Engaging Communities in Cancer Prevention and Control Activity Prioritization through a Statewide Needs Assessment: A Case Study from Nebraska.

Community outreach and engagement (COE) activities are important in identifying catchment area needs, communicating these needs, and facilitating activities relevant to the population. The National Cancer Institute-designated cancer centers are required to conduct catchment-wide cancer needs assessments as part of their COE activities. The University of Nebraska Medical Center Buffett Cancer Center undertook a three-year-long process to conduct a needs assessment, identify priorities, and develop workgroups to implement cancer prevention and control activities. Activities were conducted through collaborations with internal and external partners. The needs assessment focused on prevention, early detection, and treatment of cancer and involved secondary data analysis and focus groups with identified underrepresented priority populations (rural, African American, Hispanic, Native American, and LGBTQ+ populations). Results were tailored and disseminated to specific audiences via internal and external reports, infographics, and presentations. Several workgroups were developed through meetings with the internal and external partners to address identified priorities. COE-specific initiatives and metrics have been incorporated into University of Nebraska Medical Center and Buffett Cancer Center strategic plans. True community engagement takes a focused effort and significant resources. A systemic and long-term approach is needed to develop trusted relationships between the COE team and its local communities.

African American and Hispanic Cancer Survivors' and Caregivers' Experiences in Nebraska.

Racial and ethnic minority populations experience poorer cancer outcomes compared to non-Hispanic White populations, but qualitative studies have typically focused on single subpopulations. We explored experiences, perceptions, and attitudes toward cancer care services across the care continuum from screening through treatment among African American and Hispanic residents of Nebraska to identify unique needs for education, community outreach, and quality improvement. We conducted four focus groups (N = 19), April-August 2021 with people who were aged 30 or older and who self-identified as African American or Hispanic and as cancer survivors or caregivers. Sessions followed a structured facilitation guide, were audio recorded and transcribed, and were analyzed with a directed content analysis approach. Historical, cultural, and socioeconomic factors often led to delayed cancer care, such as general disuse of healthcare until symptoms were severe due to mistrust and cost of missing work. Obstacles to care included financial barriers, transportation, lack of support groups, and language-appropriate services (for Hispanic groups). Knowledge of cancer and cancer prevention varied widely; we identified a need for better community education about cancer within the urban Hispanic community. Participants had positive experiences and a sense of hope from the cancer care team. African American and Hispanic participants shared many similar perspectives about cancer care. Our results are being used in collaboration with national and regional cancer support organizations to expand their reach in communities of color, but structural and cultural barriers still need to be addressed.

Exploring barriers and promoters of CRC screening use among agricultural operators: a pilot study of an application of concept mapping.

INTRODUCTION: The purpose of the study was to identify barriers and facilitators of colorectal cancer (CRC) screening use among agricultural operators in Nebraska, US. METHODS: The concept mapping approach was used to engage participants and enhance the generation of ideas and opinions regarding CRC screening. Two focus groups (seven women and seven men) were conducted. RESULTS: Among women, the cost domain was most agreed upon as important, followed by experiencing symptoms, awareness, and family. Among men, the important concepts related to CRC screening were family and friend support, feeling too young to get CRC, family or personal history of CRC, and lack of awareness of the need to be screened. Some gender differences regarding barriers were observed, such as women were more concerned about the cost of screening while men were far more concerned about the embarrassment associated with CRC screening. CONCLUSION: These findings will be crucial to developing educational materials to increase knowledge of risk factors for CRC and of CRC screening in the agricultural population.

Qualitative Analysis of Colorectal Cancer Screening for African American and Hispanic Populations in Nebraska: an Application of the PRECEDE Framework.

Nationally and in Nebraska, African Americans (AA) and Hispanics have lower colorectal cancer (CRC) screening rates compared to non-Hispanic Whites. We aimed to obtain perspectives from AA and Hispanic cancer survivors and caregivers in Nebraska about CRC screening to improve outreach efforts. Data from four virtual focus groups (AA female, AA male, Hispanic rural, and Hispanic urban) conducted between April-August 2021 were analyzed using a directed content approach based on the Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model. Most of the 19 participants were female (84%) and survivors (58%). Across groups, awareness of colonoscopy was high, but awareness of fecal testing needed to be higher, with confusion about different types of fecal tests. Predisposing factors were trust in the health system; awareness of CRC screening; machismo; fear of cancer; embarrassment with screening methods; and negative perceptions of CRC screening. Enabling factors included provider recommendations, healthcare access, and insurance. Reinforcing factors included prioritizing personal health and having a support system. Suggestions to improve screening included increasing healthcare access (free or low-cost care), increasing provider diversity, health education using various methods and media, and enhancing grassroots health promotion efforts. Lack of awareness, accessibility issues, attitudes and perceptions of CRC and CRC screening, trust, and cultural and linguistic concerns are major issues that need to be addressed to reduce CRC screening disparities among AA and Hispanic adults.

