Unsung heroes in health education and promotion: How Community Health Workers contribute to hypertension management

Rural communities are noted as having poor health outcomes. Rural areas experience barriers to care primarily due to a lack of resources, including education, health insurance, transportation, and social support. Additionally, poor health outcomes are a consequence of poor health literacy skills. Community Health Workers (CHWs) are utilized as a resource to combat these issues. This study focused on a CHW led Self-Management Blood Pressure (SMBP) program offered through the University of Texas at Tyler Health Science Center. The goal of the program was to improve management of hypertension through awareness, education, navigation, advocacy, and resource assistance. The SMBP program included structured workshops and regular follow-up with participants including connections to community resources and social support. CHWs worked closely with physicians providing bi-directional feedback on referrals and engagement of communities through outreach events. Furthermore, CHWs aided to bridge cultural or linguistic gaps between service providers and community members. Data is provided indicating this CHW-led intervention played a significant role in improving hypertension through education of how to make lifestyle changes that impact overall health and quality of life. Participants gained knowledge encouraging them to create lifelong healthy habits, coping skills, stress management, self-care, and accountability. Through this innovative approach, participants thrived in the supportive and encouraging environment led by CHWs as well as improved their blood pressure management

Risk of Colorectal Polyps and Malignancies Among Predominantly Rural Hispanics

Background: Soil transmitted helminths (STH) remain a global public health concern in spite of occasional dosing campaigns. Aims: To determine baseline prevalence and intensity of STH infection in east Guatemalan school children, and describe the associated epidemiology of anemia, stunting, and wasting in this population. Setting and design: Ten schools in Izabal province (eastern Guatemala) were identified, and 1,001 school children were selected for this study. Half of the schools were used as clinical testing sites (blood and stool). Materials and Methods: Anthropometric measures were collected from all children. Over 300 children were tested for anemia and 229 for helminth infection. Ova and parasite specimens were examined via Direct, Kato Katz, and McMaster techniques. Hemoglobin was measured from venipuncture following the hemacue system. Statistical analysis: Correlation between infection intensities and growth indicators were examined. Chi Square or t tests were used for bivariate analysis. Multiple logistic regression was performed on significant variables from bivariate techniques. Results: Over two-thirds of school children were positive for infection by any STH. Prevalence of Hookworm was 30%; Ascaris, 52%; and Trichuris, 39%, most as low-intensity infection. Over half of the children were co-infected. In bivariate analysis, anemia was significantly associated with polyparasitism. Conclusions: For a Guatemalan child who experiences a unit decrease in hemoglobin, one expects to see a 24% increase in the odds of being infected with STH, controlling for age, sex, lake proximity, and growth characteristics. Infection with more than one STH, despite low intensity, led to a significant decrease in hemoglobin

Attitudes Toward COVID-19 and COVID-19 Vaccinations Among Athletic Trainers

Purpose: Following the beginning of the pandemic brought about by the novel coronavirus which causes COVID-19, the first COVID-19 vaccination received emergency use authorization in the United States of America in December of 2020. Current research has shown the authorized COVID-19 vaccines are safe and effective at preventing severe illness, hospitalizations and death have a good safety profile. Additionally, the side effects associated with these vaccines are typically mild to moderate while the protection against hospitalization and severe disease is substantial. (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html). At the time of this study, there appears to be a paucity in the research related to the attitudes toward COVID-19 and COVID-19 vaccines among athletic trainers. The purpose of this study is to describe the attitudes toward COVID-19 and COVID-19 vaccines among athletic trainers. Methods: A total of 186 athletic trainers (age= 43 ± 11, years of certified experience = 20 ± 11) opened and completed the survey. Participants were sent an electronic survey via email that collected demographic information and assessed attitudes toward COVID-19 and COVID-19 vaccines. Data was downloaded and analyzed using a commercially available statistics package. Results: The majority of athletic trainers surveyed had received a COVID-19 vaccination at the time of this study (94.1%, n=175). Most athletic trainers also agreed that the health of their patients was more important than disruption of their competition season due to COVID-19 (82.3%, n=153). In general, the most common reason for vaccine hesitancy was the speed with which currently available COVID-19 vaccines were developed. Conclusions: The findings of this study show the majority of surveyed athletic trainers had received a COVID-19 vaccine. The primary reason for athletic trainers not receiving a COVID-19 vaccination appeared to be the speed at which the currently available COVID-19 vaccines were developed. Given the available information on the new mRNA COVID vaccines, this may indicate a lack of education on the development of the COVID-19 vaccines. As athletic trainers continue to work in day-to-day patient care, it is imperative to determine the best methods for educating athletic trainers on the potential benefits of COVID-19 vaccinations

