South-central Indiana Research Articles

A community-based participatory research approach to evaluating and improving hepatitis C risk, knowledge, and stigma associations among people who inject substances in Indiana.

To explore hepatitis C risk, knowledge, and stigma among individuals who inject substances in South Central Indiana. A cross-sectional study design was employed using a community-based participatory research approach. The community partner was a grassroots harm reduction organization. Participants in this study were at least 18 years of age, current residents of Indiana, and self-identified as injection substance users (n=179). The survey measured hepatitis C risk, knowledge, and stigma, as well as differences in hepatitis C risk scores among key demographic characteristics. Most participants identified as male (n=106, 59%), White (n=139, 78%), and straight (n=143, 80%). People of color reported lower hepatitis C knowledge than White participants. Women had significantly lower hepatitis C knowledge compared with men. LGBTQ participants reported increased hepatitis C risk compared with straight participants. Increased frequency of substance use was associated with decreased stigma. Unhoused participants demonstrated significantly lower hepatitis C knowledge compared with housing-secure participants. Our findings increase understanding that knowledge and risk around hepatitis C are associated with demographic characteristics. Results underscore the need for tailored public health interventions to increase hepatitis C knowledge, reduce stigma, and improve testing and treatment among vulnerable populations.

Understanding the Homelessness Crisis and Responses in Bloomington, Indiana

This study addresses the complex challenges of homelessness in Bloomington, Indiana. Beacon, Inc., a nonprofit based in Bloomington, plays a pivotal role in providing support to individuals experiencing homelessness in south-central Indiana. Beacon’s approach prioritizes immediate and barrier-free access to shelter and housing while eliminating stringent entry requirements. Beacon offers three distinct programs: Friend’s Place, an emergency shelter; Rapid Re-Housing, facilitating rapid transitions to stable housing; and Crawford Homes, providing permanent supportive housing. This research, conducted in partnership with Beacon, employs a mixed-methods approach to examine homelessness in the city of Bloomington. It includes a literature review, quantitative data analysis from nationwide counts and Beacon’s programs, and interviews with Beacon staff to gain insights into the housing crisis and its unique dynamics in this community. The results underscore the impact of Beacon’s programs in 2022 on individuals experiencing extreme poverty in Indiana’s Region 10, which consists of six south-central counties. Despite the success of these programs, challenges persist for individuals experiencing homelessness, particularly in combating chronic homelessness. Interviews with Beacon staff highlighted additional barriers to housing, including high rents, inflexible landlords, evictions, and entanglement with the criminal justice system. This study suggests the need for diverse strategies, including expanding Housing First programs and supportive housing models, as well as long-term government housing subsidies for low-income renters. These solutions can reduce reliance on emergency shelters and work to prevent chronic/recurrent homelessness. By employing a mixed-methods research approach, this study offers valuable insights into homelessness and housing assistance programs, providing a foundation for future research aimed at addressing homelessness more comprehensively in Bloomington and similar communities.

Geologic Map of the Bedford 30- x 60-minute Quadrangle, Indiana

The Geologic Map of the Bedford 30- x 60-minute Quadrangle shows the Mississippian and lower Pennsylvanian bedrock units and the overlying Pleistocene and Holocene deposits distributed over eight counties. The mapped area includes five physiographic divisions of the Southern Hills and Lowlands Region in south-central Indiana. Bedrock units and unconsolidated deposits were characterized by outcrop field observations, and new and archived borehole data. Bedrock data was consolidated into a single mapping database, which was then processed using gridding and contouring tools in ArcGIS Pro, resulting in rock formation contact lines, mappable at 1:100,000 scale. Additional information used to delineate contacts for unconsolidated deposits was based upon Indiana Department of Natural Resources water well database and soils data from the Soil Survey Geographic (SSURGO) database. Light detection and ranging (LiDAR) digital elevation models were also used to identify landforms and refine contacts between surficial units. The mapped bedrock units, from east to west, range in age from the Borden Group (lower Mississippian) to the Raccoon Creek Group (Lower Pennsylvanian) with the strike oriented generally from northwest to southeast. Quaternary deposits are found in river and stream valleys and filling the Wabash and Scottsburg lowlands with glacial deposits. Quaternary sediments were mostly deposited during the last two major advances of the Laurentide Ice Sheet into south-central Indiana. Brief summaries of all mapped bedrock units and unconsolidated deposits are listed on the map sheet, with more detailed descriptions in the accompanying pamphlet. Bedrock survey drill hole data points are also displayed on the map with corresponding links to expanded drill hole information for each of the survey drill holes listed in the pamphlet. In addition to the map and pamphlet, a composite spatial data set that conforms to the standardized database schema known as GeMS (Geologic Map Schema) is also available for download from this site. Both ESRI-licensed geodatabase and open shapefile versions of the spatial data set are available for download. Metadata records associated with each element within the spatial data set contain detailed descriptions of their purpose, constituent entities, and attributes. This geologic map was funded in part through the STATEMAP program supported by the U.S. Geological Survey under Cooperative Agreement No. G21AC10646.

