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Abstract The disproportionate risks and impacts of climate change and extreme weather on older adults are increasingly evident. While especially true in disaster-prone areas, human-caused climate change introduces an element of uncertainty even in previously identified “safe” regions such as the Midwestern United States. Using a cumulative disadvantage and vulnerability-informed framework and descriptive statistics from multiple data sources, this article provides an overview of climate impacts, vulnerabilities, and county-level characteristics, focusing on older adults living in Central Ohio. A comparative multiple-case study methodology was used to triangulate regionally representative primary and secondary data sources to examine state and county-level measures of vulnerability, emergency preparedness, and disruptions caused by extreme weather among older adults across eight counties in Central Ohio. Seventy-eight percent of older adults in the sample reported being prepared for emergencies per Federal Emergency Management Agency guidelines. Older adults in Union County reported the highest rates of preparedness, while those in Fayette County reported the lowest. County-level rates of disruption of life activities by extreme weather ranged widely. Among the most rural in the region, Fayette County emerged as uniquely disadvantaged, with the lowest median income, the most vulnerable across multiple social vulnerability dimensions, and the most reported disruptions to life activities from extreme weather. County profiles offer a snapshot of existing vulnerabilities, socioeconomic conditions, special needs, preparedness, and current disruptions among older adults in the region and can inform resource mobilization across community and policy contexts.

The disproportionate risks and impacts of climate change and extreme weather on older adults are increasingly evident. While especially true in disaster-prone areas, human-caused climate change introduces an element of uncertainty even in previously identified "safe" regions such as the Midwestern United States. Using a cumulative disadvantage and vulnerability-informed framework and descriptive statistics from multiple data sources, this article provides an overview of climate impacts, vulnerabilities, and county-level characteristics, focusing on older adults living in Central Ohio. A comparative multiple-case study methodology was used to triangulate regionally representative primary and secondary data sources to examine state and county-level measures of vulnerability, emergency preparedness, and disruptions caused by extreme weather among older adults across eight counties in Central Ohio. Seventy-eight percent of older adults in the sample reported being prepared for emergencies per Federal Emergency Management Agency guidelines. Older adults in Union County reported the highest rates of preparedness, while those in Fayette County reported the lowest. County-level rates of disruption of life activities by extreme weather ranged widely. Among the most rural in the region, Fayette County emerged as uniquely disadvantaged, with the lowest median income, the most vulnerable across multiple social vulnerability dimensions, and the most reported disruptions to life activities from extreme weather. County profiles offer a snapshot of existing vulnerabilities, socioeconomic conditions, special needs, preparedness, and current disruptions among older adults in the region and can inform resource mobilization across community and policy contexts. [ABSTRACT FROM AUTHOR]

The current study examined whether racially minoritized children and racial majority children demonstrate different race-based learning preferences and whether the racial demographics of their schools and neighborhoods predict these preferences. Race-based information endorsement and teacher preferences of Black and White 3- to 7-year-old children (n = 238) recruited from a metropolitan area in the midwestern United States were examined. Across racially homogeneous and diverse schools, both Black and White children showed a White preference in information endorsement and teacher preference. Black and White children did not differ in their information endorsement, but they did differ in their teacher preferences: Black children chose Black teachers more than White children. Further, children overall chose the accurate adult as their teacher regardless of the adults race, but the racial demographics of childrens schools and neighborhoods related to these responses: Three-year-old children were more likely to select the accurate Black adult over the inaccurate White adult if there were more Black teachers in their schools and larger Black populations in their neighborhoods. Exploratory analyses indicated that 5- to 7-year-old White children who had non-White classroom teachers chose Black adults more than those who had White classroom teachers, but classroom teachers race did not relate to Black childrens teacher preference. The findings suggest that both microlevel factors (e.g., childrens classroom teachers) and macrolevel factors (e.g., proportion of Black teachers in childrens schools and Black population in their neighborhoods) could influence who children choose to learn from and prefer as teachers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

People who are in close relationships tend to do and like the same things, a phenomenon termed the "homophily principle." The present research probed for evidence of the homophily principle in 4- to 6-year-old children. Across two experiments, participants (N = 327; 166 girls, 161 boys; located in the Midwestern United States) were asked to predict the closeness of two people based on their preferences. Participants in Experiment 1 indicated that people with a shared preference or a shared dispreference were more closely affiliated than people whose preferences diverged, suggesting inferences of homophily. Furthermore, children were not only relying on the emotional valences expressed: They expected people with a shared preference to be closer than people who expressed positive emotions about different items and expected people with a shared dispreference to be closer than people who expressed negative emotions about different items. Experiment 2 replicated and extended the main findings of Experiment 1 with more naturalistic stimuli. The present studies provide strong evidence that young children apply the homophily principle to their reasoning about social relationships. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

