Working along the Continuum: North Carolina's Collaborative Response to COVID-19 for Migrant & Seasonal Farmworkers.

North Carolina employs 78,000+ migrant/seasonal farmworkers (MSFWs) annually. Arrival/departure dates are crop and weather dependent. MSFWs may be employed by a grower or a farm labor contractor (FLC). Like farmworker housing, FLCs may be registered or unregistered. Primary care or enabling services are provided by the NC Farmworker Health Program or community health centers that receive dedicated federal funding for MSFWs. The arrival of NC's growing season, MSFWs, and COVID-19 brought unforeseen challenges even to those experienced in caring for MSFWs. Challenges include congregate activities, consistency/accuracy of COVID-19 related communications, availability of alternate housing, barriers to testing and contact tracing, lack of internet connectivity in farmworker housing and insufficient personal protective equipment. Challenges are discussed in no order of occurrence or level of importance as many are inter-related. To meet these challenges, a migrant health and housing workgroup was convened. Members include the NC Department of Labor-Agricultural Safety and Health Bureau, NC Department of Health and Human Services - Communicable Disease Branch and NC Farmworker Health Program, NC Community Health Center Association and NC Agromedicine Institute. Members work collaboratively along the continuum from local to state levels and across agencies and communities to facilitate strategies to address COVID-19 challenges. Implications exist for practice, research and policy including testing of MSFWs on arrival with a 14-day quarantine before moving to assigned farm, a "strike team" to do on-farm tests for workers in the event of a positive case or exposure; and, research on COVID-19 outbreaks and impact of telehealth on MSFWs wellbeing.

The Effects of a Health Promotion Program on Rural, West Virginia Adults.

This health promotion project is a 12-week program for adults in a rural West Virginia community with a body mass index (BMI) of 25 or greater. The goals of this project were to facilitate learning through modules focusing on activity and nutrition, increase knowledge of healthy activity and nutrition, and improve weight and BMI. Each 12-week session provided evidenced-based information regarding obesity, physical activity, and nutrition. Participants completed pre- and postprogram and 1-month follow-up survey/questionnaire. Results were compared for changes in activity, nutrition, and BMI. The program resulted in positive changes: increase in activity and nutritional consumption and a decrease in BMI.

Effects of repeated deep inspirations on recovery from methacholine-induced airway narrowing in normal subjects.

BACKGROUND: A single deep inspiration (DI) is known to be a potent bronchodilator but it is not known if repeated DI can accelerate sustained recovery from bronchoconstriction. METHODS: We induced sustained bronchoconstriction using increasing concentrations of nebulized methacholine (Mch) during tidal breathing and assessed airway narrowing by measuring respiratory resistance (Rrs) using forced oscillation in six healthy subjects. On separate days we examined the effects of DI every 3 minutes and of prohibition of DI on recovery of Rrs for 30 minutes after the end of Mch nebulization. RESULTS: Bronchoconstriction (Rrs approximately 150% above baseline) was induced. DI during recovery had a transient bronchodilator effect but no cumulative effect. At 30 minutes after end of nebulization (and 2 minutes after the last DI) Rrs was 87% above baseline compared to 93% above baseline when DI was prohibited. CONCLUSION: Recovery from induced bronchoconstriction with methacholine was slow (approximately 2%/min) and not accelerated by frequent DI.