Lowell Community Health Center

pathways associated with BEP supplementation, including the biosynthesis of lipopolysaccharide, a factor triggering preterm labor, were depleted within the prenatal gut microbiome in women who received BEP supplements.Furthermore, the phosphotransferase system, a critical mechanism for bacterial carbohydrate uptake, exhibited enrichment in infants born to BEPsupplemented mothers.Conclusions: Overall, our results shed light on gut microbiome dynamics in a population that is underrepresented in microbiome science.The impact of maternal BEP supplementation on the maternal and infant's gut microbiome may benefit the growth of fetuses and neonates.

Physical activity, maintaining healthy weight, eating fruits and vegetables, and non-smoking are health behaviors that reduce risk for a variety of poor health outcomes. This analysis reports frequencies and socio-demographic correlates of these behaviors among 381 Cambodians aged 25 and older surveyed in Lowell, MA. The majority reported some physical activity (72 %), healthy weight (62 %), and not smoking (77 %). Only 28 % reported adequate fruit and vegetable consumption. Four multivariable models indicate that (1) physical activity was associated with higher income, lower levels of US education, reading English, and living in the US 11-19 years; (2) healthy weight with living in the US 20 or more years; (3) not smoking with being female and living in the US less than 11 years; and (4) adequate fruit and vegetable consumption with lower levels of US education and reading English. These results inform public health planning for Cambodians.

To examine how two groups (parents and healthcare providers) perceive asthma in Southeast (SE) Asian children in the United States, and to address issues of access to asthma care. Using Kleinman's Explanatory Models (EM) approach, semistructured interviews were used with 12 families and 26 providers. Families were interviewed in a clinic setting. Providers read a case example of a SE Asian child with asthma and were asked to anticipate the case family's EM of asthma. Data were analyzed using template analytic technique in which segments were clustered into etiology, causation, treatments, asthma impact, and access to asthma care. Families predominately followed current asthma practice guidelines, whereas providers believed that SE Asian families primarily followed cultural practices. Families described the severity and impact of asthma as more intense than the providers described the same items. While families identified barriers to care as difficulty getting appointments and unavailable providers, providers viewed family barriers to be predominately culturally based. Both groups noted the need for education and frequent healthcare visits as facilitators to care. This study suggests that important differences may exist between the way providers and SE Asian families perceive childhood asthma. Nurses are encouraged to ask the families in their care how they explain their children's asthma, thus facilitating more culturally competent care and increased ability to meet the family's needs. Implications for policy change relative to improving access to care to immigrant groups are also suggested.

Literature and practice are limited on strategies to reach elder Southeast Asian refugees by using their strengths and resilience. This article presents the Centers for Disease Control and Prevention-funded Cambodian Community Health 2010 Program in Lowell, Massachusetts, as a case example and provides refugee history, project background, community survey results about strengths and risks, literature on strengths-based approaches, outreach activities, and evaluation. The focus is elimination of health disparities in cardiovascular disease and diabetes. "Community conversations" and a daylong forum with community leaders were used to develop plans for outreach. A Cambodian Elders Council provided information and guidance used to refine the program. Key findings highlight involving elders in organizing events, avoiding reliance on literacy, integrating health promotion with socialization, using ties with Buddhist temples, developing transportation alternatives, and utilizing local Khmer-language media. Implications include applicability to other refugee communities with low literacy, high levels of trauma, limited English, and strong religious involvement.

It has been stated that faculty development programmes which are closely linked to particular teaching contexts are most likely to be effective. Over the past 10 years we have developed a model of 'co-teaching' for faculty development which is based upon this premise and which can be applied to any clinical rotation. In this paper we describe our model, in which paired physicians focus on developing their teaching skills while sharing the clinical supervision of residents and medical students. Through iterative phases of teaching, debriefing and planning, co-teachers gain experience in analysing teaching encounters and develop skills in self-evaluation. Teaching occurs in the usual clinical settings such as attending (consultant) teaching rounds, clinic precepting, and case conferences. We discuss our model in the context of educational theory and related literature. We support our positive assessment of the co-teaching model through the precepts of collaborative inquiry and case study methodology. Vignettes, taken from the experiences of the authors, are used to demonstrate how the model is used to develop effective solutions to problems and to help in the maturation of one's skill as an educator. Successful implementation of the model is predicated on the development of a truly collaborative process between co-teachers. We share lessons we have learned from our experience of implementing the model in different clinical venues, such as the contrast between teaching on a hospital ward or in the clinic. This collaborative process has been well received by junior and senior faculty participants in our institution for more than a decade.

Coronary heart disease (CHD) remains the number one killer in the United States. This article summarizes the recommendations for cholesterol screening of children and adolescents by the American Academy of Pediatrics and the Expert Panel on Blood Cholesterol Levels in Children and Adolescents. Screening of children and adolescents is selective, and the determination to screen is based on past medical, family health, and health behavior histories. Children or adolescents with a family history of peripheral vascular disease or coronary artery disease in primary relatives under 55 years of age, or parents with high blood cholesterol levels, are considered to be at risk for high blood cholesterol and in need of screening. Children or adolescents who are obese, inactive, have hypertension or diabetes, or who smoke are also considered to be at risk. A universal approach to the prevention of CHD through diet and lifestyle is also described.