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Background: Early care and education settings (ECE) are potential venues for young children to develop healthy lifestyle habits. The study assesses training needs and associations with relevant practices of licensed ECE providers across Minnesota and Wisconsin., Methods: A random sample of 823 providers completed a 97-item survey assessing nutrition and physical activity (PA) practices and training needs. Logistic regression, adjusted for program type (center- and family home-based), and location (urban/rural) examined associations between the top 3 selected training needs and provider practices., Results: Top training needs: (1) ways to effectively engage parents about healthy eating and PA, (2) low-cost ways to serve healthy foods, and (3) fun and easy nutrition education curricula. Providers who reported being not happy/somewhat happy vs happy/very happy with parent communication were more likely to need training to engage parents. Among providers who prepared food on-site, shopping at Farmer's Market had lower odds of needing training for serving healthy meals on a budget. Not having completed nutrition training in the past year providers were more likely to need training for fun and easy nutrition education curricula., Conclusions: Providers need additional training to improve communication with parents, healthy food shopping practices, and nutrition-related games., (© 2020 American School Health Association.)

Reed canary grass (Phalaris arundinacea L.) is an invasive, cool-season grass commonly dominating wetlands with high nutrient loads. Its impact on nitrogen removal via denitrification in wetlands is unknown. Most studies of denitrification in treatment wetlands have focused on the effects of physical or chemical variables and not on the effects of plant roots on the soil environment. The purpose of this study was to measure effects of plant type on denitrification rates in typical wetland soils of the midwestern United States by comparing wet prairie mix, switchgrass-dominated, and reed canary grass plant communities. Nitrate (NO 3 ) removal and other parameters were measured in miniature wetlands, or mesocosms, containing each plant community transplanted from a small agricultural treatment wetland in southern Minnesota. Quantitative polymerase chain reaction analysis was used to quantify the total bacteria population (measured with 16S rRNA genes) and denitrifying gene abundance (measured with nosZ genes) from the rhizosphere of each plant community. The wet prairie mix mesocosms on average removed the most NO - ) removal and other parameters were measured in miniature wetlands, or mesocosms, containing each plant community transplanted from a small agricultural treatment wetland in southern Minnesota. Quantitative polymerase chain reaction analysis was used to quantify the total bacteria population (measured with 16S rRNA genes) and denitrifying gene abundance (measured with nosZ genes) from the rhizosphere of each plant community. The wet prairie mix mesocosms on average removed the most NO 3 - in each test (p = .01 and .08). Whereas the wet prairie mix removed the most NO 3 - from the surface water (p < .01), reed canary grass removed more from the subsurface (p < .01). Ratios of denitrifying to total bacteria were higher in the wet prairie mix than in the other communities' root zones (p < .05). Results suggest that reed canary grass invasion could reduce denitrification in wetlands, especially during the spring and fall when it is growing but other plants are dormant., (© 2020 The Authors. Journal of Environmental Quality © 2020 American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America.)

The mixture cure model is an effective tool for analysis of survival data with a cure fraction. This approach integrates the logistic regression model for the proportion of cured subjects and the survival model (either the Cox proportional hazards or accelerated failure time model) for uncured subjects. Methods based on the mixture cure model have been extensively investigated in the literature for data with exact failure/censoring times. In this paper, we propose a mixture cure modeling procedure for analyzing clustered and interval-censored survival time data by incorporating random effects in both the logistic regression and PH regression components. Under the generalized linear mixed model framework, we develop the REML estimation for the parameters, as well as an iterative algorithm for estimation of the survival function for interval-censored data. The estimation procedure is implemented via an EM algorithm. A simulation study is conducted to evaluate the performance of the proposed method in various practical situations. To demonstrate its usefulness, we apply the proposed method to analyze the interval-censored relapse time data from a smoking cessation study whose subjects were recruited from 51 zip code regions in the southeastern corner of Minnesota., (Copyright © 2011 John Wiley & Sons, Ltd.)