We present gridded 8 km-resolution data products of the estimated stem density, basal area, and biomass of tree taxa at Euro-American settlement of the midwestern United States during the middle to late 19th century for the states of Minnesota, Wisconsin, Michigan, Illinois, and Indiana. The data come from settlement-era Public Land Survey (PLS) data (ca. 0.8-km resolution) of trees recorded by land surveyors. The surveyor notes have been transcribed, cleaned, and processed to estimate stem density, basal area, and biomass at individual points. The point-level data are aggregated within 8 km grid cells and smoothed using a generalized additive statistical model that accounts for zero-inflated continuous data and provides approximate Bayesian uncertainty estimates. The statistical modeling smooths out sharp spatial features (likely arising from statistical noise) within areas smaller than about 200 km2. Based on this modeling, presettlement Midwestern landscapes supported multiple dominant species, vegetation types, forest types, and ecological formations. The prairies, oak savannas, and forests each had distinctive structures and spatial distributions across the domain. Forest structure varied from savanna (averaging 27 Mg/ha biomass) to northern hardwood (104 Mg/ha) and mesic southern forests (211 Mg/ha). The presettlement forests were neither unbroken and massively-statured nor dominated by young forests constantly structured by broad-scale disturbances such as fire, drought, insect outbreaks, or hurricanes. Most forests were structurally between modern second growth and old growth. We expect the data product to be useful as a baseline for investigating how forest ecosystems have changed in response to the last several centuries of climate change and intensive Euro-American land use and as a calibration dataset for paleoecological proxy-based reconstructions of forest composition and structure for earlier time periods. The data products (including raw and smoothed estimates at the 8-km scale) are available at the LTER Network Data Portal as version 1.0.

BackgroundEnding the HIV epidemic requires that women living with HIV (WLWH) have access to structurally competent HIV-related and other health care. WLWH may not regularly engage in care due to inadequate quality; however, women's perspectives on the quality of care they receive are understudied.MethodsWe conducted 12 focus groups and three in-depth interviews with Black (90%) and Latina (11%) WLWH enrolled in the Women's Interagency HIV Study in Atlanta, GA, Birmingham, AL, Brooklyn, NY, Chapel Hill, NC, Chicago, IL, and Jackson, MS from November 2017 to May 2018 (n = 92). We used a semi-structured format to facilitate discussions about satisfaction and dissatisfaction with health care engagement experiences, and suggestions for improvement, which were audio-recorded, transcribed, and coded using thematic analysis.ResultsThemes emerged related to women's health care satisfaction or dissatisfaction at the provider, clinic, and systems levels and across Institute of Medicine-defined quality of care domains (effectiveness, efficiency, equity, patient-centeredness, safety and timeliness). Women's degree of care satisfaction was driven by: 1) knowledge-based care resulting in desired outcomes (effectiveness); 2) coordination, continuity and necessity of care (efficiency); 3) perceived disparities in care (equity); 4) care delivery characterized by compassion, nonjudgment, accommodation, and autonomous decision-making (patient-centeredness); 5) attention to avoiding side effects and over-medicalization (safety); and 6) limited wait time (timeliness).ConclusionsQuality of care represents a key changeable lever affecting engage in care among WLWH. The communities most proximally affected by HIV should be key stakeholders in HIV-related quality assurance. Findings highlight aspects of the health care experience valued by WLWH, and potential participatory, patient-driven avenues for improvement.

BackgroundNegative outcomes related to prematurity may lead to maternal distress. Mothers of premature/low birth-weight infants report increased posttraumatic stress (50%) and depressive symptoms (63%) compared with mothers of full-term infants. Low-income, minority mothers with greater posttraumatic stress and depression have an increased risk for premature/low birth-weight delivery compared with their white counterparts. Variations in the neuropeptide oxytocin are implicated in lactation, perinatal depression, and maternal behavior.PurposeTo examine the associations among posttraumatic stress, depressive symptoms, and oxytocin in a pilot sample of minority mothers with premature/low birth-weight infants in the neonatal intensive care unit (NICU).MethodsThis study employed a descriptive, correlational pilot design of 8 minority, low-income mothers with premature/low birth-weight infants. Participants answered questionnaires pertaining to posttraumatic stress, depression, lactation, and demographics and oxytocin was measured. This is a substudy that added oxytocin values.ResultsFour participants had elevated depressive symptoms and 5 supplied their own milk. Women who provided their own milk had lower depressive (t = 3.03, P = .023) and posttraumatic stress (t = 3.39, P = .015) symptoms compared with women not supplying their own milk. Women with elevated posttraumatic stress had higher levels of depressive symptoms (r(8) = 0.8, P = .006) and lower levels of oxytocin (r(8) = 0.77, P = .026).Implications for practiceThese results are congruent with previous literature on providing human milk and maternal mental health. In addition, we found a possible relationship between postpartum posttraumatic stress and oxytocin in minority women with premature/low birth-weight infants. NICU nurses should encourage lactation and assess mothers for posttraumatic stress and depressive symptoms.Implications for researchResearch is needed to identify the biologic milieu associated with posttraumatic stress and depression in at-risk mothers.

