Chicago Site Research Articles

Domestic Violence within Violence Mediation Programming: Keys Insights into the Nature, Rate, and Interconnection with Community Violence

ABSTRACT Domestic and community violence are two pervasive societal issues. While research indicates significant connections between these forms of violence, detailed exploration of their co-occurrence and specific characteristics within intervention and prevention programs remains lacking. Understanding these complex interactions is crucial, as many programs are not designed to address the diverse manifestations of violence simultaneously. They often focus on one type, potentially overlooking the broader spectrum of violence that individuals might experience or contribute to. This study aims to illuminate the frequency and nature of these violence types within the context of intervention efforts. To bridge this gap, we engaged in a systematic, secondary analysis, delving into 1,943 conflicts documented across 25 CeaseFire program sites in Chicago between 2000 and 2015. Data included information from mediation forms regularly completed by CeaseFire staff post-mediation. Our primary focus encompassed a content analysis of these cases to establish a baseline occurrence of domestic violence within violence mediations. Subsequently, we probed the prevalence and intricate interplay between community and domestic violence, exploring potential bidirectional influences. Of the 1,943 conflicts mediated among program sites in Chicago, 151 conflicts displayed signs of interconnection with community violence, falling into the categories of retaliation or intervention. In summation, the findings underscore the entwined nature of domestic and community violence, often transitioning from one form (primarily domestic) to another (typically community-based) in the form of escalating retaliatory behaviors. Violence prevention and intervention endeavors must consider the plausible escalation patterns stemming from interconnected violence forms, significantly shaping mediation strategies.

Cardiovascular Health, Race, and Decline in Cognitive Function in Midlife Women: The Study of Women's Health Across the Nation.

Cognitive decline may progress for decades before dementia onset. Better cardiovascular health (CVH) has been related to less cognitive decline, but it is unclear whether this begins early, for all racial subgroups, and all domains of cognitive function. The purpose of this study was to determine the impact of CVH on decline in the 2 domains of cognition that decline first in White and Black women at midlife. Subjects were 363 Black and 402 White women, similar in baseline age (mean±SD, 46.6±3.0 years) and education (15.7±2.0 years), from the Chicago site of the Study of Women's Health Across the Nation. Cognition, measured as processing speed and working memory, was assessed annually or biennially over a maximum of 20 years (mean±SD, 9.8±6.7 years). CVH was measured as Life's Essential 8 (blood pressure, body mass index, glucose, non-high-density lipoprotein cholesterol, smoking, physical activity, diet, sleep). Hierarchical linear mixed models identified predictors of cognitive decline with progressive levels of adjustment. There was a decline in processing speed that was explained by race, age, and the 3-way interaction of race, CVH, and time (F1,4308=8.8, P=0.003). CVH was unrelated to decline in White women but in Black women poorer CVH was associated with greater decline. Working memory did not decline in the total cohort, by race, or by CVH. In midlife Black women, CVH promotion may be a target for preventing the beginnings of cognitive decline, thereby enhancing independent living with aging.

Peripheral inflammatory subgroup differences in anterior Default Mode network and multiplex functional network topology are associated with cognition in psychosis