Warmer and more acidic conditions enhance performance of an endemic low-shore gastropod.

Changing ocean temperatures are predicted to challenge marine organisms, especially when combined with other factors, such as ocean acidification. Acclimation, as a form of phenotypic plasticity, can moderate the consequences of changing environments for biota. Our understanding of how altered temperature and acidification together influence species' acclimation responses is, however, limited compared with that of responses to single stressors. This study investigated how temperature and acidification affect the thermal tolerance and righting speed of the girdled dogwhelk, Trochia cingulata. Whelks were acclimated for 2 weeks to combinations of three temperatures (11°C: cold, 13°C: moderate and 15°C: warm) and two pH regimes (8.0: moderate and 7.5: acidic). We measured the temperature sensitivity of the righting response by generating thermal performance curves from individual data collected at seven test temperatures and determined critical thermal minima (CTmin) and maxima (CTmax). We found that T. cingulata has a broad basal thermal tolerance range (∼38°C) and after acclimation to the warm temperature regime, both the optimal temperature for maximum righting speed and CTmax increased. Contrary to predictions, acidification did not narrow this population's thermal tolerance but increased CTmax. These plastic responses are likely driven by the predictable exposure to temperature extremes measured in the field which originate from the local tidal cycle and the periodic acidification associated with ocean upwelling in the region. This acclimation ability suggests that T. cingulata has at least some capacity to buffer the thermal changes and increased acidification predicted to occur with climate change.

Ecosystem variables importance in the presence and abundance of a globally invasive fish.

Changes in physical habitat that are associated with anthropogenic disturbances facilitate the establishment and expansion of non-native species in receiving environments. Here, we evaluated the relative importance of ecosystem variables for the presence and abundance of the invasive fish Poecilia reticulata in Brazil. We collected fish species and assessed environmental variables through an established physical habitat protocol in 220 stream sites located in southeastern and midwestern Brazil. A total of 14,816 P. reticulata individuals were collected in 43 stream sites, and 258 variables that describe the physical characteristics of streams were assessed, including measures of channel morphology, substrate size and type, habitat complexity and cover, riparian vegetation cover and structure, and human influence. Dimensionality reduction methods were employed to limit redundancy, resulting in a smaller set of the most relevant environmental variables. Subsequently, we used random forest models to assess the relative importance of these variables in determining the presence and abundance of P. reticulata. The presence of this invasive fish was primarily explained by human disturbance variables related to urbanization (total impact, pavement, artificial structure areal cover, riparian canopy cover, electrical conductivity, mean thalweg depth, and sand), whereas channel morphology (mean bank full height) and fish cover variables (natural fish cover, and aquatic macrophyte areal cover) were important predictors of its abundance. Identifying which ecosystem variables are favorable to the establishment of non-native species is an important step in preventing future biological invasions, as well as managing those that already occur.

Qualitative Analysis of Colorectal Cancer Screening in Rural Nebraska.

Compared to urban residents, rural populations are less likely to engage in colorectal cancer (CRC) screening. As part of a statewide cancer needs assessment, we aimed to elicit rural perspectives about CRC screening and resources. We conducted three focus groups with rural Nebraska cancer survivors and caregivers (N = 20) in Spring 2021 using a collective case study design. Participant awareness of and knowledge about CRC screening methods varied across focus groups; overall, 95% of participants had heard of colonoscopy. Participants were less familiar with fecal tests and had confusion about them. Colonoscopy was associated with negative perceptions regarding the time, cost, and discomfort of the preparation and procedure, but some providers did not discuss alternative methods unless the patient resisted colonoscopy. Healthcare providers played a key role educating rural communities about CRC screening recommendations (age, risk) and testing options and being persistent in those recommendations. CRC awareness campaigns should include a variety of communication channels (TV, radio, billboards, health fairs, churches, healthcare settings). Promotion of CRC screening should include education about screening age guidelines, alternative test types, and informed decision-making between provider and patient regarding preferred screening methods based on the pros and cons of each test type. Individuals with a family history of colon issues (Crohn's disease, CRC) are considered high risk and need to be aware that screening should be discussed at earlier ages.

The role of seagrass meadows in the accumulation of microplastics: Insights from a South African estuary.

