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Decision tree outlining protocol for treatment of cholesterolemia.
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The U.S. Environmental Protection Agency’s (EPA) Worker Protection Standard (WPS) provides basic workplace protections to farmworkers and pesticide handlers to minimize the adverse effects of pesticide exposure. EPA announced major revisions to the WPS in September 2015. MCN and FJ's fact sheet provides a summary of the revised regulation.

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"Zika virus is a flavivirus transmitted primarily by Aedes aegypti and Aedes albopictus mosquitoes, and infection can be asymptomatic or result in an acute febrile illness with rash (1). Zika virus infection during pregnancy is a cause of microcephaly and other severe birth defects (2). Infection has also been associated with Guillain-Barré syndrome (GBS) (3) and severe thrombocytopenia (4,5). In December 2015, the Puerto Rico Department of Health (PRDH) reported the first locally acquired case of Zika virus infection. This report provides an update to the epidemiology of and public health response to ongoing Zika virus transmission in Puerto Rico (6,7). A confirmed case of Zika virus infection is defined as a positive result for Zika virus testing by reverse transcription–polymerase chain reaction (RT-PCR) for Zika virus in a blood or urine specimen. A presumptive case is defined as a positive result by Zika virus immunoglobulin M (IgM) enzyme-linked immunosorbent assay (MAC-ELISA)* and a negative result by dengue virus IgM ELISA, or a positive test result by Zika IgM MAC-ELISA in a pregnant woman. An unspecified flavivirus case is defined as positive or equivocal results for both Zika and dengue virus by IgM ELISA. During November 1, 2015–July 7, 2016, a total of 23,487 persons were evaluated by PRDH and CDC Dengue Branch for Zika virus infection, including asymptomatic pregnant women and persons with signs or symptoms consistent with Zika virus disease or suspected GBS; 5,582 (24%) confirmed and presumptive Zika virus cases were identified. Persons with Zika virus infection were residents of 77 (99%) of Puerto Rico’s 78 municipalities. During 2016, the percentage of positive Zika virus infection cases among symptomatic males and nonpregnant females who were tested increased from 14% in February to 64% in June. Among 9,343 pregnant women tested, 672 had confirmed or presumptive Zika virus infection, including 441 (66%) symptomatic women and 231 (34%) asymptomatic women. One patient died after developing severe thrombocytopenia (4). Evidence of Zika virus infection or recent unspecified flavivirus infection was detected in 21 patients with confirmed GBS. The widespread outbreak and accelerating increase in the number of cases in Puerto Rico warrants intensified vector control and personal protective behaviors to prevent new infections, particularly among pregnant women."

Resources in English and Spanish from Florida State University's Center for Child Stress and Health on how to talk to a child about deportation and associated stress.

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These Spanish and English cholesterol patient education resources were developed by the University of Texas Health Science Center at House and the School of Public Health, Ele Paso Regional Campus. The artwork was done by Salvador Saenz, a well-known and respected public health educator and artist based in El Paso, TX. 

Environmental Education Curriculum

The primary goals of this project to be achieved through this curriculum are:

1) Increasing the capacity of students and community to think critically about environmental problems and the related decisions that affect human health and the environment as it relates to disaster preparation and response;

2) Increase community participation and collaboration with the goal of improving protections for human health and the environment as it relates to disaster preparation and response; and

3) Ensure chemical safety and safe water as it relates to disaster preparation and response.

 

Videos

 

 

  1. Currículo de educación ambiental: In this Spanish-language presentation, Alma Galván, MCH, Senior Program Manager of Occupational Health, provides an introduction to MCN’s environmental education curriculum presented in Puerto Rico.
     
  2. Agua Segura y seguridad con químicos: In this Spanish-language environmental education presentation, MCN’s Myrellis Muñiz-Márquez, MPH, Program Manager in Puerto Rico, shares tools to stay safe from chemical exposure, contaminated water, and non-point source pollution, before, during, and after a disaster.
     
  3. Emergencias y desastres: In this Spanish-language environmental education presentation, MCN’s Marysel Pagán-Santana, DrPH, MS, Senior Program Manager in Puerto Rico, identifies the environmental and health risks of disasters and encourages prevention measures and planning to protect individual and community health during and after emergencies.

 

Materials

Safe Water resources

Safe Water | Environmental Education Resources

 

Emergency and Disaster Management

Emergency and Disaster Management | Environmental Education Resources

 

A Little Bit of Poison - comic book cover

This Community Health Worker manual (English/Spanish) offers information about health risks from pesticide exposure and ways to lessen these risks. It includes useful information and tips to successfully work in the community. 

Blog post from the U.S. Department of Labor highlighting common hazards during hurricane cleanup as well as links to additional readings.

Video interview with COPE Executive Director Mark Sullivan, MD, PhD.

