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    A Scoping Review to Explore the Potential Benefits of Nutrition Interventions for Latino/a Adult Cancer Survivors in the US
    (Multidisciplinary Digital Publishing Institute, 2023-11) Johnson, Cassandra M.; Stubblefield, Emily; Godinich, Brandon M.; Walker, Miranda; Salcedo Price, Ramona; Allicock, Marlyn A.
    Despite evidence for the role of healthy diets in preventing cancer, little is known about how nutrition can support positive health outcomes after a cancer diagnosis for Latino/a cancer survivors in the United States (U.S.). The purpose of this scoping review is to understand the potential benefits of nutrition interventions in supporting healthy survivorship among Latino/a cancer survivors in the U.S. A team compiled, evaluated, and summarized the available evidence. Potentially relevant studies were identified from a comprehensive search of peer-reviewed databases and the gray literature. Eligible studies included Latino/a adult cancer survivors with a nutrition education, dietary change, or behavioral intervention; and a nutrition-related health outcome. Data were extracted and summarized using tables. The review included 10 randomized controlled trials, with samples or subsamples of Latino/a cancer survivors. Interventions mostly focused on breast cancer survivors. The results showed some evidence that dietary behaviors, like fruit and vegetable intake, were related to positive outcomes, like a decreased risk of cancer (through changes in DNA methylation), decreased risk breast cancer recurrence (through changes in inflammatory biomarkers), or improved perception of health status. The findings highlight a need for community-engaged and culturally relevant nutrition interventions for Latino/a adults, especially for rural communities; and innovative intervention approaches, including m/ehealth approaches with long-term follow-up.
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    Nutrition Effects of a Family-Centered Health Promotion Program for Mexican-Heritage Children in the Lower Rio Grande Valley of Texas
    (Multidisciplinary Digital Publishing Institute, 2023-03) Laviolette, Chelsey; Johnson, Cassandra M.; Butler, J. Lauren; Biediger-Friedman, Lesli; Sharkey, Joseph R.
    Systemic and social factors, like poverty and food insecurity, negatively influence fruit and vegetable (FV) intake and body mass index (BMI) among Latino/a children. Behavioral programs are needed to support children’s nutrition. This study examined program effects on FV intake and BMI outcomes for Mexican-heritage children (9–11 years). The program used a modified stepped-wedge design in the Lower Rio Grande Valley of Texas (2019 and 2020). Promotoras led experiential nutrition education sessions and collected height, weight, and instant skin carotenoid scores (biomarker for FV intake) at pre-test (baseline), post-test (6 weeks), and maintenance (3–4 months after post-test). Mean changes and group differences in skin carotenoid scores, BMI z-scores and percentiles were obtained from analyses of variance. Linear mixed-effects models were used to determine overall program effects. Mexican-heritage children were enrolled (n = 57 and 52.6% female). An overall decrease in skin carotenoid scores was observed at post-test (−15.1; 95% CI: −24.95, −5.33). While scores varied widely (range: 17–498), an increase of 14.8 ± 23.8 points occurred in one intervention group. Compared to the control period, greater reductions in BMI outcomes occurred during the program. These findings provide evidence for the use of strengths-based approaches in behavioral nutrition programs.
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    How do Latina/o Parents Interpret and Respond to the US Household Food Security Survey Module? A Qualitative Cognitive Interviewing Study
    (Elsevier, 2023-10) McClain, Amanda C.; Johnson, Cassandra M.; DiRado-Owens, Christian; Dickin, Katherine L.
    Background: The US Latino/a population disproportionately lives in poverty and experiences household food insecurity, especially households with children. The Household Food Security Survey Module (FSSM) was originally developed among rural White women. Despite wide use in English and Spanish, how well the FSSM captures the food insecurity experiences of Latino/a households is not well known. Objective: This study explored how Latino/a caregivers understood, interpreted, and perceived FSSM items and responses, and how well quantitative FSSM responses captured their reported food insecurity experiences. Design: Trained researchers conducted in-depth cognitive interviews in a qualitative study. Participants and setting: Interviews were conducted between October 2021 and August 2022 with Latino/a adults (N = 62) experiencing food insecurity while caring for a child (aged 18 years or younger) in the same household, and living in California, New York, or Texas. Statistical analysis performed: Qualitative analysis using iterative summaries for data reduction focused on item interpretation, response patterns, and cross-cutting themes. Results: Participants generally understood FSSM items as intended. The most salient findings were themes that applied across multiple FSSM items rather than wording issues with specific items. Underreporting of food insecurity was linked to nonaffirmative (“never”) responses to items referencing not having enough money for food while describing reliance on nonmonetary resources (eg, food assistance or food pantries); emotional sensitivity to discussing food insecurity, particularly as it related to children; stigma and emotions related to skipping meals; and limited response options that participants believed did not reflect their experiences. These issues influenced multiple items, impeding ease of responding and leading to inaccurate responses in English- and Spanish-language versions. Conclusions: Assessing coping strategies and providing more acceptable response options could enhance FSSM validity. Considering emic perspectives of Latino/a caregivers and how food access experiences differ from quantitative survey measures of food security could strengthen policy and programs.