IntroductionHigh-inflammation subgroups of patients with psychosis demonstrate cognitive deficits and neuroanatomical alterations. Systemic inflammation assessed using IL-6 and C-reactive protein may alter functional connectivity within and between resting-state networks, but the cognitive and clinical implications of these alterations remain unknown. We aim to determine the relationships of elevated peripheral inflammation subgroups with resting-state functional networks and cognition in psychosis spectrum disorders. MethodsSerum and resting-state fMRI were collected from psychosis probands (schizophrenia, schizoaffective, psychotic bipolar disorder) and healthy controls (HC) from the B-SNIP1 (Chicago site) study who were stratified into inflammatory subgroups based on factor and cluster analyses of 13 cytokines (HC Low n = 32, Proband Low n = 65, Proband High n = 29). Nine resting-state networks derived from independent component analysis were used to assess functional and multilayer connectivity. Inter-network connectivity was measured using Fisher z-transformation of correlation coefficients. Network organization was assessed by investigating networks of positive and negative connections separately, as well as investigating multilayer networks using both positive and negative connections. Cognition was assessed using the Brief Assessment of Cognition in Schizophrenia. Linear regressions, Spearman correlations, permutations tests and multiple comparison corrections were used for analyses in R. ResultsAnterior default mode network (DMNa) connectivity was significantly reduced in the Proband High compared to Proband Low (Cohen’s d = -0.74, p = 0.002) and HC Low (d = -0.85, p = 0.0008) groups. Inter-network connectivity between the DMNa and the right-frontoparietal networks was lower in Proband High compared to Proband Low (d = -0.66, p = 0.004) group. Compared to Proband Low, the Proband High group had lower negative (d = 0.54, p = 0.021) and positive network (d = 0.49, p = 0.042) clustering coefficient, and lower multiplex network participation coefficient (d = -0.57, p = 0.014). Network findings in high inflammation subgroups correlate with worse verbal fluency, verbal memory, symbol coding, and overall cognition. ConclusionThese results expand on our understanding of the potential effects of peripheral inflammatory signatures and/or subgroups on network dysfunction in psychosis and how they relate to worse cognitive performance. Additionally, the novel multiplex approach taken in this study demonstrated how inflammation may disrupt the brain's ability to maintain healthy co-activation patterns between the resting-state networks while inhibiting certain connections between them.

Carnivore coexistence in Chicago: niche partitioning of coyotes and red foxes

Mesopredators including coyotes (Canis latrans) and red foxes (Vulpes vulpes) often co-occur in urban environments, but how niche partitioning facilitates their coexistence remains unclear. Highly urbanized areas can be spatial refuges for smaller mesopredators (i.e., spatial human shield effect), however these species also may coexist through temporal niche partitioning. We used camera traps (n = 110 sites) across an urbanization gradient in Chicago to examine coyote-fox interactions from 2011 to 2018. We analyzed spatial partitioning through multi-season occupancy models and structural equation modeling (SEM), and quantified temporal overlap between canids and with humans. Coyotes most often occurred in natural areas, and urbanization reduced their colonization rates and increased their extinction rates. Initial occupancy for red foxes was negatively impacted by urbanization, but their extinction rates depended on a surprising interaction between coyotes and humans. When coyotes were rare, fox extinction was related positively to human activity; but when coyotes were more common, fox extinction was related negatively to human activity. This outcome may reflect a human shield effect at a within-site scale. The SEM further supported the negative impact of urbanization on both canids, and lack of an effect of coyotes on the distribution of foxes. Diel activity of coyotes and red foxes indicated temporal niche partitioning intensified at more urbanized sites. Our results suggest the spatial human shield effect is not operating across sites in Chicago. Instead, coyotes and red foxes may share green spaces, especially in highly urbanized areas, where species coexistence is promoted by temporal niche partitioning.

Human biting mosquitoes and implications for West Nile virus transmission

BackgroundWest Nile virus (WNV), primarily vectored by mosquitoes of the genus Culex, is the most important mosquito-borne pathogen in North America, having infected thousands of humans and countless wildlife since its arrival in the USA in 1999. In locations with dedicated mosquito control programs, surveillance methods often rely on frequent testing of mosquitoes collected in a network of gravid traps (GTs) and CO2-baited light traps (LTs). Traps specifically targeting oviposition-seeking (e.g. GTs) and host-seeking (e.g. LTs) mosquitoes are vulnerable to trap bias, and captured specimens are often damaged, making morphological identification difficult.MethodsThis study leverages an alternative mosquito collection method, the human landing catch (HLC), as a means to compare sampling of potential WNV vectors to traditional trapping methods. Human collectors exposed one limb for 15 min at crepuscular periods (5:00–8:30 am and 6:00–9:30 pm daily, the time when Culex species are most actively host-seeking) at each of 55 study sites in suburban Chicago, Illinois, for two summers (2018 and 2019).ResultsA total of 223 human-seeking mosquitoes were caught by HLC, of which 46 (20.6%) were mosquitoes of genus Culex. Of these 46 collected Culex specimens, 34 (73.9%) were Cx. salinarius, a potential WNV vector species not thought to be highly abundant in upper Midwest USA. Per trapping effort, GTs and LTs collected > 7.5-fold the number of individual Culex specimens than HLC efforts.ConclusionsThe less commonly used HLC method provides important insight into the complement of human-biting mosquitoes in a region with consistent WNV epidemics. This study underscores the value of the HLC collection method as a complementary tool for surveillance to aid in WNV vector species characterization. However, given the added risk to the collector, novel mitigation methods or alternative approaches must be explored to incorporate HLC collections safely and strategically into control programs.Graphical

