Northeastern United States Research Articles

Short-Term Outcomes of a Healthy Relationship Intervention for the Prevention of Sexual Harassment and Sexual Assault in the US Military: Pilot Pretest-Postest Study.

Sexual harassment (SH) and sexual assault (SA) are serious public health problems among US service members. Few SH and SA prevention interventions have been developed exclusively for the military. Code of Respect (X-CoRe) is an innovative web-based, multilevel, SA and SH intervention designed exclusively for the active-duty Air Force. The program's goal is to increase Airmen's knowledge and skills to build and maintain respectful relationships, ultimately reducing SH and SA and enhancing Airmen's overall well-being and mission readiness. This pilot study aimed to assess the short-term psychosocial impact (eg, knowledge, attitudes, and self-efficacy) of the web-based component of X-CoRe on a sample of junior enlisted and midlevel Airmen. Airmen from a military installation located in the Northeastern United States were recruited to complete the 10 web-based modules in X-CoRe (9/15, 60% male; 7/15, 54% aged 30-35 years). Participants were given pretests and posttests to measure short-term psychosocial outcomes associated with SH and SA. Descriptive statistics and paired 2-tailed t tests were conducted to assess differences from preintervention to postintervention time points. After completing X-CoRe, participants had a significantly greater understanding of active consent (P=.04), confidence in their healthy relationship skills (P=.045), and confidence to intervene as bystanders (P=.01). Although not statistically significant (P>.05), mean scores in attitudes about SH, couple violence, and cyberbullying; perceptions of sexual misconduct as part of military life; and relationship skills self-efficacy with a romantic partner and friend also improved. The findings from this study demonstrate X-CoRe's effectiveness in improving critical determinants of SH and SA, making it a promising intervention for SH and SA prevention. More rigorous research is needed to determine X-CoRe's impact on SH and SA victimization and the long-term impact on associated psychosocial determinants.

Assessment of relationship between emotional intelligence and conflict resolution among nurse managers at tertiary Health Institutions of North Eastern States of Nigeria

Conflict in health care settings may be effectively managed if nurse managers possess conflict management skills such as reconciliation, listening, and effective communication to bring individuals closer and work together to find fair solutions and meet balanced needs. The study aimed at identifying the relationship between emotional intelligence and conflict resolution among nurse managers at tertiary Health Facilities, in the Northern States of Nigeria. The objectives of the study are to assess the level of emotional intelligence among nurse managers, also to identify the most common types of conflict, determine the causes of conflict, determine the conflict resolution strategies applied by the nurse managers and to identify relationship between emotional intelligence and conflict resolution among nurse managers in tertiary health institutions of North Eastern States. A mixed methods research design (quantitative and qualitative methods) was used. A total of 188 nurse managers and three Head Nursing Services departments formed the sample size. The nurse managers were given structured questionnaires and the Head of the Nursing Services department was interviewed (key informant interview). Three instruments were employed for data collection; Interview Guide, Structured Questionnaire and Participants Demographics Sheet. A simple random sampling technique was used for the study. The obtained data were coded and computed in an SPSS Version 26 and analyzed using percentages, mean and standard deviation for descriptive statistics while the Pearson Correlation Coefficient was used for the inferential statistics. The result of the study revealed that most of the nurse managers have a fair level of emotional intelligence when dealing with conflict among nurse managers. It also revealed that the most common type of conflict among nurses was related to environmental factors. The working environment was the highest cause of conflict among nurses. Social skill strategy was mostly used in conflict resolution. The study revealed that there was no significant relationship between years of experience and conflict resolution r=0.173. Based on the findings the researcher concluded that most of the respondents highly make use of social awareness in the application of emotional intelligence in conflict resolution, most of the causes of conflict among nurses were related to a working environment, and social skills were mostly used in conflict resolution among nurses. Based on the findings of the study, the researcher recommended that other sources of conflict management should be identified for nurse managers to manage conflict, nurse managers should use the skills they have to solve problems and conflict management to be part of a school of nursing curriculum.