Foliage-roosting eastern red bats select for features associated with management in a central hardwood forest

Forests provide crucial foraging and roosting habitat to many bat species, and the gradual loss of forests is among the principal threats to global bat diversity. Forests that persist in the face of land use change are those that are managed for a variety of uses, including recreation, hunting, timber production, and wildlife conservation. Thus, understanding how bats respond to management is imperative to their conservation. We used radio telemetry to study the roosting and foraging behaviors of male and female eastern red bats (Lasiurus borealis). These forest-dependent bats roost in the foliage of live trees and are declining across their range. We tracked 26 bats (7 males and 18 females; one female was tracked twice) from May to August 2017–2019 in two state forests in south-central Indiana, USA. We estimated space use with 95% kernel density estimates and used generalized linear and linear mixed models to assess resource selection and use at three levels: population-level foraging selection, individual-level foraging use, and population-level roost selection. On average, eastern red bats foraged over a relatively small area (81 ha) and traveled a maximum distance of 1404 m from their roosts. The eastern red bat population foraged near maintained openings, recent regeneration openings, roads, and ponds within the study area. Within their foraging ranges, eastern red bats spent more time foraging near roads, ponds, and ridges. Eastern red bats roosted near maintained openings, recent regeneration openings, and ponds, switching roosts every two days. Roost trees were larger than random trees and were in plots containing fewer live stems than random plots. Together, these results reveal that some of the most important landscape features for eastern red bats are linear corridors (e.g., roads or ridgetops), forest openings (e.g., maintained openings and recent regeneration openings), perennial sources of water (e.g., ponds), and large trees. Overall, eastern red bats exhibited strong selection for managed portions of the forest, suggesting they can coexist with and likely benefit from timber management. When considering habitat for eastern red bats in central hardwood forests, we recommend land managers work to maintain large tracts of mature (>90 years old) forest, interspersed with young regeneration openings and provisioned with perennial water sources (e.g., ponds).

Habitat selection in a recovering bobcat (Lynx rufus) population.

Understanding habitat selection of top predators is critical to predict their impacts on ecological communities and interactions with humans, particularly in recovering populations. We analyzed habitat selection in a recovering population of bobcats (Lynx rufus) in south-central Indiana using a Random Forest model. We predicted that bobcats would select forest habitat and forest edges but avoid agriculture to maximize encounters with prey species. We also predicted that bobcats would avoid developed areas and roads to minimize potential antagonistic interactions with humans. Results partially supported our predictions and were consistent with bobcats in the early stages of population expansion. Bobcats exhibited elevated use near forest edges, thresholds of avoidance near agriculture, and thresholds of selection for low and intermediate habitat heterogeneity. Bobcats exhibited peak probability of use 1–3 km from major roads, >800 m from minor roads, and <1km from developed areas, suggesting tradeoffs in reward for high-quality hunting areas and mortality risk. Our Random Forest model highlighted complex non-linear patterns and revealed that most shifts in habitat use occurred within 1 km of the edge of each habitat type. These results largely supported previous studies in the Midwest and across North America but also produced refinements of bobcat habitat use in our system, particularly at habitat boundaries. Refined models of habitat selection by carnivores enable improved prediction of the most suitable habitat for recovering populations and provides useful information for conservation.

