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As interest in local food development and urban agriculture increases, the Cooperative Extension Service is challenged to serve local and urban food communities in Arkansas. Urban farmers in Arkansas have differing motivations for operation than those in production agriculture, so understanding agricultural county agents' perceptions of urban farmers is critical for program development and implementation in this sector and to bridge any gaps between Extension and urban producers. This study was conducted to determine the perceptions of, awareness of, ability to assist with, and barriers to working with urban farmers in Arkansas. An emailed instrument was sent to Arkansas staff chairs and agricultural county agents and data were analyzed using descriptive statistics. A total of 57 agents participated in the survey. Responses from agents in more populous regions of Arkansas were comparatively analyzed to those from less populous regions. Results indicated agents infrequently interacted with urban farmers in their counties, yet believed Extension was a valuable resource for urban farmers and that more resources should be allocated to developing urban farming programming. Respondents also self-identified as having low levels of personal knowledge relating to urban agriculture, with 72% of respondents indicating they were not knowledgeable or slightly knowledgeable about urban agriculture. There was a significant difference between the responses of agents in more populous counties and those in less populous counties. Future research aims to conduct a similar survey relating to local food in Arkansas, not just urban agriculture.

Cabotegravir + rilpivirine (CAB + RPV-LA) is a long-acting antiretroviral therapy (ART) that can be utilized for people with human immunodeficiency virus (HIV) who face barriers to daily ART. Here, we describe the implementation of a program that provides low-barrier access to CAB + RPV-LA for people with HIV and opioid use disorder at a syringe exchange. [ABSTRACT FROM AUTHOR]

Effective diffusion of educational innovations is essential for evidence-based practices to have broad impacts on student learning. One of the barriers to such diffusion is the large inertia associated with changing one's teaching practices. Educational disruptions, such as COVID-19, may lower this barrier by making business-as-usual no longer feasible. Here, we reflect on the ways in which an online community, designed to promote diffusion of educational innovation, supported Advanced Placement (AP) Chemistry teachers in the rapid transition to online instruction necessitated by the pandemic. The lessons learned from supporting teachers as they responded to the pandemic may provide insights into how to better promote and support adoption of reformed teaching strategies.

Objective: The objective of this study was to assess the existence of the obesity paradox in patients with COVID‐19 admitted to the intensive care unit. Methods: This was a multicentric retrospective cohort study including individuals aged 18 years or older admitted to the intensive care unit with SARS‐CoV‐2. Data were obtained from electronic medical records. The primary outcome was in‐hospital mortality. Multiple logistic regression and restricted cubic splines analyses were conducted to assess the association between BMI and mortality. Results: From March 2020 to December 2021, 977 patients met the inclusion criteria, and 868 were included in the analysis. Obesity was identified in 382 patients (44%). Patients with obesity more often underwent prone positioning (42% vs. 28%; p < 0.001), although they used less vasoactive medications (57% vs. 68%; p < 0.001). The overall in‐hospital mortality was 48%, with 44% observed in the subgroup of individuals with obesity and 50% in those without obesity (p = 0.06). Patients with BMI < 25 kg/m2 had the highest mortality. Conclusions: Obesity was not associated with higher mortality rates in critically ill patients with COVID‐19. Moreover, patients with BMI < 25 kg/m2 had a higher mortality rate compared with those in higher BMI categories. [ABSTRACT FROM AUTHOR]

Purpose. This study's purpose was to determine the impact of weighted blanket use on moderate to severe insomnia in adults with sensory sensitivity greater than the average population. Methods. For this study, a four-week, single-case, multiple-participant ABA study design was used. Through convenience sampling, four participants scoring 15 or greater on the Insomnia Severity Index (ISI), which categorizes them as having moderate to severe insomnia, and much more than most people in sensory sensitivity on the Adolescent/Adult Sensory Profile were recruited. First, seven-day baseline sleep data was gathered, followed by two weeks of weighted blanket use, concluding with a seven-day withdrawal phase. Additional outcome measures included: Tuck and Snooze Survey, Consensus Sleep Diary Morning, and Additional Sleep Diary Questions. Data analysis included visual analysis, mean comparisons, Tau- U calculations, and pre- to post-ISI category comparisons. Results. All participants' ISI scores were categorized as one level less severe postintervention. All participants demonstrated increased sleep quality, and three participants showed an increase in sleep duration based on individual mean comparisons between baseline and intervention phases. Conclusion. Weighted blankets appear beneficial in reducing insomnia severity in adults with much more than the average population sensory sensitivity. In addition, those with self-reported anxiety may have increased benefit from this intervention. [ABSTRACT FROM AUTHOR]

The authors present the feasibility and acceptability of a parent sexuality education program led by peer educators in community settings. They also report the results of an outcome evaluation with 71 parents who were randomized to the intervention or a control group and surveyed one month prior to and six months after the four-week intervention. The program was highly feasible and acceptable to participants, and the curriculum was implemented with a high level of fidelity and facilitator quality. Pilot data show promising outcomes for increasing parental knowledge, communication, and monitoring of their adolescent children.

