Communities In Ohio Research Articles

Impact of Patient Gender and Race and Physician Communication on Colorectal Cancer Diagnostic Visits in Primary Care.

Background: Patient gender and race, and physician-patient communication are associated with clinical outcomes. Aim: To understand the role of these factors in the diagnosis of colorectal cancer (CRC) during primary care visits as measured by appropriate outcome. Materials and Methods: Caucasian and African American unannounced standardized patients (USPs) of both genders presented to 207 primary care physicians (PCPs) from community and academic practices in Ohio and Virginia as new patients with CRC symptoms. PCPs were blinded to the diagnosis. Physician subjects consented to audiotaping the encounter. Medical records were obtained. Communication elements were coded by trained observers and appropriate visit outcomes were coded from the medical record and audiofiles, defined as (1) recommendation for colonoscopy/sigmoidoscopy/fecal occult blood test (FOBT) or (2) referral to gastroenterologist. Results: A total of 141 of 367 USP visits (38%) resulted in appropriate clinical outcomes. Patient race was not associated with outcome, but being a male USP was (χ2 = 4.12, p = 0.04). Relational communication was represented as a latent variable with seven indicators (alpha = 0.84) and was independently associated with outcome (beta = 0.15; p = 0.025). After controlling for clustered sampling, relational communication, and race, structural equational modeling indicated that female USPs were less likely to have an appropriate clinical visit outcome (beta = -0.13; p = 0.033). Conclusions: Using a novel and innovative methodology capturing PCP behaviors during real-time clinician-patient interaction, appropriate clinical outcome was independently associated with being male and PCP relational communication factors such as encouraging patient communication, being engaged and expressive in the physician-patient conversation, and appearing friendly and sincere. There are persistent biases in the delivery of health care to female patients and further research into targeted communication skills programs may be warranted.

‘We’re Getting so Far Away from the Land’: Disrupting the Traditional Rural Literacy Myth through Ohio Farm Stories

The Ohio Farm Stories (OFS) project began with a grant from the Ohio Humanities Council with a goal of collecting and showcasing narratives that focus on family farm life and the ways in which agriculture has and continues to shape lives and local Ohio communities. Integral to these narratives are ideas of how farming practices and values have evolved to meet societal demands in the 21st century. This article situates OFS research within Royster and Kirsch’s (2012) three-step inquiry framework, layered with a discussion of what is often understood as traditional rural literacy within the context of public memory. Two OFS video montages are included within the article, so that readers might listen ‘deeply, reflexively, and multisensibly’ (20) to the words and images of the project. These words and images evoke questions regarding myth, education, agriculture, and societal change. The article closes with a discussion of how the rhetoric of farming disrupts the rural literacy myth and positions farmers as powerful advocates in shaping the future as well as future understandings of where and how our nation’s food sources are grown and harvested.

Roam If You Want to: Unlocking Doors for Patients With Dementia

Roam If You Want to: Unlocking Doors for Patients With Dementia

Pediatric Manganese Exposure and Neurocognition in Eastern Ohio

Manganese (Mn) is both an essential element and neurotoxicant. Two communities in eastern Ohio have the two of the highest ambient Mn concentrations in the nation. Our goal is to address the communities' primary research question: “Does Mn affect cognitive development of children?” Children ages 7-9 were enrolled in the Communities Actively Researching Exposure Study (CARES) from Marietta, Cambridge, and East Liverpool, Ohio. CARES has been conducted using community-based participatory research principles. We conducted neurocognitive assessment (child IQ). Blood was analyzed for Mn and lead (Pb); hair were analyzed for Mn, and serum was analyzed for cotinine, a measure of second hand tobacco smoke. We used penalized splines to assess potential non-linear associations between biological measures and child IQ scores, followed by multivariable regression models with categorical variables based on quartiles of the distribution for biological measures. Both low and high Mn concentrations in blood and hair were negatively associated with child IQ scores. There was a negative association between hair Mn and child IQ in East Liverpool children. Serum cotinine was also negatively associated with child cognitive function. Community engagement has enhanced the research process and the translation of study findings for these communities.

