammatory bowel disease. All patients recovered with medical management.

Understanding hazardous drinking and suicidal ideation and suicide risk among college students: anxiety sensitivity as an explanatory factor.

Suicide is a leading cause of death among college students. Although previous work indicates that the (hazardous) use of alcohol contributes to suicidal ideation/risk, little work has examined potential underlying explanatory factors. One example is anxiety sensitivity (AS). The current study evaluated whether AS explains associations between hazardous drinking and suicidal ideation and risk among college students. Data from racially/ethnically diverse students (N = 1,206; 76.7% non-White; Mage = 22.13) were analyzed. Hazardous drinking was a significant predictor of suicidal ideation (p < 0.001) and risk (p < 0.001). There were significant indirect associations of hazardous drinking via AS with both ideation (b = 0.07, 95% CI [0.05, 0.10]) and risk (b = 0.04, 95% CI [0.03, 0.06]); AS explained a significant portion of variance in both associations (42.6-51.4%). AS cognitive concerns (but not physical or social concerns) contributed significantly to the explanatory pathways. Students who engaged in hazardous drinking were also greater than twice as likely to screen positive for suicide risk (p < 0.001). The findings suggest that AS, particularly cognitive concerns, partially accounts for the associations between hazardous drinking and suicidal ideation/risk. Hazardous drinking may exacerbate AS which, in turn, may influence suicidal ideation and risk; however, results need to be replicated with longitudinal data.

Pain intensity, pain-related anxiety, and somatic and mental health symptoms: a test among latinx young adults.

Latinx individuals demonstrate significant pain-related health disparities compared to other racial/ethnic groups. Moreover, young adulthood (18-25 years of age) is a primary developmental window wherein pain-related health problems are first encountered and may be related to more severe somatic and mental health symptoms. Pain-related anxiety may be one mechanistic construct linking individual differences in the experience of pain intensity to poorer somatic experiences and mental health among Latinx young adults. Thus, the current study examined pain-related anxiety as an explanatory factor underlying the relationship between pain intensity and body vigilance, perceptions of health, worry, anxious arousal, and depressive symptoms among Latinx young adults. Participants included 401 Latinx young adults (Mage = 21 years; SD = 2.02; age range: 18-25 years; 83% female) at a large, southwestern university. Results revealed that individual differences in pain intensity had a significant indirect effect on the studied somatic and negative affect variables through pain-related anxiety. These novel findings suggest future work should continue to explore pain-related anxiety in the association between the experience of pain and somatic and mental health among Latinx young adults.

When helping hurts: COVID-19 critical incident involvement and resource depletion in health care workers.

A focus on helping others is generally lauded, particularly in medicine, but in the context of a pandemic when health care professionals are facing increased risk, loss, and trauma, this focus can potentially be detrimental. In this study, we sought to (a) examine if health care workers intensely involved in the coronavirus 2019 (COVID-19) pandemic are experiencing negative psychological and emotional outcomes, and (b) investigate if helping related factors (prosocial motivation and perceived prosocial impact) exacerbate and mitigate relationships to negative outcomes in a crisis situation. Using data collected from doctors and nurses before and during the COVID-19 pandemic, we examine the relationship between intensity of involvement in the COVID-19 pandemic response and emotional exhaustion and depression, as well as the moderating effects of prosocial motivation and perceived prosocial impact. Data was collected at three time points (T1 and T2 prepandemic, and T3 during COVID-19), with prosocial motivation and controls collected at T1/T2 and predictors and outcomes collected during the pandemic. We find that intensity of involvement does associate with emotional exhaustion at work and that higher prosocial motivation exacerbates this relationship. Supplemental analyses suggest that the exposure to self-dimension of involvement is positively associated with emotional exhaustion and depression. Understanding the roles of prosocial motivation and prosocial impact in managing regulatory resources has important ramifications for health care workers on the frontlines of health crises responses, as these resources are necessary to manage the associated trauma. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Risk Factors for Alzheimer's Disease and Related Dementia Diagnoses in American Indians.

The burden of Alzheimer's disease and related dementias (ADRD) has increased substantially in the United States, particularly in health disparity populations. Little is known about the epidemiology of ADRD in American Indian (AI) adults, although they have a high prevalence of ADRD risk factors including hypertension, diabetes, obesity, and smoking. Using electronic health records from a large health care organization during 2016-18, we describe characteristics of AI patients aged ≥55 years with and without an ADRD diagnosis, assess ADRD risk factors and contrast findings with results from age- and sex-matched non-Hispanic White (NHW) patients. To identify factors associated with ADRD diagnoses, we estimated population-averaged prevalence rate ratios to approximate relative risk (RR) using generalized estimating equations models adjusted for age, sex, and marital and rural residency status. The age-adjusted prevalence of ADRD diagnosis was 6.6% of AI patients, compared with 4.4% in NHW patients. Patient age and diagnosis of hypertension, depression, hyperlipidemia, or diabetes were significantly associated with higher risk of ADRD diagnosis in AIs (RR range: 1.1-2.8) whereas female sex or being married/having a partner were associated with lower risk of ADRD diagnosis (each RR=.7). ADRD risk factors were generally similar between AI and NHW patients, except for sex and marital status. However, the adjusted risk of ADRD was approximately 49% higher in AI patients. To our knowledge, our study is the first to examine ADRD diagnoses and comorbidities in AIs across a large geographical region in southwest United States. Future efforts to confirm our findings in diverse AI communities are warranted.

