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Background: The impact on cardiovascular health is lost when a patient does not obtain a newly prescribed lipid-lowering medication, a situation termed "initial medication nonadherence" (IMN). This research summarizes the published evidence on the prevalence, associated factors, consequences, and solutions for IMN to prescribed lipid-lowering medication in the United States. Methods: A systematic literature search using PubMed and Google Scholar, along with screening citations of systematic reviews, identified articles published from 2010 to 2021. Studies reporting results of IMN to lipid-lowering medications were included. Studies that evaluated non-adult or non-US populations, used weaker study designs (e.g., case series), or were not written in English were excluded. Results: There were 19 articles/18 studies that met inclusion and exclusion criteria. Estimates of the prevalence of IMN to newly prescribed lipid-lowering medications ranged from 10 to 18.2% of patients and 1.4–43.8% of prescriptions (n = 9 studies). Three studies reported prescriber and patient characteristics associated with IMN. Hispanic ethnicity, Black race, lower Charlson Comorbidity Index score and no ED visits or hospitalization were associated with IMN. Lipid lowering prescriptions from primary care providers were also associated with IMN. Four studies described patient-reported reasons for IMN, including preference for lifestyle modifications, lack of perceived need, and side effect concerns. Four intervention studies reported mixed results with automated calls, live calls, or letters. One study reported worse clinical outcomes in patients with IMN: higher levels of low-density lipoprotein and greater risk of emergency department visits. Conclusions: Up to one-fifth of patients fail to obtain a newly prescribed lipid-lowering medication but there is limited information about the clinical consequences. Future research should assess outcomes and determine cost-effective approaches to address IMN to lipid-lowering therapy. [ABSTRACT FROM AUTHOR]

Black women social workers (BWSWs) represent essential workforce members who are burdened by ongoing COVID-19 circumstances. Strategies to deal with highly stressful situations on the job, such as those experienced in 2020, were absent from the research literature leaving intervention strategies to support highly stressed BWSWs unknown. This study aimed to uncover the various ways BWSWs experienced their organizations as they performed work duties. Atlas.ti. 9 was used to analyze verbatim transcripts from 17 semi-structured qualitative interviews given by BWSWs across the United States in February 2021. Hermeneutic phenomenology was implemented to interpret interview data. The convenience sample was drawn from professional organizations where BWSWs claimed membership and volunteered to be electronically interviewed for 2 hours generating themes such as stress perceptions, institutional barriers to efficient work productivity and recommendations for workplace support. BWSWs reported high stress work environments in the past year. Some believed that their health and mental health declined because of the inability to find work-home life balance. Findings suggest BWSWs persevere regardless of high levels of stress and being unsupported in the workplace in order to maintain a livelihood. BWSWs play a crucial role in the lives of vulnerable populations, but need to attend to ways to be healthier given the polarization associated with racism, classism, and sexism experienced. Thematically, the data revealed stressful situations in the workplace and how organizations have failed to implement strategies in order to improve social worker health. Suggestions for workplace supports were also identified. [ABSTRACT FROM AUTHOR]

Adolescents from ethnoracially minoritized backgrounds increasingly report high rates of attempted suicide, trauma exposure, and limited access to mental healthcare services. However, less is known regarding their use of services across different youth‐serving systems. This study examines the associations and interactions between self‐injurious thoughts and behaviors (SITBs), race/ethnicity, and service sector utilization (mental healthcare, general healthcare, school, and social services) among a sample of trauma‐exposed and treatment‐seeking adolescents. Participants were treatment‐seeking adolescents (N = 4406) ages 12–17 from the National Child Traumatic Stress Network Core Data Set who had available data for SITBs, race/ethnicity, services utilized, and other key variables. Mixed effects logistic regression was used to examine main and interactive effects for whether adolescents' race/ethnicity and SITBs were associated with service utilization in each of the identified service sectors. SITBs were associated with adolescents' utilization of mental healthcare (OR = 1.38 p < 0.001), general healthcare (OR = 2.30; p < 0.001), and school services (OR = 1.38 p < 0.001). NH Black adolescents reporting SITBs were less likely to use mental health services than other NH Black youths (OR = 0.53; p = 0.004). Hispanic adolescents reporting SITBs were more likely to utilize healthcare services than other Hispanic youths (OR = 1.51; p = 0.039). Trauma‐exposed adolescents reporting SITBs are more likely to utilize mental healthcare, general healthcare, and school‐based services than other trauma‐exposed adolescents. However, NH Black adolescents experiencing SITBs may face additional barriers to utilizing mental healthcare services. Findings can be used to develop nursing practices and policies to address barriers faced by adolescents reporting SITBs. [ABSTRACT FROM AUTHOR]

