A community partnership to evaluate the feasibility of addressing food insecurity among adult patients in an urban healthcare system

BACKGROUND: Food insecurity (FI) is a significant public health problem. Possible sequelae of prolonged food insecurity include kidney disease, obesity, and diabetes. Our objective was to assess the feasibility of a partnership between Henry Ford Health System (HFHS) and Gleaners Community Foodbank of Southeastern Michigan to implement and evaluate a food supplementation intervention initiated in a hospital outpatient clinic setting. METHODS: We established a protocol for using the Hunger Vital Signs to screen HFHS internal medicine patients for food insecurity and established the data sharing infrastructure and agreements necessary for an HFHS-Gleaners partnership that would allow home delivery of food to consenting patients. We evaluated the food supplementation program using a quasi-experimental design and constructing a historical comparison group using the electronic medical record. Patients identified as food insecure through screening were enrolled in the program and received food supplementation twice per month for a total of 12 months, mostly by home delivery. The feasibility outcomes included successful clinic-based screening and enrollment and successful food delivery to consenting patients. Our evaluation compared healthcare utilization between the intervention and historical comparison group during a 12-month observation period using a difference-in-differences (DID) analysis. RESULTS: Of 1691 patients screened, 353 patients (20.9%) met the criteria for FI, of which 340/353 (96.3%) consented, and 256/340 (75.3%) were matched and had data sufficient for analysis. Food deliveries were successfully made to 89.9% of participant households. At follow-up, the intervention group showed greater reductions in emergency department visits than the comparison group, -41.5% and -25.3% reduction, respectively. Similar results were observed for hospitalizations, -55.9% and -17.6% reduction for intervention and control groups, respectively. DID regression analysis also showed lower trends in ED visits and hospitalizations for the intervention group compared to the comparison group. CONCLUSIONS: Results suggest that community-health system partnerships to address patient-reported food insecurity are feasible and potentially could reduce healthcare utilization in these patients. A larger, randomized trial may be the next step in fully evaluating this intervention, perhaps with more outcomes (e.g., medication adherence), and additional covariates (e.g., housing insecurity and financial strain)

Degree of Scaffolding: Learning Objective Metadata: A Prototype Leaning System Design for Integrating GIS into a Civil Engineering Curriculum

Digital media and networking offer great potential as tools for enhancing classroom learning environments, both local and distant. One concept and related technological tool that can facilitate the effective application and distribution of digital educational resources is learning objects in combination with the SCORM (sharable content objects reference model) compliance framework. Progressive scaffolding is a learning design approach for educational systems that provides flexible guidance to students. We are in the process of utilizing this approach within a SCORM framework in the form of a multi-level instructional design. The associated metadata required by SCORM will describe the degree of scaffolding. This paper will discuss progressive scaffolding as it relates to SCORM compliant learning objects, within the context of the design of an application for integrating Geographic Information Systems (GIS) into the civil engineering curriculum at the University of Missouri - Rolla

Signal Enhancement for Magnetic Navigation Challenge Problem

Harnessing the magnetic field of the earth for navigation has shown promise as a viable alternative to other navigation systems. A magnetic navigation system collects its own magnetic field data using a magnetometer and uses magnetic anomaly maps to determine the current location. The greatest challenge with magnetic navigation arises when the magnetic field data from the magnetometer on the navigation system encompass the magnetic field from not just the earth, but also from the vehicle on which it is mounted. It is difficult to separate the earth magnetic anomaly field magnitude, which is crucial for navigation, from the total magnetic field magnitude reading from the sensor. The purpose of this challenge problem is to decouple the earth and aircraft magnetic signals in order to derive a clean signal from which to perform magnetic navigation. Baseline testing on the dataset shows that the earth magnetic field can be extracted from the total magnetic field using machine learning (ML). The challenge is to remove the aircraft magnetic field from the total magnetic field using a trained neural network. These challenges offer an opportunity to construct an effective neural network for removing the aircraft magnetic field from the dataset, using an ML algorithm integrated with physics of magnetic navigation.Comment: 21 pages, 4 figures. See https://github.com/MIT-AI-Accelerator/MagNav.jl for accompanying data and cod

Concert recording 2015-11-22a

[Track 01]. Saxophone quartet. Elegie ; [Track 02]. Finale / Paul Reade -- [Track 03]. Gallumphery from Diversions in denim / Carl Anton Wirth -- [Track 04]. Shepherd\u27s hey / Percy Grainger -- [Track 05]. He is good and handsome / Pierre Passereau -- [Track 06]. Chorale prelude and fugue / J.S. Bach ; arranged by Laycock -- [Track 07]. Fugue in D / Michael Hanna -- [Track 08]. Explorations / Ryan Key -- [Track 09]. Fugato in F / René Borel -- [Track 10]. Finale from Quartett, opus 109 / Alexander Glazunov

Food insecurity in Detroit: exploring the relationship between patient-reported food insecurity and proximity to healthful grocery stores

Objective: The objective of the current study was to determine if patients of a large health care system in Detroit who self-identify as food insecure live further away from healthy grocery stores compared with food secure patients. Second, we explored whether food insecurity and distance to healthy grocery stores are related to ecological measures of vehicle availability in the area of residence. Design: A secondary data analysis that uses baseline data from a pilot intervention/feasibility study. Setting: Detroit, Michigan, USA. Participants: Patients of Henry Ford Health System were screened for food insecurity to determine eligibility for a pilot intervention/feasibility study (i.e. Henry’s Groceries for Health), conducted through a collaboration with Gleaners Community Foodbank of Southeastern Michigan. Only patients residing in Detroit city limits (including Highland Park and Hamtramck) were included in the secondary analysis. Of the 1,100 patients included in the analysis, 336 (31 %) were food insecure. Results: After accounting for socio-demographic factors associated with food insecurity, we did not find evidence that food insecure patients lived further away from healthier grocery stores, nor was this modified by ecological measures of vehicle access. However, some neighbourhoods were identified as having a significantly higher risk of food insecurity. Conclusions: Food insecure patients in Detroit are perhaps limited by social and political determinants and not their immediate neighbourhood geography or physical access to healthy grocery stores. Future research should explore the complexity in linkages between household socio-economic factors, socio-cultural dynamics and the neighbourhood food environment