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    Daily agreeableness and acculturation processes in ethnic/ racial minority freshmen: The role of inter-ethnic contact and perceived discrimination
    (Wiley, 2023-02) Wu, Yiqun; Xu, Jingyi; Shen, Yishan; Wang, Yijie; Zheng, Yao
    Objectives: Having higher levels of mainstream cultural orientation (MCO), an important component of acculturation attitudes and behaviors, is beneficial for ethnic/racial minority students during the transitions into university. Scant research has investigated MCO at a micro daily timescale. This study examined how personality (agreeableness) functions in conjunction with interpersonal processes (inter-ethnic contact and perceived discrimination) to influence MCO as daily within-person processes. Methods: Multi-level structural equation modeling were used to analyze month-long daily diary data from 209 ethnic/racial minority freshmen (69% female). Results: There was a positive indirect association between agreeableness and MCO through inter-ethnic contact at both within-and between-person levels. At the within-person level, on days with lower (vs. higher) levels of ethnic/racial discrimination, higher levels of agreeableness were associated with higher levels of MCO. Conclusions: These findings highlight the contributions of intensive longitudinal data in elucidating ethnic/racial minority students' personality and acculturation processes in daily life involving protective and risk factors on micro timescales.
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    “Now We’re All Family”: Exploring Social and Emotional Development in a Summer Hip Hop Mixtape Camp
    (Springer, 2022-02) Travis, Raphael; Levy, Ian; Morphew, Alexandra
    Child and adolescent mental health indicators were trending in the wrong direction pre-COVID-19 and have worsened with the exacerbation of life stressors during a pandemic, especially among youth of color and girls (Racine et al. in JAMA Pediatr 175:1142-1150, 2021). Hip Hop integrated group work with adolescents has increased in the literature, with an emphasis on being more culturally responsive and engaging compared to traditional therapeutic approaches. Levy and Travis (J Spec Group Work 45:307-330, 2020) found in their research that while all Hip Hop integrated groups were effective, the semi-structured group had the most significant reduction in symptoms of stress, depression, and anxiety, compared to the highly structured and minimally structured groups. The purpose of the present study was to determine whether a Hip Hop integrated intervention, that is multi-modal and interdisciplinary (i.e., blending two distinct models [HHE/CCMC] and facilitated by a social worker and school counselor). could effectively promote positive social and emotional development, across three leadership styles. Three groups of six high school students (total n = 18), identifying predominantly as Latinx and Black, were selected from a high school summer enrichment program. Results suggest social and emotional benefits for youth across all groups, regardless of facilitation style. Benefits included increased confidence, a strong sense of community, experiencing joy, and a willingness to step outside of their comfort zones to collaborate and create something personally meaningful. The setting (summer) and sample (high school students) have implications for programming and policies to best meet the mental health needs of youth year round and during times of instability.
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    Qualitatively Exploring Mental Health Attitude Changes among Emerging Adult Motivational Interviewing after One Motivational Enhanced Interview
    (Springer, 2022-04) Clary, Kelly; Campbell, Corey; Chiu, Chungyi
    Emerging adult military members and veterans (MMV) are experiencing many transitions (e.g., adulthood, military). The sum of these changes can cause stress, anxiety, and mental health challenges. Stigma of mental health and treatment exists, and military populations are often not seeking or engaging in appropriate care. Recent research emphasizes the need to uncover mental health attitudes and self-stigma barriers regarding help seeking. We evaluated the impact of a single motivational-interviewing enhanced interview with 26 MMV, all who reported high risk substance use. In 75-minute interviews with the primary focus of discussing their experiences regarding mental health, substance use, and identity development, the interviewer incorporated motivational interviewing strategies (e.g., affirmations, complex reflections). Participants shared their developmental experiences, stressors transitioning, and barriers and stigma around mental health treatment. Participants completed a survey which included a variety of standardized measures and open-ended questions two weeks before and after the interview. Qualitative follow-up data via open ended questions shows the session was well received by participants as they could share their stories, think critically about their military experiences, and brainstorm solutions for mental health care. We conclude that using individual, confidential interviews to discuss sensitive topics for data collection with MMV is an area to continue developing. Conducting qualitative research with motivational interviewing strategies has the potential to be twofold: advance scholarship and inform practitioners, but also serve as a therapeutic platform for some participants.
