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Purpose -- The purpose of this paper is to examine homeless women's interactions with service providers and the degree to which these interactions are perceived as social support. Design/methodology/approach -- Using a phenomenological approach, in-depth semistructured interviews were conducted with 15 homeless women recruited through a drop-in day shelter and a winter emergency shelter. Findings -- Analysis revealed being "cared for" was experienced within service provider encounters and is commensurate with widely recognized sub-categories of received social support. Participants expressed expanded definitions of service providers and made clear distinctions between routine support expected from a provider and received social support, or being "cared for" by providers. Research limitations/implications -- Studies with homeless persons that exclude service providers as a potential source of social support for homelesswomen or impose predetermined definitions of service provision may not be capturing the full range of participant encounters, relationships, networks, and experiences. Practical implications -- Widely used social support measures could serve as a guide for creating education programs for persons who work with homeless people including: professional service providers, students likely to become service providers, paraprofessionals, nonprofessionals, and volunteers. Originality/value -- Homeless women's voices have been added to the debate regarding whether social support is within the realm of service provision. [ABSTRACT FROM AUTHOR]

Chronic wasting disease (CWD), the only known prion disease endemic in wildlife, is a persistent problem in both wild and captive North American cervid populations. This disease continues to spread and cases are found in new areas each year. Indirect transmission can occur via the environment and is thought to occur by the oral and/or intranasal route. Oral transmission has been experimentally demonstrated and although intranasal transmission has been postulated, it has not been tested in a natural host until recently. Prions have been shown to adsorb strongly to clay particles and upon oral inoculation the prion/clay combination exhibits increased infectivity in rodent models. Deer and elk undoubtedly and chronically inhale dust particles routinely while living in the landscape while foraging and rutting. We therefore hypothesized that dust represents a viable vehicle for intranasal CWD prion exposure. To test this hypothesis, CWD-positive brain homogenate was mixed with montmorillonite clay (Mte), lyophilized, pulverized and inoculated intranasally into white-tailed deer once a week for 6 weeks. Deer were euthanized at 95, 105, 120 and 175 days post final inoculation and tissues examined for CWD-associated prion proteins by immunohistochemistry. Our results demonstrate that CWD can be efficiently transmitted utilizing Mte particles as a prion carrier and intranasal exposure. [ABSTRACT FROM AUTHOR]

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Increases in substance use prevalence among girls, as well as a lack of research conducted with urban girls of color, highlight the importance of understanding both predictors and outcomes of substance use abstinence (SUA) within this population. This study addresses gaps in SUA research through a longitudinal investigation conducted with urban black non-Latina and Latina girls (N = 597) as they transitioned through junior high school. Multivariate logistic regressions found social influences (i.e., friend/family use, drug access) to be significantly associated with girls’ SUA, although differential associations were found by race/ethnicity. SUA was also associated with positive adjustment and wellness by ninth grade. Implications for gender-specific prevention programming are discussed. [ABSTRACT FROM AUTHOR]

The theory of sensation seeking has conceptualized this construct as a stable personality trait associated with a variety of problem behaviors. Reckless behavior theory posits that increases in reckless behavior during adolescence can be attributed, in part, to increases in sensation seeking. This study evaluated patterns of stability and change in sensation seeking among 868 urban, minority youth (53% female), followed longitudinally across middle school (6th-8th grades). Group-based trajectory analysis identified a stable low group (20%), a moderate increasing group (60%), and a stable high group (20%) each of which demonstrated unique associations with changes in problem behaviors. Stable low sensation seekers reported consistently low levels of aggression, delinquency, and substance use across middle school. Moderate increasing sensation seekers reported significant increases in these risk behaviors over time from levels near zero in the 6th grade. Stable high sensation seekers reported high, stable levels of aggression and delinquency upon entry into middle school as well as significant increases in substance use across middle school. These results lend support to both theories and highlight a need for caution when categorizing adolescents as high or low sensation seekers. [ABSTRACT FROM AUTHOR]

This pilot study examined whether refusal assertion as defined by a proven drug prevention program was associated with adolescent perceptions of effectiveness by comparing two sets of coded responses to adolescent videotaped refusal role-plays ( N = 63). The original set of codes was defined by programmatic standards of refusal assertion and the second by a group of high school interns. Consistency with programming criteria was found for interns’ ratings of several indicators of verbal and non-verbal assertiveness. However, a strategy previously defined by the program as effective was perceived as ineffective by adolescents while another deemed ineffective and problematic by intervention developers was viewed as effective. Interns endorsed presenting detailed and reasonable arguments as an effective refusal strategy while short, simple statements were deemed ineffective. This study suggests the importance of including adolescent perspectives in the design, delivery, and evaluation of drug prevention strategies. [ABSTRACT FROM AUTHOR]

Research has begun to show associations between adolescents' mealtime practices and their engagement in problem behaviors. Few studies have addressed this longitudinally and/or examined lunchtime practices during the school day. This study tests for associations between urban multiethnic middle school students' (N = 1498) lunchtime practices in the sixth grade and their engagement in problem behaviors by eighth grade. Positive associations were found between not eating lunch at school in the sixth grade and increased drug use and delinquency by eighth grade. Eating lunch outside of school was found to be significantly associated with smoking and marijuana use only. Gender differences in associations between lunchtime practices and problem behaviors were suggested. Implications for school policy and prevention efforts are discussed. [ABSTRACT FROM AUTHOR]