The Effect of a Mediterranean Diet With or Without Calorie Restriction on Cognition, Lifestyle, and Metabolic Health of Obese, Predominately Non-Hispanic Black Older Adults

ObjectivesTo compare the effect of a Mediterranean Diet with (Med-WL) or without caloric restriction (Med-A) for intentional weight loss (IWL) versus a typical diet control (TDC) on cognition, lifestyle and cardiometabolic health.MethodsA randomized clinical trial of obese, predominately non-Hispanic black, older adults was conducted between June 2017 and December 2020 at community sites in Chicago, Illinois. Participants (n = 185) were randomized (2:2:1) to 1 of 3 groups for 8-months: Med-WL, Med-A, or TDC. The primary outcome was change from baseline to post-intervention in three cognitive composite scores: attention, information & processing; executive function; and learning, memory & recognition. Secondary outcomes included changes in MedDiet adherence, physical activity, body weight, total and regional body fat, blood pressure, fasting blood lipids, glucose, insulin and C-reactive protein (CRP).ResultsParticipants were 85.9% female with a mean (SD) age of 66.3 (6.1) years, and retention was similar across arms (85.3% Med-WL, 87.7% Med-A, 94.6% TDC, p = 0.36). The MedDiet interventions did not affect cognitive composite scores. MedDiet adherence improved significantly more in Med-WL (adjusted mean [95% CI] score change, +6.3 [4.9 to 7.6] points) and Med-A (+4.8 [3.4 to 6.2] points) relative to TDC (+0.6 [−1.3 to 2.4] points, p < 0.05). Weight loss was significantly greater in Med-WL (adjusted mean [95% CI]: −4.6 [(-5.6 to −3.5] kg) than in Med-A (-2.6 [−3.7 to −1.5] kg, p < 0.05) and TDC (−0.6 [−2.1 to 0.8] kg, p < 0.05). Reduction in central body fat was significantly greater in the MedDiet arms (adjusted mean change [95% CI], Med-WL: −147 [−235 to −59] gm; Med-A: −162 [−248 to −76] gm) than in TDC (+91 [−18 to 200] gm, p < 0.05). For cardiometabolic health, only fasting insulin changed significantly in Med-WL (adjusted mean change [95% CI]: −2.2 [−3.2 to −1.2] uIU/mL) relative to Med-A (−0.6 [−1.6 to 0.4] uIU/mL, p < 0.05) and TDC (−0.5 [−1.8 to 0.8] uIU/mL, p < 0.05).ConclusionsAn 8-month MedDiet lifestyle intervention with or without caloric restriction for IWL did not produce superior effects on cognitive function compared to a TDC, but it did produce significant effects on diet quality, total body weight and central body fat.Funding SourcesNational Heart, Lung And Blood Institute; National Cancer Institute; National Institute On Minority Health And Health Disparities.

Capture of surface water runoff for irrigation of corn in western Illinois: Implications for nutrient loss reduction

