Survey of Latino/Hispanic Adult Immigrants Living in the Colonias of Hidalgo County, Texas Evaluating Reported Food Insecurity and Immigration-Related Fear

Background: Colonias in Hidalgo County, Texas are residential communities near the Texas-Mexico border which often lack basic living necessities with high rates of poverty. Due to complex socioeconomic/geopolitical stressors (factors ranging from income inequality to access to transportation to concern regarding safety and legal status), colonia residents have limited access to fresh produce, while processed foods are more readily available, resulting in significant food insecurity. Objectives: The aim of this study is to assess levels of food insecurity, current eating habits, barriers of access, and interest in more readily affordable and accessible produce options in colonias of Hidalgo County, Texas. We hypothesize that residents of the colonias indeed have limited access to fresh produce and healthy food options and that there is interest within the population for more readily affordable and accessible produce options. Methods: In this study, we surveyed 80 residents within four colonias of Hidalgo County with health promoters from Proyecto Azteca, a program with established presences and trust within the community. The survey gathered anonymous data including respondent demographics, current food habits, barriers of access to fruits/vegetables, and interest in expanding access to fresh produce. We, furthermore, utilized geospatial analysis to map current locations of food sources in relation to the four colonias surveyed. Results: Overall, we identified high rates of food insecurity (82.5% identified as food insecure based on the Hunger Vital Signs), difficulty with many barriers of access to fresh produce (including transportation, cost, taste, and lack of knowledge about preparation), and high levels of interest in increasing fruit/vegetable consumption if there were more affordable (95%) and convenient (92.5%) options to purchase fresh produce. Furthermore, 23.8% of respondents admitted to feeling fearful of traveling outside of their colonia, the majority of whom identified immigration enforcement as their principle fear. Conclusion: This study not only demonstrates many of the impediments to accessing fresh, healthful, affordable produce, but it also highlights some of the major effects of these barriers--especially the alarmingly high rate of food insecurity. It also identifies fear of leaving one’s colonia (especially fear of immigration enforcement) as a barrier to accessing fresh produce

Early Onset Bullous Emphysema Associated with Polysubstance Use

The burden of COPD in the United States is tremendous. This disease is not only among the leading causes of mortality annually, but also takes a heavy financial toll.1 Bullous emphysema is a severe variant of COPD. The primary identified risk factor for bullous emphysema is tobacco use; however, the impact of other substances is not clearly delineated.2 This case presents a patient diagnosed with severe bullous emphysema at age 33 with substantial disease progression over the course of 12 years associated with much scarcer tobacco use than would be expected but a prominent history of methamphetamine and marijuana use. Marijuana and amphetamine-type stimulants are the most widely used illicit substances in the world, and prevalence of both are increasing in the United States. In 2020, an estimated 14.2 million Americans had a marijuana use disorder and 1.5 million had a methamphetamine use disorder.3-7 A better understanding of how these substances may contribute to development and progression of chronic lung disease, both individually and perhaps synergistically, is necessary to guide discussions with patients and inform effective public health efforts

Colchicine may decrease cardiovascular events in patients with coronary artery disease

This oral anti-inflammatory agent may offer a low-cost option for prevention of cardiovascular events in this patient population.Leslie Griffin, MD; Julia Groce, MD; Sara Conway, MD (University of Tennessee, College of Medicine, Chattanooga). Deputy Editor: Corey Lyon, DO (University of Colorado, Denver)Includes bibliographical reference

What Do We Mean by 'Forgiveness?': Some Answers from the Ancient Greeks

There seems to be confusion and disagreement among scholars about the meaning of interpersonal forgiveness. In this essay we shall venture to clarify the meaning of forgiveness by examining various literary works. In particular, we shall discuss instances of forgiveness from Homer’s The Iliad, Euripides’ Hippolytus, and Aristotle’s Nicomachean Ethics and we shall focus on the changes that the concept of forgiveness has gone through throughout the centuries, in the hope of being able to understand, and therefore, of being able to use more accurately, contemporary notions of forgiveness. We shall also explore the relationship between forgiveness and concepts that are closely associated with it, such as anger/resentment, hurt, clemency, desert/merit, excuse, etc

Development of Survey Tool to Evaluate Behavior and Educational Tools Affecting Water Health in Lewiston and Auburn Communities

The Androscoggin Valley Stormwater Group (AVSWG) has been tasked with the objective of inducing a reduction or elimination of fertilizers and/or pesticides for 15% of college educated residents between the ages of 35-55 in the cities of Lewiston and Auburn by June, 2018. This demographic was chosen as the target of the outreach program because of their financial stability and their relative willingness to change behavior when compared to other age groups. We produced a survey that targets this same demographic and is meant to evaluate the effectiveness of the AVSWG education outreach program. This deliverable fits into Permit Year 3 of the BMP Adoption Plan. Additionally, we have offered informal evaluation of the BMP adoption plan activities and materials through this tool and through critical evaluation, which also fulfills a compliance task in Permit Year 3

Using e-Learning Tools to Build a Community of Distance Learners: A Progress Review and Call for Collaboration.

