Fuquay Varina, Wake County : a community diagnosis including secondary data analysis and qualitative data collection

Located 15 miles southwest of Raleigh and only a 35 minute drive south of the Research Triangle Park (RTP), Fuquay-Varina, North Carolina, is a community in transition. In the midst of explosive growth, affecting population size, commerce, and access to limited resources, Fuquay-Varina aims to maintain its traditions and small-town feel. The University of North Carolina (UNC) School of Public Health was asked to work with Wake County Human Service’s Southern Regional Center to conduct a community diagnosis in the town of Fuquay-Varina. Six students from the University were commissioned to conduct the diagnosis over a 6-month period. Initially the community diagnosis was to be framed in the context of exploring factors related to school success. However, during the team’s tenure in the community, both talking to residents and reviewing existing data relative to a number of topics, several other issues and factors important to the community emerged. Community diagnosis is a process intended to gather information about the community, in the form of secondary data (existing statistics) and primary data (interviews with residents), which can help the community to better identify their assets and challenges in the direction of forging positive community change. A community diagnosis is very much grounded in the philosophy that a community’s success in addressing its concerns is determined by a number of factors including its history, strength of community partnerships, problem solving mechanisms, and identified assets, to name a few. The community diagnosis was implemented in two phases. Phase one included the collection of secondary data describing the overall health of Fuquay-Varina residents in terms of physical and mental health, social health, economics and growth, crime and safety, and education. During the second phase, the team conducted interviews with Fuquay-Varina community members and service providers (physicians, social service providers, political officials, and clergy) to gain insight into the community and its inner workings from the viewpoint of those who live and work there. This document is the product of the community diagnosis and incorporates the information generated from interviews, as well as the secondary data from Phase I of the process. While the team did contribute to the shaping of the information provided in interviews, this document represents the voices of Fuquay-Varina residents on issues that are important to them. The primary data collection process began by developing interview guides for service providers and community members of Fuquay-Varina. The team initially included in the guides topics that it felt might be important to explore. The service provider guide addressed questions pertaining to services/resources available (i.e. health care, recreation, religious), populations that use such services, and the strengths and weaknesses of the Fuquay-Varina community. The community member interview guide began with general questions pertaining to family, employment, and religious affiliation. Next, questions about community resources, health resources, changes that have occurred over time in Fuquay-Varina, and perceptions of Fuquay-Varina’s future were posed. Focus group interviews were conducted with children of varying ages. The focus group interview guide was comprised of six questions pertaining to the interviewees’ perceptions of Fuquay-Varina, school pride, and social support. After developing the interview guides, the team explored strategies to identify members of the community to interview. We began the interview process at the Southern Regional Center (SRC) of Fuquay-Varina. We were assisted by SRC staff in obtaining access to some primary and secondary data. The team then identified key community members and service providers as possible interview candidates who could provide valuable information on the Fuquay-Varina community. Some team members attended the annual Heritage Festival in Fuquay-Varina where they met representatives of various civic organizations, some of whom were later contacted for interviews. The final question of each interview asked for suggestions of additional community members the team could contact, resulting in a continuous process of interviewing. At the outset of the community diagnosis process, the team recognized the importance of collecting primary data that would adequately represent the various voices in Fuquay-Varina. The primary data sample includes members of the primary ethnic groups in Fuquay-Varina: whites, African Americans, and Latinos. The team attempted to gather data from members of different socioeconomic classes, though actual socioeconomic status is not known. The interviewees ranged in age from elementary school children to retired adults. Moreover, the team spoke with lifelong residents of Fuquay-Varina as well as new-comers. The team conducted forty individual interviews. Thirteen adults and eighteen youth were interviewed as Fuquay-Varina community members. Four interviewees represented both service providers and community members of Fuquay-Varina. Five individuals were interviewed as service providers only. The various backgrounds of the interviewees comprise an adequate representation of the residents of Fuquay-Varina given the time constraints of the community diagnosis process. As the interview process came to a close, each team member reviewed interview transcripts and the team convened to discuss emerging themes. Eight major themes emerged from the findings. The eight themes were grouped together into six categories: growth, drugs, schools, health, diversity/race relations, and recreation. Some barriers presented themselves during primary data collection. Due to the nature of the community diagnosis process, it