Self-reported health effects from wildfire smoke: A cross-sectional study in New York State

Abstract Background Wildfires and exposure to wildfire smoke (WFS) are forecasted to increase, in part driven by climate change. As witnessed in 2023, regions in Europe and North America are facing more sustained periods of poor air quality due to WFS. Growing evidence suggests average daily WFS correlates with morbidity and mortality, but the impact of prolonged WFS exposure remains understudied, especially in areas where WFS is a newer occurrence. We examine associations between consecutive days of WFS experienced and self-reported health symptoms in the northeastern United States. Methods This retrospective cross-sectional study explored New York State (NYS) residents’ experience with WFS in summer 2023 via an online survey. Participants reported the longest period of consecutive WFS days and symptoms experienced. Log-binomial regression models estimated prevalence ratios (PR) and 95% confidence intervals (CI). Results 553 NYS residents were included, representing a healthy, primarily female and White population, ranging from 18 to 86 years. 549 (99.3%) reported experiencing WFS, with the longest period of consecutive WFS days varying (≤3 days: n = 152; 4 to 6 days: n = 255; ≥7 days: n = 146). 490 (88.6%) reported ≥1 health symptom, with itchy/watery eyes, sore throat, and headache as the most frequent. Compared to ≤ 3 consecutive WFS days, symptom prevalence was 9.1% higher for those reporting 4 to 6 days (PR [95% CI]:1.09 [1.00, 1.19]) and 16.7% higher for ≥7 days (1.17 [1.07, 1.27]). The trend of increased symptom prevalence with longer WFS periods persisted and was pronounced for specific symptoms. Control for potential confounders did not appreciably change estimates. Conclusions Our findings suggest longer sustained WFS exposure associates with higher symptom prevalence, which may be precursors to more serious health conditions. As global populations face more WFS with climate change, public health professionals should prioritize strategies to mitigate prolonged exposure. Key messages • In a convenience sample of 553 primarily healthy New York State residents, 99.3% reported experiencing wildfire smoke and 88.6% reported at least 1 symptom of poor health during summer 2023. • Associations between consecutive days of wildfire smoke experienced and prevalence of any and specific symptoms tended to vary in a dose-response manner.

An analysis of observed and predicted extreme heat and precipitation trends across four pulse producing regions in North America: North Dakota, Montana, Saskatchewan, and Northeastern United States

Abstract The consumption of plant-based proteins in leu of animal proteins is the most important dietary shift that would be needed to keep the world under 2 C of warming, and this shift would require a dramatic increase in the percentage of cropland devoted to nuts and pulses (Peters et al. 2016). As the demand for plant-based proteins, like pulse crops, continues to grow, it is critical to understand the impact of climate change on crop production. In this paper, we study two climate-related stressors for pulse production in North America: extreme heat and excess moisture during harvest. Pulses must be dried on the plant before harvest, requiring a 7-day dry spell before harvest or the use of Roundup (glyphosate) to kill the plants quickly. However, little is known about the changes in frequency of hot extremes or dry spells during harvest in pulse-growing regions. We analyze climate trends using the Unprecedented Simulated Extreme Ensemble (UNSEEN) method and an analysis of the Coupled Model Intercomparison Project (CMIP6) in four pulse growing regions across North America: Montana, North Dakota, Saskatchewan, and the Northeast USA. We find that temperature extremes have increased in all regions, with extreme events 3-4 times more likely today than in 1981, increasing the risk of crop loss. August and September rainfall during the harvest months has been decreasing in the Midwestern regions and it is projected to continue to decrease in the future; however, the likelihood of a wet August in the Northeast has nearly doubled. Even with this drying trend, farmers cannot assume that they will have a 7-day consecutive dry spell that would enable natural drying of pulses without synthetic drying agents like glyphosate. Future expansion of pulse production should incorporate adaptation measures to manage extreme heat and the potential for rain events during harvest.