Supplemental irrigation with the runoff from agricultural fields (runoff irrigation) not only has the potential to reuse nutrients in agricultural runoff but could potentially reduce fertilizer input to farms, leading to reduced nutrient export from agricultural fields. A three-year field study designed to evaluate the impact of runoff irrigation on corn (<i>Zea mays</i>) yield and nutrient uptake was conducted in a farmer-operated field at the Metropolitan Water Reclamation District of Greater Chicago (MWRD) site in Fulton County, Illinois. The study comprised three treatments: (1) 50% agronomic nitrogen (N) and phosphorus (P) fertilizer rates with no irrigation (control), (2) 50% agronomic N and P fertilizer rates with irrigation, and (3) 100% agronomic N and P fertilizer with no irrigation. Each treatment was assigned to a 76 m by 18 m plot, planted with corn in 2016, 2017, and 2018. Runoff irrigation increased grain, stover, and total dry matter yields by an average of 38%, 45%, and 27%, respectively, as compared to the control. On average, 50% agronomic fertilizer rate, coupled with runoff irrigation, produced similar grain yields as 100% agronomic fertilizer rate. At the 50% agronomic fertilizer rate, N uptake averaged 231 ± 37 kg N ha^–1 in 2017 and 290 ± 54 kg N ha^–1 in 2018 with irrigation, as compared to 162 ± 36 kg N ha^–1 in 2017 and 179 ± 34 kg N ha^–1 in 2018 without irrigation. Similarly, P uptake was greater with irrigation than without irrigation for the same P fertilizer rate. The fertilizer replacement value (FRV) of the runoff irrigation was estimated to be 73 kg N ha^–1 and 6 kg P ha^–1 in 2018. This represents a potential of reducing N and P fertilizer application rate by 30% and 8%, respectively, by supplemental irrigation without reducing corn yield. The runoff irrigation is a potential best management practice that can be further explored for adoption in Illinois for contributing to the statewide Nutrient Loss Reduction Strategy.

Fruit lead concentrations of tomato (Solanum lycopersicum L.) grown in lead-contaminated soils are unaffected by phosphate amendments and can vary by season, but are below risk thresholds

Urban agriculture in post-industrial cities faces concerns on human health risks posed by elevated lead (Pb) concentrations of edible plant tissues grown in Pb-enriched soils. A recommended mitigation strategy to decrease soil Pb bioavailability to humans is the addition of soluble phosphate (PO43−-P), but it is unclear if this strategy can also reduce crop Pb uptake and accumulation in edible tissues. Across urban agriculture sites in Chicago, Illinois (6 site-years) with elevated total soil Pb, we tested the hypothesized decrease in tomato fruit Pb following soil-based application of three phosphate-based mitigation amendments: triple superphosphate, composted biosolids, and air dried biosolids. Fruit Pb concentrations (mg Pb kg−1 dry mass) and loads (mg Pb m−2) were unaffected by mitigation amendments. However, fruit Pb concentrations were higher by an order of magnitude in 2020 (≥0.13 mg kg−1) compared to 2019 (0.01 mg kg−1) for two of the three sites. Though highly variable across site-years, the bioconcentration factor (BCF) of Pb from soil to fruit varied was unaffected by mitigation amendments. Relatively low BCF values were consistent with fruit Pb concentrations being below FAO/WHO risk limits. Collectively, our findings support previous propositions that fruits of plants grown in soils with elevated Pb generally pose lower risk to consumers. To mitigate health risks of consuming tomatoes grown in soils with Pb contamination, the seasonality of Pb uptake should be investigated, and greater focus should be placed on where tomatoes are grown rather than phosphate-based immobilization strategies originally designed to mitigate human bioavailability.

Effect of Combination Treatment With Varenicline and Nicotine Patch on Smoking Cessation Among Smokers Who Drink Heavily