was difficult to recruit persons living within the community who do not have an active voice in the community, in the traditional sense. By asking service providers and active members of civic organizations for their referrals it is likely that the majority of interviewees were similar, in a sense, to those who referred them- active in the community in some way. Therefore some marginalized populations may not have been adequately represented. Other challenges surfaced in reaching the Latino community. Only two of the six team members were able to speak Spanish, which limited the team’s access to the Latino population. The population of migrant farm workers was unattainable because of the season in which interviews were conducted. Fuquay-Varina has a history of tobacco farming; however, the team was also unable to reach the farming population. The team encountered challenges in reaching youth. The team encountered some challenges while trying to work with the Wake County Public School System to gain access to school aged youth, but they were able to gain access to some youth through various civic organizations. Despite these limitations, the team worked well with the community to gain insight into life in Fuquay-Varina. The community expressed concerns about a number of topics important to the town. One of the major issues we heard about during our work in Fuquay-Varina was the drug problem, though not in a negative sense. As we talked with the people of Fuquay-Varina over the past 6 months, we learned that the effort to combat neighborhood drug trade is something of which people are really proud. It brought in cooperation and interaction across groups, and it brought in faith and the strength of religious institutions in the community. It brought in a concern for the health and safety of people in the community, and a special concern for the children who are not only threatened by unsafe neighborhoods, but who are also influenced by the things they see around them. Also, it brought in a sense of interest in using the local political system to achieve things the community really wants. Several other salient issues emerged from primary data collection. Among these issues was the explosive growth that the community has experienced over the past few years. Of all the themes that surfaced in community interviews, concerns about growth were the most prominent and arguably evoked the most passion among respondents. In general, growth in Fuquay-Varina is characterized by: (1) an influx of new residents who work outside of Fuquay-Varina and have no prior ties to the community, (2) an increase in the number of Latino residents, and (3) an increase in the number of large-scale businesses entering the community, accompanied by the outward growth of these businesses away from downtown. Within this context, residents’ concerns are: (1) the threat to the community’s “small town” character, (2) the sustainability of businesses in downtown Fuquay-Varina, and (3) the limitations of resources (i.e., transportation, water and sewage, and housing) to accommodate large-scale growth. The topic of education and schools also stimulated interest among interviewees. Even though specific questions were posed relative to schools, the topic was often mentioned generally in response to inquiry about the strengths of Fuquay-Varina. Many of the general statements about schools, especially elementary schools, were positive from both community members and service providers. Interview respondents also identified a number of needs of the school system in Fuquay-Varina. Regarding infrastructure, respondents consistently noted that there have been efforts underway to reduce class size, with a new elementary school in Holly Springs and the renovation of Lincoln Heights and Willow Springs Elementary Schools. However it is feared that rapid growth in the area will soon offset these efforts. Churches and community partnerships are two strong forces in Fuquay-Varina, helping mobilize citizens and encouraging interaction. The growing number of community partnerships, whose names have been seemingly embedded in citizens’ minds, address issues from drugs and crime to schools to sports. Despite the obvious strength of community partnerships the community also expressed concerns about race relations, particularly the division of the community along racial lines. While residents noted that there was little conflict, they were careful to point out that there were no organized efforts to lessen the divide. The youth voice on this issue was particularly interesting in that overwhelmingly youth reported not feeling the impact of racial divide among their classmates, but noticing its impact among their parents and grandparents. The main topics of interest in relation to health were the shortage of primary care physicians, as well as a perception of high teenage pregnancy rates. The latter was a concern of youth as well as of parents. Another issue that emerged, particularly among youth, was the lack of recreational activities for high school-aged children and adults. This document provides merely a glimpse of life in Fuquay-Varina from the perspective of its members. It is obvious from interviews that Fuquay-Varina is a healthy and thriving community. It has natural leaders who are willing to devote time and effort to making it a great place to live. Within the community there is knowledge, energy, and interest in staying informed and connected. Even from the short time that this team spent in the community, it is evident that the town has a wealth of assets beginning with its rich history and traditions and extending to the strong commitment and diverse skills of its members. It is the sincere hope of the community diagnosis team that this document can serve as a resource for the community to mobilize itself towards addressing community concerns.Master of Public Healt