Co-designing a Children’s Cabinet: a school district–university partnership for youth well-being post-pandemic

PurposeThis paper presents a case study of a school district–university partnership to co-design a Children’s Cabinet, a cross-sector initiative bringing together institutional and community leaders to address youth well-being in the aftermath of the COVID-19 pandemic. In a vibrant, immigrant-serving community in the Northeast United States, the partnership was initiated by district leaders in Spring 2021 after pandemic disruptions led to a youth mental health crisis.Design/methodology/approachOur descriptive, qualitative case study focuses on the structure and emerging design principles of the research–practice partnership, which established a Children’s Cabinet comprised of educational, government and community leaders along with researchers. From Spring 2021 through Spring 2024, we collected and analyzed member and youth interviews, ethnographic observations and artifacts from all meetings and process interviews with key partners.FindingsWe describe the structure of the partnership, including how researchers and district leaders collaborated on meeting facilitation and how researchers conducted and shared applied research. We then discuss three design principles that guided the work, including centering relationships, sustaining focus on key goals and embedding applied research.Originality/valueAs embedded research partners, our team is uniquely situated to narrate the nature and structure of the partnership and reflect on the design of our cross-sector initiative. Increasingly, universities are partnering directly with districts on school improvement initiatives. Our work shows how engaging in RPPs to bring together school, community and research partners can facilitate local leadership and collaboration to address complex, cross-sector goals such as increasing youth well-being.

Correlation of sub-centennial-scale pulses of initial Central Atlantic Magmatic Province lavas and the end-Triassic extinctions

The end-Triassic extinction (ETE) on land was synchronous with the initial lavas of the Central Atlantic Magmatic Province (CAMP) and occurred just after the brief 26 thousand year (kyr) reverse geomagnetic polarity Chron E23r that can be used for global correlation. Lava-by-lava paleomagnetic secular variation data, previously reported from Morocco and northeastern United States combined with our data for the North Mountain Basalt from the Fundy Basin of Canada show that the initial phase of CAMP volcanism occurred in only five directional groups or pulses each occupying less than a century. The first four directional groups occur during a ~40 kyr period based on available astrochronology and U-Pb geochronology. The coincidence of the initial major pulse of CAMP volcanism with the ETE points to short-lived volcanic winters albedo-induced by sulfate aerosols as a plausible key agent of the extinctions in the tropical continental realm, whereas looser correlations allow prolonged CO2 emissions to contribute to more long-ranging effects in the marine realm via ocean acidification and longer-term warming.

Knowledge of Palliative Care in Men and Women Diagnosed With Metastatic Breast Cancer.

The purpose of this study was to evaluate knowledge of Palliative Care (PC) and the impact of systemic and patient-related factors on the use of PC in a diverse population of men and women diagnosed with metastatic breast cancer. A telephone administered survey was used with patients receiving treatment at a Cancer Center in an urban area of the Northeast US. Descriptive statistics and chi square analysis were used. Of the 101 participants, 44% had no knowledge of PC and only 21.78% indicated that they were receiving palliative care. Participants who reported being followed by palliative care were less likely to have been treated in the emergency department in the past year (P = 0.003) or to have been hospitalized (P = 0.042). However, when asked about symptom burden, using the Edmonton Symptom Assessment Scale, patients who reported being followed by PC were more likely to report severe pain as compared to patients not receiving PC (P < 0.001). There were no associations found between race/ethnicity or social determinants of health and knowledge of PC or receipt of services. This sample of men and women diagnosed with metastatic breast cancer and being treated in a Cancer Center had limited knowledge and exposure to Palliative Care services across race and ethnicity. While no specific disparity was noted, the utilization of PC was low. Whether a function of a lack of referrals or patient preference, an effort should be made to increase PC referrals for all patients diagnosed with cancer.

Self-determination and Integration: A Site of Negotiation and a Village Named Panbari

The demand for self-determination of various nationalities has been central to the sociopolitical and cultural life of Assam, a northeastern state of India. The Statutory Autonomous Councils formed under the State Act are a non-territorial arrangement to address the question of self-determination without marking boundaries between co-habiting communities and therefore are a unique model of integration. However, this has led to conflicting situations reflecting how ‘integration’ emerges as a site of negotiation, redefines inter-community relationships, and challenges the state’s intervention in the matter. Drawing from a village study, this article endeavours to probe self-determination as a tool of (dis)integration, as a site of negotiation and argues that the various ways of addressing the question of self-determination adopted by the new nation-state ultimately affect the historically produced inter-community relationships. Methodologically, the article seeks to revisit the promises of ‘village study’ through the multicultural habitat named Panbari, a village in the northeast of Assam, and reflects how the every day in a small village establishes a guiding conversation with the everyday in a multicultural nation-state of India.