The concurrent use of both tobacco and alcohol causes substantial disease and early mortality, and smokers who drink heavily tend to be less successful in smoking cessation than smokers who do not. Although varenicline combined with nicotine replacement therapy for smoking cessation has been examined among smokers who do not drink heavily, this combination treatment has not yet been examined among smokers who drink heavily. To determine whether combined treatment with varenicline tartrate and nicotine patch improves continuous abstinence from cigarette smoking among smokers who drink heavily. This double-blind, placebo-controlled, superiority randomized clinical trial evaluated combined treatment with varenicline and nicotine patch compared with placebo and nicotine patch for smoking cessation (primary outcome) and drinking behavior (secondary outcome) among smokers who drink heavily. The clinical trial was conducted at 2 outpatient sites in Chicago, Illinois, with enrollment from March 26, 2018, to February 14, 2020. The 122 participants were recruited from the community via social media and public transit advertisements and equally randomized to the 2 treatment groups, which were stratified by sex and smoking behavior. Eligible participants smoked between 5 and 30 cigarettes per day and drank heavily (>14 drinks per week for men or >7 drinks per week for women and ≥1 heavy drinking day [defined as >5 drinks per occasion for men or >4 drinks per occasion for women] per month for the past year) and had a desire to quit smoking. Varenicline tartrate, 1.0 mg, twice daily or matching placebo pills twice daily for 12 weeks. Nicotine patch at manufacturer-recommended doses for 10 weeks and brief individual smoking cessation counseling the week before the quit date and on the quit date. The primary outcome was self-reported continuous cigarette abstinence through weeks 9 to 12; abstinence was biochemically confirmed at the week 12 study visit. Secondary outcomes were the frequency of weekly drinking and weekly heavy drinking during the study period. Among 122 participants (mean [SD] age, 44.0 [12.4] years; 67 men [54.9%]), 61 were randomly assigned to receive combined treatment with varenicline and nicotine patch (varenicline group), and 61 were randomly assigned to receive placebo and nicotine patch (placebo group). A total of 54 participants (44.3%) self-identified as Black, 56 (45.9%) as White, and 12 (9.8%) as other races (including American Indian or Alaska Native, Asian, >1 race, and unspecified race). A total of 8 participants (6.6%) self-identified as Hispanic and 114 (93.4%) as non-Hispanic ethnicity. Study retention to 12 weeks was 89%. The intention-to-treat analyses showed higher smoking cessation rates during weeks 9 to 12 in the varenicline group vs the placebo group (27 participants [44.3%] vs 17 participants [27.9%]; odds ratio, 2.20; 95% CI, 1.01-4.80; P = .047) and lower likelihood of relapse throughout treatment in the varenicline group relative to the placebo group (hazard ratio, 0.62; 95% CI, 0.40-0.96; P = .03). Both treatments were well tolerated; however, compared with participants in the placebo group, those in the varenicline group experienced more adverse effects, with 5 participants in the varenicline group discontinuing medication due to adverse effects. In this study, combined treatment with varenicline and nicotine patch was more effective than placebo and nicotine patch for smoking cessation among smokers who drink heavily. The combination treatment had no effect on alcohol consumption, with both groups showing significant reductions. Combination treatment with varenicline and nicotine patch may be a viable option for smokers who drink heavily. ClinicalTrials.gov Identifier: NCT02859142.

Positive Psychological Factors and Life Themes in Relation to Health Outcomes in Women Living with HIV.

This mixed methods study identified positive psychological factors and life themes expressed in autobiographical narratives of predominantly Black women living with HIV (WLWH) and investigated these in relation to depressive symptoms, antiretroviral therapy (ART) adherence (≥ 95% of time), and undetectable HIV viral load (VL) (< 80 copies/ml). Ninety-eight WLWH from the Women's Interagency HIV Study Chicago site (M age = 45.3; 91% Black) narrated three autobiographical life turning points, reliably coded for positive factors and life themes. ART adherence, VL and depressive symptoms, assessed with Center for Epidemiologic Studies Depression Scale total score (TOT) including its four factors (negative affect (NA), positive affect (PA), somatic symptoms (SS), and interpersonal problems (IP)), were collected over two time points: concurrently with narratives and 6months later. Composite scores across the two time points were used in all analyses. Ten positive psychological factors (gratitude, insight, compassion, meaning-making, acceptance, mindfulness, generativity, optimism, self-reliance, and benevolent God beliefs) and three positive life themes (health improvements, positive relationships, and accomplishments) were identified in narratives. Higher accomplishments, overall positive factors, insight, mindfulness, self-reliance, optimism, meaning-making, and acceptance related to lower depressive symptoms (TOT, NA, SS, or IP). Positive factors and life themes did not significantly relate to PA. Higher compassion related to higher ART adherence. Higher accomplishments related to undetectable VL independent of ART adherence. Findings that positive psychological factors and life accomplishments may relate to better health, especially tolower depression, potentially contribute to developing positive psychology interventions for Black WLWH.

Community daytime noise pollution and socioeconomic differences in Chicago, IL.

