Do Y'all Say Gay or Trans?: The Impact of Gender and Sexuality on College Students' Experiences in the Rural South.

While national trends indicate improvement in campus climates for LGBTQ+ students, these patterns may not exist on campuses in the Southeast region of the United States, particularly given conservative backlash in the region. Drawing from focus group and survey data, we investigated how students in a rural Southern location perceive campus and community space with regard to safety and support, and how the intersections of gender and sexual orientation affect those perceptions. We found LGBTQ+ students had a mostly positive perception of their campus experience, despite reports of harassment, perceptions of unsafe spaces, and some lack of awareness of resources.

Predicting COVID-19 Vaccination Intentions to Inform Evidence-Based Messaging for Building Vaccine Confidence Among Rural Americans.

Purpose: Examine possible message topics to promote rural vaccination using psychosocial antecedents of vaccination.

Design: Cross-sectional survey administered by Research America, Inc.

Setting: West Virginia (WV).

Healthcare provider Communication and Data-Informed Message Strategies for Encouraging Older Adults to Stay up to Date on COVID-19 Vaccination.

Older adults are a high in risk of severe COVID-19 disease outcomes and experience "vaccine hesitancy." Guided by health communication models such as the Reasoned Action Approach and the Extended Parallel Process Model, online surveys designed to inform statewide public health communication efforts were administered in West Virginia, a primarily rural and fully Appalachian state, in Winter 2021 ( = 272) and Fall 2022 ( = 248). Adults ages 50+ years ( = 520) reported attitudes, intentions, and behaviors regarding COVID-19 vaccination and their related patient-provider communication.

Comfort Providing Gender-Affirming Care and Preferences for Consultative Support Among Rural Pediatric Primary Care Providers.

To examine how specialist-to-pediatric primary care provider (PPCP) consultative support may impact PPCP comfort in providing gender-affirming care. PPCPs in West Virginia completed an electronic survey. -tests compared comfort providing gender-affirming care and rank-sum tests compared the practicality of four consultative support modalities by time in practice and specialty.

Pediatric Gender Care in Primary Care Settings in West Virginia: Provider Knowledge, Attitudes, and Educational Experiences.

Purpose: Pediatric primary care providers (PPCPs) often care for gender diverse youth (GDY), particularly in rural areas, but little is known about their relevant knowledge, attitudes, or educational experiences regarding caring for this population.

Methods: This study surveyed PPCPs throughout the rural state of West Virginia using an online survey assessing 1) demographics, 2) knowledge, 3) attitudes, and 4) educational experiences. Knowledge and attitude scores were calculated and proportion-tests and t-tests were used to compare these scores by PPCP characteristics including age, time in practice, and training background.

Quantitatively Identifying Messaging Topics to Encourage West Virginia nurses' COVID-19 Vaccination.

Nurses are particularly influential to others as it relates to COVID-19 vaccination decision-making and are at higher risk of COVID-19 themselves. Yet, nurses' COVID-19 vaccination remains suboptimal. This study combines communication science frameworks with a novel conceptualize of identity-identity fusion-to explore why nurses may not vaccinate and what strategies might encourage them to protect themselves from COVID-19.

COVID-19 Vaccine Hesitancy Among Parents: A Qualitative Study.

Objectives: Addressing parental/caregivers' coronavirus disease 2019 (COVID-19) vaccine hesitancy is critical to improving vaccine uptake in children. Common concerns have been previously reported through online surveys, but qualitative data from KII and focus groups may add much-needed context. Our objective was to examine factors impacting pediatric COVID-19 vaccine decision-making in Black, Spanish-speaking, and rural white parents/caregivers to inform the content design of a mobile application to improve pediatric COVID-19 vaccine uptake.

Serological survey of SARS-CoV-2 incidence conducted at a rural West Virginia hospital.

The SARS-CoV-2 pandemic has affected all types of global communities. Differences in urban and rural environments have led to varying levels of transmission within these subsets of the population. To fully understand the prevalence and impact of SARS-CoV-2 it is critical to survey both types of community.

All Hands on Deck: Addressing Adolescent Depression in Pediatric Primary Care.

