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Grantee Highlights
Partnerships for Environmental Public Health
- Paul English, Ph.D. – Addressing the Impacts of Air Pollution, Pesticides, and Climate Change
- Anna Goodman Hoover, Ph.D. - Taking Time to Dialogue with Stakeholders
- Neasha Graves – Translating Environmental Health Research Through Education
- Viola "Vi" Waghiyi – Fighting for Environmental Justice in the Arctic
- John Sullivan – Setting the Stage for Healthier Communities
- Erin Haynes, Dr.P.H. – Partnering for Healthier Communities
- Annie Belcourt, Ph.D. - Increasing Awareness of Native American Environmental Health Disparities
- Asa Bradman, Ph.D. – Advocating for Children's Environmental Health
- Allison Patton and Kevin Lane – Working with communities to understand near-highway air pollution
- Edith Parker, Dr.P.H. – Community-Engaged Researcher
- Edward (Ted) Emmett, M.D. – An innovator in occupational medicine, communication, and community empowerment
- Naomi Hirsch – Using Web technologies to engage with stakeholders
- Denise Moreno Ramírez – Empowering communities through research translation and outreach activities
- Related Links
Paul English, Ph.D. – Addressing the Impacts of Air Pollution, Pesticides, and Climate Change
December 18, 2014
As an environmental epidemiologist, Paul English, Ph.D. is taking a proactive approach to addressing health disparities. Over the last ten years, he has served as principal investigator of the California Environmental Health Tracking Program (CEHTP), which takes a community-based approach to developing surveillance and biomonitoring systems for environmental hazards. Specifically, his work focuses on the public health impacts of climate change, environmental links to asthma, and the impacts of pesticides on birth outcomes.
"The core issue is really about fairness and justice," says English, when speaking of his work at the California Department of Public Health (CDPH). To achieve equity, English seeks to address problems related to both income disparities and health disparities, which he believes run parallel.
"In California, we have this dichotomy of the well-off people living on the coast, and we have all these poorer and more vulnerable populations [living inland in farm country], and they're getting the brunt of the pollution," says English. "So, we're seeing all kinds of environmental justice issues at play." Vulnerable, low-income populations tend to live inland, where they are exposed to contaminated air, in part, from the air migration of pollutants coming from more affluent areas.
While working on a broad array of environmental health topics, English's work in Imperial County, California, near the U.S.-Mexico Border, has been particularly important for addressing local environmental health disparities. This low-income, primarily Latino community has one of the highest rates of asthma hospitalization and emergency room visits in the state – outcomes that have been linked to the region's poor air quality.
The project has been effective at understanding and addressing the region's high asthma rates by (1) using community expertise to inform the placement of low-cost air quality monitors, (2) using novel methods to combine data from the low-cost monitors with existing data sources in order to create high-resolution maps of air pollution and real-time maps of pollution "hot spots," and (3) enhancing a community-initiated online mapping tool with air quality data from the monitors.
English's other projects emphasize "research for action." For instance, the CEHTP published a seminal report, Agricultural Pesticide Use near Public Schools in California, documenting that pesticides of public health concern were applied within a quarter mile of one-third of public schools in California's agricultural region. Hispanic children were nearly 50% more likely, as compared with white children, to attend schools where pesticides of public health concern were measured. English used these findings to make evidence-based recommendations to state agencies and other stakeholders on how to improve data to reduce agricultural pesticide use near public schools.
What is English's vision for the future of his research? "I hope to continue accomplishing work on air quality, pesticides, and other issues of concern by taking this community-based approach to provide citizens with the capacity to take action independently – whether it's getting the help they need or seeking training," he says. In his view, community involvement will establish a sustainable approach to addressing California's most pressing public health concerns.
English acknowledges that the work of his program would not be possible without his great team, which includes experts in medicine, statistics, information technology and geographic information systems, health education/communication, and program management.
Highlighted Publications
- Carmichael SL, Yang W, Roberts E, Kegley SE, Padula AM, English PB, Lammer EJ, Shaw GM. 2014. Residential agricultural pesticide exposures and risk of selected congenital heart defects among offspring in the San Joaquin Valley of California. Environ Res 135:133-138.[Abstract]
- Shaw GM, Yang W, Roberts E, Kegley SE, Padula A, English PB, Carmichael SL. 2014. Early pregnancy agricultural pesticide exposures and risk of gastroschisis among offspring in the San Joaquin Valley of California. Birth Defects Res A Clin Mol Teratol 100(9):686-694.[Abstract]
- Yang W, Carmichael SL, Roberts EM, Kegley SE, Padula AM, English PB, Shaw GM. 2014. Residential agricultural pesticide exposures and risk of neural tube defects and orofacial clefts among offspring in the San Joaquin Valley of California. Am J Epidemiol 179(6):740-748.[Abstract]
- Carmichael SL, Yang W, Roberts EM, Kegley SE, Wolff C, Guo L, Lammer EJ, English P, Shaw GM. 2013. Hypospadias and residential proximity to pesticide applications. Pediatrics 132(5):e1216-1226.[Abstract]
- Roberts EM, English PB. 2013. Bayesian modeling of time-dependent vulnerability to environmental hazards: an example using autism and pesticide data. Stat Med 32(13):2308-2319.[Abstract]
- Reid CE, Mann JK, Alfasso R, English PB, King GC, Lincoln RA, Margolis HG, Rubado DJ, Sabato JE, West NL, Woods B, Navarro KM, Balmes JR. 2012. Evaluation of a heat vulnerability index on abnormally hot days: an environmental public health tracking study. Environ Health Perspect 120(5):715-720.[Abstract]
- Richardson MJ, English P, Rudolph L. 2012. A health impact assessment of California's proposed cap-and-trade regulations. Am J Public Health 102(9):e52-58.[Abstract]
- English P, Blount B, Wong M, Copan L, Olmedo L, Patton S, Haas R, Atencio R, Xu J, Valentin-Blasini L. 2011. Direct measurement of perchlorate exposure biomarkers in a highly exposed population: a pilot study. PLoS One 6(3):e17015.[Abstract]
- English PB, Sinclair AH, Ross Z, Anderson H, Boothe V, Davis C, Ebi K, Kagey B, Malecki K, Shultz R, Simms E. 2009. Environmental health indicators of climate change for the United States: findings from the State Environmental Health Indicator Collaborative. Environ Health Perspect 117(11):1673-1681.[Abstract]
Anna Goodman Hoover, Ph.D. - Taking Time to Dialogue with Stakeholders
December 10, 2014
Anna Hoover, Ph.D., knew she wanted to go into science communication early in life. "When I was a kid, I wanted to be Carl Sagan. He was so good at talking about complicated scientific concepts to normal people like me," she explained. After working in radio and studying theatre, history, and communication, she eventually found her home in the field of research translation.
She earned a Ph.D. in Communication Science in 2013 from the University of Kentucky, where she now serves as Communications Director and Research Translation Core (RTC) co-lead for the University of Kentucky Superfund Research Center (UK-SRC). Her role in the RTC often involves working with people from many university departments to ensure that everyone's information needs – including those of community and government stakeholders – are met, all the while trying to minimize the amount of jargon or alphabet soup in the final product.
Hoover is also deputy director for the National Coordinating Center for Public Health Services and Systems Research, a Robert Wood Johnson Foundation national program office. In this capacity, she provides scientific leadership and develops dissemination and research translation efforts for a portfolio of more than 120 extramural research projects while also supporting more than 30 academic-practitioner research networks across the country. "My role with the Coordinating Center complements my Superfund communication efforts by connecting directly to public health and policy stakeholders, helping ensure that these constituencies play important roles both in setting our environmental health research priorities and as potential research end users," said Hoover. This position includes a research faculty appointment in the UK College of Public Health, where she studies stakeholder engagement processes, participatory risk communication, and the dissemination and implementation of evidence-based public health strategies.
Some key projects that Hoover has been involved with to date include:
The Future Vision for the Paducah Gaseous Diffusion Plant (PGDP) – funded by the U.S. Department of Energy
To create a publicly-approved future vision for the PGDP National Priorities List Superfund site, Hoover worked with a multidisciplinary team, facilitating interviews and focus groups designed to identify and address stakeholder needs. The research team, which included scientists from the Kentucky Research Consortium for Energy and the Environment, the Kentucky Water Resources Research Institute, the UK College of Communication and Information, and the Kentucky Transportation Center, developed a protocol steeped in community-based participatory communication methodologies. It also incorporated key elements of Structured Public Involvement, including the Arnstein Ladder as a stakeholder engagement evaluation metric. Hoover described this methodological approach in detail during a presentation available through the US Environmental Protection Agency's (EPA) CLU-IN archive. Findings are available in the final project report. The UK-SRC RTC is now investigating ways to modify the protocol to fit the needs of other Superfund communities.
The Research Translation Seminar Series – jointly sponsored by UK-SRC and the Kentucky Department for Environmental Protection
Hoover, RTC director Lindell Ormsbee, Ph.D., and other program staff have worked closely with state government stakeholders to identify their information needs regarding Superfund-related issues. The UK-SRC RTC ensures these needs are met by arranging bimonthly presentations in the state capital that feature subject matter experts from within and outside UK-SRC.
Nutrition Brochures – produced by UK-SRC
Hoover worked closely with the UK-SRC Community Engagement Core and the university's Cooperative Extension Service to create two brochures detailing ways to offset environmental exposures with healthy food choices. One brochure is written for a lay audience, and the other brochure provides more detail for audiences who have stronger backgrounds in nutrition and environmental science.
What's next for Hoover?
Hoover's most recent work focuses on ensuring communities and decision makers have the information they need to stay safe and protect their health before, during, and after environmental crises. These efforts build on a recent EPA-funded project in which she worked with a team of communication researchers to improve guidelines for communicating with stakeholders, the media, and the public after decontamination and clearance of water emergencies.
