Same People, Different Results: Categorizing Cancer Registry Cases Across the Rural-Urban Continuum.

BACKGROUND: Many rural-urban indexes are utilized in cancer research. This variation introduces inconsistencies between studies. Recommendations on index use have prioritized geographical unit over feasibility of inclusion in analysis. We evaluated rural-urban indexes and recommend one for use to increase comparability across studies. METHODS: We assessed 9 US rural-urban indexes regarding their respective rural and urban code ranges; geographical unit, land area, and population distributions; percent agreement; suitability for analysis; and integration feasibility for national, state, and local cancer research. We referenced 1569 Wisconsin Pancreatic Cancer Registry patients to demonstrate how index choice affects patient categorization. RESULTS: Six indexes categorized rural and urban areas. Indexes agreed on binary rural-urban designation for 88.8% of the US population. As ternary variables, they agreed for 83.4%. For cancer registry patients, this decreased to 73.4% and 60.4% agreement, respectively. Rural-Urban Continuum Codes (RUCC) performed the best in differentiating metropolitan, micropolitan, and rural counties; availability for retrospective and prospective studies; and continuous coding for analysis. CONCLUSIONS: Urban/rural patient categorization changed with index selection. We conclude that RUCC is an appropriate and feasible rural-urban index to include in cancer research, as it is standardly available in national cancer registries, can be matched to patient's county of residence for local research, and it had the least amount of fluctuation of the indices analyzed. Utilizing RUCC as a continuous variable across studies with a rural-urban component will increase reproducibility and comparability of results and eliminate rural-urban index choice as a potential source of discrepancy between studies.

Cervical Cancer and a History of Incarceration: Examining a Social Determinant of Health.

Females who are incarcerated are disproportionately burdened by cancer, particularly cervical cancer. We measured the odds of cervical cancer compared with nonscreenable cancers for females who were incarcerated before diagnosis. By comparing a cancer for which screening and vaccination are available with cancers for which neither are available, we aimed to assess the relationship of incarceration with diseases for which preventive care mitigates risk. We created a novel data set combining cancer data from a large cancer center with incarceration data from the state department of corrections. We then estimated the odds of cervical cancer relative to nonscreenable cancers for those with and without a history of incarceration. Females with a history of incarceration had greater odds of being diagnosed with cervical cancer compared with nonscreenable cancers (odds ratio = 7.04; 95% confidence interval [CI]: 4.4-11.0) relative to those who had not been incarcerated. Adjusting for race and age, the odds of cervical cancer remained significantly greater for those with a history of incarceration (adjusted odds ratio = 3.86; 95% CI: 2.3-6.3). Our findings support the need for expanded cervical cancer screening and vaccination opportunities for incarcerated females and increased access to preventive health care after release.

The impact of carceral churn and healthcare organizations on HIV/AIDS incidence in Arkansas.

•Penal and healthcare institutions generate and mitigate community-level health inequality, respectively.•Arkansas Counties with high prison churn and disadvantage have higher rates of HIV/AIDS.•Hospital density moderates effect of prison churn on incidence of HIV/AIDS.

Treatment Inequity: Examining the Influence of Non-Hispanic Black Race and Ethnicity on Pancreatic Cancer Care and Survival in Wisconsin.

INTRODUCTION: We investigated race and ethnicity-based disparities in first course treatment and overall survival among Wisconsin pancreatic cancer patients. METHODS: We identified adults diagnosed with pancreatic adenocarcinoma in the Wisconsin Cancer Reporting System from 2004 through 2017. We assessed race and ethnicity-based disparities in first course of treatment via adjusted logistic regression and overall survival via 4 incremental Cox proportional hazards regression models. RESULTS: The study included 8,490 patients: 91.3% (n = 7,755) non-Hispanic White; 5.1% (n = 437) non-Hispanic Black, 1.8% (n = 151) Hispanic, 0.6% Native American (n = 53), and 0.6% Asian (n = 51) race and ethnicities. Non-Hispanic Black patients had lower odds of treatment than non-Hispanic White patients for full patient (OR, 0.52; 95% CI, 0.41-0.65) and Medicare cohorts (OR, 0.40; 95% CI, 0.29-0.55). Non-Hispanic Black patients had lower odds of receiving surgery than non-Hispanic White patients (full cohort OR, 0.67 [95% CI, 0.48-0.92]; Medicare cohort OR, 0.57 [95% CI, 0.34-0.93]). Non-Hispanic Black patients experienced worse survival than non-Hispanic White patients in the first 2 incremental Cox proportional hazard regression models (model II HR, 1.18; 95% CI, 1.06-1.31). After adding insurance and treatment course, non-Hispanic Black and non-Hispanic White patients experienced similar survival (HR, 0.98; 95% CI, 0.88-1.09). CONCLUSION: Non-Hispanic Black patients were almost 50% less likely to receive any treatment and 33% less likely to receive surgery than non-Hispanic White patients. After including treatment course, non-Hispanic Black and non-Hispanic White patient survival was similar. Increasing non-Hispanic Black patient treatment rates by addressing structural factors affecting treatment availability and employing culturally humble approaches to treatment discussions may mitigate these disparities.

