Search

The New Mexico jumping mouse (Zapus luteus) is a federally endangered species that relies on riparian sites of the southwestern United States. Only isolated populations occur throughout its range and detecting potential suitable environments and identifying new populations are important for long‐term conservation of genetic diversity and habitat restoration by management agencies. We used a presence‐only data approach compiled from multiple surveys since 2000 in Arizona, Colorado, and New Mexico with bioclimatic and vegetation variables to generate species distribution models for the species. Our models predicted environmentally suitable areas outside the current species management units that could be prioritized in surveys. Our models also highlighted opportunities for collaboration among federal, state, tribal, and private landowners and managers to secure habitat and connectivity for the species and its long‐term survival. [ABSTRACT FROM AUTHOR]

College students with psychiatric disabilities, particularly those with severe distress, have an increased risk of attrition from higher education. Highly distressed students may be hospitalized for psychiatric crises if there is a potential risk to their safety. Although college students' psychopathology has increased in severity over the last decade, hospitalized students remain an underresearched group at risk for attrition, trauma, suicide, and disconnection from their universities. The present study explored demographic, academic, and clinical characteristics of 880 undergraduate and graduate students hospitalized between Spring 2016 and Spring 2021 at a large public university in the southwestern United States. Study aims were addressed by testing proportional differences in (a) demographics of the hospitalized sample versus the student body and (b) cross-tabulations of demographic, academic, and clinical characteristics by hospital admission status (voluntary or involuntary). Results indicate that African American/Black and multiracial students; female, transgender, and lesbian, gay, bisexual, queer, or other nonheterosexual orientations students; undergraduates; and liberal arts, fine arts, and undeclared majors may be at increased risk for psychiatric hospitalization. Gender identity, sexual orientation, semester hospitalized, initiating entity, university counseling center utilization, and the presence of high-priority symptoms and suicidality were significantly associated with hospital admission status. Implications and suggestions for future research are discussed. Public Significance Statement: Severe psychopathology, suicide risk, and psychiatric hospitalizations continue to increase among college students. Study findings highlight groups of students who may be at increased risk for hospitalization. Identifying these groups provides direction for university clinicians and administrators in allocating prevention-related services and support to high-risk subgroups. [ABSTRACT FROM AUTHOR]

Morbid obesity, as characterized by BMI, is often utilized as an exclusion criterion for VV-ECMO because of presumed poor prognosis and technically complex cannulation. However, the "obesity paradox" suggests obesity may be protective during critical illness, and BMI does not capture variations in body type, adiposity, or fluid balance. This study examines relationships between BMI and patient outcomes. Adult VV-ECMO patients with BMI ≥ 35 kg/m2 admitted January 2012 to June 2021 were identified from an institutional registry. BMI and outcomes were analyzed with Mann-Whitney U tests and Pearson correlations with Bayesian post-hoc analyses. 116 of 960 ECMO patients met inclusion criteria. Median (Q1, Q3) BMI was 42.3 (37.3, 50.8) and min, max of 35.0, 87.8 with 9.0 (5.0, 15.5) ECMO days. BMI was not significantly correlated with ECMO days (r = −0.102; p =.279). Bayesian analyses showed moderate evidence against BMI correlating with ECMO days. In-hospital mortality (27%) was significantly associated with ECMO days (p =.014) but not BMI (p =.485). In this cohort of high-BMI patients, BMI was not associated with survival or time on ECMO. BMI itself should not be used as an exclusion criterion for VV-ECMO. [ABSTRACT FROM AUTHOR]

BACKGROUND: Weather variability is associated with enteric infections in people through a complex interaction of human, animal, and environmental factors. Although Campylobacter infections have been previously associated with precipitation and temperature, the association between precipitation and drought on campylobacteriosis has not been studied. OBJECTIVE: Using data from Arizona, Colorado, New Mexico, and counties in Utah, this ecological study aimed to assess the association between precipitation and the incidence of campylobacteriosis by county from 2009 to 2021 and to determine how this association is modified by prior drought level and animal operations. METHODS: We merged 38,782 cases of campylobacteriosis reported in 127 counties with total precipitation (in inches), temperature (in average degrees Fahrenheit), Palmer Drought Severity Index (PDSI, category), and animal census data (presence, density per square mile) by week from 2009 to 2021. Negative binomial generalized estimating equations adjusted for temperature with a 3-wk lag were used to explore the association between precipitation on campylobacteriosis with resulting incidence rate ratios (IRRs). Stratified analyses explored the association with precipitation following antecedent drought, presence of farm operations, and animal density. RESULTS: A 1-in (25.4 mm) increase in precipitation was associated with a 3% increase in campylobacteriosis reported 3 wks later (IRR=1.03; 95% CI: 1.02, 1.04) after adjusting for average temperature and PDSI. Compared with normal conditions, there were significantly more cases when precipitation followed antecedent extremely wet (IRR=1.15; 95% CI: 1.04, 1.26), very wet (IRR=1.09; 95% CI: 1.01, 1.18), moderately wet (IRR=1.06; 95% CI: 1.01, 1.12), moderate drought (IRR=1.11; 95% CI: 1.07, 1.16), and severe drought (IRR=1.06; 95% CI: 1.02, 1.11) conditions, whereas there were significantly fewer cases (IRR=0.89; 95% CI: 0.85, 0.94) for antecedent extreme drought. Compared to counties with no animal operations, counties with animal operations had significantly more cases following precipitation for every PDSI category except extreme drought. Counties with a higher density of beef cattle, goats for meat, chicken broilers, and chicken layers had significantly higher rates of campylobacteriosis following precipitation than those with no such operations, whereas those with dairy cattle and goats for milk, did not. DISCUSSION: In this majority arid and semiarid environment, precipitation following prior wet conditions and moderate and severe drought were significantly associated with increased rates of campylobacteriosis, and only in prior extreme drought did rates decrease. Where the precipitation fell made a difference; after precipitation, counties with farm operations had significantly more cases compared to counties without farm operations. Further work should assess individual-level risk factors within environmental exposure pathways for Campylobacter. [ABSTRACT FROM AUTHOR]

Stop the Bleed® is an emergency response course that offers a certificate of completion but no ending assessment. The purpose of this educational study was to develop and test the Response Readiness Tool (RRT) that measures learning of participants after taking Stop the Bleed®. The study used a pre‐/post‐test design to measure knowledge and attitudes, and a post‐test only for skills. Participants were recruited from existing Stop the Bleed® courses. Knowledge was measured with a 10‐item questionnaire, attitude was measured with five Likert‐style questions, and skills were measured by observing simulated tourniquet placement. Ninety‐five participants were recruited over two semesters. There was a significant difference in the knowledge and attitude scores indicating participants' improvement in learning and attitude toward responding. Internal consistency reliability of scores showed moderate reliability with Cronbach's Alpha of 0.73 and McDonald's Omega of 0.75. A positive correlation was found between expected proficiency and pre‐test indicating the tool had construct validity. RRT provides Stop the Bleed® instructors with an instrument to measure knowledge, skills, and attitude of participants after taking Stop the Bleed®. Statistics show moderate reliability and validity; however, larger samples are needed for full psychometric testing. This publication presents the revised tool after the completion of this study. [ABSTRACT FROM AUTHOR]