In coming months, Hoover also will assume co-PI duties for management of the National Health Security Preparedness Index, a tool initially developed by CDC, the Association of State and Territorial Health Officials, and other key preparedness constituencies to assess the nation's ability to prevent, respond to, and recover from public health threats. In this capacity, Hoover will coordinate stakeholder involvement in Index development while working closely with the Robert Wood Johnson Foundation to enhance the Index's dissemination and utility for supporting decision-making in both policy and practice.
Highlighted Publications
- Johnson JD, Hoover AG. 2013. When people outside the organization need information: strategically communicating with external stakeholders. In JS Wrench (ed.), Workplace communication for the 21st century: tools and strategies that impact the bottom line (vol. 2). Santa Barbara, California: Praeger.
- Hoover AG. 2013. Commentary: changing the channel: public health communication in the 21st century. Frontiers in Public Health Services and Systems Research 2(1): Article 6.[Abstract]
- Hoover AG. 2013. Communication at Superfund sites and the reification of division: toward a convergence-building model of risk communication.[Dissertation]
- Mays GP, Hogg RA, Castellanos-Cruz DM, Hoover AG, Fowler LC. 2013. Public health research implementation and translation: evidence from practice-based research networks. Am J Prev Med 45(6):752-762.[Abstract]
Select presentations can be found in Hoover's online archive.
Neasha Graves – Translating Environmental Health Research Through Education
Neasha Graves has a unique perspective on environmental health education thanks to her experiences in high school teaching and adult literacy education. She combines this perspective with a passion for providing vulnerable people with the tools they need to succeed, when she designs training workshops and materials that educate children, parents, and professionals about environmental health issues.
Graves' first foray into environmental education was as a North Carolina Governor's Public Management Fellow in the NC Department of Environment and Natural Resources (DENR). She received this fellowship while working on her master's degree in public administration at North Carolina Central University. At DENR, Graves was a statewide coordinator for the childhood lead poisoning prevention program, which involved conducting training and education that helped health professionals, lay people, and parents understand how to prevent lead poisoning in young children.
In 2006, Graves went to the University of North Carolina, Chapel Hill as the project coordinator for the Community Outreach and Engagement Core (COEC) of the NIEHS-funded Center for Environmental Health and Susceptibility (CEHS). The COEC, which is directed by Kathleen Gray, translates Center research on such topics as asthma and air quality, breast cancer, obesity, shale gas, and skin cancer into knowledge that can improve public health.
Every single day I see my past work in adult literacy affect how I say something to a layperson, how I convey information, or how I type an e-mail. I'm careful to make sure that the lay audience understands what we're saying. – Neasha Graves
As an educator, Graves finds it very fulfilling to tap into her drive and the great resources at UNC to provide environmental health education that many people need. The COEC acts as a bridge between researchers and community audiences and the professionals who serve the community. Graves says that the COEC continues to see more and more researchers, especially young investigators, who are interested in having a direct connection to community audiences.
In the COEC, she and her colleagues create research-based materials for lay audiences, such as parents who may be dealing with an issue regarding their children. Her past educational experiences directly affect her point of view in terms of how information is conveyed verbally and in print. For example, she notes that when developing materials for a lay audience, it is important to keep in mind that a significant number of people have low literacy levels.
Graves also helps develop programming, materials, and hands-on activities for professionals who may not be aware of environmental exposures and human health risks. For example, the COEC provides a training on environmental asthma triggers that is delivered mostly to nurses and social workers. During this training, participants receive a kit with tactile examples of household asthma triggers. This kit gives the professionals a powerful hands-on tool they can use when talking to a parent or a child or even when teaching a group.
Graves finds it very rewarding to see the "light bulb" moment when a professional who has been trying to help a family deal with asthma receives a trigger kit. Those who have used this hands-on educational tool report that it is more impactful than handing out a brochure or flier.
Her work also entails coordinating the outreach activities of the NIEHS-funded UNC Breast Cancer and Environment Research Program (BCERP). In this role, Graves and Gray work with project co-leaders Melissa Troester, Ph.D., and Liza Makowski, Ph.D., to develop educational tools on breast cancer. Troester and Makowski study the environmental influences on basal-like breast cancer in black women under 50. Graves and her colleagues worked with the UNC School of Information and Library Science on an interactive website, My Breast Cancer Risk, designed to help young black women understand their risk for breast cancer.
Graves says that she finds it very satisfying to know that the small group that makes up the COEC has a real impact on building capacity in terms of understanding environmental health issues. By reaching out to health professionals with train-the-trainer modules and providing them with tools like the asthma trigger kit, they are bringing environmental health education to many people across North Carolina.
Highlighted Publication
- Allicock M, Graves N, Gray K, Troester MA. 2013. African American women's perspectives on breast cancer: implications for communicating risk of basal-like breast cancer. J Health Care Poor Underserved 24(2):753-767. [Abstract]
Viola "Vi" Waghiyi – Fighting for Environmental Justice in the Arctic
Viola "Vi" Waghiyi is a Yupik mother and grandmother originally from Savoonga, Alaska, a community on St. Lawrence Island (SLI), which is close to Russia's Far East. The island has a small population, but it has found itself in the midst of large environmental issues.
When Alaska Community Action on Toxics (ACAT) hired Waghiyi in 2002, she initially worked on its St. Lawrence Island Environmental Health and Justice Project, which focused on the toxic waste left by the U.S. Air Force on the island's Northeast Cape. ACAT's NIEHS-funded community-based participatory research (CBPR) has demonstrated the presence of high levels of polychlorinated biphenyls (PCBs) at the former military site, and Waghiyi is working hard to illuminate the potential links between the waste at the Northeast Cape and a variety of health harms, including cancer and reproductive complications.
As part of its CBPR project, ACAT is also examining two endocrine-disrupting chemicals: polybrominated diphenyl ethers (PBDEs) and perfluorinated compounds (PFCs). In addition to examining SLI residents' exposure to these chemicals, the project offers training so that residents can take action to protect themselves from contamination.
Waghiyi now serves as ACAT's Environmental Health and Justice Program Director and works on projects that go beyond—but still affect—Alaska. For example, one of ACAT's (and the Yupik people's) major concerns is the distribution of persistent organic pollutants (POPs), including PCBs, throughout the world. The Arctic acts as a sink for such pollutants, and SLI data have shown a connection between high PCB levels in the marine mammals that make up the Yupik diet and PCB levels in the Yupik themselves.
Such environmental concerns are not just a matter of health but also of justice. According to the U.S. Census Bureau, the poverty rate of SLI's two communities, Gambell and Savoonga, is 38.7% and 53.3%, respectively. (The overall U.S. poverty rate is 14.9%.) Thus, poor, indigenous communities have to deal with the consequences of chemicals created and released thousands of miles away, and this injustice prompted ACAT to participate in a recent campaign that framed pesticide production and distribution as a human rights issue.
It's not a matter of 'if I will' but 'when I will' get cancer. – Vi Waghiyi
Another avenue for addressing this problem is the Stockholm Convention, a treaty that "requires its parties to take measures to eliminate or reduce the release of POPs into the environment." During the Convention's fifth Conference of the Parties (COP 5) in 2011, Waghiyi participated in the Global Indigenous People's Caucus, which informed the COP 5's official decision to add the pesticide endosulfan to the UN's list of POPs to be eliminated worldwide. In 2013, Waghiyi led a delegation of indigenous women to the COP 6 meeting and succeeded in calling for a ban on the flame retardant hexabromocyclododecane (HBCD).
Waghiyi's work is vital because it reminds us that environmental health science is not an abstract field; researchers need to keep in mind that their work has local and personal implications. As a member of the National Advisory Environmental Health Sciences Council, Waghiyi emphasizes the importance of local engagement to the NIEHS mission, and she was pleased when NIEHS and National Toxicology Program Director Linda Birnbaum, Ph.D., visited Alaska for several community forums to learn about the many local environmental health concerns. The residents of St. Lawrence Island live every day with the health and environmental consequences of others' actions, and Waghiyi asks that we work together to mitigate and prevent this "contamination without our consent."
Highlighted Publications
- Miller PK, Waghiyi V, Welfinger-Smith G, Byrne SC, Kava J, Gologergen J, Eckstein L, Scrudato R, Chiarenzelli J, Carpenter DO, Seguinot-Medina S. 2013. Community-based participatory research projects and policy engagement to protect environmental health on St Lawrence Island, Alaska. Int J Circumpolar Health 72:21656.[Abstract]
- Hoover E, Cook K, Plain R, Sanchez K, Waghiyi V, Miller P, Dufault R, Sislin C, Carpenter DO. 2012. Indigenous peoples of North America: environmental exposures and reproductive justice. Environ Health Perspect 120(12):1645-1649.[Abstract]
- Welfinger-Smith G, Minholz JL, Byrne S, Waghiyi V, Gologergen J, Kava J, Apatiki M, Ungott E, Miller PK, Arnason JG, Carpenter DO. 2011. Organochlorine and metal contaminants in traditional foods from St. Lawrence Island, Alaska. J Toxicol Environ Health A 74(18):1195-1214.[Abstract]
John Sullivan – Setting the Stage for Healthier Communities
John Sullivan never expected he would have a career in the field of environmental health. He is trained in the arts and has worked as a writer, playwright, director, poet, performance artist, and arts educator. When he learned that the NIEHS-funded Center in Environmental Toxicology (CET) at the University of Texas Medical Branch at Galveston (UTMB) was interested in using theatre to educate and engage environmental justice communities, he saw an opportunity to use his background to help people understand the science behind the issues that were affecting their health and quality of life. Sullivan is now director of the Public Forum and Toxics Assistance (Division 3) within the CET's Community Outreach and Engagement Core (COEC). He is also an instructor in the UTMB Department of Preventive Medicine & Community Health and an associate member in the Institute for Medical Humanities.