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    Childhood Bullying Victimization, Substance Use and Criminal Activity among Adolescents: A Multilevel Growth Model Study
    (Multidisciplinary Digital Publishing Institute, 2022-12) Lee, Jungup; Choi, Mijin; Holland, Margaret; Radey, Melissa; Tripodi, Stephen
    Background: This study aims to examine the effects of childhood bullying victimization (CBV) on substance use and criminal activity among adolescents over time. In addition, it identifies the moderating effects of gender and race/ethnicity on the associations of CBV with substance abuse and criminal activity in adolescence and young adulthood. Methods: This study included 8984 adolescents aged 12 to 18 years (Mage = 14.22 years) assessed biennially at four time points utilizing the National Longitudinal Survey of Youth 1997. The two-level hierarchical linear modeling was employed to test the effects of CBV on substance use and criminal activity. Results: The incidence of substance use increased over time throughout adolescence to young adulthood, while that of criminal activity decreased. CBV increased the risks of cigarette use, marijuana use, and criminal activity. Gender and race/ethnicity significantly moderated the effect of CBV on alcohol use and alcohol binges. The effect of CBV on alcohol use was stronger among females than males. Among Hispanic adolescents, CBV was more strongly related to alcohol use and binges compared to non-Hispanic White. Conclusion: Findings suggest the need for early intervention for children at high risk of being bullied to reduce later substance abuse and involvement in criminal activities. Considering the moderating effects of gender and ethnicity on the associations, target-specified intervention and prevention programs are also required. Further studies focusing on the lifelong effects of CBV beyond adolescence are recommended.
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    College Credit for Heroes: Accelerating Degree Completion
    (Virginia Tech Publishing, 2022-06) Sherron, Todd; Wilson, Lindsey
    This article overviews lessons learned and findings from implementing state-funded grant initiatives for student veterans and service members (SVSMs) at Texas State University for 3 years. The Texas Workforce Commission’s College Credit for Heroes program (CCH) supported 63 SVSMs from summer 2017 through fall 2020, funded the development of 5 new, 8-week undergraduate courses, and streamlined 2 undergraduate courses for a combined total of $387,125. SVSMs received a scholarship for completing a Prior Learning Assessment (PLA) competency portfolio and earned a stipend for completing a 120-hour capstone project. Nineteen SVSMs earned PLA credits ranging from 3–18 hours. Fifty-three SVSMs completed a capstone project and earned their bachelors within 2 to 4 semesters.
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    Prioritizing Protection by Face Masks during COVID-19: The Application of Customer Open Innovation
    (Multidisciplinary Digital Publishing Institute, 2022-02) Liang, Yuli; Hustvedt, Gwendolyn; Miller, Jasmine
    This research investigated consumers’ purchase intention and preferences for face masks during the COVID-19 global pandemic. The Theory of Planned Behavior (TPB) was used as the theoretical framework. Empirical data (with 215 valid responses) were collected nationwide from the United States via Qualtrics Panel services. Exploratory factor analysis, confirmatory factor analysis, structural equation modeling, and multi-group comparison (chi-square difference) were used to estimate construct validity and test the proposed hypotheses and theoretical framework. Results indicated that consumers’ purchase intention towards face masks was predicted by consumers’ attitude towards functional attributes, subjective norm, and perceived behavior control. But, in contrast with previous research, purchase intention was not predicted by attitudes towards aesthetic attributes and attitude towards social attributes. Purchase intention positively influenced consumers’ actual purchase behavior towards face masks. Workplace association moderated the path from social attitudes to purchase intention. Based on these results, theoretical and practical implications are discussed.