Smoking rates are projected to increase substantially in developing countries such as South Africa. The aim of this study was to test the efficacy of two contrasting approaches to school-based smoking prevention in South African youth compared to the standard health education program. One experimental program was based on a skills training/peer resistance model and the other on a harm minimization model. Thirty-six public schools from two South African provinces, KwaZulu-Natal and the Western Cape, were stratified by socioeconomic status and randomized to one of three groups. Group 1 (comparison) schools ( n = 12) received usual tobacco use education. Group 2 schools ( n = 12) received a harm minimization curriculum in grades 8 and 9. Group 3 schools ( n = 12) received a life skills training curriculum in grades 8 and 9. The primary outcome was past month use of cigarettes based on a self-reported questionnaire. Five thousand two hundred sixty-six students completed the baseline survey. Of these, 4,684 (89%) completed at least one follow-up assessment. The net change in 30-day smoking from baseline to 2-year follow-up in the control group was 6% compared to 3% in both harm minimization (HM) and life skills training (LST) schools. These differences were not statistically significant. Intervention response was significantly moderated by both gender and race. The HM intervention was more effective for males, whereas the life skills intervention was more effective for females. For black African students, the strongest effect was evident for the HM intervention, whereas the strongest intervention effect for “colored” students was evident for the LST group. The two experimental curricula both produced similar overall reductions in smoking prevalence that were not significantly different from each other or the control group. However, the impact differed by gender and race, suggesting a need to tailor tobacco and drug use prevention programs. More intensive intervention, in the classroom and beyond, may be needed to further impact smoking behavior. [ABSTRACT FROM AUTHOR]

Background: Anger, a component of negative affect, has previously been associated with increased drug use primarily among white high school–aged students. However, few studies have examined these associations over time, and fewer have examined them among younger adolescents and students of color. Affective factors may play a greater role in drug use for girls relative to boys; yet, little is known regarding differences in associations between affect and drug use by gender. Methods: The current study used data from the control condition (N = 2025) of a drug and violence preventive intervention trial to examine the association between self-reported anger levels among multiethnic urban adolescents in the sixth grade and their use of cigarettes, alcohol, and marijuana use 1 year later. Potential gender differences were examined as well. Results: Multivariate generalized estimating equations models found anger to be significantly associated with increases in smoking, drinking, and marijuana use. There were no significant gender differences found for any of the drug use outcomes. Conclusions: Results are consistent with studies conducted on primarily white high school youth, where anger had a small but significant effect on drug use over time. The findings also suggest that drug prevention programs should include emotion regulation skills, such as anger management, in addition to drug resistance skills. [ABSTRACT FROM AUTHOR]

Violence is an important public health problem among adolescents in the United States. Substance use and violence tend to co-occur among adolescents and appear to have similar etiologies. The present study examined the extent to which a comprehensive prevention approach targeting an array of individual-level risk and protective factors and previously found effective in preventing tobacco, alcohol, and illicit drug use is capable of decreasing violence and delinquency. Schools (N=41) were randomly assigned to intervention and control conditions. Participants in the 20 intervention schools received the Life Skills Training prevention program including material focusing on violence and the media, anger management, and conflict resolution skills. Survey data were collected from 4,858 sixth grade students prior to the intervention and three months later after the intervention. Findings showed significant reductions in violence and delinquency for intervention participants relative to controls. Stronger prevention effects were found for students who received at least half of the preventive intervention. These effects include less verbal and physical aggression, fighting, and delinquency. The results of this study indicate that a school-based prevention approach previously found to prevent tobacco, alcohol, and illicit drug use can also prevent violence and delinquency. [ABSTRACT FROM AUTHOR]

Objectives: To examine associations among adolescents' generated verbal strategies (ie, Simple No, Declarative Statements, Excuse, Alternatives) and underlying nonverbal assertiveness in 2 refusal situations: smoking and shoplifting. Methods: Sixth-grade urban minority students (N = 454) participated in videotaped role-play assessments of peer refusal skills. Results: Differences were found by situation with students demonstrating greater use of Simple No in the smoking refusal and Alternatives in the shoplifting refusal. Nonverbal assertiveness was similar across situations and was associated with Declarative Statements, but only in the smoking refusal. Conclusions: Prevention programs should tailor refusal skills practice to cover multiple situations. [ABSTRACT FROM AUTHOR]

This article examines family, friend, and media influences on competent and problem behaviors in a sample of 1,174 urban minority youth followed over 6th, 7th, and 8th grades. Students completed annual surveys at their schools. Each of the contextual factors investigated was significantly associated with concurrent aggression and delinquency as well as changes in these outcomes over time. In contrast, parental monitoring was most often significantly associated with indicators of competence both concurrently and over time (e.g., from 7th to 8th grade). In addition, engagement with violent media contributed to decreases in academic achievement. Overall, findings indicate that family factors, specifically parental monitoring, as a target of intervention, would not only offset risk trajectories but enhance positive development. [ABSTRACT FROM AUTHOR]

