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Subsurface tile drainage systems are common in agricultural regions of the Midwestern United States. Drainage systems remove excess water from the surface and soil profile of agricultural fields, allowing crop production in previously unsuitable locations. However, these systems impact watershed hydrology and could influence flooding events. Therefore, this study aimed to determine whether tile drainage systems influence downstream flood days in a Midwestern agricultural watershed, specifically the Skunk Creek watershed. The Soil and Water Assessment Tool (SWAT) model was used to simulate the hydrologic processes of the Skunk Creek Watershed for an 18-year period (2004-2021). The model was calibrated and validated using observed daily streamflow data with the SWAT Calibration and Uncertainty Program (SWAT-CUP) software and through the manual modification of missed precipitation data. Three tile drainage scenarios--ranging from 15% to 75% tile-drained agricultural land--were individually incorporated into the model. Results indicated that with increased tile drainage, surface runoff, groundwater flow, deep aquifer recharge, and percolation decreased, whereas lateral soil flow, tile flow, evapotranspiration, and water yield increased. A comparison of tile drainage scenarios suggests that increasing the area of tile-drained agricultural land decreases total flood days. However, the impact of tile drainage systems on downstream peak flood flows varied by event, with large precipitation events initiating flood days across all scenarios. While tile flow decreased flood days on a daily time step, flash floods might have occurred on a subdaily time step but were not captured in this study. Future studies can replicate the approach with a sub-daily time step for simulating hourly flood events with various tile drainage scenarios. [ABSTRACT FROM AUTHOR]

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.

Background: The Flint water crisis (FWC) was a public health tragedy caused by crumbling infrastructure, subverted democracy, and indifference toward a predominantly poor and Black community that resulted in lead-in-water exposure, Legionnaires' disease, and emotional and health-related trauma. Through the cooperation of community partners, the Flint Registry (FR) was conceived to track long-term health and improve public health via service connections. Objectives: This study sought to share the FR's community-partnered, multi-tiered engagement strategy and determine the efficacy of this strategy to engage the community and reach Flint residents. Methods: Community engagement and impact were measured by collecting and describing feedback from the community engagement strategies and by comparing the demographics of the enrollees recruited through community-engaged recruitment (CER) and non-CER methods. Enroll-ees indicated how they heard about the FR; CER involved direct interaction with a community member. Results: Community engagement strategies incorporated approximately 1,200 people and 7 funded organizations, impacting 22 key areas of FR design and implementation. More than 50% of enrollees heard about the FR through CER methods. They were, on average, more likely to be younger, female, Black/African American, and living outside of Flint during the FWC. Conclusions: Community engagement elevated voices of those impacted by the FWC. CER methods were as effective as non-CER methods. Although there were no differences in screened measures of social vulnerability, there were in age, gender, and race. CER methods may increase participation and build trust in populations which historically are hesitant to participate in public health efforts. [ABSTRACT FROM AUTHOR]

Background: Soil constitutes a major source of childhood lead exposure, disproportionately affecting communities of color. Mulching offers a low-cost interim control. Objectives: A community–academic partnership was established for lead poisoning prevention, with a three-fold aim: (1) control soil lead hazards by applying mulch, (2) identify home lead hazards with screening kits, and (3) connect residents to resources to address lead hazards. Methods: Student volunteers canvassed neighborhoods one month prior to the annual event. They requested consent for mulching, distributed lead screening kits, and screened residents for grant eligibility. Soil samples were collected from each home before mulching. According to principles of community-based participatory research, materials and plans were iterative, guided and adjusted by neighborhood association feedback, and detailed reports about home lead results were shared with each participating resident. Composite neighborhood data and survey results were shared with volunteers and community partners. Results: The project was evaluated in the third (41 homes) and fourth (48 homes) years of implementation. Before mulching, the median soil lead level was over 400 ppm, and after mulching, it was less than 20 ppm. Lead screening kits identified widespread lead hazards in paint, soil, and dust, but not water. Challenges remain in (a) increasing child blood lead testing and (b) increasing submissions for city grant funding for lead abatement. Evaluation surveys indicate a sense of ownership in the project among community partners and high levels of engagement among students. Conclusions: Community–academic partnerships are an effective tool for lead poisoning prevention, generating evidence for public health action. [ABSTRACT FROM AUTHOR]

