Long term temporal trends in synoptic-scale weather conditions favoring significant tornado occurrence over the central United States.

We perform a statistical climatological study of the synoptic- to meso-scale weather conditions favoring significant tornado occurrence to empirically investigate the existence of long term temporal trends. To identify environments that favor tornadoes, we apply an empirical orthogonal function (EOF) analysis to temperature, relative humidity, and winds from the Modern-Era Retrospective analysis for Research and Applications Version 2 (MERRA-2) dataset. We consider MERRA-2 data and tornado data from 1980 to 2017 over four adjacent study regions that span the Central, Midwestern, and Southeastern United States. To identify which EOFs are related to significant tornado occurrence, we fit two separate groups of logistic regression models. The first group (LEOF models) estimates the probability of occurrence of a significant tornado day (EF2-EF5) within each region. The second group (IEOF models) classifies the intensity of tornadic days either as strong (EF3-EF5) or weak (EF1-EF2). When compared to approaches using proxies such as convective available potential energy, our EOF approach is advantageous for two main reasons: first, the EOF approach allows for the discovery of important synoptic- to mesoscale variables previously not considered in the tornado science literature; second, proxy-based analyses may not capture important aspects of three-dimensional atmospheric conditions represented by the EOFs. Indeed, one of our main novel findings is the importance of a stratospheric forcing mode on occurrence of significant tornadoes. Other important novel findings are the existence of long-term temporal trends in the stratospheric forcing mode, in a dry line mode, and in an ageostrophic circulation mode related to the jet stream configuration. A relative risk analysis also indicates that changes in stratospheric forcings are partially or completely offsetting increased tornado risk associated with the dry line mode, except in the eastern Midwest region where tornado risk is increasing.

Juvenile Homicide Offenders: Factors in Desistance after Incarceration.

While several prior studies have examined the prevalence and predictors of recidivism among juvenile homicide offenders (JHOs), much less scholarly attention has been devoted to exploring the post-release factors that influence JHOs to desist from criminal behavior. Given relatively recent rulings by the U.S. Supreme Court, individuals who commit homicide offenses as juveniles are less likely to spend the rest of their lives in prison. Accordingly, it is important to understand the factors associated with desistance in the post-incarceration lives of JHOs. The present study was designed to assess the effects of post-release factors on JHOs' recidivism outcomes, using a sample of 19 male JHOs from a southeastern U.S. state who were convicted as adults and sentenced to serve time in prison in the 1980s. These men were interviewed approximately 35 years after their original homicide offense about their adjustment to life in prison and after release, as well as their reasons for engaging in criminal behavior during adolescence. Thematic qualitative analysis was used to identify the post-release factors that were prevalent in the lives of the JHOs who desisted from crime. These five factors included avoiding old neighborhood and friends, positive intimate relationship, stable employment, human agency, and generativity. The implications of the findings for the prevention of recidivism among JHOs, as well as avenues for future research, are discussed.

Assessing the role of collectivism and individualism on COVID-19 beliefs and behaviors in the Southeastern United States.

America's unique response to the global COVID-19 pandemic has been both criticized and applauded across political and social spectrums. Compared to other developed nations, U.S. incidence and mortality rates were exceptionally high, due in part to inconsistent policies across local, state, and federal agencies regarding preventive behaviors like mask wearing and social distancing. Furthermore, vaccine hesitancy and conspiracy theories around COVID-19 and vaccine safety have proliferated widely, making herd immunity that much more challenging. What factors of the U.S. culture have contributed to the significant impact of the pandemic? Why have we not responded better to the challenges of COVID-19? Or would many people in the U.S. claim that we have responded perfectly well? To explore these questions, we conducted a qualitative and quantitative study of Florida State University faculty, staff, and students. This study measured their perceptions of the pandemic, their behaviors tied to safety and community, and how these practices were tied to beliefs of individualism and collectivism. We found that collectivist orientations were associated with a greater likelihood of wearing masks consistently, severe interruptions of one's social life caused by the pandemic, greater concern for infecting others, and higher levels of trust in medical professionals for behavioral guidelines surrounding the pandemic. These associations largely persist even after adjusting for political affiliation, which we find is also a strong predictor of COVID-19 beliefs and behaviors.

