Promoting Disposal of Left-Over Opioids After Surgery in Rural Communities: A Qualitative Description Study

Background Patients rarely dispose of left-over opioids after surgery. Disposal serves as a primary prevention against misuse, overdose, and diversion. However, current interventions promoting disposal have mixed efficacy. Increasing disposal in rural communities could prevent or reduce the harms caused by prescription opioids. Aims Identify barriers and facilitators to disposal in the rural communities of the United States Mountain West region. Methods We conducted a qualitative description study with 30 participants from Arizona, Idaho, Montana, Nevada, Oregon, Utah, and Wyoming. We used a phronetic iterative approach combining inductive content and thematic analysis with deductive interpretation through the Precaution Adoption Process Model (PAPM). Results We identified four broad themes: (a) awareness, engagement, and education; (b) low perceived risk associated with nondisposal; (c) deciding to keep left-over opioids for future use; and (d) converting decisions into action. Most participants were aware of the importance of disposal but perceived the risks of nondisposal as low. Participants kept opioids for future use due to uncertainty about their recovery and future treatments, breakdowns in the patient–provider relationship, chronic illness or pain, or potential future injury. The rural context, particularly convenience, cost, and environmental contamination, contributes to decisional burden. Conclusions We identified PAPM stage-specific barriers to disposal of left-over opioids. Future interventions should account for where patients are along the spectrum of deciding to dispose or not dispose as well as promoting harm-reduction strategies for those who choose not to dispose.

Learning to Improve Program Systems While Navigating Program and Institutional Constraints

Many youth worker professional development (PD) efforts tend to focus on individualized skill development, rather than learning as a contextualized phenomenon that impacts youth workers’ everyday experiences in the field. Youth worker learning is fundamentally embedded in a broader ecosystem of programs, institutions, and systems that influence how they make sense of and implement their learnings. Examining institutionalized experiences and how they shape youth workers’ response to PD requires attention to the larger ecology of the contexts in which they work. In this paper, I analyze a PD initiative facilitated by a school district in the Rocky Mountain West. Data collected during the PD show that participating youth workers made changes to their program systems. At the same time, participants reported a range of institutional constraints that did not cohere with the PD. I bridge sensemaking theory to research on youth worker self-efficacy to unpack youth workers’ reaction to and implementation of the PD, and I discuss implications for youth worker PD. I propose that PD efforts could more closely attend to youth workers’ institutional contexts.

Finding Spaces: Teacher Education Technology Competencies (TETCs)

This article explores technology’s integration, assessment, and reflection within a single secondary education program at a Mountain West university. In light of the publication of the Teacher Education Technology Competencies (TETCs), faculty members of a secondary education program focused on existing practices and pathways for expansion to better align with the TETC standards in the future. The purpose of this study was to explore existing practices of incorporating technology into secondary methods coursework and to search for new spaces to implement the TETC guidelines and structure, as well as explore the roles faculty play in the adoption and implementation of technologies. Vignettes authored by faculty in each content area provide a rich depth of faculty experience and dispositions regarding technology integration, as well as spaces for the deeper use of technology based on the TETC recommendations. Key questions emerged about the efficacy of current technology practices, as well as the experiences and dispositions of the faculty within the secondary education program. Findings show that secondary education faculty use domain/content-specific technologies in their course; are expected to be “meta-experts”, both discovering and implementing technology simultaneously; and tend to discover technologies through content-specific interactions and discussions.

Disturbances-based plan of delineating protected area’s buffer zone: A case study in Masigit Kareumbi Mountain, West Java, Indonesia

Sumarga E, Swandhi I, Hairatunnisa, Susilowardani D, Nurrahman AY, Sadida A. 2021. Disturbances-based plan of delineating protected area’s buffer zone: A case study in Masigit Kareumbi Mountain, West Java, Indonesia. Biodiversitas 22: 5115-5122. The harmony between ecosystems and people, particularly those who live around and inside protected areas, is a key factor for the success of ecosystem protection. This subsequently will ensure the maintenance of ecosystem capacity in providing different types of services. Unfortunately, human activities are still commonly linked to different types of disturbances inside protected areas. This study aims to spatially analyze the anthropogenic disturbances inside a protected area, with a case study in Mount Masigit Kareumbi Protected Area, Indonesia. Two types of disturbances, which can be directly and indirectly related to human intervention, are analyzed, i.e., fires and encroachment for agricultural purposes. This study used Maximum Enthropy (MaxEnt) to analyze the risk of forest fire, while the encroachment was analyzed based on a combination of satellite image interpretation and direct field observation. Fire risk modeling performed well with a mean AUC of 0.98, estimating high fire risk (fire probability more than 0.5) distributed in about 109 ha area inside the Mount Masigit Kareumbi Protected Area. This study also identified about 428 ha of forest encroachment inside the protected area. This study further used the spatial information of the disturbances to determine the priority for selecting and designing areas for buffer zone development.

