A Scoping Review of Trends in the Size of Lesbian, Gay, and Bisexual Tobacco Use Disparities, 1996-2020, United States and Canada.

Purpose: Tobacco use is a major health disparity for lesbian, gay, bisexual, and transgender (LGBT) populations compared with heterosexual/cisgender populations. In this scoping review, we aimed to determine if LGBT tobacco use disparities are improving or worsening over time and if trends in disparities differed across subgroups. Methods: We included articles that longitudinally explored youth and adult LGB tobacco use in the United States and Canada after searching four databases and capturing records through July 2022. Two reviewers independently screened the title/abstract and full text of 2326 and 45 articles, respectively. Eleven articles from 18 larger assessments met inclusion criteria, spanning data collection from 1996 to 2020. Results: All studies consistently demonstrated tobacco disparities for LGB populations. No articles examined longitudinal transgender tobacco disparities. Most studies focused on smoking combustible cigarettes. Disparities in heavy or daily use for all LGB youth subgroups compared with heterosexual samples appear to be shrinking longitudinally. Results for early-onset, current, and lifetime smoking were less consistent. Adult evidence was relatively sparse; however, after 2010, studies show diminishing disparities over time, except for current smoking by bisexual women. Conclusions: Large tobacco use disparities persist for LGB populations, although the size of disparities may be decreasing for some groups. Initiatives for lesbian and bisexual women and girls should be prioritized, in addition to interventions addressing LGB smoking broadly. Surveillance instruments should uniformly and consistently assess LGBT identities and tobacco use behaviors.

Self-Reported Intake and Circulating EPA and DHA Concentrations in US Pregnant Women.

In the United States, pregnant women have low concentrations of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are essential for fetal development. Although maternal blood provides accurate polyunsaturated fatty acid (PUFA) concentrations, venipuncture is expensive and not always accessible. PUFA-containing foods consumption, both omega-3 ad omega-6 is supposed to reflect in the status (plasma, RBC, adipose tissue) of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). De novo synthesis of DHA and EPA during pregnancy is supposed to be higher compared to pre and/or post-pregnancy periods. Thus, this study aimed to determine the association between maternal self-reported dietary intake of foods high in DHA and EPA, along with vegetable oils as a source of omega-6 fatty acids, with maternal blood DHA and EPA concentrations. Pregnant women (13-16 weeks gestation) were recruited and asked to complete a food-frequency questionnaire (FFQ) and blood draw at enrollment and 36 weeks. Circulating concentrations of DHA and EPA were quantified and change scores were calculated. Correlations were done to determine associations between FFQ results and EPA/DHA maternal blood concentrations. Regression analyses were run to examine significant predictors of the main outcomes. Overall, PUFA-food consumption and RBC's DHA levels decreased from early to late pregnancy; self-reported PUFA-rich food consumption positively correlated with DHA and EPA levels. DHA concentration was predicted by self-reported PUFA-rich oils (sunflower/soy/corn/olive) consumption, but EPA concentration was predicted by maternal BMI. These findings suggest that EPA and DHA consumption decreased across pregnancy and the FFQ can be utilized as an effective method for estimating PUFA blood concentration during pregnancy.

Family Formation History and the Psychological Well-Being of Women from Diverse Racial-Ethnic Groups.

Studying disparities in psychological well-being across diverse groups of women can illuminate the racialized health risks of gendered family life. Integrating life course and demand-reward perspectives, this study applied sequencing techniques to the National Longitudinal Study of Youth: 1979 to reveal seven trajectories of partnership and parenthood through women's 20s and 30s, including several in which parenthood followed partnership at different ages and with varying numbers of children and others characterized by nonmarital fertility or eschewing such roles altogether. These sequences differentiated positive and negative dimensions of women's well-being in their 50s. Women who inhabited any family role had greater life satisfaction and fewer depressive symptoms, although these general patterns differed by race-ethnicity. Family roles were more closely related to well-being than ill-being for White women, parenthood had more pronounced importance across outcomes for Black women, and the coupling of partnership and parenthood generally mattered more for Latinas.

Influence of exercise type on maternal blood pressure adaptation throughout pregnancy.

