Southwestern Pennsylvania Research Articles

Wellness and resilience for college and beyond: protocol for a quasi-experimental pilot study investigating a dialectical behaviour therapy skill-infused college course

IntroductionCollege students’ mental health problems and suicidal behaviour are serious, persistent and prevalent public health issues. With the need for mental health support greatly exceeding the availability of on-campus treatment,...

Transport model for shale gas well leakage through the surrounding fractured zones of a longwall mine

The environmental risks associated with casing deformation in unconventional (shale) gas wells positioned in abutment pillars of longwall mines is a concern to many in the mining and gas well industry. With the recent interest in shale exploration and the proximity to longwall mining in Southwestern Pennsylvania, the risk to mine workers could be catastrophic as fractures in surrounding strata create pathways for transport of leaked gases. Hence, this research by the National Institute for Occupational Safety and Health (NIOSH) presents an analytical model of the gas transport through fractures in a low permeable stratum. The derived equations are used to conduct parametric studies of specific transport conditions to understand the influence of stratum geology, fracture lengths, and the leaked gas properties on subsurface transport. The results indicated that the prediction that the subsurface gas flux decreases with an increase in fracture length is specifically for a non-gassy stratum. The sub-transport trend could be significantly impacted by the stratum gas generation rate within specific fracture lengths, which emphasized the importance of the stratum geology. These findings provide new insights for improved understanding of subsurface gas transport to ensure mine safety.

Schistidium agassizii Confirmed in Pennsylvania

Schistidium agassizii is confirmed for Pennsylvania, after an earlier report of the species from the commonwealth was found to be misdetermined. The new collection was made from rocks within and along a stream in Fayette County, southwestern Pennsylvania.

Genetic diversity of wild and managed honey bees (Apis mellifera) in Southwestern Pennsylvania, and prevalence of the microsporidian gut pathogens Nosema ceranae and N. apis

The populations of wild honey bee (Apis mellifera) colonies in the USA were decimated after the arrival of a parasitic mite Varroa destructor in the 1980s. However, in some places, wild honey bee colonies survived. In this 3-year study, we analyzed 32 wild and 11 managed colonies in Southwestern Pennsylvania for their maternal genetic ancestries and their levels of Nosema spp. infection. We detected nine mtDNA haplotypes in the 32 wild colonies sampled: six belonged to the Eastern European lineage (C) and three belonged to the Western European lineage (M). We found only three mtDNA haplotypes in the eleven managed colonies sampled, all belonging to the C lineage. Infection levels of N. ceranae were relatively high and fluctuated over time while those of N. apis remained relatively low and constant. There were no differences in N. ceranae or N. apis levels between wild and managed colonies. This study shows that wild honey bee colonies can represent old lineages despite being susceptible to Nosema.

The Development and Evaluation of a Text Message Program to Prevent Perceived Insufficient Milk Among First-Time Mothers: Retrospective Analysis of a Randomized Controlled Trial.

BackgroundSeveral recent trials have examined the feasibility and efficacy of automated SMS text messaging to provide remote breastfeeding support to mothers, but these texting systems vary in terms of design features and outcomes examined.ObjectiveThis study examined user engagement with and feedback on a theory-grounded SMS text messaging intervention intended to prevent perceived insufficient milk (PIM)—the single, leading modifiable cause of unintended breastfeeding reduction and cessation.MethodsWe recruited 250 nulliparous individuals intending to breastfeed between 13 and 25 weeks of pregnancy in southwestern Pennsylvania. Participants were randomly assigned with equal allocation to either an SMS intervention to prevent PIM and unintended breastfeeding reduction or cessation (MILK, a Mobile, semiautomated text message–based Intervention to prevent perceived Low or insufficient milK supply; n=126) or a control group receiving general perinatal SMS text messaging–based support via the national, free Text4Baby system (n=124). Participants in both groups received SMS text messages 3 to 7 times per week from 25 weeks of pregnancy to 8 weeks postpartum. The MILK intervention incorporated several automated interactivity and personalization features (eg, keyword texting for more detailed information on topics and branched response logic) as well as an option to receive one-on-one assistance from an on-call study lactation consultant. We examined participant interactions with the MILK system, including response rates to SMS text messaging queries. We also sought participant feedback on MILK content, delivery preferences, and overall satisfaction with the system via interviews and a remote survey at 8 weeks postpartum.ResultsParticipants randomized to MILK (87/124, 70.2% white and 84/124, 67.7% college educated) reported that MILK texts increased their breastfeeding confidence and helped them persevere through breastfeeding problems. Of 124 participants, 9 (7.3%) elected to stop MILK messages, and 3 (2.4%) opted to reduce message frequency during the course of the study. There were 46 texts through the MILK system for individualized assistance from the study lactation consultant (25/46, 54% on weekends or after-hours). The most commonly texted keywords for more detailed information occurred during weeks 4 to 6 postpartum and addressed milk volume intake and breastfeeding and sleep patterns. MILK participants stated a preference for anticipatory guidance on potential breastfeeding issues and less content addressing the benefits of breastfeeding. Suggested improvements included extending messaging past 8 weeks, providing access to messaging for partners, and tailoring content based on participants’ pre-existing breastfeeding knowledge and unique breastfeeding trajectory.ConclusionsPrenatal and postpartum evidence–based breastfeeding support delivered via semiautomated SMS text messaging is a feasible and an acceptable intervention for first-time mothers. To optimize engagement with digital breastfeeding interventions, enhanced customization features should be considered.Trial RegistrationClinicalTrials.gov NCT02724969; https://clinicaltrials.gov/ct2/show/NCT02724969