American Indian chronic Renal insufficiency cohort study (AI-CRIC study).

BACKGROUND: Chronic kidney disease (CKD) is an increasing epidemic globally that is associated with adverse health outcomes including end stage kidney disease (ESKD), cardiovascular disease (CVD), and death. American Indians (AIs) have a higher prevalence of CKD than most other racial/ethnic groups, due in part to a high prevalence of type 2 diabetes. Other genetic and environmental factors not yet identified may also contribute to the disproportionate burden of CKD in AIs. METHOD: We will establish 3 clinical centers to recruit AIs from the Southwest United States (US) to expand the Chronic Renal Insufficiency Cohort (CRIC) study. We will follow the current CRIC protocol for kidney and cardiovascular measures and outcomes, which include ambulatory monitoring of kidney function and the use of mobile health technologies for CVD sub-phenotyping, and compare the outcomes in AIs with those in other racial/ethnic groups in CRIC. DISCUSSION: AI-CRIC will identify the role of various risk factors for rapid loss of kidney function among AIs of the Southwest US. In addition, to better understand the natural history of CKD and CVD in this high-risk population, we will identify unique risk factors for CKD and CVD progression in AIs. We will also compare event rates and risk factors for kidney and cardiovascular events in AIs with the other populations represented in CRIC.

Plasma Donors in the Southwestern United States Positively Contribute to the Diverse Therapeutic Antibody Profile of Immune Globulin Products.

Human-plasma-derived immune globulin (IG) is used in augmentation therapy to provide protective levels of antibodies to patients with primary immune deficiency diseases (PIDD) and for prophylaxis against infectious diseases. To maintain the breadth of antibodies necessary for clinical protection, it is important to understand regional patterns of antibody seroprevalence in source plasma from which IG products are manufactured. In this study, source plasma from donation centers in various locations of the Southwestern quarter of the United States was surveyed for antibody titers to hepatitis A virus (HAV), measles virus (MeV), and cytomegalovirus (CMV). A broad range of anti-HAV Ig plasma titers was observed among these centers, with some centers exhibiting 3-5 times the titers of the others. Minor to no differences were observed for levels of anti-MeV and anti-CMV, respectively. Importantly, elevated anti-HAV Ig titers were broadly observed across plasma units obtained from the centers exhibiting high titers, indicative of a potential regional phenomenon among donors as opposed to few donors with singularly high titers. Plasma from these high-titer centers conferred significantly greater neutralization against HAV in vitro. The outcomes of this study give a glimpse of the antibody diversity inherent in human plasma used to manufacture IG products..

Association Between Exposure to Ehrlichia spp. and Risk of Developing Chronic Kidney Disease in Dogs.

Ehrlichiosis is a common vector-borne disease caused by Ehrlichia spp. This retrospective matched cohort study was performed to determine if dogs with Ehrlichia spp. antibodies had an increased incidence of chronic kidney disease (CKD). Exposure to Ehrlichia spp. was defined as having an Ehrlichia spp. antibody-positive result recorded at any point in their available patient history. The outcome of CKD was defined as concurrent increased symmetric dimethylarginine (>14 µg/dL) and creatinine (>1.5 mg/dL) for a minimum of 25 days with inappropriate urine specific gravity (<1.030). Patients were matched using propensity score matching to control for age, geography, and breed. A total of 22,440 patients and controls in E canis-endemic regions of the United States were used in this analysis. Contingency tables were used to compare dogs with and without exposure to Ehrlichia spp.-infected ticks and CKD outcome. The relative risk of CKD for patients exposed to ticks carrying Ehrlichia spp. was found to be 2.12 (95% confidence interval [1.35-3.15], p < 0.0006). This study identified that testing positive for Ehrlichia spp. antibodies in E canis-endemic regions is associated with higher incidence of CKD in dogs.

Trajectories of Frailty and Cognitive Decline Among Older Mexican Americans.

BACKGROUND: Progressive physical frailty and cognitive decline in older adults is associated with increased risk of falls, disability, institutionalization, and mortality; however, there is considerable heterogeneity in progression over time. We identified heterogeneous frailty and cognitive decline trajectory groups and examined the specific contribution of health conditions to these trajectories among older Mexican origin adults. METHODS: We use a sample from the Hispanic Established Population for the Epidemiological Study of the Elderly (HEPESE) with at least two measures of frailty criteria during 18 years follow-up: slow gait, weak handgrip strength, exhaustion, and unexplained weight loss (n = 1362, mean age 72). Cognition was measured using the Mini-Mental State Examination (MMSE). RESULTS: Using group-based trajectory models we identified three frailty groups-non-frail (n = 331), moderate progressive (n = 855), and progressive high (n = 149)-and three cognitive decline groups-non-cognitively impaired (476), moderate decline (677) and rapid decline (n = 209). The probability of membership in a high-frailty group given membership in a progressive cognitive decline group was 63%, while the probability of being in a non-frail group given membership in a non-cognitively impaired group was 68%. Predictors of membership into both the progressive high frailty and rapid cognitive decline groups combined were low education and diabetes. Weekly church attendance was associated with a 66% reduction in the odds of being in the combined groups. CONCLUSIONS: Interventions to reduce frailty rates and cognitive decline might focus on the management of underlying chronic disease and on increasing participation in activities outside the home.

