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Pasifika (Native Hawaiian and Pacific Islander) people living in the United States experience health, economic, and social inequities, and a disproportionate burden of COVID-19 cases and deaths. This study examines employment among Pasifika living in the 10 US states with the largest Pasifika populations during the COVID-19 pandemic.We use the Current Population Survey to examine racial differences in employment status, paid work from home (PWFH), and industry telework friendliness. We use data from the Washington Office of Fiscal Management and the Washington State (WA) Employment Security Department to examine county-level unemployment claims.Nationally, Pasifika did not self-report unemployment significantly more than Black, Latino, Asian, and American Indian/Alaska Native respondents, but in WA counties with high Pasifika concentrations, unemployment insurance claim rates were higher compared with all other racial groups, particularly Whites and Asians. Surprisingly, Pasifika had more PWFH opportunities, but worked in less telework-friendly industries nationally.This study demonstrates the complexity of employment among Pasifika during the COVID-19 pandemic. The findings correspond with national reports of racialized communities impacted by unemployment, including Pasifika. Marginally significant differences in unemployment nationally may be due to Pasifika working largely in essential industries requiring workplace attendance.Although overlooked or overshadowed by size, our findings highlight the need for continued advocacy to support data disaggregation and Pasifika data sovereignty. This can be achieved through collaborations between researchers as well as local and community organizations to address data needs of Pasifika communities.

While the incidence and prevalence of type 2 diabetes is higher among Latino/as, Latino men are disproportionately affected and have poorer outcomes. We aimed to determine whether gender impacted any outcomes in a culturally tailored type 2 diabetes (T2D) intervention and to evaluate the effects of gender and intervention participation intensity on outcomes at 6-month follow-up. Nested path and regression models were compared with the likelihood ratio test and information criteria in a sample of Latino/a adults with T2D (n = 222) participating in a T2D community health worker (CHW)-led intervention. Path analysis showed that the effect of the intervention did not vary by gender. The intervention was associated with significant improvements in knowledge of T2D management 0.24 (0.10); p = 0.014, diabetes distress, −0.26 (0.12); p = 0.023, and self-efficacy, 0.61 (0.21); p = 0.005. At 6-month follow-up, improved self-management was associated with greater self-efficacy and Hemoglobin A1c (HbA1c) was lower by −0.18 (0.08); p = 0.021 for each unit of self-management behavior. Linear regressions showed that class attendance and home visits contributed to positive intervention results, while gender was non-significant. Pathways of change in a CHW-led culturally tailored T2D intervention can have a significant effect on participant behaviors and health status outcomes, regardless of gender.

Objective: Little is known about which aspects of after-school programs bolster the developmental milestones required for children to thrive intellectually, socially, and academically. To h...

National reports of diabetes and mental health for Native Hawaiian and Pacific Islanders (NHPI) are high, yet mental health professional access is low. We used multiple logistic regression to analy...

Description, Spin orbital–coupled exciton-polaritons and spin-polarized condensates are found in lead halide perovskites., Spin-orbit coupling (SOC) is responsible for a range of spintronic and topological processes in condensed matter. Here, we show photonic analogs of SOCs in exciton-polaritons and their condensates in microcavities composed of birefringent lead halide perovskite single crystals. The presence of crystalline anisotropy coupled with splitting in the optical cavity of the transverse electric and transverse magnetic modes gives rise to a non-Abelian gauge field, which can be described by the Rashba-Dresselhaus Hamiltonian near the degenerate points of the two polarization modes. With increasing density, the exciton-polaritons with pseudospin textures undergo phase transitions to competing condensates with orthogonal polarizations. Unlike their pure photonic counterparts, these exciton-polaritons and condensates inherit nonlinearity from their excitonic components and may serve as quantum simulators of many-body SOC processes.

OBJECTIVE To simulate the long-term cost-effectiveness of a peer leader (PL)–led diabetes self-management support (DSMS) program following a structured community health worker (CHW)–led diabetes self-management education (DSME) program in reducing risks of complications in people with type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS The trial randomized 222 Latino adults with T2D to 1) enhanced usual care (EUC); 2) a CHW-led, 6-month DSME program and 6 months of CHW-delivered monthly telephone outreach (CHW only); or 3) a CHW-led, 6-month DSME program and 12 months of PL-delivered weekly group sessions with telephone outreach to those unable to attend (CHW + PL). Empirical data from the trial and the validated Michigan Model for Diabetes were used to estimate cost and health outcomes over a 20-year time horizon from a health care sector perspective, discounting both costs and benefits at 3% annually. The primary outcome measure was the incremental cost-effectiveness ratio (ICER). RESULTS Over 20 years, the CHW + PL intervention had an ICER of $28,800 and $5,900 per quality-adjusted life-year (QALY) gained compared with the EUC and CHW-only interventions, respectively. The CHW-only intervention had an ICER of $430,600 per QALY gained compared with the EUC intervention. In sensitivity analyses, the results comparing the CHW + PL with EUC and CHW-only interventions were robust to changes in intervention effects and costs. CONCLUSIONS The CHW + PL–led DSME/DSMS intervention improved health and provided good value compared with the EUC intervention. The 6-month CHW-led DSME intervention without further postintervention CHW support was not cost effective in Latino adults with T2D.