Multi-year evaluation of an attract-and-kill strategy for apple maggot fly (Diptera: Tephritidae) in New England commercial apple orchards.

Previously developed behavioral approaches for controlling the apple maggot fly, Rhagoletis pomonella (Walsh) (Diptera: Tephritidae), include attract-and-kill (AK) systems such as perimeter trapping using either, odor-baited red sticky spheres or odor-baited, sticky-free attracticidal spheres with contoured tops that ensure the sustained release of both insecticide and feeding stimulant. Here, over a 3-year span in 26 commercial apple orchards across Massachusetts, New Hampshire, and Maine, we evaluated the effectiveness of a novel AK strategy for R. pomonella management. Synthetic apple blend lures were deployed on perimeter-row trees to attract the pest, while perimeter-row insecticide sprays blended with 2% sugar, a known phagostimulant, served as the lethal component. Comparatively, grower standard (GS) blocks received full-block insecticide sprays devoid of sugar and lures. Monitoring revealed that red sticky spheres in AK blocks captured significantly more R. pomonella adults than unbaited monitoring spheres in GS blocks. Penetration of R. pomonella into block interiors remained consistently low and statistically similar for both AK and GS blocks. Whole-block infestation levels showed no significant difference between the 2 management approaches. Notably, insecticide application in AK blocks was reduced by 75%, 64.7%, and 64.2% in 2019, 2020, and 2021, respectively, compared with GS blocks. This grower-friendly AK approach could be integral to a reduced insecticide spray-based strategy for apple cultivation in the northeastern United States.

'It Made Me Change the Way I Do Business': Outcomes from Age-Friendly Community Initiatives as Systems Change.

Since the early 2000s, a global age-friendly communities (AFC) movement has called for improving the built, social, and service environments of localities for aging. Yet research on the outcomes of AFC initiatives, as programmatic efforts toward AFC progress, remains in its nascence. Drawing on "The Water of Systems Change" framework, our study aimed to address this gap by exploring the extent to which accomplishments of AFC initiatives are indicative of altering six conditions for systems change: policies, organizational practices, resource allocations, power dynamics, relationships, and mental models. We analyzed qualitative data from 26 key informant interviews across eight mature AFC initiatives in the northeastern United States. We engaged in iterative phases of thematic analysis to explore how the initiatives' accomplishments, as described by the participants, align with each of six focal conditions for systems change. We found especially robust and consistent evidence for outcomes in terms of enhanced organizational practices on aging; resource flows; connections within and across communities; and mental models about older adults. Evidence for outcomes concerning changes in power dynamics and policy was more limited. Conceptualizing AFC initiatives as systems-change interventions can bolster research, evaluation, and program development as the movement proliferates and diversifies into the 21st century. Insights can help to advance praxis that empowers AFC leaders as changemakers for "successful aging" at the level of society.

Toward a “budding” individual interest: evidence for a fifth phase of development in four years of an automated greenhouse project

ABSTRACT Background and Context We report on four years of a design-based research project with all grade-eight students in two urban-ring schools of the Northeast US. Youth built automated tabletop “smart” greenhouses. Objective We addressed the research questions, (1) In what ways did four iterations of the smart-greenhouse project support students’ inflections of interest in STEM+C? and (2) How, if at all, did rightful presence foster development of interest? Method This mixed-methods study for convergence includes paired-sample t-tests of means for surveys (N = 599) and descriptive, in vivo, and inductive team-coding for interviews (25 focal students). Findings We found evidence to extend Hidi and Renninger’s four-phase model of interest development, with a phase we call “budding individual interest”, including five tensions thereof. Implications We share educational design considerations related to curriculum, instruction, and follow-up activities, and we explore the potential role of regular access, personal significance, and contextual expectations in students.