A Real-Time Trend Study of the Southern Vowel Shift in Kentuckiana

This article examines both the front and back shifts of the Southern Vowel Shift (SVS) in a rural Kentuckiana (south-central Indiana) community through 50 years of real time, from the middle of the twentieth century to the early twenty-first century. Euclidean distance measurements between the pair of high front vowels /i/ and /I/ and between the pair of mid front vowels /e/ and /ε/ are subjected to analyses of variance (ANOVAs). The mid front vowels are found to be involved in the SVS and increasingly so through real time; the high front vowels, in contrast, not only are not participating in the SVS but have exhibited movements in non-SVS directions. Fronting of the back vowels is analyzed through linear mixed-effects regression analyses. Except for /℧/, which remains stable over time in this community, the other back vowels, /u/, /o/, and the nucleus of the /a℧/ diphthong all show real-time changes that are consistent with the SVS. Some of the real-time developments are at odds with profiles of change through apparent time, which underscores the value of real-time data when and where it is available.

Endangered Myotis bats forage in regeneration openings in a managed forest

Bat populations face numerous threats, including the loss of forests in which they roost and forage. Present-day forests are commonly managed for timber harvesting, recreation, and wildlife. Understanding bat responses to forest management is crucial for balancing the conservation of endangered bats and forest restoration. We used radio telemetry to study nocturnal movements and habitat selection patterns of female and juvenile bats of two forest-dependent, federally listed bat species in an oak-dominated managed forest. We estimated foraging space use and assessed habitat selection for 33 northern long-eared bats (Myotis septentrionalis) and 25 Indiana bats (Myotis sodalis) from May to August 2014–2017 in south-central Indiana, USA. Myotis septentrionalis space use averaged 176 ha and bats selected water, historic thinning, and patch cuts (≤4 ha) over other habitats, with all but one bat avoiding larger openings (≥4-ha clearcuts). Myotis sodalis space use averaged 343 ha and bats selected 4-ha patch cuts, historic openings, and historic thinning over other habitats. In contrast to M. septentrionalis, one-third of the M. sodalis foraged over larger clearcuts, while two-thirds foraged over smaller openings and thinnings. We showed that bats were attracted to small regeneration harvests of varying structural ages. Forests maintained for a mix of mature stands, thinned stands, shelterwoods, small regenerative cuts (<7 ha), and small water sources should provide suitable foraging habitat for these endangered Myotis species, while also promoting forest regeneration.

Active surveillance of ticks in peri-domestic areas of Indiana, Midwest United States.

The incidence of Borreliosis, Anaplasmosis, Babesiosis and other tick-borne diseases acquired from private residential/peri-domestic areas has increased over the decades. However, tick activity and proportion of private residential properties with established tick populations remain unknown. The purpose of the current study was to determine the predictors of tick activity in peri-domestic areas. In a cross-sectional study design, we used snowball-sampling with cold-calling techniques to collect free-living ticks, sociodemographic, and microclimatic data from June to November 2018 from a total of 96 private residential areas in south-central Indiana, USA. Thirty-eight percent of peri-domestic areas sampled had tick activity, and of these, 50% had established tick populations. Nymphal ticks were the most abundant life stage. Self-reported TBD diagnosis was 16%. Amblyomma americanum [Linnaeus (lone star tick)] was the most abundant tick species collected. Other tick species identified include: Ixodes scapularis [Say (black-legged/deer tick)] and Dermacentor variabilis [Say (American dog tick)]. Increasing temperature was positively associated with tick activity, while elevation was negatively associated with tick abundance. Our study results reveal that the proportion of peri-domestic areas in Indiana with established tick populations is high. Amblyomma americanum tick is the most predominant tick species in peri-domestic areas of south-central Indiana. Active surveillance of ticks in peri-domestic areas is necessary for informing decisions by households and communities about where to target tick exposure and tick-borne disease prevention efforts.

Longhorned Beetle Functional Diversity in Response to Biomass Harvesting.

