African American communities, Moore County : an action-oriented community diagnosis : findings and next steps of action

An Action-Oriented Community Diagnosis (AOCD) of the African American communities in Moore County, North Carolina (NC) was completed in 2007-2008 by a team of five graduate students from the University of North Carolina at Chapel Hill (UNC) in the School of Public Health. The team was guided by two staff of FirstHealth, who served as preceptors. The purpose of the AOCD in Moore County was to identify the strengths and needs of African American communities in Moore County and engage them in determining action steps to address their identified needs and priorities. The AOCD involved four phases: 1) gaining entry into the community; 2) collecting secondary data; 3) collecting primary data through interviews with community members and service providers; and 4) holding a community forum to discuss the findings and determine action steps to address needs and priorities. The team entered Moore County in October of 2007 and began with a driving tour of the county that was guided by their preceptors, and attending community events. Secondary data sources were reviewed, such as newspaper articles from The Pilot, published literature, and websites of U.S Census Bureau and North Carolina Center for Health Statistics. The team conducted qualitative key informant interviews with 16 service providers and 20 community members, located throughout Moore County. An analysis of primary data revealed that the following 17 issues were most frequently cited as concerns among African American community members and service providers who were interviewed: 1) unity in the African American community; 2) education; 3) recreation and social activities; 4) employment; 5) younger generation leaves county in search of opportunities and does not return; 6) health; 7) politics; 8) legal services; 9) communication; 10) affordable housing and property; 11) family; 12) transportation; 13) food; 14) community involvement and divisions stemming from 15) race relations, 16) economic status and 17) location. The final stage of the AOCD process was the community forum. In order to plan a community-informed forum, interested community members and service providers formed a student facilitated Forum Planning Committee (FPC). Nine FPC members chose five of the 17 themes, which emerged from the interviews, to be topics of small group, student-facilitated discussions at the forum. The themes chosen by the committee were: access to healthcare, employment, opportunities for youth, politics, and unity within the African American community. On April 7, 2008, the team presented the findings from service provider and community member interviews at the community forum, held small group discussions, and engaged community members and service providers in generating action steps to address the themes identified by the FPC. At the conclusion of the discussion groups, one community member from each group volunteered to present action steps developed by their group. Community members and service providers took responsibility for following through on most of the action steps. Below are the four themes discussed at the forum and the corresponding action steps developed during the small discussion groups. Access to Health Care This discussion session focused primarily on the lack of health insurance and access to health services for the African American community and resulted in the following action steps: Opportunities for Youth The majority of the discussion session focused on the lack of opportunities for youth to succeed in Moore County; this leads many to leave the county to pursuer better opportunities. The discussion generated the following action steps: Action Steps Increase public awareness about available resources. Use the TV and radio to relay public service ads. Distribute information to beauty shops, barbers, grocery stores, churches, etc. Push for better transportation at county commissioners meetings. Hold health fairs in local churches. Make online calendar and resources more accessible (i.e. when and where is the FirstHealth mobile van). Increase community awareness of political candidates’ viewpoint on healthcare. Action Steps. Organize youth programs and activities that are not just related to sports (i.e. churches, existing organizations, and business could help organize and offer resources and space). Tap into committed organizations in Moore County. Increase youth involvement. Utilize and expand on existing mentoring programs. Increase commitment of community members to volunteer. Gain ideas from new residents (new residents have new ideas for activities and events). Shadowing with African American business owners to allow youth exposure to role models and examples within the community. Develop relationships between community leaders and youth so that any efforts to develop activities will truly address the youths’ desires, rather than what adults think youth want to do. Politics Participants in this discussion session talked about the lack of African American representation in local Moore County politics. One pivotal action step was created by this group: Unity Within the African American Community Discussion in this session was centered on the difficulty that many African American community groups and organizations have when attempting to work together due to differences in opinions. Action steps generated include: A forum follow-up meeting, facilitated by an FPC member, was scheduled for May 29th, seven weeks from the date of the forum, to assess the progress of community action in response to the generated action steps. Action Step. Identify African American leaders to start a county-wide coalition of leaders to begin discussions around issues relevant to African American communities throughout Moore County. Action Steps. Create a list of all African American organizations in Moore County and build partnerships among the existing organizations in Moore County. Start a Community Unity meeting once every month where all African American organizations and community groups can exchange information about issues that affect them. Start an email listserv. Use existing organizations such as churches to disseminate information relevant to the community while being sensitive to each organization’s posting requirements. Communicate issues to elected officials. Identify who elected officials are. Identify ways to get involved in local government. Based on primary data collection, challenges identified and action steps generated during the forum, the team compiled a list of recommendations for community members and service providers: To encourage the youth of Moore County to continue to live in and succeed within the county after high school graduation, the team recommends collaboration between existing organizations that provides services to youth so that the scope and reach of these services might be broadened. To encourage young adults to become politically engaged citizens in Moore County, the team encourages collaboration between church, community, and political leaders to develop an organization that facilitates an opportunity for young adults to learn about and discuss the importance and the role of the politically active African American. To avoid overlapping efforts and to increase communication among Moore County leaders, the team recommends that FirstHealth facilitate a meeting between the 2006-2007 Forum Planning Committee and the 2007-2008 Forum Planning Committee members to discuss the action steps created during the recent forum and identify ways they can work together to affect positive change in African American communities in Moore County. It is the team’s hope that this document will serve as a resource and guide for community members and service providers who work with and within African American communities in Moore County to affect positive change.Master of Public Healt

Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters

© Copyright © 2020 Sandifer, Knapp, Lichtveld, Manley, Abramson, Caffey, Cochran, Collier, Ebi, Engel, Farrington, Finucane, Hale, Halpern, Harville, Hart, Hswen, Kirkpatrick, McEwen, Morris, Orbach, Palinkas, Partyka, Porter, Prather, Rowles, Scott, Seeman, Solo-Gabriele, Svendsen, Tincher, Trtanj, Walker, Yehuda, Yip, Yoskowitz and Singer. The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop

Framework for a Community Health Observing System for the Gulf of Mexico Region: Preparing for Future Disasters

© Copyright © 2020 Sandifer, Knapp, Lichtveld, Manley, Abramson, Caffey, Cochran, Collier, Ebi, Engel, Farrington, Finucane, Hale, Halpern, Harville, Hart, Hswen, Kirkpatrick, McEwen, Morris, Orbach, Palinkas, Partyka, Porter, Prather, Rowles, Scott, Seeman, Solo-Gabriele, Svendsen, Tincher, Trtanj, Walker, Yehuda, Yip, Yoskowitz and Singer. The Gulf of Mexico (GoM) region is prone to disasters, including recurrent oil spills, hurricanes, floods, industrial accidents, harmful algal blooms, and the current COVID-19 pandemic. The GoM and other regions of the U.S. lack sufficient baseline health information to identify, attribute, mitigate, and facilitate prevention of major health effects of disasters. Developing capacity to assess adverse human health consequences of future disasters requires establishment of a comprehensive, sustained community health observing system, similar to the extensive and well-established environmental observing systems. We propose a system that combines six levels of health data domains, beginning with three existing, national surveys and studies plus three new nested, longitudinal cohort studies. The latter are the unique and most important parts of the system and are focused on the coastal regions of the five GoM States. A statistically representative sample of participants is proposed for the new cohort studies, stratified to ensure proportional inclusion of urban and rural populations and with additional recruitment as necessary to enroll participants from particularly vulnerable or under-represented groups. Secondary data sources such as syndromic surveillance systems, electronic health records, national community surveys, environmental exposure databases, social media, and remote sensing will inform and augment the collection of primary data. Primary data sources will include participant-provided information via questionnaires, clinical measures of mental and physical health, acquisition of biological specimens, and wearable health monitoring devices. A suite of biomarkers may be derived from biological specimens for use in health assessments, including calculation of allostatic load, a measure of cumulative stress. The framework also addresses data management and sharing, participant retention, and system governance. The observing system is designed to continue indefinitely to ensure that essential pre-, during-, and post-disaster health data are collected and maintained. It could also provide a model/vehicle for effective health observation related to infectious disease pandemics such as COVID-19. To our knowledge, there is no comprehensive, disaster-focused health observing system such as the one proposed here currently in existence or planned elsewhere. Significant strengths of the GoM Community Health Observing System (CHOS) are its longitudinal cohorts and ability to adapt rapidly as needs arise and new technologies develop