Approximately 25% of accidents in the United States are caused by texting while driving, prompting the creation of several media campaigns to reduce such risky behavior. The current research examined whether death-related advertisements increase cell phone use while driving. Studies 1-3 found that individuals engaged in greater distracted driving in the presence of a mortality-themed texting advertisement. Study 2 demonstrated that participants were more likely to text on their cell phone using a driving simulator, leading to more swerving and collisions after viewing a death-related (vs. neutral) poster. Finally, using eye-tracking, Study 3 showed that participants who viewed a death advertisement looked away from the road and texted more as compared to persons in the control condition. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

Introduction: Uncertainty exists regarding the best method for teaching thrust joint manipulation (TJM) to student physical therapists. The purpose of this study was to compare the effectiveness of Peyton's 4-step (P4) approach with the "see one, do one" (S1D1) approach for teaching students to perform a lumbar spine TJM task in an academic setting. Secondary objectives were to compare the effects of each instructional approach on students' attitudes and beliefs toward spinal TJM and on their motivation to learn to perform lumbar spine TJM. Review of literature: The S1D1 approach is used in the health care professions for teaching clinical tasks to students. It is unclear whether the P4 approach may better prepare students to practice TJM. Subjects: Student physical therapists. Methods: Using a factorial quasi-experimental design, an equal number of students were assigned to a P4 or S1D1 instruction group for the TJM task. Students' performance accuracy, time, and outcome performing TJM in an academic setting were measured. Paper surveys were used to collect data about students' attitudes and beliefs toward spinal TJM and their motivation to learn TJM. A generalized estimating equations approach was used for data analysis. Results: Fifty-eight students (29 per group) completed the study. There was an interaction between the instruction group and time on task performance accuracy favoring the P4 approach (P = .03). There was no interaction between the instruction group and task performance time, task performance outcome, attitudes and beliefs toward spinal TJM, or motivation to learn TJM (all P > .19). Discussion and conclusion: The P4 approach more effectively improved student accuracy when performing the TJM task in an academic setting than the S1D1 approach. However, no differences between instruction were found for performance time or outcome. Students reported a favorable perception of learning lumbar spine TJM. These preliminary results suggest that instructors may use the P4 approach to improve students' TJM procedural knowledge before task practice. However, limitations of the study may affect the internal validity and generalizability of results. [ABSTRACT FROM AUTHOR]

The Southwestern United States experiences active deformation, seismicity, and magmatism, remarkable in an intraplate setting. The Basin and Range and Colorado Plateau (CP) are inferred to differ in lithospheric thickness, but modeling geophysical properties of the lithosphere, in particular the depth of the Lithosphere‐Asthenosphere Boundary (LAB), across the entirety of the region, has proved challenging. Here, we introduce a new model of 1‐D depth profiles in shear wavespeed, determined through a probabilistic joint inversion of information from Sp receiver functions and Rayleigh wave phase velocity. From these profiles we quantify the locations and Vs contrast of wavespeed gradients that represent boundaries such as the Moho, the LAB, and intralithospheric discontinuities. We infer a lithosphere that is thinner and lower in Vs in the Basin and Range. In the CP and farther north, the LAB is more gradual, deeper, and intermittently observed. We also observe Mid‐Lithospheric Discontinuities (MLDs) near the boundaries between the CP, Wyoming Craton, and Northern Basin and Range, as well as within the Craton. When both an MLD and LAB are observed, the Vs gradient associated with the LAB is narrower than expected. Finally, we image Positive Velocity Gradients beneath areas of thinner lithosphere, which are consistent with recent global observations that have been attributed to the base of a partially molten zone below the lithosphere. Overall, the picture of the lithosphere‐asthenosphere system that emerges is one of considerable structural complexity with a strong dependency on tectonic regime and geological history. Plain Language Summary: We examine the properties of, and processes that shape, the lithosphere—the rigid outermost layer of the Earth, which participates in plate tectonics. Our focus is the southwestern United States where in fact the lithosphere does not behave like a simple, homogeneous, plate. Instead, in the Basin and Range Province, widespread deformation, frequent earthquakes, and recent volcanic activity are observed, all of which are rare for a location removed from plate boundaries. In the neighboring Colorado Plateau and the regions north and west of it, the lithosphere behaves more rigidly but volcanism is also observed. To understand how the lithosphere and mantle below vary, we produce a model of seismic wavespeed using data from surface waves, which travel along the Earth's surface, and converted body waves, which interact with interior boundaries such as the bottom of the lithosphere. This model enables us to find the depths of major boundaries and understand how the speed of seismic waves changes across them. We consistently observe decreases in seismic wavespeed that we associate with the bottom of the lithosphere or structures within the lithosphere. We also note wavespeed increases below the lithosphere that might indicate partial melting of rocks deep within the Earth. Key Points: We perform a joint inversion for Vs in the upper mantle of the Southwestern U.S., using data from body wave scattering and surface wavesThe lithosphere varies regionally: it is flat and thin in the Basin and Range, thicker in the Colorado Plateau, and complex in cratonic regionsMid‐Lithospheric Discontinuities are observed in cratonic regions, associated with sharp Vs gradients at the base of the lithosphere [ABSTRACT FROM AUTHOR]

Adverse Childhood Experiences (ACEs) are associated with poorer physical and mental health outcomes, which have been shown to negatively impact resilience. The prevalence of mental health diagnoses among college students is increasing in frequency and severity. Further, research shows that college students often have unmet mental health needs and underutilize professional help for mental health disorders. The purpose of this study was to better understand the relationship between ACES, resilience, mental health diagnosis, mental health treatment, and attitudes toward help-seeking. Specifically, we wanted to understand what contributes to college students seeking professional help. Nine hundred and forty-one college students from a large Southwest university completed a series of measures via a Qualtrics link. There was a significant relationship between ACE scores and previous/current mental health diagnosis (p =.001) and between ACE scores and previous/current psychological treatment (p =.001). When considering all factors together, a four-way ANOVA indicated the overall model was significant, but only current/recent mental health treatment had a significant effect on attitude toward seeking professional help (p=.001). ACEs, resiliency, and mental health diagnosis did not impact attitudes toward seeking help. This study adds to the growing body of literature on understanding what contributes to college students seeking help. [ABSTRACT FROM AUTHOR]

Exercise may be a useful complement to treatment programs aimed at reducing the negative neural and functional consequences of alcohol and drug use. While some empirical studies have examined the impact of physical activity (PA) as a complement to treatment, they are limited in sample size or they fail to consider the unique physiological status of women. In preparation for a developmental study, we took steps to examine the feasibility of a fitness-focused intervention with women (n = 25) in treatment. To that end, we conducted a mixed method study with actual physical wellness and perceptions of physical wellness as the target domains. Participation in PA was viewed positively; however, women wished they engaged in exercise more consistently. Ultimately, women viewed exercise as a means to feeling better about themselves emotionally and physically. Recommendations link findings to practice including psycho education, group-based goal setting, and offering a variety of PA modalities. [ABSTRACT FROM AUTHOR]