Background: Epidemic increases in childhood obesity and associated health risks are resulting in efforts to implement school policies related to nutrition and physical activity (NPA). With multicomponent policy efforts, challenges exist in characterizing the extent of policy change across the breadth of NPA policies. Methods: Aggregated policy indices were created to characterize NPA policy implementation in Arkansas public schools from 2004 through 2009. Index scores are presented by year, domain, and school level. Results: Both mean and median index scores increased over time, with greater changes seen in nutrition than in physical activity policy scores. The composite index score was heavily dependent on the nutrition index score and, thus, is relatively less useful for the purposes of our evaluation. Policy index scores varied by school level, rurality, enrollment size, and percentage of students eligible for federal meal programs. Conclusions: The policy index approach facilitates the consideration of the effect of school policy change in a holistic, aggregated way. School characteristics influence policy adoption, and thus, should be taken into consideration in the promotion of policy change. (Contains 4 tables and 1 figure.)

Background: Foods provided in schools represent a substantial portion of US children's dietary intake; however, the school food environment has proven difficult to describe due to the lack of comprehensive, standardized, and validated measures. Methods: As part of the Arkansas Act 1220 evaluation project, we developed the School Cafeteria Nutrition Assessment (SCNA) measures to assess food availability in public school cafeterias (n = 113). The SCNA provides a measure to evaluate monthly school lunch menus and to observe foods offered in school cafeterias during the lunch period. These measures provide information on the availability of fruit, vegetables, grains (whole or white), chips (reduced fat or regular), side dishes, main dishes, beverages, a la carte selections, and desserts, as well as information on healthier preparation of these items. Using independent raters, the inter-rater reliability of the measure was determined among a subsample of these schools (n = 32). Results: All food categories assessed, with the exception of the side dish and chip categories, had inter-rater reliability rates of 0.79 or greater, regardless of school type. The SCNA scores encompassed the majority of the possible scores, indicating the ability for the measures to differentiate between school cafeterias in the availability of healthier options. Conclusion: These measures allow comprehensive, rapid measurement of school cafeteria food availability with high inter-rater reliability for public health and school health professionals, communities, and school personnel. These measures have the potential to contribute to school health efforts to evaluate cafeteria offerings and/or the impact of policy changes regarding school foods. (Contains 5 tables.)

OBJECTIVE: To determine the value of the radiological study of the thorax for diagnosing left ventricular dilation and left ventricular systolic dysfunction in patients with Chagas' disease. METHODS: A cross-sectional study of 166 consecutive patients with Chagas' disease and no other associated diseases. The patients underwent cardiac assessment with chest radiography and Doppler echocardiography. Sensitivity, specificity, and positive and negative predictive values of chest radiography were calculated to detect left ventricular dysfunction and the accuracy of the cardiothoracic ratio in the diagnosis of left ventricular dysfunction with the area below the ROC curve. The cardiothoracic ratio was correlated with the left ventricular ejection fraction and the left ventricular diastolic diameter. RESULTS: The abnormal chest radiogram had a sensitivity of 50%, specificity of 80.5%, and positive and negative predictive values of 51.2% and 79.8%, respectively, in the diagnosis of left ventricular dysfunction. The cardiothoracic ratio showed a weak correlation with left ventricular ejection fraction (r=-0.23) and left ventricular diastolic diameter (r=0.30). The area calculated under the ROC curve was 0.734. CONCLUSION: The radiological study of the thorax is not an accurate indicator of left ventricular dysfunction; its use as a screening method to initially approach the patient with Chagas' disease should be reevaluated.

Children with Autism Spectrum Disorder (ASD) often exhibit feeding and eating behavior problems. The Autism Eats nutrition intervention was designed to improve problematic mealtime behaviors and diet quality in children with ASD under 3 years. To analyze qualitative data from exit interviews in a pilot randomized controlled trial (RCT). This study utilized preliminary data from semi-structured exit interviews conducted with early intervention (EI) providers and parents of toddlers with ASD. Participants were assigned to either the Autism Eats intervention or the Enhanced Usual Care (EUC) control group. Exit interviews were performed through virtual meetings post-intervention. Interviews took up to 50 minutes with questions on overall program, lesson structure/design, content/materials, delivery format, family involvement, intervention acceptability, and feeding and eating behavior changes. Interviews were recorded, transcribed verbatim, and analyzed for emerging themes and thematic codes using a general inductive approach. Constant comparisons were utilized until the codebook was finalized. Six major themes emerged: (1) Problems at mealtime, particularly not sitting at the table; (2) Sensory processing of food; (3) Communication at mealtime; (4) Improved diet quality (eg, "It would just teach you healthier habits for your child and learn more about your child's nutrition, too"); (5) Positive feedback on intervention materials (eg, "...the information is phenomenal, I think I can say that over and over again, and I love the handouts ..."); and (6) Suggestions for program improvement (eg, more recipes). The majority of providers and parents in the Autism Eats group reported noticing an improvement in mealtime and eating behaviors, while the EUC participants did not particularly mention that the program helped with ASD-specific issues. Findings suggest that parents believe the Autism Eats intervention effectively addressed problematic mealtime behaviors and diet quality among children with ASD. Participants appreciated its focus on specific problematic behaviors and nutritional issues related to ASD. Intervention materials will be refined based on feedback and suggestions for a large-scale efficacy trial. NIH, The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) [ABSTRACT FROM AUTHOR]