Environmental noise may affect hearing and a variety of non-auditory disease processes. There is some evidence that, like other environmental hazards, noise may be differentially distributed across communities based on socioeconomic status. We aimed to a) predict daytime noise pollution levels and b) assess disparities in daytime noise exposure in Chicago, Illinois. We measured 5-minute daytime noise levels (Leq, 5-min) at 75 randomly selected sites in Chicago in March, 2019. Geographically-based variables thought to be associated with noise were obtained, and used to fit a noise land-use regression model to estimate the daytime environmental noise level at the centroid of the census blocks. Demographic and socioeconomic data were obtained from the City of Chicago for the 77 community areas, and associations with daytime noise levels were assessed using spatial autoregressive models. Mean sampled noise level (Leq, 5-min) was 60.6 dBA. The adjusted R2 and root mean square error of the noise land use regression model and the validation model were 0.60 and 4.67 dBA and 0.51 and 5.90 dBA, respectively. Nearly 75% of city blocks and 85% of city communities have predicted daytime noise level higher than 55 dBA. Of the socioeconomic variables explored, only community per capita income was associated with mean community predicted noise levels, and was highest for communities with incomes in the 2nd quartile. Both the noise measurements and land-use regression modeling demonstrate that Chicago has levels of environmental noise likely contributing to the total burden of environmental stressors. Noise is not uniformly distributed across Chicago; it is associated with proximity to roads and public transportation, and is higher among communities with mid-to-low incomes per capita, which highlights how socially and economically disadvantaged communities may be disproportionately impacted by this environmental exposure.

Sound walking Chicago's waterways

What are the creative possibilities of studying soundscape ecology as citizen scientists for raising engagement with and stewardship of urban health and freshwater? Utilizing everyday technology of sound walks and recordings of Chicago's waterways, students explore sonic layers of interconnections between life in the atmosphere, geosphere, lithosphere, and hydrosphere. Citizen scientists open noise and liquid definitions of health, learning the history of Chicago's development and imagining the past, present, and future biodiversity of life. Sound walking and analysis of various Chicago sites in the loop, along the river, in parks, at the world's largest filtration plant, and along the lakefront, change understanding and begin new strategies of stewardship. Public and private partnerships with college students, Chicago public school students, Friends of the Chicago River, Chicago Line Cruises, and architectural and ecological researchers share advocacy with diverse audiences through exhibits, installation proposals, water workshops, and field trips. Hush City recordings, Radio Aporee Chicago Maps, sound emporiums, water workshops, tender house Installations, and Eco-Cruises on the river connect the public with the criticality of listening to the health of the city.

Syringe service program-based telemedicine linkage to opioid use disorder treatment: protocol for the STAMINA randomized control trial

BackgroundA key strategy for mitigating the current opioid epidemic is expanded access to medications for treating opioid use disorder (MOUD). However, interventions developed to expand MOUD access have limited ability to engage opioid users at higher levels of overdose risk, such as those who inject opioids. This paper describes the study protocol for testing STAMINA (Syringe Service Telemedicine Access for Medication-assisted Intervention through NAvigation), an intervention that engages high-risk opioid users at community-based syringe service programs (SSP) and quickly links them to MOUD using a telemedicine platform.MethodsThis randomized control trial will be conducted at three SSP sites in Chicago. All participants will complete an initial assessment with a provider from a Federally Qualified Health Center who can prescribe or refer MOUD services as appropriate. The control arm will receive standard referral to treatment and the intervention arm will receive immediate telemedicine linkage to the provider and (depending on the type of MOUD prescribed) provided transportation to pick up their induction prescription (for buprenorphine or naltrexone) or attend their intake appointment (for methadone). We aim to recruit a total of 273 participants over two years to provide enough power to detect a difference in our primary outcome of MOUD treatment linkage. Secondary outcomes include treatment engagement, treatment retention, and non-MOUD opioid use. Data will be collected using structured interviews and saliva drug tests delivered at baseline, three months, and six months. Fixed and mixed effects generalized linear regression analyses and survival analysis will be conducted to compare the probabilities of a successful treatment linkage between the two arms, days retained in treatment, and post-baseline opioid and other drug use.DiscussionIf successful, STAMINA’s telemedicine approach will significantly reduce the amount of time between SSP clients’ initial indication of interest in the medication and treatment initiation. Facilitating this process will likely lead to stronger additional treatment- and recovery-oriented outcomes. This study is also timely given the need for more rigorous testing of telemedicine interventions in light of temporary regulatory changes that have occurred during the COVID-19 pandemic.Trial registrationClinicalTrials.gov (Clinical Trials ID: NCT04575324 and Protocol Number: 1138–0420). Registered 29 September 2020. The study protocol is also registered on the Open Science Framework (DOI 10.17605/OSF.IO/4853 M).