A study of SARS-COV-2 outbreaks in US federal prisons: the linkage between staff, incarcerated populations, and community transmission.

BACKGROUND: Since the novel coronavirus SARS-COV-2 was first identified to be circulating in the US on January 20, 2020, some of the worst outbreaks have occurred within state and federal prisons. The vulnerability of incarcerated populations, and the additional threats posed to the health of prison staff and the people they contact in surrounding communities underline the need to better understand the dynamics of transmission in the inter-linked incarcerated population/staff/community sub-populations to better inform optimal control of SARS-COV-2. METHODS: We examined SARS-CoV-2 case data from 101 non-administrative federal prisons between 5/18/2020 to 01/31/2021 and examined the per capita size of outbreaks in staff and the incarcerated population compared to outbreaks in the communities in the counties surrounding the prisons during the summer and winter waves of the SARS-COV-2 pandemic. We also examined the impact of decarceration on per capita rates in the staff/incarcerated/community populations. RESULTS: For both the summer and winter waves we found significant inter-correlations between per capita rates in the outbreaks among the incarcerated population, staff, and the community. Over-all during the pandemic, per capita rates were significantly higher in the incarcerated population than in both the staff and community (paired Student's t-test p = 0.03 and p < 0.001, respectively). Average per capita rates of incarcerated population outbreaks were significantly associated with prison security level, ranked from lowest per capita rate to highest: High, Minimum, Medium, and Low security. Federal prisons decreased the incarcerated population by a relative factor of 96% comparing the winter to summer wave (one SD range [90%,102%]). We found no significant impact of decarceration on per capita rates of SARS-COV-2 infection in the staff community populations, but decarceration was significantly associated with a decrease in incarcerated per capita rates during the winter wave (Negative Binomial regression p = 0.015). CONCLUSIONS: We found significant evidence of community/staff/incarcerated population inter-linkage of SARS-COV-2 transmission. Further study is warranted to determine which control measures aimed at the incarcerated population and/or staff are most efficacious at preventing or controlling outbreaks.

Geodemographic insights on the COVID-19 pandemic in the State of Wisconsin and the role of risky facilities.

The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to impact the United States. While age and comorbid health conditions remain primary concerns in the community-based transmission of the virus, empirical evidence continues to suggest that substantial variability exists in the geographic and geodemographic distribution of COVID-19 infection rates. The purpose of this paper is to provide an alternative, spatiotemporal perspective on the pandemic using the state of Wisconsin as a case study. Specifically, in this paper, we explore the geographic nuances of COVID-19 and its spread in Wisconsin using a suite of spatial statistical approaches. We link detected hot spots of COVID-19 to local geodemographic profiles and the presence of high-risk facilities, including federal and state correctional facilities. The results suggest that the virus disproportionately impacts several communities and geodemographic groups and that proximity to risky facilities correlates to increased community infection rates.

Is There a Temporal Relationship between COVID-19 Infections among Prison Staff, Incarcerated Persons and the Larger Community in the United States?

BACKGROUND: Our objective was to examine the temporal relationship between COVID-19 infections among prison staff, incarcerated individuals, and the general population in the county where the prison is located among federal prisons in the United States. METHODS: We employed population-standardized regressions with fixed effects for prisons to predict the number of active cases of COVID-19 among incarcerated persons using data from the Federal Bureau of Prisons (BOP) for the months of March to December in 2020 for 63 prisons. RESULTS: There is a significant relationship between the COVID-19 prevalence among staff, and through them, the larger community, and COVID-19 prevalence among incarcerated persons in the US federal prison system. When staff rates are low or at zero, COVID-19 incidence in the larger community continues to have an association with COVID-19 prevalence among incarcerated persons, suggesting possible pre-symptomatic and asymptomatic transmission by staff. Masking policies slightly reduced COVID-19 prevalence among incarcerated persons, though the association between infections among staff, the community, and incarcerated persons remained significant and strong. CONCLUSION: The relationship between COVID-19 infections among staff and incarcerated persons shows that staff is vital to infection control, and correctional administrators should also focus infection containment efforts on staff, in addition to incarcerated persons.

