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Purpose: This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population. Design/methodology/approach: Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns. Findings: Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors' findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way. Research limitations/implications: Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors' findings are not reflective of new immigrants' experiences. Parents' perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo's (DRC's) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth's perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors' findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors' study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community. Practical implications: The authors' findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures. Originality/value: This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC. [ABSTRACT FROM AUTHOR]

While the literature on entrepreneurial support organizations (ESOs) proliferates, we still do not understand whether local ESOs benefit some founders more than others. Drawing on organizational sponsorship and inclusive ecosystems literatures, this paper empirically examines whether founder characteristics of gender, immigrant, and racial minority group membership moderate the relationship between participation in different types of ESO services (incubator, mentoring, and education programs) and funding received from state, federal, and venture capital (VC) sources. Relying on a detailed database of life sciences firms founded in North Carolina's Research Triangle region, the paper uncovers how funding outcomes differ depending on the funding source and the moderating ESO and founder traits. The paper concludes with practical implications for how women, immigrant, and minority founders may be better supported by ESOs for broader, inclusive ecosystem building. Plain English Summary: Do entrepreneurial support organizations (ESOs) have different benefits for different founders? This paper finds the answer is yes, which has implications for how to create a more inclusive entrepreneurial ecosystem. While the literature continues to reveal more about the role of organizations like accelerators, business incubators, and mentoring programs for entrepreneurial success, we lack understanding of the different roles these organizations might play in fostering more inclusive entrepreneurial regions. This research analyzes whether women, immigrant, and racial minority founders benefit differently from participating in different types of mainstream entrepreneurial support organization programs including incubation, education, and mentoring. Results show great variation in how founders benefit from these programs with implications for inclusive ecosystem building. Since these organizations are often publicly funded or supported, the findings have implications for policy and economic development practice as well as for entrepreneurial firm strategy. [ABSTRACT FROM AUTHOR]

The share of students attending charter schools has been rising. There is evidence that charter school growth has increased socioeconomic segregation of students between schools. In this paper, we assess whether charter school growth affects how students are organized within nearby traditional public schools (TPS). We use administrative data from North Carolina to estimate the impact of charter school openings on segregation by income within nearby TPS. Our models exploit variation in the presence and location of charter schools over time between 2007 and 2014 for students in Grades 3 to 8. We find limited evidence that the segregation of students by income at the classroom level increases when charters open nearby. We find some evidence of increasing segregation in third grade and fourth grade math and third grade ELA classrooms at TPS within 2 miles of new charters in large urban districts schools. Our results vary somewhat depending on how we control for underlying trends and measure segregation. We find no effect of charter school growth on income segregation in higher grades. [ABSTRACT FROM AUTHOR]

Local sales tax bases are determined by factors including businesses, residential populations, and nonresidential visitors. This paper capitalizes on the COVID‐19 pandemic, using the sudden absence of in‐commuters, tourists, and college students to estimate the contributions these populations have on the sales tax base in North Carolina's 100 counties. The findings suggest that losing one in‐commuter results in a loss of roughly $1000 a month in taxable sales. Similarly, the loss of one hotel night booking results in a loss in taxable sales of approximately $525. This translates, for the median county, to exporting 17% to in‐commuters and 12% to tourists. The impact on the loss of a residential college student is less clear. Key Takeaways: Nonresidents, such as commuters, tourists, and college students, are important components to many local governments' sales tax base.A single in‐commuter is estimated to contribute approximately $1000 to the local sales tax base, which translates to about 17% of the tax base for the median county in our sample.The contribution to local sales for a hotel night stay, our proxy for tourism, is estimated to be approximately $525 to the local sales tax base, which translates to about 12% of the tax base for the median county in our sample.We do not find evidence that college students contribute meaningfully to the local sales tax base.This paper informs policy conversations around tax leakage, revenue‐raising capacity, and the benefits and costs of local sales taxes. [ABSTRACT FROM AUTHOR]

This research delves into the intricate dynamics of landslides, emphasizing their consequences on transportation infrastructure, specifically highways and roadway bridges in North Carolina. Based on a prior investigation of bridges in Puerto Rico after Hurricane Maria, we found that bridges above water and situated in valleys can be exposed to both landslide and flooding risks. These bridges faced heightened vulnerability to combined landslides and flooding events due to their low depth on the water surface and the potential for raised flood heights due to upstream landslides. Leveraging a dataset spanning more than a century and inclusive of landslide and bridge information, we employed logistic regression (LR) and random forest (RF) models to predict landslide susceptibility in North Carolina. The study considered conditioning factors such as elevation, aspect, slope, rainfall, distance to faults, and distance to rivers, yielding LR and RF models with accuracy rates of 76.3% and 82.7%, respectively. To establish that a bridge's location is at the bottom of a valley, data including landform, slope, and elevation difference near the bridge location were combined to delineate a bridge in a valley. The difference between bridge height and the lowest river elevation is established as an assumed flooding potential (AFP), which is then used to quantify the flooding risk. Compared to traditional flood risk values, the AFP, reported in elevation differences, is more straightforward and helps bridge engineers visualize the flood risk to a bridge. Specifically, a bridge (NCDOT ID: 740002) is found susceptible to both landslide (92%) and flooding (AFT of 6.61 m) risks and has been validated by field investigation, which is currently being retrofitted by North Carolina DOT with slope reinforcements (soil nailing and grouting). This paper is the first report evaluating the multi-hazard issue of bridges in valleys. The resulting high-fidelity risk map for North Carolina can help bridge engineers in proactive maintenance planning. Future endeavors will extend the analysis to incorporate actual flooding risk susceptibility analysis, thus enhancing our understanding of multi-hazard impacts and guiding resilient mitigation strategies for transportation infrastructure. [ABSTRACT FROM AUTHOR]

Driver characteristics have been linked to the frequency and severity of car crashes. Among these, age and gender have been shown to impact both the possibility and severity of a crash. Previous studies have used standard ordered probit (OP) models to analyze crash data, and some research has suggested heteroskedastic ordered probit (HETOP) could provide improved model fit. The objective of this paper is to evaluate potential improvements of the heteroskedastic ordered probit (HETOP) model compared to the standard ordered probit (OP) model in crash analysis, by examining the effect of gender across age on injury severity among drivers. This paper hypothesizes that the HETOP model can provide a better fit to crash data, by allowing heteroskedasticity in the distribution of injury severity across driver age and gender. Data for 20,222 crashes were analyzed for North Carolina from 2016 to 2018, which represents the state with the highest number of fatalities per 100 million vehicle miles traveled amongst available crash data from the Highway Safety Information System. Darker lighting conditions, severe road surface conditions, and less severe weather were associated with increased injury severity. For driver demographics, the probability of severe injuries increased with age and for male drivers. Moreover, the variance of severity increased with age disproportionately within and across genders, and the HETOP was able to account for this. The results of the two applied approaches revealed that HETOP model outperformed the standard OP model when measuring the effects of age and gender together in injury severity analysis, due to the heteroskedasticity in injury severity within gender and age. The HETOP statistical method presented in this paper can be more broadly applied across other contexts and combinations of independent variables for improved model prediction and accuracy of causal variables in traffic safety. [ABSTRACT FROM AUTHOR]