School disengagement is a critical factor that will likely exacerbate long-standing racial inequities in educational outcomes during the aftermath of the coronavirus disease (COVID-19) pandemic. Due to their training and contact with at-risk students, school social workers and other school-based mental health professionals (SMHP) are in an ideal position to understand the impact of COVID-19 and virtual learning on K–12 students. To that end, this study reports on findings from a survey of SMHP about the differential impact that the COVID-19 outbreak is having on students and their families. The findings suggest that COVID-19 has had a tremendous impact on families overall, especially among populations who were experiencing hardships before the current outbreak. In addition, several barriers were noted for student learning, with many students—particularly students of color—completely disengaging from school during spring 2020. However, SMHP reported several important insights on how to support students and their families—some requiring immediate action on the part of school districts and others requiring greater community-level investment into the economic, social, emotional, and overall health of families. Findings are discussed in light of addressing disengagement and educational inequities for students of color.

Research processes that are centered on western models and rooted in colonisation and racism can have deleterious effects upon disenfranchised groups, such as people of colour and indigenous communities. Community-centred and culturally-grounded processes are necessary to achieve meaningful participation and engagement in research by creating equitable protocols and ensuring beneficial outcomes. Such processes are particularly needed in indigenous populations, including the Hawaiian community. This article describes the participatory development of the community engagement protocols and rules of engagement created by a community and academic partnership called the Waimānalo Pono Research Hui (WPRH). Through monthly gatherings, academic and community partners engaged in discussions of constructing community programmes and developing research protocols that are rooted in Hawaiian wholistic values of health and well-being with indigenous methodologies. A final set of protocols and rules of engagement was developed through an iterative feedback process that was rooted not only in community-based participatory (CBPR) principles but also Hawaiian values, beliefs and way of life. Challenges and future directions are also presented.

Prior to western arrival in 1778, Native Hawaiians possessed a sophisticated culture and resource management system conducive to an island ecosystem. However, disenfranchisement from ancestral lands and traditional food sources as a result of colonization led to Native Hawaiians being forced to abandon many of their traditional practices. Today, many Native Hawaiians experience food insecurity, placing them at further risk for obesity and other nutrition-related chronic diseases. Consequently, there is a growing need for place-based and culturally relevant strategies rooted in Hawaiian epistemology to address these issues. This paper describes the history and development of one such intervention – the MALAMA study – in the community of Waimānalo that innovatively merges the modern technology of aquaponics with traditional Native Hawaiian practices and values.

Lead halide perovskites are emerging as an excellent material platform for optoelectronic processes. There have been extensive discussions on lasing, polariton formation, and nonlinear processes in this material system, but the underlying mechanism remains unknown. Here we probe lasing from CsPbBr3 perovskite nanowires with picosecond (ps) time resolution and show that lasing originates from stimulated emission of an electron-hole plasma. We observe an anomalous blue-shifting of the lasing gain profile with time up to 25 ps, and assign this as a signature for lasing involving plasmon emission. The time domain view provides an ultra-sensitive probe of many-body physics which was obscured in previous time-integrated measurements of lasing from lead halide perovskite nanowires.

Objective To examine which components of a culturally tailored community health worker (CHW) intervention improved glycemic control and intermediate outcomes among Latina/o and African American participants with diabetes. Methods The sample included 326 African American and Latina/o adults with type 2 diabetes in Detroit, MI. CHWs provided interactive group diabetes self-management classes and home visits, and accompanied clients to a clinic visit during the 6-month intervention period. We used path analysis to model the processes by which each intervention component affected change in diabetes self-efficacy, diabetes-related distress, knowledge of diabetes management, and HbA1c. Results The group-based healthy lifestyle component was significantly associated with improved knowledge. The group-based self-management section was significantly associated with reduced diabetes-related distress. Intervention class attendance was positively associated with self-efficacy. Diabetes self-management mediated the reductions in HbA1c associated with reductions in diabetes distress. Conclusions Path analysis allowed each potential pathway of change in the intervention to be simultaneously analyzed to identify which aspects of the CHW intervention contributed to changes in diabetes-related behaviors and outcomes among African Americans and Latinas/os. Practice Implications Findings reinforce the importance of interactive group sessions in efforts to improve diabetes management and outcomes among Latina/o and African American adults with diabetes.

