A Feasibility Study of Supply and Demand for Diabetes Prevention Programs in North Carolina

Diabetes Prevention Programs (DPPs) have shown that healthy eating and moderate physical activity are effective ways of delaying and preventing type 2 diabetes in people with impaired glucose tolerance. We assessed willingness to pay for DPPs from the perspective of potential recipients and the cost of providing these programs from the perspective of community health centers and local health departments in North Carolina

The Diabetes Primary Prevention Initiative interventions focus area: A case study and recommendations

Background: In 2005, CDC began the Diabetes Primary Prevention Initiative Interventions Focus Area (DPPI-IFA), which funded fıve state Diabetes Prevention and Control Programs (DPCPs) to translate diabetes primary prevention trials into real-world settings by developing and implementing a framework for state-level diabetes primary prevention. Purpose: The purpose of this case study, conducted in 2007, was to describe DPPI-IFA implementation, including facilitators and challenges to the initiative. Methods: Case studies of the fıve DPCPs in the DPPI-IFA involving site visits with key informant interviews of state staff and partners and archival record collection. Results: Partners recruited for DPPI-IFA activities included local or state public health agencies (three of fıve DPCPs); regional or state nonprofıt organizations (fıve DPCPs); businesses or employers (three DPCPs); and healthcare organizations (four DPCPs). The DPCPs implemented a variety of interventions in three main domains: diabetes primary prevention and prediabetes awareness, screening activities and lifestyle interventions, and prediabetes-related health policy efforts. Preliminary outcomes are described at the individual and organization/partnership levels. Results suggest the importance of utilizing preexisting partnerships to extend work into diabetes prevention, providing even small amounts of funding to partners, and prior program planning for diabetes prevention. Challenges for the DPPI-IFA included recruiting participants, establishing links with providers to obtain diagnostic testing for people screened for prediabetes, and offering a lifestyle intervention. Conclusions: The DPPI-IFA represents a unique effort by state public health programs in the translation of diabetes primary prevention trials into real-world settings. The experiences of the DPPI-IFA programs offer valuable lessons for future community-based diabetes prevention initiatives, especially regarding the need to strengthen clinical–community partnerships for referral of people with prediabetes to evidence-based lifestyle programs

Upcycling phosphorus recovered from anaerobically digested dairy manure to support production of vegetables and flowers

Dissolved air flotation (DAF) separates phosphorus (P)-rich fine solids from anaerobically digested dairy manure, creating opportunities to export surplus P to the marketplace as a bagged plant food product. Seedlings of tomato and marigold were amended at various volume per volume (v/v) ratios with plant foods consisting of fine solids upcycled (i.e., transformed into a higher quality product) by drying and blending with other organic residuals. A plate competition assay was conducted to assess the fine solids\u27 potential to suppress the plant pathogen Rhizoctonia solani. Plant foods were comprised of 2.0-2.1% N, 0.8-0.9% P and 0.6-0.8% K. Extractions indicated that plant foods contained a mixture of plant-available and slow-release P. At 6% v/v plant food, dry biomass of marigold and tomato were six-times greater than the unamended control and not significantly different from a market alternative treatment. Fine solids exhibited negligible potential to suppress R. solani. This study indicates that DAF-separated fine solids could be used to support horticulture, providing information for design of a circular economy approach to dairy manure nutrient management. Life cycle assessment and business model development for this nutrient recovery strategy are necessary next steps to further guide sustainability efforts

Weathering the seasons of cancer survivorship: mind-body therapy use and reported reasons and outcomes by stages of cancer survivorship

Mind-body therapies (MBT), a subset of complementary and alternative medicine (CAM), are used by cancer survivors to manage symptoms related to their cancer experience. MBT use may differ by cancer survivorship stage (i.e., acute, short-term, long-term) because each stage presents varying intensities of medical activities, associated emotions, and treatment effects. We examined the relationship between MBT use and survivorship stage (acute: 5 years since diagnosis) using the CAM supplement of the 2012 National Health Interview Survey. We also examined reported reasons for and outcomes of MBT use and frequency of MBT types

Assessing Local Health Department Performance in Diabetes Prevention and Control — North Carolina, 2005

Introduction: To improve the public health system's ability to prevent and control chronic diseases, we must first understand current practice and develop appropriate strategies for measuring performance. The objectives of this study were to measure capacity and performance of local health departments in diabetes prevention and control and to investigate characteristics associated with performance. Methods: In 2005, we conducted a cross-sectional mailed survey of all 85 North Carolina local health departments to assess capacity and performance in diabetes prevention and control based on the 10 Essential Public Health Services and adapted from the Local Public Health System Performance Assessment Instrument. We linked survey responses to county-level data, including data from a national survey of local health departments. Results: Local health departments reported a median of 0.05 full-time equivalent employees in diabetes prevention and 0.1 in control. Performance varied across the 10 Essential Services; activities most commonly reported included providing information to the public and to policy makers (76%), providing diabetes education (58%), and screening (74%). The mean score on a 10-point performance index was 3.5. Characteristics associated with performance were population size, health department size and accreditation status, and diabetes-specific external funding. Performance was not better in localities where the prevalence of diabetes was high or availability of primary care was low. Conclusion: Most North Carolina local health departments had limited capacity to conduct diabetes prevention or control programs in their communities. Diabetes is a major cause of illness and death, yet it is neglected in public health practice. These findings suggest opportunities to enhance local public health practice, particularly through targeted funding and technical assistance

The Science Performance of JWST as Characterized in Commissioning

This paper characterizes the actual science performance of the James Webb Space Telescope (JWST), as determined from the six month commissioning period. We summarize the performance of the spacecraft, telescope, science instruments, and ground system, with an emphasis on differences from pre-launch expectations. Commissioning has made clear that JWST is fully capable of achieving the discoveries for which it was built. Moreover, almost across the board, the science performance of JWST is better than expected; in most cases, JWST will go deeper faster than expected. The telescope and instrument suite have demonstrated the sensitivity, stability, image quality, and spectral range that are necessary to transform our understanding of the cosmos through observations spanning from near-earth asteroids to the most distant galaxies.Comment: 5th version as accepted to PASP; 31 pages, 18 figures; https://iopscience.iop.org/article/10.1088/1538-3873/acb29

Screening for diabetes in an African-American community: the Project DIRECT experience.

AIM: To report the results of a community-based screening program associated with Project DIRECT, a multiyear diabetes mellitus prevention and control project targeting African-American residents of southeast Raleigh, NC. METHODS: Between December 1996 and June 1999, 183 screening events took place in community settings.Screening was by capillary glucose concentration. Participants with a positive screen were referred for confirmatory testing and physician follow-up. MAIN RESULTS: Risk factors for diabetes were prevalent, including ethnic minority race (88.2%), obesity (45.6%), and family history of diabetes (41.7%). In all, 197 personshad an elevated screening result; the prevalence of diabetes in the screened population that underwent follow-up testiing was 1.7%. Despite persistent tracking efforts, 28% of the persons with a high screening test received no final diagnosis CONCLUSIONS: In this community-based screening program targeted to high-risk African Americans, risk factors for diabetes were common, but new cases of undiagnosed diabetes among participants were uncommon. Intensive follow-up for persons with high screening values is necessary but difficult to achieve. Our results support national recommendations against community-based screening; opportunistic screening for diabetes in clinical settings is likely a more effective use of resources