Efforts Targeting Factors of Health Disparities that Impair HIV Treatment Engagement

Health disparities exist in Northeast Florida. Some locations experience morbidities at higher rates than others. Health zone 1 is a prime example. Differences in disease rates are interlaced with the social determinants of health, (SDOH). Long-standing social and structural influences of disparities are beyond the scope of Ryan White programs. However, empowerment for health promotion is a strategy for targeting health disparities. The Theory of Health Empowerment targets sense of agency and offers some leverage for helping people living with HIV/AIDS, (PLWHA) despite environments blemished by SDOH. Eclectic leadership occurring in a climate of respectful point-counter point discussions established the context for implemented projects in Northeast Florida. Nine activities directed efforts to reduce disparities. These activities are in the infancy stage of development. Some successes have been achieved, but much more remains to be accomplished to increase overall viral suppression above the 80% threshold. Directions for the future suggest that perhaps external influences of federal Ryan White Parts may be a catalyst for incentivizing the JTGA to participate in national efforts to reduce health disparities. Opportunities to strengthen understanding of approaches to nullify SDOH using science-based approaches hold promise to pursue health equity in treatment cascade outcomes for PLWHAs

A Comparative Study of Aerocapture Missions with a Mars Destination

Conventional interplanetary spacecraft use propulsive systems to decelerate into orbit. Aerocapture is an alternative approach for orbit capture, in which the spacecraft makes a single pass through a target destination's atmosphere. Although this technique has never been performed, studies show there are substantial benefits of using aerocapture for reduction of propellant mass, spacecraft size, and mission cost. The In-Space Propulsion (ISP) Program, part of NASA's Science Mission Directorate, has invested in aerocapture technology development since 2002. Aerocapture investments within ISP are largely driven by mission systems analysis studies, The purpose of this NASA-funded report is to identify and document the fundamental parameters of aerocapture within previous human and robotic Mars mission studies which will assist the community in identifying technology research gaps in human and robotic missions, and provide insight for future technology investments. Upon examination of the final data set, some key attributes within the aerocapture disciplines are identified

Evaluation of a Pilot Intervention to Relink Formerly Incarcerated PLHWHAs to HIV/AIDS Care

HIV is a manageable chronic disease. However, it requires knowing one’s status, retention in care, and medication adherence for viral suppression. Disadvantaged groups of persons living with HIV/AIDS (PLWHAs) who experience incarceration and major depressive disorders, homelessness, substance use and lack of social support are overwhelmed by these burdens and do not fully engage in HIV care, without help. Four Northeast Florida entities engaged in action research to influence health equity for formerly detained PLWHAs. The City of Jacksonville, Ryan White Part-A Program, Florida Department of Health-Duval, Lutheran Social Services, and Jacksonville Sherriff’s Office convened a coalition, called CAPRICE. Activities focused on intensive medical case management, linkage to core HIV services, job placement, and up to 90-days of transition housing to support the transition from jail to community. The coalition created system level relationships, with structure and processes. Next steps should focus on how to support the infrastructure for disadvantaged groups over the long-term. Estimated sustainable cost compared reasonably with published research. The local HIV Health Services Planning Council and CAPRICE members have the task of garnering financial support for this work, which aims to plug one of the leaks in the local HIV Continuum of Care

Lessons from the Field: A Systems Thinking Approach for Case Management Documentation

Case management is a core HIV health service that focuses on service coordination—the seamless access to an array of integrated services. Integration aims to reduce barriers to medical care. In the busy HIV health services environment, inadequate documentation of case management activities limits the capacity of stakeholders to know what happens during care encounters. This study used theory and qualitative inquiry to uncover best practices that support optimal case management documentation. Two research questions guided the inquiry: What principles should arise in higher order cognitive functioning among case managers during client encounters? What characteristics of a system level approach to care encounter documentation reinforces case management critical thinking skills? The study settings included two, Northeast Florida, Ryan White funded organizations. Findings indicated that the confluence of intrapersonal, interpersonal, organizational, community, and policy factors support more rather than less robust case management documentation. A multi-tired approach to documentation of services rendered is no panacea. However, it offers a useful framework for defining stakeholders’ roles and expectations and monitoring the performance of activities. Disseminating these findings in the local Ryan White network and the public domain may trigger dialog and more research about the preservation and effective use of documentation skills

Exile Vol. XIX No. 1

POETRY Play by Dick Cameron 3 by Judy Hasel 3 First Selectman by Carl Tillmanns 9 A Dream Character Writes of... by Dick Cameron 10 Org City by Dick Carothers 12 lying by Bob Smyth 13 Lover by Eric Odor 13 Sitting long by the benches by Vaughan Matthews 16 sitting on the step by Judy Hasel 17 O my love by David Toole 30 In the dampness of my place by Val Evans 31 FICTION Locus Significology on the Significance of Location by Rich Ottum 5-7 The Rift by Linda Phillips 8 Basic American History Workebook- October 3, 1992: Chapter 9: The Ryatt Act by Gary Parks 15-16 The Best Man by Heather Johnson 18-29 Untitled by Kgw 32 ART by Alex Hutton 11 by Ann Merrill 14 by Pat Victory cover, 17 by Sarah Stranglen 29 PHOTOGRAPHY by Pam Purcell 1 by John Fergus 4, 21 by Bart Dean 9, 32 by Bob Dewey 10 by Nick Carlozzi