Sullivan uses a technique called Forum Theatre to help communities understand science and to help scientists understand communities. Created by Augusto Boal, a ground-breaking director and playwright from Brazil, Forum Theatre promotes positive community change. The technique encourages the audience, or "spect-actors," to step into the show when they have a different idea or solution about how to solve the problem being portrayed. "Forum Theatre is community driven, community members create and act in their own shows, the audience is attentive and interactive, and the process gets people to think about realistic ways to solve a community problem," Sullivan explained
Many Gulf Coast families live in communities bordering oil refineries or industrial plants. These families often cannot afford to move to healthier, safer places. Sullivan organizes Forum Theatre workshops around environmental health issues of immediate concern to these communities. Over the years, workshops have covered topics such as hazardous air pollutants, lead poisoning, environmental asthma triggers, the built environment, and trichloroethene vapor intrusion.
Sullivan also trains community leaders to facilitate their own Forum Theatre workshops. In partnership with the Houston-based community group de Madres a Madres, Sullivan trained a troupe of volunteers in Forum Theatre techniques, and a team of CET researchers taught them about community-relevant environmental health issues. The troupe delivered over 30 bilingual and culturally sensitive performances, raising awareness of childhood lead exposure and environmental asthma triggers and teaching families how to reduce or eliminate these hazards from their homes. The project, Communities Organized against Asthma & Lead (COAL), was funded by the NIEHS Environmental Justice: Partnerships for Communication Program.
More recently, Sullivan has been working alongside Gulf Coast Health Alliance: Health Risks Related to the Macondo Spill (GC-HARMS) project. GC-HARMS is one of several projects funded by the NIEHS to examine the health effects stemming from the 2010 Deepwater Horizon oil spill. The goal of GC-HARMS is to examine the impact of the oil spill on seafood safety and ultimately develop seafood consumption guidelines.
Sullivan helps coordinate the community involvement component of GC-HARMS, giving presentations to local fishermen about how the knowledge gained from the project could benefit their families and communities and training them to collect samples. The fishermen used their local knowledge of inland and coastal waters to develop with the exposure assessment team a multi-species sampling matrix that eventually became a GPS-coded map of all of the project sampling sites. "I've been closely connected with the local fishermen for several years now and working with them has been a really rewarding part of this project. We couldn't do this without their help and knowledge of the local environment," said Sullivan.
For more information, including a video and articles, about some of the workshops Sullivan has facilitated, visit the UTMB Center to Eliminate Health Disparities' Forum Theatre Skills & Concept Demonstration page.
Highlighted Publications
- Sullivan J. 2010. Engaging neighbors, transforming toxic realities: community environmental forum theatre using Augusto Boal's Theatre of the Oppressed to promote environmental justice. In: Creative Arts in Interdisciplinary Practice: Inquiries for Hope and Change (McLean CL, Kelly R, eds). Edmonton: Brush Education.
- Sullivan J, Lloyd RS. 2007. The forum theatre of Augusto Boal: a dramatic model for dialogue and community-based environmental science. Local Environment: The International Journal of Justice and Sustainability 11(6):627-646.[Abstract]
Erin Haynes, Dr.P.H. – Partnering for Healthier Communities
Erin Haynes has always loved both people and the environment, so when she first learned about the field of environmental health as an undergrad at Wilmington College of Ohio, she saw the perfect opportunity to marry her two passions. Haynes has since dedicated her life to studying how chemicals in the environment affect people and to working with communities to ensure they understand how to protect their health.
After receiving her Dr.P.H. in Environmental Health Science from the University of Michigan's School of Public Health, Haynes was hired as a postdoctoral fellow in the NIEHS T32 Molecular Epidemiology in Children's Environmental Health training program. From there, she moved to the University of Cincinnati (UC), where she now serves as an associate professor and director of the UC master's program in Clinical and Translational Research. Haynes played an integral role in establishing and shaping the program, which offers a community-based participatory research course that emphasizes the role of community engagement in clinical research.
Haynes is also director of the UC Community Outreach and Engagement Core (COEC) within the NIEHS-funded Center for Environmental Genetics and is currently leading three community-based research projects in Ohio. All three studies were prompted by community concerns about local air quality and its effect on health.
Through the Communities Actively Researching Exposure Study (CARES), Haynes has been studying how airborne manganese emissions from a Marietta, Ohio industrial plant are affecting local children's health. The community helped shape the research direction of CARES. After meeting with community groups and sharing with them what was known about the health effects of manganese, the question of how exposure was affecting their children's mental development stood out as the major concern. This was also a primary question among scientists at the time.
The communities I work with influence the path of my research. I listen to their questions and concerns which then drive the research. My research has benefited tremendously from community involvement. – Erin Haynes, Dr.P.H.
Before launching CARES, Haynes conducted a community-wide survey and learned that Marietta residents looked primarily to physicians and journalists to get environmental health information. In response, Haynes and her UC COEC colleagues developed educational resources, including modules for physicians and nurses and a video for journalists, to ensure they had accurate information to educate the community about air pollution and health.
Since starting CARES, Haynes has partnered with a second Ohio community, East Liverpool, which also experiences high levels of airborne manganese. Haynes first learned of the manganese issue in East Liverpool after residents, who had heard of her work in Marietta, expressed their desire to have a similar study conducted in their community. Haynes is now replicating CARES in East Liverpool, and she has also teamed up with colleagues from the UC College of Engineering to develop a portable sensor that can measure blood metal levels in real time. This partnership was driven by Haynes's desire to get results back to CARES participants faster than the six to nine months it can take to analyze samples using traditional blood-testing methods. Both CARES studies and the development of the sensor are funded by NIEHS.
Most recently, community members have expressed concerns about how chemicals used in the hydraulic fracturing (fracking) process could affect their health. Their concerns have prompted Haynes to initiate two community-engaged research projects. She worked with COECs at the University of Rochester and the University of North Carolina, Chapel Hill to gauge community perception of fracking. She has also teamed up with researchers from Oregon State University to study the effects of fracking on air quality in Carroll County, Ohio, which contains a growing number of fracking sites. To do this, the researchers set up passive air sampling devices at residences near fracking sites and also enlisted study participants to wear personal wristband monitors. The stationary sampling devices can measure more than 1,000 chemicals in the air.
Under Haynes's leadership, the UC COEC received a community-health award for helping protect families from exposures associated with demolition of a lead-painted bridge in their neighborhood. UC COEC staff created bilingual educational materials and talked with residents about ways to keep their families safe from lead exposure. Intervention was also a critical part of the project – the COEC gave out sticky mats to pick up lead dust from people's shoes before they entered their homes.
What's next for Haynes? She hopes to continue following the CARES children to examine the effects of manganese and other metals on their behavior, brain chemistry, structure, and function. According to Haynes, the community continues to ask questions and is very interested in keeping CARES alive and in expanding it to study manganese-induced Parkinsonism in adults. She also hopes to continue her fracking research so that she can provide answers to community questions about potential health effects and provide training for emergency response crews who respond to spills or fires related to the process.
Highlighted Publications
- Rugless F, Bhattacharya A, Succop P, Dietrich KN, Cox C, Alden J, Kuhnell P, Barnas M, Wright R, Parsons PJ, Praamsma ML, Palmer CD, Beidler C, Wittberg R, Haynes EN. 2014. Childhood exposure to manganese and postural instability in children living near a ferromanganese refinery in Southeastern Ohio. Neurotoxicol Teratol 41:71-79.[Abstract]
- Parin ML, Yancey E, Beidler C, Haynes EN. 2014. Efficacy of environmental health e-training for journalists. Studies in Media and Communication 2(1): 71-80.[Abstract]
- Korfmacher KS, Elam S, Gray KM, Haynes EN, Hughes MH. 2014. Unconventional natural gas development and public health: toward a community-informed research agenda. Rev Environ Health.[Abstract]
- Haynes EN, Ryan P, Chen A, Brown D, Roda S, Kuhnell P, Wittberg D, Terrell M, Reponen T. 2012. Assessment of personal exposure to manganese in children living near a ferromanganese refinery. Sci Total Environ 427-428:19-25.[Abstract]
- Haynes EN, Beidler C, Wittberg R, Meloncon L, Parin M, Kopras EJ, Succop P, Dietrich KN. 2011. Developing a bidirectional academic-community partnership with an Appalachian-American community for environmental health research and risk communication. Environ Health Perspect 119(10): 1364-1372.[Abstract]
Annie Belcourt, Ph.D. - Increasing Awareness of Native American Environmental Health Disparities
American Indian and Alaska Native (AI/AN) peoples suffer from both a historic legacy of trauma (stemming from European colonization) and current socioeconomic disparities. According to the U.S. Census Bureau, AI/AN peoples have higher rates of poverty, lower median incomes, and lower rates of high school and college completion. In addition, according to the Centers for Disease Control and Prevention, AI/AN peoples have higher rates of infant mortality; substandard housing; smoking; binge drinking; and death from drug abuse, motor vehicles, and suicide.
Annie Belcourt (Otter Woman), an enrolled member of the Three Affiliated Tribes and a descendent of the Blackfeet and Chippewa, is working to address these health issues. Belcourt received her Ph.D. in clinical psychology from the University of Montana and currently teaches at its School of Public & Community Health Sciences and Department of Pharmacy Practice.
In addition to her psychological research on trauma, Belcourt also has participated in environmental health research. Health problems related to environmental exposures play a large role in the lives of Native Americans in Montana. This includes poor water quality stemming from factors such as hydraulic fracturing and a lack of safe water supplies and waste disposal facilities, as well as poor indoor air quality related to mold, wood stoves, and tobacco.