The Failed Diffusion of the Unicameral State Legislature, 1934–1944

The early twentieth-century witnessed numerous efforts to reform state government institutions, resulting in the widespread adoption of such reforms as the direct primary and citizen initiative. By contrast, efforts to establish unicameral state legislatures experienced success in just one state: Nebraska. In this article, I examine why movements to adopt one-house legislatures in other states failed in the wake of the Nebraska breakthrough of 1934. Using a most-similar case study research design, I compare the successful Nebraska effort to unsuccessful subsequent efforts in Ohio and Missouri, and I point to rural opposition as being the decisive factor explaining divergent outcomes across the three states. In Nebraska, the lack of malapportionment in the bicameral legislature meant that rural communities did not fear that unicameralism would lead to their diminished influence in state government, but in Ohio and Missouri (where malapportionment was high) rural communities used their structural advantages in state politics to shut down unicameralism efforts. The article's findings suggest that the bicameral state legislature is an important institutional legacy of the bygone era of rural dominance in American politics.

Atrazine Contamination of Drinking Water and Adverse Birth Outcomes in Community Water Systems with Elevated Atrazine in Ohio, 2006–2008

Atrazine, a common water contaminant in the U.S., has been associated with adverse birth outcomes in previous studies. This study aimed to determine if atrazine concentrations in drinking water are associated with adverse birth outcomes including small for gestational age (SGA), term low birth weight (term LBW), very low birth weight (VLBW), preterm birth (PTB), and very preterm birth (VPTB). This study included 14,445 live singleton births from Ohio communities served by 22 water systems enrolled in the U.S. Environmental Protection Agency’s Atrazine Monitoring Program between 2006 and 2008. Mean gestational and trimester-specific atrazine concentrations were calculated. Significantly increased odds of term LBW birth was associated with atrazine exposure over the entire gestational period (OR 1.27, 95% CI 1.10, 1.45), as well as the first (OR 1.20, 95% CI 1.08, 1.34) and second trimesters (OR 1.13, 95% CI 1.07, 1.20) of pregnancy. We observed no evidence of an association between atrazine exposure via drinking water and SGA, VLBW, PTB, or VPTB. Our results suggest that atrazine exposure is associated with reduced birth weight among term infants and that exposure to atrazine in drinking water in early and mid-pregnancy may be most critical for its toxic effects on the fetus.

Impact of Public Health Responses During a Measles Outbreak in an Amish Community in Ohio: Modeling the Dynamics of Transmission.

We quantified measles transmissibility during a measles outbreak in Ohio in 2014 to evaluate the impact of public health responses. Case incidence and the serial interval (time between symptom onset in primary cases and secondary cases) were used to assess trends in the effective reproduction number R (the average number of secondary cases generated per case). A mathematical model was parameterized using early R values to determine the size and duration of the outbreak that would have occurred if containment measures had not been initiated, as well as the impact of vaccination. As containment started, we found a 4-fold decline in R (from approximately 4 to 1) over the course of 2 weeks and maintenance of R < 1 as control measures continued. Under a conservative scenario, the model estimated 8,472 cases (90% confidence interval (CI): 8,447, 8,489) over 195 days (90% CI: 179, 223) without control efforts and 715 cases (90% CI: 103, 1,338) over 128 days (90% CI: 117, 139) when vaccination was included; 7,757 fewer cases (90% CI: 7,130, 8,365) and 67 fewer outbreak days (90% CI: 48, 98) were attributed to vaccination. Vaccination may not account entirely for transmission reductions, suggesting that changes in community behavior (social distancing) and other control efforts (isolation, quarantining) are important. Our findings highlight the benefits of measles outbreak response and of understanding behavior change dynamics.

Utilization of outpatient medical care and substance use among rural stimulant users: Do the number of visits matter?

Rural substance users are less likely than their urban peers to use formal substance use treatment. It is therefore important to understand how the utilization of potentially more appealing care options, such as outpatient medical care (OMC), may affect substance use over time. This study sought to examine whether the number of OMC visits, after controlling for important covariates, was associated with days of alcohol, crack and powder cocaine, and methamphetamine use among a sample of rural stimulant users over a three year period. Data were collected from a natural history study of 710 stimulant users living in rural communities in Arkansas, Kentucky, and Ohio. Participants were adults, not in drug treatment, and reporting stimulant use in the last 30days. In terms of alcohol use, for participants with higher employment-related problems, having 3 or more OMC visits (relative to none) was associated with fewer days of alcohol use. The results for days of cocaine and methamphetamine use were mixed. However, we did find that for participants reporting at least one substance use treatment or mutual help care visit in the past 6-months, having 1–2 OMC visits (compared to none) was associated with fewer days of crack cocaine use. Regarding methamphetamine use, results showed that for participants without medical insurance, having 3 or more OMC visits (compared to none) was associated with significantly fewer days of methamphetamine use if they also reported greater than or equal to a high school education. The findings from this study may help us begin to understand some of the characteristics of rural drug users, who utilize OMCs, associated with reductions in substance use. These findings may help health care administrators better plan, coordinate, and allocate resources to rural OMCs to more effectively address substance use in this population.