About COPE: The University of Washington’s COPE for Chronic Pain CME Program offers evidence-based clinical knowledge and training on how best to treat patients experiencing chronic pain. COPE CME helps clinicians assess patients and monitor their progress, mitigate risk, and focus on restoring function and quality of life. It provides guidance on when and how to start, stop, or modify opioid therapies. COPE’s online course includes case-based video vignettes that model interactions between providers and patients, helping to improve communications that promote trust. Live and web-based CME is available.

 

Only 25% of physicians feel very confident in managing patients on opioids. 

When many of today's physicians were in medical school, they learned that opioids were safe, and no dose seemed too high. Now, evidence-based practice paints a far more nuanced picture. More than 200 million prescriptions a year have contributed to widespread problems:

  • 33% of young adults say that prescription opioids are "easy to get," with many taking their friends' or parents' pills.
  • Nearly 20% of U.S. veterans with PTSD are receiving higher-dose or multiple opioids, or early refills.
  • Increased prescribing to women of childbearing age has contributed to a 4-fold increase in neonatal abstinence syndrome

COPE offers free CME on safe opioid prescribing:

  • COPE-REMS: an online, self-paced tutorial that awards up to 4 CME credits
  • UW TelePain: Providers can call in to UW Medicine and present their most difficult chronic pain cases to a multidisciplinary panel of pain medicine experts for discussion and advice. Tune in to live, lunchtime, 1-hour sessions most Wednesdays at 12 PM to earn up to 1.5 CME credits per session.

Other resources from COPE include:

APHA's Get Ready campaign helps Americans prepare themselves, their families and their communities for all disasters and hazards, including pandemic flu, infectious disease, natural disasters and other emergencies.

 

Arthur L. Frank, MD, PhD, Amy K. Liebman, MPH, MA, Bobbi Ryder, BA, Maria Weir, MAA, MPH, and Thomas A. Arcury, PhD

 

 

Background The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in the
US is comprised primarily of Latino immigrants. Health care access for these workers
is limited and increases health disparities.

Background The Agriculture, Forestry, and Fishery (AgFF) Sector workforce in theUS is comprised primarily of Latino immigrants. Health care access for these workersis limited and increases health disparities.

 

Methods This article addresses health care access for immigrant workers in the AgFF Sector, and the workforce providing care to these workers.

 

Contents Immigrant workers bear a disproportionate burden of poverty and ill health and additionally face significant occupational hazards. AgFF laborers largely are uninsured, ineligible for benefits, and unable to afford health services. The new Affordable Care Act will likely not benefit such individuals. Community and Migrant Health Centers (C/MHCs) are the frontline of health care access for immigrant AgFF workers.C/MHCs offer discounted health services that are tailored to meet the special needs of their underserved clientele. C/MHCs struggle, however, with a shortage of primary care providers and staff prepared to treat occupational illness and injury among AgFF workers. A number of programs across the US aim to increase the number of primary care physicians and care givers trained in occupational health at C/MHCs. While such programs are beneficial, substantial action is needed at the national level to strengthen and expand the C/MHC system and to establish widely Medical Home models and Accountable Care Organizations. System-wide policy changes alone have the potential to reduce and eliminate the rampant health disparities experienced by the immigrant workers who sustain the vital Agricultural, Forestry, and Fishery sector in the US. Am. J. Ind. Med.

 

For the first time, the U.S. Preventive Services Task Force has released an e-book version of its Guide to Clinical Preventive Services. The e-book is compatible with many readers, including Kindle, Nook, iBook, and Kobo. The new “Guide to Clinical Preventive Services, 2014” is a comprehensive resource that can help primary care clinicians and patients decide together which preventive services are right for a patient’s needs. It includes all active Task Force evidence-based recommendations since 2004, including 28 new and updated recommendations since the 2012 guide, in a format meant for use at the point of patient care. It also includes information about topics in development, clinical summary tables and additional resources.

The world continues to deal with COVID-19 and herd immunity is not reached and skepticism, resistance and hesitation about vaccines continues representing a major obstacle. During the first few months of the vaccination effort, filmmaker Chris Newberry and his team followed a diverse set of health professionals as they gained the trust of at-risk communities across Minnesota. The resulting documentary is a tribute to the doctors, nurses, organizers and influencers who are embracing community-led efforts to overcome vaccine doubts.

Watch the conversation with the film's creators and a panel of experts:

Our partners at NRC RIM have put together a series of discussion guides for clinicians, community groups, and community health workers in English and Spanish for the documentary can be found here.

For anyone who would like to contact the producers with questions or for help in organizing their own TRUSTED MESSENGER event, they can reach us here:

http://www.terminal1.tv/contacta

July has information about substance abuse among migrant workers. Followed by "Harm Reduction" Strategies for HCV substance abusers in August,and Potential substance abuse treatment sites and resources for migrants in September.

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