Pima Community College

One Health clinics integrate human, animal, and environmental health to provide interdisciplinary health care and community resources to people experiencing homelessness (PEH). Five mobile, public health-led One Health clinics were newly implemented in Pima County, Arizona, during October 2023-February 2024. Clinic locations included parks, libraries, and homeless shelters to reduce transportation-related barriers and integrate public health, veterinary, and housing services. Originally designed for PEH and their pets, Pima County One Health clinics were open to everyone in neighborhoods where clinics were hosted to promote community engagement with clinics and strengthen relationships with public health. We evaluated the performance of these clinics by describing service patterns, client perceptions, and lessons learned to support development of clinics by other jurisdictions. During clinic visits, basic demographic information was collected for people and pets, along with data on housing status, environmental and resource concerns, use of clinic services, and perceptions of clinics. The first 5 monthly mobile community clinics served 108 clients and 93 pets; 44% of clients were unhoused or unstably housed, 36% of clients were housed, and housing status was unknown for 20% of clients. Clinics facilitated partnership among service providers and with housed and unhoused community members. Clinics supported vaccine uptake among people and their pets and identified 3 cases of sexually transmitted infections that might otherwise have remained undetected. By implementing a One Health Clinic framework, our local health department helped address gaps in human and veterinary health care services. Other public health agencies might consider implementing similar models to enhance public health engagement with local communities.

Pain assessment in Alzheimer's disease and related dementias (ADRD) is challenging due to cognitive decline and communication barriers, limiting the reliability of self-report and observational tools. Functional near-infrared spectroscopy (fNIRS) offers a noninvasive measure of cerebral hemodynamic responses and may serve as an objective biomarker for pain. This pilot study evaluated the feasibility of fNIRS for pain assessment in ADRD, using transcranial direct current stimulation (tDCS) solely as a controlled cortical modulation paradigm to test fNIRS sensitivity, rather than as a therapeutic intervention. Forty older adults with mild to moderate ADRD were randomized to active (n = 20) or sham (n = 20) tDCS for 5 consecutive days to generate controlled cortical modulation. Pain was assessed using the Numerical Rating Scale (NRS), Mobilization-Observation-Behavior-Intensity-Dementia-2 (MOBID-2), and fNIRS responses to standardized pain stimuli. Hemodynamic changes in prefrontal and somatosensory cortices were analyzed to determine whether fNIRS detected pain-related brain activity. NRS and MOBID-2 scores were significantly correlated at baseline (r = .605, p < .001) and post-intervention (r = .567, p < .001). In the active tDCS condition, pain stimulation elicited significant cortical hemodynamic changes that correlated with pain scores (p < .05), supporting fNIRS's sensitivity for detecting pain-related neural responses. In the sham group, only a few significant correlations were observed post-intervention (e.g., frontal cortex r = .44, p = .049; prefrontal cortex r = .52, p = .017), which were less consistent compared to the active condition. fNIRS demonstrated feasibility as an objective pain assessment tool in ADRD. tDCS served only as a probe to induce cortical modulation for evaluating fNIRS performance. In this study, tDCS functioned as a probe to induce cortical modulation for evaluating fNIRS sensitivity, not as a therapeutic intervention. Larger trials are needed to confirm fNIRS validity for clinical application.

BackgroundHealthcare professionals are motivated to improve their cannabis knowledge—yet few training opportunities exist. The unique legal status of cannabis, lack of rigorous research, and rapid expansion of consumer demand present challenges to the development and implementation of cannabis education for healthcare professionals and trainees. As a result, an alarming gap in quality of care is developing: health care professionals across disciplines lack the knowledge needed to counsel their patients, even as cannabis use rapidly accelerates.MethodsWe aimed to address the gap by developing and implementing an interprofessional cannabis training for healthcare trainees. Considering the challenges to development and implementation of cannabis training, we identified 4 implementation strategies to maximize training quality, uptake, and utility: 1) incorporating a diverse array of scientific expertise and perspectives in curriculum development; 2) offering a comprehensive, evidence-based treatment of potential risks and potential benefits; 3) using an interprofessional training format; 4) adopting a person-centered lens with special emphasis on patient-provider communication. A post-survey evaluated implementation success and intermediate outcomes in trainee attitudes and behavioral intentions that would suggest high potential to deliver healthcare improvements at scale.ResultsThe virtual training “It's Legal, Now What? Cannabis Epidemiology, Treatment, and Safety Recommendations” was successfully implemented; since 2023 a total of 345 trainees in Pharmacy, Nursing, Public Health, and Medicine have earned certificates. Evaluation results are encouraging: 90% agree the training addressed a training need in their current role, 83% agree it should be required for trainees in their profession, 98% and 96% agree it comprehensively addressed potential risks and benefits, respectively, 94% agree it was inclusive of diverse perspectives, 94% agree it improved their knowledge of community resources, 96% report improved ability to respond to patients interested in cannabis, 96% report greater likelihood of providing information on cannabis to others, and 97% of trainees agree they learned information that would help them in their work or community. ConclusionsWe present our training development process, implementation strategy, and evaluation as an adaptable model for contexts where both recreational and medical use of cannabis are legal. Supplementary InformationThe online version contains supplementary material available at 10.1186/s42238-025-00321-8.

