Reflection and Remembrance: Oral histories and critical thinking

The research assignment for this class was to interview someone who lived through World War II. The interviewee could be someone who served in the military service, someone on the home front or even a child-anyone who was touched by the experience of World War II

Assessing Preliminary Impact of the North Carolina Community Transformation Grant Project Farmers\u27 Market Initiatives Among Rural Residents

Objective: Using the Social Determinants of Health as the study\u27s theoretical underpinning, the authors examined the impact of the North Carolina Community Transformation Grant Project farmers\u27 market initiatives on changes in awareness and use of farmers\u27 markets, and fruit and vegetable consumption. Methods: During the farmers\u27 market season, the researchers conducted a random digit-dial telephone survey among residents in 3 rural North Carolina counties to examine changes in farmers\u27 market awareness, shopping, and fruit and vegetable consumption. They examined change over 1 year using t tests, chi-square tests, and propensity score matching. Results: In 1 county there were increases in farmers\u27 market shopping and fruit and vegetable consumption, and in 1 county there were decreases in farmers\u27 market shopping and fruit and vegetable consumption. Conclusions and Implications: The impact of farmers\u27 market initiatives may be affected by county-specific socioeconomic contexts

Availability of Farmers’ Markets and Supplemental Nutrition Assistance Program/Electronic Benefit Transfer Systems and Associations With Rurality, Poverty, Race/Ethnicity, and Obesity Among North Carolina Counties

Increasing the number of farmers’ markets and implementing Electronic Benefit Transfer (EBT) systems for the Supplemental Nutrition Assistance Program (SNAP) at more farmers’ markets have been suggested as strategies to overcome food access issues, but little is known about their availability in the rural South. This study examines differences in availability of farmers’ markets and SNAP/EBT at markets by county-level rural/urban classification, percentage poverty, percentage racial/ethnic minority, and percentage obese residents in North Carolina counties. Data were collected using a cross-sectional survey. Though results related to rurality and economic status are mixed, regression analyses indicate that the percentage of African American residents is inversely associated with the number of markets and number of markets that accept EBT. Results suggest that access to farmers’ markets varies in North Carolina, and additional research is needed to determine whether this impacts obesity

Cognitively impaired elderly exhibit insulin resistance and no memory improvement with infused insulin

Insulin resistance is a risk factor for Alzheimer's disease (AD), although its role in AD etiology is unclear. We assessed insulin resistance using fasting and insulin-stimulated measures in 51 elderly subjects with no dementia (ND; n = 37) and with cognitive impairment (CI; n = 14). CI subjects exhibited either mild CI or AD. Fasting insulin resistance was measured using the homeostatic model assessment of insulin resistance (HOMA-IR). Insulin-stimulated glucose disposal was assessed using the hyperinsulinemic-euglycemic clamp to calculate glucose disposal rate into lean mass, the primary site of insulin-stimulated glucose disposal. Because insulin crosses the blood-brain barrier, we also assessed whether insulin infusion would improve verbal episodic memory compared to baseline. Different but equivalent versions of cognitive tests were administered in counterbalanced order in the basal and insulin-stimulated state. Groups did not differ in age or body mass index. Cognitively impaired subjects exhibited greater insulin resistance as measured at fasting (HOMA-IR; ND: 1.09 [1.1] vs. CI: 2.01 [2.3], p = 0.028) and during the hyperinsulinemic clamp (glucose disposal rate into lean mass; ND: 9.9 (4.5) vs. AD 7.2 (3.2), p = 0.040). Cognitively impaired subjects also exhibited higher fasting insulin compared to ND subjects, (CI: 8.7 [7.8] vs. ND: 4.2 [3.8] μU/mL; p = 0.023) and higher fasting amylin (CI: 24.1 [39.1] vs. 8.37 [14.2]; p = 0.050) with no difference in fasting glucose. Insulin infusion elicited a detrimental effect on one test of verbal episodic memory (Free and Cued Selective Reminding Test) in both groups (p < 0.0001) and no change in performance on an additional task (delayed logical memory). In this study, although insulin resistance was observed in cognitively impaired subjects compared to ND controls, insulin infusion did not improve memory. Furthermore, a significant correlation between HOMA-IR and glucose disposal rate was present only in ND (p = 0.0002) but not in cognitively impaired (p = 0.884) subjects, indicating potentially important physiological differences between these cohorts

Complexities of Short-Term Mobility for Sex Work and Migration among Sex Workers: Violence and Sexual Risks, Barriers to Care, and Enhanced Social and Economic Opportunities

Despite research on the health and safety of mobile and migrant populations in the formal and informal sectors globally, limited information is available regarding the working conditions, health, and safety of sex workers who engage in short-term mobility and migration. The objective of this study was to longitudinally examine work environment, health, and safety experiences linked to short-term mobility/migration (i.e., worked or lived in another city, province, or country) among sex workers in Vancouver, Canada, over a 2.5-year study period (2010–2012). We examined longitudinal correlates of short-term mobility/migration (i.e., worked or lived in another city, province, or country over the 3-year follow-up period) among 646 street and off-street sex workers in a longitudinal community-based study (AESHA). Of 646 sex workers, 10.84 % (n = 70) worked or lived in another city, province, or country during the study. In a multivariate generalized estimating equations (GEE) model, short-term mobility/migration was independently correlated with older age (adjusted odds ratio (AOR) 0.95, 95 % confidence interval (CI) 0.92–0.98), soliciting clients in indoor (in-call) establishments (AOR 2.25, 95 % CI 1.27–3.96), intimate partner condom refusal (AOR 3.00, 1.02–8.84), and barriers to health care (AOR 1.77, 95 % CI 1.08–2.89). In a second multivariate GEE model, short-term mobility for sex work (i.e., worked in another city, province, or country) was correlated with client physical/sexual violence (AOR 1.92, 95 % CI 1.02–3.61). In this study, mobile/migrant sex workers were more likely to be younger, work in indoor sex work establishments, and earn higher income, suggesting that short-term mobility for sex work and migration increase social and economic opportunities. However, mobility and migration also correlated with reduced control over sexual negotiation with intimate partners and reduced health care access, and mobility for sex work was associated with enhanced workplace sexual/physical violence, suggesting that mobility/migration may confer risks through less control over work environment and isolation from health services. Structural and community-led interventions, including policy support to allow for more formal organizing of sex work collectives and access to workplace safety standards, remain critical to supporting health, safety, and access to care for mobile and migrant sex workers