BACKGROUND: It has been reported that 10% of all pregnancies are complicated by a hypertensive disorder of pregnancy. Previous research has shown that moderate-vigorous intensity exercise has a positive effect on maternal resting blood pressure. A research gap, however, exists related to how different types of exercise (resistance, aerobic, combined resistance and aerobic) affect maternal blood pressure. Most of the previous studies solely focused on aerobic exercise. OBJECTIVE: The aim of this study was to examine the effects of exercise types on maternal blood pressure throughout pregnancy. STUDY DESIGN: This study employed a secondary analysis using data from a randomized controlled prenatal exercise intervention trial. This study utilized 3 exercise intervention groups (aerobic, resistance, combination) and compared the results with those of a nonexercize control group. Participants completed 3 50-minute sessions weekly from 16 weeks of gestation until delivery. Maternal vital signs and physical measurements such as systolic blood pressure, diastolic blood pressure, and heart rate were measured every 4 weeks throughout the intervention period. Between-group mean differences in maternal measurements were assessed using Pearson's chi-square tests for continuous (age, prepregnancy body mass index, heart rate, systolic blood pressure, diastolic blood pressure, pulse pressure) variables. For gravida, exact Wilcox 2-sample tests were performed to determine between-group differences in mean values. Hierarchical linear growth curves were used to estimate maternal trajectories of systolic blood pressure and diastolic blood pressure from 16 weeks to 36 weeks' gestation in each of the 4 groups (aerobic, combination, control, and resistance). RESULTS: There were no differences among the groups in maternal age or prepregnancy body mass index. Controlling for maternal body mass index, the lowest significant systolic blood pressure curve was noted throughout the pregnancy for women who participated in resistance exercise, followed by women in the aerobic exercise group all relative to the no exercise control group. At 36 weeks' gestation, the systolic blood pressure was lower in the resistance group by 12.17 mm Hg (P<.001) and in the aerobic group by 7.90 mm Hg (P<.001) relative to controls. No significant change in systolic blood pressure was noted in the combination group in comparison with controls at 36 weeks' gestation. Similarly, we demonstrated a significantly lower linear growth curve in diastolic blood pressure that was maintained throughout pregnancy in any exercise type relative to controls. After controlling for maternal body mass index, all 3 exercise types (combination, resistance, and aerobic) significantly predicted a similar decrease in diastolic blood pressure that was maintained throughout pregnancy. At 36 weeks' gestation, the diastolic blood pressure was lower in the aerobic group by 7.30 mm Hg (P<.01), in the combination group by 6.43 mm Hg (P<.05), and in the resistance group relative to controls. CONCLUSION: Overall, all exercise types were beneficial in lowering maternal resting blood pressure throughout pregnancy. Resistance training was noted to be the most beneficial in improving systolic blood pressure, followed by aerobic exercise. All 3 exercise groups were noted to improve diastolic blood pressure equally. Further research needs to be done to determine if either resistance or aerobic exercise throughout pregnancy decreases the risk for hypertensive disorders of pregnancy and the associated morbidity and mortality.

Rates and correlates of medicine disposal program implementation at pharmacies in North Carolina: A longitudinal study, 2016-2021.

BACKGROUND: Unused prescription opioids from family and friends continue to be the primary access point to prescription opioids for nonmedical use among youth. Implementation of medicine disposal boxes at pharmacies is one approach to facilitate removal of unused prescription opioids from the home to prevent diversion. OBJECTIVES: We sought to examine the implementation rates of disposal boxes at pharmacies in North Carolina from 2016 to 2021 and place-based health disparities in availability. METHODS: We identified pharmacies with a disposal box in 2016, 2018, and 2021 among licensed pharmacies in North Carolina in 2018 (N = 2587). We computed descriptive statistics to describe disposal box implementation rates over time and used geographic information systems to identify spatial trends. We used separate logistic regression models in 2018 and 2021 to assess the relationship between neighborhood characteristics and the likelihood of a pharmacy implementing a disposal box. RESULTS: We found an increase in disposal boxes over time with 43 pharmacies (1.7%) in 2016, 144 (5.6%) in 2018, and 350 (13.5%) in 2021 implementing a disposal box. In 2018, independent pharmacies were more likely than chains to have a disposal box. In 2021, medical-affiliated and pharmacies defined as "other" were less likely than chains to have a disposal box. In both 2018 and 2021, pharmacies in census tracts with a higher percentage of the population below the federal poverty line were more likely to have a disposal box. In 2021, pharmacies in tracts with a higher percentage of the population unemployed were less likely to have a disposal box. In 2018, pharmacies located in counties with a greater number of opioid overdose deaths were more likely to have a disposal box. CONCLUSION: Our findings highlight the growth of disposal boxes in North Carolina over time and the potential for continued expansion to provide opportunities to prevent prescription opioid diversion.