Belcourt is working to improve indoor air quality in two Native American communities, Nez Perce and the Navajo Nation, as part of an NIEHS-funded, two-level health intervention. Highlighting the health risks associated with burning wet wood, the researchers are helping the communities establish wood banks so that residents have access to dry wood for fuel. At the household level, the researchers are comparing the efficacy of (1) an educational intervention focusing on healthy wood-burning practices with (2) an indoor air-filtration system and (3) a placebo (dummy air filters).
Belcourt conducts focus groups and key-informant interviews to help make the educational intervention accessible and culturally appropriate. Part of the intervention involves digital storytelling, a format that allows Native Americans (and others) to create and distribute their own stories in their own words and, in turn, promote health and environmental protection. Storytellers receive training on scriptwriting and digital technology, and they own the rights to their material. The format enables community members to weave together personal narrative, reflections on Native American spirituality, and activism using their native language and images. (See some examples of digital stories from nDigiDreams, which conducts media workshops with Native American communities.)
More broadly, Belcourt is part of the University of Montana's push to hire more Native American tenure-track professors, and she believes that the key to bringing more Native Americans into academia lies in developing the infrastructure to do so. She is grateful for the postdoctoral research opportunities she had with the Native Elder Research Center and the Indigenous HIV/AIDS Research Training Program, which allowed her to interface with other Native scholars from around the country, and for the support that the National Institute on Minority Health and Health Disparities provided through an endowment grant to the University of Montana – a grant that allowed the University to hire her.
NIEHS is pleased to be a part of Annie Belcourt's career development and to support her involvement in interdisciplinary research that combines environmental science, cultural literacy, and educational interventions – research that is necessary to address Native American health disparities.
Highlighted Publications
- Beals J, Belcourt-Dittloff A, Garroutte EM, Croy C, Jervis LL, Whitesell NR, Mitchell CM, Manson SM; AI-SUPERPFP Team. 2013. Trauma and conditional risk of posttraumatic stress disorder in two American Indian reservation communities. Soc Psychiatry Psychiatr Epidemiol 48(6):895-905.[Abstract]
- Jervis LL, Spicer P, Belcourt A, Sarche M, Novins DK, Fickenscher A, Beals J; AI-SUPERPFP Team. 2014. The social construction of violence among Northern Plains tribal members with antisocial personality disorder and alcohol use disorder. Transcult Psychiatry 51(1):23-46.[Abstract]
- Kelley A, Belcourt-Dittloff A, Belcourt C, Belcourt G. 2013. Research ethics and indigenous communities. Am J Public Health 103(12):2146-2152.[Abstract]
Asa Bradman, Ph.D. – Advocating for Children's Environmental Health
"Children are not little adults!" This refrain that one sometimes hears in the medical world reminds us that we must take into account children's distinct developmental and physiological concerns. What is true in the clinical setting also applies to environmental exposures. Children eat, breathe, and drink more than adults (per unit of body weight); they engage in behaviors that increase their levels of exposure (e.g., crawling on the floor, putting their hands into their mouths); and their bodies are less able to metabolize and remove chemicals to minimize toxic effects. Since children's bodies change so rapidly, environmental exposures may impact developmental trajectories.
Asa Bradman knows this better than most. Though he started his career working in environmental chemistry, particularly focusing on acid rain and snow melt chemistry in the Rockies, he later became interested in research that was more directly engaged with people and their wellbeing. He worked for several years at the California Department of Public Health, a crucible for the emerging field of children's environmental health in the 1980s, and he immersed himself in the issue of pediatric lead exposure while completing his Ph.D. in environmental health sciences. He later cofounded the University of California – Berkeley's Center for Environmental Research and Children's Health(CERCH), where he currently serves as its Associate Director for Exposure Assessment.
Under CERCH's CHAMACOSproject, which is examining the connection between environmental exposures and health in a cohort of children (birth through 14 years) in California's Salinas Valley, he has led studies on pesticide and flame-retardant exposures in pregnant women and children. These exposures have been associated with poorer neurodevelopment in the CHAMACOS children.
Bradman's flame-retardant work has had a particularly significant impact. Because of the Golden State's flammability standards that resulted in heavy use of chemicals, the flame-retardant levels in California children are much higher than in children elsewhere. As a result, Governor Jerry Brown has ordered new regulations that meet fire-safety goals and minimize or eliminate chemical exposures.
(Under a new NIEHS-funded grant, Bradman is continuing this line of research by examining the exposure of mothers to organophosphate flame retardants (OPFRs), the prenatal exposure of their children to OPFRs, and the subsequent neurodevelopment of those children.)
Bradman also has focused on the environmental health risks in childcare centers. Under a contract with the California Air Resources Board, he conducted a groundbreaking studyof the level of formaldehyde(373KB) (a human carcinogen) and other toxins in childcare centers. He and other researchers also developed an integrated pest management (IPM) curriculum for childcare professionals. IPM is a healthier, more environmentally sound method of dealing with pests; it either avoids chemicals altogether or (if chemicals prove necessary) aims for the least toxic options. For his effort, Bradman won a 2012 IPM Innovator Awardfrom the California Department of Pesticide Regulation.
[We need] careful evaluation of indoor environments and the materials that are used there, particularly when we're thinking of very young children. – Asa Bradman, Ph.D.
Bradman would like more resources put toward understanding environmental exposures in childcare and school environments. He sees big opportunities to support education and outreach that can inform decisions about the materials used in indoor environments and thereby reduce chemical exposures to children.
More broadly, Bradman stresses that when we consider widely used chemicals like flame retardants, we should note that virtually every American has these chemicals in their bodies. Thus, we must ensure that decisions to use chemicals that will expose all of us, starting in the womb, are fully informed and protect public health.
Highlighted publications
- Bradman A, Castorina R, Gaspar F, Nishioka M, Colón M, Weathers W, Egeghy PP, Maddalena R, Williams J, Jenkins PL, McKone TE. 2014. Flame retardant exposures in California early childhood education environments. Chemosphere. [Epub ahead of print][Abstract]
- Bradman A, Castorina R, Sjödin A, Fenster L, Jones RS, Harley KG, Chevrier J, Holland NT, Eskenazi B. 2012. Factors associated with serum polybrominated diphenyl ether (PBDE) levels among school-age children in the CHAMACOS cohort. Environ Sci Technol 46(13):7373-7381.[Abstract]
- Bradman A, Kogut K, Eisen EA, Jewell NP, Quirós-Alcalá L, Castorina R, Chevrier J, Holland NT, Barr DB, Kavanagh-Baird G, Eskenazi B. 2013. Variability of organophosphorous pesticide metabolite levels in spot and 24-hr urine samples collected from young children during 1 week. Environ Health Perspect 121(1):118-124.[Abstract]
- Eskenazi B, Bradman A, Finkton D, Purwar M, Noble JA, Pang R, Burnham O, Cheikh Ismail L, Farhi F, Barros FC, Lambert A, Papageorghiou AT, Carvalho M, Jaffer YA, Bertino E, Gravett MG, Altman DG, Ohuma EO, Kennedy SH, Bhutta ZA, Villar J; International Fetal and Newborn Growth Consortium for the 21st Century. 2013. A rapid questionnaire assessment of environmental exposures to pregnant women in the INTERGROWTH-21st Project. BJOG 120(Suppl 2):129-138.[Abstract]
- Gunier RB, Bradman A, Jerrett M, Smith DR, Harley KG, Austin C, Vedar M, Arora M, Eskenazi B. 2013. Determinants of manganese in prenatal dentin of shed teeth from CHAMACOS children living in an agricultural community. Environ Sci Technol 47(19):11249-11257.[Abstract]
Allison Patton and Kevin Lane – Working with communities to understand near-highway air pollution
Collaboration between environmental health scientists and community groups provides researchers a unique opportunity to strengthen the research process and translate findings to improve community health and inform policy. The NIEHS recognizes the value of community involvement in scientific research and funds many projects that use community-based participatory research (CBPR) approaches. In turn, many of those projects are training a new generation of graduate students and postdoctoral fellows to utilize CBPR methods.
Two such trainees, Allison Patton and Kevin Lane, work on the Community Assessment of Freeway Exposure and Health (CAFEH) (PI: Doug Brugge, Ph.D.) study at Tufts University. CAFEH is working with Boston-area communities to ascertain the relationship between near-highway residential areas and adverse health outcomes. In partnership with local community groups — such as the Chinatown Resident Association, the Chinese Progressive Association, the Committee for Boston Public Housing, and the Somerville Transportation Equity Partnership — CAFEH has conducted research, analyzed results, and published various journal articles, newsletters, and fact sheets regarding particulate matter and the relationship between traffic pollution and health.
Allison Patton received her Bachelor of Science in Environmental Engineering from MIT and is currently a doctoral student in Tufts University's Civil and Environmental Engineering department; she is also a fellow in the U.S. Environmental Protection Agency (EPA) Science to Achieve Results (STAR) program. She likes measuring the world around her and felt that environmental engineering offered a good way of combining her interests with helping people.
Under the CAFEH study, Patton investigates particulate matter concentrations at varying distances from Interstate 93. For her thesis, she has developed models that predict ambient ultrafine particle (UFP) number concentrations in the study-area neighborhoods under a variety of traffic and meteorological conditions.
Patton measured particulate matter concentrations at different times of day and through different seasons and was in charge of much of the mobile monitoring near the highway, which involved compiling the data and performing quality control.
Patton did not always think her work would involve a major community or public policy component. She figured that she would follow the path of many academics: conduct research, publish findings, and then have the scientific community use her findings to pursue further research. However, she is working on making the data in her models more visual and suitable for those who want to use them for policy development. In addition, she has learned that community members want practical ways to implement research findings. She explained, for example, that people who regularly exercise near a highway should try to avoid doing so during rush hour (when particulate matter concentrations are at their highest), and people who do exercise at a higher-risk time should try to move away from the highway; even just moving to another side of a building — away from the road — can reduce exposure.