Native Hawaiian and other Pacific Islanders, and the environment they are in relationship with, have been the targets of exploitation, extraction, and destruction. Environmental atrocities throughout the Pacific have demonstrated how imperialism, capitalism, and white supremacy drive destruction through efforts to dominate and exploit for material gain. The relationship between Pacific people and the environment, which defines who they are socially, spiritually, and ancestrally, continues to be damaged and even severed by these injustices. The purpose of this article is to provide examples of major environmental injustices in the Pacific and to develop a deeper understanding of the relationship between settler colonialism and environmental injustices. Indigenous knowledge, with a focus on traditional ecological knowledge, is incorporated not just to demonstrate the deep impact of injustices on Pacific people's cultures but also to highlight how this way of knowing cultivates a path to revitalization and community resilience. Cultural practices rooted in traditional ecological knowledge, such as the preservation of food systems, promote reciprocity between living beings and self-determination, necessary for community flourishing. With this understanding, Pacific peoples' relationship with their land offers further evidence of the critical role culture and Indigenous knowledge can play in environmental justice policies and practices.

Background. Community health workers (CHWs), often called “health promotion volunteers” in Japan, are individuals who act as a natural helping resource in the community. Aim. This study tested the efficacy of a CHW-based intervention to improve dietary habits among community-dwelling older people in Japan, using a controlled, crossover design. Method. Seventy-eight people aged 65 to 74 years with poor dietary variety living in four administrative districts in Hikone City (Shiga Prefecture, Japan) were nonrandomly allocated to an immediate-intervened group (IIG; n = 41) or a delayed-intervened group (DIG; n = 37). Participants joined a biweekly, four-session program (120 minutes/session), comprising “CHW drama-style lectures,” “group discussion among participants and CHWs,” “tasting of dishes,” and “take-home practical activities.” For the initial 2-month period, the IIG received the intervention and the DIG did not. The groups were crossed over for the subsequent 2-month period. The primary outcome measure was participants’ dietary variety score (score range: 0-10). Results. The dietary variety score in the IIG significantly increased in the initial 2-month period compared with the DIG (effect size 1.60 points; 95% confidence interval: 0.75, 2.45). The intervention had a similar effect in the DIG in the subsequent 2-month period. Moreover, an analysis within the IIG showed that the intervention effects persisted for at least 2 months after the intervention. Conclusions. The CHW-based intervention improved dietary habits among older people. Our findings provide evidence that a CHW-based natural helping approach is a possible solution to promote healthy aging in the community.

This special issue and introduction focuses on promoting health equity and addressing health disparities among Indigenous peoples of the United States (U.S.) and associated Territories in the Pacific Islands and Caribbean. We provide an overview of the current state of health equity across social, physical, and mental health domains. In Part 1 of the special issue, we trace promotive, protective, and risk factors related to Indigenous health equity. Part 2 of the special issue describes interventions that address and promote wellness, providing promising pathways to achieving and transcending health equity.

While blatant forms of racism and discrimination have largely been “condemned” in our society, systematic oppression and racism can be manifested in less obvious forms as microaggressions. The term...

This study explores gender values and beliefs among Latino and African American men with diabetes and examines how these values and beliefs may influence their health behaviors. Participants were recruited from individuals who participated in one of three Racial and Ethnic Approaches to Community Health Detroit Partnership diabetes self-management interventions. One focus group was conducted with African American men ( n = 10) and two focus groups were conducted with Latino men ( n = 12) over a 3-month period. Sessions lasted 90 minutes, were audiotaped, and analyzed using thematic content analysis techniques. Two themes emerged that characterize gender identity and its relationship to health behavior in men: (a) men’s beliefs about being men (i.e., key aspects of being a man including having respect for themselves, authority figures, and peers; fulfilling the role as breadwinner; being responsible for serving as the leader of the family; and maintaining a sense of chivalry) and (b) influence of gender values and beliefs on health behavior (i.e., the need to maintain a strong image to the outside world, and the need to maintain control of themselves served as barriers to seeking out and engaging in diabetes self-management behaviors). Results suggest that gender values and beliefs may have implications for how health behaviors among men with diabetes. Future research should study the direct impact masculine identity has on health behaviors among men with diabetes.

Objective. In a randomized controlled trial we compared two models of community health worker–led diabetes medication decision support for low-income Latino and African American adults with diabetes. Most outcomes were improved when community health workers used either an interactive e-Health tool or print materials. This article investigates mediators and moderators of improved medication adherence in these two models. Method. Because both programs significantly improved satisfaction with medication information, medication knowledge, and decisional conflict, we examined whether improvements in each of these outcomes in turn were associated with improvements in self-reported medication adherence, and if so, whether these improvements were mediated by improvements in diabetes self-efficacy or diabetes distress. Potential moderators of improvement included gender, race/ethnicity, age, education, insulin use, health literacy, and baseline self-efficacy, diabetes distress, and A1c. Results. A total of 176 participants (94%) completed all assessments. After adjusting for potential confounders, only increased satisfaction with medication information was correlated with improved medication adherence ( p = .024). Improved self-efficacy, but not diabetes distress, was associated with improvements in both satisfaction with medication information and medication adherence. However, the Sobel–Goodman Mediation test did not support improvements in self-efficacy as a mechanism by which improved satisfaction led to better adherence. None of the examined variables achieved statistical significance as moderators. Conclusions. Improvements in satisfaction with medication information but not in medication knowledge or decision conflict were associated with improvements in medication adherence. Interventions that target low-income ethnic and racial minorities may need to focus on increasing participants’ satisfaction with information provided on diabetes medications and not just improving their knowledge about medications. Future research should explore in more depth other possible mediators and moderators of improvements in medication adherence in low-income minority populations.

