Correlates of leisure-time physical activity participation among Latino children and adolescents with acanthosis nigricans

pre-printChildhood obesity has become a serious public health concern in the United States. The prevalence rates of childhood obesity largely increased in the 1980s and 1990s and remained persistently high between 1999-2000 and 2007-2008 in the United States [20]. The highest extreme obesity prevalence rate, defined at the 97th percentile or higher of the age-gender-specific growth chart [13, 22], was found in Mexican American youth ages 6-11, closely followed by other Latino youth of the same age group. Childhood obesity has negative consequences on many health outcomes [19]. For example, weight-related type-2 diabetes mellitus (T2DM), previously only observed among adults, is now more and more being diagnosed in youth [1, 15]. Public health measures are urgently needed to improve early identification of at-risk youth and implement interventions effective in delaying or even preventing the development of metabolic abnormalities or other morbidities associated with obesity and insulin resistance [5, 6, 30]

Wheat stripe rust grading by deep learning with attention mechanism and images from mobile devices

Wheat stripe rust is one of the main wheat diseases worldwide, which has significantly adverse effects on wheat yield and quality, posing serious threats on food security. Disease severity grading plays a paramount role in stripe rust disease management including breeding disease-resistant wheat varieties. Manual inspection is time-consuming, labor-intensive and prone to human errors, therefore, there is a clearly urgent need to develop more effective and efficient disease grading strategy by using automated approaches. However, the differences between wheat leaves of different levels of stripe rust infection are usually tiny and subtle, and, as a result, ordinary deep learning networks fail to achieve satisfying performance. By formulating this challenge as a fine-grained image classification problem, this study proposes a novel deep learning network C-DenseNet which embeds Convolutional Block Attention Module (CBAM) in the densely connected convolutional network (DenseNet). The performance of C-DenseNet and its variants is demonstrated via a newly collected wheat stripe rust grading dataset (WSRgrading dataset) at Northwest A&F University, Shaanxi Province, China, which contains a total of 5,242 wheat leaf images with 6 levels of stripe rust infection. The dataset was collected by using various mobile devices in the natural field condition. Comparative experiments show that C-DenseNet with a test accuracy of 97.99% outperforms the classical DenseNet (92.53%) and ResNet (73.43%). GradCAM++ network visualization also shows that C-DenseNet is able to pay more attention to the key areas in making the decision. It is concluded that C-DenseNet with an attention mechanism is suitable for wheat stripe rust disease grading in field conditions

Mental health disparities within the LGBT population: A comparison between transgender and nontransgender individuals

Purpose: This study assessed within a Midwestern LGBT population whether, and the extent to which, transgender identity was associated with elevated odds of reported discrimination, depression symptoms, and suicide attempts. Methods: Based on survey data collected online from respondents who self-identified as lesbian, gay, bisexual, and/or transgender persons over the age of 19 in Nebraska in 2010, this study performed bivariate t- or chisquare tests and multivariate logistic regression analysis to examine differences in reported discrimination, depression symptoms, suicide attempts, and self-acceptance of LGBT identity between 91 transgender and 676nontransgender respondents. Results: After controlling for the effects of selected confounders, transgender identity was associated with higher odds of reported discrimination (OR = 2.63, p < 0.01), depression symptoms (OR = 2.33, p < 0.05), and attempted suicides (OR = 2.59, p < 0.01) when compared with nontransgender individuals. Self-acceptance of LGBT identity was associated with substantially lower odds of reporting depression symptoms (OR = 0.46, p < 0.001). Conclusion: Relative to nontransgender LGB individuals, transgender individuals were more likely to report discrimination, depression symptoms, and attempted suicides. Lack of self-acceptance of LGBT identity was associated with depression symptoms among transgender individuals

2016 Refugee Health Needs Assessment in Omaha, Nebraska

Refugees resettling to Nebraska undeniably have different health needs compared to native Nebraska residents. Capturing those differences is the start to catering local health care to refugees. A health needs assessment of refugees in Omaha, Nebraska seek to assess their perceived needs, barriers, and preferences regarding health care, in order to address them justly. The refugee population in Omaha, Nebraska has exponentially increased over the past decade and will continue to increase, bringing global health matters to our backyard. The data and results from surveying over 290 refugees will guide health care organizations and services to appropriately serve refugees and their specific needs.https://digitalcommons.unmc.edu/coph_pres/1000/thumbnail.jp

Refugee Health Needs Assessment in Omaha, Nebraska

https://digitalcommons.unmc.edu/coph_disp_reports/1000/thumbnail.jp

Disparities in Awareness of and Willingness to Participate in Cancer Clinical Trials Between African American and White Cancer Survivors

BACKGROUND: Cancer clinical trials (CCTs) are essential for cancer care, yet the evidence is scarce when it comes to racial disparities in CCT participation among cancer survivors in the Midwest. This study aimed to 1) assess disparities in the awareness of and willingness to participate in CCTs between African American and White cancer survivors; and 2) compare perceptions about CCTs between the two racial groups. METHODS: The study was based on cross-sectional data from the survey Minority Patient Participation in Cancer Clinical Trials that collected information from 147 Black and White cancer survivors from Nebraska between 2015 and 2016. Chi-square tests and logistic regressions were used to assess differences between Black and White cancer survivors regarding their awareness, willingness, and perceptions associated with CCT participation. RESULTS: After adjusting for the effects of socio-demographic, health status, and psychosocial variables, Black cancer survivors were much less likely than White cancer survivors to be aware of CCTs (AOR 0.26; CI 0.08-0.81), to express willingness to participate in CCTs (AOR 0.03; CI 0.01, 0.32) and to actually participate in CCTs (AOR 0.13; CI 0.04-0.38). Black cancer survivors reported a lower level of trust in physicians and were less likely than White cancer survivors to believe that CCTs make a significant contribution to science. CONCLUSIONS: Relative to White cancer survivors, Black cancer survivors had much lower awareness of and willingness to participate in CCTs. Part of these differences might be related to the differential perception of CCTs, psychosocial factors, and trust in physicians between the two groups

