Follow-up care after a health fair screening in three Houston neighborhoods in 2008

Background. Each year thousands of people participate in mass health screenings for diabetes and hypertension, but little is known about whether or not those who receive higher than normal screening results obtain the recommended follow-up medical care, or what barriers they perceive to doing so. ^ Methods. Study participants were recruited from attendees at three health fairs in low-income neighborhoods in Houston, Texas Potential participants had higher than normal blood pressure (> 90/140 mgHg) or blood glucose readings (100 mm/dL fasting or 140 mm/dL random). Study participants were called at one, two, and three months and asked if they had obtained follow-up medical care; those who had not yet obtained follow-up care were asked to identify barriers. Using a modified Aday-Andersen model of health service access, the independent variables were individual and community characteristics and self-perceived need. The dependent variable was obtaining follow-up care, with barriers to care a secondary outcome. ^ Results. Eighty-two study participants completed the initial questionnaire and 59 participants completed the study protocol. Forty-eight participants (59% under an intent to treat analysis, 81% of those completing the study protocol) obtained follow-up care. Those who completed the initial questionnaire and who reported a regular source of care were significantly more likely to obtain follow-up care. For those who completed the study protocol the relationship between having a regular source of care and obtaining follow-up care approached but did not reach significance. For those who completed the initial questionnaire, self-described health status, when examined as a binary variable (good, very good, excellent, or poor, fair, not sure) was associated with obtaining follow-up care for those who rated their health as poor, fair, or not sure. While the group who completed the study protocol did not reach statistical significance, the same relationship between self-described health status of poor, fair, or not sure and obtaining follow-up care was present. The participants who completed the study protocol and described their blood pressure as OK or a little high were statistically more likely to get follow-up care than those who described it as high or very high. All those on oral medications for hypertension (12/12) and diabetes (4/4) who were told to obtain follow-up care did so; however, the small sample size allows this correlation to be of statistical significance only for those treating hypertension. ^ The variables significantly associated with obtaining follow-up care were having a regular source of care, self-described health status of poor, fair, or not sure, self-described blood pressure of OK or a little high, and taking medication for blood pressure. ^ At the follow-up telephone calls, 34 participants identified barriers to care; cost was a significant barrier reported by 16 participants, and 10 reported that they didn’t have time because they were working long hours after Hurricane Ike. ^ The study included the offer of access assistance: information about nearby safety-net providers, a visit to or information from the Health Information Center at their Neighborhood Center location, or information from Project Safety Net (a searchable web site for safety net providers). Access assistance was offered at the health fairs and then again at follow-up telephone calls to those who had not yet obtained follow-up care. Of the 48 participants who reported obtaining follow-up care, 26 said they had made use of the access assistance to do so. The use of access assistance was associated with being Hispanic, not having health insurance or a regular source of care, and speaking Spanish. It was also associated with being worried about blood glucose. ^ Conclusion. Access assistance, as a community enabling characteristic, may be useful in aiding low-income people in obtaining medical care. ^

Occupational injuries among day laborers in Houston

Research has indicated that day laborers engage in higher risk occupations and suffer a high number of occupationally related fatal and non-fatal injuries. Although there have been some studies focusing on immigrant workers and their occupational injuries, none to our knowledge has studied Houston’s day laborers. An exploratory study of Houston’s day laborer population was conducted in 2008 by Dr. Fernández-Esquer from the University of Texas. ^ The aims of the current study are to analyze secondary data from this parent study and describe the prevalence of the self reported occupational injuries among Houston immigrant day laborers seeking work during the months of October through December 2008. The study also aims to determine if the reported injuries varied by age group, education level, length of time living in the U.S. and length of time working as day laborers and describe if injuries were more common by the number of different job types or job conditions reported or the use of personal protective equipment used (PPE). ^ This study analyzed 325 questionnaires that included job-related information from the parent study. One hundred and nine workers (35 %) reported an occupational injury or illness in the year before the interview. The most frequent injuries or illnesses reported were falls (26.7 %), cuts and lacerations (23.3 %) and being struck by an object (18.3 %). Over half of the workers (57 %) reported working 4 to 6 different jobs in the year before the interview, followed by 22.5 % reporting 1 to 3 different jobs. A combined 79 % of day laborers in Houston reported exposure to 7 or more of the job conditions listed and 69 % of those workers also reported an injury or illness. PPE use varied from 44 % of workers reporting using 4 to 6 PPE items to 6.8 % reporting not using any type of PPE. Thirty two percent of workers reporting not using any PPE also reported an injury or illness. ^ Injuries were found not to have varied significantly by age group, time living in the US, time working as a day laborer, numbers of different job types and the number of PPE used. Injuries did vary significantly by education level of the participants and the number of different job conditions reported (education, X2 (4, N = 315) = 12.651, p =0.013; and job conditions, X2 (3, N = 319) = 14.698, p = 0.002). ^ Although this first study of Houston’s day laborers was successful at engaging the population and getting background information regarding the occupational health of these workers, more studies are needed to further characterize the day laborers occupational experiences and injuries along with determining what specific job types and job conditions were present when injuries occurred and what kind of PPE was being used at the time. It is also clear that these workers need better safety training programs regarding working in potentially dangerous jobs and job conditions. They would also benefit from programs that would help empower them to negotiate for safer conditions.^

