Metagenomics-Guided Assessment of Water Quality and Predicting Pathogenic Load

Antibiotic-resistant bacteria (ARB) are becoming more prevalent in the environment and are efficiently disseminating through contaminated wastewater resulting in resistome cycling. This chapter compares the bacterial profile of hospital effluents collected from rural, urban, and delta regions of West Bengal, India. Comparative metagenomics analysis identified pathogenic bacterial genera like pseudomonas, escherichia, staphylococcus, lactobacillus, prevotella, acinetobacter across the samples. Delta sample showed highest abundance of pseudomonas whereas rural sample had lower titre of all the common bacterial genera. Urban sample reflected more diversity of different genera in terms of abundance. Pathogenic load prediction revealed significant occurrence of diarrhea, irritable bowel syndrome, liver cirrhosis, ulcerative colitis in the disease network. This chapter proposes a monitoring programme for assessing wastewater health using a combination of culture independent and culture-dependent molecular techniques in order to prevent the spread of pollutants in tropical environments.

Evaluation of the Brief Multidimensional Students’ Life Satisfaction Scale in a Diverse Sample of Rural Early Adolescents

Although life satisfaction has been associated with maladjustment and adverse experiences among adolescents, few validated measures of life satisfaction have been evaluated for use with diverse populations. The Brief Multidimensional Students’ Life Satisfaction Scale (BMSLSS) is a promising measure that has been validated in samples of White and Black adolescents. This study used an item response theory approach to evaluate its psychometric properties in a diverse rural sample of early adolescents and its concurrent associations with other measures of youth adjustment. Support was found for partial invariance across sex and racial and ethnic identities. Scores on the BMSLSS were also correlated with measures of youth adjustment. However, the strength of these correlations differed for adolescents of different racial and ethnic identities. Findings suggest that the BMSLSS is a psychometrically sound measure for assessing life satisfaction in diverse samples of adolescents and highlights the importance of assessing invariance across racial and ethnic groups.

Abstract 16350: Predicted versus Observed 10-year Cardiovascular Event Rates in a Rural Population-Based Health Program: The Heart of New Ulm Project

Introduction: Assessment of 10-year ASCVD risk via the Pooled Cohorts Equation (PCE) is a standard component of the clinician-patient risk discussion to aid treatment decisions for the primary prevention of ASCVD. However, calibration of the PCE to modern populations remains a concern. Methods: We studied a sample of individuals participating in the Heart of New Ulm (HONU) Project, a population-based health program aimed at reducing ASCVD risk in a rural, agricultural community of New Ulm, Minnesota. HONU collected baseline survey data on 5,221 individuals in 2009. For this analysis, we included participants who were aged 40-79 years, free of ASCVD at baseline and had adequate data to calculate 10-year ASCVD risk. New Ulm is served by a single healthcare system, allowing surveillance via electronic health records (EHR). EHR data and state death records were used to determine rates of non-fatal myocardial infarction and stroke, and ASCVD death from 2010-2019. ASCVD event rates were compared to estimated 10-year risks calculated using the PCE, and stratified by sex and clinically relevant risk categories. Results: The sample (n=2,819, mean age 56.1 ± 9.9 years, 59.6% female) had a low prevalence of tobacco use (8.1% current smokers), diabetes (6.5%) and higher prevalence of hypertension (44.4%) and hyperlipidemia (56.6%). The median estimated 10-year ASCVD risk for the entire sample was 5.7% (interquartile range 2.3 -13.5%) with an observed 10-year ASCVD event rate of 3.4%. ASCVD rates were lower than predicted across all risk categories in both men and women, especially in those with a 10-year risk ≥7.5% (Table). Conclusion: In a rural sample exposed to ASCVD risk reduction efforts, observed rates of ASCVD were substantially lower compared to estimated ASCVD risk. The uncertainty of current risk models and the potential for significantly lower than predicted ASCVD event rates in certain populations should be included in the clinician-patient risk discussion.

Profiling Malnutrition Prevalence among Australian Rural In-Patients Using a Retrospective Census of Electronic Medical Files over a 12-Month Period

In-patient malnutrition leads to poor outcomes and mortality, and it is largely uninvestigated in non-urban populations. This study sought to: (1) retrospectively estimate the prevalence of malnutrition as diagnosed by dietetics in the rural Australian setting; (2) establish the proportion of all patients at “nutritional risk”; and (3) explore associations between demographic and clinical factors with malnutrition diagnosis and nutritional risk. A retrospective census was undertaken of medical files of all patients aged ≥18 years admitted to a rural hospital setting over a 12-month period. Logistic regression was used to explore associations between malnutrition diagnosis, nutritional risk and patient-related factors. In total, 711 admissions were screened during the 12-month period comprising 567 patients. Among the 125 patients seen by dietitians, 70.4% were diagnosed with malnutrition. Across the total sample, 77.0% had high levels of nutrition related symptoms warranting a need for further assessment by dietitians. Malnutrition diagnosis by dietitians was associated with being over the age of 65 years, and patients had higher odds of being admitted to a residential aged care facility following discharge. In this rural sample, the diagnosis rate of malnutrition appeared to be high, indicating that rural in-patients may be at a high risk of malnutrition. There was also a high proportion of patients who had documentation in their files that indicated they may have benefited from dietetic assessment and intervention, beyond current resourcing.

Behavioral Health Needs, Barriers, and Parent Preferences in Rural Pediatric Primary Care

Objective The goal of this study was to examine modifiable factors related to health disparities by exploring the role of predisposing, need, and enabling characteristics on mental/behavioral health treatment-seeking behaviors in a rural sample. Parental treatment preferences and knowledge about treatment options were also examined. Methods One hundred eighteen parents completed questionnaires assessing demographics, child prior psychological treatment, child psychological symptoms, barriers to care, mental health stigma, and willingness to seek services across settings. Questions also assessed preferences for treatment, awareness of behavioral/mental health services, and knowledge of community treatment options. Results Prior treatment use and stigma significantly predicted willingness to seek services in a doctor’s office after controlling for predisposing (demographic) and need characteristics (psychological symptoms). Symptom severity and barriers significantly differentiated between parents who previously sought treatment or reported an unmet treatment need from those who reported no prior treatment and no treatment need. Families overwhelmingly (94%) reported a preference for individual versus group treatment, and up to 10 sessions were most commonly reported (38%) as the ideal number of sessions. Forty percent of respondents reported no knowledge of treatment options in their community. Conclusions These results highlight the role of enabling characteristics (i.e., stigma, barriers to care, psychological symptoms) and prior service use in understanding parental treatment seeking in a rural sample. Overall, these results support integrated behavioral health in rural settings. Understanding modifiable factors and parent treatment preferences and knowledge may be important to increase access to services and reduce health disparities in rural areas. Future research directions are discussed.

Environmental Satisfaction, Residential Satisfaction, and Place Attachment: The Cases of Long-Term Residents in Rural and Urban Areas in China

Drawing on literature from environmental psychology and urban planning, this study evaluates the relationships between environmental satisfaction, residential satisfaction, and place attachment in the context of both rural and urban areas in China. A field survey was carried out with 490 valid questionnaires collected in rural areas and 420 from urban areas in China. Partial least squares path modeling was applied for testing the relationships between the three main constructs. The results indicate a significant mediating role of residential satisfaction between environmental satisfaction and place attachment, suggesting the importance of residential satisfaction in residents’ attachment-building to place. This study also found significant differences between rural and urban contexts with the mediating effect of residential satisfaction being absent from the rural sample.