Neighborhood Inequities in Tobacco Product Descriptors, Washington, DC, 2018-2019.

Background: The tobacco industry uses product descriptors to communicate reduced harm and increase appeal. This cross-sectional study assessed store-level racial, ethnic, and socioeconomic inequities in the distribution of retail tobacco product descriptors in a convenience sample of retailers in Washington, DC.

Methods: Young adults (n = 146) who did not currently use tobacco reported real-time store visits over 14 days.

Child and Adolescent Manganese Biomarkers and Adolescent Postural Balance in Marietta CARES Cohort Participants.

Background: Manganese (Mn) plays a significant role in both human health and global industries. Epidemiological studies of exposed populations demonstrate a dose-dependent association between Mn and neuromotor effects ranging from subclinical effects to a clinically defined syndrome. However, little is known about the relationship between early life Mn biomarkers and adolescent postural balance.

The relationship between psychosocial factors, self-care, and blood sugar in an Appalachian population.

Introduction: Appalachian residents are more likely than other populations to have Type 2 Diabetes Mellitus (T2DM) and to experience more severe complications from the disease, including excess and premature mortality.

Methods: This study examines health alongside sociodemographic factors, psychosocial factors (including knowledge, empowerment, social support/function, religiosity, distress), and perceived problems in diabetes management that may influence self-care and HbA1c among vulnerable rural residents. A survey of a community-based sample of 356 adults with diagnosed diabetes or HbA1c > 6.

Adult asthma associated with roadway density and housing in rural Appalachia: the Mountain Air Project (MAP).

Background: Appalachian Kentucky is a rural area with a high prevalence of asthma among adults. The relative contribution of environmental exposures in the etiology of adult asthma in these populations has been understudied.

Objective: This manuscript describes the aims, study design, methods, and characteristics of participants for the Mountain Air Project (MAP), and focuses on associations between small area environmental exposures, including roadways and mining operations, and lifetime and current asthma in adults.

A New Look at Barriers to Clinical Care Among Appalachian Residents Living With Diabetes.

In the United States, diabetes is the seventh leading cause of death and continues to rise in prevalence, with type 2 diabetes accounting for 90-95% of all cases. Rates of diabetes in Kentucky, and, in particular, the Appalachian region, are among the highest in the nation and are increasing faster than the national average. Despite this disproportionate burden, barriers to clinical appointment attendance have not been fully explored in this population.

Neighborhood distribution of availability of newer tobacco products: A US four-site study, 2021.

Audits of tobacco retailers can identify marketing patterns as newer tobacco products are introduced in the US. Our study examined store and neighborhood correlates of availability of nicotine pouches and disposable e-cigarettes in four US sites. We conducted standardized store audits of n = 242 tobacco retailers in 2021 in different states: New Jersey, Kentucky, North Carolina, and New York.

An evaluation of injurious falls and Fall-Risk-Increasing-Drug (FRID) prescribing in ambulatory care in older adults.

Background: Falls are a major public health problem affecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur. The primary objective of this study was to investigate whether an injurious fall is associated with being prescribed a new FRID.

Inequitable Distribution of FTP Marketing by Neighborhood Characteristics: Further Evidence for Targeted Marketing.

Introduction: Flavored tobacco products (FTPs) are disproportionately used among young people and racial/ethnic minority populations. However, few studies have examined the retail distribution of such product marketing beyond menthol cigarettes. This study created geographic-based predictions about marketing of FTPs (overall, cigarettes, cigars, e-cigarettes, and smokeless) in stores across Washington, DC neighborhoods.

Disinfectant use by K-12 school staff to combat SARS-CoV-2.

K-12 school staff from Indiana, Kentucky and Ohio were asked about their use of disinfectants to mitigate the spread of COVID-19 in schools. Survey participants (n = 1,555) reported frequent use of disinfectants, often using unknown products, and were provided little to no training on safe and effective use. Participant concerns included student involvement in disinfection, inadequate ventilation, surface contact time, and potential health effects.

