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Type 2 diabetes is a complex disease with several modifiable lifestyle factors. The Extension 'Live well, Eat well, be Active with Diabetes' curriculum provides four 90-minute sessions teaching individuals to live well, eat well, and be active with diabetes. Fourteen Extension educators implemented and evaluated the curriculum with 107 participants. Participants reported the program helped them feel better able to take care of their health. We observed significant differences in participants' retrospective pre and post 'Live well,' 'Eat well' and 'be Active' total scores. Extension has a unique opportunity to educate individuals so they may better manage their diabetes.

Based on critical content analyses of picturebooks about children who have sought refuge, we outline a scaffolded method for social studies teachers and teacher educators to historicize forced displacement in children's literature. The method integrates critical literacy, culturally sustaining pedagogies, and inquiry-based social studies frameworks to work toward anti-racist decolonizing stances in education. Drawing from excerpts of representative picturebooks, we share generative questions and instructional resources that invite both teachers and students to investigate the historical and sociopolitical contexts of these narratives, and to deliberately construct counter-narratives, challenging underlying values and assumptions that reproduce persistent hierarchies of power. A generative method of historicizing forced displacement in children's literature aims to nurture critical understanding of geopolitical interconnectedness of countries and cultures, and to develop a sense of shared responsibility for preventing and addressing forced displacement as a collective humanitarian injustice.

English-language teachers are increasingly recognizing the pedagogical value of using children's literature that authentically represents diverse multilingual learners, including children who have sought refuge. This study analyses representations of children who have experienced displacement and sought refuge in picture books. Framed by a critical multicultural perspective of children's literature, critical refugee studies and critical race theory, the study investigates how children's emotions and agency are represented in focal stories. Our findings suggest that, contrary to the complex intellectual and emotional ways children and youth process displacement, picture books about seeking refuge tend to represent child protagonists as incurious about why they are forced to flee. Such representations construct legally scripted narratives associated with refugee status that normalize war and violence. These narratives ultimately mask colonialism, imperialism and racism that contribute to refugee flight around the world. We discuss how policies for seeking refuge influence picture books and invite educators to critically evaluate literature for their classrooms, directly engage families to foreground generative perspectives and develop comprehensive multilingual environments that affirm learners' agency.

Purpose: This study aims to examine the unique lived experiences of international graduate students in light of COVID-19 and the recent sociopolitical climate in the USA (e.g. Black Lives Matter movement, protests against anti-Asian hate crimes and gun violence). Design/methodology/approach: The authors used an exploratory qualitative design embedded within a constructivist/interpretivist paradigm. A total of 31 international health service psychology graduate students completed an online survey, 17 of whom participated in a 60-min one-on-one semi-structured interview. Findings: Participants reported facing a range of difficulties (e.g. travel ban/inability to spend time with family, visa-related concerns, racism, decreased support) during the global pandemic and the recent sociopolitical climate in the USA. A total of 48 themes were identified and organized into six domains: COVID-19-related stress and worry, experiences of racism/discrimination, coping mechanisms, support received, recommendations for programs and higher learning institutions and advice for other international graduate students. Originality/value: The recent sociopolitical climate in the US exacerbated some of the preexisting inequities for international graduate students due to their international student status and the global pandemic. Although few in number, students also spoke about some positive changes as a result of these major historical and political events. Implications for graduate education, clinical practice and policymaking are discussed.

This paper examines national, state, and local factors impacting the creation of a new dual language immersion program (DLI) program in a Midwestern school district, a relatively understudied regional context. Using a critical bifocal lens and an ethnographic case study methodology, we examined two main questions: first, why was the DLI program created in the focal school district? And second, what were the most salient factors that impacted the creation and implementation of the DLI program? The findings show the significance of analyzing the role of dissimilar social factors in the context of historical and contemporary local and national circumstances when implementing educational options like DLI programs. The evidence provided by this study helps to problematize unidimensional explanations regarding equity and the role of various social actors in the decision making process in school communities. This study highlights the importance of considering local issues from more comprehensive perspectives in bi/multilingual, multiracial, and multiethnic learning contexts.