Stream assessment goes local—identifying regional drivers of water quality to inform management for local watershed groups.

Two non-profit organizations in southwestern Pennsylvania requested water quality data for several local watersheds in need of conservation attention. We conducted a study to identify the primary drivers of stream ecological condition in each watershed to inform future management decisions. Our study consisted of land cover analysis, routine water chemistry monitoring and macroinvertebrate assessment of 20 stream sites within the Upper Ohio-Wheeling subbasin in southwestern Pennsylvania and the Northern Panhandle of West Virginia. We ranked land cover classes and water chemistry parameters for their predictive strength of macroinvertebrate diversity and biomass. We also matched prevailing macroinvertebrate life history traits with multiple time series of water chemistry data to further deduce the environmental conditions characterizing the biotic communities of each site. Our study aims to help each non-profit group prioritize conservation actions within their watersheds. Furthermore, we hope to provide a template for localized conservation assessment in an understudied region under mounting threat of degradation from hydraulic fracturing.

Conservation Assessment of Cambarus dubius in Pennsylvania with Distribution Notes on Lacunicambarus thomai.

Burrowing crayfishes are poorly understood animals that face conservation and management issues due to a lack of distribution and ecological data. Within Pennsylvania, the burrowing crayfish Cambarus dubius has a limited distribution and its conservation status within the state is unranked. An assessment was conducted in southwestern Pennsylvania to assess the conservation status of C. dubius throughout its historic range. GIS-landscape data was used to analyze potential predictors of presence/absence. Six historic sites and 790 new sites were sampled for the presence of C. dubius. Of the 796 sites sampled, C. dubius was collected from 61 sites. Active crayfish burrows were present at 137 additional sites; these are predicted to be those of C. dubius due to the structure of the burrows. Additional biological and ecological data on C. dubius are also provided. The global model produced from logistic regression analysis was unable to predict variables of presence/absence; suggestions for additional variables to better predict presence/absence of C. dubius are provided. Collections also yielded populations of Lacunicambarus thomai within the range of C. dubius and are the easternmost within Pennsylvania.

Loss of Habitat Leads to Bigger Toads and Bigger Eggs: Natural Area Management Predictions for the Eastern American Toad, Anaxyrus americanus americanus (Holbrook, 1836)

Reproductive characteristics of the Eastern American Toad (Anaxyrus americanus americanus) vary geographically across its broad eastern North American range. Northern populations are known to breed for a shorter period that begins later in the season (April and/or May) than southern populations that can begin in winter and last until April. Delayed maturity and larger minimum body size are also associated with northern populations. Specimens collected during two years of systematic trapping during 1982–1983 at the Powdermill Nature Reserve (PNR), Westmoreland County, Pennsylvania, were examined to test predictions of geographic patterns associated with reproduction and growth of a southwestern Pennsylvania population. The results indicate a short egg laying season in May, large adult body size, and delayed maturity. An apparent response to northern Allegheny climate, the reproductive-related patterns of this population were similar to those of other northern regions rather than populations at similar latitudes within Pennsylvania. Eastern American Toads collected from a breeding site at PNR in 2014 were larger in body size, clutch size, and egg size than those of the 1982–1983 study. Most notably, loss of open breeding habitat in the 30+ years between sampling periods resulted in fewer larger toads producing on average larger eggs and twice the clutch size than counterparts studied during earlier successional series of this study site. These differences quantify geographic and temporal variability in life history traits of an ecologically versatile and geographically widespread species and provide landscape-wide predictions of life history responses by the Eastern American Toad to natural or human-mediated changes to natural areas.