Two Methods for Studying the Developmental Significance of Family Structure Trajectories.

Objective: The objective of this research note is to use both sequence analysis (SA) and repeated-measures latent class analysis (LCA) to identify children's family structure trajectories from birth through age 15 and compare how the two sets of trajectories predict alcohol use across the transition from adolescence into young adulthood. Background: Contemporary family scholars have studied the influence of changes in family structure, often referred to as family structure instability, on child and adolescent development. Typically, this research has focused on either the number or type of transitions children have experienced, but statistical advances are increasing the viability of more complex person-centered approaches to this issue, such as SA and LCA. The choice to use one approach or the other, however, is often discipline specific and relies on different assumptions and estimation techniques that may produce different results. Method: The authors used data from the National Longitudinal Study of Youth-Child and Youth Cohort (N = 11,515) to identify clusters (using SA) and classes (using repeated-measures LCA) that represented children's family structure trajectories from birth through age 15. Using two multiple-group random slope models, the authors predicted alcohol use across adolescence and young adulthood (ages 16-24) among the clusters (Model 1) and classes (Model 2). Results: The SA identified five clusters, but the LCA further differentiated the sample with more detail on timing and identified eight classes. The sensitivity to timing in the LCA solution was substantively relevant to alcohol use across the transition to young adulthood. Conclusion: Overall, the SA is perhaps more suited to research questions requiring exclusive group membership in large, comparative analyses, and the LCA more appropriate when the research questions include timing or focus on transitioning into or out of single-parent and stepfamily homes.

Family structure patterns from childhood through adolescence and the timing of cohabitation among diverse groups of young adult women and men.

Family structure changes experienced by children are likely to shape their transitions into young adulthood, including the formation of their own romantic relationships. This study examined links between children's family structure trajectories from childhood through adolescence and their timing of entry into cohabitation as young adults, a transition with implications for future relationship instability through adulthood. Repeated measures latent class analysis identified configurations of family structures and family structure changes from birth through age 15 among 10,706 young people in the National Longitudinal Survey of Youth, 1979 Children and Young Adults. A Cox proportional hazard model then used the resulting classes to predict timing into cohabitation over the period from age 15 to age 38. Both timing of family structure transitions and the type of transitions (e.g., early transitioning into a stepfamily home) were associated with earlier entry into cohabitation. Notably, links between family structure trajectories and the timing of cohabitation differed by gender and race/ethnicity (Latinx, African American, White), such as a faster entry into cohabitation by women who experienced early entry into stepfamily structures. Regardless of gender, Latinx and White young adults were faster to enter into cohabitation if they lived in a stepfamily structure during early childhood. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A unifying approach for evaluating the condition of wetland plant communities and identifying related stressors.

Assessment of vegetation is an important part of evaluating wetland condition, but it is complicated by the variety of plant communities that are naturally present in freshwater wetlands. We present an approach to evaluate wetland condition consisting of: (1) a stratified random sample representing the entire range of anthropogenic stress, (2) field data representing a range of water depths within the wetlands sampled, (3) nonmetric multidimensional scaling (MDS) to determine a biological condition gradient across the wetlands sampled, (4) hierarchical clustering to interpret the condition results relative to recognizable plant communities, (5) classification and regression tree (CART) analysis to relate biological condition to natural and anthropogenic environmental drivers, and (6) mapping the results to display their geographic distribution. We applied this approach to plant species data collected at 90 wetlands of the U.S. Great Lakes coast that support a variety of plant communities, reflecting the diverse physical environment and anthropogenic stressors present within the region. Hierarchical cluster analysis yielded eight plant communities at a minimum similarity of 25%. Wetlands that clustered botanically were often geographically clustered as well, even though location was not an input variable in the analysis. The eight vegetation clusters corresponded well with the MDS configuration of the data, in which the first axis was strongly related (R2 = 0.787, P < 0.001) with floristic quality index (FQI) and the second axis was related to the Great Lake of occurrence. CART models using FQI and the first MDS axis as the response variables explained 75% and 82% of the variance in the data, resulting in 6-7 terminal groups spanning the condition gradient. Initial CART splits divided the region based on growing degree-days and cumulative anthropogenic stress; only after making these broad divisions were wetlands distinguished by more local characteristics. Agricultural and urban development variables were important correlates of wetland biological condition, generating optimal or surrogate splits at every split node of the MDS CART model. Our findings provide a means of using vegetation to evaluate a range of wetland condition across a broad and diverse geographic region.

