The Rio Grande Valley of Texas has an exceptionally high number of COVID-19 cases and case fatality rate. The region makes up only 3% of the Texas population but, as of April 2021, accounted for 9% of the state's COVID-19 deaths.Additionally, during the summer of 2020, the Rio Grande Valley had one of the highest per capita infection rates in the United States. This paper explores the social-ecological elements that impact health-seeking behaviors in this community using interviews conducted with healthcare personnel and nonprofit leaders in the Rio Grande Valley between 2019 and 2020. Using this data, we found that anti-immigrant rhetoric has increased levels of fear among immigrants and mixedstatus families, which has made them less willing to access healthcare. Additionally, we found that changes in the public charge rule has led to a decreasing number of children accessing government-provided health insurance. Our findings suggest that these outcomes likely contributed to the severity of the COVID-19 outbreak in the Rio Grande Valley.
Critical reflection upon nursing practice is pivotal in achieving optimal patient outcomes. Implicit in this statement is knowledge about and an understanding of the implementation of evidence-based practice (EBP). This study sought to evaluate baseline knowledge in order to assess and inform a multifaceted intervention to promote EBP in a multi-site facility in Western Sydney, Australia. On two consecutive days in February 2003, a convenience sample of 229 nurses were surveyed using a five-item, investigator developed, written survey tool. Data were analysed using descriptive statistics. Although the majority of respondents (n = 143: 62%) stated that they were aware of EBP, a considerable number (n = 86: 38%) stated they had not previously heard of the term. Of concern, 43% (n = 99) of respondents were unable to identify a source of information and resources about EBP. The results of this observational, descriptive survey underscore the importance of ongoing strategic interventions to improve knowledge, access and implementation of EBP amongst clinical nurses. This study also provides baseline data upon which to evaluate local interventions to promote knowledge of EBP amongst clinicians.
Gastrointestinal parasites are generally associated with lower-income countries in tropical and subtropical areas, but they are also prevalent in low-income and extreme low-income communities in the Southern United States. To date, studies characterizing the epidemiology of gastrointestinal parasites in the United States are limited, resulting in little comprehensive understanding of the challenge. This study investigates the environmental contamination of gastrointestinal parasites in the Southern United States by determining the contamination rate and burden of each parasite in five low-income communities. A total of 499 soil samples of approximately 50g were collected from public parks and private residences in Alabama, Louisiana, Mississippi, South Carolina, and Texas. A novel technique utilizing parasite floatation, filtration, and bead-beating was applied to concentrate and extract parasite DNA from samples. A multi-parallel qPCR-based molecular method detected Blastocystis spp (19.0%), Toxocara cati (6.01%), Toxocara canis (3.61%), Strongyloides stercoralis (2.00%), Trichuris trichiura (1.80%), Ancylostoma duodenale (1.42%), Giardia intestinalis (1.40%), Cryptosporidium spp (1.00%), Entamoeba histolytica (0.201%), and Necator americanus (0.200%). Overall parasite contamination rates varied significantly between communities: Western Mississippi (46.88%); Southwestern Alabama (39.62%); Northeastern Louisiana (28.24%); Southwestern South Carolina (27.03%); and South Texas (6.93%) (p < 0.0001). Furthermore, Toxocara spp. contamination rates were correlated with community poverty rates (rs = 0.7000; p = 0.2333). Toxocara cati DNA burdens were greater in communities with higher poverty rates, including Northeastern Louisiana (50.57%) and Western Mississippi (49.60%) compared to Southwestern Alabama (30.05%) (p = 0.0011). This study demonstrates the environmental contamination of parasites and their relationship with high poverty rates in communities in the Southern United States.
The City of Brownsville was made vulnerable to the COVID-19 pandemic due to high rates of obesity and diabetes, high rates of poverty, and adverse social determinants of health. To address the unique challenges faced by the community, Brownsville’s COVID-19 response brought together the skills of academia with the local understanding and health expertise of the city’s public health department to craft a pandemic response that addressed the specific needs and unique challenges of the residents. This article explores the response partnerships formed and the data-driven, community-oriented campaigns that were designed by the Brownsville Public Health Department. The collaborative partnership of the COVID-19 working group and the innovative dissemination strategies designed by the health department provided an effective method of disease mitigation among the city’s most vulnerable residents. The article demonstrates the impact of the response campaigns by including a resident’s perspective on the impact of the response, specifically how the health department tailored their efforts to meet the needs of the Brownsville community.
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