Assessing the role of collectivism and individualism on COVID-19 beliefs and behaviors in the Southeastern United States.

America's unique response to the global COVID-19 pandemic has been both criticized and applauded across political and social spectrums. Compared to other developed nations, U.S. incidence and mortality rates were exceptionally high, due in part to inconsistent policies across local, state, and federal agencies regarding preventive behaviors like mask wearing and social distancing. Furthermore, vaccine hesitancy and conspiracy theories around COVID-19 and vaccine safety have proliferated widely, making herd immunity that much more challenging. What factors of the U.S. culture have contributed to the significant impact of the pandemic? Why have we not responded better to the challenges of COVID-19? Or would many people in the U.S. claim that we have responded perfectly well? To explore these questions, we conducted a qualitative and quantitative study of Florida State University faculty, staff, and students. This study measured their perceptions of the pandemic, their behaviors tied to safety and community, and how these practices were tied to beliefs of individualism and collectivism. We found that collectivist orientations were associated with a greater likelihood of wearing masks consistently, severe interruptions of one's social life caused by the pandemic, greater concern for infecting others, and higher levels of trust in medical professionals for behavioral guidelines surrounding the pandemic. These associations largely persist even after adjusting for political affiliation, which we find is also a strong predictor of COVID-19 beliefs and behaviors.

One size does not fit all: Preferences for HIV care delivery among out-of-care people living with HIV in the Southeastern United States.

Approximately half of the people with HIV (PWH) in the United States are retained in HIV care and only 57% have achieved viral suppression, due to barriers including transportation access, stigma, poor mental health, substance use, and medical mistrust. Community-based HIV care models have potential to address the diverse needs of patients and to improve retention in care, but their success is contingent on acceptance by patients and key community stakeholders. Recognizing that the preferences of PWH who are out-of-care (PWH-OOC) likely differ from those retained in care, we conducted a mixed-methods study from June 2019 to May 2021 composed of surveys with PWH-OOC (n = 50) and in-depth interviews with key clinic and community stakeholders (n = 41) to examine the relative preference and perceived advantages and disadvantages for six different community-based HIV care models versus the traditional fixed-clinic model. Survey data was analyzed to assess average rank preference for each care model and interview transcripts were thematically coded to examine factors influencing model acceptance. The highest preference for care delivery was via a mobile clinic, followed by community-based peer navigation, primary care clinics, telemedicine, traditional HIV subspeciality clinic, homeless shelter, and drug treatment center. Common factors influencing preference included convenience, accessibility, potential to preserve confidentiality, quality of care assurance, opportunity to develop rapport with their HIV care provider, access to a smart device, and potential to alleviate versus exacerbate HIV stigma. Participants discussed need for integration of care models and for individuals to choose different care models at different times. Providers and patients differed in preference for care model and weighting of relative advantages and disadvantages of each. Findings highlight the need to integrate alternative, community-based care models into the national plan to end the HIV epidemic and to allow for PWH-OOC to choose the model most fitting based on individual circumstances.

Trichomonas Vaginalis Infections Among Youth in Detention in the Southeastern United States.

Most juvenile detention facilities do not screen for Trichomonas Vaginalis (TV) despite being the most common parasitic STI. We aimed to assess TV prevalence and risk factors among young women in a large urban juvenile detention center. We evaluated a retrospective cohort from April to December 2016. Youth submitted an intake urine sample for gonorrhea and chlamydia testing; we tested remnant urine for TV. Outcomes included prevalence of TV and risk factors for infection. A total of 1009 samples were collected, 374 from young women ages 13 - 17 years old. Among females, 8% tested positive for TV with co-infection of either gonorrhea, chlamydia or both occurring in 12/29 (41%) patients. Compared to youth without TV females with TV were more likely to be African American (76%) and report symptoms (41%) (p<0.05). In our study population, prevalence of TV was 8%. As nearly half of those with TV were asymptomatic, we recommend routine screening among this population.

Assessing the Influence of Child Sexual Behavior on Depression among Black SMM in the Southeastern United States.

