Addressing Geographical Inequities and Barriers in Access to Mental Health Care among Youth in a Rural Western Kentucky County.

A Community Health Assessment (CHA) was conducted among community members in a rural Western Kentucky county in 2022-2023 identified mental health as one of the top health issues in the county. The purpose of a CHA is to identify key health needs and issues through data and develop strategies for action. One of the objectives was to identify barriers to accessing mental health care, especially among youth. Secondary data analyses were performed from survey results conducted by the local health department and local public schools. Quantitative data were analyzed using SPSS software. Qualitative data were analyzed using a two-cycle coding process. Access to mental healthcare is an area of great need in this rural Western Kentucky county. Recommendations include working with healthcare providers, especially specialists, to accept Medicaid and it is recommended to cross-train other professionals to address mental health needs in this region.

Role of pitch in toddler looking to new and given referents in American English.

This study examined how toddler looking to a discourse referent is mediated by the information status of the referent and the pitch contour of the referring expression. Eighteen-month-olds saw a short discourse of three sets of images with the proportion of looking time to a target analyzed during the final image. At test, the information status of the referent was either new or given and the referring expression was presented with one of three pitch contours (flat f0, monotonal (~H*), or bitonal (~L+H*)). In Experiment 1, toddlers looked reliably longer to a target referent when it was either new to the discourse or carried a non-flat pitch contour. In Experiment 2, the referring expression was removed to observe effects of information status alone on looking to a target referent. Toddlers looked significantly longer to a target when it was new versus given. More fine-grained time course analyses of eye movements revealed differences in the speed and duration of fixation to a target. Overall, the experiments show that discourse reference in toddlers is mediated by the presence of newness and pitch contours, even in the case of given information.

Engagement and outcomes of cancer patients referred to a tobacco cessation program at a National Cancer Institute-designated cancer center.

INTRODUCTION: Tobacco cessation is a critical but challenging intervention for cancer patients. Our National Cancer Institute-designated Comprehensive Cancer Center instituted a tobacco cessation program in 2019. This manuscript reports on the first 2 years of our experience. METHODS: Patients were referred to the program by their care team, and a certified tobacco treatment specialist contacted patients remotely and provided behavioral therapy and coordinated pharmacotherapy. We retrospectively captured data from patients with a cancer diagnosis referred to the tobacco cessation program. Univariate and multivariable logistic regression analyses with the backward elimination approach were performed to determine factors associated with patient acceptance of referral to the tobacco cessation program. Tobacco cessation rates after referral to the program were also captured. RESULTS: Between July 2019 and August 2021, 194 patients were referred to the tobacco cessation program. Of the 194 patients referred, 93 agreed to enroll in the tobacco cessation program (47.9%), of which 84 requested pharmacotherapy (90.3%). Twenty-four were able to cease tobacco use (25.8%). Only 7 patients out of the 101 patients (6.9%) who declined cessation services were successful (p < 0.001). On univariate logistic regression, race (p = 0.027) and marital status (p = 0.020) were associated with referral acceptance. On multivariable analysis, single patients (odds ratio [OR] = 0.33) and Caucasian patients (OR = 0.43) were less likely to accept a referral. CONCLUSIONS: Access to tobacco cessation services is a critical component of comprehensive cancer care. Our experience highlights the need to understand patient-specific factors associated with engagement with a tobacco cessation program during cancer treatment. The use of pharmacotherapy is also a critical component of successful tobacco cessation.

Asymmetric discrimination of nonspeech tonal analogues of vowels.

Directional asymmetries reveal a universal bias in vowel perception favoring extreme vocalic articulations, which lead to acoustic vowel signals with dynamic formant trajectories and well-defined spectral prominences because of the convergence of adjacent formants. The present experiments investigated whether this bias reflects speech-specific processes or general properties of spectral processing in the auditory system. Toward this end, we examined whether analogous asymmetries in perception arise with nonspeech tonal analogues that approximate some of the dynamic and static spectral characteristics of naturally produced /u/ vowels executed with more versus less extreme lip gestures. We found a qualitatively similar but weaker directional effect with 2-component tones varying in both the dynamic changes and proximity of their spectral energies. In subsequent experiments, we pinned down the phenomenon using tones that varied in 1 or both of these 2 acoustic characteristics. We found comparable asymmetries with tones that differed exclusively in their spectral dynamics, and no asymmetries with tones that differed exclusively in their spectral proximity or both spectral features. We interpret these findings as evidence that dynamic spectral changes are a critical cue for eliciting asymmetries in nonspeech tone perception, but that the potential contribution of general auditory processes to asymmetries in vowel perception is limited. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Asymmetries in unimodal visual vowel perception: The roles of oral-facial kinematics, orientation, and configuration.