The nationwide shortage of psychiatric providers delays patients from receiving vital mental health (MH) treatments. Mental Health clinical pharmacist practitioners (CPPs) are qualified to provide comprehensive medication management (CMM) services and expand care; however, many MH interdisciplinary teams have not incorporated MH CPPs or have not optimized their role. The purpose of this paper is to highlight how MH CPPs leveraged telemedicine to provide CMM to outpatient MH clinics requiring provisional coverage for other prescribing providers. This paper also reviews supplemental services and barriers to implementation. The Veterans Integrated Services Network (VISN) 6 Clinical Resource Hub‐Telemental Health (CRH‐TMH) is a centralized interdisciplinary team that provides telemental health services to veterans through coordination with their local Veterans Health Administration Health Care Systems located in North Carolina and Virginia. The MH CPPs serve as advanced practice providers with a scope of practice that authorizes prescriptive authority including controlled substances. The VISN 6 CRH‐TMH program was initiated in 2020 and expanded from one MH CPP to include three MH CPPs and a MH CPP supervisor. Since initiation, the MH CPPs have supported 10 outpatient MH clinics. From October 2021 to March 2023, the MH CPPs have completed 5080 clinical encounters. The MH CPPs decreased phone appointments and increased the percentage of video‐to‐home encounters from 56% in fiscal year 2021 to 91% by March fiscal year 23. Virtual same‐day access was implemented at three locations and the substance use disorder program provided timely access to life‐saving treatments. The joint intake clinic optimized veterans' intake into the MH clinic by the therapist providing diagnostic services and the CPP performing CMM during the same appointment. The telehealth learning experience increased training opportunities for residents. The success of this initiative further supports the expansion of MH CPPs as advanced practice providers. [ABSTRACT FROM AUTHOR]

South Africa's Just Energy Transition (JET) from coal to renewable energy in response to climate change mitigation policies comes packaged with social costs that these mitigation policies tend to overlook, considering their focus on carbon emission reduction. The paper argues that Social Impact Assessments (SIAs), a component of Environmental Impact Assessments (EIAs) focused on social impact mitigation, can be a long-term approach to closing the social cost gap. Against this backdrop, the paper's arguments were informed by a literature analysis on SIAs and the Just Energy Transition, semi-structured interviews, and surveys with 230 participants, including experts, from Kriel and Carolina in Mpumalanga, South Africa. The findings point to skills development barriers such as poor school attendance, a lack of alignment between existing curriculum design and labour markets, and students' low aptitude for STEM subjects. It also identifies community sustainability issues linked to poor public participation, gender inequalities in land reform and economic participation, and culturally disruptive displacements that will intensify as the energy shift unfolds. The paper submits that SIAs, if incorporated into mainstream energy transition planning, might be a long-term approach to mitigating societal costs and can support socially responsible policies. [ABSTRACT FROM AUTHOR]

The floods caused by Hurricane Matthew in 2016 affected Lumberton, a socioeconomically diverse city in North Carolina with 729 public housing units. Public housing residents face unique challenges in accessing resources and post-disaster temporary accommodations, further delaying their recovery compared to other survivors. This paper investigates the obstacles to public housing recovery and the residents' recovery challenges using descriptive statistics, mapping, and qualitative analysis in Lumberton. Findings show the dependency of public housing units' recovery on assistance policies and decisions of various organizations, including local housing authorities. Multiple changes in recovery plans and limited, uncertain, delayed funding and bureaucratic obstacles to funding allocation slow the units' recovery and prolong the residents' displacement, adversely affecting their recovery. Hence, pre-disaster resilience initiatives should address these vulnerabilities and the recovery policy's limitations to support public housing units and residents' recovery. Moreover, affordable housing recovery must become a priority in national housing recovery policies. [ABSTRACT FROM AUTHOR]

Like other minoritized populations, American Indian/Alaska Native (AI/AN) females experience disparate morbidity and mortality outcomes to that of the general US population. This study identified discrepancies in reporting of AI/AN female decedents between the North Carolina Violent Death Reporting System (NC-VDRS) and an online, user-generated database. Female AI/AN decedent data of all ages were collected from the NC-VDRS and compared against that of the publicly available North Carolina Missing and Murdered Indigenous Women (MMIW NC) database for the study period, 2004–2019. Twenty-four of the 72 cases matched between data systems (33.3%). Substantive differences between the NC-VDRS and the MMIW NC database were found. Future efforts should be directed towards supporting Indigenous communities with the comprehensive data the NC-VDRS can provide. This paper highlights statewide public health systems like the NC-VDRS supporting community efforts to understand, advocate for, and disseminate information on MMIW. [ABSTRACT FROM AUTHOR]

Community health workers are responsible for finding, processing, and transferring health information to communities with limited access to health‐related resources, including farmworkers. This paper is the culmination of an undergraduate student research project to explore the learning processes and preferences of farmworker‐serving community health workers in the USA. The project was designed for students from farmworker or agricultural backgrounds at two North Carolina universities and was supported by a North Carolina Department of Health and Human Services workforce development grant. Semi‐structured interviews were conducted, in person and virtually, with a convenience sample of 17 current and former community health workers. The interview data were analysed thematically and identified a preference for a combination of learning styles, with visual and hands‐on learning being the most preferred. Community health workers also identified the importance of learning preferences in relation to their responsibilities as health educators. This study provides librarians, along with public health and medical professionals, with useful information about learning preferences to inform the creation of new and varied learning materials for community health workers. [ABSTRACT FROM AUTHOR]

Background. Health equity impact assessments (HEIAs) inform the reduction of health inequities by evaluating programs or policies that affect target populations. Local health departments (LHD) receiving funding through the Improving Community Outcomes for Maternal and Child Health (ICO4MCH) Program conducted HEIAs for evidence-based strategies (EBSs). This paper describes the impact of HEIAs on the implementation of EBSs and highlights lessons learned during implementation of HEIA modifications. Methods. We conducted a content analysis using data from the HEIA Modification Tracker and focus groups to identify themes and lessons learned. Results. Fifteen HEIAs were conducted by five LHDs between 2016 and 2020. The most common modifications to EBS implementation were 1) increasing education and training for community members and 2) altering messaging mediums and language to reach intended audiences. Discussion. Health equity impact assessments serve as a systematic and tangible way to center health equity, reflect on past processes, and inform improvements. [ABSTRACT FROM AUTHOR]