Genome Sequence of Vibrio cholerae Strain RFB16, Isolated from North Park Lake in Allegheny County, Pennsylvania.

Vibrio cholerae is an aquatic organism and facultative human pathogen that typically resides in coastal areas and brackish water. Here, we report the complete genome sequence of V. cholerae strain RFB16, which was isolated from a freshwater lake in southwestern Pennsylvania.

Media use habits, negative encounters with the police, and perceptions of the police: the mainstreaming hypothesis versus the resonance hypothesis

ABSTRACT Media researchers have long considered the extent to which the media influence perceptions of the police. More recently, scholars have encouraged more specific investigations to determine if media effects can vary depending on the audience’s characteristics. The present article contributes to and extends this line of research by employing unique measures of the media considering various modes of media and content and by examining whether individual experiences condition media effects on perceptions of the police. Using a sample of college students from Southwestern Pennsylvania, results show that there are significant interaction effects between some media measures and audience characteristics, highlighting that it is critical to consider individual characteristics and experiences in understanding media effects on perceptions of the police. Our findings provide mixed support for both of the mainstreaming hypothesis and the resonance hypothesis.

Virtual induction ceremonies: Upholding time-honored tradition

An induction ceremony is a time-honored tradition among honor societies. Designed to recognize new members and denote transition into the society, induction signifies an important step in formal membership. However, with the growth of online education programs, there is a need for honor societies to adapt from traditional on-ground communities to virtual ones. This adaptation includes conducting an induction ceremony virtually to further create a sense of membership belonging and value. Recognizing the importance of upholding a time-honored tradition, a small private liberal arts university in Southwestern Pennsylvania sought to digitally record their international honor society chapter induction ceremony and share it with their distance inductees via their chapter website. Use of the virtual induction began prior to becoming an international chapter and has continued annually for the past 10 years. Therefore, this experience exchange shares strategies for planning and conducting a successful virtual induction ceremony, thus emphasizing the importance of membership induction for all students especially those online.

The transition from planar to en echelon morphology in a single vein in shale: Insights from X-ray computed tomography scanning

Abstract En echelon fractures and veins are among the most common and distinctive geological structures, yet their three-dimensional forms and relationships to surrounding structures are commonly unclear. X-ray computed tomography (CT) offers an unrivaled ability to examine structures within rocks in three dimensions, and it is applied here to a sample of drill core from the Marcellus Shale of southwestern Pennsylvania (USA). CT images yield qualitative and quantitative data on the transition from a pyrite-rich planar vein to an en echelon veinlet array, and on the heterogeneity of veinlets within the array. Using a combination of three- and two-dimensional images, geometric data, and traditional petrography, we identify a range of veinlet shapes consistent with deformation during formation of an antitaxial graphite-calcite-pyrite vein system. Each of the veinlets is rooted in the underlying planar vein where it is narrowest. The transition from planar vein to en echelon array coincides with a change in bedding, suggesting that competency contrasts between adjacent beds controlled the fracture morphology. Veinlets initiated as short, lenticular fractures at ∼45° to the planar vein before lengthening, dilating, and rotating. None of the veinlets are strongly sigmoidal, nor is there measurable offset across the margins of the planar vein; therefore, finite non-shear strain was very limited, and fluid overpressure–induced fracturing during burial and diagenesis is probably the most likely process for fracturing and vein formation.