Nitrate-N losses to surface waters in the Upper Midwest of the Untied States have increased in recent decades, contributing to hypoxia in the Gulf of Mexico. This paper investigates whether increasing nitrate-N export from cropland in the Upper Midwest since the late 1960s results from changes in land use or climate. The Agricultural Drainage and Pesticide Transport (ADAPT) Model simulated current and historical agricultural systems under past and recent wet climate for Seven Mile Creek in Minnesota. Simulations were run with management and climate for three distinctly different periods--namely, 1965 to 1969, 1976 to 1980, and 1999 to 2003 (wettest period). Results showed discharge and nitrate-N losses responded more to changes in climate than management. The wetter period (1999-2003) caused a simulated 70% increase in discharge under 1960s-era management compared with that period's observed climate and a simulated 51% increase in discharge under 1970s-era management compared with the 1976 to 1980 climate. The recent, wetter climate also produced a 62% increase in nitrate-N losses for 1960s-era management compared with the actual climate and a 137% increase in nitrate-N losses for 1978 management conditions compared with actual 1970s climate. Had recent climate been in place and stable since 1965, agricultural changes would have decreased discharge by 6.4% through the late 1970s and then by another 21.1% under modern management but would have increased nitrate-N losses by 184% through the late 1970s and then decreased nitrate-N losses by 13.5% between 1978 and 2001. Management changes that were important drivers included increasing N-fertilizer rates, increases in corn acreage, and increases in crop yield. But the most important factor driving increased nitrate-N losses from agriculture since the 1970s was an increasingly wetter climate.

Nitrate losses from subsurface tile drained row cropland in the Upper Midwest U.S. contribute to hypoxia in the Gulf of Mexico. Strategies are needed to reduce nitrate losses to the Mississippi River. This paper evaluates the effect of fertilizer rate and timing on nitrate losses in two (East and West) commercial row crop fields located in south-central Minnesota. The Agricultural Drainage and Pesticide Transport (ADAPT) model was calibrated and validated for monthly subsurface tile drain flow and nitrate losses for a period of 1999-2003. Good agreement was found between observed and predicted tile drain flow and nitrate losses during the calibration period, with Nash-Sutcliffe modeling efficiencies of 0.75 and 0.56, respectively. Better agreements were observed for the validation period. The calibrated model was then used to evaluate the effects of rate and timing of fertilizer application on nitrate losses with a 50-yr climatic record (1954-2003). Significant reductions in nitrate losses were predicted by reducing fertilizer application rates and changing timing. A 13% reduction in nitrate losses was predicted when fall fertilizer application rate was reduced from 180 to 123 kg/ha. A further 9% reduction in nitrate losses can be achieved when switching from fall to spring application. Larger reductions in nitrate losses would require changes in fertilizer rate and timing, as well as other practices such as changing tile drain spacings and/or depths, fall cover cropping, or conversion of crop land to pasture.

This paper is concerned with the formation of sudden infant death syndrome (SIDS) rates over time. Because of differential numbers of births throughout the year, a new SIDS rate is developed that takes into account the changing number of infants at risk and in particular the changing age distribution throughout the year. Differences between this newly adjusted rate and the commonly used unadjusted rates will be presented. Data from Minnesota linked birth--death records from 1990--1998 will be used for analysis., (Copyright 2004 John Wiley & Sons, Ltd.)

Cancers detected at a later disease stage are associated with significantly higher mortality risk. Lack of uniformity in county-level cancer detection rates is thus of substantial interest to state health departments and other public health professionals. In this paper, we perform several spatial analyses of breast and colorectal cancer detection data for Minnesota counties for 1995-1997. We look for outliers and clusters in the late detection rates using a number of techniques: (i). applying various mapping schemes, (ii). smoothing the data using Bayesian methods implemented via Markov chain Monte Carlo, and (iii). applying maximum likelihood techniques to test for the presence of clusters and to identify the most likely clustersOur results suggest a fairly uniform spatial pattern in both sets of detection rates. Spatially smoothed rates did not reveal clusters of counties with significantly higher late detection risk, nor were county-level covariates (such as income, education, and race) particularly helpful in explaining the rates. However, our spatial clustering approach (using the scan statistic) did produce statistically significant clusters of counties which may indicate differences of practical importance for public health., (Copyright 2003 John Wiley & Sons, Ltd.)

