What Promotes healing among the wrongfully convicted? Results from a qualitative study of exonerated persons in California

Background: Exonerees are individuals who have been wrongfully convicted of a crime. Later found innocent and released from prison, exonerees often spend decades incarcerated. While limited, research suggests that the unique trauma of wrongful conviction has profound adverse mental health implications which challenge reintegration, well-being and healing. In this study we examined exoneree perceptions of their mental health and coping mechanisms used to support healing. Methods: We conducted a qualitative study utilizing a phenomenological approach to examine shared coping and healing mechanisms among exonerees. Twelve California exonerees participated in semi-structured interviews describing their experiences with coping and healing due to wrongful conviction. Interviews were audio recorded and transcribed, transcripts were coded with a hybrid coding scheme utilizing a thematic analysis. Results: Overall findings underscore the lifelong trauma and subsequent adverse mental well-being among wrongfully convicted exonerees, framed in association with depression, anxiety, post-traumatic stress disorder (PTSD) and hypervigilance. Three areas emerged as valuable coping mechanisms for exonerees that support a pathway toward healing: 1) Peer support and building community with other exonerees through organized meetings (convenings and healing circles); 2) Community education to build community awareness through storytelling; and 3) Advocacy engagement in the wrongful conviction movement and criminal justice reform. Conclusions: Complementing comprehensive mental health services with opportunities for peer support, advocacy, and community education through storytelling may help exonerees regain lives lost to their wrongful convictions

Developing a Health Equity and Criminal Justice Concentration for a Master of Public Health (MPH) Program: Results From a Needs Assessment Among Community Partners and Potential Employers

The United States has experienced a 4-fold increase in jail and prison populations over the last 40 years, disproportionately burdening African American and Hispanic/Latinx communities. Mass incarceration threatens the health of individuals, families, and communities, and requires a public health response. The Master of Public Health (MPH) Program at Touro University California (TUC) trains students to become skillful, socially-conscious public health professionals. We are developing a concentration focused on the public health impacts of incarceration. Along with the core public health curriculum, students of this new Health Equity and Criminal Justice (HECJ) concentration will receive training in criminal justice, reentry, reintegration, recidivism, restorative justice, structural racism, and social and community impacts of incarceration. Our study gauges interest in an HECJ concentration in our local community, including potential employers. We surveyed a cross-section of community partners including public health departments, other governmental agencies, California correctional facilities, county jails, community groups, health clinics, and hospitals. A majority (89%) of respondents consider mass incarceration a public health problem and 86% believe specialized training would make graduates employable by criminal justice related organizations. The HECJ track will fill a gap in the field and train a future generation of public health professionals to address the epidemic of mass incarceration

Enrolment of families with overweight children into a program aimed at reducing childhood obesity with and without a weight criterion: a natural experiment

© The Author(s). 2019 This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BACKGROUND: Difficulties engaging families with overweight children to enrol into programs aimed at reducing childhood obesity have been well documented. During the implementation of the Parenting, Eating and Activity for Child Health Program (PEACH™) over a large geographical area (Queensland (QLD), Australia), a natural experiment developed. This experiment provided an opportunity to observe if there was a difference in enrolment for families with overweight children with a weight criterion (referred to as the period with a Targeted Eligibility Criterion (TEC)) compared to when a weight criterion was removed (the period referred to as Universal Eligibility Criterion (UEC)). We also examined the eligibility criterion’s relationship with attendance, parental concern about their child’s weight, estimation of overweight and obesity from parent-reported data. METHODS: A secondary analysis of baseline data from 926 overweight/obese children from 817 families enrolled in PEACH™ QLD was performed. Analyses were adjusted to control for the presence of clustered data. Bivariate statistics were performed using Pearson chi-square test with the second-order Rao-Scott correction, and Mann–Whitney U-test for non-parametric continuous variables. Generalized Estimating Equations (GEE) explored the association between weight status-based eligibility criteria and enrolment of overweight children. GEE were adjusted for sex, age and socioeconomic index and stratified for weight category. RESULTS: Compared to obese children, overweight children were almost twice as likely to be enrolled when the program did not have weight status-based eligibility criteria (during UEC period) (OR = 1.90 (CI 95% 1.35–2.68, p <  0.001)). Parents of overweight children enrolled during the UEC period were more likely to regard their child’s weight as less of a concern than during the TEC period (UEC 67% vs. TEC 45%, p = 0.036). Children whose parent-reported data underestimated their weight category were more likely to be enrolled while the program did not have weight-related eligibility criteria OR = 2.27 (CI 1.38–3.70, p <  0.01). Program session attendance did not appear to be impacted by the changes in eligibility criteria. CONCLUSIONS: The omission of weight criteria for healthy lifestyle programs is a consideration for health professionals and decision-makers alike when encouraging the enrolment of children who are overweight into healthy lifestyle programs