Psychiatric comorbidity and co-occurring opioid misuse: Depression mediates the relationship between post-traumatic stress disorder and opioid misuse in community pharmacy settings

sBackground: Individuals who misuse opioids frequently have comorbid psychiatric issues, including post-traumatic stress disorder (PTSD) and depression. However, little is known about the mechanisms by which these disorders are associated with opioid misuse and specifically in community pharmacy settings. The current study examined whether depression mediated the relationship between PTSD and opioid misuse in patients filling opioid prescriptions. Methods: We administered a health survey in four community pharmacies among patients filling opioid medications in southwestern Pennsylvania. Univariate statistics were used to assess relationships among demographic and clinical characteristics of PTSD, depression, and opioid misuse behaviors. We then examined whether depression mediated the relationship between PTSD and opioid misuse using ordinary least squares path analysis with bootstrapping. Results: A total of 333 participants completed the health survey. Opioid misuse was reported among 15.9% of all participants, 33.3% among those with a positive PTSD screen, and 29.3% of those who screened positive for depression. Depression significantly mediated the relationship between PTSD and opioid misuse. Specifically, there was a statistically significant indirect effect (ab) of PTSD on opioid misuse through a pathway mediated by depression (ab = .06, SEab = .02, 95% CI = .02–.10). The direct effect (c’) of PTSD on opioid misuse was also significant (c’ = .12, SEc’ = .05, P = .01, 95% CI = .03–.22), suggesting partial mediation. Conclusions: Results suggest an indirect pathway by which clinical intervention may help ameliorate outcomes in patients with PTSD. Further, there is an increased need for screening, assessment, and intervention protocols for this patient population in which community pharmacy is a novel setting to expand future efforts within the patient population.

Threaded Discussion

This article presents the results of two studies that focus on the role that threaded discussion plays in student learning. Over a period of three and one-half years, researchers conducted a series of surveys of graduate and undergraduate students at a private, nonprofit university in Southwestern Pennsylvania to determine how students viewed the value of threaded discussions in enhancing their ability to learn course material. Students were asked which types of threaded discussions they preferred; whether they found the threaded discussion to be a better tool for learning than a written assignment; and, which learning environment they felt was more conducive to learning, classroom or online. Results from the combined studies revealed some statistically significant differences based on enrollment status and gender. Upon comparing study results, researchers found statistically significant differences with regard to a preference for classroom versus online instruction and the usefulness of threaded discussions to learning.

Improving Academic–Community Partnerships: A Case Study of a Project Investigating Attitudes about Diversity

This case study describes a process evaluation of a successful academic–community research partnership that measured attitudes about diversity in a southwestern Pennsylvania county. While this is the first case study based on a process evaluation with an outside facilitator, the authors summarize three previous case studies of academic–community research partnerships. In keeping with previous literature, the authors focus on three primary areas: factors that promote partnership success, factors that hinder partnership success, and frameworks for successful partnerships. For each of these three areas, the authors summarize the literature, detail their own experiences, and note ways that their research contributes to knowledge of such partnerships. The authors include lessons learned and suggestions intended to benefit those who engage in similar academic–community relationships.

The impact of clinical pharmacy services on pneumococcal vaccine frequency and appropriateness in a family medicine clinic

ObjectiveTo evaluate the impact of an ambulatory clinical pharmacy service (inclusive of immunization needs assessments) on the frequency and appropriateness of pneumococcal vaccine administration in a family medicine clinic. MethodsThis cohort study had an observational and retrospective design and included patients who received pneumococcal vaccines at a family medicine clinic in a medically underserved area in Southwestern Pennsylvania across a 42-month period from January 1, 2015, to June 30, 2018. The outcome measures included the administration and appropriateness of pneumococcal 13-valent conjugate (PCV13) and pneumococcal 23-valent polysaccharide (PPSV23) vaccines across 3 time cohorts including before, during, and after the establishment of a clinical pharmacy service. ResultsA total of 457 pneumococcal vaccines were administered, including 198 (43.3%) PCV13 and 259 (56.7%) PPSV23, across all time cohorts. Overall vaccine administration per month increased by 143% with the introduction of a dedicated clinical pharmacy service, including a 270% increase for PCV13 and an 87% increase for PPSV23. A strong correlation was found between recommendations made and doses administered for both pneumococcal vaccines (r = 0.89; P < 0.003). Across the entire time frame, PPSV23 administrations were appropriate in more than 96% of instances, whereas the appropriateness of PCV13 administrations were statistically significantly improved after the introduction of a fully dedicated clinical pharmacy service (58.5% vs. 90.8%; P < 0.05). The appropriateness of vaccine administration remained high even after the reduction of clinical pharmacy services. ConclusionClinical pharmacy service implementation in a family medicine clinic was associated with increased pneumococcal vaccine administration and increased appropriateness of PCV13 administrations.

