OTHERED: Displaced From Malaga

Exhibition catalog for OTHERED: Displaced from Malaga Presented by the USM Art Gallery with a foreword by Carolyn Eyler, USM Director of Exhibitions and Programs An exhibition by USM Artist-in-Residence Daniel Minter USM Art Gallery, Gorham, Maine October 4-December 9, 2018https://digitalcommons.usm.maine.edu/usmag_catalogs/1001/thumbnail.jp

“Can we walk?” Environmental supports for physical activity in India

India is currently facing a non-communicable disease epidemic. Physical activity (PA) is a preventative factor for non-communicable diseases. Understanding the role of the built environment (BE) to facilitate or constrain PA is essential for public health interventions to increase population PA. The objective of this study was to understand BEs associations with PA occurring in two major life domains or life areas—travel and leisure—in urban India. Between December 2014 and April 2015, in-person surveys were conducted with participants (N = 370; female = 47.2%) in Chennai, India. Perceived BE characteristics regarding residential density, land use mix-diversity, land use mix-access, street connectivity, infrastructure for walking and bicycling, aesthetics, traffic safety, and safety from crime were measured using the adapted Neighborhood Environment Walkability Scale-India (NEWS-India). Self-reported PA was measured the International Physical Activity Questionnaire. High residential density was associated with greater odds of travel PA (aOR = 1.9, 95% CI = 1.2, 3.2). Land use mix-diversity was positively related to travel PA (aOR = 2.1, 95%CI = 1.2, 3.6), but not associated with leisure or total PA. The aggregate NEWS-India score predicted a two-fold increase in odds of travel PA (aOR = 1.9, 95% CI = 1.1, 3.1) and a 40% decrease in odds of leisure PA (aOR = 0.6, 95% CI = 0.4, 1.0). However, the association of the aggregated score with leisure PA was not significant. Results suggest that relationships between BE and PA in low-and-middle income countries may be context-specific, and may differ markedly from higher income countries. Findings have public health implications for India suggesting that caution should be taken when translating evidence across countries

Maternal obesity support services: a qualitative study of the perspectives of women and midwives

Background - Twenty percent of pregnant women in the UK are obese (BMI ≥ 30 kg/m2), reflecting the growing public health challenge of obesity in the 21st century. Obesity increases the risk of adverse outcomes during pregnancy and birth and has significant cost implications for maternity services. Gestational weight management strategies are a high priority; however the evidence for effective, feasible and acceptable weight control interventions is limited and inconclusive. This qualitative study explored the experiences and perceptions of pregnant women and midwives regarding existing support for weight management in pregnancy and their ideas for service development. Methods - A purposive sample of 6 women and 7 midwives from Doncaster, UK, participated in two separate focus groups. Transcripts were analysed thematically. Results - Two overarching themes were identified, 'Explanations for obesity and weight management' and 'Best care for pregnant women'. 'Explanations' included a lack of knowledge about weight, diet and exercise during pregnancy; self-talk messages which excused overeating; difficulties maintaining motivation for a healthy lifestyle; the importance of social support; stigmatisation; and sensitivity surrounding communication about obesity between midwives and their clients. 'Best care' suggested that weight management required care which was consistent and continuous, supportive and non-judgemental, and which created opportunities for interaction and mutual support between obese pregnant women. Conclusions - Women need unambiguous advice regarding healthy lifestyles, diet and exercise in pregnancy to address a lack of knowledge and a tendency towards unhelpful self-talk messages. Midwives expressed difficulties in communicating with their clients about their weight, given awareness that obesity is a sensitive and potentially stigmatising issue. This indicates more could be done to educate and support them in their work with obese pregnant women. Motivation and social support were strong explanatory themes for obesity and weight management, suggesting that interventions should focus on motivational strategies and social support facilitation

Psychiatry Diversity Leadership in Academic Medicine: Guidelines for Success.

