Washeteria closures, infectious disease and community health in rural Alaska: a review of clinical data in Kivalina, Alaska

Background. Kivalina is a northwest Alaska barrier island village of 400 people vulnerable to storm surges exacerbated recently by delayed winter sea and shore ice formation. The village has no in-home piped water or sewage; the “washeteria” is the only structure providing public showers, laundry facilities and flush toilets. In October 2004, a storm damaged the washeteria septic system resulting in prolonged facility closures. We assessed rates of gastrointestinal, respiratory and skin infections potentially impacted by prolonged washeteria closures. Methods. We obtained washeteria closure dates from 2003 to July 2009 and defined >7 day closure as prolonged. We received de-identified data on all Kivalina clinic visits from 2003 to 2009 and selected visits with ICD-9 diagnosis codes for respiratory, skin, or gastrointestinal infection; subsequent same patient/same illness-category visits within 14 days were excluded. We compared annual visit rates, for all ages combined, before (2003–2004) and after (2005–2009) the “2004” storm. Results. The washeteria had prolonged closures for 34 days (4.7%) in the 2 years 2003–2004 and 864 days (51.7%) between January 2005 and July 2009. Closures ranged from 8 to 248 days. Respiratory infection rates declined significantly from 1.32 visits/person/year in the 2003–2004 period to 0.99 visits/person/year in the 2005–2009 period. There was a significant increase in skin infection rates after 2004, peaking at 0.28 visits/person/year in 2007 and then declining significantly to 0.15 visits/person/year in 2009. Gastrointestinal infection rates remained stable and low throughout (average: 0.05 visits/person/year). No temporal association was observed between respiratory, gastrointestinal or skin infection rates and prolonged washeteria closures. Conclusion. The Kivalina washeteria was closed frequently and for extended periods between 2005 and 2009. Initial closures possibly resulted in increased skin infection rates. No increase in respiratory or gastrointestinal infections was noted. Evaluation of community adaptations to closures and other factors (e.g. childhood pneumococcal vaccination) would expand understanding of these findings

Street Crime in London: Deterrence, Disruption and Displacement

In early 2002 the Government implemented the Street Crime Initiative (SCI) in response to a rapid rise in street crime and growing public and media concern. The report examines the nature of street crime in the capital during 2001/02 and the early stages of the government initiative designed to tackle it. The study takes an innovative approach combining offence statistics, information gathered from interviews with offenders and those involved in the Street Crime Initiative (SCI) and crime mapping techniques to assess the impact of the SCI. It pays particular attention to how these offences can displace into other forms of crime or shift across time or place. It was precisely these issues which led the Government Office for London ultimately to commission this study in order to understand the nature of street crime across the London region

Prevalence of a Gluten-free Diet and Improvement of Clinical Symptoms in Patients with Inflammatory Bowel Diseases:

Background—Maintaining a gluten free diet (GFD) without an underlying diagnosis of celiac disease has enjoyed widespread acceptance in the USA. Methods—We performed a cross-sectional study utilizing a GFD questionnaire in 1647 patients with inflammatory bowel diseases (IBD) participating in the CCFA Partners longitudinal, Internet-based cohort. Results—A diagnosis of celiac disease (CD) and non-celiac gluten sensitivity (NCGS) were reported by 10 (0.6%) and 81 (4.9%) respondents, respectively. Three hundred fourteen (19.1%) participants reported having previously tried a GFD and 135 (8.2%) reported current use of GFD. Overall 65.6% of all patients, who attempted a GFD described an improvement of their GI-symptoms and 38.3% reported fewer or less severe IBD flares. In patients currently attempting a GFD, excellent adherence was associated with significant improvement of fatigue (p<0.03). Conclusion—In this large group of patients with IBD, a substantial number had attempted a GFD, of whom the majority had some form of improvement in GI-symptoms. Testing a GFD in clinical practice in patients with significant intestinal symptoms, which are not solely explained by the degree of intestinal inflammation, has the potential to be a safe and highly efficient therapeutic approach. Further prospective studies into mechanisms of gluten sensitivity in IBD are warranted