Food insecurity is a pressing issue in Hawai‘i as the vast majority of available and accessible foods are imported. To address this issue, a backyard aquaponics program was implemented from 2010 to 2016 to offer additional avenues to food sovereignty in a rural predominantly Native Hawaiian community. Aquaponics provides a contained and sustainable food production system that models Native Hawaiian principles of land and water stewardship. The purpose of this community-engaged study was to identify the outcomes and resources needed to continue sustaining the backyard aquaponics systems. The researchers began building a relationship with the community by helping to build several aquaponics systems. The researchers and community partner co-developed the interview questions and participants were interviewed in-person. The outcomes of the study revealed multiple benefits of having a backyard aquaponics system, including increased access to vegetables and fruit, improved diet, low maintenance cost, and enhanced family and community connectedness. Participants reported a renewed connection to Native Hawaiian values, especially land stewardship. Challenges included leaks and breakages with the system, overproduction of fish, complications in water temperature, and vulnerability to unpredictable weather. These findings suggest that backyard aquaponics systems have the potential to provide multiple benefits including alleviating barriers related to food security.

Lead halide perovskites are emerging as an excellent material platform for optoelectronic processes. There have been extensive discussions on lasing, polariton formation, and nonlinear processes in this material system, but the underlying mechanism remains unknown. Here we probe lasing from CsPbBr

Diabetes management for older Latino adults is complex, given a higher incidence of multiple coexisting medical conditions and psychosocial barriers to self-management. Community health workers (CHWs) may be effective in reducing these barriers. The REACH Detroit CHW randomized controlled intervention studies with Latino/as with diabetes found improvements in self-management behaviors and glucose control after participating in a CHW-led intervention. Using data from the REACH Detroit Partnership&prime, s cohort 3, this study used descriptive statistics and multiple linear regression analyses to evaluate whether the six-month CHW intervention had a greater effect on older Latino/as (ages 55 and older) than younger participants between baseline and post-intervention follow-up at six months. There were significant intervention effects by age group that varied by outcome. Compared to a control group that received enhanced usual care, there were statistically significant intervention effects demonstrating greater self-efficacy scores 1.27 (0.23, 2.32), p &lt, 0.05, and reductions in HbA1c 1.02 (&minus, 1.96, &minus, 0.07), 0.05, among older participants in the CHW intervention, and increases in diabetes support 0.74 (0.34, 1.13), 0.001, and understanding of diabetes management 0.39 (0.08, 0.70), 0.01 among younger participants.

To impact clinical and behavioral diabetes care, understanding the cost-effectiveness (CE) of diabetes self-management education and support (DSME/S) in community settings is critical. We aimed to determine the long-term CE of 2 DSME/S modalities (Community Health Worker (CHW) vs. CHW + Peer Leader (PL)), compared to enhanced usual care (EUC), in reducing risk of diabetes complications in Hispanic adults with type 2 diabetes (diabetes) in metro-Detroit. CE analyses were based on empirical outcome data from a randomized controlled effectiveness trial. Eligible subjects were recruited from one Federally Qualified Health Center and randomized to 1) 6 months of CHW-led DSME + 12 months of CHW-led telephone outreach, 2) 6 months of CHW-led DSME+ 12 months of PL-led weekly group sessions with telephone outreach, or 3) EUC. We used the validated Michigan Model for Diabetes to estimate the CE of the 2 DSME/S modalities compared to EUC over a 10-year simulation time horizon, discounting costs and benefits at 3% annually. Trial-based costs and outcomes were used; other data regarding costs, disease progression, mortality, and utilities were from published literature. From a healthcare sector perspective, CHW+PL was associated with lower costs ($76,599 vs. $77,203 in CHW and $76,779 in EUC) and increased health benefits (quality-adjusted life-years (QUALY): 5.137 vs. 5.1in CHW and EUC) compared to CHW and EUC, respectively, in the model time horizon. CHW was associated with higher costs but yielded similar QALYs compared to EUC. The greater intervention costs of CHW + PL were completely or substantially offset by savings arising from averted diabetes complications compared to CHW or EUC. Using CHW+PL for DSME/S appears to be a sound investment and may be cost-saving for Hispanic adults with diabetes in metro-Detroit. Disclosure G. Piatt: None. W. Ye: None. S. Kuo: None. B.R. Sinco: None. W.H. Herman: Other Relationship; Self; Merck Sharp & Dohme Corp., Lexicon Pharmaceuticals, Inc.. Consultant; Self; Janssen Scientific Affairs, LLC.. Research Support; Spouse/Partner; Nestlé. Other Relationship; Self; American Diabetes Association. Advisory Panel; Self; National Committee for Quality Assurance (NCQA). M.S. Spencer: None. G. Palmisano: None. M. Heisler: None. E.C. Kieffer: None.

