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

Emergency Department Chief Complaint and Diagnosis Data to Detect Influenza-Like Illness with an Electronic Medical Record

Background: The purpose of syndromic surveillance is early detection of a disease outbreak. Such systems rely on the earliest data, usually chief complaint. The growing use of electronic medical records (EMR) raises the possibility that other data, such as emergency department (ED) diagnosis, may provide more specific information without significant delay, and might be more effective in detecting outbreaks if mechanisms are in place to monitor and report these data.Objective: The purpose of this study is to characterize the added value of the primary ICD-9 diagnosis assigned at the time of ED disposition compared to the chief complaint for patients with influenza-like illness (ILI).Methods: The study was a retrospective analysis of the EMR of a single urban, academic ED with an annual census of over 60, 000 patients per year from June 2005 through May 2006. We evaluate the objective in two ways. First, we characterize the proportion of patients whose ED diagnosis is inconsistent with their chief complaint and the variation by complaint. Second, by comparing time series and applying syndromic detection algorithms, we determine which complaints and diagnoses are the best indicators for the start of the influenza season when compared to the Centers for Disease Control regional data for Influenza-Like Illness for the 2005 to 2006 influenza season using three syndromic surveillance algorithms: univariate cumulative sum (CUSUM), exponentially weighted CUSUM, and multivariate CUSUM.Results: In the first analysis, 29% of patients had a different diagnosis at the time of disposition than suggested by their chief complaint. In the second analysis, complaints and diagnoses consistent with pneumonia, viral illness and upper respiratory infection were together found to be good indicators of the start of the influenza season based on temporal comparison with regional data. In all examples, the diagnosis data outperformed the chief-complaint data.Conclusion: Both analyses suggest the ED diagnosis contains useful information for detection of ILI. Where an EMR is available, the short time lag between complaint and diagnosis may be a price worth paying for additional information despite the brief potential delay in detection, especially considering that detection usually occurs over days rather than hours. [West J Emerg Med. 2010; 11(1):1-9]

Review of Pesticide Urinary Biomarker Measurements from Selected US EPA Children’s Observational Exposure Studies

Children are exposed to a wide variety of pesticides originating from both outdoor and indoor sources. Several studies were conducted or funded by the EPA over the past decade to investigate children’s exposure to organophosphate and pyrethroid pesticides and the factors that impact their exposures. Urinary metabolite concentration measurements from these studies are consolidated here to identify trends, spatial and temporal patterns, and areas where further research is required. Namely, concentrations of the metabolites of chlorpyrifos (3,5,6-trichloro-2-pyridinol or TCPy), diazinon (2-isopropyl-6-methyl-4-pyrimidinol or IMP), and permethrin (3-phenoxybenzoic acid or 3-PBA) are presented. Information on the kinetic parameters describing absorption and elimination in humans is also presented to aid in interpretation. Metabolite concentrations varied more dramatically across studies for 3-PBA and IMP than for TCPy, with TCPy concentrations about an order of magnitude higher than the 3-PBA concentrations. Temporal variability was high for all metabolites with urinary 3-PBA concentrations slightly more consistent over time than the TCPy concentrations. Urinary biomarker levels provided only limited evidence of applications. The observed relationships between urinary metabolite levels and estimates of pesticide intake may be affected by differences in the contribution of each exposure route to total intake, which may vary with exposure intensity and across individuals

Quantifying Risk Mitigation Strategies in Grocery Retail Supply Chain Operations: A Sensitivity Analysis Perspective

The purpose of this paper is to quantify risk mitigation in a grocery retail supply chain. Specifically, the analytic hierarchy process (AHP)-based sensitivity analysis (SA) is leveraged to support supply chain C-level executives manage and mitigate risks inherent in a grocery supply chain. The four most important risks for the case grocery retail firm are fuel price, demand, competitive, and supply risks, respectively. With respect to the overall priority scores of risk mitigation risk options, risk reduction is the most preferred risk management option, followed by risk avoidance, risk exploitation, risk transfer, and risk acceptance. For grocery retailers to survive and thrive in the era of disruptive influences, the mandate is clear: they must leverage adaptable and predictive supply chain risk management

Influence of Seasonality and Circulating Cytokines on Serial QuantiFERON Discordances

Objectives. An 18-month prospective study serially tested healthcare workers (HCWs) for tuberculosis infection (TBI) and reported discordant QuantiFERON Gold In-Tube® (QFT) results in some participants. The purpose of the current study was to investigate whether the interferon-gamma (IFN-γ) measured by QFT in discordant individuals could be influenced by other circulating cytokines that vary seasonally at the time of phlebotomy. Methods. The CDC funded TBESC Task Order 18 (TO18) project to assess the use of Interferon Gamma Release Assays (IGRAs), T-SPOT.TB® and QFT, compared to the tuberculin skin test (TST) for the serial testing of TBI in HCW at 4 US sites. Unstimulated plasma from 9 discordant TO18 participants at 4 different time points from the Houston site was multiplexed to determine the association between circulating cytokines and antigen stimulated IFN-γ levels. Results. IL-12, IL-1β, IL-3, GCSF, and IL-7 were associated with the amount of IFN-γ measured in response to antigen stimulation. In addition to these cytokines, a significant relationship was found between a positive QFT result and the spring season. Conclusions. Allergens during the spring season can result in the upregulation of IL-1β and IL-3, and this upregulation was observed with the amount of IFN-γ measured in discordant results

Green Justice for All: International and Comparative Dimensions of Environmental Justice

The Second Annual Environmental Law and Justice Symposium features Carlton Mark Waterhouse, J.D., Ph.D., as Keynote Speaker, a performance by Environmental and Social Justice performers, Climbing PoeTree, and closing Keynote Speaker, Esperanza Garcia.https://commons.law.famu.edu/cilj-lectures-pres/1002/thumbnail.jp