Disparities in early prenatal care and barriers to access among American Indian and white women in North Dakota

PURPOSE

American Indians/Alaska Natives (AI/AN) have received minimal attention in research on determinants of prenatal care access. We sought to gain an understanding of structural and sociocultural determinants of prenatal care access among AI/AN and White women in North Dakota (ND).

METHODS

Data were drawn from the 2017 to 2018 North Dakota Pregnancy Risk Assessment Monitoring System (n = 1,166). Late prenatal care was assessed with 2 variables: late prenatal care initiation (>13 weeks gestation) and "Did you get prenatal care as early in your pregnancy as you wanted?" (yes/no). Those not satisfied with timing of prenatal care initiation reported 12 prenatal care barriers (yes/no). Logistic regression estimated odds ratios and 95% confidence internals for late prenatal care among AI/AN and other race/ethnicity women compared to White women. Models included maternal sociodemographic, medical, and behavior factors. Chi-square was used to examine the prevalence of prenatal care barriers by race/ethnicity.

FINDINGS

AI/AN women had increased risk of late prenatal care initiation (OR: 1.93, 95%CI: 1.20, 3.09) and were more dissatisfied with timing of prenatal care initiation (OR: 1.73, 95% CI: 1.07, 2.78) compared to White women. AI/AN women reported higher prevalence for 8 of 12 (66%) barriers to care, including lack of transportation. Lack of health insurance was more prevalent among White women than AI/AN women (45%-8.5%; P<.01).

CONCLUSIONS

Socioeconomic barriers to prenatal care are more prevalent among AI/AN women. This may be a consequence of systematic separation of AI/AN populations from health care resources. Alternative prenatal care delivery methods and expansion of health insurance may improve prenatal care access in ND.

Identification of Fungal Species Associated with Crown and Root Rots of Wheat and Evaluation of Plant Reactions to the Pathogens in North Dakota

Common root rot (CRR) and crown rot (CR), caused by Bipolaris sorokiniana and Fusarium species, respectively, can cause significant yield losses in cereal crops. To assess the prevalence, incidence, and severity of these diseases in North Dakota, wheat samples were collected from spring wheat fields across the state in 2012, 2013, and 2014. Based on subcrown internode symptoms, a greater incidence and severity of CRR was observed in 2012 (warm and dry year) than in 2013 and 2014. Also, the Northwestern Glaciated Plains and Northwestern Great Plains ecoregions showed greater CRR incidence and severity compared with the Northern Glaciated Plains and Lake Agassiz Plains ecoregions in the state. B. sorokiniana and Fusarium species, including Fusarium acuminatum, Fusarium avenaceum, Fusarium culmorum, Fusarium graminearum, Fusarium equiseti, Fusarium pseudograminearum, Fusarium oxysporum, Fusarium redolens, Fusarium sporotrichioides, and Fusarium solani were isolated and identified from the root and crown tissues of the wheat samples. B. sorokiniana was isolated more frequently than other fungal species in all sampled years and ecoregions of North Dakota. F. acuminatum, F. avenaceum, F. culmorum, F. equiseti, F. graminearum, F. pseudograminearum, and F. redolens were pathogenic causing infections on seedlings of the two wheat genotypes (ND652 and Alsen), whereas isolates of F. oxysporum and F. solani were nonpathogenic and considered as secondary invaders associated with the root and CR diseases. Evaluation of some spring wheat genotypes for reactions to one B. sorokiniana isolate at seedling and adult plant stages, and one F. culmorum isolate at the seedling stage, indicated that susceptibility to these pathogens varied among different wheat genotypes tested. This study provides useful information on fungal species associated with CRR and CR of wheat in North Dakota and on resistant/susceptible reactions of some spring wheat lines to the different fungal isolates evaluated.

Characterization of Virulence Phenotypes of Soybean Cyst Nematode (Heterodera glycines) Populations in North Dakota

Soybean cyst nematode (SCN; Heterodera glycines) continues to be the greatest threat to soybean production in the United States. Because host resistance is the primary strategy used to control SCN, knowledge of SCN virulence phenotypes (HG types) is necessary for choosing sources of resistance for SCN management. To characterize SCN virulence phenotypes in North Dakota, a total of 419 soybean fields across 22 counties were sampled during 2015, 2016, and 2017. SCN was detected in 42% of the fields sampled, and population densities in these samples ranged from 30 to 92,800 eggs and juveniles per 100 cm3 of soil. The SCN populations from some of the infested fields were virulence-phenotyped with seven soybean indicator lines and a susceptible check ('Barnes') using the HG type tests. Overall, 73 SCN field populations were successfully virulence-phenotyped. The HG types detected in North Dakota were HG types 0 (frequency rate: 36%), 7 (27%), 2.5.7 (19%), 5.7 (11%), 1.2.5.7 (4%), and 2.7 (2%). However, before this study only HG type 0 was detected in North Dakota. The designation of each of these HG types detected was also validated by repeating the HG type tests for 33 arbitrarily selected samples. This research for the first time reports several new HG types detected in North Dakota and confirms that the virulence of SCN populations is shifting and overcoming resistance, highlighting the necessity of using different resistance sources, rotating resistance sources, and identifying novel resistance sources for SCN management in North Dakota.