Healthcare access greatly impacts skin cancer diagnosis and mortality rates. Recognition of current disparities in Mohs micrographic surgery (MMS) access can assist future policy and clinical decisions to correct them. For the years 2014-2018, the CPT codes for MMS (17,311 and 17,313) were counted on a per county level across the United States per the Medicare Centers for Medicare & Medicaid Services (CMS) Medicare Prescriber Database. Any county with 0 MMS CPT codes recorded were classified as without MMS cases. MMS hotspots were identified as counties that possessed a high average number of MMS cases compared to the national average, while also being surrounded by counties that possessed a low average number of MMS cases compared to the national average. Three thousand eighty-four counties in the United States were analyzed; 785 (25%) counties were designated as with MMS cases and 2301 (75%) without MMS cases. There were no significant differences in age, ethnicity distribution, or cost per enrollee between the two designations. 74% of counties with MMS cases were considered urban, while only 25% of those without cases were urban (p

BackgroundThe Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) get tested annually for urethral and rectal chlamydia (CT) and gonorrhea (NG), and pharyngeal NG. There are no national recommendations to screen women and heterosexual men at extragenital sites. We assessed extragenital CT/NG screening among men and women at Louisiana's Parish Health Units (PHU).MethodsThe Louisiana STD/HIV/Hepatitis Program piloted extragenital screening at 4 PHUs in February 2016 and expanded to 11 PHUs in 2017. Sexual histories were used to identify gender of sex partners and exposed sites. Because of billing restrictions, up to 2 anatomical sites were tested for CT/NG.ResultsFrom February 2016 to June 2019, 70,895 urogenital and extragenital specimens (56,086 urogenital, 13,797 pharyngeal, and 1,012 rectal) were collected from 56,086 patients. Pharyngeal CT positivity was 160 of 7,868 (2.0%) among women, 54 of 4,838 (1.1%) among men who have sex with women (MSW) and 33 of 1,091 (3.0%) among MSM. Rectal CT positivity was 51 of 439 (11.6%) among women and 95 of 573 (16.6%) among MSM. Pharyngeal NG positivity was 299 of 7,868 (3.8%) among women, 222 of 4,838 (4.6%) among MSW, and 97 of 1,091 (8.9%) among MSM. Rectal NG positivity was 20 of 439 (4.6%) among women and 134 of 573 (23.4%) among MSM.Urogenital-only screening would have missed: among women, 173 of 3,923 (4.4%) CT and 227 of 1,480 (15.3%) NG infections; among MSW, 26 of 2,667 (1%) CT and 149 of 1,709 (8.7%) NG infections; and among MSM, 116 of 336 (34.5%) CT and 127 of 413 (42.1%) NG infections.ConclusionsMany CT/NG infections would have been missed with urogenital-only screening. Men who have sex with men had much higher extragenital infection rates than women and MSW.

Purpose: To assess the biomechanical performance of 2 simplified loop-and-tack biceps tenodesis techniques, all-suture anchor and all-suture anchor with a button, compared with the interference screw technique in an ovine model. Methods: Twenty-one biceps tenodesis procedures were executed on the humeri and flexor digitorum profundus tendons of skeletally mature, female sheep. Limbs were evenly randomized into 2 experimental groups (all-suture anchor with or without button) and 1 control group (interference screw). Cyclic loading followed by a load-to-failure test was conducted. The primary outcome metric was end-cycle stiffness, or stiffness measured at the end of cyclic loading, because it modeled the resistance of the construct to the lower-force activities of postoperative physical therapy. Secondary metrics included ultimate failure load (UFL), yield load, creep, and load-to-failure stiffness. End-cycle stiffness difference-of-means testing was conducted with a minimal clinically important difference threshold of –15 N/mm (–1.5 kg/mm). Groups were compared using analysis of variance for all recorded variables. Results: Both the all-suture anchor techniques, without a button and with a button, were found to be noninferior in end-cycle stiffness to the interference screw technique (–5.2 N/mm [95% confidence interval, –13.6 to 3.3 N/mm] and –3.8 N/mm [95% confidence interval, –12.5 to –4.9 N/mm], respectively) with a minimal clinically important difference of –15 N/mm. The all-suture techniques showed significantly lower UFL, lower yield load, greater creep, and lower load-to-failure stiffness (P < .001, P < .001, P = .002, and P < .001, respectively). Tendon dimensions did not vary significantly across groups. Conclusions: Under subfailure loading conditions, the all-suture anchor techniques with a button and without a button showed end-cycle stiffness noninferiority to an interference screw technique; however, these techniques were inferior in all secondary outcomes, including significantly lower UFL, lower yield load, greater creep, and lower load-to-failure stiffness. Clinical Relevance: The all-suture anchor approaches with a button and without a button may retain the natural length-tension dynamics of the long head of the biceps tendon because fixation can occur before the release of the tendon origin. Additionally, they may offer a simpler and more cost-effective alternative to prevailing arthroscopic methods.