OBJECTIVE This study evaluated the effectiveness of a community health worker (CHW) diabetes self-management education (DSME) program, followed by two different approaches to maintain improvements in HbA1c and other clinical and patient-centered outcomes over 18 months. RESEARCH DESIGN AND METHODS The study randomized 222 Latino adults with type 2 diabetes and poor glycemic control from a federally qualified health center to 1) a CHW-led, 6-month DSME program or 2) enhanced usual care (EUC). After the 6-month program, participants randomized to the CHW-led DSME were further randomized to 1) 12 months of CHW-delivered monthly telephone outreach (CHW-only) or 2) 12 months of weekly group sessions delivered by peer leaders (PLs) with telephone outreach to those unable to attend (CHW+PL). The primary outcome was HbA1c. Secondary outcomes were blood pressure, lipid levels, diabetes distress, depressive symptoms, understanding of diabetes self-management, and diabetes social support. Assessments were conducted at baseline and at 6, 12, and 18 months. RESULTS Participants in the CHW intervention at the 6-month follow-up had greater decreases in HbA1c (−0.45% [95% CI −0.87, −0.03]; P < 0.05) and in diabetes distress (−0.3 points [95% CI −0.6, −0.03]; P < 0.05) compared with EUC. CHW+PL participants maintained HbA1c improvements at 12 and 18 months, and CHW-only participants maintained improvements in diabetes distress at 12 and 18 months. CHW+PL participants also had significantly fewer depressive symptoms at 18 months compared with EUC (−2.2 points [95% CI −4.1, −0.3]; P < 0.05). Participants in CHW-led DSME had significant improvements in diabetes social support and in understanding of diabetes self-management at 6 months relative to EUC, but these intervention effects were not sustained at 18 months. CONCLUSIONS This study demonstrates the effectiveness of a 6-month CHW intervention on key diabetes outcomes and of a volunteer PL program in sustaining key achieved gains. These are scalable models for health care centers in low-resource settings for achieving and maintaining improvements in key diabetes outcomes.

PURPOSE We compared a 3-month diabetes self-management education (DSME) program followed by a 12-month peer support intervention with a 3-month DSME program alone in terms of initial and sustained improvements in glycated hemoglobin (HbA1c). Secondary outcomes were risk factors for cardiovascular disease (CVD), diabetes distress, and social support. METHODS We randomized 106 community-dwelling African American adults with type 2 diabetes to a 3-month DSME program followed by 12 months of weekly group sessions and supplementary telephone support delivered by peer leaders or to a 3-month DSME program with no follow-up peer support. Assessments were conducted at baseline, 3, 9, and 15 months. RESULTS No changes in HbA1c were observed at 3 months or at 15 months for either group. The peer support group either sustained improvement in key CVD risk factors or stayed the same while the control group worsened at 15 months. At 15 months, the peer-support group had significantly lower low-density lipoprotein cholesterol levels (−15 mg/dL, P = .03), systolic blood pressure (−10 mm Hg, P = .01), diastolic blood pressure (−8.3 mm Hg, P = .001), and body mass index (−0.8 kg/m2, P = .032) than the DSME-alone group. CONCLUSIONS In this population of African American adults, an initial DSME program, whether or not followed by 12 months of peer support, had no effect on glycemic control. Participants in the peer-support arm of the trial did, however, experience significant improvements in some CVD risk factors or stay approximately the same while the control group declined.

The effect of sodium species on the physical and catalytic properties of Cu/ZnO catalysts derived from zincian georgeite has been investigated. Catalysts prepared with +, using a supercritical CO2 antisolvent technique, were characterised and tested for the low temperature water–gas shift reaction and also CO2 hydrogenation to methanol. It was found that zincian georgeite catalyst precursor stability was dependent on the Na+ concentration, with the 2.1 wt% Na+-containing sample uncontrollably ageing to malachite and sodium zinc carbonate. Samples with lower Na+ contents (+ containing sample, after calcination and reduction, was found to comprise of larger CuO crystallites and a lower Cu surface area. However, calcination of the high Na+ sample immediately after precipitation (before ageing) resulted in a comparable CuO/Cu particle size to the lower (+ containing samples, but with a lower Cu surface area, which indicates that Na+ species block Cu sites. Activity of the catalysts for the water–gas shift reaction and methanol yields in the methanol synthesis reaction correlated with Na+ content, suggesting that Na+ directly poisons the catalyst. In situ XRD analysis showed that the ZnO crystallite size and consequently Cu crystallite size increased dramatically in the presence of water in a syn-gas reaction mixture, showing that stabilisation of nanocrystalline ZnO is required. Sodium species have a moderate effect on ZnO and Cu crystallite growth rate, with lower Na+ content resulting in slightly reduced rates of growth under reaction conditions.