Microbiota and Microsatellite genotypes of Pacific oysters stemming from three oyster bed in the Northern Wadden Sea

Background: Studies of oyster microbiomes have revealed that a limited number of microbes, including pathogens, can dominate microbial communities in host tissues such as gills and gut. Much of the bacterial diversity however remains underexplored and unexplained, although environmental conditions and host genetics have been implicated. We used 454 next generation 16S rRNA amplicon sequencing of individually tagged PCR reactions to explore the diversity of bacterial communities in gill tissue of the invasive Pacific oyster Crassostrea gigas stemming from genetically differentiated beds under ambient outdoor conditions and after a multifaceted disturbance treatment imposing stress on the host. Results: While the gill associated microbial communities in oysters were dominated by few abundant taxa (i.e. Sphingomonas, Mycoplasma) the distribution of rare bacterial groups correlated to relatedness between the hosts under ambient conditions. Exposing the host to disturbance broke apart this relationship by removing rare phylotypes thereby reducing overall microbial diversity. Shifts in the microbiome composition in response to stress did not result in a net increase in genera known to contain potentially pathogenic strains. Conclusion: The decrease in microbial diversity and the disassociation between population genetic structure of the hosts and their associated microbiome suggest that disturbance (i.e. stress) may play a significant role for the assembly of the natural microbiome. Such community shifts may in turn also feed back on the course of disease and the occurrence of mass mortality events in oyster populations.

(Table 2) Survivorship of transplanted seedlings of Picea glauca inside and outside three tree islands in 1994, 1995, 2009 and after 15 years

The northern boundary of boreal forest and the ranges of tree species are expected to shift northward in response to climate warming, which will result in a decrease in the albedo of areas currently covered by tundra vegetation, an increase in terrestrial carbon sequestration, and an alteration of biodiversity in the current Low Arctic. Central to the prediction of forest expansion is an increase in the reproductive capacity and establishment of individual trees. We assessed cone production, seed viability, and transplanted seedling success of Picea glauca (Moench.) Voss. (white spruce) in the early 1990s and again in the late 2000s at four forest stand sites and eight tree island sites (clonal populations beyond present treeline) in the Mackenzie Delta region of the Northwest Territories, Canada. Over the past 20 years, average temperatures in this region have increased by 0.9 °C. This area has the northernmost forest-tundra ecotone in North America and is one of the few circumpolar regions where the northern limit of conifer trees reaches the Arctic Ocean. We found that cone production and seed viability did not change between the two periods of examination and that both variables decreased northward across the forest-tundra ecotone. Nevertheless, white spruce individuals at the northern limit of the forest-tundra ecotone produced viable seeds. Furthermore, transplanted seedlings were able to survive in the northernmost sites for 15 years, but there were no signs of natural regeneration. These results indicate that if climatic conditions continue to ameliorate, reproductive output will likely increase, but seedling establishment and forest expansion within the forest-tundra of this region is unlikely to occur without the availability of suitable recruitment sites. Processes that affect the availability of recruitment sites are likely to be important elsewhere in the circumpolar ecotone, and should be incorporated into models and predictions of climate change and its effects on the northern forest-tundra ecotone.

Initial biomass and biomass change of tundra and forest plants in three herbivore treatments in Norway and Sweden