The floodplains of the Southeast's stream network once hosted immense brakes of rivercane (Arundinaria gigantea), a disturbance-dependent native bamboo with both cultural and ecological significance. Ecologically, rivercane alters its local environments, boosts biodiversity and biomass, and protects streambanks from erosion and storm damage. Indigenous peoples of the Southeast have used rivercane for millennia, for material and cultural purposes, and formerly maintained its health and extent through harvesting and fire. Settler-colonial incursions largely destroyed rivercane, through the more intense disturbance of different land management practices, and brakes now exist mainly in relatively small areas. While numerous rivercane restoration projects are in process throughout its natural range, no comprehensive inventory of living rivercane exists. In this paper, we present both human context and the results of LiDAR analysis that identifies canebrakes based on the physical characteristics of the plant and brake. In our study area on the Little Tennessee River in western North Carolina, we found rivercane on about 9 percent of the floodplain area, based on QL1 LiDAR data available from the state of North Carolina. The technique can be applied in any part of rivercane's range, and the resulting inventory used in support of both cultural and ecological goals. [ABSTRACT FROM AUTHOR]

Objectives: To describe how the UNC Horizons program, a comprehensive women-centered program for pregnant and parenting women with substance use disorders, and its patient population have changed over time and summarize basic neonatal outcomes for infants born to women in treatment at Horizons. Methods: Yearly Annual Reports from fiscal years of 1994 to 2017 were abstracted. Patient characteristics and infant outcomes compared to normative North Carolina data were examined. Results: Highlights of findings include: The percentage of women for whom opioids were the primary substance of use increased from 0% in 1995–1996 to 62% in 2016–17, while cocaine decreased from 66 to 12%. Intravenous substance use history increased from 7% in 1994–1995 to 41% in 2016–2017. The number of women reporting a history of incarceration rose from 10–20% in the early years to 40%-50% beginning in 2007–2008. The proportion of women reporting a desire to hurt themselves rose from 20% in 2004–2005 to 40% in 2016–2017. Self-reported suicide attempt history remained consistent at 32% across years. While reporting of childhood physical abuse remained at 38% across years, reporting of sexual abuse and domestic violence trended upward. Horizons did not differ from North Carolina in the likelihood of patients giving birth prematurely [χ2(13) = 20.6,p =.082], or the likelihood of a patient giving birth to a low birthweight infant [χ2(13) = 14.7,p =.333]. Conclusions for Practice: Breaking the cycle of addiction for women and children must focus on helping women with substance use problems develop a sense of hope that their lives can improve, and a sense of feeling safe and nurtured. Significance: Systematic examinations of programs that provide treatment services to pregnant and parenting women with substance use disorders have typically been focused on a limited set of outcomes and have been cross-sectional in nature. The current paper presents a detailed examination of the patient populations over a 23-year period, with particular attention to the changes over time in the women served. The birth weight and prematurity of infants born to the women in this program were likewise examined over time, and in comparison to state-level data. [ABSTRACT FROM AUTHOR]

In this qualitative study, the experiences of students of color at a predominantly white university in North Carolina are used to expose the ways in which white homogeneity and white normativity work to maintain hidden white privileges in various campus settings. Through the counternarratives obtained during nine focus group meetings with a total of thirty-one selfidentified students of color, these students are able to expose and describe a host of unnoticed burdens associated with being Brown and Black in white campus settings. They experience racial othering, extreme visibility, and stereotypes associated with their race and gender, and they explain ways they have devised to navigate through the university in the face of daily and routine manifestations of racism. Their voices effectively counter the ideologies of majoritarian stories that consistently deny the existence and effects of racism, to reveal some of the ways in which college life is in an unequal, racialized experience. The paper concludes by acknowledging limitations of this research as well as by discussing implications for the use of experiential knowledge through counterstories of those affected by injustice to help oppose false ideologies that work to promote racialized college experiences and outcomes. [ABSTRACT FROM AUTHOR]

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are widespread groundwater contaminants and are present in over 7000 drinking water wells near a North Carolina (NC) PFAS plant (Chemours). To understand options available to affected residents, we used new and previously existing water quality data to investigate deeper aquifers as alternate drinking water supplies and compared the regulatory responses near Chemours and three other PFAS production facilities with nearby contaminated wells. Data from >100 wells show that GenX concentrations decrease with increasing depth through the four aquifers in the study area: surficial, Black Creek, Upper Cape Fear, and bedrock. This illustrates the extent of vertical PFAS penetration through the aquifer sequence following roughly 40 years of atmospheric emissions. Detailed data on 143 water quality parameters in nine deep wells (two Upper Cape Fear, seven bedrock) revealed only eight exceedances of drinking water standards (one each for arsenic, perfluorooctanoic acid [PFOA], iron, chloride, and gross alpha, and three for manganese) and nine exceedances of health advisories (all for sodium). Regulatory responses to PFAS contamination of wells in four states included mention of deeper wells as an alternate water source only for nonresidential users in NC and residential users in Vermont. The bedrock aquifer is currently used by some residents and may be a viable alternative to shallower groundwater, though arsenic treatment may be beneficial at some deep wells and long-term sustainability of the aquifer should be evaluated. PRACTITIONER POINTS: GenX concentrations decreased with increasing depth in four aquifers near a PFAS plant. A few exceedances of drinking water standards and health advisories were found in deep bedrock wells. New bedrock wells could be part of the response to PFAS issues in shallower wells. In the long term, deep bedrock wells might be a less expensive option for some residents., (© 2024 The Author(s). Water Environment Research published by Wiley Periodicals LLC on behalf of Water Environment Federation.)