A follow-up cross-sectional study was conducted continuing to explore the experiences of older adults residing in cohousing communities in the United States (U.S.) during the COVID-19 pandemic. In the initial study (P1) most participants did not feel lonely or left out but did feel isolated. In the follow-up study (P2) similar results were obtained but a higher percentage of participants felt isolated and were more likely to have self-isolated at some point in time. Many reported that living in cohousing was beneficial to them, both in providing support and allaying stressors related to the pandemic. [ABSTRACT FROM AUTHOR]

Engaged communication between mother and a child in their early developmental stages is one of the predictors of children's development of higher-order thinking skills. For deaf children, this engaged communication between mother and child hinges on the home language environment (HLE) being fully accessible to the child. This research uses agogical phenomenology in exploring the lived experiences of participants' HLE where sign language is used, with particular focus on the opportunities for extended discourse. Data were collected via semistructured interviews with the deaf children and their parents and observations in the HLEs of five signing families with at least one deaf child in the southwestern United States. The aim of this study was to document and provide insights into how language use in deaf children's HLE can impact their knowledge development; these insights uncovered the essence of reciprocal and contingent family interactions as a central aspect of the deaf child's HLE. It is hoped that the qualitative phenomenological findings will frame subsequent quantitative investigations of the variability in language access to home language components. [ABSTRACT FROM AUTHOR]

Background: Pediatric patients receiving neurologic and neurosurgical critical care undergo many procedures that result in stimulation of the sympathetic nervous system, which increases their risk of poor outcomes. Nurses typically implement a variety of interventions to minimize such stimulation; however, minimal stimulation has not been specifically defined in the literature or described as a standardized bundle of care. Objective: To examine pediatric intensive care unit nurses' interpretation and practice of minimal stimulation in patients with neurologic and neurosurgical conditions and specifically to triangulate nurses' descriptions of this practice with related findings in the literature. Methods: This was a qualitative, descriptive, exploratory study that used naturalistic inquiry. Results: A total of 13 pediatric intensive care unit nurses participated in the study. Three primary themes were identified regarding minimal stimulation: (1) new knowledge and practice, (2) communication, and (3) impact of minimal stimulation. Conclusions: The findings of this study help to establish a working definition of the nursing practice of minimal stimulation and provide a basis for future research. More detailed study is needed on the concept of a standardized minimal stimulation bundle and its impact on patient outcomes. [ABSTRACT FROM AUTHOR]

Few studies have examined differences in autism spectrum disorder (ASD) phenotype between children from multiplex and simplex families at the time of diagnosis. The present study used an age- and gender-matched, community-based sample (n = 105) from the southwestern United States to examine differences in ASD symptom severity, cognitive development, and adaptive functioning. No significant differences between children from multiplex and simplex families were observed. Exploratory analysis revealed that parents underreported receptive and expressive language and fine motor skills compared to professional observation, especially among children from multiplex families. These findings suggest that diagnosticians may need to consider family structure when choosing and interpreting assessments of receptive language, expressive language, and fine motor skills. [ABSTRACT FROM AUTHOR]

How Black Americans in the United States (U.S.) make sense of a sociopolitical climate marked by racist imagery, tensions, and police violence is important to understand given the numerously documented detrimental effects of racism‐related stress on the well‐being of Black parents and children. Informed by Racism‐Related Stress Theory, the current study employed a convergent parallel mixed methods design to better understand the ways racism‐related stressors in the sociopolitical climate impacted the daily lives and mental health of a sample of Black families with low income. Seventy‐eight Black American preadolescents (Mage = 11.0; 43.6% girls) and their parents (79% mothers; 76% living below the U.S. federal poverty level [FPL]) from the southwestern U.S. reported their symptoms of depression and how they had been affected by racial stressors in the sociopolitical climate between Fall 2018 and Summer 2019. A nested sample of 10 parents (80% mothers; 80% living below the FPL) from the quantitative sample also participated in a semi‐structured interview. Meta‐inferences across methods were drawn pertaining to the influence of child gender on parents' interpretation of effects for children, the toll racism‐related stress in the sociopolitical climate takes on Black families, and the transferal of effects on parents to children through parenting and parental depressive symptoms. Findings spotlight the need for policies and family‐centered programming that address the racism‐related stress faced by many Black youth and their families. Providing families with opportunities and tools that can potentially mitigate harmful effects and foster empowerment could promote positive and lasting change. [ABSTRACT FROM AUTHOR]

This study examined the response of two students in the Southwestern United States with autism spectrum disorder and IQ in the intellectual disability range to a comprehensive, text-based reading intervention. The intervention, Friends on the Block, includes multiple strands of literacy providing explicit instruction in phonics, phonemic awareness, high-frequency irregular or temporarily irregular words, decoding, vocabulary, oral language, and comprehension. Multiple supports for students with intensive needs are embedded within the intervention, such as specially designed multi-criteria books, extensive scaffolding, and intensive cumulative review. Teachers customize the program to address the varying needs of students. We used single-case multiple baselines across levels of instruction design to assess growth on a measure of reading (words read correctly). Results indicated a positive, functional relation between reading intervention and word reading. Both students also demonstrated modest growth on measures of phonemic awareness, letter–sound knowledge, and word identification from pre- to post-intervention. [ABSTRACT FROM AUTHOR]

In 2006, Marks and Fraley published research suggesting that people remembered more information that was consistent rather than inconsistent with a sexual double standard. Despite the impact of that paper on the field, there were several caveats of that research, including a small sample. The present research, therefore, aims to replicate and extend Marks and Fraley's research. Presently, 400 participants read a vignette about a sexually active man or woman for two minutes. This vignette contained an equal amount of positive and negative information. Participants then had 5 minutes to recall the information from the vignette. In the extension portion of the research, some participants experienced an experimentally varied delay, which was used to create forgetting curves in an effort to parse apart whether any differences in recall were due to differences in the encoding process, retrieval process, or both. Recall results replicated the pattern of results from Marks and Fraley (2006), in that participants remembered more negative information about the woman than the man, and more negative than positive information about the woman. Analyses of forgetting curves were inconclusive, as the predictors explained less than 0.5% of the variance in recalled information. [ABSTRACT FROM AUTHOR]

Background: Aquí Entre Nos (Between Us) is a community-based participatory research project to engage rural, ethno-racially diverse hotel housekeepers in a right to work state during a time of national anti-immigrant policy, wildfires and emergence of a global pandemic. Objectives: We aimed to (1) build trust and social support with the hotel housekeeping community, (2) learn about the occupational health, safety, and workers' rights challenges, strategies, and solutions held by workers, and (3) develop a workforce-driven research and action agenda to improve labor and health conditions. Methods: Participatory mixed methods rooted in popular education are described to form an advisory board and engage the workforce. Lessons Learned: Trusted relationships built through community organizing around immigration, housing, and minimum wage were critical to engage and drive a worker centered research agenda. Conclusions: Despite challenges, housekeeper advisors defined a research agenda that addressed immediate-and long-term needs of the workforce. [ABSTRACT FROM AUTHOR]

