To increase capacity for monitoring and surveillance of tick-borne diseases, publicly available tick distribution and climate change datasets are required to create accurate predictive distribution models. It is difficult, however, to assess model accuracy and utility when using incomplete datasets.  The more recent development of comprehensive tick databases for Europe and availability of climate change scenarios from multiple IPCC Assessment Reports allows for improved modeling efforts. Multiple tick datasets were combined and three climate change projections were compared by predicting current and future distributions of Ixodes ricinus ticks in Europe using the MaxEnt species distribution model. Overall, much of Europe contains suitable habitat for the Ixodes ricinus tick, both now and under future climate change projections.  Contraction of habitable areas is predicted to occur at lower latitudes and altitudes, while expansion is predicted to occur at higher altitudes in mountainous regions and the higher latitudes, primarily in northern Scandinavia.

Background: Numerous epidemiological studies have demonstrated a possible correlation between high temperature and mortality in different settings. Most of these studies have focused on urban settings in industrialized countries, concluding that urban populations are more vulnerable to heat effects than rural populations. This has mainly been attributed to the urban heat island (UHI) effect, a phenomenon which explains the elevated temperatures in urban areas. Others have contradicted this finding and concluded that rural residents are more vulnerable. For this study, we test the hypothesis that rural populations and sub-populations are also vulnerable to heat mortality. Method: A comprehensive literature search was conducted using PubMed, Web of Science and Google Scholar to identify peer-reviewed studies investigating heat mortality in rural settings. Using keywords and a set of rigorous inclusion and exclusion criteria, ten studies were selected. Meta-analysis was then performed using the Comprehensive MetaAnalysis V3.exe software. Results and discussion: The pooled relative risk (RR) was 1.191 (95% confidence interval: 1.130-1.251). Although rural populations may not be exposed to as high temperatures as urban populations, they remain vulnerable to heat effects. Conclusion: There is evidence of heat vulnerability in rural populations and subpopulations. Heat vulnerability is not only determined by heat exposure, but also by sensitivity and adaptive capacity. Rural populations and sub-populations may be vulnerable to heat mortality due to low adaptive capacity. Further studies are needed to assess risk factors that predispose rural populations and sub-populations to heat mortality in order to develop effective public health interventions.

Although arsenic is naturally present in the environment, 99% of human exposure to arsenic is through ingestion. Throughout history, arsenic is known as “the king of poisons”; it is mutagenic, carcinogenic, and teratogenic. Even in smaller concentrations, it accumulates in the body and takes decades before any physical symptoms of arsenic poisoning shows. According to the World Health Organization (WHO), the safe concentration of arsenic in drinking water is 10 µg/L. However, this limit is often times ignored until it is decades too late and people begin showing symptoms of having been poisoned. This is the current situation for Vietnam, whose legal arsenic concentration limit is 50 µg/L, five times higher than the WHO guidelines. Groundwater in Vietnam was already naturally high in arsenic due to arsenic-rich soils releasing arsenic into groundwater. Then, in the past half century, with the use of arsenic-laden herbicides dispersed during the Vietnam War and subsequent industrial developments, the levels of bio-available arsenicals has dangerously spiked. With the proliferation of government-subsidized shallow tube-wells in the past two decades, shallow groundwater has become the primary source for drinking and irrigation water in Vietnam. This is a frightening trend, because this groundwater has arsenic concentrations up to 3050 µg/L, primarily in the +3 and +5 oxidation states, the most readily available oxidation states for bioaccumulation. This thesis argues that measures must be taken immediately to remedy the high concentration of arsenic in groundwater, which in Vietnam is the primary and, in some cases, the sole source of water for domestic consumption and agricultural production. Although there are numerous technologies available for treating arsenic in groundwater, not all of them are suited for Vietnam. By analyzing the historical, cultural, economic, and political parameters of Vietnam, several optimal treatments of groundwater for drinking water emerged as most recommended, a classification that is based on their local suitability, social acceptability, financial feasibility, and governmental support. Further research on irrigation water treatment is proposed due to the need for sustainable crop production, the safe ingestion of rice and vegetables, and the continued growth of Vietnam’s economy, which is heavily dependent on agriculture.

In eastern Kentucky, as in much of central Appalachia, current local storylines narrate the frictions and contradictions involved in the structural transition from a post-WWII Fordist industrial economy and a Keynesian welfare state to a Post-Fordist service economy and Neoliberal hollow state, starving for energy to sustain consumer indulgence (Jessop, 1993; Harvey, 2003; 2005). Neoliberalism is the ideological force redefining the “societal infrastructure of language” that legitimates this transition, in part by redefining the key terms of democracy and citizenship, as well as valorizing the market, the individual, and technocratic innovation (Chouliaraki & Fairclough, 1999; Harvey, 2005). This project develops a perspective that understands cancer prevention and control in Appalachiaas part of the structural transition that is realigning community social ties in relation to ideological forces deployed as “commonsense” storylines that “lubricate” frictions that complicates the transition.

Background The incidence of type 2 diabetes has increased dramatically, particularly among Latinos. While several studies suggest the beneficial effect of lowering glycemic index and glycemic load in patients with type 2 diabetes, no data exists regarding this issue in the Latino population. The purpose of this study was to determine the effect of lowering glycemic index and glycemic load on diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes. Methods Subjects participated in a 12 month randomized clinical trial. The intervention targeted diabetes knowledge, attitudes and behavioral capabilities related to diabetes self management with content including nutrition and physical activity. The nutrition protocol emphasized reduction in glycemic index, fat, salt and portion size and increase in fiber. The control group was given usual care. Measurements included Hba1c, fasting glucose, total cholesterol (TC), low density lipoproteins (LDL) and high density lipoproteins (HDL), HDL:LDL ratio, TC:HDL ratio, waist circumference and BMI and were collected at baseline, 4 and 12-months. Results Two hundred fifty two Latino adults with type 2 diabetes participated in the study. Baseline mean HbA1C was 8.98% (SD=1.87), BMI was 34.76 kg/cm (SD=6.94), age was 56 (SD=11.18) years and 76% were female. Reduction in glycemic index was positively associated with a reduction in logHbA1c (p=0.006), HDL:LDL ratio (p=0.037) and waist circumference (p=0.003) overtime, but not with fasting glucose, TC, LDL and HDL, TC:HDL ratio, body weight or BMI. No significant associations were found between glycemic load and any measures. Conclusion Results suggest that lowering glycemic index may have a positive effect on some markers of diabetes control, lipid profiles and anthropometrics among Latinos with type 2 diabetes, but not others. While statistically significant reductions in GI and GL were noted, the actual reduction was small. Thus, greater reduction in GI and GL may be needed for clinical significance and greater effect on metabolic outcomes. Future research should target populations with higher baseline GI and GL.