Snow cover ablation within the Ohio River Basin (ORB) plays an important role in regional hydroclimatology, while also representing a potential hazard during large and rapid events. Rain‐on‐snow ablation is a particular challenge, where runoff rates are typically enhanced due to the dual inputs of snowmelt and liquid precipitation. Here, we present a 40‐year climatology of snow ablation events frequency, intensity, and timing for the ORB using a 4‐km gridded snow‐water‐equivalent dataset, focusing on the relative proportion of events caused by rain‐on‐snow and changes over time. Spatial patterns of snow ablation frequency and intensity mirror that of seasonal snowfall totals, with higher (lower) values in the northern and eastern (southern) portions of the basin. Rain‐on‐snow events represent approximately 40% of all ablation events within the basin and result in approximately 24%–25% more snow‐water‐equivalent loss than non‐rain‐on‐snow events, plus an additional 3–12 mm of liquid precipitation per event on average. Peak frequency of ablation and rain‐on‐snow events occurs in late winter and early spring, similar to that of the surrounding region. Over time, the frequency of ablation and rain‐on‐snow events has decreased in the northern and eastern portions of the basin, in some cases by as much as 30%. Trends in event magnitudes were more isolated but decreased across portions of central IN, northern KY, eastern OH and northern WV. Additionally, the magnitude of precipitation during rain‐on‐snow events has increased across the region, extending from northern KY into western PA by over 100% in many cases. Broadly, we find tendencies towards fewer events with less snow loss but more liquid precipitation that suggest complicated impacts to the hydroclimatology warranting further investigation. [ABSTRACT FROM AUTHOR]

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).

Background: Health outcomes, risk factors, and policies are complexly related to the reproductive health system. Systems-level frameworks for understanding and acting within communities through community-engaged research are needed to mitigate adverse reproductive health outcomes more effectively within the community. Objectives: To describe and share lessons learned from an ongoing application of a participatory modeling approach (community-based system dynamics) that aims to eliminate racial inequities in Black-White reproductive health outcomes. Methods: The community-based system dynamics approach involves conducting complementary activities, workshops, modeling, and dissemination. We organized workshops, co-developed a causal loop diagram of the reproductive health system with participants from the community, and created materials to disseminate workshop findings and preliminary models. Lessons Learned: Many opportunities exist for cross-fertilization of best practices between community-based system dynamics and community-based participatory research. Shared learning environments offer benefits for modelers and domain experts alike. Additionally, identifying local champions from the community helps manage group dynamics. Conclusions: Community-based system dynamics is well-suited for understanding complexity in the reproductive health system. It allows participants from diverse perspectives to identify strategies to eliminate racial inequities in reproductive health outcomes. [ABSTRACT FROM AUTHOR]

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.

Accelerated mass spectrometry (AMS) and carbon isotope analyses provide strong tandem methodologies used by archaeologists to evaluate and reevaluate the histories of maize use in the Midwest. In this article, we present newly obtained AMS dates and carbon isotope assays of alleged maize samples from the Icehouse Bottom (40MR23) and Edwin Harness sites (22RO33). Based on original studies, samples were thought to date to the Middle Woodland period (ca. 300 BC-AD 400). The results show that samples either were not maize or date to post-AD 900. As of this finding, there are no longer any securely dated Middle Woodland macrobotanical remains of maize from the Eastern Woodlands of North America. [ABSTRACT FROM AUTHOR]

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

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.

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.

Neonicotinoid pesticides are applied to seeds and are known to cause lethal and sub-lethal effects in birds and mammals. Neonicotinoid-treated seeds could be available to wildlife through spillage or exposed seeds near or at the soil surface due to incomplete or shallow drilling. We quantified seed spills that may occur during loading or refilling the hopper at a landscape-scale using road-based surveys. We also quantified undrilled seeds in 1-m2 frames on the soil in the center and corner of fields to obtain estimates at the field scale. We broadcast seeds on the soil surface of a tilled field and left them for 0, 1, 2, 4, 8, 16, and 30 days to quantify the decrease of neonicotinoids under field conditions. Lastly, we documented wildlife at neonicotinoid-treated seed spills with trail cameras. We estimated the number of spills during planting to be 3496 (95% CI: 1855–5138) and 2609 (95% CI: 862–4357) for corn, 11,009 (95% CI: 6950–15,067) and 21,105 (95% CI: 6162–36,048) for soybean, and 830 (95% CI: 160–1500) and 791 (95% CI: 0–1781) for wheat in 2016 and 2017, respectively. Exposed seeds were present at the soil surface in 35% of 71 fields. The probability that seeds were present on the soil surface was higher for soybeans (18.8 and 49.4% in the center and corners, respectively) than for corn (1.6 and 2.7%, respectively), and seed densities were also higher (1.04 vs 0.07 seeds/m2, respectively). Neonicotinoids decreased rapidly on seeds on the soil surface but persisted as long as 30 days. Over a dozen species of birds and mammals consumed seeds at simulated spills, with an average time for birds to find spills of 1.3 ± 1.5 days and an average time to consumption of 4.1 ± 3.4 days. Seeds are abundant on the soil surface for wildlife to consume during the spring planting season and should be considered in pesticide risk assessments. Unlabelled Image • We quantified neonicotinoid-treated seeds on the soil surface after planting. • Probability and density of soybean seeds on the soil surface were higher than corn. • Neonicotinoids decreased rapidly on seeds on the soil surface but persisted 30 days. • Over a dozen species of birds and mammals consumed seeds at simulated spills. • Seeds on the soil surface should be considered in pesticide risk assessments. [ABSTRACT FROM AUTHOR]