Facial Nerve Disorders: Sociodemographic Predictors and Temporal Trends in Dynamic Facial Reanimation in a National Administrative Claims Database.

Background: Recent surgical innovations have increased treatment options for patients with facial nerve disorders (FNDs), leading to substantial improvements in functional and psychosocial outcomes. However, it is unclear whether sociodemographic factors are associated with the likelihood of undergoing dynamic facial reanimation procedures. Objective: In patients undergoing FND surgical treatment, what sociodemographic variables are associated with undergoing dynamic facial reanimation compared with static facial reanimation within a 16-year period? Methods: This was a retrospective study of adults undergoing surgical management for FND from 2007 to 2022 using the Merative™ Marketscan® Research Databases. Chi-squared and logistic regression analyses were performed. Results: Among 4,730 adults who underwent FND surgical intervention, 1,390 (34.2%) underwent dynamic facial reanimation. In multivariable regression analyses, more recent treatment year, younger age, and living in the Northeast United States were significant predictors of undergoing dynamic reanimation. Secondary analysis demonstrated that FND patients who were younger, female, and living in the Northeast United States were more likely to undergo concurrent selective neurectomy. Conclusions: These analyses demonstrate significant sociodemographic and temporal associations in the surgical management of FND. Future work is needed to evaluate how sociodemographic factors might influence access and decisions to pursue different types of reanimation procedures.

Ground beetle trophic interactions alter available nitrogen in forest soil

It is generally held that microbes exert primary control over nitrogen availability in temperate forests. Yet the role of soil and litter‐dwelling invertebrates to provide additional control via the breakdown of organic matter is an area of current exploration. Through trophic interactions within soil food webs, predators may indirectly affect prey with cascading effects on litter breakdown and nitrogen availability. The importance of these interactions, however, may be context‐dependent, varying with the stage of forest development and associated decomposer species composition given that young and old forests have vast differences in nitrogen availability, vegetation litter, soil properties and invertebrate functional groups. We examined ground beetle control over soil nitrogen and soil properties using a 68‐day mesocosm experiment that manipulated trophic structure (omnivore + predator beetles, predator beetles, and no beetles) in a young and old forest stand in the northeastern United States. In the young forest, net nitrogen mineralization decreased under predator + omnivore and the bulk soil C:N ratio in the old forest. However, we found no response in either forest context to the predator only treatment. Our study demonstrates the potential for ground beetles to strongly impact nitrogen availability and soil properties in forest ecosystems. Therefore, animal trophic interactions and their contexts must be included in our paradigm of nutrient cycles in temperate forests.

Extreme-value modelling of migratory bird arrival dates: Insights from citizen science data

Abstract Citizen science mobilises many observers and gathers huge datasets but often without strict sampling protocols, resulting in observation biases due to heterogeneous sampling effort, which can lead to biased predictions. We develop a spatiotemporal Bayesian hierarchical model for bias-corrected estimation of arrival dates of the first migratory bird individuals at their breeding sites. Higher sampling effort could be correlated with earlier observed dates. We implement data fusion of two citizen-science datasets with fundamentally different protocols (BBS, eBird) and obtain posterior distributions of the latent process, which contains four spatial components endowed with Gaussian process priors: species niche; sampling effort; position and scale parameters of annual first arrival date. The data layer consists of four response variables: counts of observed eBird locations (Poisson); presence-absence at observed eBird locations (Binomial); BBS occurrence counts (Poisson); first arrival dates (Generalised Extreme-Value). We devise a Markov Chain Monte Carlo scheme and check by simulation that the latent process components are identifiable. We apply our model to several migratory bird species in the northeastern United States for 2001−2021 and find that the sampling effort significantly modulates the observed first arrival dates. We exploit this relationship to effectively bias-correct predictions of the true first arrivals.

Spanish Terms for Cleft Lip Within the United States.