Evaluation of low immunization coverage among the Amish population in rural Ohio

The Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Review included childhood immunizations among the 10 great public health achievements in the United States in the 20th century. Despite this acknowledged success, childhood immunization rates continue to be much lower in select populations. Amish communities have persistently lower immunization rates. Recent outbreaks in Amish communities include a 2014 measles outbreak in Ohio, resulting in 368 cases reported. A recent outbreak of pertussis in an Amish community in Ohio resulted in the death of a 6-week-old Amish baby. A study was designed to determine the knowledge, beliefs, attitudes, and opinions of Amish parents relative to the immunization of Amish children. Data were collected through a questionnaire. Each potential participant was mailed a copy of a letter describing the proposed study. The questionnaire, a copy of the current immunization schedule, and a return stamped envelope were also included in the mailed packet. The study sample consisted of 84 Amish individuals who voluntarily filled out and returned questionnaires. The findings from the data analysis demonstrated that fear, especially concern over too many recommended immunizations and immunizations overwhelming the child's system, was the most frequent reported reasons for not having children immunized according to recommendations. Religious factors and access to care were not among reasons most reported. Designing an educational campaign for educating Amish parents on the risks and benefits of immunizations with focus on specific concerns may improve immunization rates.

Finding Sisters in Cyberspace: Digitization and the Archives of Women’s Religious Communities

Finding Sisters in Cyberspace: Digitization and the Archives of Women’s Religious Communities Fernanda Perrone3 Introduction Roman Catholic sisters are everywhere in cyberspace: on websites, blogs, podcasts, and many social media platforms. Resources range from the online news and information resource Global Sisters Report to the faith community and vocation resource A Nun’s Life Ministry to a women religious app sponsored by the Council of Major Superiors of Women Religious.4 Individuals have created resources such as Willing Hearts about the experience of Holy Cross Sisters as nurses during the U.S. Civil War, which the authors describe as creative non-fiction.5 New websites appear all the time. Comprehensive, robust, and scholarly digital projects documenting women religious have been fewer and more difficult to find, however, but several interesting projects are currently under development. A few years ago, I was sitting next to a prioress of a Benedictine community in Ohio at a conference banquet. She told me that her community had only seven members and she did not think it had a future. As the de facto congregation archivist, she was concerned about preserving its legacy and making that story accessible to researchers. She told me that volunteers had begun digitizing the archives by scanning documents. This story remained with me as I wondered how, where, and in what format the sisters were preserving these documents. [End Page 4] When I was invited to participate in this session, I was excited by the prospect of investigating digital archives and resources related to women’s religious communities. Click for larger view View full resolution A sample image from the Providence Archives in Seattle: Sr. John of God sewing vestments, Sacred Heart Academy, ca. 1913. Courtesy Providence Archives, Seattle. Image #67.D4.84 Women Religious Community Archives The records of women’s religious communities can be found at many types of institutions, including colleges, universities, archdiocesan, and diocesan archives. Most archival collections, however, are maintained by the religious communities themselves. Women religious community archives are private entities that serve their members. Like business archives, they have no obligation to make archival resources available to researchers, although most do to some extent.6 The Archivists of Congregations of Women Religious (ACWR) is an independent professional organization for these archives. As an ACWR associate member, I have access to the membership directory, which I surveyed to explore digital resources on members’ websites. The parameters of the directory necessarily limited my survey to American communities or American provinces of international communities. [End Page 5] While almost all religious communities have websites, most community archives do not have their own pages on the community’s website. Most congregational websites include historical content, such as timelines, photographs, and historical information. A few communities have created more comprehensive digital resources, which tend to be attached to larger provincial centers. The Providence Archives in Seattle makes available historical records documenting the Sisters of Providence in the West and Providence Health and Services. The website of the archives includes a digital collections database of several thousand photographs and documents created using the CONTENTdm™ digital collection management system.7 Another example is the Digital Archives of the Sisters of St. Joseph of Carondelet, St. Paul Province, which include digitized books, pamphlets, and oral history transcripts.8 Another model is being used by the Sisters of Notre Dame de Namur, who are building a digital archives to bring together dispersed community archives. The purpose of the Virtual Archive is to “lower the obstacles between the people interested in the history of the Sisters and the Order and finding materials in the archival collections. It also helps further part of our archival mission of making our collections available to the current Sisters, relatives of Sisters, alumnae and staff at schools where Sisters taught, local communities, and researchers.”9 Most religious community archives have very limited resources of personnel and budget. Concerned with basic preservation and access, they have not able to create large digitization projects on their own. Because of declining numbers and an aging membership, religious communities are increasingly centralizing and merging, at the same time as continuing to absorb the records of closed institutions, particularly schools and...