Perceptions of opioid and other illicit drug exposure reported among first responders in the southeast, 2017 to 2018.

Background: Opioid use has risen dramatically in recent years, and its illegal use puts first responders at risk when intervening in overdoses. Synthetic opioids, like fentanyl with a potency 50 to 100 times greater than morphine, pose a great risk and accidental exposure via ingestion, inhalation, mucosal, or percutaneous routes, can potentially lead to fatal outcomes. Anecdotal media accounts in early 2017 of accidental occupational opioid exposure among first responders generated a national concern.

Real-Time Context of Tobacco Marketing Exposure and Community Vulnerability-An Ecological Momentary Assessment Among Young Adults.

Background: Exposure to tobacco product marketing increases tobacco use among young adults, especially those from vulnerable communities (VCs).

Purpose: This study examined real-time tobacco marketing exposure among young adults from vulnerable and non-vulnerable communities using Ecological Momentary Assessment (EMA).

Methods: This study used EMA data to assess context (e.

Impact of the COVID-19 Shutdown on Mental Health in Appalachia by Working Status.

Introduction: To slow the spread of COVID-19 in the United States, businesses shutdown in Spring 2020. Research has indicated the impact on frontlines workers, yet little is known about the impact on those who were not working outside the home or switched to working remotely.

Purpose: The purpose of this report is to identify the financial and healthcare issues and mental health impact of the COVID-19 shutdown on Appalachians by worker categories.

Persistent disparities in smoking among rural Appalachians: evidence from the Mountain Air Project.

Background: Adult smoking prevalence in Central Appalachia is the highest in the United States, yet few epidemiologic studies describe the smoking behaviors of this population. Using a community-based approach, the Mountain Air Project (MAP) recruited the largest adult cohort from Central Appalachia, allowing us to examine prevalence and patterns of smoking behavior.

Methods: A cross-sectional epidemiologic study of 972 participants aged 21 years and older was undertaken 2015-2017, with a response rate of 82%.

Physicians in Kentucky Perceive Physician Assistants to Be Competent Health Care Providers.

Purpose: The use of certified physician assistants (PA) has increased throughout the US health care system. The purpose of this study was to objectively evaluate physicians' perceptions of PAs' mastery of specific skills. It is important to understand stakeholders' perceptions of PAs' capabilities to support future changes in policies for better utilization of PAs in our health care system.

Late-Stage Melanoma: Be Sure to Screen Uninsured, Unmarried Men.

Objective: The purpose of this study was to assess for any associations between individual and social factors and late-stage melanoma in Kentucky from 1995 to 2013.

Methods: The study combines three datasets: individual-level data from the Kentucky Cancer Registry, census tract-level data from the US Census, and county-level physician licensure data from the Kentucky Department for Public Health. The study population is described by all cases, early stage, and late stage.

Missed Work Due to Occupational Illness among Hispanic Horse Workers.

Occupational illnesses are inadequately reported for agriculture, an industry dominated by a vulnerable Hispanic population and high fatal and nonfatal injury rates. Work-related illnesses can contribute to missed work, caused by a combination of personal and work factors, with costs to the individual, employer, and society. To better understand agricultural occupational illnesses, 225 Hispanic horse workers were interviewed via community-based convenience sampling.

A socio-cognitive strategy to address farmers' tolerance of high risk work: Disrupting the effects of apprenticeship of observation.

Introduction: Why do generations of farmers tolerate the high-risk work of agricultural work and resist safe farm practices? This study presents an analysis inspired by empirical data from studies conducted from 1993 to 2012 on the differing effects of farm safety interventions between participants who live or work on farms and those who don't, when both were learning to be farm safety advocates. Both groups show statistically significant gains in knowledge and behavioral change proxy measures. However, non-farm participants' gains consistently outstripped their live/work farm counterparts.

Farm work injuries among a cohort of children in Kentucky, USA.