Limited studies have examined the associations between child sexual abuse (CSA) and depression among Black sexual minority men (SMM) in the Southeastern United States (US). As, such, the current study examined the critical gap in understanding the impact of CSA on Black SMM's mental health. Specifically, we tested the associations between contextual CSA factors and depression among a large population-based sample of Black SMM living in two cities in the Southern US. Data were obtained from the MARI Study, a sample of Black SMM ages 18-66 years, recruited from the Jackson, MS and Atlanta, GA metropolitan areas (n = 507). Depression was assessed using the 9-item CES-D scale. We conducted multivariable regression analyses to examine the association between depression with history of CSA and other child sexual-related variables (i.e., age of perpetrator and age of sexual abuse), controlling for key confounders. Our results indicated that CSA (ß = 0.14, p < 0.001) was positively associated with depression. Our results also indicated that Black SMM who reported being sexually abused at the ages of 6 to 10 (ß = 0.30, p < 0.01) and 16 to 18 (ß = 0.25, p < 0.05) were positively associated with depression. These findings suggest that there is a need to provide culturally and safe mental health services in the Southeastern US for CSA survivors.

Increasing tidal inundation corresponds to rising porewater nutrient concentrations in a southeastern U.S. salt marsh.

Salt marshes are ecologically and economically important features of coastal environments that are vulnerable to sea level rise, the rate of which has accelerated in recent decades along the southeastern US Atlantic coast. Increased flooding frequency and duration across the marsh platform is predicted to impact vegetation community structure and overall marsh persistence, but the effect of changing inundation patterns on biogeochemical processes in marsh sediments remains largely unexplored. As part of a long-term monitoring effort to assess how marshes are responding to sea level rise in North Inlet estuary (South Carolina, USA), we collected data on porewater nutrient concentrations from a series of permanent monitoring plots across multiple transects spanning the marsh elevation gradient during the growing season from 2009 to 2019. Additionally, we calculated time inundated for each plot using local water level data and high-resolution elevation measurements to assess the change in time flooded at each plot. Our results indicate that both NH4 and PO4 nutrient concentrations have increased in most permanent plots over the 11-year study period and that nutrient concentrations are higher with increasing proximity to the creek. Spatial patterns in nutrient increases through time are coincident with considerable increases in tidal inundation observed over the marsh platform. Across plots located in the low marsh, porewater NH4 and PO4 concentrations have risen at average rates of 8.96 µM/year and 0.86 µM/year, respectively, and have reached rates as high as 27.25 µM/year and 3.13 µM/year. We suggest that increased inundation time due to rising sea level has altered biogeochemical conditions influencing nutrient availability in marsh porewater, resulting in increases that likely have relevance for larger scale nutrient cycles as well as marsh ecosystem stability and function.

Using citizen science to determine if songbird nesting parameters fluctuate in synchrony.

As global temperatures continue to rise, population or spatial synchrony (i.e., the degree of synchronization in the fluctuation of demographic parameters) can have important implications for inter- and intraspecific interactions among wildlife populations. Climatic fluctuations are common drivers of spatial synchrony, and depending on the degree of synchronization and the parameters impacted, synchrony can increase extinction probabilities. Although citizen science is an inexpensive method to collect long-term data over large spatial scales to study effects of climate changes on wildlife, few studies have used citizen science data to determine if this synchrony is occurring across populations and species. We used 21 years of citizen science nesting data collected on Eastern Bluebirds (Sialia sialis) and Carolina Chickadees (Poecile carolinensis), two widespread North American species with similar life histories and abundant data, to assess the degree of synchrony between and within their populations in the southeastern United States. We found little evidence of synchronous fluctuations in the nesting parameters of hatching success, hatchability, and fledging success between and within species, nor did we observe consistent patterns towards increased or decreased synchrony. Estimates of nesting parameters were high (≥ 0.83) and showed little variability (relative variance ≤ 0.17), supporting the hypothesis that parameters that strongly contribute to population growth rates (i.e., typically fecundity in short-lived species) show little interannual variability. The low variability and lack of synchrony suggest that these populations of study species may be resilient to climate change. However, we were unable to test for synchronous fluctuations in other species and populations, or in the survival parameter, due to large gaps in data. This highlights the need for citizen science projects to continue increasing public participation for species and regions that lack data.

