Refugees and new immigrants arriving in the United States (U.S.) often encounter a multitude of stressors adjusting to a new country and potentially coping with past traumas. Community gardens have been celebrated for their role in improving physical and emotional health, and in the Twin Cities of Minnesota, have been offered as a resource to immigrants and refugees. The purpose of this study is to present a mixed method evaluation of a refugee gardening project hosted by area churches serving primarily Karen and Bhutanese populations. Quantitative data were obtained from early and late season surveys (44 and 45 % response rates, respectively), and seven focus groups conducted at the end of the season provided qualitative data. Although few gardeners (4 %) identified food insecurity as a problem, 86 % indicated that they received some food subsidy, and 78 % reported vegetable intake increased between the early and late season surveys. Twelve percent of gardeners indicated possible depression using the PHQ-2 scale; in focus groups numerous respondents identified the gardens as a healing space for their depression or anxiety. Refugee gardeners expressed receiving physical and emotional benefits from gardening, including a sense of identity with their former selves. Gardens may serve as a meaningful health promotion intervention for refugees and immigrants adjusting to the complexity of their new lives in the U.S. and coping with past traumas.

Leptospirosis is a zoonosis of global distribution that affects tropical and temperate areas. Under suitable conditions, Leptospira can survive in water and soil and contribute to human and animal infections. The objective of this study was to describe the presence of pathogenic Leptospira in peri-domestic water samples from rural households in southern Chile. Water samples, including puddles, containers, animal troughs, rivers, canals, and drinking water were collected from 236 households and tested for Leptospira using a PCR assay targeting the lipL32 gene. Evidence of Leptospira presence was detected in all sample types; overall, 13.5% (77/570) samples tested positive. A total of 10/22 (45.5%) open containers, 12/83 (14.5%) animal drinking sources, 9/47 (19.1%) human drinking sources, and 36/306 (19.3%) puddles tested positive. Lower income (OR = 4.35, p = 0.003), increased temperature (OR = 1.23, p < 0.001), and presence of dogs (OR = 15.9, p = 0.022) were positively associated with positive puddles. Increased number of rodent signs was associated with positive puddles in the household (OR = 3.22); however, only in the lower income households. There was no association between PCR positive rodents and puddles at the household level. Results revealed the ubiquity of Leptospira in the household environment and highlight the need to develop formal approaches for systematic monitoring.

Abstract. Rodents are well-recognized reservoirs of Leptospira, contributing to its maintenance in endemic areas and playing a role in the public health risk associated with the infection. This study sought to provide some insights into rodent populations from Chile and their Leptospira carriage. In total, 393 rodents were trapped in 177 households. Higher rodent counts were associated with year 2 of the study, rainfall, and number of rodent signs. There was an inverse correlation with the number of cats. The number of rodents was higher in villages compared with slums (rate ratio = 3.23) but modified by average household age. Eighty rodents (20.4%) tested positive for Leptospira: 19.7% on the farms, 25.9% in villages, and 12.3% in the slums. Prevalence was 22.5% in Mus musculus, 20.7% in Rattus rattus, 21.1% in wild rodents, and 10.3% in R. norvegicus. Seasonal and temporal effects were the major determinants of Leptospira infection in rodent populations.

BackgroundLeptospirosis is a neglected zoonosis affecting animals and humans caused by infection with Leptospira. The bacteria can survive outside of hosts for long periods of time in soil and water. While identification of Leptospira species from human cases and animal reservoirs are increasingly reported, little is known about the diversity of pathogenic Leptospira species in the environment and how surveillance of the environment might be used for monitoring and controlling disease.Methods and FindingsWater samples (n = 104) were collected from the peri-domestic environment of 422 households from farms, rural villages, and urban slums participating in a broader study on the eco-epidemiology of leptospirosis in the Los Rios Region, Chile, between October 2010 and April 2012. The secY region of samples, previously detected as pathogenic Leptospira by PCR, was amplified and sequenced. Sequences were aligned using ClustalW in MEGA, and a minimum spanning tree was created in PHYLOViZ using the goeBURST algorithm to assess sequence similarity. Sequences from four clinical isolates, 17 rodents, and 20 reference strains were also included in the analysis. Overall, water samples contained L. interrogans, L. kirschneri, and L. weilii, with descending frequency. All species were found in each community type. The distribution of the species differed by the season in which the water samples were obtained. There was no evidence that community-level prevalence of Leptospira in dogs, rodents, or livestock influenced pathogen diversity in the water samples.ConclusionsThis study reports the presence of pathogenic Leptospira in the peri-domestic environment of households in three community types and the differences in Leptospira diversity at the community level. Systematic environmental surveillance of Leptospira can be used for detecting changes in pathogen diversity and to identify and monitor contaminated areas where an increased risk of human infection exists.

Objectives: This study explores associations between job satisfaction, career flexibility, and burnout among physician assistants (PAs) in Minnesota. Methods: A survey comprising the Maslach Burnout Inventory (a validated burnout tool) and original questions was emailed to PAs practicing in Minnesota. Spearman rank correlation coefficients were used to assess associations between variables and burnout. Results: PAs (response rate = 31.4%, N = 312) reported moderate levels of burnout. Working in primary care and being female were independently associated with higher rates of burnout. Satisfaction with one's career and one's current position were both high (95.9% and 87.8%, respectively) and independently associated with lower rates of burnout. Conclusions: Despite high levels of career and job satisfaction, PAs in Minnesota report moderate levels of burnout, particularly women in primary care. Further research should examine a broader population and the effect of burnout on patient care.