Longitudinal Pre-Exposure Prophylaxis (PrEP) Acceptability, Initiation and Adherence among Criminal Justice-Involved Adults in the USA: The Southern PrEP Cohort Study (SPECS) Protocol

INTRODUCTION: HIV prevalence among criminal justice (CJ)-involved adults is five times higher than the general population. Following incarceration, CJ-involved individuals experience multilevel barriers to HIV prevention. Pre-exposure prophylaxis (PrEP) is a widely available, daily medication efficacious in preventing HIV. Little is known about PrEP knowledge, acceptability, initiation and sustained use among CJ-involved persons or about how these outcomes vary by multilevel factors. The Southern Pre-Exposure Prophylaxis Study (SPECS) will investigate barriers and facilitators for PrEP initiation and sustained use among CJ-involved adults, building a foundation for PrEP interventions for this underserved population. METHODS AND ANALYSIS: SPECS uses a mixed-methods sequential design, including a multisite, prospective cohort study in three southern states-North Carolina, Florida and Kentucky-and subsequent qualitative interviews. HIV-negative adults clinically indicated for PrEP with CJ-involvement in the past year (n=660; 220 per site)-will be recruited for four quantitative interviews separated by 6 months, with 18 months of follow-up. Interviews will measure CJ involvement, substance use, sexual behaviours, PrEP acceptability and use, healthcare access and utilisation, support systems and psychological and emotional well-being. We will estimate probabilities of PrEP acceptability and use in a CJ-involved population using descriptive and multivariable analyses. After the follow-up, a subsample that never initiated PrEP, initiated but did not sustain PrEP or sustained PrEP will be asked to participate in a qualitative interview to contextualise their experiences and decisions around PrEP. An inductive approach will guide qualitative analyses. ETHICS AND DISSEMINATION: PrEP initiation and sustained use rates are unknown among CJ-involved adults. This research will identify individual, social and structural factors that predict PrEP initiation and use. Data generated from the study have the potential to guide research and the development and tailoring of PrEP interventions to CJ-involved populations and provide context to HIV-related outcomes for those with CJ experiences

Tag-Team Takeover: Usurpation of Woodpecker Nests by Western Bluebirds

Woodpeckers provide important ecological services by excavating nesting cavities that are used by many forest birds and animals. Black-backed woodpeckers (Picoides arcticus) have been declining throughout their range and are now a threatened species. The failure of black-backed woodpeckers to reproduce can lead to a decline of nesting cavities, which in turn can lead to a decline in secondary cavity nesters. One of the challenges black-backed woodpeckers face is displacement from their nesting cavities by aggressive secondary cavity nesters.The western bluebird (Sialia Mexicana) is known to usurp nests, even from its own kind. However, the process by which bluebirds take over nests has not been well documented. In order to understand the process by which bluebirds take over woodpecker nests, we analyzed 112 hours of video footage from two different nests located in the Okanogan-Wenatchee forest in Washington. Usurpation first involves a short period of physical confrontation followed by a prolonged period of constant presence around the nest. The male and female bluebird apparently cooperate by taking turns harassing the woodpecker and guarding the nest. The entire takeover process seems to only require one day. This information will be useful to forest managers in charge of monitoring black-backed woodpeckers, especially in areas with high bluebird density

Murder She Wrote: Death and Drama in Nesting Woodpeckers

Woodpeckers serve as primary cavity excavators in fire-dominated forests. Secondary cavity users (SCU’s) rely heavily on cavities excavated by woodpeckers. Woodpecker species are declining, and some are now locally threatened. Management needs answers. How is woodpecker reproductive success impacted by the behavior of woodpeckers, SCU’s, and predators

A scoping review protocol of anti-racism programs and practices in higher education: Implications for developing interventions to advance equity