Postoperative care pathways for adolescent idiopathic scoliosis patients undergoing posterior spinal fusion have demonstrated decreases in postoperative opioid consumption, improved pain control, and lead to decreased lengths of stay. Our objective was to implement postoperative steroids to reduce acute postoperative opioid consumption, pain scores, and length of stay. Dosing consisted of intravenous dexamethasone 0.1 mg/kg up to 4 mg per dose for a total of three doses at 8, 16, and 24 h postoperatively. As part of a quality initiative, we compared three cohorts of patients. The initial retrospective epidural cohort (EPI) (n = 59) had surgeon placed epidural catheters with infusion of ropivacaine 0.1% postoperatively for 18–24 h. Following an institutional change in postoperative care, epidural use was discontinued. A second cohort (n = 149), with prospectively collected data, received a surgeon placed erector spinae plane block and wound infiltration with a combination of liposomal and plain bupivacaine (LB). A third cohort (n = 168) was evaluated prospectively. This cohort received a surgeon placed erector spinae plane block and wound infiltration with liposomal and plain bupivacaine and additionally received postoperative dexamethasone for three doses (LB + D). Compared to the LB cohort, the LB + D cohort demonstrated statistically significant decreases in oral milligram morphine equivalents per kilogram at 0–24, 24–48, and 48–72 h. There was a statistically significant difference in median pain scores at 24–48 and 48–72 h in LB + D versus LB. The LB + D cohort's median length of stay in hours was significantly less compared to the LB cohort (52 h vs. 70 h, p < 0.0001). Postoperative intravenous dexamethasone was added to an established postoperative care pathway for patients undergoing posterior spinal fusion for idiopathic scoliosis resulting in decreased VAS pain scores, opioid consumption, and shorter length of stay. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore the determinants of risk literacy among university students in the United States by utilizing the Berlin Numeracy Test. Risk literacy skills are essential for decision-making and communication of risks, but few studies consider university students. This study aims to evaluate the association of sociodemographic factors with individual risk literacy levels. An observational cross-sectional survey study was used with a convenience sample of 184 undergraduate and graduate university students. Statistical analysis revealed significant differences for demographics at risk for negative outcomes associated with lower risk literacy. For this group of students, the majority had below-average numeracy. These findings can guide healthcare professionals to focus on college-age individuals with low-risk literacy scores to enhance patient understanding, facilitate communication, and promote healthier behaviors. [ABSTRACT FROM AUTHOR]

COVID-19 escalated the already challenged nursing workforce, causing hospitals to address their unstable staffing. This report details the journey of a large rural level 1 academic healthcare market postpandemic to stabilize their nursing workforce and create a sustainable pipeline of nurses. The results demonstrated reductions in turnover rates, vacancy rates, and days to fill nursing positions. [ABSTRACT FROM AUTHOR]

This article describes a community–academic partnership designed and implemented to address disparities in accessing COVID-19 testing in Arizona, from November 2020 through March 2023. An equitable community-academic partnership, the involvement of local leaders, and the engagement of community health workers were critical for the success of the intervention. More than 5000 previously underserved patients were tested and received COVID-19 related services. A profile comparison with a matched group documents the success of the program in reaching the targeted population. (Am J Public Health. 2024;114(S5):S388–S391. https://doi.org/10.2105/AJPH.2024.307684) [ABSTRACT FROM AUTHOR]

Wildfire air pollution is a growing concern on human health. The study aims to assess the associations between wildfire air pollution and pregnancy outcomes in the Southwestern United States. This was a retrospective cohort study. Birth records of 627,404 singleton deliveries in 2018 were obtained in eight states of the Southwestern United States and were linked to wildfire-sourced fine particulate matter (PM 2.5) and their constituents (black carbon [BC] and organic carbon [OC]) during the entire gestational period. A double-robust logistic regression model was used to assess the associations of wildfire-sourced PM 2.5 exposures and preterm birth and term low birth weight, adjusting for non-fire-sourced PM 2.5 exposure and individual- and area-level confounder variables. Wildfire-sourced PM 2.5 contributed on average 15% of the ambient total PM 2.5 concentrations. For preterm birth, the strongest association was observed in the second trimester (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.05–1.07 for PM 2.5 ; 1.06, 95% CI: 1.05–1.07 for BC; 1.04, 95% CI: 1.03–1.05 for OC, per interquartile range increment of exposure), with higher risks identified among non-smokers or those with low socio-economic status. For term low birth weight, the associations with wildfire-sourced PM 2.5 exposures were consistently elevated for all trimesters except for the exposure averaged over the entire gestational period. Overall, the associations between wildfire-sourced PM 2.5 and pregnancy outcomes were stronger than those with total PM 2.5. Wildfire-sourced PM 2.5 and its constituents are linked to higher risks of preterm birth and term low birth weight among a significant US population than the effects of ambient total PM 2.5. [ABSTRACT FROM AUTHOR]

Background: Little is known about hybrid PhD nursing students' experiences. Method: The purpose of this study was to describe and analyze the experiences of PhD nursing students in a hybrid program using a convergent mixed methods design. Recent nursing PhD alumni (n = 18), and current PhD students (n = 4) were recruited at a research-intensive university in the southwestern United States. Results: Four metainferences were identified: (1) the facilitator of faculty as both advisors and mentors; (2) the facilitator of peers as support, motivation, and a source of advice that preceded advisors; (3) the barrier of receiving conflicting feedback from advisory and dissertation committees; and (4) the barrier of not understanding the PhD student process. Conclusion: Peer support is fundamental for hybrid PhD nursing student success; conflicting feedback and not understanding the process are significant barriers. Strategies are recommended to mitigate barriers to facilitate hybrid PhD nursing students' success. [J Nurs Educ. 2024;63(5):328–331.] [ABSTRACT FROM AUTHOR]

This paper explores how social workers integrate personal spirituality within nursing homes, where a highly regulated, stressful environment marginalizes professional identity and challenges retention. Researchers offer new evidence of how spirituality informs professional identity, ethical practice, and continuation in the role. Twenty BSW/MSW licensed nursing home social workers (NHSWs) reported how they daily navigate the personal spirituality-at-work opportunity and challenge. Qualitative analysis of in-depth interviews resulted in three primary codes and related subcodes: Spirituality-Integrated Professional Identity (Vocational Affirmation and Value Alignment), Spirituality-Informed Practice (Intervention Asset, Relational Affinity, and Ambiguous Boundaries), and Spiritually-Sustained Career Resilience. Respondents reported how spirituality animated professional identity, informed daily role enactment, and sustained role involvement. Recommendations are provided for normalizing ethical spirituality-at-work through social work education and practical guidance in navigating the spirituality and practice space. [ABSTRACT FROM AUTHOR]