Woody debris left after timber harvest may be used to produce bioenergy. This will help reduce reliance on nonrenewable fossil fuels. There are ecological impacts to the use of this woody material as many species use coarse woody debris for food and shelter. An understanding of how the removal of woody biomass after forest harvest changes the functional diversity of forest communities is needed to make sustainable management decisions. Many longhorned beetles (Coleoptera: Cerambycidae) provide ecosystem services by reducing woody debris in forests and pollinating flowering plants including trees. I used a taxonomically and functionally diverse community of longhorned beetles to examine changes to functional diversity following different levels of biomass removal in a secondary forest in south-central Indiana, USA. The functional diversity was measured prior to forest harvest and biomass removal and for 2 yr after treatment. I predicted that the abundance and functional group richness of the longhorned beetles would correlate positively with the volume of woody biomass left on the site, and that the community would show resilience by returning to the functional portfolio that was in place in the pre-harvest communities and occurred in the control. The abundance and functional group richness increased with more woody debris left on site. There was much variance in the trajectory of the community following harvest, with no clear trend toward pre-harvest functional portfolio that would indicate resilience. A 3-yr study is likely not long enough to capture this resilience, especially on sensitive sites.

Distribution, Dynamics, and Diversity of Questing Ticks in the Lower Midwest.

We investigated the spatiotemporal patterns of medically important tick species in southcentral Indiana in 2018 and 2019. In recent decades, both Amblyomma americanum (Acari: Ixodidae) (Linnaeus) and Ixodes scapularis (Acari: Ixodidae) (Say) have been expanding their ranges into the Midwest. We report updates to the status of A. americanum, I. scapularis, and Dermacentor variabilis (Acari: Ixodidae) (Say) across 13 counties in southern and south-central Indiana. We found more northerly establishment of A. americanum and more widespread establishment of I. scapularis than previously reported in the literature. We also provide the first report of Amblyomma maculatum (Acari: Ixodidae) (Koch) in Indiana. Using negative binomial regression, we observed significant spatial variation among sampling sites in A. americanum adults and nymphs, D. variabilis adults, and I. scapularis nymphs. Further, we found higher densities of A. americanum nymphs and I. scapularis adults in more forested areas as opposed to less forested, more developed areas. We did not find significant interannual variation in tick densities for any species. More southern sites featured higher densities of A. americanum adults and nymphs, D. variabilis adults, and I. scapularis nymphs than more northern sites. Seasonally, we observed the highest peaks in tick activity in the spring and early summer, but I. scapularis adults were most common in the early spring and fall. Average adult A. americanum and adult D. variabilis densities were positively correlated at our sites. Our results reflect the northward expansion of A. americanum in the Lower Midwest, as well as the increasing geographic prevalence of I. scapularis in the region.

Loneliness and Activity Engagement Among Rural Homebound Older Adults With and Without Self-Reported Depression.

Rural homebound older adults are a vulnerable population at risk for depression, loneliness, and limited participation, but studies that examine these factors in this population are scarce. To describe the degree of depression, loneliness, and activity engagement among rural homebound older adults and determine differences in loneliness and activity engagement between those with and those without self-reported depression. Cross-sectional survey. Two rural counties in south central Indiana. Homebound adults ages 60 yr and older who received nutritional or companionship services from a local Area Agency on Aging. Outcomes and Measures: Depression was measured with an item on the self-report questionnaire and the Geriatric Depression Scale-15. Loneliness was measured with an item on the self-report questionnaire and the UCLA Loneliness Scale. Activity engagement was measured with the Engagement in Meaningful Activities Survey and the Meaningful Activity Participation Assessment. Ninety-one participants returned surveys, of which 78 were analyzed. Regarding depression, 40% of participants reported having it, but results for the Geriatric Depression Scale-15 showed that 63% were in the indicative or suggestive range for depression. Participants in general reported moderate loneliness and low to moderate engagement in meaningful activities. Those with self-reported depression had significantly higher loneliness and lower activity engagement, particularly in self-care, leisure, and socializing activities. A high proportion of this sample of rural homebound older adults had depression. Those who did tended to have a higher degree of loneliness and lower engagement in meaningful activities. What This Article Adds: Depression was associated with greater loneliness and lower activity engagement in rural homebound older adults. Occupational therapy practitioners serving rural homebound older adults with depression should consider providing interventions to address loneliness and facilitate activity engagement.

What is normal body weight? Perceptions around "average" and "healthy" body weight among adolescents in Indiana.