The point of departure in this study is the premise that conceptualization of nation begins at the level of self and consciousness; that nation acquires its shape in personal experience before it is projected onto the public. For Arab nations, the 'imagined community' is constructed from foundational elements of history, language, place, heritage, oral traditions, collective memory, indigenous practices, cultural values etc … Predominantly, it is the male intellectual elite that the hegemonic national narrative empowers to define constituent components of national imaginary, thereby eclipsing female narratives. Given that signifiers of nationhood comprise a fluid field of meaning that can be reinvented/ reimagined, endeavors of female writers in narrating the nation re-cast them according to their vision of subject/identity formation. Selected Palestinian female autobiographies reveal interventions disrupting national forms of patriarchal domination. By re-appropriating components of nationhood, they formulate 'an Arab woman national narrative' integrating women as active agents in mainstream discourses. Deliberations explore relevant issues in Arab female autobiography, inquire into ambivalent relationship between Arab women and communal national imaginary, and examine processes of recovering Palestinian female historical memory in articulations of nationhood. Texts are deliberately selected for their apt representation of junctures of the national crisis. The methodology and research data draw upon cultural models within colonial/postcolonial discourses, critical postulations on nation and nationalism, theories in autobiography, and feminist standpoint theory. Particularly noteworthy in the textual analysis are theoretical considerations regarding the ‘woman question’ in the context of Palestinian reality.

Structural aspects of community-engaged research are not well measured yet have critical implications for community research empowerment. This is particularly so with people who use drugs. We introduce the Structural Indicators of Community-Based Participatory Action Research (SI-CBPAR) to measure structural indicators of community-research entity relationships. A three-phased process of iterative development, feasibility and applicability assessment was used to examine theinstrument with community-engaged studies as a first stage of instrument development. The development team included people with university, non-government organisation and lived/ing drug use experience. Four studies on the health of people who use drugs were reviewed for indicator evidence followed by iterative discussion about construct and item discrepancies. Indicators were measured for the degree to which they were observed using a three-point scale. All but two constructs were confirmed for meaning. Constructs of 'community' and 'coalition' required revision and explanation. The need for further exploration of power differentials between community and community-based organisations was identified. Indicator evidence was found for all six categories across studies. The instrument was deemed applicable and easy to use. It was observed that categories could apply to studies with various degrees of community engagement and to other research focal areas. SI-CBPAR applicability testing and initial category confirmation indicate its potential utility for community research collaboratives. The next phase of development involves cognitive interviewing with researchers from across community engaged research orientations, and with communities engaged in research beyond drug user health.

Inflammation is a risk factor for myocardial infarction. Pneumonia leads to severe inflammatory response. Some studies suggest higher risk of myocardial infarction in patients with pneumonia. We used a large inpatient database (National Inpatient Sample) to evaluate this association. This study includes patients from a Nationwide Inpatient Sample hospital in 2005 to 2014 with International Classification of Diseases, Ninth Revision, and Clinical Modification codes consistent with pneumonia and non-ST elevation myocardial infarction (NSTEMI). Subjects were stratified into all hospitalized patients aged 30 and above. Univariate and multivariate analysis was performed adjusting for age, race, gender, tobacco use, diabetes mellitus, hypertension, and hyperlipidemia. NSTEMI was present in 3.2% of pneumonia patients versus 1.8% in the non-pneumonia population over 10-year period. For example, the 2005 database: [odds ratio (OR), 1.77; 95% confidence interval (CI), 1.73-1.80; P < 0.001]. For 2014, NSTEMI was present in 4.1% of pneumonia patients (PNA) versus 2.4% in the non-pneumonia population (OR, 1.72; 95% CI, 1.70-1.75; P < 0.001). NSTEMI remained independently associated with pneumonia following a multivariate analysis in 2005 (OR, 1.477; 95% CI, 1.447-1.508; P < 0.001) with a similar value in 2014 (OR, 1.445; 95% CI, 1.421-1.469; P < 0.001). Using a large inpatient database, we found that NSTEMI was strongly associated with PNA versus non-pneumonia population over a 10-year period. Suggesting acute inflammatory cytokines or hypoxia which occurs during lung infection may play a role in NSTEMI development, reinforcing the importance of acute cardiac monitoring in patients with PNA.