Risks Elaborated vs. Risks Downplayed: The Effect of Risk Comparisons in Mainstream Media During Covid-19 on Risk Perceptions and Anxiety Levels

This study examines the effects of risk comparisons in mainstream media during the Covid-19 outbreak that either expressed the severity of the outbreak or downplayed it by comparing the mortality rates of the disease to those of other risks. In an online experiment of undergraduate students at a large university in the U.S. Mountain West (n = 78) in early May 2020, we found that trust in government agencies played an important role in how people interpret risk messages in media. When the risks are amplified, those who hold low levels of trust in government agencies are more likely to report higher levels of anxiety. When risks are downplayed, people who hold high levels of trust in government agencies are more likely to report greater risk perceptions than those who hold low levels of trust in government agencies. The implications are discussed.

Hidradenitis Suppurativa Specialty Clinics in the USA

<b><i>Background:</i></b> Hidradenitis suppurativa (HS) is a complex disease that is optimally managed with specialized care. Data on HS specialty clinics (HSSCs) are lacking. <b><i>Methods:</i></b> HSSCs in the USA were identified on the HS Foundation website and analyzed for geographic location and clinic director demographics. <b><i>Results:</i></b> We identified 29 HSSCs in 16 states, an increase from 22 in 2019. Thirty-four states currently lack a HSSC; the Mountain West and East South Central regions of the USA are particularly affected. Among HSSC directors, the majority (93.3%) are dermatologists, with slightly more women (53.3%) than men (46.7%). Most (86.7%) have an academic affiliation, and the majority (60%) graduated from residency &#x3c;10 years ago. All directors are involved in research, and over half of HSSCs serve as HS clinical trial sites. <b><i>Conclusions:</i></b> The number of HSSCs in the USA has been growing, yet there remains a dearth in certain regions. Given that HS is a disease with high unmet need and a rapidly evolving therapeutic landscape, we encourage the establishment of more HSSCs to improve access to specialized care.

Transitioning a Marquee Orientation and Transition Program for Increased New Student Engagement and Retention Amidst the COVID-19 Pandemic

One mid-sized public flagship institution in the Mountain West was forced to abandon a brand-new marquee orientation and transition program, which had contributed to the first increase in first-time student retention numbers in a decade. As educators around the world were faced with similar challenges, three main concerns arose for this school: cancellation of all in-person instruction and events indefinitely in March 2020, a long-term downward trend in enrollment and retention, and a lack of adequate space to host in-person orientation activities. This paper seeks to discuss the ways in which these obstacles were overcome, and share the important lessons learned for consideration as colleges and universities continue to grapple with the uncertainty of onboarding our next cohort of students in fall 2021.

A Quantitative Comparison of Heavy Metal Concentrations in the Soils on Two Rocky Mountain West tribal Reservations

Native Americans have experienced a long history of environmental injustice, including natural resource exploitation and commercial activity with environmental impacts. A community-based participatory research (CBPR) approach was used to partner with two Rocky Mountain West reservations to conduct pilot-level assessments of potential soil contamination by heavy metals. The Community Advisory Board in conjunction with the research team selected residential areas and community sites for sampling. Samples were obtained, transported to a laboratory for dehydration and sieving, and were analyzed with a handheld X-ray fluorescence (XRF) tool for the presence of 24 heavy metals. Heavy metals concentrations were compared between reservations and were found to be statistically different from one another. Findings were also compared to levels recommended by the Environmental Protection Agency (EPA) and World Health Organization (WHO) to determine possible hazards to human health. Concentration of Sr, Rb, and Th were well above acceptable EPA levels and require further analysis. High localized Pb levels were found in one area, while Hg levels were found close to EPA standards. CBPR was essential to understanding preliminary contamination patterns. In conclusion, even reservations with similar geographies and histories present with unique contaminations and require individualized study to determine possible environmental mitigation.