The current study integrates previous research on adverse childhood experiences (ACEs) and long-term health outcomes to examine associations between ACEs, sleep duration, and depression in a diverse, mostly healthy, sample of young adults. We examine whether sleep duration mediates the association between ACEs and depression among young adults, and whether ethnicity may moderate observed relationships between ACEs, sleep duration and depression. Data were collected from 518 young adults (66.8% female, Mage=19.79 years, SDage=3.43 years) enrolled in undergraduate Psychology courses at a large Southwestern university. Participants primarily reported their racial/ethnic background as Non-Hispanic White (60.6%) and Hispanic/Latino (25.1%). Participants self-reported their ACEs exposure, sleep characteristics, and depressive symptoms. In addition to calculating overall exposure to ACEs, scores for the specific dimensions of adversity were also calculated (Abuse, Neglect, Exposure to Violence). Results supported a mediation model whereby higher reports of ACEs were associated with depressive symptoms both directly and through sleep duration. Results were not moderated by ethnicity. Findings provide support for sleep duration as one potential pathway through which ACEs may be associated with depressive symptoms in young adulthood, and suggest that this pathway is similar in Hispanic and non-Hispanic young adults. [ABSTRACT FROM AUTHOR]

Literature on occupational risks among organic farmers is scarce. This study explored safety practices and non-fatal injuries among organic producers, and the role of sociodemographic, work, and farm characteristics on safety and injury. Cross sectional survey of certified organic crop producers in the Southwest (SW) region of the United States (US). The Organic Integrity Database was used for recruitment. Data were collected through an electronic and paper survey. Analyses were conducted on 115 cases; response rate was estimated at 25%. A high majority of respondents owned their operation and were younger than 65 years, male, educated beyond high-school, and non-Hispanic whites. Less than half had more than 10 years of experience in organic farming; one-third worked off the farm year-round. Safety practices were very basic despite the widespread use of equipment and machinery, and limited to wearing normal clothing and apparel such hats and glasses. About half of respondents (52.6%) reported non-fatal injuries in the past year; and one-third (32.7%) time lost due to injuries. The overall cumulative incidence rate was estimated at 5.3 injuries per 10 workers within the last year. The injury rate decreased with hours worked. Significant differences were found on gender and education level and safety practices, with female respondents and the more educated being more proactive in practicing safety. Those working less than 40 h/week, in farms smaller than 50 acres, using light machinery or compact utility tractors, and tractors without roll-over protection reported significantly higher injury frequency compared to their counterparts. This study contributes unique data on an essential workforce not captured by current occupational injury and illness surveillance systems. It identifies important personal and contextual factors that may contribute to safety and injury in this population. The findings indicate the need to promote safety and prevent injuries that result in work time lost. This study may also inform future occupational safety and health research and practice, including surveillance, injury prevention programs that target certain workers and production practices, and policies that support and protect the organic farmer. [ABSTRACT FROM AUTHOR]

Background: The positive youth development (PYD) framework orients developmental scholarship to focusing on youth's strengths rather than deficits, however, validity evidence on PYD measures among ethnic-minority youth is limited. Objectives: The objectives of the current study were to (a) examine the factor structure of a PYD measure within a Latin American adolescent sample and (b) test associations between PYD constructs and adjustment indicators. Methods: The sample included 288 Latin American students from the Southwest (Mage = 13.69 years, SD = 0.56; 47.7 female; 86.3% U.S.-born). Participants reported their PYD (i.e., Competence, Confidence, Character, Connection, and Caring) and academic performance. Mothers reported on youth's internalizing and externalizing behaviors. The internal structure of the PYD measure was assessed through confirmatory factor analyses (CFAs) and model comparisons. Criterion evidence was evaluated via regressions between the Five C's, academic performance, internalizing, and externalizing behaviors. Results: The five-correlated factor structure best fit the data with certain modifications. Character was negatively associated with externalizing behavior. All C's were positively related to academic performance. Conclusions: The results provide empirical support for the five-correlated factor model within a sample of Latin American adolescents, but modifications were necessary to maximize model fit. Dropping items within the values diversity subscale highlight the need for cultural assets within PYD measurement models for ethnic-minority youth, to best reflect their appraisals of diversity as minoritized individuals. Additionally, our findings suggest that the C's are salient to specific indices of Latin American adolescents' adjustment. [ABSTRACT FROM AUTHOR]

Background: The progression of patients through a hospital from admission to discharge can be slowed by delays in patient discharge, increasing pressure on health care staff. We designed and piloted the Discharge Today tool, with the goal of improving the efficiency of patient discharge; however, adoption remained low. Purpose: To close this implementation gap, we deployed and evaluated a 4-part implementation strategy bundle. Methods: We measured the success of implementation by evaluating validated implementation outcomes using both quantitative and qualitative methods, grounded in Normalization Process Theory. Results: The implementation strategies used were effective for increasing use of the Discharge Today tool by hospital medicine physicians and advanced practice providers during both the active and passive implementation periods. Conclusions: While the implementation strategies used were effective, qualitative findings indicate that limitations in the functionality of the tool, alongside inconsistent use of the tool across clinical staff, continued to inhibit adoption. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Bone mineral density (BMD) and fracture risk calculators (eg, the Fracture Risk Assessment Tool [FRAX]) guide primary prevention care in postmenopausal women. BMD scores use non-Hispanic White (NHW) reference data for T-score classification, whereas FRAX incorporates BMD, clinical risk factors, and population differences when calculating risk. This study compares findings among Asian, Black, and NHW women who underwent osteoporosis screening in a US health care system. STUDY DESIGN: Retrospective cross-sectional study. METHODS: Asian, Black, and NHW women aged 65 to 75 years who underwent BMD testing (with no recent fracture, osteoporosis therapy, metastatic cancer, multiple myeloma, metabolic bone disorders, or kidney replacement therapy) were compared across the following measures: femoral neck BMD (FN-BMD) T-score (normal --1, osteoporosis --2.5), high FRAX 10-year hip fracture risk (FRAX-Hip 3%), FRAX risk factors, and diabetes status. RESULTS: Among 3640 Asian women, 23.8% had osteoporosis and 8.7% had FRAX-Hip scores of at least 3% (34.5% among those with osteoporosis). Among 11,711 NHW women, 12.3% had osteoporosis and 17.2% had FRAX-Hip scores of at least 3% (84.8% among those with osteoporosis). Among 1711 Black women, 68.1% had normal FN-BMD, 4.1% had BMD-defined osteoporosis, and 1.8% had FRAX-Hip scores of at least 3% (32.4% among those with osteoporosis). Fracture risk factors differed by group. Diabetes was 2-fold more prevalent in Black and Asian (35% and 36%, respectively) vs NHW (16%) women. CONCLUSIONS: A large subset of Asian women have discordant BMD and FRAX scores, presenting challenges in osteoporosis management. Furthermore, FN-BMD and especially FRAX scores identified few Black women at high fracture risk warranting treatment. Studies should examine whether fracture risk assessment can be optimized in understudied racial minority populations, particularly when findings are discordant. [ABSTRACT FROM AUTHOR]

Much of the work on body image socialization masks the potentially unique influence of different socializers, yet clearer understanding of socialization mechanisms and ideological context aid intervention efforts. We explored how fathers, female peers, male peers, and adolescent boys themselves produce different levels of internalized appearance-related norms and how these socializer-specific norms differentially relate to wellbeing and beliefs related to gender identity. With a sample of early adolescent boys (n = 260; M age = 11.44 years, SD age =.56, 64% White), we used SEM to investigate relations between internalized norms, wellbeing, and gender beliefs. We found that most boys internalized appearance-related norms, and that boys reported higher levels of norms from themselves than from fathers or peers. Internalized appearance-related norms from different socializers uniquely related to self-esteem, private/public regard of gender, and self-presentation expectations in peer interactions. This relational framework provides unique insights into boys' experiences with their appearance and the role of different socializers. [ABSTRACT FROM AUTHOR]