Riparian ecosystems provide various ecosystem services including habitat for a variety of plant and animal communities, biofiltering, and stabilizing stream and river systems. Due to their location, riparian zones often share long borders with agricultural fields where herbicides are commonly applied to eliminate unwanted plants. There is a general concern that exposure of riparian vegetation to off-target drifted herbicides may adversely impact their health and diversity. We utilized the Normalized Difference Vegetation Index (NDVI) to investigate the long-term (between 1992 and 2011) trend of riparian vegetation health at 17 locations in the Midwest and Great Plains areas of the United States, where herbicide usage was likely most intense. Assessment of NDVI data demonstrated that long-term vegetation health did not decline for the studied riparian zones located in proximity to croplands during spring months (April and May). During summer (June and July), while the long-term vegetation health did not decline for the majority of the sites, there were a few cases in Kansas and Nebraska with a decline in vegetation health (negative-trending NDVI). Cluster analysis of the negative-trending NDVI pixels showed that the majority of these pixels were randomly distributed throughout these riparian sites, indicating a lack of shared common causing factors. Similarly, proximity analysis suggested that distance from croplands was not associated with the decline of vegetation health found in these sites, suggesting that exposure to herbicide drift may not be a plausible factor because this would have shown higher impact on pixels closer to the cropland. Changes in canopy coverage and vegetation diversity also did not show any dependence on distance from croplands. Finally, the remote-sensing-based NDVI data sets used provide only an indirect way of assessing the impact of herbicide drift, and therefore, further work based on field survey data is recommended to completely isolate the impacts of herbicides. Integr Environ Assess Manag 2019;15:528-543. © 2019 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

Two studies have identified Coxiella burnetii in poikilotherms (vertebrates that cannot regulate body temperature physiologically); both studies originated in India. Two tortoises had antibodies to C. burnetii by capillary agglutination [...]

Introduction: Colorectal cancer (CRC) is the third most-diagnosed cancer among men and women in the US. This study aimed to evaluate the influence of an interactive inflatable colon exhibit on CRC knowledge and screening intent among men attending state fairs in 2 midwestern states., Methods: At the 2023 state fairs in 2 midwestern states, eligible participants (men aged 18-75 y who could speak and read English and resided in 1 of the 2 states) completed a presurvey, an unguided tour of the inflatable Super Colon, and a postsurvey. Primary outcomes were changes in knowledge (actual and perceived) and CRC screening intent from presurvey to postsurvey. We used χ 2 tests to examine differences in survey results between the 2 sites and the association between demographic characteristics and behaviors (knowledge and intentions) before entering the Super Colon exhibit. We used the McNemar test to examine differences in presurvey to postsurvey distributions., Results: The study sample (N = 940) comprised 572 men at site A (60.8%) and 368 men at site B (39.2%). Except for 1 question, baseline CRC knowledge was relatively high. Greater perceived knowledge was inversely associated with greater actual knowledge. After touring the Super Colon, participants improved their actual knowledge of CRC prevention and self-perceived CRC knowledge. Most participants (95.4%) agreed that the Super Colon was effective for teaching people about CRC., Conclusion: These findings emphasize the role of community-based educational initiatives in encouraging CRC screening uptake and increasing research participation among men and affirm that the inflatable colon is as an effective educational tool for increasing CRC knowledge and encouraging early-detection screening behavior among men.

Context: Pregnant athletes cannot receive proper care if they choose to conceal their pregnancy. Unfortunately, many factors may lead an athlete to conceal. Whereas the extant qualitative literature suggests scholarship and sponsorship are prominent factors in the decision to disclose, this research is limited to elite athletes., Objective: To quantitatively examine predictors of pregnancy disclosure beyond scholarship and sponsorship in National Collegiate Athletic Association Division III college athletes., Design: Cross-sectional study., Setting: Midwestern United States., Participants or Other Participants: Athletes on Division III women's sports teams (N = 127)., Main Outcome Measure(s): Confidence in the athletic trainer (AT), perceived training and performance changes, athletic identity, and athletic identity during pregnancy. Two separate multiple regression analyses were conducted with the 4 predictors and 2 outcomes: likelihood to disclose and time to disclosure., Results: Confidence in the AT and athletic identity during pregnancy were significant predictors in both models, whereas the variable of perceived training and performance changes was only significant in the likelihood to disclose model. Athletic identity was not a significant predictor in either model. Results suggest Division III athletes believe they would be more likely to disclose their pregnancy and may disclose sooner if they feel that their AT can properly manage their physical, emotional, and social wellness during the pregnancy. Additionally, disclosure is promoted if they believe they will still be viewed as athletes by themselves and the people around them., Conclusions: These findings emphasize the importance of the role of the AT, with implications that formal education of ATs should include the holistic support of the pregnant athlete., (© by the National Athletic Trainers’ Association, Inc.)

