Exploring H.pylori seropositivity as a risk factor for type 2 diabetes

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming. Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data. Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in unadjusted model. After adjustment, H.pylori seropositivity was no longer associated with diabetes. Obesity (aOR 4.94, 95% CI 2.672,9.133) was associated with having type 2 diabetes compared to normal weight. Non-Hispanic Blacks (2.436, 95% CI 1.489,3.984) and Mexican Americans (1.896, 95% CI 1.002,3.587) had greater odds of diabetes compared to Whites. For nearly all stratified analyses, H.pylori did not have a significant association with type 2 diabetes although several other noteworthy findings emerged. A chance finding, where H.pylori was associated with greater likelihood of diabetes in Mexican Americans, 60-85, \u3e25 BMI, may be worth a closer look. Conclusion: Findings indicate weight status, obesity in particular, is the strongest predictor of diabetes followed by Black race. Stratified analyses suggest increasing racial disparities over the course of the life span

Community Health Worker Employer Survey: Perspectives on CHW Workforce Development in the Midwest

A statewide Community Health Worker Employer Survey was administered to various clinical, community, and faith-based organizations (n = 240) across a range of rural and urban settings in the Midwest. At least 80% of participants agreed or strongly agreed that items characterized as supervisory support were present in their work environment. Thirty-six percent of respondents currently employed CHWs, over half (51%) of survey respondents reported seeing the need to hire/work with more CHWs, and 44% saw the need for CHWs increasing in the future. Regarding CHW support, a majority of respondents indicated networking opportunities (63%), paid time for networking (80%), adequate time for supervision (75%), orientation training (78%), mandatory training (78%), ongoing training (79%), and paid time for training (82%). Open-ended responses to the question “In your organization, what needs could CHWs meet?” resulted in the largest number of respondents reporting mental health issues as a priority, followed by connecting people with services or resources, educating the public on preventive health, family support, and home care/visitations. Our findings suggest that respondents, who largely have supervisory or managerial roles, view workplace environments in Nebraska favorably, despite the fact that nearly two-thirds of respondents typically work well over 40 h per week. In addition, CHWs could help address mental and physical health needs in a variety of community and clinical settings through primary and secondary prevention activities, such as provision of health screenings, health and nutrition education, connecting people to resources and empowering community members through these activities and more

Perspectives on certification of community health workers: A statewide mixed-methods assessment in Nebraska

Objectives: While the Community Health Worker (CHW) workforce in the United States has been growing, so far only 19 states certify CHWs. This study sought to identify perspectives on CHW certification among stakeholders in Nebraska, a state that has not established official certification for CHWs yet. Design: A concurrent triangulation mixed methods design. Sample: Study data came from a survey of 142CHWs in Nebraska and interviews with 8 key informants employing CHWs conducted in 2019. Methods: Logistic regression was used to identify significant factors associated with favoring CHW certification, supplemented by thematic analysis of qualitative data fromCHWs and key informants. Results: The majority (84%) of CHWs were in favor of a statewide CHW certification in Nebraska, citing community benefits, workforce validation, and standardization of knowledge as the main reasons. Participant characteristics associated with favoring CHW certification included younger age, racial minority, foreign born, education lower than bachelor’s degree, volunteering as a CHW, and employed for less than 5 years as a CHW. Key informants employing CHWs were divided in whether Nebraska should develop a state certification program. Conclusions: While most CHWs in Nebraska wanted to have a statewide certification program, employers of CHWs were less sure of the need for certification

Immunomodulatory Role of Urolithin A on Metabolic Diseases

Urolithin A (UroA) is a gut metabolite produced from ellagic acid-containing foods such as pomegranates, berries, and walnuts. UroA is of growing interest due to its therapeutic potential for various metabolic diseases based on immunomodulatory properties. Recent advances in UroA research suggest that UroA administration attenuates inflammation in various tissues, including the brain, adipose, heart, and liver tissues, leading to the potential delay or prevention of the onset of Alzheimer’s disease, type 2 diabetes mellitus, and non-alcoholic fatty liver disease. In this review, we focus on recent updates of the anti-inflammatory function of UroA and summarize the potential mechanisms by which UroA may help attenuate the onset of diseases in a tissue-specific manner. Therefore, this review aims to shed new insights into UroA as a potent anti-inflammatory molecule to prevent immunometabolic diseases, either by dietary intervention with ellagic acid-rich food or by UroA administration as a new pharmaceutical drug

Identifying and Assisting Human Trafficking Survivors: A Post-Training Analysis of First Responders

First responders and the agencies for which they work face numerous challenges in identifying and assisting human trafficking survivors. This article aims to outline the ways in which first responders in a Midwestern state identify and provide services to human trafficking survivors. Six months after attending a two-day training aimed at recognizing and assisting human trafficking survivors, first responders were invited to participate in a follow-up survey regarding the training that they received. Responses were collected from 270 participants who work at various government, medical, or social service agencies in both rural and urban service areas across the state. Results focus on perceived prevalence of human trafficking, type of trafficking survivor populations served, barriers to service provision, and confidence in identifying indicators of human trafficking

Listening to the Voices of Community Health Workers: A Multilevel, Culture-Centered Approach to Overcoming Structural Barriers in U.S. Latinx Communities