A cultural-ecological approach posits that multiple sources of relational support can contribute to youths' strengths development. Some such strengths are positive future expectations (PFE) and hope, both of which represent beneficial, future-oriented cognitive-motivational constructs; however, they have not been fully explored among Latinx youth. Furthermore, it is unknown how different socializing agents (i.e., family, teachers, friends) influence youths' PFE, hope, and academic achievement, and if relations differ by gender and special education (SPED) designation. The present study (5th–12th grade Latinx students living in the Southwest U.S.; n = 748; 49% male; 15% SPED) investigated whether students' relational supports longitudinally related to their PFE (for education/work, self-satisfaction, community involvement), hope, and academic achievement 1 year later. In the non-SPED designated sample, family support related to PFE for work/education and self-satisfaction for boys. Conversely, teacher support related to PFE for work/education and self-satisfaction for girls. PFE for community involvement was low across the sample. The same pattern emerged for hope, with family support significant for boys and teacher support for girls. For achievement, teacher support related positively across gender. Friend support had few significant associations overall, although a significant negative relation emerged between friend support and achievement for SPED students. SPED students had a positive path between family support and PFE for work/education. Findings support a multidimensional approach to increasing strengths and resilience through increased attention to family, teacher, and friend support across unique groups of Latinx youth. [ABSTRACT FROM AUTHOR]

Professional and avocational archaeologists have recovered thousands of perishable artifacts from caves and rockshelters across the southern US Southwest, but few have been radiocarbon dated. This article reviews thirty AMS radiocarbon dates obtained on perishable items from nine shrine caves in the Jornada and Mimbres Mogollon regions of south-central New Mexico and west Texas. Dates were obtained from fragments of tablitas, effigies, prayer sticks, projectile point foreshafts, and flat curved sticks. Several convey iconographic elements of the Jornada Style of rock art while others are implements and weapons, but all were deposited in shrine caves. Problems inherent in the dating of shrine cave deposits and perishable artifacts are reviewed and technical matters involving contamination, curation, context, and sample materials are discussed. Analysis reveals several significant trends, one of the most salient being that the Goggle-eye motif, a signature element of Jornada and Mimbres iconography, has greater antiquity than previously assumed. [ABSTRACT FROM AUTHOR]

Background: The lesbian, gay, bisexual, transgender, or queer (LGBTQ) community is diverse, and members have a shared need for culturally competent health care (CCH). Best practices show that culturally appropriate affirmation training (CAAT) bridges the sociocultural knowledge gap between patient and provider, resulting in increased access to CCH. Method: The pre-/posttest project design used validated tools to measure group changes in knowledge, attitude, and skills before and after delivery of LGBTQ CAAT. The sample included staff interacting with or making decisions on behalf of patients (n = 11) at a nonprofit clinic in the southern United States. Results: A Wilcoxon signed-rank test showed an increase in health care team scores for knowledge, attitude, and skills (knowledge, p =.006, r = −.59; attitude, p =.123, r = −.33; skills, p =.005, r = −.60). Qualitative analysis (thematic analysis) (a) showed that participants explored sensitive subjects in a nonjudgmental way; (b) connected the dots between minority stress, bias, and patient-provider trust; and (c) showed increased staff confidence in providing care to LGBTQ patients. Conclusion: As staff undergo LGBTQ CAAT, access to CCH will increase, health outcomes will improve, and LGBTQ health disparities will decrease. [J Contin Educ Nurs. 2024;55(3):121–129.] [ABSTRACT FROM AUTHOR]

Sexual and gender minority (SGM) students report higher alcohol consumption, emotion regulation difficulties, and sexual assault victimization severity than cisgender, heterosexual individuals. A sample of 754 undergraduate students completed an online survey assessing alcohol use, emotion regulation, and sexual victimization. Regression analyses indicated that, among SGM students with higher emotion regulation difficulties, typical weekly drinking was positively associated with sexual assault victimization severity, but among cisgender, heterosexual students and SGM students with lower emotion regulation difficulties, there was no association between drinking and victimization severity. Thus, SGM students benefit from interventions targeting alcohol use and emotion regulation difficulties. [ABSTRACT FROM AUTHOR]

Cancer screening rates are low among Hispanic individuals. We examined subgroups of Latinos not adherent to cancer screening guidelines, using latent class analyses, to identify how different facets of cultural identity and risk factors might coalesce. Analyses of 2,873 Hispanic/Latino individuals revealed six latent classes: Connected Immigrants, Bridging Locals, Rooted Locals, Bridging Immigrants, Isolated Locals, and Connected Locals. Multinomial regression analysis also was used to examine sociodemographic and health care predictors of belonging to each latent class. Results show that the Connected Immigrants group, who are highly connected with their Latin culture and Spanish language dominant, stood in stark contrast to Rooted Locals, US born and English language dominant with non-Hispanic/Latino friendship groups. Rooted Locals also were more likely to have a usual source of care and less likely to have visited a doctor in the past year. These differences could shape health messaging beyond common variables such as ethnicity and language. [ABSTRACT FROM AUTHOR]

As the population of the United States continues to grow and diversify, it is critical that the medical profession follows. This study aimed to evaluate aspects of the current landscape of diversity within physical medicine and rehabilitation by surveying program directors of US-based physical medicine and rehabilitation residencies. The secondary aim was to identify program characteristics that correlate with more diverse residency classes. An online, cross-sectional 17-question survey was distributed to program directors of all US-based physical medicine and rehabilitation residencies with known contact information (95/100), with a completed survey response rate of 53% (50/ 95). Race and ethnicity categories of the survey were based on those used by the US Census. The percentages of individuals identifying as women or those underrepresented in medicine in this survey were below those of the general US population, a trend also seen within the field of physical medicine and rehabilitation overall. Linear regression revealed no statistically significant association between the percentage of underrepresented in medicine residents and commonly used diversity recruitment initiatives. There was a significant association between the presence of a departmental role for diversity, equity and inclusion and the percentage of women residents (odds ratio, 1.13; P = 0.017). Continued research is required to identify additional strategies with demonstrated efficacy in recruiting diverse residency applicants. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV), sexual assault, and stalking are consequential public health and safety issues with wide reaching impacts on emerging adults, including those on college campuses in the United States. In response to high rates of violence among college student populations, universities are developing campus-based advocacy (CBA) programs, which aim to support survivors of interpersonal violence through supportive connections, resource acquisition, and safety planning. However, little data exists related to their impact on key student-survivor outcomes. Thus, this study aims to understand (a) the approach CBA programs use to address safety and academic concerns of student-survivors, and (b) the initial outcomes of CBA programs on safety and academics among students engaged in CBA services at five universities in one Southwestern state. The project used a longitudinal mixed-methods approach, with data collection activities including qualitative interviews with student survivors (n = 29) and a longitudinal, web-based, quantitative survey with matched analyses of safety and academic outcome measures from 115 student survivors who participated in an initial survey and follow-up survey after 6 months. Findings demonstrate key pathways through which CBA programs support survivors and facilitate positive safety and academic outcomes. These pathways include education, supportive connection, and resource access. Analysis of longitudinal survivor data demonstrate substantial reductions in sexual violence, IPV, stalking, and school sabotage at 6-month follow-up compared to initial survey, as well as significant reductions in academic disengagement for student survivors. The findings of the study powerfully demonstrate the positive impact of CBA programs on survivor and campus outcomes. Furthermore, programs not only enhance individual survivor safety and academic outcomes but also support the overall climate and safety of hosting universities. [ABSTRACT FROM AUTHOR]