Abstract: Given the recent debate over whether differential pathways to overt aggression and delinquency exist between boys and girls, this study examined sex differences in overt aggressive and delinquent acts along with potential differences in precursors (anger, self-control, family disruption) to antisocial behaviors among a sample of urban minority adolescents (N = 1559). Using a longitudinal design with data from 6th to 7th grade, results showed that girls had greater increases in rates of aggression relative to boys. Delinquency increased over time for both boys and girls, with boys consistently engaging in more delinquency. Girls and boys did not differ on the level of risk factors experienced except for a greater increase in anger over time for girls relative to boys. Across sex, anger and self-control predicted increases in both overt aggression and delinquency; family disruption also predicted increases in delinquency. Implications for subsequent studies on developmental process and preventive interventions are discussed. [Copyright &y& Elsevier]

This study used conflict resolution role play vignettes and self-report surveys of 450 New York City 6th graders to examine associations between adolescents’ conflict resolution efficacy and social skills. Vignettes covered 3 social contexts, conflict with a peer (disagreement over activities), with a parent (raise in allowance), and with a teacher (low grade on report). Effective and ineffective strategies for resolving these conflicts were coded from the videotaped interactions. Adolescents were more often effective in resolving conflict with peers than with parents (χ2(1) = 7.10, p < .01). Strong communication skills cut across interpersonal context as associated with effective resolution. Assertiveness and absence of aggression were associated with effective conflict resolution in vignettes with peers. Assertiveness was also associated with effective conflict resolution in vignettes with parents, however nervousness was unexpectedly found to facilitate conflict resolution in vignettes with parents. Only skills observed within a particular context were associated with effective resolution in that context; self-report skills and cross-context observed skills were not associated with efficacy. Implications for implementation and evaluation of social skills curricula and conflict resolution process are discussed. [ABSTRACT FROM AUTHOR]

This study examined associations between maternal social influences to smoke and girls' early smoking behaviors. Data were collected separately from 450 urban minority girls (65.7% Black, 21.5% Latina, and 12.8% other) and their mothers on smoking frequency as well as demographic and social factors hypothesized to promote smoking. Results showed perception of mothers' smoking to be associated with girls' early smoking behaviors, whereas mothers' report of their smoking status was not. Interactions were found between ethnicity and perception of mothers' smoking, with Black girls more influenced by their perceptions of mothers' smoking status and by mothers' expectations of adult smoking than Latinas. Findings are discussed in terms of implications for preventive efforts and recommendations for future studies with urban populations. [ABSTRACT FROM AUTHOR]

Despite implementation of enhanced management practices, chronic wasting disease in US white-tailed deer (Odocoileus virginianus) continues to expand geographically. Herein, we perform the largest genome-wide association analysis to date for chronic wasting disease (n=412 chronic wasting disease-positive; n=758 chronic wasting disease-nondetect) using a custom Affymetrix Axiom single-nucleotide polymorphism array (n=121,010 single-nucleotide polymorphisms), and confirm that differential susceptibility to chronic wasting disease is a highly heritable (h2 = 0:611 6 0:056) polygenic trait in farmed US white-tailed deer, but with greater trait complexity than previously appreciated. We also confirm PRNP codon 96 (G96S) as having the largest-effects on risk (P=3.19E-08; phenotypic variance explained 0.025) across 3 US regions (Northeast, Midwest, South). However, 20 chronic wasting disease-positive white-tailed deer possessing codon 96SS genotypes were also observed, including one that was lymph node and obex positive. Beyond PRNP, we also detected 23 significant single-nucleotide polymorphisms (P-value 5E-05) implicating 24 positional candidate genes; many of which have been directly implicated in Parkinson's, Alzheimer's and prion diseases. Genotype-by-environment interaction genome-wide association analysis revealed a single-nucleotide polymorphism in the lysosomal enzyme gene ARSB as having the most significant regional heterogeneity of effects on chronic wasting disease (P=3.20E-06); with increasing copy number of the minor allele increasing susceptibility to chronic wasting disease in the Northeast and Midwest; but with opposite effects in the South. In addition to ARSB, 38 significant genotype-byenvironment single-nucleotide polymorphisms (P-value 5E-05) were also detected, thereby implicating > 36 positional candidate genes; the majority of which have also been associated with aspects of Parkinson's, Alzheimer's, and prion diseases. [ABSTRACT FROM AUTHOR]