Bone Mineral Density and Weight Changes in Adolescents Randomized to 3 Doses of Depot Medroxyprogesterone Acetate

Study ObjectiveTo assess the association between medroxyprogesterone acetate exposure and bone mineral density (BMD) loss and weight change in adolescents. DesignForty-eight-week prospective, randomized trial conducted May 2012-April 2014. SettingRecruitment occurred in the general community and outpatient clinics in central Ohio. ParticipantsSelf-referred sample of 34 female adolescents aged 12-21 years initiating depot medroxyprogesterone acetate (DMPA). InterventionsRandomization to 1 of 3 DMPA doses (150, 104, or 75 mg) given intramuscularly every 12 weeks for 48 weeks. Main Outcome MeasuresAbsolute and percent change in BMD from 0-48 weeks at the L1-L4 lumbar spine, total hip, and femoral neck; absolute and percent change in weight at 48 weeks. ResultsDMPA dose was associated with medroxyprogesterone acetate exposure as evidenced by a direct relationship (P < .001) between dose group and area under the concentration time curve. At 48 weeks, no significant BMD decreases were seen in the 75 mg dose group. The 104 and 150 mg dose groups experienced significant (P < .01) decreases in L1-L4 lumbar spine BMD (3.1% and 4.0%, respectively). The 150 mg group also had significant (P < .05) decreases in total hip (3.0%) and femoral neck (4.0%) BMD. No group differences in weight change were observed. No pregnancies occurred in any DMPA dose group. ConclusionsOur data provide evidence of a dose-response relationship between DMPA and BMD loss. Intramuscular DMPA doses less than 150 mg can decrease risk of BMD loss in adolescents. The risk/benefit ratio of lower-dose DMPA should be further investigated in larger and more diverse adolescent populations.

A Measles Outbreak in an Underimmunized Amish Community in Ohio

BackgroundAlthough measles was eliminated in the United States in 2000, importations of the virus continue to cause outbreaks. We describe the epidemiologic features of an outbreak of measles that originated from two unvaccinated Amish men in whom measles was incubating at the time of their return to the United States from the Philippines and explore the effect of public health responses on limiting the spread of measles.MethodsWe performed descriptive analyses of data on demographic characteristics, clinical and laboratory evaluations, and vaccination coverage.ResultsFrom March 24, 2014, through July 23, 2014, a total of 383 outbreak-related cases of measles were reported in nine counties in Ohio. The median age of case patients was 15 years (range, <1 to 53); a total of 178 of the case patients (46%) were female, and 340 (89%) were unvaccinated. Transmission took place primarily within households (68% of cases). The virus strain was genotype D9, which was circulating in the Philippines at the time of the reporting period. Measles–mumps–rubella (MMR) vaccination coverage with at least a single dose was estimated to be 14% in affected Amish households and more than 88% in the general (non-Amish) Ohio community. Containment efforts included isolation of case patients, quarantine of susceptible persons, and administration of the MMR vaccine to more than 10,000 persons. The spread of measles was limited almost exclusively to the Amish community (accounting for 99% of case patients) and affected only approximately 1% of the estimated 32,630 Amish persons in the settlement.ConclusionsThe key epidemiologic features of a measles outbreak in the Amish community in Ohio were transmission primarily within households, the small proportion of Amish people affected, and the large number of people in the Amish community who sought vaccination. As a result of targeted containment efforts, and high baseline coverage in the general community, there was limited spread beyond the Amish community. (Funded by the Ohio Department of Health and the Centers for Disease Control and Prevention.)