Compliance with North Dakota's smoke-free law among vape and tobacco specialty shops

OBJECTIVE

To determine compliance with North Dakota's smoke-free law in vape shops and other tobacco specialty shops selling electronic nicotine delivery systems (ENDS) or e-liquids.

DESIGN

In this 2019 descriptive study, shops (n = 35) were assessed for compliance with the smoke-free law by observation of indoor and outdoor areas for smoking or vaping, or evidence of such activity in prohibited areas, and the presence of required no-smoking signs.

RESULTS

Only two shops (5.7%) were fully compliant with the smoke-free law. Full compliance for indoor and outdoor environments was 8.5% and 42.8%, respectively. Vaping occurred inside five shops (14.3%), and smoking occurred outdoors within required smoke-free areas in two (5.7%) shops. Four (11.4%) and 17 (48.6%) shops complied with indoor and outdoor signage requirements, respectively.

CONCLUSIONS

Overall compliance remained low, although much of the noncompliance was related to signage. Use or evidence of ENDS use occurred both indoors and outdoors where prohibited by law. Classifying ENDS as tobacco products would require tobacco licensure of shops selling ENDS and e-liquids, aiding in identification of the shops for education and enforcement efforts to ensure compliance with the law and to improve public health protection.

Maternal Adverse Childhood Experiences, Paternal Involvement, and Infant Health

OBJECTIVES

To assess the interplay between maternal exposure to adverse childhood experiences (ACEs) and father's acknowledgment of paternity (AOP; a proxy for paternal involvement) in the risk of low birth weight (<2500 grams) and preterm birth (<37 weeks) among offspring.

STUDY DESIGN

Data come from the 2018 North Dakota and South Dakota Pregnancy Risk Assessment Monitoring System (n = 1896). Logistic regression models were used to assess low birth weight and preterm birth outcomes. Moderation analyses are conducted to assess the interaction between maternal ACEs and father's AOP.

RESULTS

Moderation analyses demonstrated a positive interaction between an accumulating number of maternal ACEs and being unmarried without AOP for low birth weight and preterm birth. Upon comparing newborns of unmarried women without AOP, those whose mothers were exposed to 4 or more ACEs had a 3.74 times greater probability of low birth weight (0.050 vs 0.187) and a 1.74 times greater probability of preterm birth (0.085 vs 0.148) than those whose mothers reported no ACE exposure.

CONCLUSIONS

Exposure to accumulating ACEs substantially increases the risk of deleterious infant health outcomes, but only for newborns of unmarried women without AOP. Future research should assess the efficacy of interventions that can mitigate the impact of maternal ACEs in the absence of father's AOP.

An Instance Segmentation and Clustering Model for Energy Audit Assessments in Built Environments: A Multi-Stage Approach

Heat loss quantification (HLQ) is an essential step in improving a building's thermal performance and optimizing its energy usage. While this problem is well-studied in the literature, most of the existing studies are either qualitative or minimally driven quantitative studies that rely on localized building envelope points and are, thus, not suitable for automated solutions in energy audit applications. This research work is an attempt to fill this gap of knowledge by utilizing intensive thermal data (on the order of 100,000 plus images) and constitutes a relatively new area of analysis in energy audit applications. Specifically, we demonstrate a novel process using deep-learning methods to segment more than 100,000 thermal images collected from an unmanned aerial system (UAS). To quantify the heat loss for a building envelope, multiple stages of computations need to be performed: object detection (using Mask-RCNN/Faster R-CNN), estimating the surface temperature (using two clustering methods), and finally calculating the overall heat transfer coefficient (e.g., the U-value). The proposed model was applied to eleven academic campuses across the state of North Dakota. The preliminary findings indicate that Mask R-CNN outperformed other instance segmentation models with an mIOU of 73% for facades, 55% for windows, 67% for roofs, 24% for doors, and 11% for HVACs. Two clustering methods, namely K-means and threshold-based clustering (TBC), were deployed to estimate surface temperatures with TBC providing consistent estimates across all times of the day over K-means. Our analysis demonstrated that thermal efficiency not only depended on the accurate acquisition of thermal images but also relied on other factors, such as the building geometry and seasonal weather parameters, such as the outside/inside building temperatures, wind, time of day, and indoor heating/cooling conditions. Finally, the resultant U-values of various building envelopes were compared with recommendations from the American Society of Heating, Refrigerating, and Air-conditioning Engineers (ASHRAE) building standards.