Microplastics are widespread in marine ecosystems, where they threaten biota and human wellbeing. Seagrasses may act as natural filters of microplastics due to their particle trapping abilities, yet little is known about the extent of microplastics in the sediment of seagrass beds. The aim of this study was to compare microplastic accumulation in the sediments of Zostera capensis meadows with adjacent bare sediments at a small spatial scale (~5 km) in the Knysna estuary in South Africa. No significant difference in total microplastic counts were found between seagrass and unvegetated sediments. However, fibre microplastic counts differed significantly between the two locations at which samples were collected. This may be due to pollution levels and proximity to larger human population densities. Importantly, our study reveals variability in microplastic abundance and type even at small spatial scales, an important consideration for the design of future studies aiming to monitor for microplastics.

The EICAT+ framework enables classification of positive impacts of alien taxa on native biodiversity.

Species introduced through human-related activities beyond their native range, termed alien species, have various impacts worldwide. The IUCN Environmental Impact Classification for Alien Taxa (EICAT) is a global standard to assess negative impacts of alien species on native biodiversity. Alien species can also positively affect biodiversity (for instance, through food and habitat provisioning or dispersal facilitation) but there is currently no standardized and evidence-based system to classify positive impacts. We fill this gap by proposing EICAT+, which uses 5 semiquantitative scenarios to categorize the magnitude of positive impacts, and describes underlying mechanisms. EICAT+ can be applied to all alien taxa at different spatial and organizational scales. The application of EICAT+ expands our understanding of the consequences of biological invasions and can inform conservation decisions.

Qualitative analysis of cancer care experiences among rural cancer survivors and caregivers.

PURPOSE: Rural (vs urban) patients experience poorer cancer outcomes and are less likely to be engaged in cancer prevention, such as screening. As part of a community needs assessment, we explored rural cancer survivors' and caregivers' experiences, perceptions, and attitudes toward cancer care services. METHODS: We conducted 3 focus groups (N = 20) in Spring 2021 in rural Nebraska. FINDINGS: Three patterns of cancer diagnosis were regular care/screening without noticeable symptoms, treatment for symptoms not initially identified as cancer related, and symptom self-identification. Most participants, regardless of how diagnosis was made, had positive experiences with timely referral for testing (imaging and biopsy) and specialist care. Physician interpersonal skills set the tone for patient-provider communication, which colored the perception of overall care. Participants with physicians and care teams that were perceived as "considerate," "compassionate," and "caring" had positive experiences. Participants identified specific obstacles to care, including financial barriers, transportation, and lack of support groups, as well as more general cultural barriers. Survivors and caregivers identified organization-based supports that helped them address such barriers. CONCLUSIONS: Rural populations have unique perspectives about cancer care. Our results are being used by the state cancer coalition, state cancer control program, and the National Cancer Institute-designated cancer center to prioritize outreach and interventions aimed to reduce rural cancer disparities, such as revitalizing lay cancer navigator programs, conducting webinars for primary care and cancer specialty providers to discuss these findings and identify potential interventions, and collaborating with national and regional cancer support organizations to expand reach in rural communities.

Co-occurring predators increase biotic resistance against an invasive prey.

The presence of multiple predators can lead to variation in predator behavior and ultimately altered risk for shared prey. This concept has seldom been accounted for in studies that consider predator-driven biotic resistance from native marine predators against invasive prey. This study compared the prey selection of whelks and rock lobsters when co-occurring and when foraging in isolation. When in isolation, both predators preferred the native mussel Choromytilus meridionalis, regardless of the abundance of alternative prey. However, when co-occurring, predation risk for all prey species, including the invasive mussel Semimytilus algosus, increased. This was largely driven by greater variation in prey selection by rock lobsters in the presence of whelks. This indicates that predatory efforts from co-occurring predators can result in stronger predation pressure on invasive prey than would be recognized if predators were assessed in isolation.

The first management of a marine invader in Africa: The importance of trials prior to setting long-term management goals.

Biological invasions severely impact on marine ecosystems around the world, but to date management is rare and has not previously been attempted in Africa. This study documents a trial management programme aimed at informing a national management strategy for the invasive European shore crab, Carcinus maenas, in South Africa. The approach involved testing control methods used elsewhere (baited traps, crab condos, diver collections and sediment dredging) and adapting these to the local context. Following these trials, baited traps were deployed over the course of the year, and the catch per unit effort (CPUE) tracked. A total of 36,244 crabs were collected during the management period, six times more than a pre-management population estimate. The population was not extirpated and CPUE increased once trapping ceased. The cost of attempting nationwide eradication is prohibitive, particularly given the lack of current impacts by this crab in this region and the possibility of reintroduction. We highlight key administrative challenges encountered, and the importance of such pilot trials in setting long-term goals when attempting alien species management interventions.