Watershed discharge modulates relationships between landscape components and nutrient ratios in stream seston.

In order to understand the environmental controls of the elemental composition of suspended particles in streams and rivers, we examined relationships between the stoichiometry of suspended particles and catchment characteristics (e.g., topography and land cover) under contrasting hydrological conditions in streams from the Upper Peninsula of Michigan, USA. Particulate C:N, N:P, and C:P ratios varied considerably among streams on each of 10 separate sampling dates and within most streams through time. When averaged across the study period by stream, particulate C:N:P ratios were strongly related to several catchment properties. For example, particulate C:P and N:P ratios were negatively related to the percentage of catchment used for agriculture but positively related to the percentage of catchment found as wetlands. These relationships reflected, in part, variable concentrations of mineral particles, which were strongly related to stream length, agriculture, and upstream lake area. In addition, the strength of the relationships between particulate elemental composition and catchment properties changed depending upon hydrologic condition of the Ontonagon watershed. For example, periods of wetness, as indicated by high river discharge, were found to increase the strength of seston C:N ratio-percentage of wetlands relationships but to reduce the strength of seston C:P ratios-percentage of wetlands relationships. Our results thus demonstrate that the balance of elements fluxing through forested streams is strongly affected by catchment properties but that these effects are sensitive to watershed discharge. At times of high discharge, there are strong connections to catchment sources while in-stream processes appear to predominate at time of low discharge.

Partitioning vegetation response to anthropogenic stress to develop multi-taxa wetland indicators.

Emergent plants can be suitable indicators of anthropogenic stress in coastal wetlands if their responses to natural environmental variation can be parsed from their responses to human activities in and around wetlands. We used hierarchical partitioning to evaluate the independent influence of geomorphology, geography, and anthropogenic stress on common wetland plants of the U.S. Great Lakes coast and developed multi-taxa models indicating wetland condition. A seven-taxon model predicted condition relative to watershed-derived anthropogenic stress, and a four-taxon model predicted condition relative to within-wetland anthropogenic stressors that modified hydrology. The Great Lake on which the wetlands occurred explained an average of about half the variation in species cover, and subdividing the data by lake allowed us to remove that source of variation. We developed lake-specific multi-taxa models for all of the Great Lakes except Lake Ontario, which had no plant species with significant independent effects of anthropogenic stress. Plant responses were both positive (increasing cover with stress) and negative (decreasing cover with stress), and plant taxa incorporated into the lake-specific models differed by Great Lake. The resulting models require information on only a few taxa, rather than all plant species within a wetland, making them easier to implement than existing indicators.

Wetland types and wetland maps differ in ability to predict dissolved organic carbon concentrations in streams.

Three categories of digital wetland maps widely available in the United States were used to develop models relating wetlands to DOC: (1) wetlands mapped by the U.S. National Wetlands Inventory (NWI) (2) wetland vegetation cover mapped by the U.S. National Land Cover Dataset (NLCD), and (3) maps of hydric soils. Data extracted from these maps for 27 headwater catchments of the Ontonagon River in northern Michigan, USA were used with DOC concentrations measured in catchment streams to develop stepwise multiple regressions based on wetland area and type. The catchments of the 27 tributaries ranged in area from 2 to 66 km(2) and wetlands constituted 10 to 53% of their area. Although all three databases provided regressions that were highly significant (p<0.001), the variance explained was greater for NWI maps (R(2)=0.75) than for NLCD (R(2)=0.61) or soil maps (R(2)=0.60). Wetland-stream relationships were strongest during September 2002, but were significant for nine out of ten dates sampled during subsequent seasons. The individual wetland type most highly correlated (r>0.62) with stream DOC concentrations was conifer peatland, represented on the NWI maps as Palustrine Needle-leaved Forest, the NLCD maps as woody wetland, and the soil maps as organic soils. For the NWI dataset, DOC was negatively correlated with area of palustrine emergent wetlands (i.e., sedge meadows and graminoid fens) and bog shrubs, inferring that these wetland types may be sinks for DOC. Because of the different effects of wetland vegetation types on DOC, a GIS data source such as the NWI which depicts those wetland types is superior for predicting landscape contributions to stream DOC concentrations.

Integrated measures of anthropogenic stress in the U.S. Great lakes basin.