Variation in Soybean Aphid (Hemiptera: Aphididae) Biotypes Within Fields

Soybean aphid (Aphis glycines Matsumura (Hemiptera: Aphididae)) has been a major pest of soybean in North America since its detection in this continent in 2000 and subsequent spread. Although several aphid resistance genes have been identified, at least four soybean aphid biotypes have been discovered, with three of them being virulent on soybean cultivars with certain soybean aphid resistance genes. These biotypes are known to vary across years and locations, but information on their variation within single fields is limited. An investigation was conducted to study the variation of soybean aphid biotypes within single townships and fields in Minnesota. Screening of 28 soybean aphid isolates collected from seven soybean fields (six soybean fields in Cairo and Wellington Townships of Renville County, MN and one field in Wilmar Township of Kandiyohi County, MN) revealed the existence of multiple known biotypes of soybean aphid within single fields of soybean. We found up to three biotypes of soybean aphid in a single field. Two biotypes were found in five fields while only one field had only a single biotype. Three isolates presented reactions on a panel of resistant and susceptible indicator lines that were different from known biotypes. These results highlight the importance of characterizing soybean aphid biotypes in small geographical areas and utilizing generated knowledge to develop soybean cultivars pyramided with multiple resistance genes. The outcome will be decreased use of insecticides, thereby improving economic and environmental sustainability of soybean production.

Effects of Hybrid Susceptibility and Inoculation Timing on Goss's Bacterial Wilt and Leaf Blight Severity and Corn Yield

Goss's bacterial wilt and leaf blight (Goss's wilt) of corn is the most important corn disease in North Dakota (ND), and yield loss due to the disease has not been reliably quantified in northern corn growing regions. To help quantify the amount of yield loss caused by Goss's wilt, a total of six field experiments were conducted from 2015 to 2017. Experiments were designed in a randomized complete block with a split plot arrangement. Hybrids served as main plots and Clavibacter nebraskensis inoculation timings as subplots. Three hybrids were used and classified as susceptible, moderately susceptible, and resistant. Inoculation timings included a noninoculated control, six to 10 leaf collars (V6 to V10), reproductive silk stage (R1), or a sequential combination of V6 to V10 and R1. A high level of disease (greater than 50% on susceptible hybrid) occurred in three experiments, a low level of disease (less than 5% on susceptible hybrid) in one experiment, and no disease was reported in two experiments. A combined analysis of the high disease experiments indicated yield losses of 34 to 41% on the susceptible hybrid when C. nebraskensis inoculation occurred at V6 to V10. Yield losses of 22 to 25% occurred on the moderately susceptible hybrid when C. nebraskensis inoculation occurred at V6 to V10, and statistical differences in yield loss were not found among inoculations timings on the resistant hybrid. Correlation analyses suggest that for every 1% increase in R1 disease severity on the susceptible hybrid, yield was reduced by 117 kg/ha (1.9 bu/acre). The current study further demonstrates the importance of hybrid resistance and provides updated yield loss information on Goss's wilt in a northern corn growing region.

Development of Real-Time and Conventional PCR Assays for Identifying a Newly Named Species of Root-Lesion Nematode (Pratylenchus dakotaensis) on Soybean

A rapid and accurate PCR-based method was developed in this study for detecting and identifying a new species of root-lesion nematode (Pratylenchus dakotaensis) recently discovered in a soybean field in North Dakota, USA. Species-specific primers, targeting the internal transcribed spacer region of ribosomal DNA, were designed to be used in both conventional and quantitative real-time PCR assays for identification of P.dakotaensis. The specificity of the primers was evaluated in silico analysis and laboratory PCR experiments. Results showed that only P.dakotaensis DNA was exclusively amplified in conventional and real-time PCR assays but none of the DNA from other control species were amplified. Detection sensitivity analysis revealed that the conventional PCR was able to detect an equivalent to 1/8 of the DNA of a single nematode whereas real-time PCR detected an equivalent to 1/32 of the DNA of a single nematode. According to the generated standard curve the amplification efficiency of the primers in real-time PCR was 94% with a R2 value of 0.95 between quantification cycle number and log number of P.dakotaensis. To validate the assays to distinguish P.dakotaensis from other Pratylenchus spp. commonly detected in North Dakota soybean fields, 20 soil samples collected from seven counties were tested. The PCR assays amplified the DNA of P.dakotaensis and discriminated it from other Pratylenchus spp. present in North Dakota soybean fields. This is the first report of a species-specific and rapid PCR detection method suitable for use in diagnostic and research laboratories for the detection of P.dakotaensis.