Examine the relationship between Premenstrual Syndrome (PMS) and sleep in different menstrual cycle phases. Case-control survey conducted at the Primary Care Service and Clinical Research Center at Hospital de Clínicas de Porto Alegre with women aged between 18 and 45 years old. Women filled the Brazilian version of the Premenstrual Symptoms Screen Tool (PSST) for the screening of PMS; participants with positive screening completed the Daily Record of Severity of Problems (DRSP) to confirm PMS diagnosis. We applied the Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) Brazilian versions in the luteal phase (LP) and follicular phase (FP). 69 women were characterized with PMS and 52 without PMS. The risk of poor sleep quality (SQ) was two times higher in women with PMS (p =.006; OR = 3.057; IC95% 1.44–6.45). An interaction between no PMS and LP was found in ESS (p =.014; generalized estimating equation – GEE - adjusted for multiple comparisons by the Bonferroni test and adjusted by age); besides that, women with PMS had greater scores in ESS (p =.022; GEE adjusted by age). [ABSTRACT FROM AUTHOR]

Urban farming is a phenomenon rising in popularity across the United States. Investigating the needs of urban farmers in a predominately rural state is important in informing future programming and technical assistance for these clients. This qualitative study used semi-structured, in-depth interviews that investigated the perceptions, needs, and experiences of Arkansas urban farmers and their interactions with the University of Arkansas Division of Agriculture Cooperative Extension Service. Interviews were conducted with 16 urban farmers in Northwest and Central Arkansas. The interview data revealed highly individualized needs based on the operation size, years in operation, and mission of each urban farmer interviewed. While needs varied, some were consistent, such as market pricing, co-ops, and access to appropriate equipment. Participants also revealed a positive perception of Extension, though they cited that the organization did not always have resources specific to small-scale, sustainable farming. Building from the Community Food System Development Framework for Change and informed by the AgroEcological-Educator theory, this study provides urban farmers' insights and contextualizes urban farming in a predominately rural, southern state. Potential remains for increased collaboration and communication between Arkansas urban farmers and Extension. This article demonstrates the diverse needs of Arkansas urban farmers, which can be used by Extension and sustainable agriculture experts to inform research about urban and sustainable farmers in their respective states. [ABSTRACT FROM AUTHOR]

Objective: Approximately one in four deaths among people living with HIV (PLWH) in the United States can be attributed to cigarette smoking. Using a nationally representative sample of PLWH, this study examines the prevalence, time-trends, and correlates of current cigarette smoking among PLWH compared to people without HIV.Design: Secondary analysis of population-based cross-sectional biobehavioral survey.Methods: Data were pooled from the 1999-2016 National Health and Nutrition Examination Survey (NHANES). All adults (20-59 years) who self-reported their smoking status and were tested for HIV (HIV+ = 152; HIV- = 26 305) were included in the analysis. Prevalence with 95% confidence interval (95% CI), trend analysis by year and group (HIV+/HIV-), and multivariable logistic regression analyses were performed with the complex survey design adjustments.Results: Overall, 47.0% of PLWH were current smokers compared to 25.5% of those without HIV. From 1999 to 2016, the decline in smoking in PLWH was comparable to those without HIV (10.7% vs. 8.0%). PLWH smokers were more likely than PLWH nonsmokers to be substance users (adjusted odds ratio [aOR] = 17.52; 95% CI = 2.04 to 27.8). Compared to smokers without HIV, PLWH smokers were more likely to be older (1.10; 1.06 to 1.14), males (7.96; 2.50 to 25.40), non-Hispanic Black (10.45; 4.13 to 26.45), with depression (Patient Health Questionnaire-9 sum score ≥5) (3.79; 1.22 to 11.79), and less likely to be gay (0.02; 0.00 to 0.07).Conclusion: Cigarette smoking among PLWH is a major public health problem in the United States. Targeted and tailored smoking cessation interventions that incorporate assessment and treatment of depression and co-occurring substance use are critical for PLWH, especially among those who are disproportionately affected by smoking and HIV (sexual minority).Implications: This study offers important research implications in four areas:1. The decline in smoking among PLWH over 18 years has been modest, and half of PLWH are still smokers.2. More resources and efforts should be allocated to reduce cigarette smoking among PLWH.3. There is a critical need to develop and test culturally tailored smoking cessation interventions for minority subgroups who are most impacted by HIV infection and smoking (non-Hispanic Blacks and men who have sex with men)4. Smoking cessation interventions designed for PLWH should incorporate assessment and treatment of depression and substance use. [ABSTRACT FROM AUTHOR]