Abstract: Use of cold‐formed steel (CFS) framing as load‐bearing system for gravity and lateral loads in buildings is becoming increasingly common in the North American construction industry, notably in high seismic regions where light‐weight construction is an attractive option. Buildings framed with closely spaced and repetitively placed CFS members can be detailed to develop lateral resistance using a variety of sheathing options. A relatively new option involves the use of steel sheet as sheathing. Steel sheet sheathed CFS shear walls offer high lateral strength and stiffness, and provide ductility courtesy of tension field action within the steel sheet. Despite their acceptance, gaps in the understanding of their behavior do exist, notably, behavior under dynamic loading, the contribution of nonstructural architectural finishes, and the behavior of wall‐lines: shear walls placed inline with gravity walls. To this end, a two‐phased experimental effort was undertaken to advance understanding of the lateral response of CFS‐framed wall‐line systems. Specifically, a suite of wall‐lines, detailed for mid‐rise buildings, were evaluated through simulated seismic loading imposed via shake table and quasi‐static cyclic tests. Damage to the wall‐lines was largely manifested in the form of damage to fastener connections used for attaching the sheathing and gypsum panels, and separation of exterior finish layer. This paper documents and quantifies the progressively incurred physical damage observed in the tested wall‐line assemblies, and correlates it with the evolution of dynamic characteristics and hysteretic energy dissipated across a spectrum of performance levels.

The Yarmouth Island Formation of the East Harpswell Group (EHG) is an assemblage of metamorphosed volcanic and sedimentary rocks exposed in Casco Bay Maine. Although previously interpreted to have been deposited ca. 445 Ma, two new U-Pb zircon ages from metavolcanic rocks in the unit indicate prolonged magmatism between ca. 469-474 Ma and correlation with adjacent rocks of the more regionally extensive Casco Bay Group (CBG) in the Liberty-Orrington belt. New detrital zircon results from metasedimentary rocks in the EHG support this correlation; the age spectra indicate a peri-Gondwanan sedimentary source, consistent with earlier published results from the CBG. Detailed geochemical studies of the metavolcanic rocks in the Yarmouth Island Formation indicate a wide range of sub-alkaline compositions ([SiO.sub.2] = 47.9-77.5 wt.%), flat chondrite-normalized rare earth element distributions, and a prominent negative Nb anomaly in normalized spider plots. Tectonic discrimination plots suggest eruption in a volcanic arc setting with continental crustal influence. This tectonic setting, when combined with the co-existence of marine sedimentary rocks, suggests a transitional setting between that of subduction and subsidence in a marine setting, perhaps due to the onset of back-arc rifting. Similarities in age, lithologic character, sediment provenance, and volcanic rock geochemistry indicate a strong correlation between these rocks in the Liberty-Orrington belt and those along strike in the southern portion of the Miramichi belt of eastern Maine and southern New Brunswick. These findings confirm the preservation of > 500 km long, ca. 470 Ma, arc/back-arc terrane within the Ganderia superterrane in the northern Appalachians. Key words: northern Appalachians, tectonics, U-Pb zircon geochronology, igneous rock geochemistry, stratigraphy, Introduction Many rocks exposed along the eastern margin of the northern Appalachians (Fig. 1) originally formed outboard of the North American continent during Cambrian and Ordovician time and were subsequently [...]

Although cold-formed steel (CFS) framing systems have the potential to support the need for resilient housing, the use of CFS has been restricted due to gaps in understanding its structural behavior and by the limited guidelines provided in design standards. In particular, the contribution from nondesignated lateral systems and portions of the building system not specifically designated by the design engineers has not been substantially investigated through experiments. To address these shortcomings, a two-phased experimental effort was undertaken to assess the impact of gravity walls, finish application, window openings, and their relationship with the designated lateral force-resisting system. The wall-line assemblies tested, which have shear walls placed in-line with gravity walls, adopted chord stud packs with a tie-rod assembly and were either unfinished or finished, and laid out in a symmetrical or unsymmetrical fashion. In addition, both Type I and Type II shear wall and anchorage detailing were investigated. In this paper, the impact of test variables governing the nonstructural detailing of CFS-framed walls has been quantified, and a companion paper presents findings regarding the impact of structural detailing.