Objective: This study examines prevalence rates of elevated depression symptoms utilizing the Patient Health Questionnaire-9 Item Modified for Adolescents (PHQ-9A), characterizes recommendations and interventions by primary care providers (PCPs) and behavioral health clinicians (BHCs) in response to elevated PHQ-9As, and identifies factors associated with improved PHQ-9A scores at follow-up pediatric primary care visits.

Methods: A mixed methods approach was taken. Visit data, demographics, and PHQ-9A scores for 2,107 adolescents aged 11-18 were extracted using clinical informatics between January 3, 2017 and August 31, 2018.

Gastric Mucosa Fistula Secondary to Magnet Ingestion.

A 15-month-old female was incidentally found to have foreign bodies in the left upper quadrant on chest and abdominal imaging. She had no witnessed ingestion or gastrointestinal symptoms. Subsequent esophagogastroduodenoscopy showed 11 magnets, which formed a gastric mucosa fistula making endoscopic removal difficult.

Addressing Adolescent Depression in Primary Care: Building Capacity Through Psychologist and Pediatrician Partnership.

Early identification and treatment of depression during adolescence can contribute to healthier outcomes across the lifespan, yet adolescent depression has been underidentified and undertreated. The American Academy of Pediatrics' (AAP) Guidelines for Adolescent Depression in Primary Care (GLAD-PC) were created to enhance the identification and treatment of adolescent depression. Integrated psychologists in a pediatric primary care setting partnered with providers and clinic staff to implement an adolescent depression screening initiative and transform primary care practice around identification and management.

Congenital Herpes Simplex Virus in the Newborn: A Diagnostic Dilemma.

Although congenital herpes simplex virus (HSV) infection is rare, it is associated with severe morbidity. We report a 36-week gestational age infant who presented with atypical skin lesions, presumably mitigated by exposure to maternal antiviral suppressive therapy. The initial absence of typical herpetic vesicles and lack of viral detection in skin lesions delayed the correct diagnosis, highlighting the importance of differentiating HSV from other neonatal rashes.

Insulin-like growth factor and insulin-like growth factor-binding proteins in the bovine uterus throughout the oestrous cycle.

The aims of the present study were to assess several components of the insulin-like growth factor (IGF) system in bovine uterine flushings across different days of the oestrous cycle and to examine the relationship between the IGF system and systemic progesterone concentrations. Uterine flushings and plasma were collected from cows on Days 3, 7, 11 and 15 of the oestrous cycle. The IGF-1 concentration was more than 5-fold higher in the uterus compared with plasma on Days 7 and 11 of the cycle, with values similar on Days 3 and 15.

Retinol-binding protein (RBP), retinol and β-carotene in the bovine uterus and plasma during the oestrous cycle and the relationship between systemic progesterone and RBP on day 7.

In the dairy cow, low systemic concentrations of progesterone are known to be a major factor associated with early embryo loss. Endometrial expression of the gene encoding retinol-binding protein (RBP) is sensitive to small changes in progesterone on day 7 of the oestrous cycle. The objectives of the present study were to measure RBP concentrations in bovine uterine flushings and plasma across different days of the oestrous cycle and to examine the relationship between uterine RBP and systemic concentrations of progesterone.

CNP production in the kidney and effects of protein intake restriction in nephrotic syndrome.

C-type natriuretic peptide (CNP) possesses well-established cardiovascular properties. Although present in the mammalian kidney, CNP production in human kidney and its modulation in human renal disease remain less defined. We investigated the presence of CNP in normal human kidney and in patients with nephrotic syndrome (NS).

Differential actions of vasopeptidase inhibition versus angiotensin-converting enzyme inhibition on diuretic therapy in experimental congestive heart failure.

Background: Omapatrilat (OMA), a vasopeptidase inhibitor, simultaneously inhibits angiotensin-converting enzyme (ACE) and neutral endopeptidase, which degrades vasodilatory factors (eg, ADM) and natriuretic peptides. Based on the beneficial cardiorenal and humoral properties of the natriuretic peptides, we hypothesized that an acute vasopeptidase inhibitor with or without diuretic would result in more favorable cardiorenal and hormonal actions than ACE inhibition plus diuretic (ACEI+D) in congestive heart failure.

Methods And Results: We compared the actions of OMA alone and with diuretic (OMA+D) to ACEI+D in a model of pacing-induced congestive heart failure.