The behavioral health system's peer support workforce must be adequately trained to perform peer support services, but evidence of the adequacy of their training needs to be improved. With survey data from 667 certified peer support specialists (CPSS) from North Carolina, Kentucky, Virginia, and Tennessee, this study used (a) binomial probability test to assess perceptions about the adequacy of the workforce's training, (b) latent profile analysis to identify patterns and predictors of perceptions about the SAMHSA core competencies covered in their training, and (c) thematic analysis to identify additional training needs. Most respondents identified as White (72%), female (73%), and had some college education (83%). Most of the workforce (> 90%) felt prepared to provide services, regardless of their state. Highly and moderately sufficient coverage emerged as two distinct response patterns regarding coverage of the SAMSHA core competencies, with respondents' years of experience, state of residence, education level, race, and sense of preparedness predicting the probability of fitting into either profile. Participants desired additional training in trauma-informed practices, motivational interviewing, and new treatment approaches. Peers' experiences and perspectives were similar across different states. The findings suggest booster training sessions or continuing education opportunities are needed to maintain a robust and well-prepared peer support workforce. States should consider reciprocity agreements to enable the trained workforce to practice across states. A key implication for the training content is the need to incorporate contemporary issues relating to mental health and substance use disorders to better meet behavioral health needs., (© 2024. National Council for Mental Wellbeing.)

The United States along with the rest of the world has experienced an unprecedented disruption in daily life due to the COVID-19 pandemic. Almost everyone has experienced some sort of stay at home order resulting in an economic catastrophe greater than the Great Recession of 2008 and on par with the Great Depression almost a century ago. Educational institutions at both the K-12 and post-secondary levels have not been immune from the shutdown, with many schools closed from mid-March through the end of the 2020 school year. Many schools moved classes to remote, distance delivery platforms. Career and Technical Education (CTE) teachers were tasked with creative engaging learning activities online for curricula which is taught in a hands-on contextual learning environment. This paper will present preliminary results from research conducted by a collaborative group of nine researchers from across the United States with collectively over 200 years of career and technical education experience. The conceptual framework used for this study was Danielson's Framework for Teaching and Enhancing Professional Practice and Foundations of Career and Technical Education including Constructivism. 3,267 participants representing all 50 states responded to the 37-item survey. The research objectives included description of participants and identified challenges to planning and delivery of CTE content when schools were closed, and instruction was moved to remote/distance/online platforms. Participants ranked their challenges as instructors and their perceptions of challenges that were experienced by their students. CTE teachers ranked replicating classroom or lab environments online and lack of experience teaching online as their biggest challenges. The perceptions of the participants concerning challenges for their students included motivation to guide and manage their own learning and students' access to reliable internet connection. The emergence and prevalence of the COVID-19 pandemic added a layer of complexity to educational practice that was not foreseen and for which no intentional preparation had occurred. Understanding how CTE teachers and instructors responded to this call, and the challenges they and their students encountered, is important to efforts to improve practice in the future and to be in a better position should another crisis occur that forces learning to be delivered in alternative formats from that of the traditional face-to-face classroom. [Note: The page range (177-194) shown on the PDF is incorrect. The correct page range is 177-193.]

The use of data derived from electronic health records (EHRs) to describe racial and ethnic health disparities is increasingly common, but there are challenges. While the number of patients covered by EHRs can be quite large, such patients may not be representative of a source population. One way to evaluate the extent of this limitation is by linking EHRs to an external source, in this case with the American Community Survey (ACS). Relying on a stratified random sample of about 200,000 patient records from a large, public, integrated health delivery system in North Carolina (2016–2019), we assess linkages to restricted ACS microdata (2001–2017) by race and ethnicity to understand the strengths and weaknesses of EHR-derived data for describing disparities. The results in this research note suggest that Black–White comparisons will benefit from standard adjustments (e.g., weighting procedures) but that misestimation of health disparities may arise for Hispanic patients because of differential coverage rates for this group. [ABSTRACT FROM AUTHOR]

School nurses are pivotal to the safety of school-aged children, particularly those who receive medications in the school setting. The purpose of this study was to explore factors associated with medication administration errors in North Carolina school districts between 2012/2013 and 2017/2018. A longitudinal study using repeated measures analysis of school health services data collected in the North Carolina Annual School Health Services and Programs Survey was conducted. Over time, the number of medication errors (p =.001) and number of medication corrective action plans (p <.0001) trended upwards. There was also an increase in medication errors when the number of schools in a district was higher (p <.0001). Conversely, there was a decrease in corrective action plans when school nurses were directly employed by the school district (p =.0471). We implore school disticts to consider the important role of school nurses to keep kids safe, healthy, and ready to learn. [ABSTRACT FROM AUTHOR]

Farmers in North Carolina are turning to irrigation to reduce the impacts of droughts and rainfall variability on agricultural production. Droughts, rainfall variability, and the increasing demand for food, feed, fiber, and fuel necessitate the urgent need to provide North Carolina farmers with tools to improve irrigation management and maximize water productivity. This is only possible by understanding the current status of irrigated agriculture in the state and investigating its potential weaknesses and opportunities. Thus, the objective of this study was to perform a comprehensive analysis of the current state of irrigation management in North Carolina based on 15-year data from the Irrigation and Water Management Survey by the United States Department of Agriculture–National Agricultural Statistics Service (USDA-NASS). The results indicated a reduction in irrigation acres in the state. Also, most farms in the state have shifted to efficient sprinkler irrigation systems from gravity-fed surface irrigation systems. However, many farms in North Carolina still rely on traditional irrigation scheduling methods, such as examining crop conditions and the feel of soil in deciding when to irrigate. Hence, there are opportunities for enhancing the adoption of advanced technologies like soil moisture sensors and weather data to optimize irrigation schedules for improving water efficiency and crop production. Precision techniques and data-based solutions empower farmers to make informed, real-time decisions, optimizing water use and resource allocation to match the changing environmental conditions. The insights from this study provide valuable information for policymakers, extension services, and farmers to make informed decisions to optimize agricultural productivity and conserve water resources. [ABSTRACT FROM AUTHOR]

Background/Objectives: We aimed to investigate the influence of cardiorespiratory fitness (CRF) and body composition on arterial stiffness. Methods: Carotid-to-femoral pulse wave velocity (cfPWV) and aortic systolic (ASBP) and diastolic (ADBP) blood pressure were compared between upper and lower tertiles of oxygen consumption at the aerobic threshold (VO2AerT), peak oxygen consumption (VO2peak), percentage of fat mass (FM%), and body mass index (BMI) in sixty adolescents (30 males and 30 females, 14.9 ± 2.1 years old). A stepwise multivariable linear regression analysis was performed to investigate the independent associations between VO2AerT and VO2peak and cfPWV, and between BMI and FM% and cfPWV with adjustments for age, sex, ASBP, and ADBP. Results: cfPWV and ADBP were lower in the second and third VO2AerT tertiles compared to the first tertile (cfPWV, 4.7 ± 0.5 and 4.7 ± 0.5 vs. 5.3 ± 0.8 m/s, p < 0.01; ADBP, 62 ± 7 and 62 ± 7 vs. 70 ± 8 mmHg, p < 0.01). ASBP was lower in the third VO2AerT tertile compared to the first tertile (94 ± 7 vs. 101 ± 12 mmHg, p = 0.05). ADBP was lower in the second VO2peak tertile compared to the first tertile (62 ± 7 vs. 68 ± 9 mmHg, p = 0.03). ASBP was lower in the first and second BMI tertiles compared to the third tertile (95 ± 8 and 95 ± 7 vs. 102 ± 11 mmHg, p = 0.02). The eight-variable model significantly contributed to the variance of cfPWV (F(8, 51) = 7.450, p < 0.01), accounting for 47% of the variance. Individually, age (p < 0.05) and ADBP (p < 0.01) significantly predicted cfPWV. Conclusions: Submaximal indicators of CRF such as VO2AerT should be considered as a part of the risk stratification of cardiovascular disease in healthy adolescents. [ABSTRACT FROM AUTHOR]

