Ragtime for beginners

Ragtime for Beginners is a collection of poems concerned with questions of space--the space that not only separates people (through distance or time), but also divides the self. It examines what separates a husband and wife married twenty-five years, and conversely, what brings together a woman and the Jehovah's Witness at her door; and it explores the seismic shifts of the self, how we assemble and disassemble our own lives. The collection pivots around questions of perspective; it considers the difference between something and the image of that thing. It seeks to understand the value of fiction and metaphor in the face of loss; it attempts to distinguish a pomegranate, for example, from a picture of a pomegranate. The five "diptychs," approach their subject matter from two directions--from two voices, two places, or two moments in time. Many of the poems are concerned with memory. They ask, what does one do with a memory? Can the past be made concrete, saved, held in one's hand? In "The Velvet Jewelry Box," the speaker attempts to "unpack those memories like stones, build a road...." In "What Days Remind You Of," the speaker wants to "gather them...like sheets billowing on a clothesline." The collection oscillates between prose (with its enjambment and speed) and lineation (even, at times, metred couplets or quatrains). In every instance, these are self-conscious poems. Like Anna H., in the collection's long poem, they examine the language available to them, searching out similes, questioning images

Wastewater treatment plants as a source of microplastics in river catchments

It is now well established that the oceans contain significant accumulations of plastic debris but only very recently have studies began to look at sources of microplastics (MPs) in river catchments. This work measured MPs up- and downstream of six wastewater treatment plants (WWTPs) in different catchments with varying characteristics and found that all led to an increase in MPs in rivers. Nevertheless, the data collected indicated that there were other important sources of MPs in the catchments studied and that these may include atmospheric deposition, agricultural land to which sewage sludge has been applied, and diffuse release of secondary MPs following the breakdown of larger plastic items. MPs were comprised mainly of fibres, fragments, and flakes with pellets and beads only dominating at one site. Variation in MP pollution occurred over time and this difference was greater at some sites than others. A key research need is the further study of MP sources in river catchments to facilitate management efforts to reduce their presence in freshwater and marine environments

Repeat pneumococcal polysaccharide vaccination does not impair functional immune responses among Indigenous Australians.

Indigenous Australians experience one of the highest rates of pneumococcal disease globally. In the Northern Territory of Australia, a unique government-funded vaccination schedule for Indigenous Australian adults comprising multiple lifetime doses of the pneumococcal polysaccharide vaccine is currently implemented. Despite this programme, rates of pneumococcal disease do not appear to be declining, with concerns raised over the potential for immune hyporesponse associated with the use of this vaccine. We undertook a study to examine the immunogenicity and immune function of a single and repeat pneumococcal polysaccharide vaccination among Indigenous adults compared to non-Indigenous adults. Our results found that immune function, as measured by opsonophagocytic and memory B-cell responses, were similar between the Indigenous groups but lower for some serotypes in comparison with the non-Indigenous group. This is the first study to document the immunogenicity following repeat 23-valent pneumococcal polysaccharide vaccine administration among Indigenous Australian adults, and reinforces the continued need for optimal pneumococcal vaccination programmes among high-risk populations

ENHANCING SOCIAL SUPPORT WITH A COMMUNITY-BASED NUTRITION PROGRAM FOR HISPANIC AND BLACK MOTHERS TO ADDRESS INFANT MORTALITY DISPARITIES IN DURHAM COUNTY, NORTH CAROLINA

Among the United States Department of Health and Human Services’ (USDHHS) Healthy People 2030 objectives, social and community context is a social determinant of health (SDoH) that represents the relationships and interactions between individuals where they live and work. These dynamics are significant factors in promoting and understanding health behaviors and outcomes in a population. Specifically, infant mortality is an example of a health outcome that disproportionately affects certain racial subgroups in the United States. Although the primary causes of infant mortality are complex and often multifaceted, one’s social and community support network can play a pivotal role in reducing the risk of experiencing infant mortality. In Durham County, North Carolina (NC), Hispanic and Black families suffer from high rates of infant mortality compared to White families. The 2020 Durham County Community Health Assessment reports that these poor birth outcomes are frequently related to delayed prenatal care and racial bias; both of which are reflective of the social environment of healthcare. The purpose of this proposal is to leverage social supports for Black and Hispanic mothers through the implementation of accessible and immersive community-based prenatal care services to promote positive birth experiences, outcomes, and ultimately mitigate the disparities in infant mortality among Durham County, NC.Master of Public Healt