A large scale hearing loss screen reveals an extensive unexplored genetic landscape for auditory dysfunction

The developmental and physiological complexity of the auditory system is likely reflected in the underlying set of genes involved in auditory function. In humans, over 150 non-syndromic loci have been identified, and there are more than 400 human genetic syndromes with a hearing loss component. Over 100 non-syndromic hearing loss genes have been identified in mouse and human, but we remain ignorant of the full extent of the genetic landscape involved in auditory dysfunction. As part of the International Mouse Phenotyping Consortium, we undertook a hearing loss screen in a cohort of 3006 mouse knockout strains. In total, we identify 67 candidate hearing loss genes. We detect known hearing loss genes, but the vast majority, 52, of the candidate genes were novel. Our analysis reveals a large and unexplored genetic landscape involved with auditory function

The mammalian gene function resource: the International Knockout Mouse Consortium.

In 2007, the International Knockout Mouse Consortium (IKMC) made the ambitious promise to generate mutations in virtually every protein-coding gene of the mouse genome in a concerted worldwide action. Now, 5 years later, the IKMC members have developed high-throughput gene trapping and, in particular, gene-targeting pipelines and generated more than 17,400 mutant murine embryonic stem (ES) cell clones and more than 1,700 mutant mouse strains, most of them conditional. A common IKMC web portal (www.knockoutmouse.org) has been established, allowing easy access to this unparalleled biological resource. The IKMC materials considerably enhance functional gene annotation of the mammalian genome and will have a major impact on future biomedical research

The mammalian gene function resource: The International Knockout Mouse Consortium

In 2007, the International Knockout Mouse Consortium (IKMC) made the ambitious promise to generate mutations in virtually every protein-coding gene of the mouse genome in a concerted worldwide action. Now, 5 years later, the IKMC members have developed highthroughput gene trapping and, in particular, gene-targeting pipelines and generated more than 17,400 mutant murine embryonic stem (ES) cell clones and more than 1,700 mutant mouse strains, most of them conditional. A common IKMC web portal (www.knockoutmouse.org) has been established, allowing easy access to this unparalleled biological resource. The IKMC materials considerably enhance functional gene annotation of the mammalian genome and will have a major impact on future biomedical research

Emergence of Developmental Delay in Infants and Toddlers With an FMR1 Mutation

Children with FMR1 gene expansions are known to experience a range of developmental challenges, including fragile X syndrome. However, little is known about early development and symptom onset, information that is critical to guide earlier identification, more accurate prognoses, and improved treatment options. Data from 8 unique studies that used the Mullen Scales of Early Learning to assess children with an FMR1 gene expansion were combined to create a data set of 1178 observations of >500 young children. Linear mixed modeling was used to explore developmental trajectories, symptom onset, and unique developmental profiles of children <5 years of age. Boys with an FMR1 gene full mutation showed delays in early learning, motor skills, and language development as young as 6 months of age, and both sexes with a full mutation were delayed on all developmental domains by their second birthday. Boys with a full mutation continued to gain skills over early childhood at around half the rate of their typically developing peers; girls with a full mutation showed growth at around three-quarters of the rate of their typically developing peers. Although children with a premutation were mostly typical in their developmental profiles and trajectories, mild but significant delays in fine motor skills by 18 months were detected. Children with the FMR1 gene full mutation demonstrate significant developmental challenges within the first 2 years of life, suggesting that earlier identification is needed to facilitate earlier implementation of interventions and therapeutics to maximize effectiveness