Land conversion and pesticide use degrade forage areas for honey bees in America's beekeeping epicenter

A diverse range of threats have been associated with managed-bee declines globally. Recent increases of two known threats, land-use change and pesticide use, have resulted from agricultural expansion and intensification notably in the top honey-producing state in the United States: North Dakota. This study investigated the dual threat from land conversion and pesticide use surrounding ~14,000 registered apiaries in North Dakota from 2001 to 2014. We estimated the annual total insecticide use (kg) on major crops within 1.6 km of apiary sites. Of the eight insecticides quantified, six showed significant increasing trends over the time period. Specifically, applications of the newly established neonicotinoids Chlothianidin, Imidacloprid and Thiamethoxam, increased annually by 1329 kg, 686 kg, 795 kg, respectively. Also, the use of Chlorpyrifos, which was well-established in the state by 2001 and is highly toxic to honey bees, increased by ~8,800 kg annually from 6,500 kg in 2001 to 115,000 kg in 2014 on corn, soybeans and wheat. We further evaluated the relative quality changes of natural/semi-natural land covers surrounding apiaries in 2006, 2010 and 2014, a period of significant increases in cropland area. In areas surrounding apiaries, we observed changes in multiple indices of forage quality that reflect the deteriorating landscape surrounding registered apiary sites due to land-use change and pesticide-use increases. Overall, our results suggest that the application of foliar-applied insecticides, including pyrethroids and one organophosphate, increased surrounding apiaries when the use of neonicotinoid seed treatments surged and the area for producing corn and soybeans expanded. Spatially, these threats were most pronounced in southeastern North Dakota, a region hosting a high density of apiary sites that has recently experienced corn and soybean expansion. Our results highlight the value of natural and semi-natural land covers as sources of pollinator forage and refugia for bees against pesticide exposure. Our study provides insights for targeting conservation efforts to improve forage quality benefiting managed pollinators.

Effects of Inoculum Density and Cultivar Susceptibility on Rhizoctonia Damping-Off and Crown and Root Rot in Sugar Beet

Damping-off and crown and root rot of sugar beet caused by Rhizoctonia solani anastomosis group 2-2 (AG 2-2) are important soilborne diseases in Minnesota and North Dakota. Management involves an integrated approach, including crop rotation, use of resistant cultivars, and timely fungicide application. Our objectives were to evaluate the role of inoculum density and cultivar susceptibility on the onset and development of Rhizoctonia diseases and on yield and quality in sugar beet. Three cultivars varying in susceptibility were sown in field plots inoculated with 0, 20, 40, or 60 kg/ha of R. solani AG 2-2 IIIB infested barley during 2013 and 2015. In both years, there was a significant linear effect of inoculum density with decreasing area under the stand establishment curve (AUSEC), root yield, and sucrose quality as inoculum density increased. Cultivar susceptibility significantly affected AUSEC as well as sucrose quality in both years and root yield in 2013. In both years, there was an inoculum density by cultivar interaction on disease ratings, with the partially resistant cultivar resulting in lower ratings than the moderate and susceptible cultivars, especially as inoculum density increased. These results have implications for cultivar selection and for use and timing of postemergence fungicide application based on field history of inoculum pressure.

Effects of Cover Crops on Population Reduction of Soybean Cyst Nematode (Heterodera glycines)

Microplot experiments were conducted to evaluate the effects of cover crops on population reduction of a major soybean pest, soybean cyst nematode (SCN; Heterodera glycines Ichinohe) in 2016 and 2017. Ten crop species, including annual ryegrass (Lolium multiflorum L.), Austrian winter pea (Pisum sativum L. subsp. arvense), carinata (Brassica carinata A. Braun), faba bean (Vicia faba Roth), foxtail millet (Setaria italica (L.) P. Beauvois), daikon radish (Raphanus sativus L.), red clover (Trifolium pratense L.), sweetclover (Melilotus officinalis L.), turnip (Brassica rapa subsp. rapa L.), and winter rye (Secale cereale L.), were planted along with susceptible soybean (Glycine max (L.) Merr. 'Barnes') in soil naturally infested with each of two SCN populations (SCN103 and SCN2W) from two North Dakota soybean fields. Crops were grown in large plastic pots for 75 days in an outdoor environment (microplot). Soil samples were collected from each pot for nematode extraction and SCN eggs were counted to determine the final SCN egg density. The population reduction was determined for each crop and nonplanted natural soil (fallow). All of the tested crops and nonplanted natural soil had significantly (P < 0.0001) lower final population densities compared with susceptible soybean (Barnes). Also, a significant difference (P < 0.0001) was observed between the SCN population suppressions caused by cover crops versus the fallow treatment. All cover crops except Austrian winter pea, carinata, faba bean, and foxtail millet had consistently lower SCN egg numbers than in fallow in both years of the experiments. The average population reductions of SCN by the cover crops ranged from 44 to 67% in comparison with the initial population density, while the fallow had natural reductions from 4 to 24%. Annual ryegrass and daikon radish reduced SCN egg numbers to a greater extent than the other cover crops, with an average of 65 and 67% reduction of initial population density, respectively, from 2 years. The results suggested that cover crops reduced the SCN populations in external microplot conditions, and their use has great potential for improving SCN management in infested fields.