Biological normalcy is a framework that investigates relationship(s) between statistical norms and normative views/beliefs around particular traits. This study assessed the relationships between perceptions of average body weight, healthy body weight, and weight status among adolescents. Adolescents recruited in southcentral Indiana, United States (n=123) completed online questionnaires for demographics and body weight perceptions. Silhouettes from the Stunkard Figure Rating Scale measured perceived weight status, perceived average body weight, and perceived healthy body weight. Height and weight were measured to calculate body mass index-for-age percentiles. A subsample (n=11) provided descriptions of "average," "healthy," and "normal" bodies during semi-structured interviews. As perceived average body weight increased, selections of "healthy" silhouettes shifted downward, with smaller female silhouettes being marked healthy more often and larger male silhouettes being marked healthy less often. Additionally, perceived weight status was positively associated with perceptions around average body weight and lowest body weight perceived to be healthy for female and male silhouettes. Qualitative data demonstrated significant overlap in adolescents' descriptions of "average," "healthy," and "normal" bodies as well as dual meanings for the term "normal" in adolescents' views of body weight. Perceived weight status appears to play a role in adolescents' conceptualizations of average and healthy body weight. Additionally, Qualitative and quantitative data indicated that perceived body weight norms were associated with normative perceptions around what healthy bodies look like. This study demonstrates relationships between statistical norms and normative views around body weight, underscoring the duality in how body weight is understood to be "normal" among adolescents.

Old-growth attributes in a maturing secondary Indiana state forest: an opportunity for balanced management1

Primary old-growth forests are rare in the state of Indiana and are found only in small, isolated patches of nature preserves. Recent research underscores the values of large tracts of secondary old-growth (referred to in this paper as “older” forests), including carbon sequestration, forest resiliency, mitigation of climate change impacts, and conservation of biological diversity. Due to historical management, many portions of Indiana state forests are maturing, and yet the “older” successional stage is underrepresented. One of these maturing forests, the site of our study, is in south-central Indiana within the Back Country Area (BCA) of the Morgan-Monroe/Yellowwood State Forest (two state forests, herein called a complex, including parcels in three counties with the largest block of forests spanning Brown and Monroe counties). Our study of the forest structure of the BCA addresses the following questions: (a) Is this mature forest developing ecological attributes of old-growth forests, thus making it a good candidate for an older forest reserve? (b) Does this forest support the plant community characteristic of natural areas of Indiana? We analyzed forest stand metrics, coarse woody debris and snags, age of the largest live trees, and the floristic quality of the herbaceous layer. We then compared these data with published accounts from Indiana nature preserves. Metrics such as tree basal area, number of large-diameter trees, and number of snags are within the range of those measured in existing old-growth forests of Indiana. Analysis of tree cores and log cross-sections shows that 78% of the sample trees were over 100 yr old, with 24% over 130 yr, which is also comparable to old-growth forest nature preserves in the state. The metrics of the Floristic Quality Assessment of the broader plant community of the BCA are comparable to or higher than the metrics from published assessments of Indiana nature preserves. Collectively, the attributes measured indicate that the BCA supports a maturing secondary forest with old-growth characteristics. In the absence of further timber harvest, the BCA as a reserve could reach older forest status within 50 yr. Our study demonstrates that the BCA forest is a prime candidate for an older forest reserve. This study of the BCA could also serve as a model for future assessments of potential older forest reserves in other state forests. Reserves of older forests free from harvest are not incompatible with other management goals and can be a valuable part of a broader-scale management plan. These forest reserves should be promoted across the state to increase the representation within Indiana's state forest system of late-successional secondary forest exhibiting ecological attributes of old-growth forests, thereby enhancing the role of state forests in biodiversity protection and climate mitigation.

