Introducing a Longitudinal Study of Community Gardeners and Gardens in New York City

For almost a decade, the NYC Department of Parks and Recreation GreenThumb program has collected data about hundreds of New York City community gardens citywide to understand how these gardens function. Building on a data set that includes surveys and interviews conducted periodically with garden representatives since 2003, GreenThumb and USDA Forest Service researchers have conducted a new round of community garden interviews examining membership, programming, partnerships, and motivations for gardening. This comprehensive study of the largest community gardening program in the United States aims to understand the evolving role of community gardens in New York City. The study asks: From 2003-2011, is gardeners’ motivation for creating and participating in community gardens persistent or changing? How do the use and social functions of community gardens evolve or remain the same? What sort of programs and community events are held in gardens? How has garden membership changed over time? Is membership increasing, decreasing, or staying the same? Who participates in gardening in neighborhoods with changing demographics? During the summer of 2011, structured interviews were conducted by phone with representatives from a sample of 102 community gardens for which survey data existed from 2003, 2007, and 2009. These research findings will help assess the ways in which New York City community gardens have evolved and can continue to grow in the future

Global priorities for reduction of cetacean bycatch

Progress at reducing the scale and conservation impact of cetacean bycatch has been slow, sporadic, and limited to a few specific fisheries or circumstances. As a result, bycatch remains perhaps the greatest immediate and well-documented threat to cetacean populations globally. Having recognized the critical importance of reducing bycatch levels to prevent the depletion, and in some cases extinction, of cetacean populations, World Wildlife Fund-US launched a global bycatch initiative early in 2002. Their strategy calls on governmental and non-governmental bodies to move quickly, cooperatively, and thoughtfully to achieve bycatch reduction. As a supportive step, a working group was established to identify priorities and provide guidance on how financial and other resources should be invested to address bycatch issues. The group conducted a global survey of cetacean bycatch problems and identified a series of specific problems that should be addressed as priorities, with emphasis on: (1) situations that are especially critical (e.g. a species’ or population’s survival is immediately at risk from bycatch) and are not being addressed adequately; (2) circumstances where rapid progress could be made with a modest investment of resources; (3) situations in which bycatch is believed to pose a threat to cetaceans but a quantitative assessment is needed to verify the risk; and (4) fisheries in which a currently available solution (technical, socio-economic, or a combination) appears feasible

Global priorities for reduction of cetacean bycatch. Scientific Committee document SC/56/BC2, International Whaling Commission, July 2004, Sorrento, Italy

Progress at reducing the scale and conservation impact of cetacean bycatch has been slow, sporadic and limited to a few specific fisheries or circumstances. As a result bycatch remains perhaps the greatest immediate and well-documented threat to cetacean populations globally. Having recognized the critical importance of reducing bycatch levels to prevent the depletion, and in some cases extinction, of cetacean populations, World Wildlife Fund-US launched a global bycatch initiative early in 2002. Their strategy calls on governmental and non-governmental bodies to move quickly, cooperatively and thoughtfully to achieve bycatch reduction. As a supportive step a working group was established to identify priorities and provide guidance on how financial and other resources should be invested to address bycatch issues. The group will conduct a global survey of cetacean bycatch problems, classify and rank those problems according to an agreed set of criteria and provide a clear rationale for each problem assigned high priority for funding and intervention. The working group will emphasise: (1) situations that are especially critical (e.g. a species’ or population’s survival is immediately at risk from bycatch) and are not being addressed adequately; (2) circumstances where rapid progress could be made with a modest investment of resources; (3) situations in which bycatch is believed to pose a threat to cetaceans but a quantitative assessment is needed to verify the risk; and (4) fisheries in which a currently available solution (technical, socioeconomic or a combination) appears feasible. The report of the working group will be directed at governmental decision makers, aid agencies, nongovernmental organizations and related audiences

Using focus groups to design systems science models that promote oral health equity