Decisions being made on Capitol Hill and in state capitols may seem remote from the experiences of early childhood professionals, but policymakers have a big impact on babies and families. Early childhood professionals and parents bring key expertise and passion to policy advocacy and have a powerful role to play. This article identifies the skills that early childhood professionals naturally bring to advocacy and offers stories from two early childhood advocates. Right now, babies need you to Be a Big Voice for Little Kids™. Learn how you can leverage your unique expertise to help policymakers Think Babies™. [ABSTRACT FROM AUTHOR]

Purpose: To examine the relationship between Premenstrual Syndrome (PMS) and female sexual function (FSF) with the luteal (LP) and follicular phases (FP).Method: We performed a cross-sectional survey using the Female Sexual Function Index (FSFI) questionnaire in the LP and FP. We used the Brazilian's version of the Premenstrual Symptoms Screen Tool (PSST) and the Daily Record of Severity of Problems (DRSP) for diagnosis of PMS.Results: There was no difference in the FSF between groups in both cycle phases. We found an association between LP and worst scores on FSFI.Conclusion: PMS does not affect FSF. [ABSTRACT FROM AUTHOR]

The article discusses the study of when policy and psychology meet; and mitigating the consequences of bias in schools. Topics discussed include Harsh exclusionary discipline predicts major negative life outcomes, including adult incarceration and unemployment; and results indicate that the integrated interventions can curb teachers' troublemaker labeling and pattern prediction toward Black students who misbehave in a hypothetical paradigm.

Rationale: Recent studies of trainee evaluations of medical faculty have demonstrated subtle gender-based word choice differences. However, it is not known if this manifests in major contextual differences in written comments.Objectives: To characterize qualitative differences in narrative evaluations of female and male pulmonary and critical care medicine faculty.Methods: We performed a single-center, retrospective cohort analysis of trainee narrative evaluations of pulmonary and critical care medicine faculty at the Hospital of the University of Pennsylvania, written from 2015 to 2016. Directive and summative content analysis was performed by four raters. Major contextual themes were identified using constant comparative techniques. Thematic differences based on faculty gender were identified, with statistical significance determined using χ2 analysis (P < 0.05). Effect sizes were calculated using Cramér's V.Results: A total of 1,216 total narrative evaluations were analyzed, representing 62 faculty members (17 women and 45 men), with analysis continued for the full cohort beyond achieving saturation of themes. Five overarching themes emerged: teaching skills, clinical skills, supervision, interpersonal and communication skills, and leadership skills. Within subthemes, we found no significant gender differences in reference to general teaching skills, learning environment, enthusiasm for teaching, or interpersonal concern. We identified subtheme differences between male and female faculty evaluations in regard to mentions of learner autonomy, clinical learning environment, humor, and motivating the trainee for patient care. Although the mention of constructive criticisms did not differ between genders, constructive criticisms of female faculty were more likely to mention demeanor (P = 0.06).Conclusions: Our data suggest minimal thematic differences in trainee narrative evaluations of male and female pulmonary and critical care medicine faculty. However, we noted several subtheme contextual differences between male and female faculty, which warrants further investigation. [ABSTRACT FROM AUTHOR]

Objective: To conduct a survey of the training experiences and needs of paraprofessionals (frontline staff) serving adults with moderate–severe TBI from the perspectives of four stakeholder groups: paraprofessionals, professionals, adults living with brain injury, and family members. Participants: Participants were (a) 28 paraprofessionals, (b) 45 professionals, (c) 41 adults living with brain injury, and (d) 22 family members, for a total of 136 participants. Design: We conducted an online, nationwide survey containing closed and open-ended questions. Four different versions of the survey were developed, one for each of the stakeholder groups, to capture their unique perspectives on the topic of paraprofessional training. Results: Descriptive statistics, non-parametric statistics, and qualitative, comment-based information across the four groups revealed that (a) paraprofessionals require comprehensive training to address the complex needs of persons with brain injury; (b) a range of training options and modalities is preferred; and (c) there are several challenges associated with providing paraprofessional training. Conclusions: This survey highlights the need for a comprehensive range of paraprofessional training options that address both knowledge and skill acquisition. These data have informed the development of an online, interactive training program for paraprofessionals serving this population. [ABSTRACT FROM AUTHOR]