Fatty Acid Data and Crop Surveys Indicate Sources of Red Sunflower Seed Weevil (Coleoptera: Curculionidae), Populations and Suggest Strategies for Management

The red sunflower seed weevil, Smicronyx fulvus L., is a univoltine seed-feeding pest of cultivated sunflower, Helianthus annuus L. Artificial infestations of S. fulvus onto sunflowers with traditional (<25% oleic acid), mid-oleic (55-75%), or high oleic (>80%) fatty acid profiles were used to test if fatty acids could be used as natural markers to estimate the proportion of weevils developing on oilseed sunflowers rather than wild Helianthus spp. and confection (non-oil) types. Oleic acid (%) in S. fulvus confirmed the fatty acid compositions of mature larvae and weevil adults reflected their diets, making primary (oleic or linoleic) fatty acids feasible as natural markers for this crop-insect combination. Oleic acid in wild S. fulvus populations in North Dakota suggests at least 84 and 90% of adults originated from mid-oleic or high oleic sunflower hybrids in 2017 and 2018, respectively. Surveys in 2017 (n = 156 fields) and 2019 (n = 120 fields) extended information provided by S. fulvus fatty acid data; no significant spatial patterns of S. fulvus damage were detected in samples, damage to oilseed sunflowers was greater than confection (non-oil) types, and the majority of damage occurred in ≈10% of surveyed fields. Combined, data suggest a few unmanaged or mismanaged oilseed sunflower fields are responsible for producing most S. fulvus in an area. Improved management seems possible with a combination of grower education and expanded use of non-insecticidal tactics, including cultural practices and S. fulvus-resistant hybrids.

Traffic safety culture and prosocial driver behavior for safer vehicle-bicyclist interactions

INTRODUCTION

Bicyclist safety is a growing concern as more adults use this form of transportation for recreation, exercise, and mobility. Most bicyclist fatalities result from a crash with a vehicle. Often, the behaviors of the driver are responsible for the crash.

METHOD

This survey study of Montana and North Dakota residents (n = 938) examined the influence of traffic safety culture on driver behaviors that affect safe interactions with bicyclists.

RESULTS

Prosocial driver behavior was most common and appeared to be intentional. Intention was increased by positive attitudes, normative perceptions, and perceived control. However, normative perceptions appear to offer the most opportunity for change. Practical Application: Strategies that increase perceptions that prosocial driver behavior is normal may increase prosocial intentions, thereby increasing bicyclist safety.

Determination of Virulence Phenotypes of Plasmopara halstedii in the United States

Downy mildew, caused by Plasmopara halstedii (Farl.) Berl. and de Toni, is an economically important disease in cultivated sunflowers, Helianthus annuus L. Resistance genes incorporated into commercial hybrids are used as an effective disease management tool, but the duration of effectiveness is limited as virulence evolves in the pathogen population. A comprehensive assessment of pathogen virulence was conducted in 2014 and 2015 in the U.S. Great Plains states of North Dakota and South Dakota, where approximately 75% of the U.S. sunflower is produced annually. The virulence phenotypes (and races) of 185 isolates were determined using the U.S. standard set of nine differentials. Additionally, the virulence phenotypes of 61 to 185 isolates were determined on 13 additional lines that have been used to evaluate pathogen virulence in North America and/or internationally. Although widespread virulence was identified on several genes, new virulence was identified on the Pl₈ resistance gene, and no virulence was observed on the Pl_Arg, Pl₁₅, Pl₁₇ and Pl₁₈ genes. Results of this study suggest that three additional lines should be used as differentials and agree with previous studies that six lines proposed as differentials should be used in two internationally accepted differential sets. For effective disease management using genetic resistance, it is critical that virulence data be relevant and timely. This is best accomplished when pathogen virulence is determined frequently and by using genetic lines containing resistance genes actively incorporated into commercial cultivars.