Background While the US population overall has experienced improvements in oral health over the past 60 years, oral diseases remain among the most common chronic conditions across the life course. Further, lack of access to oral health care contributes to profound and enduring oral health inequities worldwide. Vulnerable and underserved populations who commonly lack access to oral health care include racial/ethnic minority older adults living in urban environments. The aim of this study was to use a systematic approach to explicate cause and effect relationships in creating a causal map, a type of concept map in which the links between nodes represent causality or influence. Methods To improve our mental models of the real world and devise strategies to promote oral health equity, methods including system dynamics, agent-based modeling, geographic information science, and social network simulation have been leveraged by the research team. The practice of systems science modeling is situated amidst an ongoing modeling process of observing the real world, formulating mental models of how it works, setting decision rules to guide behavior, and from these heuristics, making decisions that in turn affect the state of the real world. Qualitative data were obtained from focus groups conducted with community-dwelling older adults who self-identify as African American, Dominican, or Puerto Rican to elicit their lived experiences in accessing oral health care in their northern Manhattan neighborhoods. Results The findings of this study support the multi-dimensional and multi-level perspective of access to oral health care and affirm a theorized discrepancy in fit between available dental providers and patients. The lack of information about oral health at the community level may be compromising the use and quality of oral health care among racial/ethnic minority older adults. Conclusions Well-informed community members may fill critical roles in oral health promotion, as they are viewed as highly credible sources of information and recommendations for dental providers. The next phase of this research will involve incorporating the knowledge gained from this study into simulation models that will be used to explore alternative paths toward improving oral health and health care for racial/ethnic minority older adults

Left ventricular remodeling and hypertrophy in patients with aortic stenosis:insights from cardiovascular magnetic resonance

<p>Abstract</p> <p>Background</p> <p>Cardiovascular magnetic resonance (CMR) is the gold standard non-invasive method for determining left ventricular (LV) mass and volume but has not been used previously to characterise the LV remodeling response in aortic stenosis. We sought to investigate the degree and patterns of hypertrophy in aortic stenosis using CMR.</p> <p>Methods</p> <p>Patients with moderate or severe aortic stenosis, normal coronary arteries and no other significant valve lesions or cardiomyopathy were scanned by CMR with valve severity assessed by planimetry and velocity mapping. The extent and patterns of hypertrophy were investigated using measurements of the LV mass index, indexed LV volumes and the LV mass/volume ratio. Asymmetric forms of remodeling and hypertrophy were defined by a regional wall thickening <b>≥</b>13 mm and >1.5-fold the thickness of the opposing myocardial segment.</p> <p>Results</p> <p>Ninety-one patients (61±21 years; 57 male) with aortic stenosis (aortic valve area 0.93±0.32cm2) were recruited. The severity of aortic stenosis was unrelated to the degree (r²=0.012, P=0.43) and pattern (P=0.22) of hypertrophy. By univariate analysis, only male sex demonstrated an association with LV mass index (P=0.02). Six patterns of LV adaption were observed: normal ventricular geometry (n=11), concentric remodeling (n=11), asymmetric remodeling (n=11), concentric hypertrophy (n=34), asymmetric hypertrophy (n=14) and LV decompensation (n=10). Asymmetric patterns displayed considerable overlap in appearances (wall thickness 17±2mm) with hypertrophic cardiomyopathy.</p> <p>Conclusions</p> <p>We have demonstrated that in patients with moderate and severe aortic stenosis, the pattern of LV adaption and degree of hypertrophy do not closely correlate with the severity of valve narrowing and that asymmetric patterns of wall thickening are common.</p> <p>Trial registration</p> <p>ClinicalTrials.gov Reference Number: NCT00930735</p

Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury

BACKGROUND: Falls in older people have been characterized extensively in the literature, however little has been reported regarding falls in middle-aged and younger adults. The objective of this paper is to describe the perceived cause, environmental influences and resultant injuries of falls in 1497 young (20–45 years), middle-aged (46–65 years) and older (> 65 years) men and women from the Baltimore Longitudinal Study on Aging. METHODS: A descriptive study where participants completed a fall history questionnaire describing the circumstances surrounding falls in the previous two years. RESULTS: The reporting of falls increased with age from 18% in young, to 21% in middle-aged and 35% in older adults, with higher rates in women than men. Ambulation was cited as the cause of the fall most frequently in all gender and age groups. Our population reported a higher percentage of injuries (70.5%) than previous studies. The young group reported injuries most frequently to wrist/hand, knees and ankles; the middle-aged to their knees and the older group to their head and knees. Women reported a higher percentage of injuries in all age groups. CONCLUSION: This is the first study to compare falls in young, middle and older aged men and women. Significant differences were found between the three age groups with respect to number of falls, activities engaged in prior to falling, perceived causes of the fall and where they fell

Epilepsy and Pregnancy: For healthy pregnancies and happy outcomes. Suggestions for service improvements from the Multispecialty UK Epilepsy Mortality Group

Between 2009 and 2012 there were 26 epilepsy-related deaths in the UK of women who were pregnant or in the first post-partum year. The number of pregnancy-related deaths in women with epilepsy (WWE) has been increasing. Expert assessment suggests that most epilepsy-related deaths in pregnancy were preventable and attributable to poor seizure control. While prevention of seizures during pregnancy is important, a balance must be struck between seizure control and the teratogenic potential of antiepileptic drugs (AEDs). A range of professional guidance on the management of epilepsy in pregnancy has previously been issued, but little attention has been paid to how optimal care can be delivered to WWE by a range of healthcare professionals. We summarise the findings of a multidisciplinary meeting with representation from a wide group of professional bodies. This focussed on the implementation of optimal pregnancy epilepsy care aiming to reduce mortality of epilepsy in mothers and reduce morbidity in babies exposed to AEDs in utero. We identify in particular -What stage to intervene − Golden Moments of opportunities for improving outcomes -Which Key Groups have a role in making change -When − 2020 vision of what these improvements aim to achieve. -How to monitor the success in this field We believe that the service improvement ideas developed for the UK may provide a template for similar initiatives in other countries

Estimating alcohol-related premature mortality in san francisco: use of population-attributable fractions from the global burden of disease study

<p>Abstract</p> <p>Background</p> <p>In recent years, national and global mortality data have been characterized in terms of well-established risk factors. In this regard, alcohol consumption has been called the third leading "actual cause of death" (modifiable behavioral risk factor) in the United States, after tobacco use and the combination of poor diet and physical inactivity. Globally and in various regions of the world, alcohol use has been established as a leading contributor to the overall burden of disease and as a major determinant of health disparities, but, to our knowledge, no one has characterized alcohol-related harm in such broad terms at the local level. We asked how alcohol-related premature mortality in San Francisco, measured in years of life lost (YLLs), compares with other well-known causes of premature mortality, such as ischemic heart disease or HIV/AIDS.</p> <p>Methods</p> <p>We applied sex- and cause-specific population-attributable fractions (PAFs) of years of life lost (YLLs) from the Global Burden of Disease Study to 17 comparable outcomes among San Francisco males and females during 2004-2007. We did this in three ways: Method 1 assumed that all San Franciscans drink like populations in developed economies. These estimates were limited to alcohol-related harm. Method 2 modified these estimates by including several beneficial effects. Method 3 assumed that Latino and Asian San Franciscans drink alcohol like populations in the global regions related to their ethnicity.</p> <p>Results</p> <p>By any of these three methods, alcohol-related premature mortality accounts for roughly a tenth of all YLLs among males. Alcohol-related YLLs among males are comparable to YLLs for leading causes such as ischemic heart disease and HIV/AIDS, in some instances exceeding them. Latino and black males bear a disproportionate burden of harm. Among females, for whom estimates differed more by method and were smaller than those for males, alcohol-related YLLs are comparable to leading causes which rank somewhere between fifth and fourteenth.</p> <p>Conclusions</p> <p>Alcohol consumption is a major contributor to premature mortality in San Francisco, especially among males. Interventions to avert alcohol-related harm in San Francisco should be taken at the population level and deserve the same attention that is given to other major risk factors, such as smoking or obesity.</p