Rethinking Sudan Studies: A Post-2011 Manifesto

Abstract This essay appraises “Sudan Studies” following the 2011 secession of South Sudan. It asks two questions. First, what has Sudan Studies been as a colonial and postcolonial field of academic inquiry and how should or must it change? Second, should we continue to write about a single arena of Sudan Studies now that Sudan has split apart? The authors advance a “manifesto” for Sudan Studies by urging scholars to map out more intellectual terrain by attending to non-elite actors and women; grass-roots and local history; the environment and the arts; oral sources; and interdisciplinary studies of culture, politics, and society. They propose that scholars can transcend the changing boundaries of the nation-state, and recognize connections forged through past and present migrations and contacts, by studying the Sudan as a zone rather than a fixed country. Finally, in their introduction to this bilingual special issue, they highlight the increasing relevance of French scholarship to the endeavor of rethinking Sudan Studies. Résumé Cet essai évalue la situation des « études soudanaises » après la sécession du Soudan du Sud. Il pose deux questions. La première : En quoi ont consisté les études soudanaises en tant que domaine colonial et postcolonial de recherche universitaire et dans quelle mesure doivent-elles changer, si tant est qu\u27elles doivent changer ? La seconde : Devrions-nous continuer à baser nos écrits sur un domaine unique d\u27études soudanaises maintenant que le Soudan est divisé ? Les auteurs proposent un « manifeste » pour les études soudanaises en exhortant les experts à cartographier un terrain intellectuel élargi en s\u27intéressant aux acteurs ne faisant pas partie des élites et des femmes ; à l\u27histoire de la base populaire et locale ; à l\u27environnement et à l\u27art ; aux sources orales ; et aux études interdisciplinaires portant sur la culture, la politique et la société. Ils avancent que les chercheurs peuvent aller au-delà des frontières en mutation de l\u27État-nation et reconnaitre les connexions établies grâce aux migrations et aux contacts passés et présents en étudiant le Soudan comme zone plutôt que comme un pays fixe. Enfin, dans leur introduction à ce numéro bilingue spécial, ils mettent en relief la pertinence croissance des travaux universitaires français dans le cadre de l\u27initiative visant à repenser les études soudanaises

Peat Bog Wildfire Smoke Exposure in Rural North Carolina Is Associated with Cardiopulmonary Emergency Department Visits Assessed through Syndromic Surveillance

Background: In June 2008, burning peat deposits produced haze and air pollution far in excess of National Ambient Air Quality Standards, encroaching on rural communities of eastern North Carolina. Although the association of mortality and morbidity with exposure to urban air pollution is well established, the health effects associated with exposure to wildfire emissions are less well understood. Objective: We investigated the effects of exposure on cardiorespiratory outcomes in the population affected by the fire. Methods: We performed a population-based study using emergency department (ED) visits reported through the syndromic surveillance program NC DETECT (North Carolina Disease Event Tracking and Epidemiologic Collection Tool). We used aerosol optical depth measured by a satellite to determine a high-exposure window and distinguish counties most impacted by the dense smoke plume from surrounding referent counties. Poisson log-linear regression with a 5-day distributed lag was used to estimate changes in the cumulative relative risk (RR). Results: In the exposed counties, significant increases in cumulative RR for asthma [1.65 (95% confidence interval, 1.25–2.1)], chronic obstructive pulmonary disease [1.73 (1.06–2.83)], and pneumonia and acute bronchitis [1.59 (1.07–2.34)] were observed. ED visits associated with cardiopulmonary symptoms [1.23 (1.06–1.43)] and heart failure [1.37 (1.01–1.85)] were also significantly increased. Conclusions: Satellite data and syndromic surveillance were combined to assess the health impacts of wildfire smoke in rural counties with sparse air-quality monitoring. This is the first study to demonstrate both respiratory and cardiac effects after brief exposure to peat wildfire smoke

Garden and landscape-scale correlates of moths of differing conservation status: significant effects of urbanization and habitat diversity

Moths are abundant and ubiquitous in vegetated terrestrial environments and are pollinators, important herbivores of wild plants, and food for birds, bats and rodents. In recent years, many once abundant and widespread species have shown sharp declines that have been cited by some as indicative of a widespread insect biodiversity crisis. Likely causes of these declines include agricultural intensification, light pollution, climate change, and urbanization; however, the real underlying cause(s) is still open to conjecture. We used data collected from the citizen science Garden Moth Scheme (GMS) to explore the spatial association between the abundance of 195 widespread British species of moth, and garden habitat and landscape features, to see if spatial habitat and landscape associations varied for species of differing conservation status. We found that associations with habitat and landscape composition were species-specific, but that there were consistent trends in species richness and total moth abundance. Gardens with more diverse and extensive microhabitats were associated with higher species richness and moth abundance; gardens near to the coast were associated with higher richness and moth abundance; and gardens in more urbanized locations were associated with lower species richness and moth abundance. The same trends were also found for species classified as increasing, declining and vulnerable under IUCN (World Conservation Union) criteria