More broadly, Patton says that increasing the use of public transportation would decrease air pollution related to traffic congestion (though, she notes, public transportation is losing funding at a time when more people want to switch to it).
Kevin Lane is a doctoral student in environmental health at Boston University and is also an adjunct faculty member in the university's City Planning and Urban Affairs program. He was a recipient of the Ruth L. Kirschstein National Research Service Award and is now a fellow in the EPA STAR program. His interest in environmental science and policy developed early when he was an undergraduate at St. Michael's College, majoring in biology and political science, and when he worked as an intern at the New Hampshire Department of Environmental Services, where he conducted quality assurance/control of data and filter analysis for air pollution.
He says he was "thrown into the fire," however, when he spent three-and-a-half years working as a research assistant for the Harvard School of Public Health's Trucking Industry Particle Study. He collected air pollution data in working conditions involving high PM2.5 concentrations, and he reported feeling ill himself after coming home from fieldwork.
While a master's student in Tufts' Urban and Environmental Policy and Planning program, his professors convinced him that he could contribute the most to society if he focused on the intersection of science and policy. They said that there are plenty of lawyers to work on the policy front, but more work is needed on science translation and the effective use of epidemiological information in policy development.
"[Community participation] helps train us as doctoral students...to be better translators of science so that we're not just living in the ivory tower. We're able to actually communicate with everyday citizens and people that are actually being affected by these pollutants. - Kevin Lane
Under the CAFEH study, Lane investigates the health associations between hourly UFP (from Patton's models) and markers of cardiovascular health. He conducts data and statistical analysis and serves as the geographic information system (GIS) specialist. The latter involves building maps and collaborating with community members to make sure the maps are accurate — even down to the apartment level — to get as close as possible to the research subjects' personal exposure levels.
Lane sees policy implications for the CAFEH research. He says that at the federal level, more and larger human epidemiological studies of UFP are needed to inform regulatory determinations. In addition, if roadways are indeed the primary sources of UFP, then more local or mobile monitoring will be needed to capture air pollution data from where people actually live and work.
At the local level, he says that officials and community members could help to inform ordinances that reduce exposure to near-roadway air pollution, such as prohibiting new construction of certain buildings (e.g., schools, public housing complexes) within 200 meters of roadways or requiring HEPA filtration systems for existing buildings. He adds that including policy officials throughout the entire course of an environmental health study is vital. By getting involved early, the officials become familiar with the concerns of community members and researchers and can start to consider policy ideas in tandem with data collection and analysis.
Lane is very happy that community members form an integral part of his research. He recognizes the importance of translating his statistical work at public presentations so that residents can then spread the word to their neighbors and peers. He sees this research communication and translation as an important part of his doctoral program that will help him throughout his career.
Highlighted Publications
- Brugge D, Lane K, Padró-Martínez LT, Stewart A, Hoesterey K, Weiss D, Wang DD, Levy JI, Patton AP, Zamore W, Mwamburi M. 2013. Highway proximity associated with cardiovascular disease risk: the influence of individual-level confounders and exposure misclassification. Environ Health 12(1):84.[Abstract]
- Fuller CH, Patton AP, Lane K, Laws MB, Marden A, Carrasco E, Spengler J, Mwamburi M, Zamore W, Durant JL, Brugge D. 2013. A community participatory study of cardiovascular health and exposure to near-highway air pollution: study design and methods. Rev Environ Health 28(1): 21-35.[Abstract]
- Lane KJ, Kangsen Scammell M, Levy JI, Fuller CH, Parambi R, Zamore W, Mwamburi M, Brugge D. 2013. Positional error and time-activity patterns in near-highway proximity studies: an exposure misclassification analysis. Environ Health 12(1):75.[Abstract]
- Padró-Martínez LT, Patton AP, Trull JB, Zamore W, Brugge D, Durant JL. 2012. Mobile monitoring of particle number concentration and other traffic-related air pollutants in a near-highway neighborhood over the course of a year. Atmos Environ 61:253-264.[Abstract]
Edith Parker, Dr.P.H. – Community-Engaged Researcher
Edith Parker, Dr.P.H.
Director of the Community Outreach and Engagement Core (COEC) of the Environmental Health Sciences Research Center at the University of Iowa
March 8, 2013
Edith Parker is a strong advocate for community-engaged research, particularly projects aimed at designing interventions to reduce environmental exposures and translating research to inform policy change. Her research reflects the mission of the NIEHS Partnerships for Environmental Public Health (PEPH) program to bring together researchers, community members, and policy makers to advance the impact of environmental public health.
Parker's passion for community-engaged research began in Africa, when she was assigned to a community health project. In the University of Iowa (UI) College of Public Health newsletter, she describes,
While working in Africa both as a secondary school teacher in Kenya and later as a Program Coordinator with Save the Children in Burkina Faso, I was exposed to public health and what it can do to improve the health of populations. I was also exposed to the power of communities and the need to work with, not for, communities in identifying their needs and designing interventions to address those needs. – Edith Parker
Parker returned to the United States to pursue a public health degree and studied with researchers who were well-versed in a community-based approach.
In Michigan, Parker was involved with a team of researchers and community organizations conducting community-based participatory research (CBPR). They worked at an urban research center funded by the Centers for Disease Control and Prevention that partnered with community members to set priorities for research projects. Children's health issues, with a focus on asthma and lead poisoning, rose to the top.
Parker was part of several NIEHS-funded projects using CBPR approaches to study childhood asthma. The community partners were instrumental in designing the project, from their input on the length and content of the survey to their suggestion that home visits were a more effective way to recruit participants in the air filter part of the study. One project focused on an intervention for childhood asthma using air filters and air conditioning. The team is currently analyzing the results of the intervention, but they have initially found that the air filters reduced particulate matter when used properly. Parker thinks the CBPR approach was critical for this project; she explains, "The project was so effective because there were a lot of logistics, and the input and guidance from the community partners, both in designing the intervention and in the research design, were invaluable in strengthening the research."
Parker became interested in methods for communicating study data to participants. She got a chance to analyze risk communication in the Community Perceptions of Dioxin (CPOD). The CPOD project focused on examining community members' perceptions of risk and any behavior changes that resulted from their involvement in the University of Michigan Dioxin Exposure Study (UMDES) study. The team used the mental models approach to assess what is important to the community participants through qualitative interviews and surveys with a large number of people, which was very time intensive. The team is preparing for a stakeholder meeting where they will discuss the study findings. Parker emphasizes how this type of investigation is invaluable in developing successful risk communication messages.
PEPH is a tremendous resource for researchers in terms of helping us find others to help with certain issues or with working with different populations. – Edith Parker
What's next for Parker? She's excited about advancing the work with the UI community outreach and engagement core (COEC) that she joined in 2010. The Community Advisory Board of the COEC has been instrumental in suggesting education and outreach activities focused on radon, environmental effects of floods, the farm bill, and other issues relevant to the rural Midwest. She also is exploring future research with Peter Thorne, Ph.D., of the UI Environmental Health Research Center, to work on rural asthma issues related to environmental exposures in Iowa.
Highlighted publications
- Zikmund-Fisher BJ, Turkelson A, Franzblau A,Diebol JK, Allerton L, Parker EA. 2013. The effect of misunderstanding the chemical properties of environmental contaminants on exposure beliefs: A case involving dioxins. Science of the Total Environment 447:293-300.
- Parker EA, Chung L, Israel BA, Reyes A, Wilkins DW. 2010. Community organizing network for environmental health: Using a community health development approach to increase community capacity around reduction of environmental triggers. Journal of Primary Prevention 31:41–58.[Abstract]
- Hammond DM, Dvonch JT, Keeler GJ, Parker EA, Kamal AS, Barres JA, Yip FY, Brakefield-Caldwell W. 2008. Sources of ambient fine particulate matter at two community sites in Detroit, Michigan. Atmospheric Environment 42:720-732.
- Parker EA, Lewis TC, Israel BA, Robins TG, Mentz G, Lin X, et al. 2008. Evaluation of Community Action Against Asthma: A community health worker intervention to improve children's asthma-related health by reducing household environmental triggers for asthma. Health Education & Behavior 35(3) 376-395.
- Edgren KK, Parker EA, Israel BA, Lewis TC, Salinas MA, Robins TG, Hill YR. 2005. Community involvement in the conduct of a health education intervention and research project: The Community Action Against Asthma Project. Health Promot Pract 6(3):263-269.[Abstract]
- Du L, Batterman S, Parker E, Godwin C, Chin JY, O'Toole A, Robins T, Brakefield-Caldwell W, Lewis T. Accepted 13 May 2011. Particle concentrations and effectiveness of free-standing air filters in bedrooms of children with asthma in Detroit, Michigan. J Build Env.
Edward (Ted) Emmett, M.D. – An innovator in occupational medicine, communication, and community empowerment
Edward A. Emmett, M.D., MS
Director of the Community Outreach and Engagement Core of the Center for Excellence in Environmental Toxicology at the Perelman School of Medicine at the University of Pennsylvania
February 11, 2013
Dr. Ted Emmett is an innovator in the field of occupational and environmental medicine, creating training programs and helping set standards for occupational medicine that have laid a foundation for excellence. His approach to research that combines quality science, practical training, and community empowerment represents the type of action-oriented research at the heart of the NIEHS Partnerships for Environmental Public Health program.