Pathways between neighbourhood factors, stress and glycaemic control in individuals with type 2 diabetes in Southeastern United States: a cross-sectional pathway analysis.

OBJECTIVES: Understanding the pathway by which neighbourhood factors influence glycaemic control may be crucial to addressing health disparities in diabetes. This study aimed to examine if the pathway between neighbourhood factors and glycaemic control is mediated by stress. DESIGN: Structured equation modelling (SEM) was used to investigate direct and indirect effects in the relationship between neighbourhood factors, stress and glycaemic control, with standardised estimates to allow comparison of paths. PARTICIPANTS: Data was obtained from 615 adults with type 2 diabetes in the Southeastern United States. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome variable was glycaemic control determined by glycated haemoglobin (HbA1c) within the prior 6 months. Neighbourhood factors included neighbourhood violence, aesthetic quality of the neighbourhood, access to healthy food, and social cohesion. Stress was measured using the perceived stress scale. RESULTS: In the final model (χ2(158)=406.97, p<0.001, root mean square error of approximation=0.05, p-close 0.38, Comparative Fit Index=0.97, Tucker-Lewis index=0.96, the coefficient of determination=1.0), violence (r=0.79, p=0.006), neighbourhood aesthetics (r=0.74, p=0.02) and social cohesion (r=0.57, p=0.04) were significantly associated with higher perceived stress. Stress (r=0.06, p=0.004) was directly associated with higher glycaemic control. Significant indirect effects existed between violence and higher HbA1c (r=0.05, p=0.04). After controlling for other neighbourhood factors, there was no significant relationship between access to healthy food and either stress or glycaemic control. CONCLUSIONS: While a number of neighbourhood factors were directly associated with stress, only neighbourhood violence had a significant indirect effect on glycaemic control via stress within the tested pathway. Future studies should examine individual-level stress management interventions and should consider community-level interventions targeting neighbourhood violence as strategies for addressing disparities in diabetes.

Minimal COVID-19 quieting measured in the deep offshore waters of the U.S. Outer Continental Shelf.

Using a 2-year time series (2019-2020) of 1-min sound pressure level averages from seven sites, the extension of COVID-related quieting documented in coastal soundscapes to deep (approximately 200-900 m) waters off the southeastern United States was assessed. Sites ranged in distance to the continental shelf break and shipping lanes. Sound level decreases in 2020 were observed at sites closest to the shelf break and shipping lanes but were inconsistent with the timing of shipping changes related to a COVID-19 slowdown. These observations are consistent with increased numbers of vessel tracks in 2020 compared to 2019 at a majority of sites.

Metabolic responses to increased temperatures in three semi-aquatic turtle species from the southeastern United States.

Physiological maintenance of ectotherms is largely dependent on temperature. Abrupt changes in environmental conditions can cause shifts in energy budgets, with higher temperatures requiring more energy be devoted to maintenance functions, making less energy available for other activities. As a group, freshwater turtles are of conservation concern; thus, it is important to understand their physiological responses to temperature shifts, particularly given current climate change predictions. We quantified metabolic rates (MR) for three species of semi-aquatic turtles that vary in their degree of terrestriality and propensity to aestivate: chicken turtles (Deirochelys reticularia), eastern mud turtles (Kinosternon subrubrum), and eastern musk turtles (Sternotherus odoratus). Metabolic trials were performed using a flow-through respirometer at three environmentally-relevant temperatures: 25 °C, 30 °C, and 35 °C. As expected, MRs of turtles were significantly and positively associated with increases in mass and temperature. Pairwise comparisons revealed that D. reticularia exhibited significantly higher oxygen consumption rates (VO2) relative to K. subrubrum, which had significantly higher VO2 than S. odoratus. The combination of higher metabolic rates, the tendency to terrestrially aestivate, and declining quantity of high quality thermal habitats may place some semi-aquatic turtles at a disadvantage when considering future climate scenarios. Our findings, when combined with knowledge of other ecological traits, may be a useful tool for predicting relative sensitivities of turtle species to predicted climate change, particularly those species inhabiting seasonal wetlands.

Consumption of endemic arbovirus mosquito vectors by bats in the southeastern United States.

