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ABSTRACTJustice-impacted persons may inconsistently access HIV testing. This cross-sectional secondary analysis investigates lifetime HIV testing prevalence among adults with prior histories of incarceration in Southern California, United States, participating in health-focused programming (n = 3 studies). Self-reported demographic and lifetime HIV testing data were collected between 2017-2023; descriptive analyses were conducted. Across the three samples, at least 74% of participants were male; Latino and African American individuals accounted for nearly two-thirds of participants. Lifetime HIV testing ranged from 72.8% to 84.2%. Males were significantly more likely than females to report never being tested in two samples and accounted for >95% of those never tested. No statistically significant differences in testing were observed by race/ethnicity. Single young adults (ages 18-26) were less likely than their partnered peers to report testing. HIV testing is critical for ensuring that individuals access prevention and treatment. HIV testing among justice-impacted adults in this study was higher than in the general population, potentially due to opt-out testing in correctional settings. Nevertheless, these findings underscore the importance of implementing targeted interventions to reduce structural (e.g., health insurance, access to self-testing kits) and social barriers (e.g., HIV stigma) to increase HIV testing among justice-impacted males and single young adults.

Interdisciplinary service-learning (IDSL) has become a staple of healthcare education over the last two decades as a mechanism of training students to provide cohesive, team-based health care in a complicated and sometimes fragmented health care system. This case study describes the perceived learning of Doctor of Physical Therapy (DPT) students from [Blinded] University who attended a week-long interdisciplinary, interuniversity service-learning trip in rural [Blinded]. Qualitative data from two consecutive year teams (n = 26) were collected via surveys and focus groups and thematically analyzed for motivation to attend the trip and perceived learning. Intrinsic motivation to "give back" and desire to hone professional skills were the primary drivers for desiring to attend the trip. Three themes of perceived learning that emerged were: 1) impact on core values, 2) perceived improvement in para-clinical (soft) skills including interdisciplinary fluency and cultural competence, and 3) improvement of clinical (hard) skills. The dominant theme was the impact the trip had on students' core values. The learning occurred predominantly in Bloom's affective domain and aligned with the physical therapy profession's Core Values and Code of Ethics.

BackgroundReward and threat processes work together to support adaptive learning during development. Adolescence is associated with increasing approach behavior (e.g., novelty-seeking, risk-taking) but often also coincides with emerging internalizing symptoms, which are characterized by heightened avoidance behavior. Peaking engagement of the nucleus accumbens (NAcc) during adolescence, often studied in reward paradigms, may also relate to threat mechanisms of adolescent psychopathology.Methods47 typically developing adolescents (9.9-22.9 years) completed an aversive learning task during functional magnetic resonance imaging, wherein visual cues were paired with an aversive sound or no sound. Task blocks involved an escapable aversively reinforced stimulus (CS+r), the same stimulus without reinforcement (CS+nr), or a stimulus that was never reinforced (CS-). Parent-reported internalizing symptoms were measured using Revised Child Anxiety and Depression Scales.ResultsFunctional connectivity between the NAcc and amygdala differentiated the stimuli, such that connectivity increased for the CS+r (p = .023) but not for the CS+nr and CS-. Adolescents with greater internalizing symptoms demonstrated greater positive functional connectivity for the CS- (p = .041).ConclusionsAdolescents show heightened NAcc-amygdala functional connectivity during escape from threat. Higher anxiety and depression symptoms are associated with elevated NAcc-amygdala connectivity during safety, which may reflect poor safety versus threat discrimination.