The Train-the-Trainer approach is widely used in Cooperative Extension education to efficiently disseminate research-based information to many clientele groups, including farmers. This paper compares the traditional Train-the-Trainer model to a comprehensive Collaborative Train-the-Trainer model and discusses weaknesses of the traditional model that are addressed in the Collaborative model. Sources of information used by farmers (growers) and overall effectiveness were measured through a survey instrument created and distributed to farmers in South and North Carolina. The Collaborative Train-the-Trainer model, which emphasizes peer-to-peer interaction and feedback loops, represents an enhanced approach for conceptualizing and implementing Extension educational programs.

Traffic accidents are usually unique events with unpredictable geographical and temporal dimensions; thus, accident injury severity level (INJ-SL) analysis presents formidable categorization and data stability problems. Classical statistical models are limited in their ability to correctly model INJ-SL, whilst sophisticated machine learning approaches do not appear to have any equations to prioritize/analyze multiple contributing factors to forecast accidents accompanying INJ-SLs. In addition, the intercorrelations between the input variables may render the conclusions of a formal sensitivity analysis incorrectly. Rear-end collisions are the most common form of traffic accidents; consequently, their linked INJ-SL requires more research. This paper provides a complex technique based on a deep learning paradigm paired with different indicators of Global Sensitivity Analysis to address all of these concerns. Unlike existing neural network designs, this technique presents a deep residual neural network structure that employs residual shortcuts (i.e., connections). The connections enable the DRNNs to sidestep a few levels of the deep network architecture, evading the regular training with high accuracy issues. Using the trained DRNNs model, a Latin Hypercube sampling simulation was undertaken to determine each explanatory component's influence on the resulting INJ-SL. The latest available data from 2011 to 2018 is used to assess all rear-end collisions in North Carolina. A comparison was made between the performance of two different schemes of data categorization using a set of global sensitivity metrics. It was determined that the devised technique overcame the data heterogeneity problems to achieve an accuracy of 87%. In addition, the proposed sensitivity analysis identified the most relevant factors associated with INJ-SL rear-end collisions. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to assess whether varying input communication factors impacted participants' perceived confidence, motivation, and likelihood to act (i.e., share or discuss their preferences and values with their clinician or family/caregiver) when receiving tailored communication from a values-clarification tool. Methods: This study was conducted over a two-month period at the North Carolina Basnight Cancer Hospital. Patients with hematologic malignancies participated in evaluating three distinct messages that varied on three input communication factors. Results: Results from this study indicate that most study participants preferred messages that were moderately direct, contained succinct question prompts, and that were empowering. Results also indicate that diverse perspectives and external influences may impact confidence and motivation toward discussing preferences with their clinicians. Discussion: Our findings suggest the importance of validating the input communication factors within values-clarification tools before presenting results to patients and the need to evaluate potential disparities in patients' participation toward discussing their preferences. Evidence from this study provides direction for future research efforts focused on improving shared decision-making among older adults. [ABSTRACT FROM AUTHOR]

Here we present the palynological composition of a single sample of the elusive purple honey collected in southern North Carolina and discuss how it fits within a nearby statewide South Carolina melissopalynological study. 302 samples were collected by nineteen beekeepers participating in this year-long project, submitting honey samples while honeybees were actively collecting nectar. The absence of pollen of Pueraria (kudzu) in the purple honey dismisses the often-suggested link between the unique tint of the purple honey and kudzu's purple pollen. A second hypothesis hinting that the tint could be linked to ripened berries is not reinforced by our investigation as pollen of Ericaceae (eg blueberries) and Rosaceae (eg blackberries) were not found in the purple honey sample but were commonly found in classic golden honey analyzed. The presence of Vitis pollen supports the possibility that bees forage on wild muscadine grapes (Vitis rotundifolia) which was available in the foraging area. This study cannot discredit the possibility that bees were foraging on berry juices or other sugar sources containing purple pigments because these sources contain little or no pollen. A third hypothesis proposes a link between purple honey and the sourwood tree, Oxydendrum arboretum. This hypothesis is supported by this investigation as the dominant pollen type recovered in the purple honey was sourwood, with 19% in relative abundance, a significant percentage for this plant. We suggest chemical analysis of purple honey samples be conducted to determine if berry juice or sourwood is the more likely source of the pigmentation. [ABSTRACT FROM AUTHOR]

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Geotechnical sediment properties, morphological change, and hydrodynamics were measured as part of the During Nearshore Event Experiment (DUNEX) in October 2021 at the sandy Atlantic side beach in Duck, North Carolina. In this study, direct relationships were explored between in situ soil properties and direct erodibility measurements in the context of morphological change. Moisture content, grain size, total density, relative density, void ratio, and sediment strength were compared to bed-level change using ground-based LiDAR and erodibility parameters from laboratory jet erosion tests (JETs) conducted along a cross-shore transect stretching from the dune toe to the lower intertidal zone. Directly relating changes in sediment properties to changes in morphology from LiDAR proved inconclusive due to the complex interactions between sediments, hydrodynamics, and morphology, even on a local scale, but initial observations and possibly impacting factors were discussed. Void ratio and total unit weight correlated well with the detachment rate coefficient from JETs, with denser sediments testing as less erodible. In situ sediment strength measurements related—as expected—to total unit weight, void ratio, and water content, with increases in firmness factor associated with increases in total unit weight, void ratio, and water content. These strength measurements were also found to have a correlation with the detachment coefficient from the JET, with stronger/firmer sediments being less erodible than weaker ones. [ABSTRACT FROM AUTHOR]