Background: There has been little research exploring paternal needs while experiencing a neonatal intensive care unit (NICU) stay. Some tools exist to measure paternal needs, but do not incorporate items to capture important information about how fathers cope with stress differently, and may have different needs. Therefore, an instrument is needed to measure and prioritize what needs are important to fathers to help facilitate the development of nursing interventions to help fathers cope with the NICU environment. Purpose: The purpose of this study was to conduct a feasibility study before large-scale pilot testing the instrument, the NICU Paternal Needs Inventory (NPNI), so we could then determine what are the physical, emotional, and psychological needs of fathers. Methods: A nonexperimental, quantitative, and descriptive design was used to address the study's aims. Fathers were recruited from a level IV NICU and asked to complete an online survey (consisting of a demographic survey and the NPNI). Results: Needs rated 100% were knowing infant's progress, directions on caring for infant, flexible visitation, and assurance receiving the best care. The remainder showed a wide range of responses suggesting that needs of fathers are individual and varied. Implications for Practice and Research: Use of the NPNI to evaluate a father's unique and individual needs would allow for the nurse to develop father-specific, individualized interventions. Findings support that the NPNI is feasible to accomplish measuring fathers' needs, but a larger study is needed to test the reliability and validity of this tool. [ABSTRACT FROM AUTHOR]

Purpose: Research shows that women who experience intimate partner violence (IPV) are at risk for a range of adverse mental health outcomes, including depression, post-traumatic stress disorder (PTSD), and suicidality. However, few studies use measures that reflect the broad range of IPV exposures that women experience. This paper examines the associations between multiple IPV types and adverse mental health among a sample of survivors engaged in care. Methods: This article draws on data from a web-based survey administered to 377 women seeking IPV services in a Southwestern U.S. state. Multivariate regression analyses with multiple imputation were conducted to investigate the net association between multiple types of IPV and three mental health outcomes: depression, PTSD, and a prior suicidal attempt or threat, controlling for socio-demographics and self-rated health. Results: Multivariate analyses indicated significant associations between reproductive coercion (β = 6.89, p <.001), technology-facilitated violent threats (β = 5.27, p <.05), and psychological vulnerability/abuse (β = 4.45, p <.05) and symptoms of depression. Findings also indicated significant net associations between reproductive coercion (β = 7.05, p <.001), technology-facilitated humiliation (β = 4.87, p <.05), and psychological vulnerability/abuse (β = 7.76, p <.001) and increased PTSD symptomology. Finally, psychological vulnerability/abuse (aOR = 3.36, p <.01) increased the likelihood of reporting a prior suicidal attempt or threat. Conclusion: Women reporting reproductive coercion, technology-facilitated abuse, and psychological vulnerability/abuse had a higher risk of adverse mental health. More research is needed to understand the mechanisms that underlie these varied associations and to develop a cohesive practice model attuned to integrated needs. [ABSTRACT FROM AUTHOR]

Objective: Immigrant Muslim Arab women are a fast-growing and underserved minority group in the United States. Immigrant Muslim Arab women face breastfeeding challenges in accessing and seeking healthcare. Little is known about breastfeeding challenges that immigrant Muslim Arab women face to establish successful breastfeeding. This study aimed to identify the barriers and facilitators to adequate breastfeeding among immigrant Muslim Arab women who reside in a metropolitan area of the Southwestern United States and inform recommendations for practice. Methods: A cross-sectional, descriptive study was used to identify facilitators and barriers to adequate breastfeeding using the social–ecological model of health promotion. A survey was carried out with a convenience sample of 116 immigrant Muslim Arab women with at least one child, 5 years or younger, from a large metropolitan area between September and November 2016. Results: Facilitators of breastfeeding within the sample were high intentions to breastfeed, positive breastfeeding attitudes related to the benefits of breastfeeding, religious teachings promoting breastfeeding, and encouragement to breastfeed from the mothers' social support system. Several barriers to successful breastfeeding were related to lacking the specific knowledge of the benefits of breastfeeding and discomfort with breastfeeding in public and in front of strangers. Conclusions: Nurses and healthcare providers need to apply ecological breastfeeding interventions to promote optimal breastfeeding in this population. [ABSTRACT FROM AUTHOR]

Using a computer-based, information acquisition process tracing task (MouselabWEB), participants (N = 100) were presented with varying types and amounts of information and were tasked with choosing a mental health professional (MHP). Results of this lab-based study indicated that the tendency to engage in heuristically-driven decision-making process increases as MHP choice and cognitive burden increases. When MHP choices are limited, participants tend to acquire information on MHP's age, treatment orientation, education, and years of experience. As MHP choices increase, MHP gender and ethnicity information were utilized the most, and education and years of experience utilized the least. [ABSTRACT FROM AUTHOR]

BACKGROUND: A trauma registry review of our trauma center's alcohol misuse screening compliance noted inconsistent screening and data collection methods, putting our American College of Surgeons trauma center reverification at risk for a deficiency. OBJECTIVE: The objective of this study was to evaluate an alcohol misuse screening improvement initiative on screening compliance in trauma patients. METHODS: This before and after analysis of a quality improvement initiative to improve alcohol misuse screening was conducted from 2019 to 2021 at a Southwestern U.S. Level II trauma center on admitted trauma patients aged 13 years and older. The multicomponent initiative included a change in the screening instrument and timing of application, implementing electronic medical record documentation screens, and educating staff. The primary outcome measure was screening adherence. RESULTS: A total of n = 4,734 patients were included in the study period. Alcohol misuse screening improved from 2.9% to 87.4% and remained sustained for over a year after the initiative's implementation. CONCLUSION: The performance improvement initiative improved the alcohol misuse screening process, resulting in consistent screenings exceeding the American College of Surgeons standards of 80% for verified trauma centers. [ABSTRACT FROM AUTHOR]