Background: Lack of physical activity is a concern for children across diverse backgrounds, particularly affecting those in rural areas who face distinct challenges compared to their urban counterparts. Community-derived interventions are needed that consider the unique context and additional physical activity barriers in under-resourced rural settings. Therefore, a prospective pre-post pilot/feasibility study of Hoosier Sport was conducted over 8-weeks with 6th and 7th grade children in a low-socioeconomic rural middle school setting. The primary objective of the present study was to assess trial- and intervention-related feasibility indicators; and the secondary objective was to collect preliminary assessment data for physical activity levels, fitness, psychological needs satisfaction, and knowledge of physical activity and nutrition among participating youth., Methods: This prospective 8-week pilot/feasibility study took place in the rural Midwestern United States where twenty-four middle school students participated in a mixed-methods pre-post intervention during physical education classes. The intervention included elements like sport-based youth development, individualized goal setting, physical activity monitoring, pedometer usage, and health education. Data were collected at baseline (T1) and post-intervention (T3), with intermediate measures during the intervention (T2). Qualitative data were integrated through semi-structured interviews. Analytical methods encompassed descriptive statistics, correlations, repeated measures ANOVA, and thematic analysis., Results: Key findings indicate robust feasibility, with intervention-related scores (FIM, AIM, and IAM) consistently surpassing the "good" threshold and 100% retention and recruitment success. Additionally, participants showed significant physical performance improvement, shifting from the 25th to the 50th percentile in the 6-minute walk test (p < 0.05). Autonomy and competence remained high, reflecting positive perceptions of program practicality. Nutrition knowledge, initially low, significantly improved at post-intervention (p < 0.01), highlighting the efficacy of targeted nutritional education in Hoosier Sport., Conclusions: This study pioneers a community-engaged model for physical activity intervention in under-resourced rural settings. Positive participant feedback, coupled with improvements in physical fitness and psychosocial factors, highlights the potential of the co-design approach. The findings offer valuable insights and a practical template for future community-based research, signaling the promising impact of such interventions on holistic well-being. This research lays the foundation for subsequent phases of the ORBIT model, emphasizing collaborative, community-driven approaches to address the complex issue of declining physical activity levels among adolescents., (© 2024. The Author(s).)

Abstract: This study looked for associations between measures of emotional intelligence in an intensive clinical experience for nursing students in their final semester of an associate degree program. Twenty nursing students from a technical college in the Midwest volunteered to complete the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) before and after an intensive clinical experience. The results were mixed with a significant decrease in several specific scores within the MSCEIT on the Time Point 2 test. Stress levels or fatigue could have impacted participants' decreased performance on the MSCEIT., Competing Interests: The author has declared no conflict of interest., (Copyright © 2023 National League for Nursing.)

Aim: A full annual cycle approach to conservation and understanding of regional population trends requires an understanding of migratory connectivity. We present tracking data on the eastern whip‐poor‐will (Antrostomus vociferus), a Neotropical migrant that has declined by 70% in recent decades. When and where populations of this species are limited throughout the annual cycle is poorly understood. Location: Breeding area: midwestern United States; passage area and winter area: midwestern/southern United States, Mexico, Central America. Methods: We utilized data from 52 archival GPS tags from five breeding areas covering a 9.5‐degree latitudinal span (~1000 km) of the whip‐poor‐will breeding range in the summers of 2017 and 2019. We identified migratory routes and spatiotemporal bottlenecks, stopover and wintering locations, calculated migratory connectivity throughout migration and on the wintering grounds and tested predictions for three latitudinal connectivity patterns. Results: Whip‐poor‐wills circumvented the Gulf of Mexico, and populations across a large latitudinal gradient came together in eastern Texas in early October, resulting in decreased connectivity throughout migration. Breeding‐winter migratory connectivity was low (MC = 0.22 ± 0.12), with extensive overlap of core wintering areas in southern Mexico and Guatemala. The overlap of wintering areas by individuals from dispersed breeding latitudes suggests that whip‐poor‐wills most closely resemble telescopic migrants. Main conclusions: Circumventing the Gulf of Mexico influenced connectivity in the whip‐poor‐will, funnelling individuals into a small region in eastern Texas in migration and likely influencing breeding‐winter connectivity. Thus, geographically dispersed breeding populations overlap in space and time during migration and winter, and non‐breeding season conditions affecting populations (both positively and negatively) impact individuals from across the core breeding range. For example, extensive deforestation occurring in the whip‐poor‐will's core wintering area likely impacts individuals from all five deployment locations. We demonstrate that combining multiple indices of spatiotemporal cohesion is critical to fully understand how migratory animals are distributed in the non‐breeding season. [ABSTRACT FROM AUTHOR]

This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N=118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment.

