Social Determinants of Health in Dunn, NC - Advocacy Toolkit

This folder contains a public health advocacy toolkit created by the Southern Oral History Program (SOHP)’s 2020-2021 Capstone Team at University of North Carolina Gillings School of Global Public Health. The 2020-2021 SOHP Capstone team worked on the ongoing SOHP Stories to Save Lives project, which collected a series of oral histories from rural North Carolinians about their experiences living, working, and receiving and providing healthcare. The team analyzed 38 unique oral histories that had been collected from patients and providers at a Federally Qualified Health Center (FQHC) based in Dunn, NC between 2018 and 2019. Based on these histories, the team assembled these products to advocate for change and improvements to social determinants of health that had affected the narrators of these oral histories

The magnitude of the snow-sourced reactive nitrogen flux to the boundary layer in the Uintah Basin

Reactive nitrogen (Nr = NO, NO2, HONO) and volatile organic carbon emissions from oil and gas extraction activities play a major role in wintertime ground-level ozone exceedance events of up to 140 ppb in the Uintah Basin in eastern Utah. Such events occur only when the ground is snow covered, due to the impacts of snow on the stability and depth of the boundary layer and ultraviolet actinic flux at the surface. Recycling of reactive nitrogen from the photolysis of snow nitrate has been observed in polar and midlatitude snow, but snow-sourced reactive nitrogen fluxes in mid-latitude regions have not yet been quantified in the field. Here we present vertical profiles of snow nitrate concentration and nitrogen isotopes (δ15N) collected during the Uintah Basin Winter Ozone Study 2014 (UBWOS 2014), along with observations of insoluble light-absorbing impurities, radiation equivalent mean ice grain radii, and snow density that determine snow optical properties. We use the snow optical properties and nitrate concentrations to calculate ultraviolet actinic flux in snow and the production of Nr from the photolysis of snow nitrate. The observed δ15N(NO−3) is used to constrain modeled fractional loss of snow nitrate in a snow chemistry column model, and thus the source of Nr to the overlying boundary layer. Snow-surface δ15N(NO−3) measurements range from −5 to 10 ‰ and suggest that the local nitrate burden in the Uintah Basin is dominated by primary emissions from anthropogenic sources, except during fresh snowfall events, where remote NOx sources from beyond the basin are dominant. Modeled daily averaged snow-sourced Nr fluxes range from 5.6 to 71 × 107 molec cm−2s−1 over the course of the field campaign, with a maximum noontime value of 3.1 × 109 molec cm−2s−1. The top-down emission estimate of primary, anthropogenic NOx in Uintah and Duchesne counties is at least 300 times higher than the estimated snow NOx emissions presented in this study. Our results suggest that snow-sourced reactive nitrogen fluxes are minor contributors to the Nr boundary layer budget in the highly polluted Uintah Basin boundary layer during winter 2014

Do 72-Hour Waiting Periods and Two-Visit Requirements for Abortion Affect Women's Certainty? A Prospective Cohort Study

PurposeThis paper examines how Utah's two-visit requirement and 72-hour waiting period influence women's certainty about their decision to have an abortion.ProceduresThis study uses data from a prospective cohort study of 500 women who presented at an abortion information visit at four Utah family planning facilities. At the information visit, participants completed a baseline survey; 3 weeks later, they completed telephone interviews that assessed their pregnancy outcome, change in certainty, and factors affecting changes in certainty.Main findingsOverall, 63% reported no change in certainty owing to the information visit and 74% reported no change in certainty owing to the waiting period. Changes in certainty were primarily in the direction of increased certainty, with more women reporting an increase (29%) than a decrease (8%) in certainty owing to the visit and more women reporting an increase (17%) than a decrease (8%) owing to waiting. Changes in certainty in either direction were concentrated among the minority (8%) who were conflicted about their decision at baseline. Learning about the procedure, meeting staff, and discovering that the facility was a safe medical environment were main contributors to increased certainty.ConclusionMost women were certain of their decision to have an abortion when they presented for their abortion information visit and their certainty remained unchanged despite the information visit and 72-hour waiting period. Changes in certainty were largely concentrated in the minority of women who expressed uncertainty about their decision before the beginning of the information visit. Thus, individualized counseling for the minority who are conflicted when they first present for care seems more appropriate than universal requirements

Physiological Adaptations to Progressive Endurance Exercise Training in Adult and Aged Rats: Insights from the Molecular Transducers of Physical Activity Consortium (MoTrPAC)

While regular physical activity is a cornerstone of health, wellness, and vitality, the impact of endurance exercise training on molecular signaling within and across tissues remains to be delineated. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) was established to characterize molecular networks underlying the adaptive response to exercise. Here, we describe the endurance exercise training studies undertaken by the Preclinical Animal Sites Studies component of MoTrPAC, in which we sought to develop and implement a standardized endurance exercise protocol in a large cohort of rats. To this end, Adult (6-mo) and Aged (18-mo) female (n = 151) and male (n = 143) Fischer 344 rats were subjected to progressive treadmill training (5 d/wk, ∼70%-75% VO2max) for 1, 2, 4, or 8 wk; sedentary rats were studied as the control group. A total of 18 solid tissues, as well as blood, plasma, and feces, were collected to establish a publicly accessible biorepository and for extensive omics-based analyses by MoTrPAC. Treadmill training was highly effective, with robust improvements in skeletal muscle citrate synthase activity in as little as 1-2 wk and improvements in maximum run speed and maximal oxygen uptake by 4-8 wk. For body mass and composition, notable age- and sex-dependent responses were observed. This work in mature, treadmill-trained rats represents the most comprehensive and publicly accessible tissue biorepository, to date, and provides an unprecedented resource for studying temporal-, sex-, and age-specific responses to endurance exercise training in a preclinical rat model

Dataset to support article titled: The magnitude of the snow-sourced reactive nitrogen flux to the boundary layer in the Uintah Basin, Utah, USA

This data set is for a paper in the open access journal Atmospheric Chemistry and Physics. The submitted (not revised, final) version can be found at the following link: http://www.atmos-chem-phys-discuss.net/acp-2016-320

Entrustment and Mapping of Observable Practice Activities for Resident Assessment

Entrustable Professional Activities (EPAs) and the Next Accreditation System reporting milestones reduce general competencies into smaller evaluable parts. However, some EPAs and reporting milestones may be too broad to use as direct assessment tools. We describe our internal medicine residency curriculum and assessment system, which uses entrustment and mapping of observable practice activities (OPAs) for resident assessment. We created discrete OPAs for each resident rotation and learning experience. In combination, these serve as curricular foundation and tools for assessment. OPA performance is measured via a 5-point entrustment scale, and mapped to milestones and EPAs. Entrustment ratings of OPAs provide an opportunity for immediate structured feedback of specific clinical skills, and mapping OPAs to milestones and EPAs can be used for longitudinal assessment, promotion decisions, and reporting. Direct assessment and demonstration of progressive entrustment of trainee skill over time are important goals for all training programs. Systems that use OPAs mapped to milestones and EPAs provide the opportunity for achieving both, but require validation