I think a good researcher needs to ask the question: Is there a better way of communication that engages people to think for themselves and then follow up on that. – Ted Emmett
After founding occupational medicine programs at Johns Hopkins University and serving as Chief Executive of the body that set standards for health and safety in Australia, Emmett developed the innovative NIOSH-funded occupational medicine residency at the University of Pennsylvania (UPenn). This program allows residents to work in the field and learn through hands-on work in the community where they intend to practice as well as receiving supplemental education and training at UPenn. A trainee from this program, Hong Zhang, M.D., of Parkersburg, W. Va., learned that a manufacturing facility was causing perfluorooctanoic acid (PFOA) contamination in the water distributed the Little Hocking Water Authority(LHWA) in nearby southeastern Ohio.
Emmett partnered with Zhang and the Decatur Community Association in a NIEHS-funded study to address the exposure of residents of the LHWA district to PFOA. As part of this project, Emmett and partners developed the acclaimed "Community-First Communication" model based on discussions with affected community members. Together they established an information hierarchy where the study participants would be the first notified about test results, a procedure that was previously unheard of in environmental health research.
Most notably, 95% of people involved in the study made a change to their behavior as a result of this project, thereby reducing their exposures and risks to their health. This level of compliance with the recommendations of a public health research project is remarkable. – Ted Emmett about his PFOA study in Little Hocking and surrounding communities.
As a result of this project, DuPont reduced its discharges of PFOA, offered free bottled water to affected residents, and entered into a consent agreement with EPA to help any other similarly affected communities. Most notably, 95% of people involved in the study made a change to their behavior as a result of this project, thereby reducing their exposures and risks to their health. This level of compliance with the recommendations of a public health research project is remarkable.
When asked about conducting research to inform policy and change behavior, Emmett said the key to success is to start with a solid project design that will produce results that will be accepted as good science, to respect the people involved in the study, and to disseminate results in multiple formats so information is widely available to different audiences. Emmett summarized, "If the information is trusted and presented in a logical manner and options and risks are understood, people will generally make healthy choices for themselves."
What's next for Emmett? He's interested in health disparities. He's working with the community of Chester, Pa. , to address health disparities. He has just begun a project with the Chemical Heritage Museum (partnering with Fran Barg, an anthropologist at UPenn, and others) to create an environmental health history of communities around Ambler, Pa., particularly examining exposures to asbestos. Additionally, he is partnering with another former UPenn resident, Amanda Phillips, M.D., and a current UPenn resident in training, Mark Boquet, M.D., to assess the impacts of the Gulf Oil Spill on the Houma Native Americans in Louisiana and on other community groups as part of the NIEHS-funded GuLF study with the University of Texas Medical Branch in Galveston.
Highlighted publications
- Emmett EA, Zhang H, Shofer FS, Rodway N, Desai C, Freeman D, Hufford M. 2009. Development and successful application of a "community-first" communication model for community based environmental health research. J Occup Environ Med 51: 146-156.
- Emmett EA, Desai C. 2010.Community first communication: reversing information disparities to achieve environmental justice. Environmental Justice 3(3): 79-84.
- Emmett EA, Shofer FS, Zhang H, Freeman D, Desai C, Shaw LM. 2006. Community exposure to perfluorooctanoate: relationships between serum concentrations and exposure sources. J Occup Env Med 48:759-770.
- Emmett EA, Green-McKenzie J. 2001. External practicum-year residency training in occupational and environmental medicine. J Occup Env Med 43:501-511.
Naomi Hirsch – Using Web technologies to engage with stakeholders
Naomi Hirsch, Ed.M.
Project Coordinator for the Superfund Research Program Research Translation Core and the Environmental Health Sciences Center Community Engagement and Outreach Core at Oregon State University
February 11, 2013
Naomi Hirsch is passionate about utilizing Web technologies to enhance communication with stakeholders and reach broader audiences. Throughout her career, she has been at the forefront of incorporating emerging technologies into her work. This vision of adopting the tools used by your target audience to facilitate communication is central to the NIEHS Partnerships for Environmental Public Health program.
Hirsch's interest in outreach began with her work in the Peace Corps where she used her background in forestry to work with tree crops in Paraguay. The experience in South America brought her to the University of California, Davis fruit and nut breeding research team. After spending time as a research assistant in the lab and field, Hirsch knew she was more interested in outreach. In 1996, the Web was beginning to play an important role in sharing research and information with the public. Hirsch dove into this new method of information sharing with a position managing an online information and research center that brought together the University of California fruit and nut research from around the state. At that time, Hirsch's longstanding fascination with Web communication began, because she saw its importance, impact, and challenge. In her current position as project coordinator for the Superfund Research Program (SRP) Research Translation Core (RTC) and the Environmental Health Sciences Center Community Engagement and Outreach Core at Oregon State University, she works to encourage the use of emerging technologies such as Twitter to engage with stakeholders. Her motto for scientists is to "be where the people are" to share research findings and educate about environmental health topics of concern.
Curriculum: Hirsch's work at OSU began with the Hydroville Curriculum Project , which is a NIEHS-funded, problem-based curriculum that uses environmental health topics to enhance connections between science, language arts, math, social studies, health, and technology. There are three modules available, each focusing on a real-world environmental health issue – pesticide spill, water quality, and indoor air quality. Hirsch's initial role was assisting with developing and piloting the curriculum, and training the high school teachers. She then adapted the indoor air quality module for community audiences . Later, she obtained funding from the Institute for Water and Watersheds to adapt the curriculum for community college audiences working toward degrees in water, environment, and technology, a program retraining many people out of work for positions in the growing field of water science. Hirsch still manages the Hydroville website, and receives regular requests for the curriculum.
Podcasts: In 2006, Hirsch created a series of podcasts with teachers and students to allow them to share positive experiences using the curriculum and called it the Hydroville Café . She was at the front end of podcasting and found that it was successful, and so began another podcast series with Sandra Uesugi focusing on the Linus Pauling Institute . This series interviewed scientists about micronutrient research and its relationship to environmental health, and was well-received. Hirsch and Uesugi then partnered with the National Pesticide Information Center at OSU to help them produce a podcast series called Pestibytes .
Video: Hirsch and the Outreach team have now moved toward video production. Related to her work with the OSU Gulf of Mexico Oil Spill project , two videos were produced in English, Spanish, and Vietnamese to help the public, specifically the communities impacted by the Gulf Oil Spill, understand environmental contaminants. Hirsch produced other technical videos for a scientific audience about the sampling equipment being used in the Gulf. Recently she produced videos of graduate students giving elevator speeches about their research with the goal of providing them practice and experience with communicating their science via the Web.
Social Media: Hirsch has given many presentations outlining the benefits of incorporating social media into programs. She has created a resource page for scientists who want to get started with social media. She helps manage OSU SRP's social media strategy that includes a Facebook page , a very active Twitter account , a YouTube channel , and a Pinterest page (designed especially to share K-12 environmental health resources with teachers). She encourages people to try out one social media tool at a time, to think strategically about what they want to achieve through it, and to have an internal workgroup to support the learning curve.
What's next for Hirsch? She'll continue enhancing her Centers' social media, sharing resources and best practices, and offering training and ideas to help scientists be "where the people are" so they can better foster trust and have platforms for engagement, dialogue, and sharing. Be sure to follow her on Twitter ( @naomiadventure ) to see what's next with emerging technology!
Highlighted resources
- Web and Emerging Technology Resources for Scientists
This is the OSU SRP resource page Hirsch created to help scientists communicate with a broader audience.
- Oregon State University Superfund Research Program Research Translation Core
This is the home page of the OSU SRP RTC.
- Oregon State University Environmental Health Sciences Center
This is the home page of the OSU EHSC.
Denise Moreno Ramírez – Empowering communities through research translation and outreach activities
Denise Moreno Ramírez, M.S.
Community Engagement Coordinator for the University of Arizona Superfund Research Program and the Dean Carter Binational Center for Environmental Health Sciences
February 11, 2013
Denise Moreno Ramírez is dedicated to empowering communities affected by environmental contamination. In her work at the University of Arizona, she ensures that citizens have the information they need to make important decisions about their health. This focus on building the capacity of the community is part of the mission of the NIEHS Partnerships for Environmental Public Health program.
Moreno Ramírez first became interested in community engagement work in the mid-1990s when her hometown of Nogales, Ariz., was on the national news due to health effects (cancer and lupus clusters) as a result of environmental exposures. At this time, researchers approached her high school science club to help conduct a survey of community members concerning these effects. When her club never received the results of the survey and she became more aware of the environmental justices issues in her community, she decided to pursue a career in environmental science. In her job as community engagement coordinator for the University of Arizona Superfund Research Program (UA SRP) and the Dean Carter Binational Center for Environmental Health Sciences , she actively communicates with those affected by UA SRP research. Some recent projects include:
Our collaboration with promotoras is essential because they can effectively convey important environmental information to disadvantaged populations, which we would not necessarily encounter on a day-to-day basis. Promotoras approach community members as neighbors and friends, so they can readily provide a special type of outreach that is very grassroots-driven. - Denise Moreno Ramírez
Train-the-Trainer Module Program – funded by the U.S. Environmental Protection Agency (EPA) Border 2012
The UA SRP Community Engagement Core (CEC) recently created a train-the-trainer program for promotoras to complement outreach in their communities. This program was developed because promotora groups wanted access to training materials UA SRP had developed for local promotoras. The program features four modules – arsenic, environmental toxicology, pesticides, and fate and transport of contaminants – each of which contain background information and additional resources, hands-on activities, a PowerPoint presentation and multi-media materials, and real-time assessment tools. UA leveraged funding from its SRP grant to pilot the trainings, which were led by UA SRP professors, graduate trainees, and environmental promotoras. A number of training workshops were held, and the final workshop was led entirely by promotoras from the Sonoran Environmental Research Institute (SERI). The modules are now being finalized and will be published soon (online and hard copies).