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    Adiponectin Influences FGF2 in the Developing Porcine Corpus Luteum
    (Multidisciplinary Digital Publishing Institute, 2022-02) Flores, Rita; Ramirez, Martha; Ayala, Luis; Benavides, Elizabeth; Xie, Fang; Arellano, Adrian; Stanko, Randy; Garcia, Michelle
    Luteal angiogenesis is regulated by pro-angiogenic hormones including fibroblast growth factor 2 (FGF2) and angiopoietin 1 (Ang1), which are regulated by the adipokine leptin during development. Another adipokine, adiponectin, exhibits an inverse relationship with leptin and has been identified in the CL. Therefore, it is hypothesized that adiponectin will influence pro-angiogenic hormones in the developing porcine CL. Crossbred sows were randomly allocated to one of two days of the estrous cycle, day 5 (D5; n = 4) or day 7 (D7; n = 5) for CL collection. Tissue was processed for immunohistochemical localization of adiponectin receptor 2 (AdipoR2), gene expression of FGF2, Ang1, leptin, AdipoR2, and cell culture for adiponectin treatment. The expression of AdipoR2 tended (p = 0.09) to be higher in D7 lutea and was more prevalently localized to the cell surface of large and small luteal cells than in D5 tissue. Adiponectin influenced (p ≤ 0.05) FGF2, leptin, and AdipoR2 gene expression relative to the dose and day (D5 or D7). Collectively, the evidence supports the supposition that adiponectin influences angiogenic factors in the developing CL.
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    Exploring the Diverse Family Structures in South Korea: Experiences and Perspectives of Nonmartial Cohabitants
    (Multidisciplinary Digital Publishing Institute, 2021-08) Byoun, Soo-Jung; Choi, Shinwoo; Kim, Hye-Young
    Historically, South Korean society has been deeply influenced by Confucianism, which has an emphasis on the traditional family structure. If a given family does not belong in the “traditional” norm, which is composed of husband, wife, and children, they are often discriminated against and ostracized. Despite the increasing number of nonmarital cohabiters in South Korea, research is still insufficient to understand the phenomenon. This study explores the prevalence of nonmarital cohabitation in South Korea, which is still met with discrimination. Online surveys and in-depth interviews were conducted with cohabiters to gain an understanding of the phenomenon and to explore their marriage and family values. The findings of this study indicate that cohabiters who chose cohabitation as an alternative to marriage had more progressive values. Findings from the study provide implications for practice and policy.
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    Asian Americans’ Ethnic Identity Exploration and the Role of Ethnic Community in a Southern City in the United States
    (Multidisciplinary Digital Publishing Institute, 2021-09) Weng, Suzie; Choi, Shinwoo
    This qualitative study explores Asian Americans’ ethnic identity concerning their process of exploring their own identity belonging and the impact of an ethnic community in a southern city in the United States. The South has mainly consisted of European Americans and African Americans. However, it has diversified to include an increasing number of Latinx and Asian Americans over the last several decades. Yet, the growing Asian American community remains disparate in its ethnic identity and nationality. Therefore, this study uses the phenomenological method to provide a more in-depth understanding of ethnic identity in an Asian American community within a southern region of the United States. Themes emerging from interviews included the need to bridge two worlds, the desire to be part of a community, and the existence of a two-layer community involving both ethnic and racial identity. This study contributes to a greater understanding of Asian Americans’ experiences in and adaptation to the Southern region within the United States. Implications for practice are provided for social workers when working alongside Asian American clients.
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    Designing for Multilevel Behavior Change: A Father-Focused Nutrition and Physical Activity Program for Mexican-Heritage Families in South Texas Border Communities
    (Multidisciplinary Digital Publishing Institute, 2021-09) Johnson, Cassandra M.; Sharkey, Joseph R.; Umstattd Meyer, M. Renee; Gomez, Luis; Allicock, Marlyn; Prochnow, Tyler; Beltran, Elva; Martinez, Luz
    Fathers significantly influence family functioning, as coparents and partners, and must be part of family-based approaches to behavioral health interventions or programs. But little is known regarding how to support Latino fathers in health promotion within their family systems, specifically for Latino families living in border communities. Program development was embedded in a larger community-based grant and part of a longstanding academic-community collaboration. An interdisciplinary research team applied theories related to health behavior, family systems, behavior change, and community engagement to develop a father-focused and family-centered behavioral program for Mexican-heritage fathers and children living near the Texas-Mexico border to support changes in nutrition and physical activity at the individual and family levels. Promotoras de salud (trained community health workers) delivered the program through group sessions, check-in calls, and at-home activities. Group session activities were designed to engage family triads and dyads using experiential education related to nutrition and physical activity, like cooking lessons and active play, over a six-week period. Future research can use the program approach and curricula as a roadmap for designing context-specific and culturally-relevant programs for Latino families. Additional research is needed to explore how approaches like this can support families and their health goals.