Globalization of fishery products is playing a significant role in shaping the harvesting and use of aquatic foods, but a vigorous debate has focused on whether the trade is a driver of the inequitable distribution of aquatic foods. Here, we develop species-level mass balance and trophic level identification datasets for 174 countries and territories to analyze global aquatic food consumption patterns, trade characteristics, and impacts from 1976 to 2019. We find that per capita consumption of aquatic foods has increased significantly at the global scale, but the human aquatic food trophic level (HATL), i.e., the average trophic level of aquatic food items in the human diet, is declining (from 3.42 to 3.18) because of the considerable increase in low-trophic level aquaculture species output relative to that of capture fisheries since 1976. Moreover, our study finds that trade has contributed to increasing the availability and trophic level of aquatic foods in >60% of the worlds countries. Trade has also reduced geographic differences in the HATL among countries over recent decades. We suggest that there are important opportunities to widen the current focus on productivity gains and economic outputs to a more equitable global distribution of aquatic foods.

COVID-19 created an opportunity to (re)envision students as partners in curriculum development and the curriculum process. Understanding the design and delivery of courses as a flattened hierarchy, particularly with graduate students as partners, is the focus of this study. This article reports findings from research undertaken collaboratively with students as partners in developing a new approach for conducting a capstone course and project. This research was enacted at a research-intensive university in the United States in 2020 and 2021. We describe the need for the shift in stance to students as partners in our institution as well as what the findings indicate as imperatives for teachers in both K-12 settings and institutions of higher education. The findings indicate how teachers' mental health and experiences of stress were affected by specific attributes of the pandemic and pandemic teaching (which aligns with the majority of COVID-19 research in education), as well as how some learned to cope with these demands. Findings also indicate the need for flexibility in all learning environments.

Behavioral speech tasks have been widely used to understand the mechanisms of speech motor control in typical speakers as well as in various clinical populations. However, determining which neural functions differ between typical speakers and clinical populations based on behavioral data alone is difficult because multiple mechanisms may lead to the same behavioral differences. For example, individuals with cerebellar ataxia (CA) produce atypically large compensatory responses to pitch perturbations in their auditory feedback, compared to typical speakers, but this pattern could have many explanations. Here, computational modeling techniques were used to address this challenge. Bayesian inference was used to fit a state feedback control (SFC) model of voice fundamental frequency (fo) control to the behavioral pitch perturbation responses of speakers with CA and typical speakers. This fitting process resulted in estimates of posterior likelihood distributions for five model parameters (sensory feedback delays, absolute and relative levels of auditory and somatosensory feedback noise, and controller gain), which were compared between the two groups. Results suggest that the speakers with CA may proportionally weight auditory and somatosensory feedback differently from typical speakers. Specifically, the CA group showed a greater relative sensitivity to auditory feedback than the control group. There were also large group differences in the controller gain parameter, suggesting increased motor output responses to target errors in the CA group. These modeling results generate hypotheses about how CA may affect the speech motor system, which could help guide future empirical investigations in CA. This study also demonstrates the overall proof-of-principle of using this Bayesian inference approach to understand behavioral speech data in terms of interpretable parameters of speech motor control models.

The global population consumes more seafood from aquaculture today than from capture fisheries and although the aquaculture industry continues to grow, both seafood sectors will continue to be important to the global food supply into the future. As farming continues to expand into ocean systems, understanding how wild populations and fisheries will interact with farms will be increasingly important to informing sustainable ocean planning and management. Using a spatially explicit population and fishing model we simulate several impacts from ocean aquaculture (i.e., aggregation, protection from fishing, and impacts on fitness) to evaluate the mechanisms underlying interactions between aquaculture, wild populations and fisheries. We find that aggregation of species to farms can increase the benefits of protection from fishing that a farm provides and can have greater impacts on more mobile species. Splitting total farm area into smaller farms can benefit fishery catches, whereas larger farms can provide greater ecological benefits through conservation of wild populations. Our results provide clear lessons on how to design and co-manage expanding ocean aquaculture along with wild capture ecosystem management to benefit fisheries or conservation objectives.