There is great interest in the development of executive function (EF) in the preschool period. Accordingly, multiple performance-based measures of EF have been developed for this age group, yet little is known about how they compare to one another. This study used a large and diverse sample of 3-to-5-year-old children (N = 846), who completed subtests of the National Institutes of Health's Toolbox Cognition Battery (NTCB), the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV), and the EF Touch battery. Scores across the three batteries were compared and associations with age, income, and race/ethnicity were examined. Results revealed that (1) the three tasks were moderately correlated (r = 0.44–0.51, all p < 0.001), but children had higher mean accuracy scores on EF Touch than on the NTCB or the WPPSI-IV. (2) Mean accuracy scores on all batteries were linearly associated with child age (all F > 32.68, all p < 0.0001). (3) Comparisons by income and race/ethnicity showed lower accuracy for low-income children on the WPPSI-IV and lower accuracy for White children on the NTCB. Across all batteries, there was consistently lower accuracy for Hispanic children. In conclusion, the three batteries we examined performed similarly across several metrics. EF Touch may be more appropriate for younger children, while the NTCB performed well with older children. [ABSTRACT FROM AUTHOR]

Manure relocation strategies are needed to mitigate excessive phosphorus (P) application to agricultural land in areas of intensive animal agricultural production. This requires conceptual frameworks such as the manureshed, which categorizes agricultural areas according to the potential to export or receive manure for P fertilization. To further understand how the manureshed concept could be utilized, assessments of the potential implementation and necessity of the manureshed model are needed. With North Carolina at the center of the largest manureshed in the United States, North Carolina is an ideal test case to identify areas of concern for manure relocation under the manureshed framework. Swine and poultry dominate North Carolina's agricultural production, and because the vast majority of North Carolina producers are not required to limit manure applications to a P‐based rate, P accumulates. Therefore, soil test data from samples submitted to the North Carolina Department of Agriculture and Consumer Services (NCDA&CS) from 2017 to 2019 were used to determine how manureshed classes defined by Spiegal et al. correspond to current soil test P levels. It was determined that 36% of counties experience very high (>100 mg P kg−1; N = 36) median P concentrations in soil. Furthermore, fields cultivated with warm‐season forages had the highest mean P concentration (188 mg kg−1) and high median P trended toward counties with high animal production. Lastly, while mean soil P for all manureshed classifications fell into the very high category, manure source counties had the highest mean soil P concentrations (188 mg kg−1), which was 39%–52% higher than the other classifications. This suggests that, in addition to manuresheds classification, soil test data are needed to design and promote manure redistribution strategies. Core Ideas: Soil tests confirm the accumulation of phosphorus in areas of intense livestock production.Redistribution of manure based on the manuresheds concept should include counties identified for within county transfers adjacent to manure source counties.Soil test reports add valuable context when making decisions regarding manure relocation strategies. [ABSTRACT FROM AUTHOR]

Background: HIV, opioid use disorder (OUD), and mental health challenges share multiple syndemic risk factors. Each can be effectively treated with routine outpatient appointments, medication management, and psychosocial support, leading implementers to consider integrated screening and treatment for OUD and mental health in HIV care. Provider perspectives are crucial to understanding barriers and strategies for treatment integration. Methods: We conducted in-depth qualitative interviews with 21 HIV treatment providers and social services providers (12 individual interviews and 1 group interview with 9 participants) to understand the current landscape, goals, and priorities for integrated OUD, mental health, and HIV care. Providers were purposively recruited from known clinics in Mecklenburg County, North Carolina, U.S.A. Data were analyzed using applied thematic analysis in the NVivo 12 software program and evaluated for inter-coder agreement. Results: Participants viewed substance use and mental health challenges as prominent barriers to engagement in HIV care. However, few organizations have integrated structured screening for substance use and mental health into their standard of care. Even fewer screen for opioid use. Although medication assisted treatment (MAT) is effective for mitigating OUD, providers struggle to connect patients with MAT due to limited referral options, social barriers such as housing and food insecurity, overburdened staff, stigma, and lack of provider training. Providers believed there would be clear benefit to integrating OUD and mental health treatment in HIV care but lacked resources for implementation. Conclusions: Integration of screening and treatment for substance use and mental health in HIV care could mitigate many current barriers to treatment for all three conditions. Efforts are needed to train HIV providers to provide MAT, expand resources, and implement best practices. [ABSTRACT FROM AUTHOR]

Background: There is limited understanding of how social determinants of health (SDOH) impact family decision-making when seeking surgical care for children. Our objectives of this study are to identify key family experiences that contribute to decision-making when accessing surgical care for children, to confirm if family experiences impact delays in care, and to describe differences in family experiences across populations (race, ethnicity, socioeconomic status, rurality). Methods: We will use a prospective, cross-sectional, mixed methods design to examine family experiences during access to care for children with appendicitis. Participants will include 242 parents of consecutive children (0–17 years) with acute appendicitis over a 15-month period at two academic health systems in North Carolina and Virginia. We will collect demographic and clinical data. Parents will be administered the Adult Responses to Children's Symptoms survey (ARCS), the child and parental forms of the Adverse Childhood Experiences (ACE) survey, the Accountable Health Communities Health-Related Social Needs Screening Tool, and Single Item Literacy Screener. Parallel ARCS data will be collected from child participants (8–17 years). We will use nested concurrent, purposive sampling to select a subset of families for semi-structured interviews. Qualitative data will be analyzed using thematic analysis and integrated with quantitative data to identify emerging themes that inform a conceptual model of family-level decision-making during access to surgical care. Multivariate linear regression will be used to determine association between the appendicitis perforation rate and ARCS responses (primary outcome). Secondary outcomes include comparison of health literacy, ACEs, and SDOH, clinical outcomes, and family experiences across populations. Discussion: We expect to identify key family experiences when accessing care for appendicitis which may impact outcomes and differ across populations. Increased understanding of how SDOH and family experiences influence family decision-making may inform novel strategies to mitigate surgical disparities in children. [ABSTRACT FROM AUTHOR]