Reduced Prevalence of Obesity in 14 Disadvantaged Black Communities in the United States: A Successful 4-Year Place-Based Participatory Intervention.

To assess the impact of a large-scale place-based intervention on obesity prevalence in Black communities. The Racial and Ethnic Approaches to Community Health across the United States (REACH US) project was conducted in 14 predominantly Black communities in California, Illinois, Massachusetts, New York, Ohio, Pennsylvania, South Carolina, Virginia, Washington, and West Virginia. We measured trends from 2009 to 2012 in the prevalence of obesity. We used Behavioral Risk Factor Surveillance System data to compare these trends with trends among non-Hispanic Whites and non-Hispanic Blacks in the United States and in the 10 states where REACH communities were located, and with a propensity score-matched national sample of non-Hispanic Blacks. The age-standardized prevalence of obesity decreased in REACH US communities (P = .045), but not in the comparison populations (P = .435 to P = .996). The relative change was -5.3% in REACH US communities versus +2.4% in propensity score-matched controls (P value for the difference = .031). The net effect on the reduction of obesity prevalence was about 1 percentage point per year for REACH. Obesity prevalence was reduced in 14 disadvantaged Black communities that participated in the REACH project.

Understanding Perceptions of Fresh Produce Safety and Barriers to Good Agricultural Practice (GAP) Use Among Amish Growers in the Holmes County Settlement of Ohio

Addressing the complex problem of ensuring on-farm produce safety entails processes that allow for participation of affected groups, and integration of their knowledge and perceptions into the solutions. Such participatory processes, however, are difficult to develop among underserved groups, like the Amish communities of Ohio, where members seek deliberate separation from mainstream society and have insular social networks and limited trust in government agents. Using a mental models framework, we present research findings that will be used to help develop an outreach program to address produce safety in Amish communities in Ohio. These findings expand our understandings of Amish growers' perceptions and knowledge of on-farm produce safety practices in the following areas: the microbial risks to fresh and fresh-cut produce; practices that can prevent contamination; perceptions of the economic feasibility of adopting these practices; preparedness for a contamination event; and information needs and preferences. Information was collected to aid the development of outreach that respects the values and goals of the Amish produce growers, which is a key factor for program success, and that encourages the adoption of food safety principles in scale-appropriate ways by addressing barriers and building rapport and trust with community members. We believe that the information learned in this study is useful to a variety of people working with Plain Communities and other non-mechanized, small-scale farmers in addition to these communities.

Fractured Relationships

Municipalities are on fracking’s front lines. Unlike the extraction techniques of the past, many of today’s operations are located within a mile or two of residential areas. Yet, little scholarly attention has been paid to the factors that can precipitate municipal challenges to the state’s authority. For some, the decision to oppose the state may be related to environmental concerns, while in other communities, leaders are much more concerned about how development impacts homeowners. Recognizing this debate, this article examines local defiance in the era of fracking with a sample of Colorado, Texas, and Ohio communities.

Factors influencing adults' immunization practices: a pilot survey study of a diverse, urban community in central Ohio.