This study extends research on perspectival understanding (Greeno & van de Sande, 2007) by using Du Bois' (2007) discourse work on stancetaking to investigate how students expressed their perspectives on course content through a variety of stances/positions as they negotiated meaning in online discussions. Participants were students in a hybrid graduate-level course with weekly synchronous computer-mediated discussions. Adapting Du Bois' stancetaking triangle, we coded discussion transcripts for shifts in stance and for evidence of influence on students' perspective taking as they considered course concepts. Findings were that stances and stance objects (that is, topics) were introduced as students collaborated in discussion, with an epistemic stance indicating students' primary focus on wanting to learn and understand course concepts. Evaluative and affective stances were less frequent and most often intertwined with an epistemic stance but nevertheless important in supporting the group's discussion. Synchronous online discussions afforded a venue for iterative discourse interactions of evaluation, positioning, and alignment and for shared knowledge co-construction and perspectival understanding.

BackgroundDrug overdoses are the leading cause of injury death in the United States with an estimated 105,752 individuals dying from an overdose in the United States in a 12-month period ending October 2021. Given that people who have opioid use disorder (OUD) are at an increased risk of death, it is crucial to assess risk factors associated with opioid overdose to improve interventions.ObjectivesWe examine factors associated with non-fatal overdose among a suburban/exurban population with OUD in Southern California.MethodsParticipants were recruited by convenience sampling (n = 355) and were interviewed between November 2017 to August 2018. Participants were eligible for the study if they had a history of pharmaceutical opioid use.ResultsA total of 198 (55.8%) participants reported at least one overdose in their lifetime. A total of 229 participants identified as male, 124 identified as female, and 2 identified as non-binary. When controlling for demographic factors, non-oral opioid administration at first opioid use (AOR 2.82, 95% CI 1.52-5.22), having a history of methadone detoxification, (AOR 2.23, 95% CI 1.27-3.91), history of buprenorphine detoxification (AOR 1.77, 95% CI 1.02-3.07), and history of 12 step attendance (AOR 1.89, 95% CI 1.12-3.20) were found to be independently and positively associated with lifetime opioid overdose.ConclusionsDetoxification with buprenorphine and methadone was found to be associated with having a non-fatal opioid overdose. Buprenorphine and methadone should not be prescribed as a detoxification medication as long-term use of medication for OUD results in better outcomes than medication that is used short-term.

Best-practice recommendations for young children at high likelihood of autism include active involvement of caregivers in intervention. However, the use of evidence-based parent-mediated interventions in community practice remains limited. Preliminary evidence suggests that Project ImPACT for Toddlers demonstrates positive parent and child outcomes in community settings. Project ImPACT for Toddlers was adapted specifically for toddlers and teaches parents of young children strategies to build their child's social, communication, and play skills in daily routines. This study reports implementation outcomes from the initial community rollout of Project ImPACT for Toddlers and examines the system-wide intervention reach, with the goal of informing continued community sustainment and scale-up. Participants include 38 community providers who participated in a Project ImPACT for Toddlers' training study who completed an implementation survey and semi-structured interviews after approximately 3 months of community implementation. Participants perceived the training model as acceptable and appropriate, and identified several strengths of the approach. Interview themes also supported the feasibility, acceptability, and utility of the intervention in community settings. Quantitative findings complemented the thematic results from interviews. Intervention reach data indicate an increasing number of agencies delivering and families receiving Project ImPACT for Toddlers. Efforts to scale-up evidence-based interventions in early intervention should continue to build upon the model of the Bond, Regulate, Interact, Develop, Guide, and Engage Collaborative.

In response to the SARS-CoV-2 pandemic, a cancer research education program at the University of Nebraska Medical Center designed for Native American middle school, high school and undergraduate students adapted activities to be delivered online. There are considerable challenges to adapting in-person science programming to online delivery that can impact overall effectiveness. These challenges are further exacerbated when the cognate student population also faces significant disparities in health, wealth, and educational outcomes. We encountered both disadvantages and advantages in transitioning programming to online virtual formats. Challenges faced in delivering our programming during the pandemic included varied online accessibility, peripheral stressors, and disconnection to places and people. Despite these challenges, we found several benefits in remote delivery, some of which have alleviated barriers to program participation for Native American students. Some successes achieved by transitioning to fully remote programming included increased program reach, sustainability, and cultural relevancy. In this overview of the implementation of four online programs at the middle school, high school, and undergraduate levels, we highlight the challenges and successes experienced. Through this program description, we aim to provide insight into potential strategies to improve program delivery designed for Native American students during the SARS-CoV-2 pandemic and beyond.