Genetic diversity can modulate a population's response to a changing environment and plays a critical role in its ecological function. While multiple processes act to maintain genetic diversity, sexual reproduction remains the primary driving force. Eelgrass (Zostera marina) is an important habitat‐forming species found in temperate coastal ecosystems across the globe. Recent increases in sea surface temperatures have resulted in shifts to a mixed‐annual life‐history strategy (i.e., displaying characteristics of both annual and perennial meadows) at its southern edge‐of‐range. Given that mating systems are intimately linked to standing levels of genetic variation, understanding the scope of sexual reproduction can illuminate the processes that shape genetic diversity. To characterize edge‐of‐range eelgrass mating systems, developing seeds on flowering Z. marina shoots were genotyped from three meadows in Topsail, North Carolina. In all meadows, levels of multiple mating were high, with shoots pollinated by an average of eight sires (range: 3–16). The number of fertilized seeds (i.e., reproductive success) varied significantly across sires (range: 1–25) and was positively correlated with both individual heterozygosity and self‐fertilization. Outcrossing rates were high (approx. 70%) and varied across spathes. No clones were detected, and kinship among sampled flowering shoots was low, supporting observed patterns of reproductive output. Given the role that genetic diversity plays in enhancing resistance to and resilience from ecological disturbance, disentangling the links between life history, sexual reproduction, and genetic variation will aid in informing the management and conservation of this key foundation species. This study provides a thorough description of fine‐scale patterns in Zostera marina's mating system at the species' southern edge‐of‐range, an area where eelgrass experiences frequent summer heat stress. Sampled populations displayed a reliance on sexual recruitment, and male quality was linked to reproductive success. Our findings serve as stepping stones to further understand the evolutionary processes underpinning seagrass genetic composition and life history, which is essential for informed conservation and management. [ABSTRACT FROM AUTHOR]

Background: Experiencing a miscarriage can have profound psychological implications, and the added strain of the COVID-19 pandemic may have compounded these effects. This study aimed to explore the psychological experiences, assess the levels of psychological distress (depression, anxiety, and post-traumatic stress disorder), and examine the relationships of personal significance of miscarriage and perceived stress with psychological distress of women in North Carolina who suffered a miscarriage of a desired pregnancy between March 30, 2020, and February 24, 2021, of the COVID-19 pandemic, at 14 to 31 months after the loss. Methods: We conducted a cross-sectional mixed-methods study using a convergent parallel design. A total of 71 participants from North Carolina completed the online survey and 18 completed in-depth interviews. The survey assessed demographics, mental health and reproductive history, personal significance of miscarriage, perceived stress, anxiety, depression, and PTSD. Interview questions asked about the psychological experience of the miscarriage and how the COVID-19 pandemic affected them and their experience. Results: Findings indicated moderate to severe levels of depression, anxiety, and PTSD, which persisted 14 to 31 months post-miscarriage. After conducting hierarchical binary logistic regressions, we found that perceived stress and prior trauma increased the odds of depression, perceived stress increased the odds of anxiety, and personal significance and prior trauma increased the odds of PTSD symptoms 14–31 months post-miscarriage. Notably, a subsequent successful childbirth emerged as a protective factor against depression, anxiety, and PTSD. Qualitative findings depicted emotions such as profound isolation, guilt, and grief. Women noted that additional pandemic-specific stressors exacerbated their distress. The categories identified via conventional content analysis fell under five broader thematic groups: mental health disorders, negative emotions/feelings, positive emotions/feelings, thoughts, and other experiences. Conclusions: Miscarriage during the COVID-19 pandemic intensified and added complexity to the psychological distress experienced by affected women. The study underscores the need for comprehensive mental health screenings, specialized support for vulnerable groups, and the necessity of trauma-informed care. Providers are strongly encouraged to adopt a multifaceted, individualized approach to patient care that is cognizant of the unique stressors introduced by the pandemic. [ABSTRACT FROM AUTHOR]

The combined region of eastern Tennessee and western North Carolina has a persistently high risk of pediatric La Crosse virus neuroinvasive disease (LACV-ND). To guide public health intervention in this region, the objectives of this retrospective ecological study were to investigate the geographic clustering and predictors of pediatric LACV-ND risk at the ZIP code tabulation area (ZCTA) level. Data on pediatric cases of LACV-ND reported between 2003 and 2020 were obtained from Tennessee Department of Health and North Carolina Department of Health and Human Services. Purely spatial and space-time scan statistics were used to identify ZCTA-level clusters of confirmed and probable pediatric LACV-ND cases from 2003–2020, and a combination of global and local (i.e., geographically weighted) negative binomial regression models were used to investigate potential predictors of disease risk from 2015–2020. The cluster investigation revealed spatially persistent high-risk and low-risk clusters of LACV-ND, with most cases consistently reported from a few high-risk clusters throughout the entire study period. Temperature and precipitation had positive but antagonistic associations with disease risk from 2015–2020, but the strength of those relationships varied substantially across the study area. Because LACV-ND risk clustering in this region is focally persistent, retroactive case surveillance can be used to guide the implementation of targeted public health intervention to reduce the disease burden in high-risk areas. Additional research on the role of climate in LACV transmission is warranted to support the development of predictive transmission models to guide proactive public health interventions. Author summary: La Crosse virus (LACV) is the most common cause of mosquito-borne neuroinvasive disease (e.g., encephalitis or meningitis) among children in the United States, but the spatial patterns and population-level risk factors for LACV infections are not well understood. In this study, we investigated the spatial patterns and areal risk factors of pediatric LACV neuroinvasive disease (LACV-ND) in eastern Tennessee and western North Carolina, a persistent hotspot of LACV-ND. We found that from 2003–2020, the highest risks of pediatric LACV-ND consistently occurred in a few areas within the study region. We also found that precipitation and temperature had positive but antagonistic relationships with area-level risk from 2015–2020, although the strength of those associations varied significantly across the study area. The results of this study have important implications for public health policy. Most notably, because LACV-ND consistently occurs in the same geographic areas over extended time periods, areas where cases have been previously reported should be prioritized for disease prevention programs to prevent continuous transmission. This study also provides initial evidence that climate may be related to the distribution of LACV-ND risk, but additional research is needed to better understand the complex relationship between climate and LACV epidemiology. [ABSTRACT FROM AUTHOR]

A putative glufosinate‐resistant Amaranthus palmeri population was reported in 2015 in Anson County, North Carolina. The results from dose–response assays conducted in the field suggested plants were surviving lethal rates of glufosinate. Dose–response assays conducted in the glasshouse determined the Anson County accession exhibited reduced susceptibility to glufosinate compared to three glufosinate‐susceptible populations. The LD50 values (210–316 g ai ha−1) for the Anson County population were always higher than the LD50 values (118–158 g ai ha−1) for the tested susceptible populations from the dose–response assays. Anson County plants that survived lethal glufosinate rates were reciprocally crossed with susceptible plants to create F1 genotypes and treated with a lethal rate of glufosinate (267 g ai ha−1; ascertained from glasshouse dose–response assay) to determine the distribution of injury and survival for each cross compared to a cross of susceptible parents. The distribution of injury was non‐normal for the crosses containing an Anson County plant compared to the cross with a susceptible parent. Survival was 68%–84% for crosses containing an Anson County plant, whereas the survival was significantly reduced to 35% for the susceptible plant cross. Chi‐square goodness of fit tests were used to test inheritance models to describe the responses of the genotypes. The resistant × susceptible crosses were best described with a heterozygous two loci with incomplete dominance model compared to the resistant × resistant cross that was best described with a heterozygous single locus with incomplete dominance model. The Anson County population has evolved resistance to glufosinate that is heritable and likely conferred by an oligogenic mechanism with incomplete dominance. [ABSTRACT FROM AUTHOR]