This study used qualitative methods and quantitative statistical analyses to examine whether race and gender are associated with reasons for which adults perceive a situation or object as fearful. The sample consists of 197 African-American and White adults (ages 18–85) recruited through a convenience sample and community sources in the Midwest. A cognitive interviewing instrument was utilized to examine respondents understanding of words and phrases from a mental health instrument. Using qualitative methods, free-response answers were content coded using 5 “fear-codes” (i.e., harm/danger, external locus of control, self-perception, and past experience), developed by the researchers. Results from logistic regression analyses indicate that race significantly predicts usage of specific fear codes (p

OBJECTIVE To compare a peer leader (PL) versus a community health worker (CHW) telephone outreach intervention in sustaining improvements in HbA1c over 12 months after a 6-month diabetes self-management education (DSME) program. RESEARCH DESIGN AND METHODS One hundred and sixteen Latino adults with type 2 diabetes were recruited from a federally qualified health center and randomized to 1) a 6-month DSME program followed by 12 months of weekly group sessions delivered by PLs with telephone outreach to those unable to attend or 2) a 6-month DSME program followed by 12 months of monthly telephone outreach delivered by CHWs. The primary outcome was HbA1c. Secondary outcomes were cardiovascular disease risk factors, diabetes distress, and diabetes social support. Assessments were conducted at baseline, 6, 12, and 18 months. RESULTS After DSME, the PL group achieved a reduction in mean HbA1c (8.2–7.5% or 66–58 mmol/mol, P < 0.0001) that was maintained at 18 months (−0.6% or −6.6 mmol/mol from baseline [P = 0.009]). The CHW group also showed a reduction in HbA1c (7.8 vs. 7.3% or 62 vs. 56 mmol/mol, P = 0.0004) post–6 month DSME; however, it was attenuated at 18 months (−0.3% or −3.3 mmol/mol from baseline, within-group P = 0.234). Only the PL group maintained improvements achieved in blood pressure at 18 months. At the 18-month follow-up, both groups maintained improvements in waist circumference, diabetes support, and diabetes distress, with no significant differences between groups. CONCLUSIONS Both low-cost maintenance programs led by either a PL or a CHW maintained improvements in key patient-reported diabetes outcomes, but the PL intervention may have additional benefit in sustaining clinical improvements beyond 12 months.

Leafless deciduous canopies in boreal regions affect the energy available for snowmelt and reduce overall surface albedo during winter, thereby exerting a strong influence on weather and climate. In this work, ground-based measurements of leafless canopy structure, including hemispherical photography, terrestrial laser scanning (TLS) and manual tree surveys were collected at 38 sites in an area of mountain birch forest in northern Sweden in March 2011 and 2012. Photo-derived sky view fraction was strongly inversely correlated (r < −0.9) to the total tree basal area in a 5 m radius around the photo site. To expand findings to wider areas, maps of canopy height for a 5 km × 3 km area were obtained from airborne lidar (ALS) data collected during summer 2005. Canopy heights derived from TLS were used to validate the ALS estimates, and simple models were developed to establish relationships between hemispherical sky view and ALS canopy height (RMSE < 5%). The models and ALS data provide useful methods for estimating canopy radiative transfer and biomass over wide areas of birch forest, despite the relatively low ALS resolution (∼1 return m−2).

A series of copper–zinc acetate and zincian georgeite precursors have been produced by supercritical CO2 antisolvent (SAS) precipitation as precursors to Cu/ZnO catalysts for the water gas shift (WGS) reaction. The amorphous materials were prepared by varying the water/ethanol volumetric ratio in the initial metal acetate solutions. Water addition promoted georgeite formation at the expense of mixed metal acetates, which are formed in the absence of the water co‐solvent. Optimum SAS precipitation occurs without water to give high surface areas, whereas high water content gives inferior surface areas and copper–zinc segregation. Calcination of the acetates is exothermic, producing a mixture of metal oxides with high crystallinity. However, thermal decomposition of zincian georgeite resulted in highly dispersed CuO and ZnO crystallites with poor structural order. The georgeite‐derived catalysts give superior WGS performance to the acetate‐derived catalysts, which is attributed to enhanced copper–zinc interactions that originate from the precursor.

Purpose The purpose of the study was to determine the effects of gender on participation in a community-based, culturally tailored diabetes lifestyle intervention, led by trained community health workers (CHW) and conducted with African Americans and Latinos with type 2 diabetes. Methods This study utilized data collected from 180 participants. Multivariable binary and cumulative logistic regression models were used to analyze associations between gender and race/ethnicity with study completion and participation in 3 aspects of the intervention: group classes, CHW home visits, and CHW-accompanied doctor visits. Results Among Latinos, men were less likely than women to complete the study, attend group classes, and complete CHW home visits. There were no gender differences in participation seen among African Americans. Conclusions Diabetes management interventions may need to adapt their designs to optimize retention and participation of Latino men. Among African American men, the CHW model may be promising. Reasons for low participation among Latino men should receive more study. Future studies should assess whether similar findings apply in other communities and populations.