Chronic wasting disease (CWD) is a fatal prion disease of cervids spreading across North America. More effective mitigation efforts may require expansion of the available toolkit to include new methods that provide earlier antemortem detection, higher throughput, and less expense than current immunohistochemistry (IHC) methods. The rectal mucosa near the rectoanal junction is a site of early accumulation of CWD prions and is safely sampled in living animals by pinch biopsy. A fluorescence-based, 96-well format, protein-aggregation assay—the real-time quaking-induced conversion (RT-QuIC) assay—is capable of ultra-sensitive detection of CWD prions. Notably, the recombinant protein substrate is crucial to the assay's performance and is now commercially available. In this blinded independent study, the preclinical diagnostic performance of a standardized RT-QuIC protocol using a commercially sourced substrate (MNPROtein) and a laboratory-produced substrate was studied using mock biopsy samples of the rectal mucosa from 284 white-tailed deer (Odocoileus virginianus). The samples were from a frozen archive of intact rectoanal junctions collected at depopulations of farmed herds positive for CWD in the United States. All deer were pre-clinical at the time of depopulation and infection status was established from the regulatory record, which evaluated the medial retropharyngeal lymph nodes (MRPLNs) and obex by CWD-IHC. A pre-analytic sample precipitation step was found to enhance the protocol's detection limit. Performance metrics were influenced by the choice of RT-QuIC diagnostic cut points (minimum number of positive wells and assay time) and by deer attributes (preclinical infection stage and prion protein genotype). The peak overall diagnostic sensitivities of the protocol were similar for both substrates (MNPROtein, 76.8%; laboratory-produced, 73.2%), though each was achieved at different cut points. Preclinical infection stage and prion protein genotype at codon 96 (G = glycine, S = serine) were primary predictors of sensitivity. The diagnostic sensitivities in late preclinical infections (CWD-IHC positive MPRLNs and obex) were similar, ranging from 96% in GG96 deer to 80% in xS96 deer (x = G or S). In early preclinical infections (CWD-IHC positive MRPLNs only), the diagnostic sensitivity was 64–71% in GG96 deer but only 25% in xS96 deer. These results demonstrate that this standardized RT-QuIC protocol for rectal biopsy samples using a commercial source of substrate produced stratified diagnostic sensitivities similar to or greater than those reported for CWD-IHC but in less than 30 hours of assay time and in a 96-well format. Notably, the RT-QuIC protocol used herein represents a standardization of protocols from several previous studies. Alignment of the sensitivities across these studies suggests the diagnostic performance of the assay is robust given quality reagents, optimized diagnostic criteria, and experienced staff. [ABSTRACT FROM AUTHOR]

This study examined individual and familial influences on Black female adolescents' (N = 1426) sexual pleasure expectancies, sexual guilt, and age of sexual debut using data from the National Longitudinal Study on Adolescent to Adult Health. Results indicated significant differences between Black female adolescents that were sexually active and those that were not. Religious importance, having a residential father, and perceived pubertal timing were significantly associated with sexual guilt and pleasure expectancies. Religious importance and perceived pubertal timing were also associated with later ages of sexual debut. These results have implications for sexuality education and future research using sex positive and intimate justice frameworks. [ABSTRACT FROM AUTHOR]

Chronic wasting disease (CWD) is a prionopathy affecting wild and farmed cervids. This disease is endemic in North America and has been recently identified in Europe. Ante-mortem CWD tests of pre-clinical cervids may be an important tool in helping control the spread of this disease. Unfortunately, current CWD diagnostic methods are not suitable for non-tissue type samples. We reported that CWD prions can be detected in blood of pre-clinical CWD-infected white-tailed deer (WTD) with high sensitivity and specificity using the Protein Misfolding Cyclic Amplification (PMCA) assay. However, that report only included animals homozygous for codon 96G, the most common polymorphic version of the prion protein within this animal species. Here, we report CWD prion detection using blood of naturally infected WTD coding one or two copies of the PrP-96S polymorphic variant. Our results, from a blinded screening, show 100% specificity and ~ 58% sensitivity for animals harboring one 96S codon, regardless of their stage within the pre-clinical phase. Detection efficiency for PrP-96S homozygous animals was substantially lower, suggesting that this allele affect peripheral prion replication/tropism. These results provide additional information on the influence of codon 96 polymorphisms and the ability of PMCA to detect CWD in the blood of pre-clinical WTD. [ABSTRACT FROM AUTHOR]

Objective: To examine the relationship between race, gender, and pre-hookup relationship intentions and college students' participation in condomless vaginal sex. Participants: 3,315 Black and White college students who participated in the Online College Social Life Survey (OCSLS). Methods: Secondary data analysis of the OCSLS using Chi-square and multiple logistic regression analyses. Results: The model revealed that students who did not want a relationship with their hookup partners and students unsure of their relationship intentions were more likely to use condoms during their last vaginal hookup. Further, White and Female students were less likely to have used condoms during their last vaginal hookup. Conclusions: White and female students, as well as students desiring romantic relationships with hookup partners may be at risk for sexually transmitted infections (STIs) due to decreased condom use. However, more research is needed to explore the factors driving STI disparities facing Black students despite higher condom use. [ABSTRACT FROM AUTHOR]