Many studies illustrate variable patterns in individual species distribution shifts in response to changing temperature. However, an assemblage, a group of species that shares a common environmental niche, will likely exhibit similar responses to climate changes, and these community-level responses may have significant implications for ecosystem function. Therefore, we examine the relationship between observed shifts of species in assemblages and regional climate velocity (i.e., the rate and direction of change of temperature isotherms). The assemblages are defined in two sub-regions of the U.S. Northeast Shelf that have heterogeneous oceanography and bathymetry using four decades of bottom trawl survey data and we explore temporal changes in distribution, spatial range extent, thermal habitat area, and biomass, within assemblages. These sub-regional analyses allow the dissection of the relative roles of regional climate velocity and local physiography in shaping observed distribution shifts. We find that assemblages of species associated with shallower, warmer waters tend to shift west-southwest and to shallower waters over time, possibly towards cooler temperatures in the semi-enclosed Gulf of Maine, while species assemblages associated with relatively cooler and deeper waters shift deeper, but with little latitudinal change. Conversely, species assemblages associated with warmer and shallower water on the broad, shallow continental shelf from the Mid-Atlantic Bight to Georges Bank shift strongly northeast along latitudinal gradients with little change in depth. Shifts in depth among the southern species associated with deeper and cooler waters are more variable, although predominantly shifts are toward deeper waters. In addition, spatial expansion and contraction of species assemblages in each region corresponds to the area of suitable thermal habitat, but is inversely related to assemblage biomass. This suggests that assemblage distribution shifts in conjunction with expansion or contraction of thermal habitat acts to compress or stretch marine species assemblages, which may respectively amplify or dilute species interactions to an extent that is rarely considered. Overall, regional differences in climate change effects on the movement and extent of species assemblages hold important implications for management, mitigation, and adaptation on the U.S. Northeast Shelf.

Arsenic toxicokinetics are important for disease risks in exposed populations, but genetic determinants are not fully understood. We examined urine arsenic species patterns measured by HPLC-ICPMS among 2189 Strong Heart Study participants 18 years of age and older with data on ~400 genome-wide microsatellite markers spaced ~10 cM and arsenic speciation (683 participants from Arizona, 684 from Oklahoma, and 822 from North and South Dakota). We logit-transformed % arsenic species (% inorganic arsenic, %MMA, and %DMA) and also conducted principal component analyses of the logit % arsenic species. We used inverse-normalized residuals from multivariable-adjusted polygenic heritability analysis for multipoint variance components linkage analysis. We also examined the contribution of polymorphisms in the arsenic metabolism gene AS3MT via conditional linkage analysis. We localized a quantitative trait locus (QTL) on chromosome 10 (LOD 4.12 for %MMA, 4.65 for %DMA, and 4.84 for the first principal component of logit % arsenic species). This peak was partially but not fully explained by measured AS3MT variants. We also localized a QTL for the second principal component of logit % arsenic species on chromosome 5 (LOD 4.21) that was not evident from considering % arsenic species individually. Some other loci were suggestive or significant for 1 geographical area but not overall across all areas, indicating possible locus heterogeneity. This genome-wide linkage scan suggests genetic determinants of arsenic toxicokinetics to be identified by future fine-mapping, and illustrates the utility of principal component analysis as a novel approach that considers % arsenic species jointly.

Mounting evidence shows overall insect abundances are in decline globally. Habitat loss, climate change, and pesticides have all been implicated, but their relative effects have never been evaluated in a comprehensive large-scale study. We harmonized 17 years of land use, climate, multiple classes of pesticides, and butterfly survey data across 81 counties in five states in the US Midwest. We find community-wide declines in total butterfly abundance and species richness to be most strongly associated with insecticides in general, and for butterfly species richness the use of neonicotinoid-treated seeds in particular. This included the abundance of the migratory monarch (Danaus plexippus), whose decline is the focus of intensive debate and public concern. Insect declines cannot be understood without comprehensive data on all putative drivers, and the 2015 cessation of neonicotinoid data releases in the US will impede future research., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Van Deynze et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Conservation agriculture (CA) is a set of principles thought to be able to enhance crop productivity while minimizing impacts on the environment. The evidence base for CA can be challenging to synthesize because it encompasses many different practices and social and agroecological outcomes. To facilitate synthesis of CA evidence we have created a dataset organizing 218 response variables from five common categories of CA: cover crops, tillage management, pest management, nutrient management, and crop diversification. These data cover the Midwestern United States (U.S.) from 1980-2020. The dataset is also summarized and visualized on the AgEvidence website, which enables users to interactively explore, filter, and download data. We hope this dataset will help a wide variety of stakeholders, including researchers, policy makers, advocacy groups, and growers access the evidence needed to make informed and impactful decisions about how to produce food with less negative environmental impact., (© 2024. The Author(s).)

White-nose syndrome has devastated bat populations in eastern North America. In Midwestern United States, prevalence increased quickly in the first year of invasion (2012-13) but with low population declines. In the second year (2013-14), environmental contamination led to earlier infection and high population declines. Interventions must be implemented before or soon after fungal invasion to prevent population collapse.

AimsMost patients with diabetes have comorbid chronic conditions that could support (concordant) or compete with (discordant) diabetes care. We sought to determine the impact of the number of concordant and discordant chronic conditions on diabetes care quality.MethodsLogistic regression analysis of electronic health record data from 7 health systems on 24,430 patients with diabetes aged 18-75 years. Diabetes testing and control quality care goals were the outcome variables. The number of diabetes-concordant and the number of diabetes-discordant conditions were the main explanatory variables. Analysis was adjusted for health care utilization, health system and patient demographics.ResultsA higher number of concordant conditions were associated with higher odds of achieving testing and control goals for all outcomes except blood pressure control. There was no to minimal positive association between the number of discordant conditions and outcomes, except for cholesterol testing which was less likely with 4+ discordant conditions.ConclusionsHaving more concordant conditions makes diabetes care goal achievement more likely. The number of discordant conditions has a smaller, inconsistently significant impact on diabetes goal achievement. Interventions to improve diabetes care need to align with a patient's comorbidities, including the absence of comorbidities, especially concordant comorbidities.