A pilot multisite study of patient navigation for pregnant women with opioid use disorder

The opioid crisis continues to affect pregnant and postpartum women the United States, with the number of pregnant women diagnosed with opioid use disorder (OUD) quadrupling over the last decade. The associated increase in morbidity and mortality among mother and baby warrants prompt, targeted intervention efforts that improve engagement, linkage of care, and treatment retention. Patient navigation (PN) is a chronic care intervention that can directly address this need by helping women identify medical, behavioral, and psychosocial care goals. Moreover, PN can assist women in preparing for, engaging in, and maintaining patient participation in necessary services. Specifically, PN includes strengths-based case management, 1-1 clinical support, motivational interviewing, and addiction-relapse prevention programming. The objective of this article is to present the study protocol of a pilot multisite randomized clinical trial, entitled: Optimizing Pregnancy and Treatment Interventions for Moms 2.0 (OPTI-Mom 2.0; NCT03833245). In this study, we build upon a proof-of-concept study, employing evidence-informed frameworks for protocol and intervention expansion in order to construct a PN intervention tailored for pregnant women with OUD in central Utah and southwestern Pennsylvania. Our protocol provides an initial framework of a potentially impactful intervention and may guide development of future programs. Importantly, this study further establishes the evidence-base—with potential to ameliorate serious adverse opioid-related outcomes and improve health for women and their children.

Free Clinic Patients' Perceptions and Barriers to Applying for Health Insurance After Implementation of the Affordable Care Act.

Despite implementation of the Affordable Care Act (ACA), many Americans remain uninsured and receive care in free clinics. It is unknown what free clinic attendees in Pennsylvania know about health insurance expansion or what they perceive as barriers in enrolling in health insurance. The objective of this study was to assess the perceptions and experiences of free clinic patients from southwestern Pennsylvania when applying for health insurance after implementation of the ACA. We designed and implemented a survey of patients at three free clinics within Allegheny County, Pennsylvania from September 2016 to February 2017. Our survey included 22-items, 7 sociodemographic questions and 15 questions regarding the patient's health status and their perspectives related to obtaining health insurance. Data was obtained from 203 patient surveys; 110 (55.3%) of the respondents were men and 99 (48.8%) were African American. There were 48 respondents (24.1%) who did not report any income at the time of the study, and of those that did report an income, 92 (46.2%) respondents reported an income below 133% of the federal poverty level. The main barriers patients faced when applying for health insurance were: (1) lack of knowledge about health insurance (n = 127, 58.1%), (2) cost of health coverage (n = 85, 41.9%), (3) lack of resources (n = 83, 40.4%), and (4) lack of enrollment documentation (n = 43, 23.8%). Significant work is needed to better educate patients about their eligibility and options for health insurance. Free clinics can play a key role in eliminating barriers to health insurance enrollment.

Prehospital management of pediatric asthma patients in a large emergency medical services system.

Asthma is a common pediatric diagnosis for emergency medical services (EMS) transports, however there is a paucity of data on prehospital asthma management. The purpose of this study was to describe prehospital management of pediatric patients with suspected asthma exacerbation. We conducted a retrospective review of electronic medical records from 24 ground EMS agencies in Southwestern Pennsylvania between 1 January 2014 to 31 December 2017. We identified patients 2 to 17 years with documented wheezing, excluding those with suspected anaphylaxis. Patients with documented respiratory distress were classified as severe asthma. We report descriptive statistics of demographics, vital signs, and management including administration of medications and performance of procedures. Of 19 246 pediatric transports, 1078 (5.6%) patients had wheezing. Of these, 532 (49%) met criteria for severe asthma. Patients with severe asthma were more likely to be adolescents compared to those with nonsevere asthma (49.6% vs 6%; P < .001). While rates of intravenous methylprednisolone administration were higher in patients with severe asthma (68/532, 12.8%) compared to those with nonsevere asthma (13/546, 2.4%; P < .001), overall use of steroids was low (7.5%). Other therapies provided included albuterol (n = 699, 64.8%), ipratropium bromide (n = 271, 25.1%), and oxygen (n = 280, 26.0%). One hundred eighty patients (16.7%) received a peripheral IV line. Two patients (0.4%) were given continuous positive airway pressure. Approximately 6% of pediatric EMS transports are for asthma. Steroid usage was low in even those with severe asthma, representing an area of process improvement. These data provide a baseline to future research to identify interventions that may improve outcomes.

Abandoned Tracks: The Underground Railroad in Washington County, Pennsylvania

Abandoned Tracks: The Underground Railroad in Washington County, Pennsylvania