Dr. A, a Black woman researcher and clinician-educator in the Department of Psychiatry at a prestigious academic institution, was appointed chair of the Diversity, Equity, and Inclusion (DEI) committee in 2017, in the context of public complaints and media coverage concerning sexism and racism. Following recent high-profile murders of Black people by police, Dr. A is called upon by the department chair to develop "antiracist programming." As a first step, Dr. A drafts a strong message against racismandexcessive police force.Despite the statement being vetted by all senior leadership, the department chair insists thatDr.Aplace only her name on it, in case it is not "well received." Dr. A receives negative e-mails in response to the statement, with minimal support from the department. Not to be dismayed, Dr. A assembles a DEI committee to plan an "antiracist" strategy for the entire department, without financial support, protected time, or additional resources. The DEI committee progress is slowed by the lack of institutional and departmental commitment. Additionally, several well-meaning non- Black colleagues in the department organize responses to the murders-including protests, town hall events, and public statements-without concerted coordination with the DEI committee, implying that "nothing was being done." In parallel, Dr. A is tasked with organizing and dispatching the limited number of Black psychiatrists, psychologists, and social workers in the department to deliver care to the entire Black community at her institution. Feeling overwhelmed by the number of tasks she has been asked to initiate-while navigating a tense climate, with minimal financial or administrative departmental support-Dr. A requests a meeting with the department chair and executive committee. At the meeting, Dr. A, a tenured faculty memberfor the past 10 years, is addressed by another colleague's name-the only other Black professor in the department. When Dr. A points out this microaggression, a senior colleague tells her she is being "too sensitive," and is "overreacting." Despite this interaction, Dr. A highlights multiple institutional barriers, including the structural racism that minimizes the work of DEI initiatives in the department. She presents her proposal for protected time and resources to successfully execute robust antiracist programming but is toldmoneyis tight and to "scale back" and "do the best you can."

Psychiatry Diversity Leadership in Academic Medicine: Guidelines for Success.

Dr. A, a Black woman researcher and clinician-educator in the Department of Psychiatry at a prestigious academic institution, was appointed chair of the Diversity, Equity, and Inclusion (DEI) committee in 2017, in the context of public complaints and media coverage concerning sexism and racism. Following recent high-profile murders of Black people by police, Dr. A is called upon by the department chair to develop "antiracist programming." As a first step, Dr. A drafts a strong message against racismandexcessive police force.Despite the statement being vetted by all senior leadership, the department chair insists thatDr.Aplace only her name on it, in case it is not "well received." Dr. A receives negative e-mails in response to the statement, with minimal support from the department. Not to be dismayed, Dr. A assembles a DEI committee to plan an "antiracist" strategy for the entire department, without financial support, protected time, or additional resources. The DEI committee progress is slowed by the lack of institutional and departmental commitment. Additionally, several well-meaning non- Black colleagues in the department organize responses to the murders-including protests, town hall events, and public statements-without concerted coordination with the DEI committee, implying that "nothing was being done." In parallel, Dr. A is tasked with organizing and dispatching the limited number of Black psychiatrists, psychologists, and social workers in the department to deliver care to the entire Black community at her institution. Feeling overwhelmed by the number of tasks she has been asked to initiate-while navigating a tense climate, with minimal financial or administrative departmental support-Dr. A requests a meeting with the department chair and executive committee. At the meeting, Dr. A, a tenured faculty memberfor the past 10 years, is addressed by another colleague's name-the only other Black professor in the department. When Dr. A points out this microaggression, a senior colleague tells her she is being "too sensitive," and is "overreacting." Despite this interaction, Dr. A highlights multiple institutional barriers, including the structural racism that minimizes the work of DEI initiatives in the department. She presents her proposal for protected time and resources to successfully execute robust antiracist programming but is toldmoneyis tight and to "scale back" and "do the best you can."