Pyrenophora tritici-repentis Race 4 Isolates Cause Disease on Tetraploid Wheat

The ascomycete fungus Pyrenophora tritici-repentis is the causal agent of tan spot of wheat. The disease can occur on both common wheat (Triticum aestivum) and durum wheat (T. turgidum ssp. durum) and has potential to cause significant yield and quality losses. The fungal pathogen is known to produce necrotrophic effectors (NEs) that act as important virulence factors. Based on the NE production and virulence on a set of four differentials, P. tritici-repentis isolates have been classified into eight races. Race 4 produces no known NEs and is avirulent on the differentials. From a fungal collection in North Dakota, we identified several isolates that were classified as race 4. These isolates caused no or little disease on all common wheat lines including the differentials; however, they were virulent on some durum cultivars and tetraploid wheat accessions. Using two segregating tetraploid wheat populations and quantitative trait locus mapping, we identified several genomic regions significantly associated with disease caused by two of these isolates, some of which have not been previously reported. This is the first report that race 4 is virulent on tetraploid wheat, likely utilizing unidentified NEs. Our findings further highlight the insufficiency of the current race classification system for P. tritici-repentis.

Transferability of a diabetes escape room into an accelerated pharmacy program

BACKGROUND AND PURPOSE

Educational games can be used to increase students' knowledge of diabetes management. Students perceive educational games to be valuable learning tools. This study evaluated the transferability of a serious game, the diabetes escape room, between skills laboratories in a traditional program and an accelerated program. The authors believe that this is a valuable addition to educational methods for students in any pharmacy program.

EDUCATIONAL ACTIVITY AND SETTING

Faculty at an accelerated, three-year pharmacy program replicated a diabetes escape room previously used by a traditional, four-year pharmacy program. The diabetes escape room required students to compete in a team-based educational game in which they solved diabetes-themed puzzles. Students completed pre- and post-game knowledge assessments and a perception survey linked to activity participation. The accelerated program students completed an additional delayed post-game knowledge assessment.

FINDINGS

Students showed a statistically significant difference between pre- and post-game knowledge assessment scores at both institutions as well as in the delayed post-game knowledge assessment implemented at the accelerated program. Perception survey results were statistically significantly higher for the accelerated program, however both cohorts suggested positive perceived engagement with and usefulness of the escape room.

SUMMARY

The use of a diabetes escape room resulted in statistically significant gains in knowledge and positive student perceptions. The diabetes escape room is a transferrable activity that can be used by other colleges or schools of pharmacy.

Increasing adult immunization rates in a rural state through targeted pharmacist education

BACKGROUND

Most immunization rates fall below the Healthy People 2020 goals for adults. Pharmacists have the potential to have a positive effect on immunization rates through vaccine administration.

OBJECTIVE

The purpose of this study was to assess if an educational program developed for pharmacists could increase pharmacist-delivered statewide immunization rates.

PRACTICE DESCRIPTION

This study was conducted in the state of North Dakota. North Dakota law allows authorized pharmacists to provide any immunization to individuals aged 11 years or older.

PRACTICE INNOVATION

In collaboration with the state health department, a needs assessment of North Dakota pharmacists was conducted to determine what resources and education could increase the delivery of immunizations within the pharmacy. The results were used to develop focused continuing pharmacy education material, create an online toolkit, and provide immunization administration certification.

EVALUATION

The number and proportion of pharmacist-delivered immunizations and overall adult immunizations rates were compared pre- and postintervention. The North Dakota Immunization Information System was used for data comparison. In addition, the number of pharmacists registered to provide immunizations with the State Board of Pharmacy was tabulated.

RESULTS

The number of pharmacist-provided immunizations increased by more than 3900 doses. In addition, the percentage of adult immunizations provided by pharmacists and overall adult immunization rates increased throughout the state. After adjusting for seasonality, there was an increase in the number of pharmacist-delivered pneumococcal polysaccharide vaccine immunizations (P < 0.001). The number of pharmacists registered to provide immunizations increased throughout the study period by 39%.

CONCLUSION

This study suggests that focused education and resources delivered to pharmacists can increase pharmacy-based immunization rates and adult immunization rates overall. Improving adult immunization rates through greater pharmacist engagement may help to decrease overall infectious disease threats.