BackgroundThe COVID-19 pandemic has disproportionately impacted disabled people, especially those who are members of marginalized communities that were already denied access to the resources and opportunities necessary to ensure health equity before the pandemic.ObjectiveCompare COVID-19 impact on basic needs access among households with and without disabled adults.MethodsAn online survey was distributed to households with children enrolled in one of 30 socially vulnerable elementary or middle schools in San Diego County, California. We measured disability using the single-item Global Activities Limitations Indicator. We measured pandemic impacts on basic needs access using the RADx-UP common data elements toolkit. We then assessed number of impact items reported by household disability using multivariable linear regression, adjusting for household income, household size, education, parent gender, and child's ethnicity.ResultsOf 304 participants, 41% had at least one disabled household member. Participants reporting a disabled household member were more likely to report challenges accessing basic needs, such as food, housing, healthcare, transportation, medication, and stable income during the pandemic (all p

BackgroundSchools are high-risk settings for SARS-CoV-2 transmission, but necessary for children's educational and social-emotional wellbeing. Previous research suggests that wastewater monitoring can detect SARS-CoV-2 infections in controlled residential settings with high levels of accuracy. However, its effective accuracy, cost, and feasibility in non-residential community settings is unknown.MethodsThe objective of this study was to determine the effectiveness and accuracy of community-based passive wastewater and surface (environmental) surveillance to detect SARS-CoV-2 infection in neighborhood schools compared to weekly diagnostic (PCR) testing. We implemented an environmental surveillance system in nine elementary schools with 1700 regularly present staff and students in southern California. The system was validated from November 2020 to March 2021.FindingsIn 447 data collection days across the nine sites 89 individuals tested positive for COVID-19, and SARS-CoV-2 was detected in 374 surface samples and 133 wastewater samples. Ninety-three percent of identified cases were associated with an environmental sample (95% CI: 88%-98%); 67% were associated with a positive wastewater sample (95% CI: 57%-77%), and 40% were associated with a positive surface sample (95% CI: 29%-52%). The techniques we utilized allowed for near-complete genomic sequencing of wastewater and surface samples.InterpretationPassive environmental surveillance can detect the presence of COVID-19 cases in non-residential community school settings with a high degree of accuracy.FundingCounty of San Diego, Health and Human Services Agency, National Institutes of Health, National Science Foundation, Centers for Disease Control.

Rapid identification and isolation/quarantine of COVID-19 cases or close contacts, respectively, is a vital tool to support safe, in-person learning. However, safe isolation or quarantine for a young child also necessitates home confinement for at least one adult caregiver, as well as rapid learning material development by the teacher to minimize learning loss. The purpose of this study is to better understand barriers and supports to student home confinement. We conducted a mixed-methods study using focus group discussions and a self-administered online survey with parents and staff members from 12 elementary schools and childcare sites across San Diego County serving low-income and socially vulnerable families. Focus group participants reported that mental distress and loneliness, learning loss, childcare, food, income loss, and overcrowded housing were major barriers related to home confinement. The experiences described by FGD participants were prevalent in a concurrent community survey: 25% of participants reported that isolation would be extremely difficult for a household member who tested positive or was exposed to COVID-19, and 20% were extremely concerned about learning loss while in isolation or quarantine. Our findings suggest that there are serious structural impediments to safely completing the entire recommended course of isolation or quarantine, and that the potential for isolation or quarantine may also lead to increased hesitancy to access diagnostic testing.