Community Health Workers (CHWs) are often incorporated into efforts to reduce health disparities for vulnerable populations. However, their voices are rarely the focus of research when considering how to increase their job effectiveness and sustainability. The current study addresses this gap by privileging the voices of 28 CHWs who work with Latinx communities in Nebraska through in-depth, semi-structured interviews. Using a multilevel, Culture-Centered Approach (CCA) to Health Communication, we identified two key structural communication issues: (a) increasing language accommodation and (b) increasing (and stabilizing) network integration across three ecological levels of health behavior (individual, microsystem, and exosystem). This study shows the uniquely valuable perspective that CHWs have as they navigate hierarchical health care structures and community cultures to meet the needs of their Latinx clients. Findings suggest that CHWs should be included in health care organization and policy discussions to reduce health disparities for Latinx populations

Urolithin A, a Gut Metabolite, Improves Insulin Sensitivity through Augmentation of Mitochondrial Function and Biogenesis

Objective: Urolithin A (UroA) is a major metabolite of ellagic acid produced following microbial catabolism in the gut. Emerging evidence has suggested that UroA modulates energy metabolism in various cells. However, UroA’s physiological functions related to obesity and insulin resistance remain unclear. Methods: Male mice were intraperitoneally administrated either UroA or dimethyl sulfoxide (vehicle) along with a high-fat diet for 12 weeks. Insulin sensitivity was evaluated via glucose and insulin tolerance tests and acute insulin signaling. The effects of UroA on hepatic triglyceride accumulation, adipocyte size, mitochondrial DNA content, and proinflammatory gene expressions were determined. The impact of UroA on macrophage polarization and mitochondrial respiration were assessed in bone marrow–derived macrophages. Results: Administration of UroA (1) improved systemic insulin sensitivity, (2) attenuated triglyceride accumulation and elevated mitochondrial biogenesis in the liver, (3) reduced adipocyte hypertrophy and macrophage infiltration into the adipose tissue, and (4) altered M1/M2 polarization in peritoneal macrophages. In addition, UroA favored macrophage M2 polarization and mitochondrial respiration in bone marrow–derived macrophages. Conclusions: UroA plays a direct role in improving systemic insulin sensitivity independent of its parental compounds. This work supports UroA’s role in the metabolic benefits of ellagic acid–rich foods and highlights the significance of its microbial transformation in the gut

Food Resource Management Education With SNAP Participation Improves Food Security

Objective: To determine the influence of Supplemental Nutrition Assistance Program (SNAP) and participant demographics on nutrition education outcomes. Methods: At program enrollment (pre) and 1 month later (post), a statewide convenience sample of adults, who participated in the Plan, Shop, Save, and Cook program, completed a 7-item questionnaire to evaluate change in resource management skills (RMS) and running out of food before the end of the month. Results: Percent of participants (n = 3,744) who reported behavioral improvements in RMS ranged from 38.8%in comparing prices to 54% in reading labels. Female gender and Hispanic ethnicity were positively related to pre–post RMS change (P = .001). Participants who received SNAP food assistance and made greater pre–post improvement in RMS reported the greatest decrease in running out of food (P = .001). Conclusions and Implications: Both food assistance and education on nutrition and resource management are needed to reduce food insecurity in SNAP-eligible audiences

Food Resource Management Education With SNAP Participation Improves Food Security

Objective: To determine the influence of Supplemental Nutrition Assistance Program (SNAP) and participant demographics on nutrition education outcomes. Methods: At program enrollment (pre) and 1 month later (post), a statewide convenience sample of adults, who participated in the Plan, Shop, Save, and Cook program, completed a 7-item questionnaire to evaluate change in resource management skills (RMS) and running out of food before the end of the month. Results: Percent of participants (n = 3,744) who reported behavioral improvements in RMS ranged from 38.8%in comparing prices to 54% in reading labels. Female gender and Hispanic ethnicity were positively related to pre–post RMS change (P = .001). Participants who received SNAP food assistance and made greater pre–post improvement in RMS reported the greatest decrease in running out of food (P = .001). Conclusions and Implications: Both food assistance and education on nutrition and resource management are needed to reduce food insecurity in SNAP-eligible audiences

Comparison of maternal beliefs about causes of autism spectrum disorder and association with utilization of services and treatments

Background: This study aimed to describe parental perceptions of the causes of autism spectrum disorder (ASD) in an ethnically diverse sample and explore whether these perceptions relate to treatment choices. Methods: The sample consisted of White (n=224), Hispanic (n=85) and Asian (n=21) mothers of a child with ASD. A mixed methods approach was used in this secondary analysis focusing on parental perceptions about the causes of ASD and the relationship of these to utilization of services and treatment. Results: Environmental and genetic factors were most often believed to be the cause or one of the causes of ASD by mothers across all ethnic groups studied. Asian mothers were more likely to cite multiple causes. Environmental causes were associated with receiving 20 or more hours of autism related services per week; while belief in environmental exposures and vaccines and medications as causes were associated with complementary-alternative medicine (CAM) use. Conclusion: Our findings suggest that ethnic differences in autism causal beliefs and treatment choices may exist. Future research should be conducted to specifically confirm the findings, to understand parental motivation behind their service and treatment choices; and to gain more insight into the types, usage and sources of CAM treatments. Clinicians can use parental autism causal beliefs in discussions about treatment recommendations