Agricultural intensification heightens food safety risks posed by wild birds

Agricultural intensification and simplification are key drivers of recent declines in wild bird populations, heightening the need to better balance conservation with food production. This is hindered, however, by perceptions that birds threaten food safety. While birds are known reservoirs of foodborne pathogens, there remains uncertainty about the links between landscape context, farming practices, and actual crop contamination by birds. Here, we examine relationships between landscape context, farming practices, and pathogen contamination by birds using a barrier-to-spillover approach. First, we censused bird communities using point count surveys. Second, we collected 2,024 faecal samples from captured birds alongside 1,215 faecal samples from brassica fields and food processing areas across 50 farms spanning the USA West Coast. We then estimated the prevalence of three foodborne pathogens across landscape and livestock intensification gradients. Finally, we quantified the number of plants with faeces. Campylobacterspp. were detected in 10.2% of faeces from captured birds and 13.1% of faeces from production areas. Non-native birds were 4.1 times more likely to haveCampylobacterspp. than native birds.Salmonellaspp. were detected in 0.2% of faeces from production areas and were never detected in captured birds. We detected evidence of Shiga toxigenicE. coliin one sample across the >3,200 tested. Campylobacterspp. prevalence in faeces from production areas increased with increasing mammalian livestock densities in the landscape but decreased with increasing amounts of natural habitat. We encountered bird faeces on 3.3% of plants examined. Despite the impact on pathogen prevalence, amount of natural habitat in the landscape did not increase the number of plants with bird faeces, although on-farm mammalian livestock density slightly did. Synthesis and applications. Food safety and wildlife conservation are often thought to be in conflict. However, our findings suggest that natural habitat around farms may reduce crop contamination rates by birds. This is perhaps because natural habitat can promote native birds that are less likely to harbour foodborne pathogens or because it decreases contact with livestock waste. Our results suggest that preservation of natural habitats around farms could benefit both conservation and food safety, contrary to current standards for 'best practices'

Mosque-based emotional support among young Muslim Americans

Despite a growing literature on social support networks in religious settings (i.e., church-based social support), little is known about mosque-based support among Muslims. This study investigates the demographic and religious behavior correlates of mosque-based social support among a multi-racial and ethnic sample of 231 young Muslims from southeast Michigan. Several dimensions of mosque-based support are examined including receiving emotional support, giving emotional support, anticipated emotional support and negative interactions with members of one’s mosque. Results indicated that women both received and antic- ipated receiving greater support than did men. Higher educational attainment was associated with receiving and giving less support compared to those with the lowest level of educational attainment. Moreover, highly educated members reported fewer negative interactions than less educated members. Mosque attendance and level of congregational involvement positively predicted receiving, giving, and anticipated emotional support from congregants, but was unrelated to negative interactions. Overall, the study results converge with previously established correlates of church- based emotional support.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107410/1/art%3A10.1007%2Fs13644-013-0119-0(1).pd

Imperial Power and Dictatorship: Britain and the Rise of Reza Shah, 1921-1926

Born in obscurity about 1878 and soon orphaned, Reza Pahlavi enlisted at fifteen in a Russian-officered Cossack brigade. Rising through the ranks, he provided force for a February 1921 coup d\u27etat, seizing power for journalist Sayyid Zia alDin Tabatabai. Reza Khan provided strength in the new government and rose from army commander to minister of war (April 1921) to prime minister (1923) and, after failing to make a republic in 1924, to the throne in 1925. As shah he ruled with increasingly arbitrary power until Britain and Russia deposed him in 1941. He died in exile in 1944.1 This paper examines British activity in Iran during Reza\u27s rise to the throne and analyzes the longstanding belief that Britain made Reza shah of Iran. Within the context of Iranian and British history it tracks British involvement in the coup that first brought Reza to power and explores the policy of Sir Percy Loraine, British minister in Tehran, 1921-26. It shows that Britain did less than is believed by those who accept the myth, but more than London thought at the time: British aid to the coup was a key to its success, and aid to Reza helped him survive; Loraine\u27s policy of good relations and nonintervention was part of the process by which Reza came to dominate Iran

Meta-analysis of genome-wide association studies from the CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque

Carotid intima media thickness (cIMT) and plaque determined by ultrasonography are established measures of subclinical atherosclerosis that each predicts future cardiovascular disease events. We conducted a meta-analysis of genome-wide association data in 31,211 participants of European ancestry from nine large studies in the setting of the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. We then sought additional evidence to support our findings among 11,273 individuals using data from seven additional studies. In the combined meta-analysis, we identified three genomic regions associated with common carotid intima media thickness and two different regions associated with the presence of carotid plaque (P < 5 × 10 -8). The associated SNPs mapped in or near genes related to cellular signaling, lipid metabolism and blood pressure homeostasis, and two of the regions were associated with coronary artery disease (P < 0.006) in the Coronary Artery Disease Genome-Wide Replication and Meta-Analysis (CARDIoGRAM) consortium. Our findings may provide new insight into pathways leading to subclinical atherosclerosis and subsequent cardiovascular events