BACKGROUND: Pain and anxiety occurring from cardiovascular disease are associated with long-term health risks. Integrative medicine (IM) therapies reduce pain and anxiety in small samples of hospitalized cardiovascular patients within randomized controlled trials; however, practice-based effectiveness research has been limited. The goal of the study is to evaluate the effectiveness of IM interventions (i.e., bodywork, mind-body and energy therapies, and traditional Chinese medicine) on pain and anxiety measures across a cardiovascular population. METHODS: Retrospective data obtained from medical records identified patients with a cardiovascular ICD-9 code admitted to a large Midwestern hospital between 7/1/2009 and 12/31/2012. Outcomes were changes in patient-reported pain and anxiety, rated before and after IM treatments based on a numeric scale (0-10). RESULTS: Of 57,295 hospital cardiovascular admissions, 6,589 (11.5%) included IM. After receiving IM therapy, patients averaged a 46.5% (p-value

On August 10,2020, an intense derecho with low predictability passed over three separate WSR88Ds and produced widespread high-wind damage from eastern Nebraska through northern Indiana. Although many structures were impacted [...]

ObjectiveThe objective of this study was to evaluate the association between measures of body composition and patterns of urine arsenic metabolites in the 1989-1991 baseline visit of the Strong Heart Study, a cardiovascular disease cohort of adults recruited from rural communities in Arizona, Oklahoma, North Dakota and South Dakota.MethodsWe evaluated 3,663 Strong Heart Study participants with urine arsenic species above the limit of detection and no missing data on body mass index, % body fat and fat free mass measured by bioelectrical impedance, waist circumference and other variables. We summarized urine arsenic species patterns as the relative contribution of inorganic (iAs), methylarsonate (MMA) and dimethylarsinate (DMA) species to their sum. We modeled the associations of % arsenic species biomarkers with body mass index, % body fat, fat free mass, and waist circumference categories in unadjusted regression models and in models including all measures of body composition. We also considered adjustment for arsenic exposure and demographics.ResultsIncreasing body mass index was associated with higher mean % DMA and lower mean % MMA before and after adjustment for sociodemographic variables, arsenic exposure, and for other measures of body composition. In unadjusted linear regression models, % DMA was 2.4 (2.1, 2.6) % higher per increase in body mass index category (< 25, ≥25 &

The increase in agricultural production over the past 40 y has greatly altered land-use patterns, often resulting in simplified landscapes composed of large swaths of monocultures separated by small fragments of natural lands. These simplified landscapes may be more susceptible to insect pest pressure because of the loss of natural enemies and the increased size and connectivity of crop resources, and a recent analysis from a single year (2007) suggests this increased susceptibility results in increased insecticide use. I broaden the temporal analysis of this connection between landscape simplification and insecticide use by examining cross-sectional and panel data models from multiple decades (US Department of Agriculture Census of Agriculture years 2007, 2002, 1997, 1992, 1987) for seven Midwestern states composed of over 560 counties. I find that although the proportion of county in cropland--my metric for landscape simplification--was positively correlated with insecticide use in 2007, this relationship is absent or reversed in prior census years and when all years are analyzed together. This broader temporal perspective suggests that landscape simplification has inconsistent effects on insecticide use and that multiyear studies will be key to unlocking the true drivers of variation in insecticide application.

BackgroundA doctor's ability to communicate effectively is key to establishing and maintaining positive doctor-patient relationships. The Consumer Assessment of Healthcare Providers and System (CAHPS(®)) Clinician and Group Survey is the standard for collecting and reporting information about patients' experiences of care in the USA.ObjectiveTo evaluate how well CAHPS(®) Clinician and Group 2.0 core and supplemental survey items (CG-CAHPS) with a 12-month reference capture doctor-patient communication.Data sources/study settingEleven of the 40 highest-rated physicians on the CG-CAHPS survey treating patients in a Midwest commercial health plan.Study designData were obtained via semi-structured interviews. Specific behaviors, practices, and opinions about doctor communication were coded and compared to the CG-CAHPS items.Principal findingsCG-CAHPS fully captures six of the nine behaviors most commonly mentioned by high-performing physicians: employing office staff with good people skills; involving office staff in communication with patients; spending enough time with patients; listening carefully; providing clear, simple explanations; and devising an action plan with each patient. Three physician behaviors identified as key were not captured in CG-CAHPS items: use of nonverbal communication; greeting patients and introducing oneself; and tracking personal information about patients.ConclusionsCG-CAHPS survey items capture many of the most commonly mentioned doctor-patient communication behaviors and practices identified by high-performing physicians. Nonverbal communication, greeting patients, and tracking personal information about patients were identified as key aspects of doctor-patient communication, but are not captured by the current CG-CAHPS. We recommend further research to assess patients' perceptions of specific verbal and nonverbal behaviors (such as leaning forward in a chair, casually asking about other family members), followed by the development of new items (if needed) that aim to capture what these specific behaviors represent to patients (e.g., listens attentively, seems to care about me as a person, empathy). We also recommend including items about greeting and tracking personal information about patients in future CAHPS item sets addressing doctor-patient communication. Enriching the content of the CAHPS communication measure can help health-care organizations improve doctor-patient communication and interactions.