Northern long-eared bats roosting in a managed forest in south-central Indiana

Forest management can have mixed impacts on tree-roosting bats. Several bat species have benefitted from increased roost availability generated by certain silvicultural methods. To further investigate the impacts of forest management on bats, we conducted a study on the federally threatened northern long-eared bat (Myotis septentrionalis) in managed forests within south-central Indiana, USA. During the summers of 2012–2015, we captured and tracked 69 female bats back to 175 roosts, for which we collected roost-scale data. We compared the frequency that roosts and random points were located in (or within 10 m of) timber harvest openings and first-stage shelterwood cuts as well as their distances to these harvest types. Female northern long-eared bats roosted in a variety of roost types in a variety of tree species. However, bats tended to roost more frequently in crevices and cavities located on live sassafras (Sassafras albidum; which were often hollow) that dominated the forest mid-story and large oaks and maples in the overstory (Quercus spp., Acer spp.). While bats used roosts that were closer to harvest openings and first-stage shelterwood cuts, they did not preferentially use or avoid roosts within these sites based on their availability. However, bats did roost within both harvest openings and shelterwood cuts. Roosts used by bats in this study area are similar to those used in other landscapes, suggesting that forest management does not affect bats’ choice of roost. Our results suggest that the roosting behavior of female northern long-eared bats are not negatively impacted by forest management, at least within these south-central Indiana forests.

A Space-Time Permutation Scan Statistic for Evaluating County-Level Tickborne Disease Clusters in Indiana, 2009-2016.

The purpose of this study was to identify age group, gender, rural-urban differences, and spatiotemporal clusters of tickborne disease diagnoses in Indiana. We analyzed retrospective surveillance data for Lyme disease, ehrlichiosis, Rocky Mountain spotted fever, typhus/rickettsial diseases, and tularemia diagnosed in Indiana from 2009 to 2016. We used chi-square cross tabulation to test gender, age group, and county classification (rural, rural-mixed, urban) differences in tickborne disease. We used the Kruskal-Wallis test with a post hoc Conover test to identify differences in summated tickborne disease by county classification. Finally, we used retrospective space-time permutation models in SaTScan to test the hypothesis of complete spatiotemporal randomness of tickborne disease. We found more Lyme disease diagnoses among Indiana residents 44 years of age or younger compared with those over 44 years. Conversely, more ehrlichiosis, Rocky Mountain spotted fever, and tularemia were reported in Indiana residents aged over 44 years of age. An analysis of summated tickborne disease by county showed significantly higher diagnosis reported in urban counties, compared with rural and rural-mixed counties. Finally, 2 significant clusters of summated tickborne disease were observed in south-central Indiana in 2014 and in western Indiana from 2010 to 2011. The detection of tickborne disease clusters, coupled with the finding that significant differences exist in the diagnosis of tickborne diseases between urban, rural, and rural-mixed counties in Indiana, suggests a need for continued surveillance of the counties observed within these clusters.

Survival and Mortality Sources in a Recovering Population of Bobcats (Lynx rufus) in South-central Indiana

Bobcat (Lynx rufus) populations have increased in the midwestern U.S. since the 1980s after substantial declines and local extirpations into the mid-1900s. We monitored 38 radio-collared bobcats (25 males, 13 females) from 1998 to 2006 in a recovering population in south-central Indiana to investigate survival and mortality causes. Annual survival was high (Ŝ = 0.80, 95% CI = 0.71–0.89), comparable to results from other studies of bobcats in unexploited populations and higher than in harvested populations. Of 17 known deaths, vehicle collisions were the largest source of mortality (n = 9; 53%), followed by illegal shootings (n = 3; 18%). Higher values of habitat heterogeneity within home ranges were associated with lower risk of mortality. Estimates of survival and mortality sources in recovering populations provide an important context to compare management strategies to improve bobcat conservation.

Survival and Mortality Sources in a Recovering Population of Bobcats (Lynx rufus) in South-central Indiana

Bobcat (Lynx rufus) populations have increased in the midwestern U.S. since the 1980s after substantial declines and local extirpations into the mid-1900s. We monitored 38 radio-collared bobcats (25 males, 13 females) from 1998 to 2006 in a recovering population in south-central Indiana to investigate survival and mortality causes. Annual survival was high (Ŝ = 0.80, 95% CI = 0.71–0.89), comparable to results from other studies of bobcats in unexploited populations and higher than in harvested populations. Of 17 known deaths, vehicle collisions were the largest source of mortality (n = 9; 53%), followed by illegal shootings (n = 3; 18%). Higher values of habitat heterogeneity within home ranges were associated with lower risk of mortality. Estimates of survival and mortality sources in recovering populations provide an important context to compare management strategies to improve bobcat conservation.