Examination of Urinary Pesticide Concentrations, Protective Behaviors, and Risk Perceptions Among Latino and Latina Farmworkers in Southwestern Idaho

Introduction: Studies have documented high levels of pesticide exposure among men farmworkers; however, few have examined exposures or the experiences of women farmworkers. Data gaps also exist regarding farmworkers’ perceived risk and control related to pesticides, information that is critical to develop protective interventions. Objective: We aimed to compare urinary pesticide biomarker concentrations between Latino and Latina farmworkers and examine associations with occupational characteristics, risk perceptions, perceived control, and protective behaviors. Methods: We enrolled a convenience sample of 62 farmworkers (30 men and 32 women) during the pesticide spray season from April–July 2022 in southwestern Idaho. Participants were asked to complete two visits within a seven-day period; at each visit, we collected a urine sample and administered a questionnaire assessing demographic and occupational information. Urine samples were composited and analyzed for 17 biomarkers of herbicides and of organophosphate (OP) and pyrethroid insecticides. Results: Ten pesticide biomarkers (TCPy, MDA, PNP, 3-PBA, 4-F-3-PBA, cis- and trans-DCCA, 2,4-D, Glyphosate, AMPA) were detected in \u3e80% of samples. Men and women had similar urinary biomarker concentrations (p = 0.19–0.94); however, women worked significantly fewer hours than men (p = 0.01), wore similar or greater levels of Personal Protective Equipment (PPE), and were slightly more likely to report having experienced an Acute Pesticide Poisoning (26% of women vs. 14% of men; p = 0.25). We observed inconsistencies in risk perceptions, perceived control, and protective behaviors among men. Discussion: Our study is one the first to examine pesticide exposure and risk perceptions among a cohort of farmworkers balanced on gender. Taken with previous findings, our results suggest that factors such as job tasks, biological susceptibility, or access to trainings and protective equipment might uniquely impact women farmworkers’ exposure and/or vulnerability to pesticides. Women represent an increasing proportion of the agricultural workforce, and larger studies are needed to disentangle these findings

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Predictive Modeling of Future Forest Cover Change Patterns in Southern Belize

Tropical forests and the biodiversity they contain are declining at an alarming rate throughout the world. Although southern Belize is generally recognized as a highly forested landscape, it is becoming increasingly threatened by unsustainable agricultural practices. Deforestation data allow forest managers to efficiently allocate resources and inform decisions for proper conservation and management. This study utilized satellite imagery to analyze recent forest cover and deforestation in southern Belize to model vulnerability and identify the areas that are the most susceptible to future forest loss. A forest cover change analysis was conducted in Google Earth Engine using a supervised classification of Landsat 8 imagery with ground-truthed land cover points as training data. A multi-layer perceptron neural network model was performed to predict the potential spatial patterns and magnitude of forest loss based on the regional drivers of deforestation. The assessment indicates that the agricultural frontier will continue to expand into recently untouched forests, predicting a decrease from 75.0% mature forest cover in 2016 to 71.9% in 2026. This study represents the most up-to-date assessment of forest cover and the first vulnerability and prediction assessment in southern Belize with immediate applications in conservation planning, monitoring, and management