A natural wetland receiving drainage from a 24-ha urbanized catchment in the Falls Lake Watershed of North Carolina was evaluated to determine if it was providing ecosystem services with regards to phosphate and Escherichia coli (E. coli) attenuation. Inflow and outflow characteristics including nutrient and bacteria concentrations along with physicochemical properties (discharge, pH, oxidation reduction potential, temperature, and specific conductance) were assessed approximately monthly for over 2 years. The median exports of phosphate (0.03 mg/s) and E. coli (5807 MPN/s) leaving the wetland were 85% and 57% lower, respectively, relative to inflow loadings, and the differences were statistically significant (p < 0.05). Hydraulic head readings from three piezometers installed at different depths revealed the wetland was a recharge area. Phosphate and E. coli concentrations were significantly greater in the shallowest piezometer relative to the deepest one, suggesting treatment occurred during infiltration. However, severe erosion of the outlets is threatening the stability of the wetland. Upstream drainageway modifications were implemented to slow runoff, and septic system repairs and maintenance activities were implemented to improve water quality reaching the wetland and Lick Creek. However, more work will be needed to conserve the ecosystem services provided by the wetland. [ABSTRACT FROM AUTHOR]

New Hanover County, North Carolina, has been experiencing rapid population growth and is expected to continue this growth, leading to increased land use and development in the area. The county is also threatened by sea level rise (SLR) and its effects because of its coastal location and frequent occurrences of major storms and hurricanes. This study used a land change modeler to map the land cover change throughout the county over a period of 20 years, and predicted land cover distribution in the area in the years 2030 and 2050. Statistics revealed that the developed land in the area increased by 85 km2 between 2000 and 2010, and by 60 km2 between 2010 and 2020. Such land is predicted to increase by another 73 km2 by 2030, and 63 km2 by 2050. This increase in development is expected to occur mainly in the central area of the county and along the barrier islands. Modeling of SLR illustrated that the northwestern part of New Hanover County along the Cape Fear River, as well as the beach towns located on the barrier islands, are estimated be the most affected locations. Results indicate that sections of major highways throughout the county, including I-140 near downtown Wilmington and US-421 in Carolina Beach, may be inundated by SLR, which might delay residents during mandatory evacuations for emergency situations such as hurricanes. Some routes may be unusable, leading to traffic congestion on other routes, which may impede some residents from reaching safety before the emergency. Wrightsville Beach and Carolina Beach are estimated to have the highest levels of inundation, with 71.17% and 40.58% of their land being inundated under the most extreme SLR scenario of 3 m, respectively. The use of the present research approach may provide a practical, quick, and low-cost method in modeling rapidly growing urban areas along the eastern United States coastline and locating areas at potential risk of future SLR inundation. [ABSTRACT FROM AUTHOR]

A community engaged research (CER) approach was used to provide an exposure assessment of poly- and perfluorinated (PFAS) compounds in North Carolina residential drinking water. Working in concert with community partners, who acted as liaisons to local residents, samples were collected by North Carolina residents from three different locations along the Cape Fear River basin: upper, middle, and lower areas of the river. Residents collected either drinking water samples from their homes or recreational water samples from near their residence that were then submitted by the community partners for PFAS analysis. All samples were processed using weak anion exchange (WAX) solid phase extraction and analyzed using a non-targeted suspect screening approach as well as a quantitative approach that included a panel of 45 PFAS analytes, several of which are specific to chemical industries near the collection site locations. The non-targeted approach, which utilized a suspect screening list (obtained from EPA CompTox database) identified several PFAS compounds at a level two confidence rating (Schymanski scale); compounds identified included a fluorinated insecticide, a fluorinated herbicide, a PFAS used in polymer chemistry, and another that is used in battery production. Notably, at several locations, PFOA (39.8 ng/L) and PFOS (205.3 ng/L) were at levels that exceeded the mandatory EPA maximum contaminant level (MCL) of 4 ng/L. Additionally, several sites had detectable levels of PFAS that are unique to a local chemical manufacturer. These findings were communicated back to the community partners who then disseminated this information to the local residents to help empower and aid in making decisions for reducing their PFAS exposure. [ABSTRACT FROM AUTHOR]

Coastal Zone Soil Survey mapping provides interpretive information that can be used to increase coastal resiliency and quantify how coastal ecosystems are changing over time. North Carolina has approximately 400,500 ha of land within 500 m of the tidal coastline that is expected to undergo some degree of salinization in the next century. This study examined 33 tidal wetlands in the Albemarle–Pamlico Sound along a salinity gradient to provide a coastal zone mapping framework to quantify shoreline change rates. The primary ecosystems evaluated include intact tidal forested wetlands (average water salinity, 0.15–1.61 ppt), degraded "ghost forest" wetlands (3.51–8.28 ppt), and established mesohaline marshes (11.73–15.47 ppt). The average shoreline rate of change (m/yr) was significantly different among estuary ecosystems (p = 0.004), soil type (organic or mineral) (p < 0.001), and shore fetch category (open or protected) (p < 0.001). From 1984 to 2020, a total of 2833 ha of land has been submerged due to sea level rise in the Albemarle–Pamlico Sound with the majority (91.6%) of this loss coming from tidal marsh and ghost forest ecosystems. The results from this study highlight the importance of maintaining healthy coastal forests, which have higher net accretion rates compared to other estuarine ecosystems. [ABSTRACT FROM AUTHOR]

Plain Language Summary: Diseases and weeds can reduce yield of peanut (Arachis hypogaea L.) if effective control measures including fungicides and herbicides are not used. A survey of 76 farmers in North Carolina and Virginia at Cooperative Extension Service meetings was completed relative to fungicide and herbicide use in 2021. Eighty‐two percent of farmers made between three and five herbicide applications, while 68% of farmers made between four and five fungicide applications. 2,4‐DB was the herbicide applied most frequently. The fungicide chlorothalonil was applied the most often. Pydiflumetofen was applied by 61% of farmers. Results from this survey can be used to inform regulatory agencies on pesticide use patterns by defining the relative importance of individual or groups of pesticides currently used to suppress pests and prevent or mitigate associated economic losses. [ABSTRACT FROM AUTHOR]