Children residing on farms with livestock may be at an increased risk for work-related injuries, compared to children who work on other commodity farms. This study characterizes children's work tasks on Kentucky farms and assesses whether children who work on beef cattle farms are at an increased risk for farm work injuries. The results of a cohort study of children aged 5-18 years (N=999 at baseline) working on family farms in Kentucky, followed for two consecutive years after an initial enumeration five years previously, found that 70% of the children were involved in animal-related chores.

Poor safety climate, long work hours, and musculoskeletal discomfort among Latino horse farm workers.

This study investigated the prevalence of self-reported musculoskeletal discomfort (MSD) and work-related factors associated with elevated MSD among Latino thoroughbred farm workers. Participants (N = 225) were recruited using a community-based purposive sampling approach to participate in in-person interviews. Of these workers, 85% experienced MSD.

Rural Kentucky High School Students' Exposure to All-Terrain Vehicle Riding and Injuries.

From 1982 to 2007, Kentucky had 459 deaths related to all-terrain vehicles (ATVs), fifth highest among US states. By 2012, Kentucky ranked fourth highest, with 578 ATV-related deaths. Following the sentinel event of an ATV-related traumatic brain injury to an unhelmeted high school student, the authors developed a 19-item survey that collected data regarding rural Kentucky high school students' years of ATV driving, second-rider frequency, typical duration of riding events, estimated weekly number of riding events, and frequency of helmet use.

From the Horse Worker's Mouth: A Detailed Account of Injuries Experienced by Latino Horse Workers.

Horse breeding farms are hazardous. Yet, little is known about the injuries of Latino horse workers. This study assesses Latino horse workers' injury prevalence, describes their injuries, and analyzes differences between injuries receiving medical versus those receiving first aid care.

Achieving 80% BSN by 2020: Lessons Learned From Kentucky's Registered Nurses.

Objective: The aim of this study was to understand the educational status and plans of Kentucky's RN workforce in advancing nursing educational levels.

Background: The Institute of Medicine called for 80% of nurses to hold a minimum of a BSN by 2020. Nurse leaders from practice, academe, and the community need evidence to guide the development of effective strategies.

Integrating Cost-effective Rollover Protective Structure Installation in High School Agricultural Mechanics: A Feasibility Study.

This study with three Appalachian county agricultural education programs examined the feasibility, effectiveness, and impact of integrating a cost-effective rollover protective structure (CROPS) project into high school agricultural mechanics classes. The project aimed to (1) reduce the exposure to tractor overturn hazards in three rural counties through the installation of CROPS on seven tractors within the Cumberland Plateau in the east region; (2) increase awareness in the targeted rural communities of cost-effective ROPS designs developed by the National Institution for Occupational Safety and Health (NIOSH) to encourage ROPS installations that decrease the costs of a retrofit; (3) test the feasibility of integration of CROPS construction and installations procedures into the required agricultural mechanics classes in these agricultural education programs; and (4) explore barriers to the implementation of this project in high school agricultural education programs. Eighty-two rural students and three agricultural educators participated in assembly and installation instruction.

Occupational injuries on thoroughbred horse farms: a description of Latino and non-Latino workers' experiences.

Animal production is a dangerous industry and increasingly reliant on a Latino workforce. Within animal production, little is known about the risks or the occupational hazards of working on farms involved in various aspects of thoroughbred horse breeding. Extant research suggests that horse workers are at risk of musculoskeletal and respiratory symptoms, kicks, and other injuries.

Occupational health among Latino horse and crop workers in Kentucky: the role of work organization factors.

Agriculture is a dangerous industry often reliant on Latino workers, a vulnerable population. Using a work organization framework, this cross-sectional study analyzes the relationship between work organization variables and the occupational health of Latino crop (n = 49) and horse breeding (n = 54) workers in Kentucky. Increased levels of abusive supervision were associated with occupational injury (odds ratio [OR] = 2.