Perspectives on certification of community health workers: A statewide mixed-methods assessment in Nebraska

Objectives: While the Community Health Worker (CHW) workforce in the United States has been growing, so far only 19 states certify CHWs. This study sought to identify perspectives on CHW certification among stakeholders in Nebraska, a state that has not established official certification for CHWs yet. Design: A concurrent triangulation mixed methods design. Sample: Study data came from a survey of 142CHWs in Nebraska and interviews with 8 key informants employing CHWs conducted in 2019. Methods: Logistic regression was used to identify significant factors associated with favoring CHW certification, supplemented by thematic analysis of qualitative data fromCHWs and key informants. Results: The majority (84%) of CHWs were in favor of a statewide CHW certification in Nebraska, citing community benefits, workforce validation, and standardization of knowledge as the main reasons. Participant characteristics associated with favoring CHW certification included younger age, racial minority, foreign born, education lower than bachelor’s degree, volunteering as a CHW, and employed for less than 5 years as a CHW. Key informants employing CHWs were divided in whether Nebraska should develop a state certification program. Conclusions: While most CHWs in Nebraska wanted to have a statewide certification program, employers of CHWs were less sure of the need for certification

Knowledge and Attitudes of Cypriots on Melanoma Prevention: Is there a Public Health Concern?

BACKGROUND: Melanoma is the deadliest type of skin cancer. It is the eighth most common cancer in males and the tenth in females in Cyprus, an island in the Mediterranean with a high ultraviolet (UV) index. Cyprus is expected to be strongly affected by climate change and consequently, melanoma will likely become an increasing public health problem. Melanoma prevention is possible; however, it is unknown if people living in Cyprus are aware of melanoma and prevention methods. To this end, we used a validated survey to evaluate the level of melanoma knowledge and factors associated with it in the Cypriot population. METHODS: We conducted a 47-item survey with sections on demographics, knowledge of melanoma and risk factors, attitudes toward relevant health practices, and protective behaviors among six hundred Cypriot residents from October 2015 to April 2016. RESULTS: Our results revealed that only 59% of participants check their skin for moles, 87% protect their skin from the sun during summer holidays, and 57% do not take measures to protect their skin from the sun during non-holiday periods. Protective behavior was positively associated with educational level (P=0.016) and district of residence (P CONCLUSIONS: There are gaps in melanoma knowledge and prevention practices in the study population. Further education on melanoma and its prevention should be specifically targeted to individuals of lower education levels as well as teenagers, such that protective behaviors for melanoma are adopted early in life

Barriers of Colorectal Cancer Screening in Rural USA: A Systematic Review

INTRODUCTION: Colorectal cancer (CRC) screening rates are lower in rural areas in the USA. To guide the design of interventions to improve CRC screening, a systematic review was conducted to identify CRC screening barriers for rural populations. METHODS: A search was conducted in four literature databases - Medline, CINAHL, Embase, and Scopus - for articles from 1998 to 2017 that examine CRC screening barriers in rural areas. This review included a total of 27 articles reporting perceived CRC screening barriers by rural residents or providers or examining factors associated with CRC screening of rural populations in the USA. RESULTS: The most frequently reported barriers were high screening cost and lack of insurance coverage, embarrassment or discomfort undergoing screening, lack of knowledge or perceived need on CRC screening, and lack of physician recommendation. These barriers were confirmed in quantitative studies examining their association with CRC screening status. Age, marital status, and race/ethnicity were the most frequently reported factors associated with CRC screening in rural areas. Lack of prevention attitude toward cancer, perceived lack of privacy, shortage of specialists, and distance to test facilities were reported as rural-specific barriers for CRC screening. CONCLUSIONS: Main barriers for CRC screening at both the individual and healthcare system level are identified in rural areas and they are in line with those found in urban areas in general. In particular, lack of prevention attitude toward cancer, perceived lack of privacy, shortage of specialists, and distance to test facilities disproportionately hamper CRC screening for rural Americans

Joint Influence of Individual Choices, Parenting Practices, and Physician Advice on Adolescent Obesity, Nebraska, 2008

Introduction Reducing childhood obesity remains a public health priority given its high prevalence and its association with increased risk of adult obesity and chronic diseases. The objective of this study was to examine the joint influence of multiple risk factors on adolescent overweight status. Methods We conducted a random-digit-dialed telephone survey of adolescents aged 12 to 19 years in fall 2008 in a Midwestern city in Nebraska. On the basis of survey data for 791 youths aged 12 to 18 years, we conducted latent class analysis to group youths by the joint occurrence of dietary behavior, physical activity, parenting practices, and physician advice. We then examined the association between the groups and overweight status by using logistic regression, controlling for age, sex, race/ethnicity, and parent and family information. Results Youths were clustered into 3 groups. Group I (52%) were youths with healthy dietary behavior and physical activity, less permissive parenting practices, and physician advice; Group II (30%) were youths with moderately healthy dietary behavior and physical activity, less permissive parenting practices, and no physician advice; and Group III (18%) were youths with unhealthy dietary behavior and physical activity, permissive parenting practices, and physician advice. Youths in Groups I and II were less likely to be overweight than youths in Group III. Conclusions Youths with healthier behavior and less permissive parenting practices were less likely to be overweight. Study findings highlight the need to address obesity risk factors among youths with unhealthy dietary behavior, inadequate exercise, permissive parenting practices, and some physician advice. Tailored interventions should be used to target youths with different obesity risk factors