Peer education has become a popular strategy for health promotion interventions with adolescents, but it has not been used widely in school-based nutrition education. This paper describes and reports on the feasibility of the peer leader component of a school-based nutrition intervention for young adolescents designed to increase fruit and vegetable intakes and lower fat foods. About 1,000 seventh-grade students in eight schools received the nutrition intervention. Of these, 272 were trained as peer leaders to assist the teacher in implementing the activities. Results from a multicomponent process evaluation based on peer leader and classroom student feedback, direct classroom observation, and teacher ratings and interviews are presented. Results show that peer-led nutrition education approaches in schools are feasible and have high acceptability among peer leaders, classroom students, and teachers.

To the extent that the asthma morbidity so prevalent in children today is due to underdiagnosis or lack of appropriate treatment, schools are increasingly faced with the issue of defining their role in the care of children with asthma. This paper describes efforts to conduct schoolwide screening for asthma in an inner-city elementary school over the past two years. Screening methodology adopted for the project resulted in a simple and noninvasive approach for identifying children with current asthma in a school setting. While not as medically comprehensive as would be required to conclusively diagnose asthma, the simple screening approach proved efficient in identifying a population of elementary school children with a significant level of asthma morbidity. The paper discusses the effectiveness and feasibility of the screening efforts and proposes how such a screening program might be incorporated into the routine health activities undertaken at any elementary school.

This paper describes an interdisciplinary health team training program for school-based clinic staff in Minnesota. The project sought to improve team functioning, level of practice, and health care services at the school sites. Participants were interdisciplinary staff members from clinics in senior high, middle, and elementary schools. The program consisted of further development in team training knowledge and skills and educational sessions on issues identified by participants. Evaluations indicated participants reported greater knowledge and improved team functioning experiences from the team training. Gains also were shown in knowledge and skills in specific school topic areas such as violence, resiliency, working with resistant families, and self-care. The program could serve as a model for other interdisciplinary school health team training.

Quality assurance in radiation oncology attempts to prescribe consistent, safe, and optimal delivery of radiation to treat disease. It encompasses three major areas of treatment: clinical, physical, and technical. Although national approaches and guidelines of quality assurance in radiation oncology are available, they usually are not adequate to deal with the particular needs of individual institutions, nor are they adequate to ensure uniform standards of diagnosis and treatment among institutions. Therefore, it is important for individual institutions to develop and implement strict quality assurance standards, based on national guidelines as well as their own strengths and needs, to ensure that patients receive the highest quality of radiotherapy and that the successes and failures of treatment are statistically reliable. This paper addresses the importance of quality assurance in radiation oncology and examines the quality assurance program in the Department of Therapeutic Radiology-Radiation Oncology at the University of Minnesota as an example of a program tailored to the needs of an individual institution.

This paper describes the rationale, conceptual framework, and program components of a peer participation program for prevention of alcohol use among young adolescents. The peer participation program was one component of Project Northland, a community-wide program that seeks to prevent or delay onset of alcohol use among a cohort of young adolescents. The peer participation program, implemented in 20 northeastern Minnesota schools when students were in seventh grade, consisted of student groups who planned supervised, alcohol-free activities for themselves and their classmates. Program goals included 1) providing peer leadership and social support for non-use of alcohol, 2) creating opportunities for alternative behaviors to alcohol use, thereby 3) creating a norm of non-use among young adolescents.

Injuries represent the leading cause of death for children older than age one. Likewise, some 22 million children are injured each year, with more than 1 million requiring medical treatment. More than 40% of children currently receive full-time or part-time day care, but little research has examined the status of injuries to children in daycare. This paper provides information on the nature and extent of injuries to children, and contributing factors responsible for those injuries. One case study of research on injuries in Minneapolis, Minn., daycare centers is discussed. Recommendations for action are offered.

This paper underscores the need for true sample selection before statistical inference of any value can be made. Its findings suggest that the sample selection strategy of symptomatic volunteers can produce samples of anxious subjects with remarkable demographic similarity across the country. Anxiety as a constitutional rather than pathognomonic symptom is illustrated by the heterogeneity of its psychometric evaluation in our volunteers. Expecting a drug to safely relieve the anxiety of all anxious symptomatic volunteers is akin to expecting a drug to safely relieve the headaches of all headache sufferers. We feel that careful psychodiagnosis remains the best sample selection strategy.