Chronic wasting disease (CWD) continues to spread in wild and farmed cervid populations. Early antemortem CWD testing of farmed cervids is of considerable interest to producers and regulatory agencies as a tool to combat this spread. The tissues accessible for antemortem sampling are limited and include biopsy of the tonsil and recto-anal mucosa-associated lymphoid tissue (RAMALT). The sensitivity to detect CWD by immunohistochemistry (IHC)—the regulatory gold standard—using biopsy samples of RAMALT from naturally infected white-tailed deer (WTD) has been determined by several studies. However, similar information is lacking for tonsil biopsy. In this study, two-bite tonsil biopsies from 79 naturally infected farmed WTD were used to determine the diagnostic sensitivity of tonsil IHC compared to the official CWD status based on results from the medial retropharyngeal lymph nodes and obex. IHC detection of CWD by tonsil biopsy was compared to the result and follicle metrics from the contralateral whole tonsil. The sensitivity of two-bite tonsil biopsy for detecting CWD by IHC was 72% overall. When the stage of infection was considered, the sensitivity was 92% for deer in late preclinical infection but only 55% for early preclinical infection. For deer with early preclinical infection, the sensitivity for deer homozygous for the prion protein gene (PRNP) coding for glycine at codon 96 (GG) was 66% but only 30% when heterozygous for the serine substitution (GS). The results indicate that the sensitivity of two-bite tonsil biopsy in WTD, and consequently its potential utility as an antemortem diagnostic, is limited during early infection, especially in WTD heterozygous for the serine substitution at PRNP codon 96. [ABSTRACT FROM AUTHOR]

Narcofeminism Storyshare is an iterative storyshare model developed by NC Survivors Union, a harm reduction and advocacy organization led by directly impacted people, that uses autobiographical story development by women and gender diverse people who use drugs to disrupt stigmatizing societal narratives, achieve healing for individuals and communities, and spark organizing and structural change. We describe the theoretical frameworks behind Narcofeminism Storyshare, including the international movement of narcofeminism, narrative theory, and stigma reduction theory. We detail the components of the Narcofeminism Storyshare process–structural analysis conversations, group editing, one-on-one peer editing, grounding our stories in the evidence base, completing various types of story exercises that Narcofeminism Storyshare has developed, the creation of trauma-informed spaces, and the utilization of the stories in advocacy and trainings for health and social service professionals. Finally, we conclude by describing lessons learned while developing the model that may be useful for other organizations working in this capacity as well as by outlining the model's unique contribution to the field. [ABSTRACT FROM AUTHOR]

Chronic wasting disease (CWD) is a prevalent prion disease affecting cervids. CWD is thought to be transmitted through direct animal contact or by indirect exposure to contaminated environmental fomites. Other mechanisms of propagation such as vertical and maternal transmissions have also been suggested using naturally and experimentally infected animals. Here, we describe the detection of CWD prions in naturally-infected, farmed white-tailed deer (WTD) fetal tissues using the Protein Misfolding Cyclic Amplification (PMCA) technique. Prion seeding activity was identified in a variety of gestational and fetal tissues. Future studies should demonstrate if prions present in fetuses are at sufficient quantities to cause CWD after birth. This data confirms previous findings in other animal species and furthers vertical transmission as a relevant mechanism of CWD dissemination. [ABSTRACT FROM AUTHOR]

Efforts to contain the spread of chronic wasting disease (CWD), a fatal, contagious prion disease of cervids, would be aided by the availability of additional diagnostic tools. RT-QuIC assays allow ultrasensitive detection of prion seeds in a wide variety of cervid tissues, fluids and excreta. The best documented antemortem diagnostic test involving RT-QuIC analysis targets lymphoid tissue in rectal biopsies. Here we have tested a more easily accessed specimen, ear pinna punches, using an improved RT-QuIC assay involving iron oxide magnetic extraction to detect CWD infections in asymptomatic mule and white-tailed deer. Comparison of multiple parts of the ear pinna indicated that a central punch spanning the auricular nerve provided the most consistent detection of CWD infection. When compared to results obtained from gold-standard retropharyngeal lymph node specimens, our RT-QuIC analyses of ear samples provided apparent diagnostic sensitivity (81%) and specificity (91%) that rivaled, or improved upon, those observed in previous analyses of rectal biopsies using RT-QuIC. These results provide evidence that RT-QuIC analysis of ear pinna punches may be a useful approach to detecting CWD infections in cervids. [ABSTRACT FROM AUTHOR]

Chronic wasting disease (CWD) is a rapidly spreading prion disease of cervids, yet antemortem diagnosis, treatment, and control remain elusive. We recently developed an organotypic slice culture assay for sensitive detection of scrapie prions using ultrasensitive prion seeding. However, this model was not established for CWD prions due to their strong transmission barrier from deer (Odocoileus spp) to standard laboratory mice (Mus musculus). Therefore, we developed and characterized the ex vivo brain slice culture model for CWD, using a transgenic mouse model (Tg12) that expresses the elk (Cervus canadensis) prion protein gene (PRNP). We tested for CWD infectivity in cultured slices using sensitive seeding assays such as real-time quaking-induced conversion (RT-QuIC) and protein misfolding cyclic amplification (PMCA). Slice cultures from Tg12, but not from prnp−/− mice, tested positive for CWD. Slice-generated CWD prions transmitted efficiently to Tg12 mice. Furthermore, we determined the activity of anti-prion compounds and optimized a screening protocol for the infectivity of biological samples in this CWD slice culture model. Our results demonstrate that this integrated brain slice model of CWD enables the study of pathogenic mechanisms with translational implications for controlling CWD. [ABSTRACT FROM AUTHOR]