Trends in the detection of aquatic non-indigenous species across global marine, estuarine and freshwater ecosystems: A 50-year perspective.

Aim: The introduction of aquatic non-indigenous species (ANS) has become a major driver for global changes in species biogeography. We examined spatial patterns and temporal trends of ANS detections since 1965 to inform conservation policy and management. Location: Global. Methods: We assembled an extensive dataset of first records of detection of ANS (1965-2015) across 49 aquatic ecosystems, including the (a) year of first collection, (b) population status and (c) potential pathway(s) of introduction. Data were analysed at global and regional levels to assess patterns of detection rate, richness and transport pathways. Results: An annual mean of 43 (±16 SD) primary detections of ANS occurred-one new detection every 8.4 days for 50 years. The global rate of detections was relatively stable during 1965-1995, but increased rapidly after this time, peaking at roughly 66 primary detections per year during 2005-2010 and then declining marginally. Detection rates were variable within and across regions through time. Arthropods, molluscs and fishes were the most frequently reported ANS. Most ANS were likely introduced as stowaways in ships' ballast water or biofouling, although direct evidence is typically absent. Main conclusions: This synthesis highlights the magnitude of recent ANS detections, yet almost certainly represents an underestimate as many ANS go unreported due to limited search effort and diminishing taxonomic expertise. Temporal rates of detection are also confounded by reporting lags, likely contributing to the lower detection rate observed in recent years. There is a critical need to implement standardized, repeated methods across regions and taxa to improve the quality of global-scale comparisons and sustain core measures over longer time-scales. It will be fundamental to fill in knowledge gaps given that invasion data representing broad regions of the world's oceans are not yet readily available and to maintain knowledge pipelines for adaptive management.

Blender interstitial volume: A novel virtual measurement of structural complexity applicable to marine benthic habitats.

Blender interstitial volume is a novel method that utilizes 3D modeling techniques to accurately and efficiently quantify the volume of interstitial gaps in marine benthic habitats, as well as the space provided by substrate rugosity. This method builds upon the analog methods routinely used on rocky shores and intertidal habitats, including those that measure rugosity, topography, fractals and volume. The method provides a direct Euclidean measurement and uniquely allows retrospective analysis if historical data on species composition are available. Blender interstitial volume allows users to quickly build and measure a large number of samples at no extra cost. •The program for Blender is free and opensource, and requires no extra equipment.•Once 3D models of species are made, the entire method takes less than ten minutes to complete.•Blender interstitial volume is as accurate as Fractal analysis in determining structural complexity on rocky shores, but is more consistent and precise, and better at discerning differences.

Using empirical and simulation approaches to quantify merits of rival measures of structural complexity in marine habitats.

Ecosystem engineers often affect structural complexity of habitats. There are multiple methods of quantifying complexity, variously measuring topography, surface area, volume, fractal dimension, or rugosity. We compared eight methods, four employing the 3D modelling program 'Blender' to estimate total surface area, top surface area, their ratio, and interstitial volume; and four empirically measuring interstitial volume, fractals and two indices of rugosity. We compared these using seven metrics: 1) correlations among comparable measures; 2) consistency; 3) accuracy; 4) precision; 5) discrimination among configurations of objects; 6) discernment of complexities among zones on rocky shores; and 7) practicality. Of the eight methods, the virtual volumetric method, Blender interstitial volume, performed the best. Direct measurements of three-dimensional space related more closely to patterns in biodiversity than did measurements of two-dimensional space or indirect measures of complexity like fractals. Blender interstitial volume is thus the recommended means of measuring structural complexity of benthic environments.

Sampling methods and approaches to inform standardized detection of marine alien fouling species on recreational vessels.

Recreational vessels are important contributors to the spread of marine alien species, particularly in relation to secondary spread within novel regions. As such, these vessels should be considered a monitoring priority. The aim of this study was to identify a preferred method for monitoring recreational vessels for alien species, while simultaneously developing a framework that enables managers to objectively choose the most effective sampling approach given their financial constraints. Divers and a remotely operated vehicle (ROV) were considered in relation to four sampling approaches i.e. meanders, transects, inspection of niche areas and the collection of quadrats. Each was applied to the same 53 vessels which represented a spectrum of hull fouling cover. The most effective methods were diver scrape quadrats (Range of alien species numbers per quadrat: 0-9, Total alien species: 20) and inspections of niche areas (Range of alien species numbers: 0-5, Total alien species: 9). All methods employed using an ROV had low efficacy and incurred high costs. While scrape samples were one of the most expensive methods, this was offset by the lowest cost per species detected. Thus, it is recommended that monitoring programmes utilize scrape samples and niche area inspections, but when faced with financial constraints, diver meanders and niche inspections offer sound alternatives for detecting alien species.