Importance of anthropogenic sources at shaping the antimicrobial resistance profile of a peri-urban mesocarnivore

Anthropogenically derived antimicrobial-resistant bacteria (ARB) and antimicrobial resistance genes (ARG) have been detected in wildlife. The likelihood of detecting ARB and ARG in wildlife increases with wildlife exposure to anthropogenic sources of antimicrobial resistance (AMR). Whether anthropogenic sources also increase the risk for AMR to spread in bacteria of wildlife is not well understood. The spread of AMR in bacteria of wildlife can be estimated by examining the richness of ARB and ARG, and the prevalence of ARB that have mobilizable ARG (i.e., ARG that can be transferred across bacteria via plasmids). Here, we investigated whether raccoons (Procyon lotor), with different exposures to anthropogenic sources, differed in prevalence and richness of extended-spectrum cephalosporin-resistant (ESC-R) Escherichia coli, richness of ARG present in ESC-R E. coli, and prevalence of ESC-R E. coli with plasmid-associated ARG. Sampling took place over the course of 10 months at seven sites in Chicago, USA. ESC-R E. coli were isolated from over half of the 211 raccoons sampled and were more likely to be isolated from urban than suburban raccoons. When examining the whole-genome sequences of ESC-R E. coli, 56 sequence types were identified, most of which were associated with the ARG blaCMY and blaCTX-M. A greater richness of ESC-R E. coli sequence types was found at sites with a wastewater treatment plant (WWTP) than without, but no difference was detected based on urban context. ARG richness in ESC-R E. coli did not significantly vary by urban context nor with presence of a WWTP. Importantly, ESC-R E. coli carrying plasmid-associated blaCTX-M and blaCMY ARG were more likely to be isolated from raccoons sampled at sites with a WWTP than without. Our findings indicate that anthropogenic sources may shape the AMR profile of wildlife, reinforcing the need to prevent dissemination of AMR into the environment.

Addressing Racial/Ethnic Equity in Access to COVID-19 Testing Through Drive-Thru And Walk-In Testing Sites in Chicago.

Mile Square Health Center (MSHC), a network of Federally Qualified Health Centers (FQHCs) run by the University of Illinois Hospital (UIH) in Chicago, established Drive-Thru and Walk-Up COVID-19 testing sites. The primary aim of the UIH/MSHC testing project was to increase testing capacity in the most affected, racial/ethnic minority communities. More than 7,500 tests were performed over a six-month period. Half of those who were tested were Black and Latinx residents. The majority of those tested at the Walk-Up sites were Black, while "Other" race group tended to get tested in Drive Thru testing sites. Latinx residents had the highest positivity rate, followed by Other race group. Younger age groups were more likely to have higher positivity rates. Overall, UH/MSHC testing results reflected the overall Chicago COVID-19 testing results. Our findings substantiate the need to advocate for equitable resource allocation to counter the disproportionate burden of COVID-19 infection among minority communities. FQHCs were shown to be an effective approach to reduce structural barriers to COVID-19 testing and subsequently reduce disparities. Going forward, FQHCs can be key to ensuring COVID-19 vaccine outreach and dissemination.

Factors Associated With Effective Inhaler Technique Among Children With Moderate to Severe Asthma

A Volerman, J Fierstein, K Boon. Ann Allergy Asthma Immunol. 2019;123(5):507–525.e1 To determine which individual and health care factors were associated with effective inhaler technique among urban children with persistent asthma. The study included 130 parent-child dyads, age 4–17 years, with persistent asthma on inhaled corticosteroids daily for at least a year and had received oral corticosteroids within the preceding year. They were recruited from five pediatric clinic sites (3 general, 1 allergy, and 1 pulmonary) in Chicago, Illinois. Inhaler …

Negative affect, affect-related impulsivity, and receptive syringe sharing among people who inject drugs.