Heatwaves are becoming more frequent and intensified with climate change. Freshwater ecosystems are among the most threatened, within which, differing responses between cool- and warmwater species to heatwaves can lead to fundamental changes in communities. Physiological experiments can identify potential mechanisms underlying the impacts of such heatwaves on fish communities. In the current study, we quantified the oxygen consumption rate, aerobic scope and swimming performance of cool- and warmwater fish species following the simulation of short-term heatwaves currently occurring in streams in the Midwestern United States. The coolwater predator walleye (Sander vitreus) showed clear thermal disadvantages relative to the warmwater predator largemouth bass (Micropterus salmoides), based on a high metabolic cost during the heatwave, low metabolic activity when encountering prey, and reduced swimming performance following the heatwave. Largemouth bass also showed a thermal advantage relative to the warmwater prey fathead minnow (Pimephales promelas) related to swimming performance and energetic costs, highlighting differing thermal responses between predators and prey. This study demonstrates the importance of considering short-term extreme thermal events in the response of aquatic communities to climate stressors., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Dai, Suski. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Older Black men are underrepresented in research despite being disproportionately affected by Alzheimer's disease (AD) and cardiovascular (CV) risk factors related to AD compared with non-Hispanic Whites. Although dietary interventions have shown promise to reduce modifiable CV risk factors related to AD, Black Americans have lower adherence likely due to lack of cultural considerations. Using a noninterventional convergent parallel mixed-methods approach, this study examined the cultural contexts that inform perceptions of dietary interventions among older Midwestern Black men. All participants completed an online demographic and dietary habit survey prior to focus group discussions. Two focus group discussion sessions were conducted with a total of 10 cognitively normal Black men aged 55 years and older. Survey data were analyzed using a frequency analysis and qualitative data were analyzed using a six-step thematic analysis process. Most men indicated having hypertension ( N = 7, 77.8%) and currently not following a dietary eating pattern ( N = 8, 88.9%). Emerging themes identified included (1) knowledge of dementia, (2) perceptions of dietary interventions, (3) barriers impacting participation in dietary interventions, and (4) overcoming barriers to engage Black men in dietary interventions. Findings from this study should inform the design of future dietary interventions for AD prevention to enhance participation among older Black men., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Sun-induced chlorophyll fluorescence (SIF) provides an opportunity to study terrestrial ecosystem photosynthesis dynamics. However, the current coarse spatiotemporal satellite SIF products are challenging for mechanistic interpretations of SIF signals. Long-term ground SIF and vegetation indices (VIs) are important for satellite SIF validation and mechanistic understanding of the relationship between SIF and photosynthesis when combined with leaf- and canopy-level auxiliary measurements. In this study, we present and analyze a total of 15 site-years of ground far-red SIF (SIF at 760 nm, SIF 760 ) and VIs datasets from soybean, corn, and miscanthus grown in the U.S. Corn Belt from 2016 to 2021. We introduce a comprehensive data processing protocol, including different retrieval methods, calibration coefficient adjustment, and nadir SIF footprint upscaling to match the eddy covariance footprint. This long-term ground far-red SIF and VIs dataset provides important and first-hand data for far-red SIF interpretation and understanding the mechanistic relationship between far-red SIF and canopy photosynthesis across various crop species and environmental conditions., (© 2024. The Author(s).)

Documentation of adverse drug reactions (ADRs) is a key factor in guiding future prescribing. However, incomplete documentation is common and often fails to distinguish implicated drugs as true allergies. This in turn leads to unnecessary avoidance of implicated drug classes and may result in sub-optimal prescribing. Pharmacovigilance (PV) programs utilize a systematic approach to clarify ADR documentation and are known to improve patient safety. Yet it remains unclear if PV alters prescribing. Or, if the existence of the ADR documentation itself continues to prompt avoidance of implicated drugs. To address this, our work presents a retrospective cohort study assessing if clarification of antibiotic ADRs by a hospital-wide PV team was associated with future, safe, re-prescribing at a freestanding pediatric hospital in the midwestern United States. First, we compared the likelihood of future prescribing in an antibiotic class with an active ADR, as compared to alternative drug classes, between PV-clarified and non-clarified patients. Second, we assessed differences in adverse event rates 30-days after future prescribing based on PV clarification status. For robustness, analyses were performed on patients with ADRs in four antibiotic classes: penicillin-based beta-lactams (n = 45,642), sulfonamides/trimethoprim (n = 5,329), macrolides (n = 3,959), and glycopeptides (n = 622). Results illustrate that clarification of an ADR by PV was associated with an increased odds of future prescribing in the same drug class (Odds Ratio [95%-CI]): penicillin-based beta-lactams (1.59 [1.36-1.89]), sulfonamides/trimethoprim (2.29 [0.89-4.91]), macrolides (0.77 [0.33-1.61]), and glycopeptide (1.85 [1.12-3.20]). Notably, patients clarified by PV experienced no increase in the rate of adverse events within 30-days following the prescribing of antibiotics in the same class as an active ADR. Overall, this study provides strong evidence that PV reviews safely increase the rate of re-prescribing antibiotics even in the presence of an existing implicated drug ADR., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Feldman et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Chronic cough (CC) affects about 10% of adults, but opioid use in CC is not well understood., Objectives: To determine the use of opioid-containing cough suppressant (OCCS) prescriptions in patients with CC using electronic health records., Design: Retrospective cohort study., Methods: Through retrospective analysis of Midwestern U.S. electronic health records, diagnoses, prescriptions, and natural language processing identified CC - at least three medical encounters with cough, with 56-120 days between first and last encounter - and a 'non-chronic cohort'. Student's t -test, Pearson's chi-square, and zero-inflated Poisson models were used., Results: About 20% of 23,210 patients with CC were prescribed OCCS; odds of an OCCS prescription were twice as great in CC. In CC, OCCS drugs were ordered in 38% with Medicaid insurance and 15% with commercial insurance., Conclusion: Findings identify an important role for opioids in CC, and opportunity to learn more about the drugs' effectiveness.