Recent Pan-Arctic shrub expansion has been interpreted as a response to a warmer climate. However, herbivores can also influence the abundance of shrubs in arctic ecosystems. We addressed these alternative explanations by following the changes in plant community composition during the last 10 years in permanent plots inside and outside exclosures with different mesh sizes that exclude either only reindeer or all mammalian herbivores including voles and lemmings. The exclosures were replicated at three forest and tundra sites at four different locations along a climatic gradient (oceanic to continental) in northern Fennoscandia. Since the last 10 years have been exceptionally warm, we could study how warming has influenced the vegetation in different grazing treatments. Our results show that the abundance of the dominant shrub, Betula nana, has increased during the last decade, but that the increase was more pronounced when herbivores were excluded. Reindeer have the largest effect on shrubs in tundra, while voles and lemmings have a larger effect in the forest. The positive relationship between annual mean temperature and shrub growth in the absence of herbivores and the lack of relationships in grazed controls is another indication that shrub abundance is controlled by an interaction between herbivores and climate. In addition to their effects on taller shrubs (> 0.3 m), reindeer reduced the abundance of lichens, whereas microtine rodents reduced the abundance of dwarf shrubs (< 0.3 m) and mosses. In contrast to short-term responses, competitive interactions between dwarf shrubs and lichens were evident in the long term. These results show that herbivores have to be considered in order to understand how a changing climate will influence tundra ecosystems.

Pollen profiles from three former lakes in the Lake Garda area

1. Late glacial and postglacial sediments from three former lakes in the Lake Garda area (Southern Alps) were investigated. 2. The pollen diagram from Bondone (1550 m) shows an older phase rich in NAP. A younger one corresponds with the Younger Dryas time according to two radiocarbon determinations. In the Preboreal no climatic deterioration could be found. 3. At first plants, which are nowadays typical for snow-ground, pioneer and dwarf shrub associations, immigrated into the surroundings of Bondone. In Alleröd times larch and pine appeared as the first trees. At the beginning of the Preboreal dense forest existed in that region. During the Alleröd timber line was at about 1500 m. 4. In the pollen diagrams from Saltarino (194 m) and Fiavè (654 m) an oldest period rich in NAP is followed by two stadial and two interstadial phases. Tree birches and larches immigrated during the oldest interstadial phase. 5. In the case of Saltarino and Fiavè only a preliminary dating could be made. A correlation seems to be possible with diagrams published by Zoller as well as with the diagram of Bondone. Discrepances in dating, which arise then, are discussed. According to the two possibilities of dating the youngest stadial is synchronous either with the so-called Piottino stadial or the Younger Dryas time. Consequently the oldest interstadial phase of Saltarino corresponds either with the Bölling or with a pre-Bölling interstadial. The last possibility seems to be more probable. 6. In the southern part of the Lake Garda area reforestation was preceded by a long shrub phase mainly with Juniperus. At about 650 m there was a period with Pinus mugo and only with a small amount of Juniperus before reforestation. A phase with Betula nana well known from areas north of the Alps could nowhere be found. 7. In the area under study larch appeared as the first tree. Lateron it has been the most important constituent of the forests near timber line. Birch, which plays an important role as a pioneer tree in Denmark - for instance at the transition of the pollen zones III/IV - as well as in Southern Germany during Bölling time, was of less importance at the southern border of the Alps. In that area the spreading of Pinus occurred very early causing dense forests. 8. During the last stadial phase (probably Younger Dryas time) dense forests with Pinus and Larix existed at 650 m. In the lower part of the Lake Garda area, however, both thermophilous trees as Quercus and herbs frequently occurred. This leads to the conclusion that during this time tree growth was limited by dryness in lower altitudes of the border of the Southern Alps. Pinus and Juniperus, however, do not show higher values in this period, a fact which cannot yet be explained. 9. A list of plants, which were found in the sediments, is compiled. Helodium lanatum, Dictamnus albus, Mercurialis cf. ovata, Buxus, Cerinthe cf. minor, Onosma, Anthericum and Asphodelus albus are findings, which are of special interest for the history of the flora of that region.

High-resolution IP25 of three sediment cores in the western North Pacific and Bering Sea

Due to its strong influence on heat and moisture exchange between the ocean and the atmosphere, sea ice is an essential component of the global climate system. In the context of its alarming decrease in terms of concentration, thickness and duration, understanding the processes controlling sea-ice variability and reconstructing paleo-sea-ice extent in polar regions have become of great interest for the scientific community. In this study, for the first time, IP25, a recently developed biomarker sea-ice proxy, was used for a high-resolution reconstruction of the sea-ice extent and its variability in the western North Pacific and western Bering Sea during the past 18,000 years. To identify mechanisms controlling the sea-ice variability, IP25 data were associated with published sea-surface temperature as well as diatom and biogenic opal data. The results indicate that a seasonal sea-ice cover existed during cold periods (Heinrich Stadial 1 and Younger Dryas), whereas during warmer intervals (Bølling-Allerød and Holocene) reduced sea ice or ice-free conditions prevailed in the study area. The variability in sea-ice extent seems to be linked to climate anomalies and sea-level changes controlling the oceanographic circulation between the subarctic Pacific and the Bering Sea, especially the Alaskan Stream injection though the Aleutian passes.