Sources and severity of stress in a Southwestern police department.

BACKGROUND: Policing is a stressful occupation. Most research examining police stress focuses solely on patrol officers, and often focuses on black and white officers only. Further, organizational sources of stress tend to be more important for police officers generally. AIMS: To explore sources and severity of stress in a predominately Hispanic, mid-sized, Southwestern police department. METHODS: A cross-sectional study of 147 police officers of all ranks was conducted. A modified version of the Police Stress Survey (PSS) was administered during daily briefings. Logistical regression models were utilized to examine predictors of stress based on gender, race/ethnicity, rank and tenure. RESULTS: Overall, occupational stressors proved more prominent than organizational stressors, contrary to previous research. Additionally, race/ethnicity was predictive of both total stress and occupational stress; rank was predictive of organizational stress; and tenure in law enforcement was predictive of occupational stress. CONCLUSIONS: The sources of stress that impact police officers may be shifting as the climate surrounding law enforcement changes. What is stressful for officers depends on the race/ethnicity, rank and tenure of the officer within the organizational structure. Potential interventions designed to alleviate stress should be mindful of the variety of needs within any given department.

Racial/Ethnic Differences in Drug- and Alcohol-Related Arrest Outcomes in a Southwest County From 2009 to 2018.

Objectives. To estimate the association between race/ethnicity and drug- and alcohol-related arrest outcomes.Methods. We used multinomial logistic regression and general estimating equations to estimate the association between race/ethnicity and arrest outcomes in 36 073 drug- and alcohol-related arrests obtained from administrative records in a Southwest US county from 2009 to 2018. Results were stratified by charge type.Results. Among misdemeanor drug- and alcohol-related arrests, American Indian/Alaska Native (AI/AN; adjusted odds ratio [AOR] = 3.60; 95% confidence interval [CI] = 3.32, 3.90), Latino (AOR = 1.53; 95% CI = 1.35, 1.73), and Black persons (AOR = 1.28; 95% CI = 1.05, 1.55) were more likely than White persons to be booked into jail as opposed to cited and released. AI/AN (AOR = 10.77; 95% CI = 9.40, 12.35), Latino (AOR = 2.63; 95% CI = 2.12, 3.28), and Black persons (AOR = 1.84; 95% CI = 1.19, 2.84) also were more likely than White persons to be convicted and serve time for their misdemeanor charges. Results were similar for felony drug- and alcohol-related arrests aggregated and stratified.Conclusions. Our results suggest that race/ethnicity is associated with outcomes in drug-related arrests and that overrepresentation of racial/ethnic minorities in the criminal justice system cannot be attributed to greater use of drugs and alcohol in general.

ARGAS (PERSICARGAS) GIGANTEUS SOFT TICK INFECTION WITH RICKETTSIA HOOGSTRAALI AND RELAPSING FEVER BORRELIA ON WILD AVIAN SPECIES OF THE DESERT SOUTHWEST, USA.

Changing climatic conditions and the northward expansion of ticks and pathogens are of immense importance to human, animal, and environmental health assessment and risk management. From 2014 through 2015, a wildlife rehabilitation center in south-central Arizona, US noted soft ticks (Argasidae) infesting 23 birds, including Cooper's Hawks (Accipiter cooperii), Gray Hawks (Buteo plagiatus), Harris's Hawks (Parabuteo unicinctus), Red-tailed Hawks (Buteo jamaicensis), Great Horned Owls (Bubo virginianus), Common Ravens (Corvus corax), and a Greater Roadrunner (Geococcyx californianus), during the late summer seasonal rainy seasons. The parasites numbered in the hundreds on individual birds. Infested birds were moribund, obtunded, or paralyzed on presentation, with no prior histories of illness or evidence of trauma. Tick and avian blood samples were collected for vector-borne pathogen analysis focusing on the molecular detection of Rickettsia and Borrelia species. Ticks were identified as the neotropical species of soft tick, Argas (Persicargas) giganteus; their occurrence in the southern US on raptors represented an expansion of host range. Pathogen testing of ticks showed that 41% of 54 ticks were infected with Rickettsia hoogstraalii and 23% of 26 ticks were infected with a relapsing fever Borrelia; both agents are associated with uncertain health consequences. Among the blood samples, one was infected with the same Borrelia spp.; this Red-tailed Hawk also had Borrelia-positive ticks. With supportive therapy, the majority of birds, 74% (17/23), recovered and were released or permanent residents. The management of soft tick-infested birds and mitigation of future disease risk will require additional characterizations of these poorly studied soft ticks and their associated pathogens.