The paper is an interim progress statement of a two year research project into how a higher education institution may develop online student support systems that effectively help build a community of distance learners. In doing so it seeks to investigate means of creating and maintaining learner social presence, similar attention is paid to the provision of non-academic support of learners and engendering a sense of identity and belonging to their learning community. Drawing together theoretical and practical perspectives the paper is of interest to those engaged in supporting online learners. It looks how online collaboration and communication tools may be deployed to create a social community within online learners. The paper recognises that non-academic support plays an essential role in setting the quality of student experience within distance learning and therefore is crucial to optimising success and retention rates. The utilisation of online technologies potentially permits institutions to prevent isolation amongst distance learners and narrow the gap between the experience of on-campus and off-campus students through increased sense of community and belonging. We explore the work of the project to date in doing so it identifies the context of the project, the strategic importance and the rationale for conducting research into the key areas of investigation. We present the findings of the literature review and the preliminary research findings looking at usage and participation including barriers to participation and requirements for effective support identified by learners. This aspect looks at identified usage trends of existing facilities and looks at student perceptions of existing provision and the nature of support systems they would like to see incorporated. We then outline future research activity in the provision of appropriate student support mechanisms and the measurement of their effectiveness along with the attendant project tasks set within the timescale. The project also represents an opportunity to seek collaborative exploration of the issues in conjunction with national and international partner higher education institutions. The paper is of interest to practitioners engaged in supporting online learners along with those involved in the provision of distance learning based higher education, particularly those concerned with programme design and those responsible for the non academic support of distance learners

Interactive electronic lectures on genes and chromosomes

Brunel University is proud to present computer-based courseware implanted in an interactive virtual learning environment (VLE) in the chromosomal aspects of genetics. This courseware can be used either as a revision aid (supporting previously delivered didactic lectures) or as a means of primary delivery of courseware (which can then be supported by seminars). In our experience, some students prefer the latter approach as it allows them to learn the material in their own time, at their own pace, using their own learning processes and in a place of their own choosing. In this way the students learn the material using their computer terminals and are supported with face-to-face seminars in which any problems, directions for further reading and examination technique can be addressed. A further bonus to this approach is that tutors occasionally report that, although they are spending less time talking at the students, the time they do spend is more quality time and more enjoyable as a result

Patients' experiences of screening for type 2 diabetes:prospective qualitative study embedded in the ADDITION (Cambridge) randomised controlled trial

Objectives To provide insight into factors that contribute to the anxiety reported in a quantitative study of the psychological effect of screening for type 2 diabetes. To explore expectations of and reactions to the screening experience of patients with positive, negative, and intermediate results. Design Prospective qualitative interview study of patients attending a screening programme for type 2 diabetes. Setting Seven general practices in the ADDITION (Cambridge) trial in the east of England. Participants 23 participants (aged 50-69) attending different stages in the screening process. Results Participants' perceptions changed as they progressed through the screening programme; the stepwise process seemed to help them adjust psychologically. The first screening test was typically considered unimportant and was attended with no thought about its implications. By the final diagnostic test, type 2 diabetes was considered a strong possibility, albeit a “mild” form. After diagnosis, people with screen detected type 2 diabetes tended to downplay its importance and talked confidently about their plans to control it. Participants with intermediate results seemed uncertain about their diagnosis, and those who screened negative were largely unaware of their remaining high risk. Conclusions This study helps in understanding the limited psychological impact of screening for type 2 diabetes quantified previously, in particular by the quantitative substudy of ADDITION (Cambridge). The findings have implications for implementing such a screening programme in terms of timing and content

The Men’s Safer Sex Trial: a feasibility randomised controlled trial of an interactive digital intervention to increase condom use in men

OBJECTIVE: We aimed to determine the feasibility of an online randomised controlled trial (RCT) of the Men’s Safer Sex website, measuring condom use and sexually transmitted infection (STI). METHODS: For this study 159 men aged ≥16 with female sexual partners and recent condomless sex or suspected STI were recruited from three UK sexual health clinics. Participants were randomised to the intervention website plus usual clinic care (n = 84), or usual clinic care only (n = 75). Online outcome data were solicited at 3, 6, and 12 months. RESULTS: Men were enrolled via tablet computers in clinic waiting rooms. Software errors and clinic Wi-Fi access presented significant challenges, and online questionnaire response rates were poor (36% at 3 months with a £10 voucher; 50% at 12 months with £30). Clinical records (for STI diagnoses) were located for 94% of participants. Some 37% of the intervention group did not see the intervention website (n = 31/84), and (as expected) there was no detectable difference in condomless sex with female partners (IRR = 1.01, 95% CI 0.52 to 1.96). New acute STI diagnoses were recorded for 8.8% (7/80) of the intervention group, and 13.0% (9/69) of the control group over 12 months (IRR = 0.75, 95% CI 0.29 to 1.90). CONCLUSIONS: It is likely to be feasible to conduct a future large-scale RCT to assess the impact of an online intervention using clinic STI diagnoses as a primary outcome. However, practical and technical challenges need to be addressed before the potential of digital media interventions can be realised in sexual health settings