BackgroundAdult vaccination rates in the United States are well below recommendations with disparities in race, ethnicity, and education level resulting in even lower rates for these populations. This study aimed to identify the barriers to and perceptions of immunizations in adults in an urban, underserved, multicultural community. Understanding the factors that influence adults’ decisions to receive routinely recommended vaccines will aid health care providers and public health officials to design programs to improve vaccination rates.MethodsThis cross-sectional, survey-based study was conducted in January 2014 in Columbus, Ohio. Participants were recruited from four urban federally-qualified health centers and four grocery stores affiliated with those clinics. The survey gathered self-reported receipt of immunizations, knowledge about indications for immunizations, and factors influencing decisions to receive an immunization. Data was analyzed in 2014. Descriptive statistics were generated for all survey items and Chi-Square or Fisher’s Exact tests were used as appropriate to test for associations between demographic characteristics and factors influencing immunization decisions.ResultsThe top five factors likely to affect the decision to receive an immunization among the 304 respondents were: “doctor’s recommendation” (80.6 %), “knowing why I should get a vaccine” (78.2 %), “knowing which vaccines I need” (75.5 %), cost (54.2 %), and “concern about getting sick if I get a vaccine” (54.0 %). Significant differences in factors influencing the immunization decision exist among respondents based on ethnicity and education level. For those participants with self-identified diabetes, heart disease, or asthma, less than half were aware that certain immunizations could reduce the risk of complications associated with their disease(s).ConclusionsData from this study may inform and shape patient education programs conducted in clinics, retailers, and communities, as well as advocacy efforts for adult immunizations. Results from this study suggest that patients would respond to programs for promoting vaccine uptake if they focused on benefits and indications for vaccines. The results also highlighted the need for education regarding immunizations for patients with chronic diseases and special indications. The differences in perceptions found between groups can be used to create targeted interventions based on the needs of those patient populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3107-9) contains supplementary material, which is available to authorized users.

Book Review: News, Public Affairs, and the Public Sphere in a Digital Nation: Rise of the Audience, by Edgar Simpson

Edgar Simpson News, Public Affairs, and the Public Sphere in a Digital Nation: Rise of the Audience. Lanham: Rowman & Littlefield, 2014. 263 pp.Simpson, a Central Michigan University journalism assistant professor, provides a good qualitative analysis of might be happening to the concept of informed civic participation in a representative democracy in this work. As the name of the book implies, Simpson describes the emergence of the digital nation has had on our understanding of legacy news, public affairs reporting, and the resultant dialogue with the audience in the public sphere.Simpson's study builds upon two seminal works that described how information is communicated throughout an electorate: Paul Lazarsfeld's 1940 two-step flow model of communication from Erie County, OH, and the 1972 agenda-setting function of journalists on readers and policy makers as observed by Maxwell McCombs and Donald Shaw in Chapel Hill, NC.The unique approach Simpson adds is to find two Ohio communities that are demographically similar but have one major distinction: one, Geauga County, had lost its daily newspaper in 1992, but the other, Wood County, was still operating with a daily newspaper.To this comparison, Simpson adds two more critical streams, online news sources and social media (primarily Facebook, the preferred source of audience participation with the news). The result is a unique triangulation of what is available, could be available and the human interaction that creates or ignores those streams of information. (p. 14)Simpson carefully built this case study during 2012 by multiple visits to both Ohio communities, discourse analyses of news and social media texts, in-depth interviews and focus groups, and online surveys. Because the work was meticulously grounded in well-thought-out conceptual principles, Simpson's results are noteworthy.Some of the findings are predictable: When leftto their own devices, the public can become distracted by such inconsequential debates as whether to call a planned egg roll event in the spring the Hunt or as erroneously reported by a stringer for a weekly paper, the Easter Egg Hunt.What is remarkable is that an inaccurate news item that probably would have been treated with a correction in the paper pre-Internet became instead a controversy with a life of its own. After being trumpeted as fact by a local television station, the errant report hit the Internet, where conservative bloggers and social media commentators propelled it onto the radar screens of producers for Fox News' Sean Hannity show. …

Issachar Bates: A Shaker’s Journey by Carol Medlicott (review)