Assessing inter-sectoral climate change risks: the role of ISIMIP

The aims of the Inter-Sectoral Impact Model Intercomparison Project (ISIMIP) are to provide a framework for the intercomparison of global and regional-scale risk models within and across multiple sectors and to enable coordinated multi-sectoral assessments of different risks and their aggregated effects. The overarching goal is to use the knowledge gained to support adaptation and mitigation decisions that require regional or global perspectives within the context of facilitating transformations to enable sustainable development, despite inevitable climate shifts and disruptions. ISIMIP uses community-agreed sets of scenarios with standardized climate variables and socio-economic projections as inputs for projecting future risks and associated uncertainties, within and across sectors. The results are consistent multi-model assessments of sectoral risks and opportunities that enable studies that integrate across sectors, providing support for implementation of the Paris Agreement under the United Nations Framework Convention on Climate Change

CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes

<p>Abstract</p> <p>Background</p> <p>Quality improvement (QI) programs focused on mastery of content by individual staff members are the current standard to improve resident outcomes in nursing homes. However, complexity science suggests that learning is a social process that occurs within the context of relationships and interactions among individuals. Thus, QI programs will not result in optimal changes in staff behavior unless the context for social learning is present. Accordingly, we developed CONNECT, an intervention to foster systematic use of management practices, which we propose will enhance effectiveness of a nursing home Falls QI program by strengthening the staff-to-staff interactions necessary for clinical problem-solving about complex problems such as falls. The study aims are to compare the impact of the CONNECT intervention, plus a falls reduction QI intervention (CONNECT + FALLS), to the falls reduction QI intervention alone (FALLS), on fall-related process measures, fall rates, and staff interaction measures.</p> <p>Methods/design</p> <p>Sixteen nursing homes will be randomized to one of two study arms, CONNECT + FALLS or FALLS alone. Subjects (staff and residents) are clustered within nursing homes because the intervention addresses social processes and thus must be delivered within the social context, rather than to individuals. Nursing homes randomized to CONNECT + FALLS will receive three months of CONNECT first, followed by three months of FALLS. Nursing homes randomized to FALLS alone receive three months of FALLs QI and are offered CONNECT after data collection is completed. Complexity science measures, which reflect staff perceptions of communication, safety climate, and care quality, will be collected from staff at baseline, three months after, and six months after baseline to evaluate immediate and sustained impacts. FALLS measures including quality indicators (process measures) and fall rates will be collected for the six months prior to baseline and the six months after the end of the intervention. Analysis will use a three-level mixed model.</p> <p>Discussion</p> <p>By focusing on improving local interactions, CONNECT is expected to maximize staff's ability to implement content learned in a falls QI program and integrate it into knowledge and action. Our previous pilot work shows that CONNECT is feasible, acceptable and appropriate.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00636675">NCT00636675</a></p

Peptidyl-prolyl <i>cis</i>/<i>trans</i>-Isomerase A1 (Pin1) Is a Target for Modification by Lipid Electrophiles

Oxidation of membrane phospholipids is associated with inflammation, neurodegenerative disease, and cancer. Oxyradical damage to phospholipids results in the production of reactive aldehydes that adduct proteins and modulate their function. 4-Hydroxynonenal (HNE), a common product of oxidative damage to lipids, adducts proteins at exposed Cys, His, or Lys residues. Here, we demonstrate that peptidyl-prolyl <i>cis</i>/<i>trans</i>-isomerase A1 (Pin1), an enzyme that catalyzes the conversion of the peptide bond of pSer/pThr-Pro moieties in signaling proteins from cis to trans, is highly susceptible to HNE modification. Incubation of purified Pin1 with HNE followed by MALDI-TOF/TOF mass spectrometry resulted in detection of Michael adducts at the active site residues His-157 and Cys-113. Time and concentration dependencies indicate that Cys-113 is the primary site of HNE modification. Pin1 was adducted in MDA-MB-231 breast cancer cells treated with 8-alkynyl-HNE as judged by click chemistry conjugation with biotin followed by streptavidin-based pulldown and Western blotting with anti-Pin1 antibody. Furthermore, orbitrap MS data support the adduction of Cys-113 in the Pin1 active site upon HNE treatment of MDA-MB-231 cells. siRNA knockdown of Pin1 in MDA-MB-231 cells partially protected the cells from HNE-induced toxicity. Recent studies indicate that Pin1 is an important molecular target for the chemopreventive effects of green tea polyphenols. The present study establishes that it is also a target for electrophilic modification by products of lipid peroxidation