Fairfax County Park Authority

<strong>Background:</strong> Inflammatory bowel disease (IBD) is a term used to describe two conditions, Crohn’s disease and ulcerative colitis (UC), that currently have no definite cure. The incidence of IBD worldwide has increased, frequently affecting women during their reproductive years. <strong>Objectives:</strong> This study examines the association of Crohn's disease and ulcerative colitis (UC) with adverse pregnancy outcomes and looks at the interactions of race/ethnicity on these associations. <strong>Study Design:</strong> We examined hospital birth records in the National Inpatient Sample (NIS) data sets in 2011 and 2012. We identified maternal demographics and clinical characteristics using international classification of disease-9 codes. Chi-square and Fisher exact tests were used to examine associations and logistic regression models were used to control for confounders. <strong>Results:</strong> Crohn's disease is associated with small for gestational age, aOR 1.70(CI:1.53-1.89,p<0.001) but not premature delivery, whereas UC was associated with prematurity, aOR 1.5(CI:1.36-1.66,p<0.001) to a greater extent than with SGA. Analyses by race/ethnicity showed Crohn’s disease to be associated with SGA among newborns of all racial groups, but most evident among African Americans, aOR 2.55(CI:2.06-3.15,p<.001). Crohn’s disease was associated with prematurity only in Caucasian women, aOR 1.21(CI:1.10-1.34,p<.001). UC was associated with SGA newborns only in Hispanic mothers, aOR 3.40(CI:2.24-5.15,p<0.001), and with premature delivery only among Caucasian mothers, aOR 1.60(CI:1.42-1.80,p<.001). <strong>Conclusion:</strong> Both Crohn's disease and ulcerative colitis are associated with prematurity and small for gestational age in a way that is significantly affected by maternal race. Qualitative studies are needed to understand mechanisms for these associations and the role of race/ethnicity.

Public sector park and recreation agencies have become more entrepreneurial in their financing and revenue generation efforts. A number of phenomena, including decreased tax-based revenues, have created the need for alternative funding strategies. One such strategy, corporate sponsorship, has become increasingly common within parks and public spaces. While there is an existing body of research concerning sponsorship effectiveness and acceptability in park and recreation contexts, few studies examine the evolution or shift in constituent support for sponsorship over time. Given the increasing ubiquity of sponsorship in society, it is possible that the public has adapted and become desensitized to sponsorship—becoming more positive and favorable toward it across a range of settings. To assess this issue, this study examines whether constituents’ opinions regarding corporate sponsorship of a metropolitan public park agency (i.e., Fairfax County Park Authority) have changed over the course of time. Data were collected in 1998 and 2012 through random surveys of subscribers to the Park Authority’s monthly magazine. Surveys assessed participants’ level of support for corporate sponsorship at the park agency, the perceived impact of sponsorship on the recreation experience, and the perceived appropriateness of specific corporate sponsorship activation activities and conditions. Comparisons between the two time periods were conducted with independent samples t -tests or Chi-square analyses (along with Cramer’s V statistics) in order to determine whether there were significant changes in sponsorship attitudes and what the nature of those changes were. Results suggest that, over this 14-year period, park constituents became significantly more likely to support park sponsorships. There were significant increases in sponsorship favorability toward sponsorship and well as its perceived impact on the recreation experience. Findings also indicate more favorable opinions toward specific sponsorship elements. Park constituents perceived a wider range of sponsor activities and conditions as appropriate. However, certain sponsorship issues remained problematic. For example, respondents still identified specific industries/products as more appropriate than others, were still wary of granting exclusivity to a sponsor, allowing naming rights, and eschewed visible sponsor recognition at trails and historic settings. Findings suggest that park and recreation agencies proceed cautiously and develop clear guidelines to maximize sponsorship’s contribution and minimize its negative impact.

The population of the lone star tick Amblyomma americanum has expanded in North America over the last several decades. It is known to be an aggressive and nondiscriminatory biter and is by far the most common human-biting tick encountered in Virginia. Few studies of human pathogen prevalence in ticks have been conducted in our state since the mid-twentieth century. We developed a six-plex real-time PCR assay to detect three Ehrlichia species (E. chaffeensis, E. ewingii, and Panola Mountain Ehrlichia) and three spotted fever group Rickettsiae (SFGR; R. amblyommii, R. parkeri, and R. rickettsii) and used it to test A. americanum from around the state. Our studies revealed a presence of all three Ehrlichia species (0-24.5%) and a high prevalence (50-80%) of R. amblyommii, a presumptively nonpathogenic SFGR, in all regions surveyed. R. parkeri, previously only detected in Virginia's Amblyomma maculatum ticks, was found in A. americanum in several surveyed areas within two regions having established A. maculatum populations. R. rickettsii was not found in any sample tested. Our study provides the first state-wide screening of A. americanum ticks in recent history and indicates that human exposure to R. amblyommii and to Ehrlichiae may be common. The high prevalence of R. amblyommii, serological cross-reactivity of all SFGR members, and the apparent rarity of R. rickettsii in human biting ticks across the eastern United States suggest that clinical cases of tick-borne disease, including ehrlichiosis, may be commonly misdiagnosed as Rocky Mountain spotted fever, and that suspicion of other SFGR as well as Ehrlichia should be increased. These data may be of relevance to other regions where A. americanum is prevalent.

Home Healthcare Nurse: The Journal for the Home Care and Hospice Professional 24(6):p 402-403, June 2006.