The CTSA University of Texas Health Science Center (UTHSC) Northeast—Tyler and Rio Grande Valley Success Story: How Rural, Underserved Academic Communities Rapidly Built a Robust Engine for Collaborative COVID-19 Clinical Research

In 2018, The University of Texas Health Science Center– Tyler and University of Texas Rio Grande Valley were invited to develop clinical research units for an existing Clinical and Translational Science Award (CTSA) consortium with the objective to equip medically underserved, economically disadvantaged communities and subsequently to deploy COVID-19 clinical trials in response to a public health emergency

Analysis of a wild mouse promoter variant reveals a novel role for FcγRIIb in the control of the germinal center and autoimmunity.

Genetic variants of the inhibitory Fc receptor FcγRIIb have been associated with systemic lupus erythematosus in humans and mice. The mechanism by which Fcgr2b variants contribute to the development of autoimmunity is unknown and was investigated by knocking in the most commonly conserved wild mouse Fcgr2b promoter haplotype, also associated with autoimmune-prone mouse strains, into the C57BL/6 background. We found that in the absence of an AP-1-binding site in its promoter, FcγRIIb failed to be up-regulated on activated and germinal center (GC) B cells. This resulted in enhanced GC responses, increased affinity maturation, and autoantibody production. Accordingly, in the absence of FcγRIIb activation-induced up-regulation, mice developed more severe collagen-induced arthritis and spontaneous glomerular immune complex deposition. Our data highlight how natural variation in Fcgr2b drives the development of autoimmune disease. They also show how the study of such variants using a knockin approach can provide insight into immune mechanisms not possible using conventional genetic manipulation, in this case demonstrating an unexpected critical role for the activation-induced up-regulation of FcγRIIb in controlling affinity maturation, autoantibody production, and autoimmunity

Development of self-reactive germinal center B cells and plasma cells in autoimmune FcγRIIB-deficient mice

The leukemogenic effects of Myc drive recurrent trisomy in a mouse model of acute myeloid leukemia

Colorectal Adenoma Detection Rate in Northeast Texas – Outcome from Community Service Project Using the Fecal Immunochemical Test and Colonoscopy

Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer in the United States. CRC incidence rates in Northeast Texas, a primarily rural region of the state, far exceed state and national averages. The current study sought to determine the proportion of polyps found in a sample of 5,391 individuals living in Northeast Texas using either colonoscopy or fecal immunochemical testing. In addition, the role of insurance to CRC screening was also investigated. An adenomatous polyp was detected in 44.7% participants in the colonoscopy group and in 2.6% of participants undergoing FIT testing. Additionally, participants in the colonoscopy group who were un- or under-insured were 30% more likely to have an adenomatous polyp detected. While a larger proportion of participants had an adenomatous polyp detected in the colonoscopy group, many including the un- or under-insured are not able to afford, at which point FIT testing may be a better option

Colorectal Cancer Education and Screening Program For The Un- or Under- Insured In A Primarily Rural Setting in Northeast Texas: Design and Methods

Background: Although early detection and screening for colorectal cancer saves lives, screening rates remain suboptimal, especially for minorities, underserved populations, older adults (>60), men, un/under insured, and those living in rural settings. The goal of the colorectal cancer education and screening program is to target the un- or under- insured in a 19-county primarily rural target area to provide: 1) education concerning CRC and CRC screening to 12,000 individuals, and 2) CRC screenings (colonoscopy and/or FIT) to 5,1613 un- or under- insured individuals. Methods: The education outreach team targets local health fairs, clinics, churches, etc. to educate individuals on CRC and the importance of screening. The program aims to then have those individuals electively undergo a colonoscopy and/or a FIT test. The number of those educated and screened is recorded. The results related to colonoscopy, FIT, and follow-up are collected. Results: Primary outcomes include number of individuals educated, number of FIT test/colonoscopies performed and results of screening procedures. Conclusions: This education and screening outreach program is designed to reach primarily rural and underserved populations eligible for colorectal screening. Results of efficacy of program will advance knowledge on how to conduct colorectal cancer outreach programs in rural settings. &nbsp