Pushing them to the edge: Suicide in immigrant detention centers as a product of organizational failure.

In this paper, we argue that the U.S. immigrant apparatus is a racial project that jeopardizes immigrants' wellbeing through organizational failure (Omi and Winant, 2014; Meyer & Rowman, 1977; Mellahi and Wilkinson, 2004). We utilize Provine and Doty's (2011) work as a foundation to understand how this racial project is systemic and multifaceted in nature. It begins with the negative characterization and criminalization of certain immigrants, mostly Latinx, followed by a poor infrastructure of processing and detention riddled with impediments to their wellbeing, which ultimately pushes detainees to the edge, to poor mental health, and suicidality. ICE's system of detention consistently operates poorly and normalizes organizational failure, jeopardizing immigrant lives through basic human rights violations, family separation, substandard living conditions, and minimal consideration to poor mental health, suicide prevention, and prompt and adequate intervention. Utilizing qualitative data from ICE inspection reports, contracts, and detainee death reports, we examine suicide policies across 116 detention facilities in the United States to highlight how detention facilities supervised by ICE unsuccessfully prevents detainee suicide due to organizational failure. Under ICE's oversight, facilities are inadequately staffed and resourced, resulting in the failure to implement federally mandated protocols regarding detainees' well-being competently and promptly. Their organizational failure leads to unequal health outcomes for Latinxs who are overrepresented across immigrant detention.

The Effects of Various Weighted Implements on Baseball Swing Kinematics in Collegiate Baseball Players.

Williams, CC, Gdovin, JR, Wilson, SJ, Cazas-Moreno, VL, Eason, JD, Hoke, EL, Allen, CR, Wade, C, and Garner, JC. The effects of various weighted implements on baseball swing kinematics in collegiate baseball players. J Strength Cond Res 33(5): 1347-1353, 2019-The purpose of this study was to investigate the effects of different warm-up (WU) devices on bat swing parameters including maximal resultant velocity (MRV), resultant velocity at ball contact (RVBC), time difference between MRV and RVBC, bat angle at MRV, bat angle at RVBC, and perceptual differences of each WU implement used by National Collegiate Athletic Association Division-I baseball players. Fifteen varsity baseball players completed 1 experimental session during fall training. Retroreflective markers were placed on the bat and tee to measure basic bat kinematics during the swing. Participants completed a general calisthenics WU before being counter-balanced into 1 of 4 WU conditions: standard bat (SB) (33 in/30 oz), fungo (10.6 oz), weighted gloves with SB (weighted gloves) (55.6 oz) and donut with SB (donut) (55.6 oz). Each participant was asked to perform their normal on-deck routine over a 2-minute period, finishing with 5 practice swings with the designated condition. After completion of the WU, a 1-minute rest period (simulating normal game conditions) was given to allow each participant to get set to perform 5 maximal swings with a SB. Five, 1 × 4 (group × condition) repeated measures analysis of variance examined the aforementioned variables. There were no significant differences in MRV, RVBC, time difference between MRV and RVBC, and bat angle at MRV and RVBC between all WU conditions. If presented with the current options, athletes should choose the WU implement with which they are most comfortable using before an at-bat situation.

The Influence of an Acute Bout of Whole Body Vibration on Human Postural Control Responses.

The use of vibrating platforms has become increasingly available, and popular at sports and rehabilitation institutes. Given the discrepancies in the literature regarding whole body vibration (WBV) and human reflexive responses, the purpose of this study was to examine the acute effects of WBV on postural response latencies, as well as associated electromyography measures of the lower extremities during balance perturbations. Reflexive responses during backward and forward balance perturbations were examined before, after, and 10 min after a bout of WBV. The findings suggest that following an acute bout of whole body vibration, muscle activity of the lower extremities is decreased during a reflexive response to an unexpected perturbation, and may be associated with faster reaction time.