To examine Spanish terms used for “cleft lip” within the United States. Perceived acceptability of these terms was also considered. An online survey was distributed to Spanish-speaking medical interpreters, clinicians, and parents of children with cleft lip. Survey questions probed demographics, language use, preferred term for “cleft lip,” and perceived acceptability of terms for cleft lip. There were 158 respondents. Significant differences were observed with profession ( P &lt; .001) as 62.5% of medical providers used labio hendido, while 71.8% of interpreters preferred labio leporino. Perceived acceptability of terms was consistent with the term use patterns reported by respondent groups. Significant differences were also observed with geographical region ( P = .001) as 90% of respondents from the Northeast United States employed labio leporino, compared to 60% to 70% of respondents from other regions. Selection and perception of Spanish terms for “cleft lip” may differ across regions and professions. Cleft teams should invite stakeholders to discuss what terms best suit their community.

Connectivity of toxigenic Pseudo-nitzschia species assemblages between the Northeast U.S. continental shelf and an adjacent estuary

Pseudo-nitzschia harmful algal blooms have recently caused elevated domoic acid in coastal environments of the Northeast United States. In 2017, the toxigenic species P. australis was observed in Narragansett Bay, Rhode Island, a temperate estuarine ecosystem, for the first time since 2009 when DNA monitoring for Pseudo-nitzschia species began. This highly toxic species likely contributed to toxin-related shellfish harvest closures and is hypothesized to have been introduced by an offshore source. Little is known about offshore Pseudo-nitzschia spp. populations in the Northeast Continental Shelf marine ecosystem or how often toxigenic species enter Narragansett Bay through physical processes. Here, we collected filtered biomass samples from multiple time series sites within Narragansett Bay and along the Northeast U.S. Shelf Long-Term Ecological Research transect in winter and summer to investigate the frequency and seasonality of potential Pseudo-nitzschia spp. inflow from the continental shelf to the estuary. Species were taxonomically identified using DNA sequencing of the ITS1 region and domoic acid concentrations were quantified by liquid chromatography with tandem mass spectrometry and multiple reaction monitoring. During six years of sampling, Pseudo-nitzschia species assemblages were more similar between Narragansett Bay and the Northeast shelf in winter than summer, suggesting greater ecosystem connectivity in winter. These winter assemblages were often accompanied by higher domoic acid. Several Pseudo-nitzschia species co-occurred most often with domoic acid and were likely responsible for toxin production in this region, including P. pungens var. pungens, P. multiseries, P. calliantha, P. plurisecta, P. australis, and P. fraudulenta. Domoic acid was detected during periods of relatively low macronutrient concentrations in both seasons, warmer sea surface temperatures in winter, and colder temperatures in summer within this dataset. This study represents some of the first domoic acid measurements on the offshore Northeast U.S. Continental Shelf, a region that supplies water to other coastal environments and could seed future harmful algal blooms. The elevated domoic acid and frequency of hypothesized inflow of toxigenic Pseudo-nitzschia spp. from the Northeast continental shelf to Narragansett Bay in winter indicate the need to monitor coastal and offshore environments for toxins and harmful algal bloom taxa during colder months.

Significant changes in global maize yield sensitivity to vapor pressure deficit during 1983–2010

Vapor pressure deficit (VPD) is a critical factor in crop growth, and low yields are often associated with high VPD. The adverse effects of VPD on crop yield have been well-documented; however, whether and where yield sensitivity to VPD (SVPD) changes over time across global cropping areas remain elusive. Based on the observed maize yield and VPD at the grid scale, the SVPD calculated using least-squares linear regression for 27.5 % and 25.9 % of the global maize-growing areas, respectively, showed a significant (p < 0.05) decreasing and increasing trend from 1983 to 2010. Spatially, a statistically negative trend in SVPD was found in southeastern Brazil, the central United States, most of Europe, and northeastern China, whereas a positive trend was observed in the eastern United States and northern China. In particular, negative SVPD was alleviated in 23.2 % of global maize areas, primarily in the northeastern United States and northern China, but was aggravated in 18.4 % of maize areas in the middle latitudes of the Northern Hemisphere. In addition, the sign of SVPD was reversed in 34.4 % of the global maize areas, notably in the central United States, northern China, and southern Brazil. The results of the random forest model show that shortwave radiation was identified as the primary co-varying factor that modulated the pattern of changing SVPD in about 26 % of the global maize area, followed by maximum temperature (24.3 %) and minimum relative humidity (21.5 %). By assessing the 14 process-based crop models, we found that their ensemble mean could reproduce the annual patterns of SVPD well but failed to capture its decadal change trends.