This secondary analysis re-examined stories of caregiving told by NICU nurses in the southeast US through a trauma theory lens expanding on research surrounding substance-exposed pregnancies. Narrative analysis identified distress-related experiences of nurses related to child custody decisions and outcomes, suggesting traumatic stress within this caregiving dynamic. Four distinct story types and three themes were identified across 23 stories, highlighting similarities and differences and illustrating how distress and trauma were experienced and may be manifested in care practices. Study findings suggest cumulative and residual effects from traumatic experiences can impact NICU nurses' well-being and care provision, in part by promoting anticipatory trauma. The role of relationship-building with families, as part of family-centered care, was also implicated in the intensity of distressful experiences and may increase nurses' vulnerability to trauma as well as create pathways to stigmatizing interactions. Incorporating principles of relational ethics into nurse practice guidelines, while recognizing how care work can influence and be influenced by the potential pathways from trauma to stigma, may provide valuable support for nurses. The application of such a framework could potentially reduce distressing and/or traumatic experiences for nurses caring for families with a substance-exposed pregnancy., (© 2024 The Author(s). Nursing Inquiry published by John Wiley & Sons Ltd.)

Chronic wasting disease (CWD) is a naturally occurring prion disease in cervids that has been rapidly proliferating in the United States. Here, we investigated a potential link between CWD infection and gut microbiome by analyzing 50 fecal samples obtained from CWD-positive animals of different sexes from various regions in the USA compared to 50 CWD-negative controls using high throughput sequencing of the 16S ribosomal RNA and targeted metabolomics. Our analysis reveals promising trends in the gut microbiota that could potentially be CWD-dependent, including several bacterial taxa at each rank level, as well as taxa pairs, that can differentiate between CWD-negative and CWD-positive deer. Through machine-learning, these taxa and taxa pairs at each rank level could facilitate identification of around 70% of both the CWD-negative and the CWD-positive samples. Our results provide a potential tool for diagnostics and surveillance of CWD in the wild, as well as conceptual advances in our understanding of the disease.IMPORTANCEThis is a comprehensive study that tests the connection between the composition of the gut microbiome in deer in response to chronic wasting disease (CWD). We analyzed 50 fecal samples obtained from CWD-positive animals compared to 50 CWD-negative controls to identify CWD-dependent changes in the gut microbiome, matched with the analysis of fecal metabolites. Our results show promising trends suggesting that fecal microbial composition can directly correspond to CWD disease status. These results point to the microbial composition of the feces as a potential tool for diagnostics and surveillance of CWD in the wild, including non-invasive CWD detection in asymptomatic deer and deer habitats, and enable conceptual advances in our understanding of the disease., Competing Interests: A.D., M.B., G.K., A.Z., and B.K. are employed by Sigma Aldrich and Millipore Sigma, affiliates of Merck KGaA, Darmstadt, Germany.

Aims: To explore the effects of power dynamics and hospital organizational structure upon neonatal intensive care nurses' experiences caring for infants and families from a substance-exposed pregnancy (SEP)., Design: This secondary data analysis further investigated the results of a primary study after the original analysis suggested differences in work environments may impact relationship-building opportunities between nurses and mothers/families. Critical discourse analysis served as both the theoretical lens and analytic technique., Method: Nine (9) nurses from the southeast region of the United States (U.S.) were interviewed in 2019. Fifty-one (51) stories of caregiving experiences were analysed with a focus on narratives related to organizational structure and care delivery., Results: Study findings revealed nurses experienced challenges providing high-quality, family-centered care for patients in the neonatal intensive care unit (NICU) affected by substances during pregnancy. Nurses described the central challenge of workload, exacerbated by power imbalances and structural constraints within the hospital's organizational structure. Findings suggest workload issues may endorse stigma by inhibiting opportunities to build relationships. Nurses report manageable workloads can support healthcare teams and recipients of care., Conclusion: The study suggests power imbalances between nurses, families and adjacent healthcare professionals can inhibit the delivery of high-quality care. Supporting healthcare teams and recipients of care while centering the role of organizational structure is critical. Questions emerged about workload demands impacting the potential production of stigma in clinical environments., Impact: This study examines the intersection of nurses' care experiences and hospital organizational structure. It identifies how the unique needs of caring for infants and families from a SEP increase the complexity of power imbalances and organizational constraints to further increase workload demands. Findings have implications for global healthcare organization leaders who build and maintain the structural integrity of clinical environments and nurse leaders who advocate and guide clinical teams to provide high-quality care in stressful healthcare environments., Reporting Method: EQUATOR guidelines were followed, using the COREQ checklist., Patient or Public Contribution: NICU nurses were interviewed about their care-provision experiences. Interviews were analysed in the primary study and the current analysis of secondary data., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Chronic wasting disease (CWD) is a prion disease affecting farmed and free-ranging cervids. CWD is rapidly expanding across North America and its mechanisms of transmission are not completely understood. Considering that cervids are commonly afflicted by nasal bot flies, we tested the potential of these parasites to transmit CWD. Parasites collected from naturally infected white-tailed deer were evaluated for their prion content using the protein misfolding cyclic amplification (PMCA) technology and bioassays. Here, we describe PMCA seeding activity in nasal bot larvae collected from naturally infected, nonclinical deer. These parasites efficiently infect CWD-susceptible mice in ways suggestive of high infectivity titers. To further mimic environmental transmission, bot larvae homogenates were mixed with soils, and plants were grown on them. We show that both soils and plants exposed to CWD-infected bot homogenates displayed seeding activity by PMCA. This is the first report describing prion infectivity in a naturally occurring deer parasite. Our data also demonstrate that CWD prions contained in nasal bots interact with environmental components and may be relevant for disease transmission., (© 2024. The Author(s).)