Masapollo, Polka, and Ménard (2017) recently reported a robust directional asymmetry in unimodal visual vowel perception: Adult perceivers discriminate a change from an English /u/ viseme to a French /u/ viseme significantly better than a change in the reverse direction. This asymmetry replicates a frequent pattern found in unimodal auditory vowel perception that points to a universal bias favoring more extreme vocalic articulations, which lead to acoustic signals with increased formant convergence. In the present article, the authors report 5 experiments designed to investigate whether this asymmetry in the visual realm reflects a speech-specific or general processing bias. They successfully replicated the directional effect using Masapollo et al.'s dynamically articulating faces but failed to replicate the effect when the faces were shown under static conditions. Asymmetries also emerged during discrimination of canonically oriented point-light stimuli that retained the kinematics and configuration of the articulating mouth. In contrast, no asymmetries emerged during discrimination of rotated point-light stimuli or Lissajou patterns that retained the kinematics, but not the canonical orientation or spatial configuration, of the labial gestures. These findings suggest that the perceptual processes underlying asymmetries in unimodal visual vowel discrimination are sensitive to speech-specific motion and configural properties and raise foundational questions concerning the role of specialized and general processes in vowel perception. (PsycINFO Database Record

Evaluation of a visit preparation intervention implemented in two rural, underserved counties of Northern California.

OBJECTIVE: Evaluate satisfaction with visit preparation at three rural resource center sites. METHODS: The resource centers sent eight employees and two volunteers for training at UCSF in Consultation Planning (CP). CP is a service to help patients make a list of questions before seeing their doctors. Researchers used multivariate ordered logistic regression analysis to investigate the variation in satisfaction among 99 CP Clients served by the resource centers in 2003. RESULTS: Sixty-seven CP Clients who completed surveys were highly satisfied (mean=8.67, standard deviation (S.D.)=1.85, range=5-10). Variation in satisfaction was associated only with whether or not the CP Provider was a breast cancer survivor serving a breast patient (p=0.005). Satisfaction was not associated with CP Client demographics; type of upcoming medical visit; or CP Provider age, remuneration status, nursing background, and volume of CP Clients. CONCLUSION: Community-based resource centers have implemented CP to the satisfaction of their clients. Further research should expand the delivery of CP to more underserved members of the community and evaluate its acceptability and impact. There may be a therapeutic alliance formed when survivors provide CP to newly diagnosed patients. PRACTICE IMPLICATIONS: CP should be considered by patient support programs wishing to expand their client services to include visit preparation.

Surface assembly and nanofabrication of 1,1,1-tris(mercaptomethyl)heptadecane on Au(111) studied with time-lapse atomic force microscopy.

The solution self-assembly of multidentate organothiols onto Au(111) was studied in situ using scanning probe nanolithography and time-lapse atomic force microscopy (AFM). Self-assembled monolayers (SAMs) prepared from dilute solutions of multidentate thiols were found to assemble slowly, requiring more than six hours to generate films. A clean gold substrate was first imaged in ethanolic media using liquid AFM. Next, a 0.01 mM solution of multidentate thiol was injected into the liquid cell. As time progressed, molecular-level details of the surface changes at different time intervals were captured by successive AFM images. Scanning probe based nanofabrication was accomplished using protocols of nanografting and nanoshaving with n-alkanethiols and a tridentate molecule, 1,1,1-tris(mercaptomethyl)heptadecane (TMMH). Nanografted patterns of TMMH could be inscribed within n-alkanethiol SAMs; however, the molecular packing of the nanopatterns was less homogeneous compared to nanopatterns produced with monothiolates. The multidentate molecules have a more complex assembly pathway than monothiol counterparts, mediated by sequential steps of forming S-Au bonds to the substrate.

Surface-directed synthesis of erbium-doped yttrium oxide nanoparticles within organosilane zeptoliter containers.

