The mediation and moderation effect of social support on the relationship between opioid misuse and suicide attempts among native American youth in New Mexico: 2009-2019 Youth Risk Resiliency Survey (NM-YRRS).

BACKGROUND: Suicide attempt and opioid misuse continue to be major behavioral health challenges among American Indians and Alaska Natives (AI/AN). The aim of the study is to evaluate the mediating and moderating role that social support (SS) plays in their association among AI/AN high-school students in New Mexico (NM). METHODS: An aggregated NM Youth Resiliency and Risk Survey (NM-YRRS, 2009-2019: odd years) dataset was used. Multivariable logistic regression modeling and mediation analysis were conducted while adjusting for confounding variables. RESULTS: Overall, 12.0 and 14.0% of AI/AN students reported opioid misuse and suicide attempt, respectively. The adjusted odds ratio of suicide attempt in students with high SS relative to low SS who misused opioids was 0.43 (p-value = 0.007). The effect of high SS relative to low SS among males who misused opioids was more pronounced (AOR = 0.24, p-value < 0.0001) compared to females (AOR = 0.43, p-value = 0.007). Relative to low SS, high SS was protective for suicide attempt among AI/AN students who misused opioids and attended school in off-reservation (AOR = 0.42, p-value = 0.012) communities, rural communities (AOR = 0.44, p = 0.040), and in communities that are both rural and off-reservation (AOR = 0.39, p = 0.035). Overall, 23.64, and 41.05% of the association between opioid misuse, and suicide attempt was mediated and moderated by SS, respectively. The mediation effect of SS was lowest for rural, on-reservation schools. CONCLUSION: More resources need to be allocated to rural on-reservation schools to enhance social support. The study highlights key insights into the significant role SS plays in promoting health and mitigating the association between opioid misuse and suicide attempt.

Indoor Air Quality Issues for Rocky Mountain West Tribes.

Native American populations face considerable health disparities, especially among those who live on reservations, where access to healthcare, education, and safe housing can be limited. Previous research on tribal housing has raised concerns about housing construction, damage, and possible linkage to adverse health effects (e.g., asthma). This community-based participatory research (CBPR) project investigated indoor air quality issues on two Rocky Mountain west reservations. At the onset of the project, the research team formed a partnership with community advisory boards (CABs) consisting of representatives from tribal councils and community members. Research design, implementation, and dissemination all took place in full collaboration with the CABs following approval through official tribal resolutions. Residential homes were monitored for particulate matter with diameter <2.5 microns (PM2.5) and radon concentrations. Low-cost air quality sensors and activated charcoal radon test kits were placed in tribal households for 6-8 days. A large amount of data were below the sensor limit of quantification (LOQ), but several homes had daily averages that exceeded suggested PM2.5 guidelines, suggestive of the potential for high exposure. Additionally, nearly half of all homes sampled had radon levels above the EPA action level, with mitigation activities initiated for the most concerning homes. Findings from this study indicate the need for future community-wide assessments to determine the magnitude and patterns of indoor air quality issues.

Evaluation of a 25-mm disposable sampler relative to the inhalable aerosol convention.

An ideal inhalable aerosol sampler for occupational exposure monitoring would have a sampling efficiency that perfectly matches the inhalable particulate matter (IPM) criterion. Two common aerosol samplers in use worldwide are the closed-face cassette (CFC) and the Institute of Occupational Medicine (IOM) sampler. However, the CFC is known to under-sample, with near zero sampling efficiency for particles >30 µm, whereas the IOM, considered by many to be the "gold standard" in inhalable samplers, has been shown to over-sample particles >60 µm. A new sampler in development incorporates characteristics of both the CFC and the IOM. Like the CFC, it would be disposable, have a simple design, and is intended to be oriented at a 45° downward angle. Like the IOM, the new sampler has a 15-mm inlet diameter and incorporates a 25-mm filter cassette with a protruding lip. The IOM is oriented at 0° to the horizontal, so it is hypothesized that orienting the new sampler at ∼45° downward angle will reduce oversampling of larger particles. In comparison, the CFC's inlet diameter is 4 mm; increasing the size of the inlet should allow the new sampler to have an increased efficiency relative to the CFC for all particles. A unique characteristic of the new sampler is the incorporation of a one-piece capsule-style filter that mimics the IOM's cassette but is made of disposable material. Seven different sizes of alumina particles (mean aerodynamic diameters from 4.9-62.4 µm) were tested (total = 124 samples collected). For each test, six samplers were placed on a manikin located inside a wind tunnel operated at 0.2 m/sec. Results indicated that the new sampler improved on the CFC for smaller particles, providing a larger range for which it matches the IPM criterion, up to 44.3 µm. However, the efficiency was significantly lower in comparison to the IPM criterion for particle sizes above 60 µm. Overall, the new sampler showed promise, but additional modifications may help improve sampling efficiency for larger particles.

Assessment of increased sampling pump flow rates in a disposable, inhalable aerosol sampler.

A newly designed, low-cost, disposable inhalable aerosol sampler was developed to assess workers personal exposure to inhalable particles. This sampler was originally designed to operate at 10 L/min to increase sample mass and, therefore, improve analytical detection limits for filter-based methods. Computational fluid dynamics modeling revealed that sampler performance (relative to aerosol inhalability criteria) would not differ substantially at sampler flows of 2 and 10 L/min. With this in mind, the newly designed inhalable aerosol sampler was tested in a wind tunnel, simultaneously, at flows of 2 and 10 L/min flow. A mannequin was equipped with 6 sampler/pump assemblies (three pumps operated at 2 L/min and three pumps at 10 L/min) inside a wind tunnel, operated at 0.2 m/s, which has been shown to be a typical indoor workplace wind speed. In separate tests, four different particle sizes were injected to determine if the sampler's performance with the new 10 L/min flow rate significantly differed to that at 2 L/min. A comparison between inhalable mass concentrations using a Wilcoxon signed rank test found no significant difference in the concentration of particles sampled at 10 and 2 L/min for all particle sizes tested. Our results suggest that this new aerosol sampler is a versatile tool that can improve exposure assessment capabilities for the practicing industrial hygienist by improving the limit of detection and allowing for shorting sampling times.