Integrated, quantitative expressions of anthropogenic stress over large geographic regions can be valuable tools in environmental research and management. Despite the fundamental appeal of a regional approach, development of regional stress measures remains one of the most important current challenges in environmental science. Using publicly available, pre-existing spatial datasets, we developed a geographic information system database of 86 variables related to five classes of anthropogenic stress in the U.S. Great Lakes basin: agriculture, atmospheric deposition, human population, land cover, and point source pollution. The original variables were quantified by a variety of data types over a broad range of spatial and classification resolutions. We summarized the original data for 762 watershed-based units that comprise the U.S. portion of the basin and then used principal components analysis to develop overall stress measures within each stress category. We developed a cumulative stress index by combining the first principal component from each of the five stress categories. Maps of the stress measures illustrate strong spatial patterns across the basin, with the greatest amount of stress occurring on the western shore of Lake Michigan, southwest Lake Erie, and southeastern Lake Ontario. We found strong relationships between the stress measures and characteristics of bird communities, fish communities, and water chemistry measurements from the coastal region. The stress measures are taken to represent the major threats to coastal ecosystems in the U.S. Great Lakes. Such regional-scale efforts are critical for understanding relationships between human disturbance and ecosystem response, and can be used to guide environmental decision-making at both regional and local scales.

Environmentally stratified sampling design for the development of Great Lakes environmental indicators.

Understanding the relationship between human disturbance and ecological response is essential to the process of indicator development. For large-scale observational studies, sites should be selected across gradients of anthropogenic stress, but such gradients are often unknown for apopulation of sites prior to site selection. Stress data available from public sources can be used in a geographic information system (GIS) to partially characterize environmental conditions for large geographic areas without visiting the sites. We divided the U.S. Great Lakes coastal region into 762 units consisting of a shoreline reach and drainage-shed and then summarized over 200 environmental variables in seven categories for the units using a GIS. Redundancy within the categories of environmental variables was reduced using principal components analysis. Environmental strata were generated from cluster analysis using principal component scores as input. To protect against site selection bias, sites were selected in random order from clusters. The site selection process allowed us to exclude sites that were inaccessible and was shown to successfully distribute sites across the range of environmental variation in our GIS data. This design has broad applicability when the goal is to develop ecological indicators using observational data from large-scale surveys.

Material Fluxes Across Wetland Ecotones in Northern Landscapes.

The spatial and temporal distribution of sediment, nutrients, and cations in a 2-ha wetland near Shawano, Wisconsin (USA) was used to evaluate the effect of wetland ecotones on water- and windborne fluxes at ecosystem and landscape scales. Within the wetland ecosystem the ecotones studied were beach ridges deposited by post-glacial White Clay Lake, and stream levees deposited by a second-order stream flowing through the wetland. Snow, soil, and surface water data collected from a 52-point sampling grid were geostatistically analyzed to derive contour plots of within-wetland concentrations. Wind-blown snow form the frozen lake surface accumulated in the wetland behind a low beach ridge to a depth of >65 cm, nearly 7 times the depth at wind-protected areas of the wetland. As a result of this snow accumulation, areas to the lee of the beach ridge annually received 10% more water and 1.5% more inorganic N from direct precipitation than did other areas of the watershed. The use of geostatistical plots to analyze wetland surface waters revealed that: (1) within-wetland spatial variability was high on every sampling date except early snowmelt; (2) on a given sampling date, concentration patterns differed for different elements, sometimes substantially; (3) with the exception of NO3 -N, the spatial patterns for a given material changed considerably over time; and (4) many of these spatial patterns were interpretable on the basis of observed water flow patterns and wetland ecology. In general, there was a decrease in the concentrations of inorganic solids and most ions, and an increase in Ca++ and chemical oxygen demand with distance from the stream. Overbank fluxes contributed P to the wetland during spring and fall floods, but diluted ambient P concentrations during snowmelt events. During snow-free periods there was a sharp gradient in NO3 -N concentrations from a streamside value of °5 mg/L to <0.4 mg/L in wetland areas >45 m from the stream. Measurement of the concentration gradient perpendicular to the stream indicated NO3 -N disappearance rates of 6.6 g/100 m of distance during the spring flood. Soil concentrations of mineral matter and P were highest in areas of the wetland closest to the stream; soil concentrations of ammonium and nitrate were spatially disaggregated, and related to levee elevation. At the watershed scale the wetland retained and/or denitrified 15.2% of the total solids, 13.7% of the N, and 14.2% of the P fluxes from the watershed, thus benefitting the water quality of White Clay Lake.