The Importance of Community for a Study Examining Pesticide Exposure and Risk Perceptions Among Latinx Farmworkers

Latinx farmworkers make up over 80% of the United States farmworkers, and research has shown they have high levels of exposure to pesticides. Studies have also shown females are at risk for higher levels of pesticide exposure. The purpose of the overall study is to examine pesticide exposure and risk perceptions among male and female Latinx farmworkers. Here, I describe the importance of community when working with structurally marginalized populations like Latinx farmworkers. The purpose of presenting this component is to give researchers an understanding of why creating trust and getting the respect of the communities that are being researched is so important. In addition, this will give researchers ideas as to how their research project can be more collaborative and include the community that is participating in the study. In this case, we have forged partnerships with multiple trusted community partners and organizations in order to recruit study participants, address potential power dynamics inherent in many research studies, and ensure this research provides a benefit to participants. Following the conclusion of the study, we will partner with Boise State’s Project SCIENTIA to create multi-media science communication products to translate the study findings and recommendations to participants and groups supporting farmworkers

Challenges and Opportunities in Human Subjects Research: Assessing Glyphosate Exposure in Pregnant Women

The herbicide glyphosate has rapidly become the most used agricultural chemical. Worldwide glyphosate use rose more than 12-fold in the last two decades, from 150 million pounds in 1995 to nearly 2 billion pounds in 2014. Recent epidemiologic research suggests that exposure to glyphosate may lead to negative pregnancy outcomes, especially pre-term birth. Despite glyphosate’s widespread use and potential toxicity, very little research exists to quantify human exposure to this chemical. The purpose of this study is to measure long-term glyphosate exposure in pregnant women and determine how much of that exposure comes from agricultural and dietary sources. We hypothesize that living near glyphosate-treated agricultural fields and consuming conventional diets results in higher glyphosate exposure. We recruited 40 women from whom we will collect over 1,400 urine samples throughout their pregnancies. We will measure each sample’s glyphosate level to evaluate its potential relationship with residential proximity to agriculture and dietary choices. Here, we aim to describe challenges and opportunities in conducting human subjects research in a vulnerable population of low-income pregnant women — particularly during a global pandemic. Challenges included revising recruitment and sample collection protocols to eliminate “in-person” contact; developing new processes to adapt to major heat waves that could potentially damage samples; and maintaining contact with hard-to-reach populations who were often dealing with housing insecurity. Opportunities included the collection of real-world data; the chance to provide food and financial assistance to study participants; and — perhaps surprisingly — the potential to build unique connections and relationships with those participants

An Analysis of the Different Layers of Inclusive Research

The work presented here is a component of a larger study to measure glyphosate exposure among pregnant women in rural regions of Idaho. Glyphosate is weed killer, and in the last two decades has become the single most commonly used agricultural chemical in the world. At the same time, emerging research indicates that glyphosate exposure during pregnancy may be associated with adverse health outcomes, such as pre-term birth. The overarching aim of our larger study is to understand whether and how pregnant women in Idaho may be exposed to glyphosate. The overall population of interest in that study are all pregnant women in Idaho who live in agricultural regions, and our study population therefore includes both Spanish- and English-speaking women, to reflect that overall population of interest. The purpose of presenting this particular component of this study is to provide a better understanding of what it means to do inclusive research and what we, as researchers, can do to improve our ability to conduct inclusive research. For example, translating documents is not enough if the documents are not going to be culturally appropriate. In addition, researchers may have to think about their protocols and if there may have to be multiple protocols with different explanations. I suggest that researchers think about their methodologies and how accessible and inclusive are they for the communities they are wanting to research