Chronic wasting disease (CWD) is a fatal transmissible spongiform encephalopathy that affects both free-ranging and farmed cervid species, including mule deer, white-tailed deer, and elk ( Odocoileus hemionus, Odocoileus virginianus , and Cervus canadensis ). Due to the long incubation period and variability of clinical signs, CWD can expand and spread to new areas before they reach diagnostically detectable levels. Antemortem testing methods currently available can be difficult to obtain and to be applied to the large numbers required for adequate surveillance. However, key volatile biomarkers could be harnessed for non-invasive antemortem surveillance. Detection dogs are the most effective tool currently available for volatile detection; dogs can effectively complete wildlife surveys at rates surpassing that of humans. This study is the first to demonstrate that trained detection dogs can be used as an antemortem test for CWD. First, we trained three dogs to differentiate between CWD-positive and CWD-negative white-tailed deer faeces in a laboratory setting. Dogs spent significantly more time at the positive sample than the negative samples, suggesting that they differentiated between the positive and negative volatile signatures. We then trained the same dogs to search for CWD-positive faecal samples in a more naturalistic field setting. In the field, dogs found 8/11 CWD-positive samples and had an average false detection rate of 13%. These results suggest that dogs can be trained to differentiate CWD-positive faeces from CWD-negative faeces in both laboratory and field settings. Future studies will compare canine accuracy to other antemortem methods, as well as improved canine training methods.

Chronic wasting disease (CWD) is a prion disease affecting cervids. Confirmatory testing of CWD is currently performed postmortem in obex and lymphoid tissues. Extensive evidence demonstrates the presence of infectious prions in feces of CWD-infected deer using in vitro prion-amplification techniques and bioassays. In experimental conditions, this has been achieved as soon as 6-month post-inoculation, suggesting this sample type is a candidate for antemortem diagnosis. In the present study, we optimized the detection of CWD-prions in fecal samples from naturally infected, pre-clinical white-tailed deer by comparing protocols aiming to concentrate CWD-prions with direct spiking of the sample into the PMCA reactions. Results of this screening were compared with similar analyses made in blood. Our data shows that CWD-prion detection in feces using PMCA is best in the absence of sample pre-treatments. We performed a screening of 169 fecal samples, detecting CWD-prions with diagnostic sensitivity and specificity of 54.81% and 98.46%, respectively. In addition, the PMCA seeding activity of 76 fecal samples was compared with that on blood of matched deer. Our findings, demonstrate that CWD-prions in feces and blood are increased at late pre-clinical stages, exhibiting similar detection in both sample types (> 90% sensitivity) when PrP96GG animals are tested. Our findings contribute to understand prion distribution across different biological samples and polymorphic variants in white-tailed deer. This information is also relevant for the current efforts to identify platforms to diagnose CWD., (© 2023. The Author(s).)

Disclosure is the act of sharing a stigmatized identity, and members of the LGBTQ+ community make decisions related to disclosure multiple times throughout their life. Disclosure in medical settings can impact perceptions of care and outcomes for LGBTQ+ patients; however, little is understood about the process of decision-making regarding disclosure in the genetic counseling setting. As such, this study aimed to explore LGBTQ+ experiences in genetic counseling sessions and their disclosure behaviors. Fifty-five LGBTQ+ individuals who attended a genetic counseling session and 91 genetic counselors completed online surveys. The patient survey assessed for disclosure behaviors, experiences of discrimination, and comfort in genetic counseling sessions. The counselor survey evaluated comfort with the LGBTQ+ population in a counseling setting, whether counselors facilitate disclosure in sessions, and whether counseling is tailored for the LGBTQ+ population. Eighty-two percent of genetic counselors "rarely" or "never" ask about sexual orientation, and 69% "rarely" or "never" ask about gender identity. The majority of patients indicated they were not asked about their sexual orientation (87%) or gender identity (80%). Some patients reported experiencing discrimination or homo/transphobia in their genetic counseling sessions, with 6.12% of LGBQ+ patients experiencing discrimination and 24.1% of trans+ patients reporting discrimination. Over half of genetic counselors reported receiving training in LGBTQ+ healthcare and the majority reported comfort with providing care to LGBTQ+ patients. However, discrepancies between patient-reported experiences and genetic counselors' descriptions of their care for the LGBTQ+ population warrant further research and suggest additional training or changes in practice may be necessary., (© 2023 The Authors. Journal of Genetic Counseling published by Wiley Periodicals LLC on behalf of National Society of Genetic Counselors.)