Master plans for pedestrian and bicycle transportation: community characteristics

Background:Recent research demonstrates the importance of targeting the built environment to support individual physical activity, particularly for people experiencing health disparities. Master plans to promote biking and/or pedestrians (BPMPs) are a potential method for environmental change. This descriptive study aims to provide a snapshot of plan attributes and better understand demographic, social and transportation characteristics of communities with BPMPs. Methods: We collected a census sample of BPMPs from 4 states. Population and commuting data were obtained from national statistics. Results: 294 master plans were included, with most plans representing municipalities. 62% of plans targeted biking only, one-fifth targeted biking and walking, and 15% targeted walking only. The sampled locations have a similar demographic profile as the overall U.S. for median age and household income, people of color, high school education, and income inequality. The degree of racial diversity of sampled communities is slightly less than the U.S. average and the percentage of people who walk to work were slightly higher. Conclusions: Given that communities with master plans have a similar profile as the overall U.S., BPMPs could feasibly be spread to communities throughout the country. Further research is planned to describe BPMPs in detail toward informing future plan development

Ethnic Disparities in Trends in High BMI Among California Adolescents, 2003–2012

INTRODUCTION: Because California is home to one in eight U.S. children and accounts for the highest Medicaid and Children’s Health Insurance Program spending, childhood obesity trends in California have important implications for the entire nation. California’s racial/ethnic diversity and large school-based data set provide a unique opportunity to examine trends by race/ethnicity, including understudied Asian and American Indian youth, which has not been possible using national data sets. This study examined racial/ethnic disparities in prevalence of high BMI from 2003 to 2012. METHODS: This observational study included 11,624,865 BMI records from repeated cross-sections of fifth, seventh, and ninth graders who underwent California’s school-based fitness testing. Analyses conducted in 2015 used logistic regression to identify trends in prevalence of high BMI (BMI ≥85th, 95th, and 97th percentiles) and differences in trends by race/ethnicity from 2003 to 2012. RESULTS: African American and Hispanic girls and American Indian boys increased in prevalence of high BMI, whereas non-Hispanic white and Asian youth and Hispanic boys decreased in prevalence of high BMI (p-values<0.05) from 2003 to 2012. Over this period, African American, Hispanic, and American Indian youth had higher slopes for trends in high BMI than non-Hispanic white youth (p-values<0.05). CONCLUSIONS: Based on California’s statewide data, there is evidence that racial/ethnic disparities in prevalence of high BMI have widened over time. Minority youth have either decreased more slowly or increased in prevalence compared with non-Hispanic white youth. There continues to be an urgent need for policies and interventions that effectively reduce racial/ethnic obesity prevalence disparities

Small-molecule targeted therapies induce dependence on DNA double-strand break repair in residual tumor cells.

Residual cancer cells that survive drug treatments with targeted therapies act as a reservoir from which eventual resistant disease emerges. Although there is great interest in therapeutically targeting residual cells, efforts are hampered by our limited knowledge of the vulnerabilities existing in this cell state. Here, we report that diverse oncogene-targeted therapies, including inhibitors of epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), KRAS, and BRAF, induce DNA double-strand breaks and, consequently, ataxia-telangiectasia mutated (ATM)-dependent DNA repair in oncogene-matched residual tumor cells. This DNA damage response, observed in cell lines, mouse xenograft models, and human patients, is driven by a pathway involving the activation of caspases 3 and 7 and the downstream caspase-activated deoxyribonuclease (CAD). CAD is, in turn, activated through caspase-mediated degradation of its endogenous inhibitor, ICAD. In models of EGFR mutant non-small cell lung cancer (NSCLC), tumor cells that survive treatment with small-molecule EGFR-targeted therapies are thus synthetically dependent on ATM, and combined treatment with an ATM kinase inhibitor eradicates these cells in vivo. This led to more penetrant and durable responses in EGFR mutant NSCLC mouse xenograft models, including those derived from both established cell lines and patient tumors. Last, we found that rare patients with EGFR mutant NSCLC harboring co-occurring, loss-of-function mutations in ATM exhibit extended progression-free survival on first generation EGFR inhibitor therapy relative to patients with EGFR mutant NSCLC lacking deleterious ATM mutations. Together, these findings establish a rationale for the mechanism-based integration of ATM inhibitors alongside existing targeted therapies