Not a One-Size-Fits-All Approach: Building Tribal Infrastructure for Research Through CRCAIH

The Collaborative Research Center for American Indian Health (CRCAIH) was created to foster tribal partnerships in the Minnesota, North Dakota, and South Dakota regions to increase capacity for tribal research. Since 2013, through community engagement and technical assistance from CRCAIH's cores and divisions, seven tribal partners have expanded research infrastructure and recognize the benefits of an established tribal research office. This manuscript showcases the unique approaches individual CRCAIH tribal partners have taken to build tribal research infrastructure. The unique experiences of the CRCAIH tribal partnership holds valuable lessons for other tribes interested in increasing research capacity through research review, regulation, and data management.

Evaluating Inoculation Methods to Infect Sugar Beet with Fusarium oxysporum f. betae and F. secorum

Minnesota and North Dakota combined contain 55% of the sugar beet production area in the United States, contributing to 49% of the nation's sugar beet production in 2018. Fusarium diseases caused by Fusarium oxysporum f. betae and F. secorum on sugar beet can cause significant reduction in both root yield and sucrose concentration and purity. The objective of this research was to identify an alternative artificial inoculation method to induce Fusarium diseases on sugar beet leaves and roots caused by both Fusarium spp. in greenhouse conditions to better aid in research efforts. We tested four inoculation methods, including barley to seed, barley to root, drenching, and cutting. and compared them with the conventional root-dipping inoculation method. The inoculation method of placing Fusarium-colonized barley seed close to sugar beet seed (barley to seed) caused levels of symptom severities on both leaves and roots similar to the root-dipping method. Because the traditional root-dipping method involves a laborious transplant process, use of infected barley seed as inoculum may serve as an alternative method in the evaluation of host resistance and pathogen virulence among Fusarium diseases by Fusarium spp. on sugar beet at the seed or seedling stage.

Evaluation of soil treatment techniques on remediated brine spill sites in semi-arid rangelands

Unconventional oil and gas development (UOG) generates high volumes of flowback and produced water, byproducts of hydraulic fracturing operations, that are often released or spilled on the soil surface. Soil contamination with these wastewaters, commonly referred to as brine, has the potential to inhibit vegetation growth indefinitely. Natural attenuation of brine is not expedient in arid and semi-arid regions where most United States UOG developments are located, including the Bakken region of North Dakota. In situ (at-site) and ex situ (off-site) soil treatment techniques are commonly employed to remediate brine-contaminated soils in the Bakken. However, little is known regarding each technique's efficacy despite differences in application, cost, and efficiency. We selected 10 sites previously remediated with chemical amendments (in situ) and 11 sites with topsoil excavation (ex situ) in the United States Forest Service Little Missouri National Grasslands. We paired each remediated site with a reference to examine the ability of each strategy to return brine-contaminated sites to conditions reflective of the current state of the surrounding semi-arid rangeland ecosystem. At each site, we quantified soil electrical conductivity (EC_e) as an indicator of soil salinity and measured vegetation cover, biomass production, bare ground, and litter. The difference between paired reference and remediated sites was used for analysis. Brine contamination was still evident as soil EC_e was similarly increased on chemical amendment and topsoil excavation remediated sites over paired references at all soil depths tested. Due to the nature of the topsoil excavation treatment, elevated EC_e in the 0-15 cm depth suggested resalinization of the new topsoil. Remediation techniques also resulted in similar plant community composition marked by an increase in exotic forb biomass, largely due to the invasion of kochia (Bassia scoparia) which was absent from reference sites. However, remediation techniques differed substantially in vegetation establishment. We found 15% more bare ground on sites remediated with chemical amendment treatment than paired references and 55% more with topsoil excavation. Our results indicate that in situ strategies may be more suitable than ex situ strategies for brine-spill remediation in semi-arid rangelands like the Bakken in North Dakota as they cause less disturbance and likely require less post-remediation management to establish adequate vegetation cover to protect the soil from further erosion.

Capitate Glandular Trichomes Fail to Provide Significant Resistance to Banded Sunflower Moth (Lepidoptera: Tortricidae)

Extracts from capitate glandular trichomes (CGT) of wild and cultivated sunflowers, Helianthus spp., have repellent or toxic effects on sunflower specialists and generalist herbivores less closely associated with sunflower. Though CGT have been primarily examined for their potential to provide partial resistance to the sunflower moth, Homoeosoma electellum Hulst (Lepidoptera: Pyralidae), a floret- and seed-feeding pest, the banded sunflower moth (Cochylis hospes Walsingham [Lepidoptera: Tortricidae]) is a similar species more common in the primary sunflower-producing states of North Dakota and South Dakota. Replicated field trials using partially inbred lines with low or high CGT densities were used to evaluate possible reductions to seed damage by C. hospes larvae in 2016-2017. Results failed to support the idea that CGT are a useful defense against larvae of C. hospes; the putative plant defense of high trichome density corresponded to slightly more, rather than less, insect damage. A test of a secondary explanation, that strength of sunflower hulls could help determine patterns of seed damage among tested lines, produced similarly negative results. Though timing of bloom differed between groups of most- and least-damaged lines, prior research and pheromone-trapping data suggest differences in plant maturity also cannot adequately explain the observed results. While the specific mechanisms remain unclear, significant differences in susceptibility to C. hospes exist for cultivated sunflower and limit losses from this primary insect pest.