Issachar Bates: A Shaker's Journey. By Carol Medlicott. (Hanover, NH: University Press of New England, 2013. Pp. 424. Cloth, $85.00; paper, $40.00; ebook, $39.99.)Reviewed by Bret E. CarrollOnce either overshadowed by their handicrafts or simplistically idealized as orderly communalists, the Shakers have in recent decades been revealed by Priscilla Brewer, Stephen Stein, and others as a contentious people struggling to keep their movement vigorous as they sought unity among their far-flung communities and contended with ongoing crises of leadership and apostasy. Still more recently, a wave of biographical analysis featuring work by Jean Humez, Richard Williams, Elizabeth De Wolfe, and Glendyne Wergland has further demythologized the Shakers by exploring their inner lives. Carol Mecllicott's biography of western Shaker leader Issachar Bates reflects and advances this historiographical trajectory. A historical geographer by training, Medlicott initially approached Shakerism with the aim of understanding its cultural dynamics and gauging its cohesiveness and stability as it expanded westward across the early republic. Her research interests led her to Bates, whose life reveals the ways in which the Shaker movement remained coherent across vast distances (xiii). In Bates she found a colorful and outsized figure who in many respects defies the Shaker stereotype: He was a gregarious man who came to Shakerism through a long and rocky spiritual conversion process during a midlife crisis (49). His early life was marked by instability in his father's household, drinking, coarse speech, service as a Revolutionary War fifer, a mobile and hardscrabble existence in rural Massachusetts and New York trying to provide for a large family, and a tendency toward depression.It is precisely such characteristics, Medlicott argues, that make Bates so revealing of the dynamics of Shaker expansion. On the one hand, his sociability, bawdiness, gift for singing, history of mobility, experience in newly opening areas of settlement, and personal sacrifice of biological family ties made him particularly well suited to carrying the Shaker message from its early centers in New York and Massachusetts to a transAppalachian West being religiously galvanized by such charismatic preachers as Barton Stone, James McGready, and Peter Cartwright. His personal magnetism attracted and retained many converts, including Kentucky Revival leader Richard McNemar and his entire congregation, which became the basis of Ohio's Union Village Shaker community; won him the support of Indiana territorial governor William Henry Harrison; and helped Indiana Shakers maintain peaceful relations with rebellious Shawnee leaders Prophet and Tecumseh. Bates helped early western Shakers cope with the sometimes daunting challenges of life in the Old Northwest, including malaria epidemics, the New Madrid earthquakes, and the tensions leading up to the War of 1812. His experience settling in new places as a young man served him well as he and other Shaker pioneers worked to build new communities. I lis singing and his hymns- many of which appeared in Millennial Praises (1812), the Shakers' first printed hymn book-introduced western converts to Shaker doctrine, which was only beginning to assume written form, generated community among them, and linked them to the Shaker East. His importance to Shakerism's western expansion propelled him to the position of elder at what became the West Union community in Indiana and, later, at Ohio's Watervliet community.On the other hand, many of Bates's personal qualities ran counter to the Shakers' emphasis on and, especially in the West, their need for structures of authority. A peripatetic man who headed west to proselytize before the Shaker gospel order had been fully established in the East, he chafed at himself and moved frequently among budding communities in Kentucky, Ohio, and Indiana, sometimes generating resentment and restiveness among more settled believers. …

Recovery of native plant communities in southwest Ohio afterLonicera maackiiremoval1

Abstract Lonicera maackii (Rupr.) Herder (Amur honeysuckle) is one of the most important invasive plants in the Ohio Valley. Because of its phenology and dense canopy, L. maackii can exclude native herbs and interfere with regeneration of woody plants. In 2005, in a county park in southwest Ohio, I established modified Whittaker plots in four stands with a gradient of L. maackii cover ranging from 24 yr old to 40 yr old. The L. maackii canopies were removed by herbicides in fall 2005. Plant cover was monitored from 2005 to 2013. After 8 yr, there was an increase in species richness and herbaceous cover at all sites. Herbaceous species turnover was generally greater at sites with greater initial L. maackii cover. All of the most-common herbaceous species increased or maintained their coverage; most of the species that increased were those that bloom in late spring or summer. The abundances of other invasive species also increased, including Alliaria petiolata (M. Bieb.) Cavara & Grande (garlic mustard). Ho...

Modeling Measles Transmission in the North American Amish and Options for Outbreak Response.

Measles outbreaks in the United States continue to occur in subpopulations with sufficient numbers of undervaccinated individuals, with a 2014 outbreak in Amish communities in Ohio pushing the annual cases to the highest national number reported in the last 20 years. We adapted an individual-based model developed to explore potential poliovirus transmission in the North American Amish to characterize a 1988 measles outbreak in the Pennsylvania Amish and the 2014 outbreak in the Ohio Amish. We explored the impact of the 2014 outbreak response compared to no or partial response. Measles can spread very rapidly in an underimmunized subpopulation like the North American Amish, with the potential for national spread within a year or so in the absence of outbreak response. Vaccination efforts significantly reduced the transmission of measles and the expected number of cases. Until global eradication, measles importations will continue to pose a threat to clusters of underimmunized individuals in the United States. Aggressive outbreak response efforts in Ohio probably prevented widespread transmission of measles within the entire North American Amish.