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    The Effects of Knowledge Types on Consumer Decision Making for Non-Toxic Housing Materials and Products
    (Multidisciplinary Digital Publishing Institute, 2021-10) Kwon, Hyun Joo; Ahn, Mira; Kang, Jiyun
    This study explored how different types of consumer knowledge (exposure, subjective knowledge, and objective knowledge) predict perceptions (benefits, severity, and barriers) and behavioral intention to choose non-toxic housing materials and products based on the extended health belief model (HBM). The target population was people 18 years or older living in the U.S. A total of 1050 valid responses were collected through an online survey. Structural equation modeling was used to test the model via AMOS version 24. Results show that the prediction of exposure, subjective knowledge, and objective knowledge for behavioral intention is mediated by health belief perceptions in different ways. Exposure had a significant impact on perceived benefits and perceived severity but not on perceived barriers. Subjective knowledge was not significantly associated with perceptions, but all of the effects of objective knowledge on the HBM elements were significant. Significant indirect effects of exposure and subjective knowledge on behavioral intention were found; the indirect effects of objective knowledge on behavioral intention were insignificant. By adopting the extended HBM, this study contributes to a better understanding of the link among knowledge types and perceptions of non-toxic housing materials and products, and behavioral intention to choose them.
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    The HOME Study: Understanding How College Students at a Hispanic Serving Institution Coped with Food Insecurity in a Pandemic
    (Multidisciplinary Digital Publishing Institute, 2021-10) Manboard, Miriam; Johnson, Cassandra M.; Thornton, Hannah; Biediger-Friedman, Lesli
    College students represent a unique population of adults, who may be more likely to experience food insecurity due to their transient circumstances, limited access to resources, and increased educational expenses. But little is known about how college students and their households mitigate food insecurity, particularly during a crisis like the COVID-19 pandemic. The Household Observations of Meals and Environments (HOME) Study described how college students in the US utilized multilevel resources, including an on-campus food pantry, to maintain food security during the pandemic. A convenience sample of college students (n = 18) were recruited from an on-campus food pantry and provided quantitative and qualitative data through online surveys and in-depth Zoom interviews. Survey data were analyzed to describe sociodemographic characteristics. In-depth interviews were recorded, transcribed, coded, and analyzed thematically to identify emergent themes. Social support and the use of an on-campus food pantry were primary factors in maintaining a food security safety net. Students faced barriers when trying to access federal and state food assistance programs and identified multilevel resources, their food security, and the role of social support as facilitators in their perceptions of food insecurity status and experiences. Findings highlight practical implications for research related to on-campus food insecurity interventions and policies to support food security among college students.
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    Lime and Manure Amendment Improve Soil Fertility, Productivity and Nutrient Uptake of Rice-Mustard-Rice Cropping Pattern in an Acidic Terrace Soil
    (Multidisciplinary Digital Publishing Institute, 2021-10) Islam, Mohammad Rafiqul; Talukder, Mohammad Moyeed Hasan; Hoque, Mohammad Anamul; Uddin, Shihab; Hoque, Tahsina Sharmin; Rea, Rafea Sultana; Alorabi, Mohammed; Gaber, Ahmed; Kasim, Susilawati
    Acid soil is an obstacle to agricultural development and a concern regarding food and environmental security. Therefore, a study was carried out for two consecutive years to see how lime and organic manure (OM) amendments affect yield and nutrient absorption in the Transplanted (T.) Aman–Mustard–Boro cropping pattern in an acidic terrace soil. With nine treatments and three replications, the experiment was set in a randomized complete block design. The treatments were applied to the first crop, T. Aman, with different dosages of lime (dololime at the rate of 1 and 2 t ha−1), OM (cow dung at 5 t ha−1, poultry manure at 3 t ha−1) and lime–OM combination, and their residual effects were studied in the following mustard and boro rice crops. Results demonstrate that the effect of lime and manure was more pronounced in the case of the second and third crops in the first year and of all crops in the pattern in the second year. In the first year, grain and straw yield of T. Aman as well as the overall system productivity were not influenced significantly by the application of lime and manure, but significant increases were obtained in the second year. As an average of both years, the highest grain yield of 5.2 t ha−1 (12% over control) was recorded for T. Aman, 1.7 t ha−1 (41% over control) for mustard and 5.9 t ha−1 (47% over control, 3.9 t ha−1) for boro rice when dololime was applied in combination with poultry manure. In both years, N, P, K and S uptake were significantly increased compared to the control in all the crops due to the combined application of lime and cow dung or poultry manure. Combined application of lime and manure amendment significantly improved nutrient availability and soil quality. Therefore, applying lime in combination with manure can be practiced to uplift crop productivity in acidic terrace soils.