Mosquitoes affect human health and well-being globally through their roles as disease-causing pathogen vectors. Utilizing genetic techniques, we conducted a large-scale dietary study of three bat species common to the southeastern U.S.A., Lasiurus seminolus (Seminole bat), Nycticeius humeralis (evening bat), and Myotis austroriparius (southeastern myotis). Through next-generation sequencing of a 180 bp portion of cytochrome oxidase subunit I (COI) of mitochondrial DNA from 180 bat guano samples, we documented consumption of 17 species of mosquitoes by bats, including six endemic arbovirus vectors. Culex quinquefasciatus, Culex coronator, Culiseta melanura, Culex salinarius, Culex erraticus, and Coquillettidia perturbans were consumed by 51.3%, 43.7%, 27.2%, 22.8%, 18.0%, and 12.7% of bats sampled, respectively. Consumption of two of these mosquito species was explained by spatial variables reflecting the prevalence of mosquito larval habitat, five were explained by bat traits (bat mass, bat species), and two were explained by these factors plus temporal variables (maximum daily temperature, time since sunset, date), making it challenging to offer specific guidance on how best to promote bats as a means of reducing arbovirus vector species. Our results show that common bat species of the southeastern U.S.A. consume endemic, but not exotic, arbovirus mosquito vectors. Future studies are needed to understand the impact of bat consumption on mosquito numbers and public health.

Distribution and predicted climatic refugia for a reef-building cold-water coral on the southeast US margin.

Climate change is reorganizing the planet's biodiversity, necessitating proactive management of species and habitats based on spatiotemporal predictions of distributions across climate scenarios. In marine settings, climatic changes will predominantly manifest via warming, ocean acidification, deoxygenation, and changes in hydrodynamics. Lophelia pertusa, the main reef-forming coral present throughout the deep Atlantic Ocean (>200 m), is particularly sensitive to such stressors with stark reductions in suitable habitat predicted to accrue by 2100 in a business-as-usual scenario. However, with new occurrence data for this species along with higher-resolution bathymetry and climate data, it may be possible to locate further climatic refugia. Here, we synthesize new and published biogeographic, geomorphological, and climatic data to build ensemble, multi-scale habitat suitability models for L. pertusa on the continental margin of the southeast United States (SEUS). We then project these models in two timepoints (2050, 2100) and four climate change scenarios to characterize the occurrence probability of this critical cold-water coral (CWC) habitat now and in the future. Our models reveal the extent of reef habitat in the SEUS and corroborate it as the largest currently known essentially continuous CWC reef province on earth, and also predict abundance of L. pertusa to identify key areas, including those outside areas currently protected from bottom-contact fishing. Drastic reductions in L. pertusa climatic suitability index emerged primarily after 2050 and were concentrated at the shallower end (<~550 m) of the regional distribution under the Gulf Stream main axis. Our results thus suggest a depth-driven climate refuge effect where deeper, cooler reef sites experience lesser declines. The strength of this effect increases with climate scenario severity. Taken together, our study has implications for the regional and global management of this species, portending changes in the biodiversity reliant on CWC habitats and the critical ecosystem services they provide.

Reflections of Nursing Students Following Hurricane Michael.

Background: Students in the southeastern United States were affected by Hurricane Michael in 2018. The storm's devastation led to communication and education issues that transformed students' paths to completing their nursing degree program. Climate change will cause increased natural disasters, and educators must be prepared. Method: This qualitative study used a descriptive phenomenological design. A purposive sample of 10 graduate nursing students were recruited and interviewed. The data gathering ended when data saturation was achieved. Results: Five themes were generated: Devastation and no communication, survival mode, emotional impact, before and after, and forever changed. The rich data documented the resiliency of the students as they described events during and after the hurricane in relation to their personal and educational experiences. Conclusion: Universities and students need to be prepared for natural disasters; understanding graduate nursing students' prior experiences can benefit educators.

Preserving independence among under-resourced older adults in the Southeastern United States: existing barriers and potential strategies for research.