Background: In the United States and Canada, racism continues to persist in higher education systems. Hate violence and racial trauma on campuses are significant barriers to health and well-being, particularly for Black, Indigenous and People of Color (BIPOC). Additionally, higher education systems often fail to successfully bridge achievement gaps to facilitate the success of BIPOC. This protocol describes a scoping review of anti-racism efforts through higher education programs and practices from 1950 to 2022. No previous scoping reviews have been identified that illustrate anti-racist organizational programs and practices in higher education settings. Method: This scoping review protocol aims to identify and map the characteristics of anti-racism programs and practices (occurring at the organizational level) in higher education settings throughout the United States and Canada. A systematic search will be conducted using nine electronic databases, with date limits from 1950 to 2022: Academic Search Ultimate (Ebscohost), ERIC (Ebscohost), APA PsycINFO (Ebscohost), Medline (OVID), Dissertations & Theses Global (ProQuest), Social Services Abstracts (ProQuest), Social Work Abstracts (Ebscohost), Sociological Abstracts (ProQuest) and Scopus (Elsevier). Reference lists of documents included in data charting will be searched. The scoping review will follow guidance from the most recent 2020 version of the JBI Manual for Evidence Synthesis and PRISMA reporting guidelines for scoping reviews (PRISMA-ScR). Two reviewers will perform full-text screening of preselected studies independently to select studies according to inclusion criteria. Covidence will be used to upload search results, screen abstracts and full text study reports. Data will be extracted, and findings and characteristics synthesized in a narrative summary. Additionally, frequency counts of concepts, populations, and characteristics will be presented. Discussion: Our scoping review will be the first to map anti-racism programs and practices in higher education. It is anticipated the findings will interest policymakers, researchers, and higher education practitioners concerned about creating interventions aimed at improving social, economic, and environmental factors which shape health equity and empower underrepresented communities towards increased educational attainment

COVID-19 in corrections: Quarantine of incarcerated people.

Carceral settings in the United States have been the source of many single site COVID-19 outbreaks. Quarantine is a strategy used to mitigate the spread of COVID-19 in correctional settings, and specific quarantine practices differ state to state. To better understand how states are using quarantine in prisons, we reviewed each state's definition of quarantine and compared each state's definition to the Centers for Disease Control's (CDC) definition and recommendations for quarantine in jails and prisons. Most prison systems, 45 of 53, define quarantine, but definitions vary widely. No state published definitions of quarantine that align with all CDC recommendations, and only 9 states provide quarantine data. In these states, the highest recorded quarantine rate occurred in Ohio in May 2020 at 843 per 1,000. It is necessary for prison systems to standardize their definitions of quarantine and to utilize quarantine practices in accordance with CDC recommendations. In addition, data transparency is needed to better understand the use of quarantine and its effectiveness at mitigating COVID-19 outbreaks in carceral settings

Perceptions and experiences of appetite awareness training among African-American women who binge eat

Introduction: Binge eating may contribute to the prevalence of obesity in African-American women. Yet, there has been scant intervention research on the treatment of binge eating in this population. We tested the feasibility of an appetite awareness training (AAT) intervention in a sample of African-American women with binge and overeating behaviors. Participants who completed AAT were recruited to participate in focus groups to elicit information about their perceptions and experiences with this intervention to inform the design of future interventions to treat binge eating and obesity in African-American women. Methods: African-American women, aged 18–70 years, who had completed an 8-week randomized AAT intervention, were invited to attend a focus group discussion. Session content was recorded and transcribed. Data were analyzed by use of open coding. Themes were identified that described their perceptions and experiences of participating in the intervention. Results: Seventeen women participated in three focus group discussions. Pertinent themes identified included: paying attention to internal cues of hunger and satiety, influence of culture on eating patterns, breaking patterns of disordered eating, and perceptions about weight. Overall, participants were satisfied with their experience of AAT, and reported they found it valuable to learn about listening to biological signals of hunger and satiety and to learn specific strategies to reduce maladaptive eating patterns. Conclusion: AAT was acceptable and provided helpful eating behavior instruction to African-American women with reported binge and overeating behaviors. Future research should examine the potential of AAT to improve weight management in this underserved population. Level of evidence: Level V, qualitative descriptive study