The North American construction industry has seen substantial growth in the use of cold-formed steel (CFS) framing for midrise buildings in recent years. In seismic zones, CFS-framed buildings utilize shear walls to provide the primary lateral resistance to earthquake induced loads. Although oriented strand board (OSB) and plywood panels have been traditionally used as the sheathing material for these essential components, more recently, steel sheet sheathing has emerged as a novel strategy due to its strength, ductility, ease of installation, and use of noncombustible material, among other benefits. To address the paucity of data regarding CFS-framed shear wall response within actual wall lines of buildings, a two-phased experimental effort was conducted. Wall-line assemblies were fabricated and tested with shear walls placed in-line with gravity walls. The shear walls chord stud packs include tie-rod assemblies consistent with multi-story detailing. Specimens were either unfinished or finished, and the shear walls were laid out in a symmetrical or unsymmetrical fashion within in the wall line. In addition, both Type I and Type II shear wall and anchorage detailing were investigated. In this paper, the impact of test variables governing the structural detailing of CFS-framed walls are quantified through dynamic and quasi-static tests, and a companion paper presents findings regarding the impact of architectural variations on seismic performance.

Cold-Formed Steel (CFS) framing has gained substantial popularity in the North American market in the recent years, particularly in mid-rise building construction. Buildings framed with closely spaced CFS members repetitively placed in the walls develop resistance to lateral loads through a variety of systems including steel sheet sheathing attached to the CFS members. Damage to walls sheathed with steel sheet largely manifests in the form of local failure of screw fasteners. To this end, in the present paper, the damage observed in fastener connections between steel sheet sheathing and CFS framing members in wall-lines subjected to quasi-static cyclic loading is systematically quantified. Four symmetric and unfinished wall-line configurations, including two each of Type I and Type II shear wall detailing systems, are evaluated at different performance levels. Tilting/bearing and sheet pullover are identified as the two predominant fastener connection failure modes and damage statistics for each failure mode demonstrate the progression of connection damage. Specimens with a larger quantity of fastener connections demonstrated 1.5-3.0 times greater hysteretic energy dissipation at similar cumulative drift. However, the number of fasteners used had no apparent effect on equivalent hysteretic damping due to the reduction in wall lateral strength developed.

This case study shares feedback from program alumni who are from underrepresented groups in STEM and who participated in either an undergraduate internship program or a Bridge to Ph.D. program designed to broaden participation in the marine and environmental sciences. The internship program was hosted by a Historically Black College and University (HBCU), in partnership with local collaborators who hosted students. The Bridge to Ph.D. program was co-designed by faculty leaders from the HBCU and faculty partners at a primarily White institution (PWI) who hosted the program on their campus. Interviews were conducted one to four years after participation in one of the programs to learn whether students were still involved in the geosciences and to document the ways they used agency to navigate the marine sciences learning ecosystem. Almost all students were still engaged in the marine and environmental sciences, and all were still engaged in STEM fields. The agency included in their stories reiterates themes from the literature and demonstrates a range of successful pathways that can be encouraged and supported by those striving for inclusion in the geosciences. Results are described in relation to the importance of changing the shared social practices utilized within the geosciences to support inclusion, particularly regarding how success is defined.

Objective: Using Bronfenbrenner's socio-ecological model as a frame, we explored the impact of neighborhood disadvantage, household chaos, and personal stressors on current mental health symptoms in college students. Participants: 144 students at a large, public university in the southern U.S. Methods: Participants completed measures of demographics, family-of-origin household chaos, stressors, anxiety, and depression, and provided their childhood home ZIP code. Using U.S. Census Data, four structural indicators of neighborhood disadvantage were extracted and appended to each participant's ZIP code. Results: Hierarchical regression revealed that all three variables predicted anxiety symptoms. However, only household chaos and personal stressors predicted current depressive symptoms. Unexpectedly, greater neighborhood disadvantage predicted lower levels of current anxiety. Mediation analyses demonstrated that personal stressors partially mediated the relationships between household chaos and mental health symptoms. Conclusions: College administration and counseling centers may wish to consider pre-college factors that influence college students' current anxious and depressive symptoms.

Abstract Across the planet, Indigenous societies control, use, and manage large tracts of tropical forest that are crucial for combating climate change. Here we investigate whether customary Indigenous agricultural practices can increase forest species diversity using swidden (aka, slash-and-burn) agriculture. We examine the community lands surrounding two Q’eqchi’ Maya villages in southern Belize using high-resolution multispectral imagery that we collected with drones, ground truth data related to land use and history, and a plant and tree biodiversity survey. We use computational methods including simulation and Bayesian modeling to analyze the relationship between spectral diversity, forest diversity, and landscape disturbance. Our key result, replicated in both villages, is that the highest level of spectral diversity (a proxy for forest diversity) is associated with an intermediate level of forest disturbance. In conclusion, we suggest that concepts from complex adaptive systems can provide an important conceptual framework for understanding how ecosystem enhancement can emerge from customary Indigenous land use practices.