Avoidance of Fiber Is Associated With Greater Risk of Crohn’s Disease Flare in a 6-Month Period

Chronic inflammatory bowel diseases (IBDs) have been associated with an abnormal mucosal response to the gastrointestinal microbiota. Although dietary fiber affects the gastrointestinal microbiota, there is limited information on the role of fiber on IBD activity. We investigated factors associated with fiber consumption and whether it was associated with flares in patients with IBD

Maintaining police-citizen relations on social media during the COVID-19 pandemic

Despite a growing body of recent literature that has examined the role of the police during the COVID-19 pandemic, little is known about police approaches to citizen-engagement on social media in England. Accordingly, this paper draws on robust qualitative research conducted with police officers and staff across England who utilised either official, semi-official, or unofficial police social media accounts. The paper illustrates how they understood their role on social media during the pandemic, and the opportunities and lessons that can be learned. Above all, officers and staff in the study reported that the police transitioned between three distinct stages on social media during the first year of the pandemic. First, they discussed the need to move police engagement with citizens entirely online when the first lockdown started in March 2020 to maintain contact, albeit under very restricted circumstances. Second, during the initial stages of lockdown, they believed it was important that the police shared content on social media on how to keep safe, although they also acknowledged specific challenges in relation to sharing visual content, details of coronavirus legislation, and government guidance. Third, police participants later reported withdrawing from discussing pandemic-related content on social media, and instead promoting positive and feel-good stories about generic police activity. These findings are significant because they reveal that social media enabled the police to maintain their relationship with citizens during the pandemic, although in doing so the police played less of a role in relation to broadcasting guidance and rules linked to keeping people saf

Role of Nonsteroidal Anti-Inflammatory Drugs in Exacerbations of Inflammatory Bowel Disease

To determine the role of NSAIDs in activation of IBD

The Abstract Police and Occupational Culture

This chapter uses data from qualitative interviews with serving police officers, police community support officers (PCSOs) and police civilian staff (herein referred to as staff) from four English police services to explore potential consequences of 'abstract' forms of policing for occupational identity, subculture and, relatedly, staff well-being. Terpstra et al. (2019: 340) use the concept of "abstract police" to describe a situation within contemporary policing where, "both internally and externally, the police have become more at a distance, more impersonal and formal, less direct, and more disconnected". They argue that forms of abstract police impact on relations, both internally with colleagues and externally with partners and the public. In this vein, we identify changes to police working practices that make police more abstract. According to those interviewed, these changes to police practices could have a negative impact on mental and physical health in the workplace, in part because they have reduced opportunities for informal mutual support - identified as important for mitigating the impact of stressful, risky and dangerous experiences

Street crime in London: deterrence, disruption and displacement

In early 2002 the Government implemented the Street Crime Initiative (SCI) in response to a rapid rise in street crime and growing public and media concern. The report examines the nature of street crime in the capital during 2001/02 and the early stages of the government initiative designed to tackle it. The study takes an innovative approach combining offence statistics, information gathered from interviews with offenders and those involved in the Street Crime Initiative (SCI) and crime mapping techniques to assess the impact of the SCI. It pays particular attention to how these offences can displace into other forms of crime or shift across time or place. It was precisely these issues which led the Government Office for London ultimately to commission this study in order to understand the nature of street crime across the London region

Nonmelanoma skin cancer in inflammatory bowel disease: A review

At least 1 million new cases of non-melanoma skin cancer (NMSC) are diagnosed in the United States each year, and the incidence is increasing. A higher incidence of non-melanoma skin cancer (NMSC) in organ transplant recipients on immunosuppression has been documented for some time, and recent studies indicate that patients with inflammatory bowel disease (IBD), particularly those treated with immunosuppressive medications, might also be at higher risk for this condition. In this review, we summarize recent data evaluating the associations between immunomodulators, anti-tumor necrosis factor-α (anti-TNF) biologic agents and NMSC in patients with IBD and other autoimmune conditions such as rheumatoid arthritis (RA). We also offer recommendations for prevention of NMSC in these populations