We introduce an approach to synthesize rare earth oxide nanoparticles using high temperature without aggregation of the nanoparticles. The dispersity of the nanoparticles is controlled at the nanoscale by using small organosilane molds as reaction containers. Zeptoliter reaction vessels prepared from organosilane self-assembled monolayers (SAMs) were used for the surface-directed synthesis of rare earth oxide (REO) nanoparticles. Nanopores of octadecyltrichlorosilane were prepared on Si(111) using particle lithography with immersion steps. The nanopores were filled with a precursor solution of erbium and yttrium salts to confine the crystallization step to occur within individual zeptoliter-sized organosilane reaction vessels. Areas between the nanopores were separated by a matrix film of octadecyltrichlorosilane. With heating, the organosilane template was removed by calcination to generate a surface array of erbium-doped yttria nanoparticles. Nanoparticles synthesized by the surface-directed approach retain the periodic arrangement of the nanopores formed from mesoparticle masks. While bulk rare earth oxides can be readily prepared by solid state methods at high temperature (>900 °C), approaches for preparing REO nanoparticles are limited. Conventional wet chemistry methods are limited to low temperatures according to the boiling points of the solvents used for synthesis. To achieve crystallinity of REO nanoparticles requires steps for high-temperature processing of samples, which can cause self-aggregation and dispersity in sample diameters. The facile steps for particle lithography address the problems of aggregation and the requirement for high-temperature synthesis.

Spatially selective surface platforms for binding fibrinogen prepared by particle lithography with organosilanes.

We introduce an approach based on particle lithography to prepare spatially selective surface platforms of organosilanes that are suitable for nanoscale studies of protein binding. Particle lithography was applied for patterning fibrinogen, a plasma protein that has a major role in the clotting cascade for blood coagulation and wound healing. Surface nanopatterns of mercaptosilanes were designed as sites for the attachment of fibrinogen within a protein-resistant matrix of 2-[methoxy(polyethyleneoxy)propyl] trichlorosilane (PEG-silane). Preparing site-selective surfaces was problematic in our studies, because of the self-reactive properties of PEG-organosilanes. Certain organosilanes presenting hydroxyl head groups will cross react to form mixed surface multi-layers. We developed a clever strategy with particle lithography using masks of silica mesospheres to protect small, discrete regions of the surface from cross reactions. Images acquired with atomic force microscopy (AFM) disclose that fibrinogen attached primarily to the surface areas presenting thiol head groups, which were surrounded by PEG-silane. The activity for binding anti-fibrinogen was further evaluated using ex situ AFM studies, confirming that after immobilization the fibrinogen nanopatterns retained capacity for binding immunoglobulin G. Studies with AFM provide advantages of achieving nanoscale resolution for detecting surface changes during steps of biochemical surface reactions, without requiring chemical modification of proteins or fluorescent labels.

Consultation support for rural women with breast cancer: results of a community-based participatory research study.

OBJECTIVE: This study asked: (1) What do rural women with breast cancer need to make the most out of their major medical appointments? and (2) What can the community resource centers do to best support those needs? METHODS: We interviewed 12 doctors, 12 breast cancer survivors and 10 community agency staff, including those who provide services to Latinos and Native Americans. Interviews generated success factors and barriers related to meeting patient information needs. Examples were categorized into themes. RESULTS: Success factors included making sure patients review high quality educational materials before the visit; and that someone is available to take notes. Doctors felt that a patient list of questions was productive, but some survivors felt doctors did not always respond productively to the list. Respondents did not mention audiorecording unless prompted. Most then endorsed it. CONCLUSION: Educational materials, question lists, and note-takers can help rural women with breast cancer and their doctors achieve their goals during treatment discussions. Audiorecording may be an implicit but not explicit need. PRACTICE IMPLICATIONS: Other cancer resource centers and support agencies should consider offering information, question-listing, and note-taking services. They should assess whether audiorecording is an implicit need in their settings.

Adaptation of consultation planning for Native American and Latina women with breast cancer.

CONTEXT: Resource centers in rural, underserved areas are implementing Consultation Planning (CP) to help women with breast cancer create a question list before a doctor visit. PURPOSE: To identify changes needed for acceptable delivery of CP to rural Native Americans and Latinas. METHODS: We interviewed and surveyed 27 Native American and Latino key informants. We coded interviews thematically, and calculated summary statistics for the survey data. FINDINGS: Native American and Latino respondents endorsed CP as culturally acceptable to their communities, while suggesting changes. Respondents also raised the topic of how to further support patients once they have successfully prepared a question list using CP. CONCLUSIONS: The resource centers implemented the requested changes.