Due to the success of the training program, the UA SRP received an additional grant (from UA) to add another module on risk assessment. The development of this module will be informed by the lessons learned during the pilot tests of the other four modules. It will also expand work with promotoras in the Border region who are working on broadening the scope to environmental themes.
Small Business Pollution Prevention – funded by the EPA
Another collaborative project of the UA SRP and SERI is promoting green business practices in the Tucson, Ariz. area. SERI initiated this project by mapping areas of concern, such as industrial odors, reported to them by community members. The UA SRP and others provided the promotoras with training and resources related to pollution prevention. With this information, the promotoras visited businesses and held workshops to address the community concerns and promote green practices. Some of the businesses the team has approached include printers; woodworking shops; dry cleaners; auto body, paint, and repair shops; and beauty and hair salons. As part of the visits and workshops, the team surveyed the businesses to identify their interest in green practices, knowledge gaps, and practices already in place. They followed up with the businesses later to assess practices that were implemented as a result of their visits. Moreno Ramírez said she has seen an improvement in the way businesses respond in the two years they've been conducting these visits. Additionally, she notes, "We were able to document reduced exposures and reduced uses of certain chemicals." The results have recently been shared at pollution prevention forums, and there are plans to put materials used online.
UA SRP Student Training – funded by the National Institute of Environmental Health Sciences
The CEC has started working with the Training Core to ensure that all new UA SRP students receive an experience in both community engagement and research translation. This program began two years ago and is now required for new students. Each student has a choice of short- or long-term community engagement and research translation related activities, such as attending a community meeting, creating an information sheet, or participating in promotora module trainings. Moreno Ramírez indicated that the program has been a success: "Many of the students say this was one of the most fulfilling experiences they had as SRP training core students because they were able to see how science is applied."
What's next for Moreno Ramírez? The next few months will be busy as she works with SERI to publish their work. She is also developing a community engagement project exploring new communication methods, which she plans on implementing in the Border region.
Featured websites:
- https://www.azpm.org/s/6253-finding-gold-in-going-green/
An interview with Moreno Ramírez and team members about the Small Business Pollution Prevention program
- http://www.clu-in.org/live/archive/
Moreno Ramírez's presentation – "Pollution Prevention Success Story: Partnering with Promotoras"
- http://superfund.pharmacy.arizona.edu/?q=node/673
A news story about the Train-the-Trainer program
- http://superfund.pharmacy.arizona.edu/content/informational-materials
Bilingual Information Sheets


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Interview with Ed Wallerstein, expert on circumcision
(15:01) The legal status of circumcision is many modern states is unclear. In the US, circumcision is not illegal, but some argue that the circumcision of a child violates general laws enacted for the protection of children. Recently (June 2012), a German court issued a ruling that circumcision without medical indication for religious reasons causes irreparable bodily harm, is a felony and goes against the interests of the child to decide later in life on his religious beliefs. This video gives a little background on circumcision by medical historian Ed Wallerstein, author of the 1980 book, "Circumcision, An American Health Fallacy".
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The U.S. began its withdrawal from Afghanistan in earnest by sending the first of tens of thousands of containers home through a once-blocked land route in Pakistan. We are joined by Lt. Col. Tony Shaffer (Ret.), Dan Steadman, Jeanette Bennett, Reyna Ramirez and Tom Cunningham.
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Attention Bridezilla's! I've just found a new wedding stresser for you, and it's a doozie! So, you and your planner have just left the final meeting with your catering manager. The meal has been dutifully pre-tasted and modified to your liking. You've confirmed the lighting and decor of the dining room, made sure that the flowers will be vibrant and open (but not too open too early), the cake will be moist (but not too moist), the champagne will be cool and crisp and served in 6 oz champagne flutes (and not the 4 oz. ) but…what about the bread? My GAWD, WHAT-ABOUT-THE-BREAD????
At American weddings, not much fuss is made about the bread served with dinner. It's pretty much the same basket of rolls that you get in finer restaurants from coast to coast. But in France, where NO meal is complete without a baguette, it's kind of a big deal. Big enough to warrant fairly detailed guidelines for choosing correctly when selecting your wedding menu, as outlined in this article on MarieClaire.fr. Here's my translated recap. Who knew?:
Wedding Bread
"The bread served during a wedding dinner is often practical, but is unfortunately not always of good quality. For a successful dinner, take care that the bread that you offer compliments the meal. To make sure that everything goes smoothly during your wedding dinner, pay attention to even the smallest of details, which are, despite everything, very important- including… The Bread" (emphasis is mine).
"Indeed, each dish has its bread of reference, and the dish will taste differently whether you serve it with pain de campagne, rye bread or leavened bread…"
The choice of the bread
"It's normally up to the caterer to decide which bread will be served with a meal. Usually, they will propose a more obvious choice, like baguettes or bastards (huh? I swear it says that! What does that mean???) Ask your caterer if you can taste all of the breads that he is proposing: keeping in mind that just because a bread is called "pain de campagne" doesn't mean that it will have the taste and quality of a pain de campagne….If you're not happy with your caterers choice of bread, you can always order a different one yourself elsewhere."
"If you want a specialty bread, like a fougasse aux gratons, originating in the Languedoc region, or Bretzels, from the Alsatian area, know that certain bakers will make them especially for you, if you order a large enough quantity of it. Don't hesitate to flip through caterer or bakery brochures to get an idea of what types of breads they provide."
And then the article goes on to describe the different breads: "Pain de Mie: Easy to slice, used for aperitifs, toasts and canapés. Pain de Seigle: Goes well with marinated fish, seafood, soft cheeses… Le Baguette or Batard (which does mean bastard, right?): Accompanies cold-cuts, red meats and raw veggies. Best seller in France, baguettes (or flutes, depending on what region you're in) is indispensable in any meal…)"
I found this article so funny and so charming because it illustrates another subtle cultural difference between French and American weddings. I'm imagining a French bride in New Jersey asking her American caterer to do a "bread tasting"…she'd probably be met with the same reaction as the American bride in Paris gets when she presents her French photographer with her "Wedding Photography Shot List" (a perfectly acceptable thing to provide in the States, but completely frowned upon by photographers in France.). Ah, well. Vive les differences!
- parisian events, May 2007


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By: Amanda Froelich,
True Activist.
We all have those memories, dozing off, forehead in hand in church while an insufferably long speech is made on the values of right and wrong. Minds on the parties to attend after the hour-long-session or things-to-do work to zone out the heartfelt preaching, and as soon as the last hymn ends (or before) you're long gone out of church.
Think you're not a spiritual person? "It's just not for me" you may think… the garbled notion of either devout nuns with bruised knees or new-age hippies dancing around a wildfire leave no room for you, a person of reason and deep faith in the scientific system. But if you really think what 'spirituality' means, you'll realize that different from 'religious', following a set mode of rules to attain 'enlightenment' or 'purity', spirituality is instead your personal relationship with the energy of the Universe, what you are and what is. This energy identified by Quantum Physics (source) could be God, or it could be the reflection of what you are, a reminder that everything technically is the same, therefore there's faith right there to believe in a higher purpose.
Regardless of your personal feelings on the subject, if you're still searching for an inkling that you may indeed be spiritual or are hard set against it, the following 12 signs may help you make up your mind:
1) You gaze at the stars.
Fascinated by something bigger than you are, the phenomenon of creation is as mysterious and beautiful as the stars. You can't help but feel awe and inspiration with your back pressed to a wavy mat of grass, staring into the light that truly is a reflection of the light within.
If you find stillness in the grandeur of the universe, this could be a signal of experiencing spirituality; you're connecting deeper to the truth within and calming the human ego.
2) You try to think happy thoughts.
Thoughts are energy – where attention goes, energy flows. If you're seeking to stay in a positive mindset, you're naturally already praying …to what or whom, you may not know. But without even knowing it, you're creating a message that's sent out into the energy of the Universe.
3) You offer a helping hand.
"Do unto others as you would have done unto you." Whether the Law of Abundance, the Golden Rule, or the message of Karma, this fundamental teaching has been passed down in many traditions and religions. The essence is to embody the principle that you and all are one, so the actions you inflict upon another will in return be cast unto you. Naturally a do-gooder? You're more connected than you think.
4) You feel serenity in Nature
Perfectly flowing, calming, and un-touched nature; many are called to empty their thoughts and emotions into the alkalizing environment where there is no judgment to answer to. Nature is healing on many levels and as creatures of this Earth, it only makes sense we seek to return to it. Toxic lifestyles and harsh thoughts serve no one, so the more you seek to clear your head and return to a positive mental and physical balance, the more you're naturally tuning up your own energy, or vibration, to the source. Who knew so much good could come from a hike in the woods?
5) You follow your guided Intuition
No need to label the 'voice' that speaks to you, but you know when to follow your gut in all types of situations. This is a clear sign you're following faith in something more than can be measured by science.
6) You're for the Truth…in all situations
"And the truth will set you free…" mentions John in the Bible. In this world which seems set on cheating neighbor out of financial means and merit, you're in opposition if you seek truth in all situations. Having integrity is mentioned in many traditions and religions, though, (Native American, Jewish Kabbalah, Judeo-Christianity Bible…) for reason. If you are truly to align yourself with the highest intention of this experience and draw in positive opportunities, life lessons, and individuals into your present, opting for the truth is optimal. Related to new-age philosophy of the Law of Attraction, your hard-wired passion to be the truth is a sign of your deep rooted spirituality.
7) You honor life
Albert Einstein said: "There are two ways of looking at the world, one as if everything is a miracle, and second, as if nothing is". Either way of perceiving the world influences your mindset and expectation for life. If you choose to honor this experience and be present with the true miracle that is life and the complexity required to create this universe, then you choose to also honor what you've been given. A single life in this viewpoint is magnificent, precious, and worthy of one's time. Likewise, your personal self requires appreciation of just how wonderful a reflection you are in this universe.