Geometric effect analysis of highway-rail grade crossing safety performance

Highway-rail grade crossings (HRGCs) are where a roadway and railway intersect at the same level. Safety at HRGCs has been identified as a high-priority concern among transportation agencies, but there has been little research on the effects of HRGC geometric parameters on their safety performance. This paper evaluates the effects of HRGC geometric parameters on crash occurrence and severity likelihoods. The competing risk algorithm is selected to simultaneously analyze crash occurrence and severities. Four main HRGC geometric factors, along with other contributors, are investigated at 3,194 public HRGCs in North Dakota. This study focuses primarily on four geometric features of an HRGC: (1) acute crossing angle, (2) number of tracks (indicator of crossing width), (3) the roadway distance between the HRGC and the signalized intersection, and (4) number of highway lanes. Distance to the nearest roadway intersections and highway-railway crossing angles are map-based calculations drawn from geographic information systems (GIS). The findings are: (1) all contributors tested in this study, including highway characteristics, traffic exposures from both railway and highway, and the four geometric features, significantly affect at least one crash severity level; (2) all contributors significantly impact crash frequency except for the distance between crossings and the nearest roadway intersection; and (3) geometric parameters' long-term effects on cumulative probability of crash severity and occurrence over 30 years is also evaluated. Crossings with three main tracks contribute the highest long-term crash probabilities.

The shale gas production and economic growth in local economies across the US

Recently, several seminal works have been drawing attention to the revolution of shale gas production technology of the USA, the impact of shale gas on energy sectors, as well as the influences of shale gas on macroeconomic variables of employment, economic growth, etc. Nevertheless, one may claim that two gaps appear in literature. The first gap is the absence of an econometric study estimating the effect of shale oil/gas on national economies. The more considerable second gap is the absence of econometric analyses revealing the impulses of shale gas on local economies. Therefore, this paper observes the possible causalities between the shale gas and local gross domestic product (GDP) employing quarterly data covering the period 2007-2016 for 12 states in the US. After performing the tests of cross-sectional dependence, heterogeneity, stationarity, and cointegration, the paper conducts the panel Granger causality analyses. The empirical findings depict that (i) there is available unidirectional relationship from local shale gas production to local GDP in Colorado, Ohio, and West Virginia; (ii) there occurs an impulse from GDP to local shale gas production for Louisiana, North Dakota, and Oklahoma; (iii) a bidirectional causality coexists between local shale gas production and GDP in Arkansas, California, and Texas; and (iv) there exists no association between local GDP and local shale gas extraction in Montana, New Mexico, and Wyoming.

Managing a Destructive, Episodic Crop Disease: A National Survey of Wheat and Barley Growers' Experience With Fusarium Head Blight

The main techniques for minimizing Fusarium head blight (FHB, or scab) and deoxynivalenol in wheat and barley are well established and generally available: planting of moderately FHB-resistant cultivars, risk monitoring, and timely use of the most effective fungicides. Yet the adoption of these techniques remains uneven across the FHB-prone portions of the U.S. cereal production area. A national survey was undertaken by the U.S. Wheat and Barley Scab Initiative in 17 states where six market classes of wheat and barley are grown. In 2014, 5,107 usable responses were obtained. The highest percentages reporting losses attributable to FHB in the previous 5 years were in North Dakota, Maryland, Kentucky, and states bordering the Great Lakes but across all states, ≥75% of respondents reported no FHB-related losses in the previous 5 years. Adoption of cultivar resistance was uneven by state and market class and was low except among hard red spring wheat growers. In 13 states, a majority of respondents had not applied an FHB-targeted fungicide in the previous 5 years. Although the primary FHB information source varied by state, crop consultants were considered to be an important source or their primary source of information on risk or management of FHB by the largest percentage of respondents. Use of an FHB risk forecasting website was about twice as high in North Dakota as the 17-state average of 6%. The most frequently cited barriers to adopting FHB management practices were weather or logistics preventing timely fungicide application, difficulty in determining flowering timing for fungicide applications, and the impracticality of FHB-reducing rotations. The results highlight the challenges of managing an episodically damaging crop disease and point to specific areas for improvement.