Antenatal influenza and pertussis vaccine uptake among Aboriginal mothers in Western Australia

Background: Antenatal influenza and pertussis vaccination prevent serious disease in mothers and infants. Aboriginal individuals are at increased risk of infection yet little is known about vaccine coverage among Aboriginal mothers. Aims: To estimate the uptake of influenza and pertussis vaccination among pregnant Aboriginal women in Western Australia and identify barriers and enablers to vaccination. Materials and methods: Four hundred Aboriginal women, aged ≥18 years, who gave birth to a live infant between April and October 2015, were randomly selected and invited to participate in telephone interviews. Of the 387 women who did not decline, 178 had a functioning phone number and 100 completed the survey. Analyses were weighted by maternal residence. Results: During pregnancy the majority of Aboriginal mothers were recommended influenza (66%; unweighted, 65/96 = 68%) and pertussis (65%; unweighted, 62/94 = 66%) vaccines, with 62% (unweighted, 56/94 = 56%) and 63% (unweighted, 60/93 = 65%) receiving the vaccinations, respectively. Almost all vaccinated women (98%) reported wanting to protect their baby as the reason for immunisation. Rural mothers were more likely than metropolitan mothers to have been vaccinated against influenza (odds ratio (OR) 4.1, 95% CI 1.7–10.2) and pertussis (OR 3.1, 95% CI 1.2–7.6). Recommendation by a healthcare provider was strongly associated with vaccine uptake (influenza: OR 15.6, 95% CI 4.9–49.5; pertussis: OR 13.3, 95% CI 4.6–38.0). Conclusion: Vaccination uptake among Western Australian Aboriginal mothers is comparable with rates reported for non‐Aboriginal populations worldwide. Provider recommendation is the single most important factor associated with vaccination uptake, underlining the importance of integrating vaccination into routine antenatal care

Repeat pneumococcal polysaccharide vaccine in Indigenous Australian adults is associated with decreased immune responsiveness.

BACKGROUND: Indigenous adults residing in the Northern Territory of Australia experience elevated rates of invasive pneumococcal disease despite the routine use of 23-valent pneumococcal polysaccharide vaccine (23vPPV). We hypothesised that the limited protection from 23vPPV may be due to hyporesponsiveness as a result of vaccine failure from repeated vaccination. To explore this possibility, we evaluated the immune response to a first and second dose of 23vPPV in Indigenous adults and a first dose of 23vPPV in non-Indigenous adults. METHODS: Serotype-specific IgG was measured by ELISA for all 23 vaccine serotypes at baseline and at one month post-vaccination. Individuals were considered to have an adequate immune response if paired sera demonstrated either: a four-fold rise in antibody concentration; a two-fold rise if the post vaccination antibody was >1.3μg/ml but 4.0μg/ml for at least half of the serotypes tested (12/23). Our per-protocol analysis included the comparison of outcomes for three groups: Indigenous adults receiving a second 23vPPV dose (N=20) and Indigenous (N=60) and non-Indigenous adults (N=25) receiving their first 23vPPV dose. RESULTS: All non-Indigenous adults receiving a first dose of 23vPPV mounted an adequate immune response (25/25). There was no significant difference in the proportion of individuals with an adequate response using our definition (primary endpoint), with 88% of Indigenous adults mounted an adequate response following first dose 23vPPV (53/60) compared to 70% having an adequate response following a second dose of 23vPPV (14/20; p=0.05). The risk difference between Indigenous participants receiving first dose compared to non-Indigenous participants receiving first dose was significant when comparing a response threshold of at least 70% (-27%, 95% CI: -43% to -11%; p=0.01) and 90% (-38%, 95% CI: -60% to -16%; p=0.006) of serotypes with a positive response. CONCLUSION: Indigenous participants demonstrated a poorer response to a first dose 23vPPV compared to their non-Indigenous counterparts, with lower IgG following a second 23vPPV dose. These findings highlight the critical need to evaluate the efficacy of future pneumococcal vaccine programs in the Australian Indigenous populations that recommend repeated doses of 23vPPV