What are future doctors learning about sex? An assessment of sexual health curricula across medical schools in the Northeastern United States.

Sexual health is an imperative area of study in medical school education, yet many medical schools do not offer a comprehensive curriculum nor is it standardized across the United States (US). This study aims to assess written curriculum materials from sexual health curricula in medical schools across the northeast region of the US and compare the current teachings to suggested standards. A compilation of academic resources including lecture materials and syllabi were systematically reviewed utilizing a standardized and validated rubric with variables assessed including: biological and psychological aspects of human sexual development, anatomy and physiology of the human sexual response cycle, sexual health in relation to human reproduction, and contraceptive options. We analyzed our data from the document analysis to look at the frequency of inclusion and exclusion of the sexual health topics included in our rubric. The outcomes of our data set were in line with our hypothesis that there is significant variance between sexual health curricula across institutions as well as an overall lack in material covering sexual health topics. The data show significant sex specific differences such that male-specific topics were covered more frequently than female-specific information. Additionally, only one of the 10 schools examined taught about vulvar conditions. There was also a paucity of information about sexuality in the post-partum period. The clinical implications of this study aim to highlight the discrepancy between an ideal sexual health curriculum and what is actually being taught in medical schools and help to guide future work of creating a comprehensive and standardized sexual medicine education in US. medical schools. The validity of this study was strengthened by analyzing direct curricula materials as opposed to previous use of subjective, self-reported questionnaires. However, the sample location being restricted to the Northeast was a limitation to generalize findings across the country. Future studies would aim to analyze medical school curricula across different regions in the US. This study shows that there is a lack of comprehensive and standardized sexual health curriculum in medical schools in the Northeastern US and serves as initial evidence for further investigation of this topic across American medical schools.

Dimensions of community context that affect coalition effectiveness: development of an instrument

ABSTRACT This study investigates the role of multidimensional contextual factors on the perceived effectiveness of community coalitions engaged in the Strategic Prevention Framework (SPF) for addressing substance misuse. We introduced and validated an instrument for assessing a broad range of contextual factors for coalition development and program implementation. This research also scrutinizes how contextual factors impact coalition effectiveness, considering internal capacity indicators as mediators. Data were sourced from 295 and 297 coalition members across 2015 and 2016, respectively, involved in SPF initiatives within a northeastern state in the United States. Our analysis identifies three critical dimensions of contextual factors – collaboration and resources, politics, and demographics and norms – that significantly affect the perceived management and program effectiveness through different mechanisms. The findings underline the importance of prevention coalitions to comprehensively assess community contexts and strategically address contextual challenges to enhance their impact on substance misuse prevention.

Transferability of machine-learning-based modeling frameworks across flood events for hindcasting maximum river water depths in coastal watersheds

Abstract. Despite applications of machine learning (ML) models for predicting floods, their transferability for out-of-sample data has not been explored. This paper developed an ML-based model for hindcasting maximum river water depths during major events in coastal watersheds and evaluated its transferability across other events (out-of-sample). The model considered the spatial distribution of influential factors that explain the underlying physical processes to hindcast maximum river water depths. Our model evaluations in a six-digit hydrologic unity code (HUC6) watershed in the northeastern USA showed that the model satisfactorily hindcasted maximum water depths at 116 stream gauges during a major flood event, Hurricane Ida (R2 of 0.94). The pre-trained, validated model was successfully transferred to three other major flood events, hurricanes Isaias, Sandy, and Irene (R2&gt;0.70). Our results showed that ML-based models can be transferable for hindcasting maximum river water depths across events when informed by the spatial distribution of pertinent features, their interactions, and underlying physical processes in coastal watersheds.