Background: Arsenic is a well-known toxin which may contaminate household water. It is harmful when ingested over prolonged periods of time. As a result, public health experts recommend that water should be screened and treated to prevent arsenic ingestion. In the United States, the responsibility of testing and treatment of private wells falls on homeowners. Despite recommendations for routine screening, this is rarely done., Objectives: To assess the prevalence of well water use in a Midwestern patient population, how patients and clinicians perceive the risks of arsenic in well water, and whether additional resources on well water testing are desired. These findings will be used to influence tools for clinicians regarding symptom and examination findings of chronic arsenic exposure and potentiate the distribution of informational resources on well water testing., Methods: Surveys were sent via email to all actively practicing primary care clinicians at the Mayo Clinic in the United States Midwest, and all active adult patients at the Mayo Clinic in the same region. Our team analyzed survey data to determine whether both patients and clinicians are aware of the health effects of chronic arsenic toxicity from well water, the need for routine well water testing and whether each group wants more information on the associated risks., Results: Both patients and primary care clinicians worry about arsenic exposure. Patients with well water are concerned about their water safety yet feel uninformed about testing options. Clinicians do not know how prevalent well water use is among their patients, feel uninformed about the chronic risks of arsenic exposure and the physical examination associated with it. Both groups unanimously want more information on testing options., Conclusions: Our findings show a significant reliance on well water use in the American Midwest, and unanimous support for the need for further well water testing information and resources for patients and their clinicians., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

In the Midwestern United States (US), river flooding is a climate change-related hazard that poses a significant threat to health, well-being and economic stability. The 2019 Midwest floods led to major flooding at every monitoring site along the Mississippi River, set record water levels at 42 sites, and resulted in an estimated $6.2 billion in infrastructure damage and recovery costs. Although the risks associated with increasing flooding in the Midwestern US have been well recognized, less is known about the adaptation challenges and opportunities in the region, particularly in the Upper Mississippi River Basin. This exploratory study examined stakeholder perspectives on river system management, flood risk reduction, and adaptation planning in the Upper Mississippi River Basin. We conducted in-depth interviews with flood management stakeholders between August and October 2019. Interview data were analyzed using thematic analysis. Five themes emerged from the interviews: (1) River flooding in the Midwestern US is a different experience than US coastal flooding; (2) River flooding in the Midwestern US is a regional experience that requires a regional response; (3) Local actors face constrained resources for flood risk protection and recovery; (4) Differentiated responsibility across levels of governments makes recovery and response difficult to navigate; and (5) Competing stakeholder goals challenge cooperative flood hazard management. Overall, these results suggest that locally focused adaptation efforts, while perhaps appropriate for coastal communities or more urban contexts, are suboptimal strategies for communities in the flood-prone river basins of the Midwestern US. Instead, structures and support for regional collaboration should be considered and pursued. [ABSTRACT FROM AUTHOR]

Stress during pregnancy has been associated with a number of adverse outcomes. This study compared and correlated neuroendocrine parameters in women (n=8) who self-reported battering during their pregnancy to those in women who did not (n=8). Women who identified themselves as having a violent relationship with an intimate partner were recruited from a rural midwestern community. They were matched on age, self-reported ethnicity, parity, gestational age, and personal and family income with nonbattered controls. Midgestational measures of self-reported stress levels showed that battered women reported markedly higher levels of anxiety and depression. Neuroendocrine levels were not different between groups (battered vs. nonbattered); however, the relationships among hormones were different between groups. In nonbattered women, adrenocorticotropic hormone (ACTH) and cortisol levels were correlated but not in battered women. Beta endorphin and ACTH levels in battered women showed a significant linear relationship but not in nonbattered women. These results suggest that the maternal experience of stress alters the relationship of hypothalamic-pituitary-adrenal-placental axis hormones despite the lack of absolute differences in blood levels.