Receptive syringe sharing (RSS) among people who inject drugs (PWID) is a risk factor for hepatitis C virus and HIV infections. PWID with borderline personality disorder (BPD) have increased risk of RSS, but it remains unclear what drives this association. This study used ecological momentary assessment (EMA) to study characteristics associated with BPD, and RSS among PWID. We recruited PWID, ages 18-35, through two Community Outreach Intervention Projects syringe service program sites in Chicago, Illinois. After a baseline interview, participants used a mobile phone app to respond to momentary surveys on mood, substance use, and injection risk behavior for two weeks. For each momentary assessment, ratings on negative mood descriptors were combined to create measures of total negative affect (NA), and NA components of dejection, shame, anger, irritability, and worry. RSS was defined by participant responses indicating that they had used a syringe that someone else had used. We estimated mixed effects logistic models, regressing RSS on baseline affect-related impulsivity, lagged momentary NA, and the interaction term. Out of 163 participants who completed at least two EMA assessments, 152 (93%) reported at least one injection event and had valid pre-injection mood assessments required to be included in the analysis. We found that affect-related impulsivity, combined with worried mood in the hours preceding the injection episode, predicted increased risk of RSS. PWID having difficulties with emotion regulation may be at increased risk of RSS during periods of anxiety or tension. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Negative affect and emotion dysregulation among people who inject drugs: An ecological momentary assessment study.

This study used ecological momentary assessment (EMA) to measure positive affect (PA) and negative affect (NA) among people who inject drugs (PWID) and examined associations with borderline personality disorder (BPD) symptoms and difficulties with emotion regulation, in the context of injection drug use. We recruited PWID, ages 18-35 years, through syringe exchange program sites in Chicago, Illinois. After completing a baseline interview including a screener for BPD and the Difficulties in Emotion Regulation Scale (DERS), participants used a mobile phone app to report mood, substance use, and injection behavior for 2 weeks. Participants who completed at least 2 EMA assessments were included in the analysis (N = 161). The mean age was 30, about 1/3 were women, 63% were non-Hispanic White, and 23% were Hispanic. In multivariable mixed-effects regression models, positive BPD screen was associated with greater momentary NA intensity and greater instability of both NA and PA. Independent of BPD screening status, DERS score was associated positively with momentary NA intensity and instability and negatively with PA intensity. This finding suggests that emotion dysregulation is an appropriate target for assessment and intervention. Whereas concurrent withdrawal was associated with both greater NA and less PA, opioid intoxication was associated with only greater PA. We did not find support for our hypothesis that emotion dysregulation would moderate the effect of withdrawal on NA. Findings support the validity of the EMA mood measure and the utility of studying mood and behavior among PWID using EMA on mobile phones. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Readability Assessment of Online Rhytidectomy Patient Information.

Patients frequently access online resources for medical information. The National Institutes of Health and the American Medical Association recommend that to be understood by the average American, patient information should be presented at or below the sixth to seventh academic grade level. The popularity of rhytidectomy (facelift) is rising, and providers are frequently using the Internet to attract patients. All rhytidectomy information provided by 100 private practice Web sites in New York City, Los Angeles, Chicago, Houston, and Phoenix was analyzed using Readable.io software. The information was also assessed using the Flesch-Kincaid Grade Level, Gunning-Fog Index, Coleman-Liau Index, Simple Measure of Gobbledygook, Automated Readability Index, Flesch Reading Ease Score, and Fry Reading Graph tools. Analyzed material was written at a higher academic grade level than recommended for the average American. The overall average grade level was 10.99 ± 1.39. Online patient education materials about rhytidectomy provided by private practice clinics in 5 major cities of the United States were written at academic grade levels above the National Institutes of Health and American Medical Association recommended levels. This may lead to rhytidectomy patients having unrealistic or inaccurate expectations related to their surgical procedure.

Examining the complexities of increasing park access in two Latinx neighbourhoods

ABSTRACTAlthough research has shown that park resources and other open green spaces lead to numerous benefits, progress in increasing access to parks and open green space has also come with unexpected challenges, which have received less attention in the scholarly literature. The purpose of this study was to examine the contradictory effects of improved park and green space access in the cases of two newly created sites in Chicago, IL. The study focused on the neighbourhoods of Little Village and Humboldt Park, both of which experienced the integration of a new public park or greenway. The data analysis revealed several health benefits associated with the new park or greenway, but also revealed some unintended consequences (i.e. crime, rising taxes, and gentrification) associated with the increased access. The practical and theoretical implication associated with the study findings are discussed.