Disability prevention and preservation of independence is crucial for successful aging of older adults. To date, relatively little is known regarding disparities in independent aging in a disadvantaged older adult population despite widely recognized health disparities reported in other populations and disciplines. In the U.S., the Southeastern region also known as "the Deep South", is an economically and culturally unique region ravaged by pervasive health disparities - thus it is critical to evaluate barriers to independent aging in this region along with strategies to overcome these barriers. The objective of this narrative review is to highlight unique barriers to independent aging in the Deep South and to acknowledge gaps and potential strategies and opportunities to fill these gaps. We have synthesized findings of literature retrieved from searches of computerized databases and authoritative texts. Ultimately, this review aims to facilitate discussion and future research that will help to address the unique challenges to the preservation of independence among older adults in the Deep South region.

Environmental Drivers of Gulf Coast Tick (Acari: Ixodidae) Range Expansion in the United States.

In the United States, the Gulf Coast tick (Amblyomma maculatum Koch) is a species of growing medical and veterinary significance, serving as the primary vector of the pathogenic bacterium, Rickettsia parkeri (Rickettsiales: Rickettsiaceae), in humans and the apicomplexan parasite, Hepatozoon americanum, in canines. Ongoing reports of A. maculatum from locations outside its historically reported distribution in the southeastern United States suggest the possibility of current and continuing range expansion. Using an ecological niche modeling approach, we combined new occurrence records with high-resolution climate and land cover data to investigate environmental drivers of the current distribution of A. maculatum in the United States. We found that environmental suitability for A. maculatum varied regionally and was primarily driven by climatic factors such as annual temperature variation and seasonality of precipitation. We also found that presence of A. maculatum was associated with open habitat with minimal canopy cover. Our model predicts large areas beyond the current distribution of A. maculatum to be environmentally suitable, suggesting the possibility of future northward and westward range expansion. These predictions of environmental suitability may be used to identify areas at potential risk for establishment and to guide future surveillance of A. maculatum in the United States.

Affordable Housing Specialists' Perceptions of Advance Care Planning Among Low-Income Older Adult Residents: A Qualitative Study.

This preliminary qualitative study aimed to explore affordable housing specialists' perceptions of challenges and patterns of advance care planning behaviors among low-income older residents in affordable housing. Advance care planning rates among such residents are disproportionally lower than higher-income older adults. Individual telephone interviews were conducted with affordable housing specialists in a major urban area in the Southeastern United States (N = 5). Using thematic content analysis, 2 independent coders synthesized the 2 coding sets into a single codebook that was iteratively and individually reapplied to the transcripts. The Ecological Model of Active Living, a model that embeds individual behavior within a physical and social environment, was used to categorize prominent codes to visualize relationships among codes and create a cohesive, ecological picture of planning behavior in this population. Four themes emerged from the data and were plotted in an adapted ecological model. Residents' ongoing struggles despite obtaining housing prevent self-initiation and maintenance of advance care planning. Housing specialists possess the expertise and empathy to guide change efforts and provide advance care planning, but aid is required to ensure adequate resources to prevent role conflict and burnout. Recommendations for interprofessional collaboration, practice, policy, and research are discussed.

Neighborhood Characteristics, Intersectional Discrimination, Mental Health, and HIV Outcomes Among Black Women Living With HIV, Southeastern United States, 2019‒2020.

Objectives. To examine the effects of within-neighborhood and neighboring characteristics on discrimination, stigma, mental health, and HIV outcomes among Black women living with HIV (BWLWH). Methods. A total of 151 BWLWH in a southeastern US city provided baseline data (October 2019‒January 2020) on experienced microaggressions and discrimination (race-, gender-, sexual orientation-, or HIV-related), mental health (e.g., depression, posttraumatic stress disorder), and HIV outcomes (e.g., viral load, antiretroviral therapy adherence). Neighborhood characteristics by census tract were gathered from the American Community Survey and the National Center for Charitable Statistics. Spatial econometrics guided the identification strategy, and we used the maximum likelihood technique to estimate relationships between a number of predictors and outcomes. Results. Within-neighborhood and neighboring characteristics (employment, education, crime, income, number of religious organizations, and low-income housing) were significantly related to intersectional stigma, discrimination, mental health, HIV viral load, and medication adherence. Conclusions. Policy, research, and interventions for BWLWH need to address the role of neighborhood characteristics to improve quality of life and HIV outcomes. (Am J Public Health. 2022;112(S4):S433-S443. https://doi.org/10.2105/AJPH.2021.306675).