Chronic wasting disease (CWD) is an infectious prion disease affecting the cervids, including white-tailed deer (WTD) ( Odocoileus virginianus ). CWD is typically diagnosed postmortem in farmed cervids by immunohistochemistry (IHC). Amplification-based detection methods are newer generation tests currently being evaluated to improve the detection of prion disease. In addition to improving sensitivity, antemortem detection by amplification assays is a focus for improving disease control and management. In this study, we evaluate the use of real-time quaking-induced conversion (RT-QuIC) to detect CWD in fecal and recto-anal mucosal-associated lymphoid tissue (RAMALT) samples from naturally infected farmed WTD herds at postmortem . We successfully detected the presence of CWD prions in WTD RAMALT with a specificity of 100% and a sensitivity of 85.7% ( n = 71) and in feces with a specificity of 100% and a sensitivity of 60% ( n = 69), utilizing RT-QuIC on samples collected postmortem . Seeding activity detected in RAMALT (15.3 ± 4.2%, n = 18) was much stronger than in feces (44.4 ± 4.2%, n = 15), as measured by cycle threshold (Ct) and rise in relative fluorescence in samples collected from the same WTD. Prion detection in the RAMALT (94.7%) and feces (70.5%) was highest when both obex and retropharyngeal lymph nodes (RPLNs) were positive for CWD via IHC. In the study group, we were also able to test prion protein gene variants and associated disease susceptibility. A majority of tested WTD were the CWD genotype (96 GG) and also harbored the highest percentage of positive animals (43.7%). The second highest population of WTD was the genotype 96 GS and had a CWD positivity rate of 37.5%. Each of these groups showed no difference in RAMALT or fecal detection of CWD., Competing Interests: Author DH was employed by CWD Evolution LLC. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tewari, Fasnacht, Ritzman, Livengood, Bower, Lehmkuhl, Nichols, Hamberg, Brightbill and Henderson.)

Purpose: To explore the caregiving dynamic between NICU nurses and mothers with a substance-exposed pregnancy (SEP) by examining how nurses view these mothers compared to mothers without an SEP., Design: A qualitative design using interviews with NICU nurses who care for infants and families with an SEP., Sample: The sample (n = 9) was all female, with an average of approximately 10 years of nursing experience in the NICU, with two-thirds having achieved a Bachelor of Science in Nursing (BSN) or higher., Main Outcome Variable: Perceptions of nurses working with families affected by an SEP., Results: Stigmatized views and trust issues shaped nurses' views of mothers with an SEP as different from other mothers. Empathy levels toward mothers differed related to nurses' views of substance use as either a moral decision or chronic disease. These viewpoints shaped the nurse's judgment of the mother's potential to provide a safe environment and independently care for the infant at home. Nurses described personal distress when caring for these families., (© Copyright 2022 Springer Publishing Company, LLC.)

There is limited research on how Black women's perspectives of their relationship influence their sexual experiences (i.e., sex initiation and orgasm frequency) in early adulthood. This quantitative study examined the association between relationship and partner-specific factors (e.g., relationship satisfaction, love, egalitarianism, partner's age, physical violence) with the sexual experiences of 216 Black heterosexual women (ages 19-27) from Wave III of the National Longitudinal Study on Adolescent to Adult Health (Add Health), the majority of the sample report being in long-standing, committed, loving, monogamous, and egalitarian relationships with older men. Most participants reported having an orgasm more than half the time when they have sexual intercourse (62%), and that they equally initiate sex with their partners (55%), with only 18% reporting that they initiate sex most of the time. Results indicated that relationship and partner-specific factors were significantly associated with initiating sexual intercourse and/or orgasm frequency. Egalitarianism was the only factor that was significantly associated with orgasm frequency and the three types of sex initiation. Physical violence and verbal threats were associated with equal initiation and partner initiation. There were no significant associations between any partner-specific factors and women initiating sex more often in their relationship. Implications for sex research and sexuality education are discussed.

Introduction: Increases in opioid use during pregnancy fueled concerns among reproductive health advocates, policy makers, and providers in North Carolina, United States. A stakeholder group designed a set of knowledge translation (KT) interventions to increase the use of evidence-based practices across relevant health care and social service arenas. Efforts to decrease stigma was included as a best practice. Understanding the process and the contexts in which KT intervention activities occur can help increase their effectiveness. Toward that end, this study examined how stigma was addressed and how audiences responded to evidence-based messages., Methods: Data were collected over a seven-year period and included observations of KT activities (conferences, workshops, and community meetings), focus groups and interviews conducted with providers, and a review of publicly available documents, including KT intervention materials. Clarke's situational mapping was initially applied, and stigma emerged as a critical contextual element. Data were then analyzed to identify how stigma was addressed and how evidence-based messages were received., Results: Despite direct stigma-reduction messages, biases against maternal drug use and ambivalence toward evidence-based recommendations of harm reduction principles were found in audience responses. Findings also revealed tensions around the interpretation of knowledge and the appropriate implementation of best practices between "experts" and among practitioners., Discussion: Stigma and professional biases may serve as significant barriers to KT activities. Results suggest that even under the best of circumstances, evidence-based practices for highly stigmatized and controversial issues are difficult to disseminate and may require unique approaches.