The Northeast United States (NEUS) has faced the most rapidly increasing occurrences of extreme precipitation within the US in the past few decades. Understanding the physics leading to long‐term trends in regional extreme precipitation is essential but the progress is limited partially by the horizontal resolution of climate models. The latest fully coupled 25‐km GFDL (Geophysical Fluid Dynamics Laboratory) SPEAR (Seamless system for Prediction and EArth system Research) simulations provide a good opportunity to study changes in regional extreme precipitation and the relevant physical processes. Here, we focus on the contributions of changes in synoptic‐scale events, including atmospheric rivers (AR) and tropical cyclone (TC)‐related events, to the trend of extreme precipitation in the fall season over the Northeast US in both the recent past and future projections using the 25‐km GFDL‐SPEAR. In observations, increasing extreme precipitation over the NEUS since the 1990s is mainly linked to TC‐related events, especially those undergoing extratropical transitions. In the future, both AR‐related and TC‐related extreme precipitation over the NEUS are projected to increase, even though the numbers of TCs in the North Atlantic are projected to decrease in the SPEAR simulations using the SSP5‐8.5 projection of future radiative forcing. Factors such as enhancing TC intensity, strengthening TC‐related precipitation, and/or westward shift in Atlantic TC tracks may offset the influence of declining Atlantic TC numbers in the model projections, leading to more frequent TC‐related extreme precipitation over the NEUS. Plain Language Summary: In recent decades, the densely populated Northeast United States has faced the most rapid increase in the frequency of extreme rainfall within the US. Here, we examine the causes of the increase in extreme rainfall over the Northeast US in both current and future climates. We find that the surge in extreme rainfall since the 1990s is primarily linked to events associated with tropical cyclones. In a future warming climate, based on projections from a high‐resolution climate model, our research shows that we can expect more frequent occurrences of extreme rainfall related to both atmospheric rivers and tropical cyclones. However, the increase in extreme rainfall linked to atmospheric rivers is projected to outpace that associated with tropical cyclones. Given the distinct spatial patterns of extreme rainfall resulting from atmospheric rivers and tropical cyclones, changes in their relative contributions could have profound implications for flood prevention and mitigation strategies. Key Points: The autumn extreme precipitation trend over the Northeast US is primarily attributed to tropical cyclone‐related events since the 1990sIn future projections, extreme precipitation linked to atmospheric rivers increases faster than that associated with tropical cyclonesDespite fewer projected tropical cyclones in the future, extreme precipitation associated with them is projected to increase [ABSTRACT FROM AUTHOR]

Background: Young adult sexual minority women (SMW) are at elevated risk for sexual assault (SA), posttraumatic stress disorder (PTSD), and inadequate social support. While SA and PTSD can lead to reductions in social support from close significant others, the impact of SA and PTSD on SMWs’ social support has not previously been assessed. Objective: This study examined the associations of past year SA and PTSD with SMW’s social support from intimate partners, family, and friends. It was hypothesized that SA and PTSD would be negatively associated with support from partners, family and friends, and that PTSD would moderate the effect of SA on support in early adulthood. Method: Young adult SMW in the United States (N = 235) who were M = 23.93 (SD = 2.15) years old, primarily lesbian or bisexual (n = 186, 79.1%) and White (n = 176, 74.9%) completed measures on past year exposure to SA and non-SA trauma, PTSD, and social support from intimate partners, family and friends. Results: PTSD was associated with less social support from partners, (b = −0.06, SE = 0.02, p = .010, R² change= .02), family, (b = −0.06, SE = 0.03, p = .025, R² change= .02), and friends, (b = −0.07, SE = 0.02, p = .008, R² change= .02). There was a significant interaction between PTSD and SA on social support from partners (b = −0.01, SE = 0.01, p = .047, R2 change= .01). Neither non-SA nor SA trauma was associated with support from family or friends. Conclusions: Results underscore the potential impact of recent SA on intimate partnerships for young adult SMW with more severe PTSD. Future work should explore how addressing PTSD and improving social support quality may help SMW recover from traumatic experiences and ameliorate the effects of SA on intimate partnerships. [ABSTRACT FROM AUTHOR]