BACKGROUND: Most pediatric patients present to general emergency departments, yet maintaining pediatric equipment, skilled staff, and resources remains a challenge for many hospitals. Pediatric readiness assessment is now a requirement for trauma center verification. OBJECTIVE: This study aims to assess the impact of a quality improvement initiative to improve emergency department pediatric readiness. METHODS: A pre- and poststudy design was used to evaluate a quality improvement initiative to improve the National Pediatric Readiness assessment survey results conducted at a Southwestern United States adult Level I trauma center from September 2022 to April 2023. The multicomponent initiative included implementing a pediatric emergency care coordinator, pediatric-specific policies and procedures, identifying pediatric-specific quality and performance indicators, and educating pediatric-specific staff. Study inclusion criteria were all patients younger than 18 years who presented to the emergency department. The primary outcome measure was the improvement in the weighted Pediatric Readiness Score. Secondary outcomes were throughput, nursing documentation of vital signs, and pain scores. RESULTS: A total of N = 2,356 patients met inclusion, of which n = 1,158 (49.2%) were in the preintervention group and n = 1,198 (50.8%) postintervention group. The weighted Pediatric Readiness Score improved by 45.4%. Transfers to a pediatric hospital increased from 4.1% to 8.6% (p = .016). Blood pressure documentation improved slightly from 88.3% to 88.6%. Pain score documentation decreased from 83.9% to 63.1% (p = .008). Pain medication and administration improved from 19.8% to 26.7% (p = .046). CONCLUSION: We found that participation in the quality improvement initiative was associated with emergency department pediatric readiness improvements. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to determine the relationship between trait and situational empathy, and the effect of educational activities on empathy of nursing students towards people living with dementia. Design/methodology/approach: This embedded mixed-methods study compared trait and situational empathy examined situational empathy pre/post didactic and experiential activities with nursing students and used qualitative data from focus group discussions to corroborate the quantitative data. Findings: There was no significant difference between trait and situational empathy. Post intervention scores (situational) demonstrated improvements on empathic concern, shared affect, empathic imagination, helping motivation and cognitive empathy. Focus group discussions supported quantitative findings and also included distress. Research limitations/implications: Limitations include lack of generalizability, single group threats and exclusion of stakeholder input. Single group threats include absence of a control group, familiarity with the CSES from pre-test to post-test and reactive measurements, as the students were observed by faculty while completing the Dementia Live activity. The perspective of stakeholders would strengthen the impact of the results on implementation. Practical implications: Information gleaned from this study can help inform administrators in education and in practice. CliftonStrengths assessment and Dementia Live simulation activities can be used for administrators, faculty and students in schools of nursing as well as administrators and health-care workers. Social implications: Information from this study can impact those living with dementia as well as their caregivers. Originality/value: Most studies involving health-care students and empathy do not delineate between trait and situational empathy. This study is unique in that it measured both and sought a relationship between the two. Determining one's personal attributes such as trait empathy, can help students capitalize on their strengths and ultimately enhance patient care. [ABSTRACT FROM AUTHOR]

Purpose: Research shows peer health education programs on university campuses can support students in pursuing sustainable health-related behavior changes. However, few programs deliver peer health education through a nondiet, weight-inclusive framework. Research shows that health educators who challenge the status quo of diet culture and weight-focused health interventions may face unique challenges when sharing this perspective with others. Thus, the purpose of this study was to examine the experiences of peer educators who provided critical health education by introducing a nondiet, weight-inclusive approach to health. Design/methodology/approach: Five health coaches from a university health coaching program at a mid-sized southwestern university participated in a semi-structured interview. The data were analyzed through interpretative phenomenological analysis. Findings: Peer educators faced numerous challenges when introducing nondiet, weight-inclusive approaches such as lacking credibility as a peer to challenge weight-centric messages, feeling conflicted about honoring clients' autonomy when clients are resistant to a weight-inclusive approach and feeling uncomfortable when discussing client vulnerabilities. Peer educators also identified several strategies that helped them navigate these challenges such as being intentional with social media, using motivational interviewing to unpack clients' concerns about weight, and seeking group supervision. Originality/value: Given the reality that health coaches will face challenges sharing weight-inclusive health approaches, educators and supervisors should explicitly incorporate strategies and training methods to help peer health coaches prepare for and cope with such challenges. More research is also needed to examine effective ways to introduce weight-inclusive approaches to college students. [ABSTRACT FROM AUTHOR]

Climate warming, land use change, and altered fire regimes are driving ecological transformations that can have critical effects on Earth's biota. Fire refugia—locations that are burned less frequently or severely than their surroundings—may act as sites of relative stability during this period of rapid change by being resistant to fire and supporting post‐fire recovery in adjacent areas. Because of their value to forest ecosystem persistence, there is an urgent need to anticipate where refugia are most likely to be found and where they align with environmental conditions that support post‐fire tree recruitment. Using biophysical predictors and patterns of burn severity from 1180 recent fire events, we mapped the locations of potential fire refugia across upland conifer forests in the southwestern United States (US) (99,428 km2 of forest area), a region that is highly vulnerable to fire‐driven transformation. We found that low pre‐fire forest cover, flat slopes or topographic concavities, moderate weather conditions, spring‐season burning, and areas affected by low‐ to moderate‐severity fire within the previous 15 years were most commonly associated with refugia. Based on current (i.e., 2021) conditions, we predicted that 67.6% and 18.1% of conifer forests in our study area would contain refugia under moderate and extreme fire weather, respectively. However, potential refugia were 36.4% (moderate weather) and 31.2% (extreme weather) more common across forests that experienced recent fires, supporting the increased use of prescribed and resource objective fires during moderate weather conditions to promote fire‐resistant landscapes. When overlaid with models of tree recruitment, 23.2% (moderate weather) and 6.4% (extreme weather) of forests were classified as refugia with a high potential to support post‐fire recruitment in the surrounding landscape. These locations may be disproportionately valuable for ecosystem sustainability, providing habitat for fire‐sensitive species and maintaining forest persistence in an increasingly fire‐prone world. [ABSTRACT FROM AUTHOR]

BACKGROUND: Preterm birth (PTB), defined as birth before 37 wk gestation, is associated with hypertension, diabetes, inadequate prenatal care, unemployment or poverty, and metal exposure. Indigenous individuals are more likely to have maternal risk factors associated with PTB compared with other populations in the United States; however, the role of environmental metals on PTB among pregnant Indigenous women remains uncertain. Previous research identified associations between PTB and individual metals, but there is limited investigation on metal mixtures and this birth outcome. OBJECTIVES: We used a mixtures analysis framework to investigate the association between metal mixtures and PTB among pregnant Indigenous women from the Navajo Birth Cohort Study (NBCS). METHODS: Maternal urine and blood samples were collected at the time of study enrollment and analyzed for metals by inductively coupled plasma dynamic reaction cell mass spectrometry. Bayesian Profile Regression was used to identify subgroups (clusters) of individuals with similar patterns of coexposure and to model association with PTB. RESULTS: Results indicated six subgroups of maternal participants with distinct exposure profiles, including one group with low exposure to all metals and one group with total arsenic, cadmium, lead, and uranium concentrations exceeding representative concentrations calculated from the National Health and Nutrition Examination Survey (NHANES). Compared with the reference group (i.e., the lowest exposure subgroup), the subgroup with the highest overall exposure had a relative risk of PTB of 2.9 times (95% credible interval: 1.1, 6.1). Exposures in this subgroup were also higher overall than NHANES median values for women 14–45 years of age. DISCUSSION: Given the wide range of exposures and elevated PTB risk for the most exposed subgroups in a relatively small study, follow-up investigation is recommended to evaluate associations between metal mixture profiles and other birth outcomes and to test hypothesized mechanisms of action for PTB and oxidative stress caused by environmental metals. [ABSTRACT FROM AUTHOR]