So if you're aware that this reality you're experiencing is a gift and you choose to honor yourself and be present, you are indeed engaging in a very spiritual perception.
8) You're appreciative of the smallest bug to the largest animal.
Buddhists recognize that the flowing life through all creatures – bugs to mammals, reptiles to birds – is equal, no matter size. This doesn't mean one who adopts this philosophy is vegetarian, there are many facets to that choice, but it does mean that one who adopts this viewpoint has a deeper appreciation for the life of all.
Native Americans were known to give thanks to the spirit of an animal after slaughtering it, bestowing blessings on the life they took and in return invoking grace from their actions. If you choose to honor even the tiniest bug on your computer screen such as you would respect a horse or another living individual, you are very well engaging your spirituality.
9) You recognize the power of forgiveness
It's a simple lesson that's been passed down, forgive thy neighbor, but has deeper purpose than most realize. More for the individual who needs to forgive, holding on to negative emotions and burying one's pain into past memories keeps the individual out of the now and disconnected from the source of all energy. Similarly, harboring bad energy and ill intentions can create energetic imbalances, later manifesting as physical symptoms according to Chinese Medicine.
To be in the flow and feeling your best, it truly is a good idea to let go of those whom have trespassed against you in the past, send them peace, and move on into the future. You may already be seeking to do this in your own life or asking for help from a friend, family member, or counselor. In this action, you are benefiting your spirituality, even unknowing, because it will beneficially impact your life.
10) You strive to detach from Drama
Gossip, worry, stress, and violence among many lower-vibration patterns keep one wrapped up in the ego, away from the true self, and more importantly, away from more fulfilling activities and the source of all energy. In the "Celestine Prophecy", it is mentioned that 2,000 years ago the Mayans foretold that humans of this age would wake up to the fact that they are energetic beings, and engaging in lower energy forms of vibration is literally sucking the energy out of others.
Ever feel drained when you're around an individual who wants to dump their problems on you, mope, intimidate, or interrogate you? This is an example of an energetic vampire, and a clear picture of what happens when one is not connected to the true source of Energy, which you could call God.
If you're naturally seeking a way out of dramatic settings and looking for higher energy activities that leave you feeling restored, refreshed, and happy, you're naturally calling spirituality into your life.
11) Travel is appealing
Human life is experience to better understand and reflect the many contrasts of divinity, sage's say. So if your heart is passionate for travel, in a way you feel called to experience more and gain fluent contrast of this world while observing the intricacies it holds. Whatever reason you feel guided to venture to unknown lands, to you it's a calling which resonates in a place which cannot be placed, a personal passion you follow.
An example of how this shows your inherent spirituality is you seek to experience even more reflection of the cosmos and in example gain more fulfillment from all you are a part of.
12) You have a heart of humor
The three rules of the universe, some say, are Change, Paradox, and Humor. (Way of the Peaceful Warrior) Life is a big ball of confusion, mystery, amazing-ness, and sometimes humility, but it all depends on how you look at it. The most important lesson psychologists and scientists are beginning to find out is that you are in control of your mind. You are more than your thoughts, but by choosing to change your focus and what you dwell on, you start to see things a bit differently. (Wayne Dyer). In effect this allows perception to change, and if you can switch your viewpoints from what you were taught as a young individual, you can illuminate new possibilities and truly engage in a futurist mindset, no limits to the potential of the human intellect or this world.
Embracing the humor of life, the many shades that this world casts, you are again, unknowingly, growing more into your spirituality.
Not by any means are the signs that you are unknowingly spiritual limited to these twelve, nor does this mean you should go jet to the nearest convent (unless that's supremely appealing to you)… instead, pick and choose what you wish to take from this article. If it's inspiring to think that deep down you already show the signs of a connected human being, search for more.
It could be opinion, but as energetic beings, you can't help but be spiritual to a point, as the incredibly amazing and difficult-to-comprehend matter of this universe is just as amazing as you.
Additional sources:
102 Responses to "12 Signs you may be Spiritual and Don't Even Know it."
I studied biology. I studied astronomy. I am amazed by stars but know that a feeling is not evidence of a creator. I never hurt living things if I can avoid it and know that I evolved. I don't pray to anything when I trust my gut. I lend a helping hand because I'm a member of an evolved social species. I love travel and exposing myself to different things because it's stimulating. There is no evidence of "something bigger". That's a catch phrase. I am in awe of existence because it's huge and complex and sublime. That's all I need to be in awe. I don't need to add the supernatural to make it inspiring. If you need spirits to be amazed, then you are missing the majesty of the stars. I'm definitely for the truth, and saying "the energy of the universe" is making a specious claim. We know what energy is. This article is unicorn-fantasy fluffy-speak. If you really valued truth you'd stop making unsupported claims. Peace be with y'all.
I do not claim to know everything, but deep down in in me i feel there is more to life than what it looks. Why we are here; who send us here and for what purpose? These are some of the questions that I need to seek their answers. That is The driving force behind my search for the truth. Science and other school of thought contribute to some of the answers, but i pray for revelation from the universal mind, which I call God, to provide me with the only answer.


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Despite reports, Colin Farrell not involved in street fight
By Michael Lewittes | 7:59 am, April 19th, 2010
"Farrell in London club brawl," screamed a headline in a post by the British OK!," which claimed "reformed bad boy" Colin Farrell was "embroiled in a brawl outside a London club" over the weekend.
The site noted that outside the famed Café de Paris nightclub, Farrell "got involved in a heated exchange with a fellow partygoer," and "the altercation threatened to turn violent when the other man lunged at Farrell, but his pals managed to pull the Irish actor away and avoid it turning into a full-blown fight."
Other sites had similar headlines including, "Colin Farrell Turns Drunken Street Fighter In London," and even showed photos of the star allegedly getting into fisticuffs.
While Farrell has successfully battled the bottle, he did not battle anyone in London.
The person pictured in these inaccurate accounts is not Farrell, who was nearly 5,500 miles away in Los Angeles.
Follow @GossipCop on Twitter for accurate celebrity news!
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Basal rate
|This article includes a list of references, but its sources remain unclear because it has insufficient inline citations. (February 2013)
In biology, basal rate is the rate of continuous supply of some chemical or process. In the case of diabetes mellitus, it is a low rate of continuous insulin supply needed for such purposes as controlling cellular glucose and amino acid uptake. Together with a bolus of insulin, the basal insulin completes the total insulin needs of an insulin-dependent person. An insulin pump and wristop controller is one way to arrange for a closely controlled basal insulin rate. The slow-release insulins (e.g., Lantus and Levemir) can provide a similar effect.
In healthy individuals, basal rate is monitored by the pancreas, which provides a regular amount of insulin at all times. The body requires this flow of insulin to enable the body to utilize glucose in the blood stream, so the energy in glucose can be used to carry out bodily functions. Basal rate requirements can differ for individuals depending on the activities they will carry out on that particular day. For example, is one is not highly active on a certain day, they will have a decreased basal rate because they are not using a lot of energy. On the other hand, basal rate increases dramatically when an individual is highly active.[1]
Basal rates often even vary from hour to hour throughout the day. For example, one's insulin needs vary from activity to activity. Activities, such as sports, housework, shopping, gardening, tidying the house, and consuming alcohol all require a lowering in basal rate. These activities all require energy and, thus, use glucose; basal rate must decrease in order to keep glucose levels high enough to be used as fuel for the body. On the other hand, fevers, having a cold, taking a nap, taking cortisone-containing medication, and moments of excitement call for different basal rate needs. In these instances, the body has an overwhelming supply of glucose, and glucose levels need to decrease. To induce this decrease, basal rate needs to increase to increase insulin release to absorb some of the excess glucose from the blood stream.[2]
Those with diabetes mellitus must be aware of their basal rates and regulate them accordingly. Basal rate can be raised and lowered through various methods. For example, individuals with diabetes mellitus often use an insulin pump to supply an increased amount of insulin into the blood stream. Those with diabetes also may eat carbohydrates or sugars to account for low blood sugar. However one monitors and regulates their blood sugar levels and basal rates, it is important to make changes gradually. An initial lowering in basal rate should be no more than 10% of the original. After the initial lowering point, one must note the factor by which one's blood sugar changes. If blood sugar levels decreased, one should lower their basal rate by 20% next time. If their blood sugar levels increased, a lowering of 10% was too great, and one should not lower their basal rate at all next time. If blood sugar levels remained relatively constant, a drop in basal rate of 10% was sufficient.[3]
Just as the action to change basal rate should be gradual in nature, the actual response from changing basal rate does not happen instantly. A change in basal rate is felt around two hours after the action is done. This is especially important for those with diabetes to be note, as it affects when they should act to monitor their basal rates. For example, if there is a particular time in the day when one notices a problem with blood glucose levels, they should act to change their basal rate accordingly two hours prior to hen the problem was previously experienced.[4]
External links[edit]
- Insulin Pump Terminology: Basal Rates
- Information on the varying basal rate needs throughout the day
- General guidelines on changing basal rate
- Further guidelines in changing basal rate


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Carpet Cleaning Raleigh, NC - Chem-Dry of Wake County
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Chem-Dry is the world's largest carpet cleaning company, with more than 4,000 locations across the globe. Trust your carpets and upholstery to Chem-Dry.
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Trapped Above Ground
In Nashville, our legendary music, comfort food, white lightning, and hallowed spaces are best experienced together. Join us as we stop to savor all of the above every Wednesday from 8 p.m. until 10 p.m. at historic Lower Broadway's Acmemore…Guthrie Trapp's True Grit — In Rolling Stone
Hey friends! I'm honored to have the first feature interview on Rolling Stone.com!! Please check it out! Thanks to D'Addario and Matt Diehl for making this happen. Thanks again for all the support! GT