Accessibility to emergency food systems in south-central Indiana evaluated by spatiotemporal indices of pressure at county and pantry level

Families living in poverty in the United States rely on earnings, federal government programmes, the emergency food system (EFS) and a variety of informal networks to get adequate nutrition. The EFS is a large network of emergency food operations (EFOs) that serve as a supplement both for people receiving Supplemental Nutrition Assistance Program benefits and for those requiring food aid who do not qualify for government assistance. The static view of the distribution of EFOs across 11 counties in south-central Indiana typically employed by policymakers and non-governmental organizations shows this largely rural area to be well covered. However, when examined by the time of day and day of month that EFOs in the region operate, coverage proves illusory. Here, we map and analyse the spatiotemporal availability of services offered by these EFOs and develop measures of availability of EFOs, dependent on EFO open hours, service area limitations and numbers of food-insecure individuals. This allows policymakers and non-governmental organizations to better gauge the adequacy of the EFS within a given region. Food pantries are part of the emergency food network in the United States, but they are an understudied component of food access. The Pantry Accessibility Index and Individual Accessibility Index developed here allow measurement of the spatiotemporal availability of these services to the food insecure of south-central Indiana.

Implementing a pharmacist-led emergency department microbiology follow-up collaborative practice agreement

ObjectiveDescribe the use of an emergency department (ED) pharmacist–driven microbiology follow-up collaborative practice agreement (CPA) at a community hospital ED. SettingA 297-bed community hospital that serves several counties in south-central Indiana. Practice descriptionThe 40-bed ED had 48,550 visits in 2018. The clinical staff consists of 14 physicians, 14 advanced practice providers, and 2 ED pharmacists. Practice innovationA CPA exists between the ED medical director and the ED clinical pharmacists. The pharmacist reviews the patient’s case, culture result(s), and medications administered in or prescribed at the ED. If supported by the CPA, the pharmacist will intervene independently. If the intervention is not supported by the CPA, the pharmacist will discuss treatment options with an ED provider. EvaluationThe primary end point was the number of cases reviewed and acted upon independently by the ED pharmacists using the CPA. The secondary end points included the average number of culture cases reviewed per day, average time spent daily reviewing culture data, number of cases not requiring further action under the CPA because the treatment is appropriate, type of intervention used under the CPA, number of culture cases unable to be executed under the CPA, reason for CPA exclusion, and ED provider satisfaction with the CPA. Descriptive statistics were used for data analysis. ResultsThe CPA covered 1094 microbiology follow-up cases. Of these, 36% (n = 394) required further intervention under the CPA. The CPA was unable to be used in 31% (n = 493) of the cases. Typically, a pharmacist reviewed 5.5 new cases daily over an estimated 2 hours. The ED providers strongly support the ED clinical pharmacists’ current use of the CPA and also its expansion. ConclusionThe CPA has several avenues for potential expansion that are being explored in response to the information gathered in this study.

Growing-Season Synoptic and Phenological Controls on Heat Fluxes over Forest and Cropland Sites in the Midwest U.S. Corn Belt

AbstractSpatial variations in land use/land cover (LULC) in the Midwest U.S. Corn Belt—specifically, deciduous forest and croplands—have been suggested as influencing convective rainfall through mesoscale circulations generated in the atmosphere’s boundary layer. However, the contributing role of latent and sensible heat fluxes for these two LULC types, and their modulation by synoptic weather systems, have not been determined. This study compares afternoon averages of convective fluxes at two AmeriFlux towers in relation to manually determined synoptic pressure patterns covering the nine growing seasons (1 May–30 September) of 1999–2007. AmeriFlux tower U.S.-Bo1 in eastern Illinois represents agricultural land use—alternating between maize and soybean crops—and AmeriFlux tower U.S.-MMS in south-central Indiana represents deciduous forest cover. Phenologically, the latent and sensible heat fluxes vary inversely across the growing season, and the greatest flux differences between cropland and deciduous forest occur early in the season. Differences in the surface heat fluxes between crop and forest LULC types vary in magnitude according to synoptic type. Moreover, statistically significant differences in latent and sensible heat between the forest and cropland sites occur for the most frequently occurring synoptic pattern of a low pressure system to the west and high pressure to the east of the Corn Belt. The present study lays the groundwork for determining the physical mechanisms of enhanced convection in the Corn Belt, including how LULC-induced mesoscale circulations might interact with synoptic weather patterns to enhance convective rainfall.