This study investigated the influence of a community health worker (CHW) diabetes lifestyle intervention on mental health outcomes. Our study was guided by the principles of community-based participatory research. Data were collected from 164 African American (N = 94) and Hispanic adults (N = 70) participating in a randomized, 6-month delayed intervention group design for improving glycemic control. The intervention time periods were baseline to 6 months for the treatment group and 6–12 months for the delayed group. Linear mixed models were used to conduct longitudinal analyses of the Problem Areas in Diabetes (PAID) and Patient Health Questionnaire (PHQ) scales. In the model adjusted for demographics, the PAID dropped significantly from pre-intervention to post-intervention within both the treatment and delayed groups (p < 0.05) with an average intervention effect of −6.4 (p < 0.01). The PAID dropped even further within the immediate group from 6 to 12 months. Although the PHQ did not change significantly, the PHQ-2 had an average intervention effect of −0.3 (p < 0.05) in the model adjusted for demographics. This study contributes to an understanding of how a CHW-led diabetes intervention can result in positive mental health outcomes for Latinos and African Americans with Type 2 diabetes. It also highlights the importance of further exploring what factors may contribute to racial/ethnic variation in mental health outcomes for African Americans and Latinos with diabetes and the role CHWs can play.

This study examined whether or not direct social support is associated with long-term health among middle-aged and older adults with diabetes mellitus.Direct social support was assessed at baseline (2003) for 1,099 adults with type 2 diabetes mellitus from the Health and Retirement Study. Self-reported health status was examined at baseline and in 4 biennial survey waves (2003-2010). A series of ordinal logistic regression models examined whether or not the 7-item Diabetes Care Profile scale was associated with a subsequent change in health status over time. Additional analyses examined whether or not individual components of direct social support were associated with health status change.After adjusting for baseline covariates, greater direct social support as measured by the Diabetes Care Profile was associated with improved health outcomes over time; however, this trend was not significant (p = .06). The direct social support measures that were associated with improved health over follow-up were support for taking medicines (odds ratio [OR] = 1.22), physical activity (OR = 1.26), and going to health care providers (OR = 1.22; all p.05).Interventions that specifically target improving specific aspects of diabetes social support may be more effective in improving long-term health than less targeted efforts.

Forecasting seasonal snow cover is useful for planning resources and mitigating natural hazards. We present a link between the North Atlantic Oscillation (NAO) index and days of snow cover in Scotland between winters beginning from 1875 to 2013. Using broad (5 km resolution), national scale data sets like UK Climate Projections 2009 (UKCP09) to extract nationwide patterns, we support these findings using hillslope scale data from the Snow Survey of Great Britain (SSGB). Currently collected snow cover data are considered using remotely sensed satellite observations, from moderate-resolution imaging spectroradiometer; but the results are inconclusive due to cloud. The strongest correlations between the NAO index and snow cover are found in eastern and southern Scotland; these results are supported by both SSGB and UKCP09 data. Correlations between NAO index and snow cover are negative with the strongest relationships found for elevations below 750 m. Four SSGB sites (two in eastern Scotland, two in southern Scotland) were modelled linearly with resulting slopes between −6 and −16 days of snow cover per NAO index integer value. This is the first time the relationship between NAO index and snow cover duration has been quantified and mapped in Scotland.

International audience; Product detection studies of C(P-3) atom reactions with butene (C4H8) isomers (but-1-ene, cis-but-2-ene, trans-but-2-ene) are carried out in a flow tube reactor at 353 K and 4 Torr under multiple collision conditions. Ground state carbon atoms are generated by 248 nm laser photolysis of tetrabromomethane, CBr4, in a buffer of helium. Thermalized reaction products are detected using synchrotron tunable VUV photoionization and time-of-flight mass spectrometry. The temporal profiles of the detected ions are used to discriminate products from side or secondary reactions. For the C(P-3) + trans-but-2-ene and C(P-3) + cis-but-2-ene reactions, various isomers of C4H5 and C5H7 are identified as reaction products formed via CH3 and H elimination. Assuming equal ionization cross sections for all C4H5 and C5H7 isomers, C4H5:C5H7 branching ratios the C(P-3) + trans-but-2-ene and the C(3P) + cis-but-2-ene reactions, respectively. For the C(P-3) + but-1-ene reaction, two reaction channels are observed: the H-elimination channel, leading to the formation of the ethylpropargyl isomer, and the C3H3 + C2H5 channel. Assuming equal ionization cross sections for ethylpropargyl and C3H3 radicals, a branching ratio of 1:0.95 for the C3H3 + C2H5 and H + ethylpropargyl channels is derived. The experimental results are compared to previous H atom branching ratios and used to propose the most likely mechanisms for the reaction of ground state carbon atoms with butene isomers.

Although Asian Americans are one of the fastest growing ethnic minority groups in the United States, research on this population continues to lag behind that on other minorities. In this article, we take factors recognized as critical elements to the physical and mental health outcomes of Asian Americans and apply the social determinants of health (SDH) framework to reconceptualize these factors as structural or intermediary factors. This study uses a nationally representative sample of Asian Americans from the National Latino and Asian American Study (N = 2,067) to examine the relationships between the SDH factors and 4 physical and mental health outcomes (chronic conditions, diagnosable mental health disorders, self-rated physical health, self-rated mental health). Negative binomial, logistic, and ordinary least squares regression analyses are modeled to estimate these associations. The results show that structural and intermediary factors are significantly associated with all 4 health outcomes. The ass...