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    Proximate Composition and Nutritional Attributes of Ready-to-Cook Catfish Products
    (Multidisciplinary Digital Publishing Institute, 2021-11) Bland, John M.; Grimm, Casey C.; Bechtel, Peter J.; Deb, Uttam; Dey, Madan
    To increase the demand for U.S. farm-raised catfish, five healthy, convenient ready-to-cook products were developed to expand consumers’ options beyond basic fresh or frozen fillets. Five new catfish products were produced, consisting of one hundred samples of each, including three size-types of Panko-breaded fish products (strips, center cuts of regular fillets, and center cuts from Delacata fillets) and two marinated products (sriracha and sesame-ginger). The breaded products were to be prepared by baking for convenience over traditional frying methods, while the marinated products were to be microwaved as healthy and convenient products. The nutrient content of the samples was analyzed, including protein, moisture, fat, fiber, ash, and carbohydrate, as well as minerals, amino acid, and fatty acid constituent content, with associated atherogenic index (AI) and thrombogenic index (TI), showing unique differences between the Panko-breaded and marinated products. In addition, a trend was observed showing an increase in moisture, protein, ash, and carbohydrate percentages, and a decrease in lipid content related to the volume-to-surface-area ratio, having the order of strips < standard fillets < Delacata fillets.
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    Value chains in aquaculture and fisheries in Bangladesh
    (Routledge, 2020-12) Dey, Madan; Surathkal, Prasanna
    Bangladesh is one of the major fish producing and consuming countries in the world. For all population groups in Bangladesh, fish is the primary source not only of animal protein but also of micronutrients. Both capture fisheries and aquaculture play a significant role in fish production and consumption in the country. The rapid growth of aquaculture in Bangladesh has made possible higher per capita fish consumption despite an increasing population. Aquaculture, as a method of fish production, has become more intensified and diversified in response to market demand. In this chapter, we review some of the salient features of this transformation in fish value chains and their implications for livelihood, and we explore future research priorities.
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    Sexting among Teenagers in the United States: A Retrospective Analysis of Identifying Motivating Factors, Potential Targets, and the Role of a Capable Guardian
    (International Journal of Cyber Criminology, 2014-06) Martinez-Prather, Kathy; Vandiver, Donna
    Sexting is often broadly defined as the sending and/or receiving of sexually suggestive images or messages to peers through a cell phone (Mitchell et al., 2012). The use of broad definitions and sampling methods among prior sexting studies has produced variations in the research findings. The current study provides a retrospective examination of sexting among 378 teenagers sampled from university college freshmen at a midsize southern university in the United States regarding sexting attitudes and behaviors during high school. Approximately one-third of the participants reported sending a sexting image of himself or herself in high school to someone else using a cell phone. Those who reported more texting use, in general and those who spent more time with friends in an unsupervised setting were significantly more likely to report sexting. Parental monitoring, however, was not significantly related to sexting. The implications of these findings are discussed.
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    Best practices for working with transgender clients in Outdoor Behavioral Healthcare
    (University of New Hampshire, 2020-01) Tucker, Anita; Norton, Christine; Stifler, Julia; Gass, Michael; Bostick, Kendra
    Research suggests that simply identifying an individual as transgender does not necessarily indicate the existence of other mental health concerns. However, many transgender adolescents experience significant psychosocial and mental health concerns, which are likely due to the challenges faced by youth with nonconforming gender identity and expression. Though issues related to gender identity are rarely the primary reason why individuals seek mental health treatment, it is important for mental health practitioners to possess some knowledge of the issues affecting the transgender community to provide effective treatment. This paper examines the clinical needs of youth who identify as transgender, and best practices for working with transgender clients in Outdoor Behavioral Healthcare. Recommendations for best practices include ensuring that clinicians and other staff members are adequately educated on issues related to gender identity, examining bias on a personal and institutional level, taking corrective action to create more trans-affirming environments, and promoting client self-determination and voice before and during treatment. In addition, more research on the topic of transgender clients in mental health treatment, and specifically in OBH programs, is needed to better inform clinical practice.