Peer providers of mental health services use their personal illness and recovery narratives to help other mental health service users. Despite a substantial body of evidence supporting the effectiveness of these providers, little is known about the underlying strategies they employ in their professional practice. In this study, I used in-depth interviews with 23 peers to explore the most important practices they used in their day-to-day work with others. Results indicated that peers engaged in a reflexive process to strategically use their personal illness and recovery stories to help others re-story their life narratives. Peers also used communication strategies from motivational and cognitive–behavioral treatment approaches to engage, inspire, and mentor other service users. Findings suggest the need for research that further explores the rhetorical strategies used by peers using narrative methods. The development and testing of professional development opportunities to assist peers in maximizing their therapeutic potential are also warranted. [ABSTRACT FROM AUTHOR]

Using a lens of structuration theory, this study highlights the ways that specific structures within the current community-based model of mental health care might enable and constrain individuals and families living with mental illness. Through a case study of a volunteer mental illness advocacy group, the authors employed a duality analysis on a variety of data collected from the case (i.e., interviews, organizational documents, and community health care data). Findings indicate that while group members encountered structural barriers to their organizational mission, they also used communicative agency creatively and collectively to (re)create structures within the current community-based model of mental health care. Member agency is examined in relation to perceived structural influence. Theoretical and practical applications of the findings are discussed. [ABSTRACT FROM AUTHOR]

French colonists in seventeenth century New France were introduced to maize, the staple of the Native American diet. In the eighteenth century, when French agriculturalists settled along the Mississippi River, they grew maize but preferred not to eat it themselves, as fur traders and soldiers had previously done. Maize avoidance reflected the changing socio-economic framework of French settlement. Fur traders were concerned with integrating themselves into Native American kin networks, while farmers elaborated distinctions between “French” and “Indian” in the domains of housing, clothing, and food, symbolized by the opposition of wheat bread to maize mush, while readily adopting other native foods - game, pumpkins, maple sugar, even bear oil. Maize was shipped down the Mississippi to Louisiana, but also used to feed the sizeable slave population as well as landless French laborers. Food choices reflected race and class differences, rather than set cultural preferences. [ABSTRACT FROM AUTHOR]

Before the nineteenth - century's mandatory education laws, churches and towns created schools according to local needs. The one-room school was a product of local community and autonomy. Educational reformers sought to standardize schooling through guidelines for schoolhouse and playground design and standards for curriculum and attendance. These external reform movements provided the impetus for communities to reform or resist such impositions. America's social memory of the 'little red schoolhouse' paints the picture of one-room schools as sites of conformity and innocence, but historical archaeology of specific schools reveals tensions encoded in these buildings, their documentary records, and associated artifact assemblages. [ABSTRACT FROM AUTHOR]

Refugees have recently been thrust into the spotlight worldwide. The strikingly negative rhetoric currently surrounding refugees calls for increased action from public health educators. In 2016, the largest proportion of refugees to the United States came from the Democratic Republic of Congo. This presents the opportunity to explore health needs as Congolese refugees resettle in the United States, with women taking priority due to health disparities linked to gender-based discrimination, trauma, sexual and gender-based violence, lower literacy rates, and less access to learning English. Insight into experiences of Congolese women in the United States is critical for the proactive development of socioculturally relevant health promotion rather than reaction interventions once health inequities are exacerbated. Therefore, to better understand perceptions and experiences of Congolese women in Indianapolis related to health and health care, a community-based participatory research study with an anthropological approach was conducted in collaboration with a refugee resettlement agency utilizing photovoice and semistructured interviews. Sixteen women participated in six photovoice sessions and home-based interviews. Selected photos, photo stories, and interview transcripts were analyzed using ethnographic content analysis. Major themes were health care system issues, social support, and daily experiences of health. Findings provide needed insight into the sociocultural context of health for Congolese refugees in the United States for both health educators and resettlement agencies. Findings also revealed specific priority areas for culturally tailoring health education and assets on which to build when promoting health for this population. Additionally, lessons were learned about the power of an anthropological, community-based participatory research approach to qualitative research for promoting health equity. [ABSTRACT FROM AUTHOR]