Functional responses of a cosmopolitan invader demonstrate intraspecific variability in consumer-resource dynamics.

BACKGROUND: Variability in the ecological impacts of invasive species across their geographical ranges may decrease the accuracy of risk assessments. Comparative functional response analysis can be used to estimate invasive consumer-resource dynamics, explain impact variability, and thus potentially inform impact predictions. The European green crab (Carcinus maenas) has been introduced on multiple continents beyond its native range, although its ecological impacts appear to vary among populations and regions. Our aim was to test whether consumer-resource dynamics under standardized conditions are similarly variable across the current geographic distribution of green crab, and to identify correlated morphological features. METHODS: Crabs were collected from multiple populations within both native (Northern Ireland) and invasive regions (South Africa and Canada). Their functional responses to local mussels (Mytilus spp.) were tested. Attack rates and handling times were compared among green crab populations within each region, and among regions (Pacific Canada, Atlantic Canada, South Africa, and Northern Ireland). The effect of predator and prey morphology on prey consumption was investigated. RESULTS: Across regions, green crabs consumed prey according to a Type II (hyperbolic) functional response curve. Attack rates (i.e., the rate at which a predator finds and attacks prey), handling times and maximum feeding rates differed among regions. There was a trend toward higher attack rates in invasive than in native populations. Green crabs from Canada had lower handling times and thus higher maximum feeding rates than those from South Africa and Northern Ireland. Canadian and Northern Ireland crabs had significantly larger claws than South African crabs. Claw size was a more important predictor of the proportion of mussels killed than prey shell strength. DISCUSSION: The differences in functional response between regions reflect observed impacts of green crabs in the wild. This suggests that an understanding of consumer-resource dynamics (e.g., the per capita measure of predation), derived from simple, standardized experiments, might yield useful predictions of invader impacts across geographical ranges.

A framework for engaging stakeholders on the management of alien species.

Alien species can have major ecological and socioeconomic impacts in their novel ranges and so effective management actions are needed. However, management can be contentious and create conflicts, especially when stakeholders who benefit from alien species are different from those who incur costs. Such conflicts of interests mean that management strategies can often not be implemented. There is, therefore, increasing interest in engaging stakeholders affected by alien species or by their management. Through a facilitated workshop and consultation process including academics and managers working on a variety of organisms and in different areas (urban and rural) and ecosystems (terrestrial and aquatic), we developed a framework for engaging stakeholders in the management of alien species. The proposed framework for stakeholder engagement consists of 12 steps: (1) identify stakeholders; (2) select key stakeholders for engagement; (3) explore key stakeholders' perceptions and develop initial aims for management; (4) engage key stakeholders in the development of a draft management strategy; (5) re-explore key stakeholders' perceptions and revise the aims of the strategy; (6) co-design general aims, management objectives and time frames with key stakeholders; (7) co-design a management strategy; (8) facilitate stakeholders' ownership of the strategy and adapt as required; and (9) implement the strategy and monitor management actions to evaluate the need for additional or future actions. In case additional management is needed after these actions take place, some extra steps should be taken: (10) identify any new stakeholders, benefits, and costs; (11) monitor engagement; and (12) revise management strategy. Overall, we believe that our framework provides an effective approach to minimize the impact of conflicts created by alien species management.

Existing and emerging high impact invasive species are characterized by higher functional responses than natives.

Predicting ecological impacts of invasive species and identifying potentially damaging future invaders are research priorities. Since damage by invaders is characterized by their depletion of resources, comparisons of the 'functional response' (FR; resource uptake rate as a function of resource density) of invaders and natives might predict invader impact. We tested this by comparing FRs of the ecologically damaging 'world's worst' invasive fish, the largemouth bass (Micropterus salmoides), with a native equivalent, the Cape kurper (Sandelia capensis), and an emerging invader, the sharptooth catfish (Clarias gariepinus), with the native river goby (Glossogobius callidus), in South Africa, a global invasion hotspot. Using tadpoles (Hyperolius marmoratus) as prey, we found that the invaders consumed significantly more than natives. Attack rates at low prey densities within invader/native comparisons reflected similarities in predatory strategies; however, both invasive species displayed significantly higher Type II FRs than the native comparators. This was driven by significantly lower prey handling times by invaders, resulting in significantly higher maximum feeding rates. The higher FRs of these invaders are thus congruent with, and can predict, their impacts on native communities. Comparative FRs may be a rapid and reliable method for predicting ecological impacts of emerging and future invasive species.