Objectives: There is an increasing interest in conducting research within indigenous communities among indigenous and non-indigenous researchers alike. This paper offers the critical reflections of one Native Hawaiian researcher and the process of engaging in research as both an insider–outsider. Conclusions: Community-based, participatory research (CBPR) offers one model for outsiders to work effectively with indigenous communities, but CBPR also offers valuable principles for insiders who desire to work with their own communities.

Objectives. We tested the effectiveness of a culturally tailored, behavioral theory-based community health worker intervention for improving glycemic control. Methods. We used a randomized, 6-month delayed control group design among 164 African American and Latino adult participants recruited from 2 health systems in Detroit, Michigan. Our study was guided by the principles of community-based participatory research. Hemoglobin A1c (HbA1c) level was the primary outcome measure. Using an empowerment-based approach, community health workers provided participants with diabetes self-management education and regular home visits, and accompanied them to a clinic visit during the 6-month intervention period. Results. Participants in the intervention group had a mean HbA1c value of 8.6% at baseline, which improved to a value of 7.8% at 6 months, for an adjusted change of -0.8 percentage points (P

The purpose of this study was to estimate how many presentations at the Annual Meeting of the Society for Social Work and Research (SSWR) are subsequently published in peer-reviewed journals. A 30% random sample of abstracts presented at the 2006 Annual Meeting of SSWR was reviewed. To determine publication status of the presentations, the authors conducted searches using Google Scholar, PubMed, PsycINFO, and Social Work Abstracts, in addition to reviewing faculty pages and curriculum vitae (CVs). The authors recorded information about the published articles including the journal title, impact factor, year, and authors. Forty-three percentage (95% CI = [34.5%, 51.9%]) of presentations were published in a peer-reviewed journal. Twenty-eight percentage (95% CI = [20.9%, 36.7%]) of publications were in a journal with an ISI Impact Factor (M = 1.32). The number of presentation authors was not associated with a subsequent publication. No differences were observed by type of presentation.

Family support is important in diabetes self-management. However, children as providers of support have received little attention. This study examines the role of children in their parents' diabetes self-management, diet, and exercise.This research used community-based participatory research principles. Researchers conducted semi-structured parallel interviews of 24 Latino and African-American adults with diabetes and with a child (aged 10-17 years) in their home (2004-2006). Interviews were transcribed, coded, and analyzed for themes (2004-2007).Adults and children perceived that children play many roles related to adults' diabetes self-management. Parents described children as monitoring parents' dietary intake and reminding them what they should not be eating. Some children helped with shopping and meal preparation. Families described children reminding parents to exercise and exercising with their parents. Children reminded parents about medications and assisted with tasks such as checking blood sugar. Parents and children perceived that children played a role in tempting parents to stray from their diabetes diet, because children's diets included food that parents desired but tried to avoid.Children and parents perceived that children have many roles in both supporting and undermining adults' diabetes self-management. There is more to learn about the bi-directional relationships between adults and children in this setting, and the most beneficial roles children can play. Healthcare providers should encourage family lifestyle changes, strengthen social support for families, and direct children toward roles that are beneficial for both parent and child without placing an unreasonable level of responsibility on the child.

Background The specific ways in which community health worker (CHW) programs affect participants' healthcare behaviors and interactions with their healthcare providers, as well as mechanisms by which CHW programs influence these outcomes, are poorly understood. A qualitative descriptive study of participants in a successful CHW diabetes self-management program was designed to examine: (1) what gaps in diabetes care, with a focus on patient–doctor interactions, participants identify; (2) how the program influences participants' diabetes care and interactions with healthcare providers, and what gaps, if any, it addresses. Methods From November 2005 to December 2006, semi-structured interviews with 40 African- American and Latino adults were conducted and analyzed. Participants had diabetes and had completed or were active in a CHW-led diabetes self-management program developed and implemented using community-based participatory research principles in Detroit. Interviews were audiotaped, transcribed, and coded through a consensual and iterative process. Results Participants reported that prior to the intervention they had received inadequate information from healthcare providers for effective diabetes self-management, had had low expectations for help from their providers, and had not felt comfortable asking questions or making requests of their healthcare providers. Key ways participants reported that the program improved their ability to manage their diabetes were by providing (1) clear and detailed information on diabetes and diabetes care; (2) education and training on specific strategies to meet diabetes care goals; (3) sustained and nonjudgmental assistance to increase their motivation and confidence; and (4) social and peer support that enabled them to better manage their diabetes. The knowledge and confidence gained through the CHW intervention increased participants' assertiveness in asking questions to and requesting necessary tests and results from their providers. Conclusions Study findings suggest ways that CHW programs that provide both one-on-one support and group self-management training sessions may be effective in promoting more effective diabetes care and patient–doctor relationships among Latino and African-American adults with diabetes. Through these mechanisms, such interventions may help to mitigate racial and ethnic disparities in diabetes care and outcomes.