Intersections of climate change, migration, and health: experiences of first-generation migrants from Latin America to the Atlanta-metropolitan area.

Climate change is an important driver of migration, but little research exists on whether migrant communities in the U.S. identify climate change-related factors as reasons for migrating. In 2021, we conducted a multidisciplinary, collaborative project to better understand the nexus of climate change and immigrant health in the Atlanta area. This paper presents one arm of this collaboration that explored both the role of climate change in decisions to immigrate to Georgia and the ways that climate change intersects with other possible drivers of migration. First generation migrants from Latin America were recruited primarily through CPACS Cosmo Health Center and were invited to participate in an intake survey and an in-depth interview. Results were analyzed using descriptive statistics and thematic analysis. Findings suggest that while participants may not have explicitly identified climate change as a primary reason for migration, in both surveys and in-depth interviews, participants reported multiple and intersecting social, economic, political, and environmental factors that are directly or indirectly influenced by climate change and that are involved in their decisions to migrate. The narratives that emerged from in-depth interviews further contextualised survey data and elucidated the complex nexus of climate change, migration, and health.

Evaluating strengths and opportunities for a co-created climate change curriculum: Medical student perspectives.

Introduction: Medical trainees are front-line workers in our worsening climate and health crisis. A movement is underway to teach medical students essential climate change and health content. Few evaluations of climate and health curricula exist to support ongoing curricular development, innovation, and improvement. This study explores student perspectives on climate change and health content and delivery post-implementation of a climate change and health curriculum that was co-created by students and faculty and integrated across 16 months of pre-clinical coursework at Emory University School of Medicine. Methods: The authors conducted focus groups with the inaugural cohort of students to receive the climate and health education content at the conclusion of their preclinical curriculum. The focus groups elicited student perspectives across four domains: (i) prior perceptions of climate change and health, (ii) current attitudes about climate change and health, (iii) reflections on the existing curriculum, and (iv) opportunities for the curriculum. In this qualitative evaluation, the authors coded focus group transcripts using an inductive content analysis approach. Results: Out of 137 eligible students in the cohort, 13 (9.5%) participated in the focus groups. Implementation strategies that students valued included contextualization and integration of climate content within existing topics and student representation through the co-creation process. Students recommended bolstering small group sessions and case-based learning to build relevant history and physical examination skills as well as creating interprofessional and community-based opportunities. Discussion: This evaluation offers in-depth student perspectives of our climate and health curriculum. Opportunities exist to synergize climate and health education with broader transformations in medicine toward health promotion and sustainable, climate-ready healthcare. From the input of focus groups, the authors derive a framework for strengthening and extending curricular content.

Coronavirus Disease 2019 (COVID-19) Prevalences Among People Experiencing Homelessness and Homelessness Service Staff During Early Community Transmission in Atlanta, Georgia, April-May 2020.

BACKGROUND: In response to reported coronavirus disease 2019 (COVID-19) outbreaks among people experiencing homelessness (PEH) in other US cities, we conducted multiple, proactive, facility-wide testing events for PEH living sheltered and unsheltered and homelessness service staff in Atlanta, Georgia. We describe the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and associated symptoms, and review shelter infection prevention and control (IPC) policies. METHODS: PEH and staff were tested for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR) during 7 April-6 May 2020. A subset of PEH and staff was screened for symptoms. Shelter assessments were conducted concurrently at a convenience sample of shelters using a standardized questionnaire. RESULTS: Overall, 2875 individuals at 24 shelters and 9 unsheltered outreach events underwent SARS-CoV-2 testing, and 2860 (99.5%) had conclusive test results. The SARS-CoV-2 prevalences were 2.1% (36/1684) among PEH living sheltered, 0.5% (3/628) among PEH living unsheltered, and 1.3% (7/548) among staff. Reporting fever, cough, or shortness of breath in the last week during symptom screening was 14% sensitive and 89% specific for identifying COVID-19 cases, compared with RT-PCR. Prevalences by shelter ranged 0-27.6%. Repeat testing 3-4 weeks later at 4 shelters documented decreased SARS-CoV-2 prevalences (0-3.9%). Of 24 shelters, 9 completed shelter assessments and implemented IPC measures as part of the COVID-19 response. CONCLUSIONS: PEH living in shelters experienced a higher SARS-CoV-2 prevalence compared with PEH living unsheltered. Facility-wide testing in congregate settings allowed for the identification and isolation of COVID-19 cases, and is an important strategy to interrupt SARS-CoV-2 transmission.

The Unique Role of Medical Students in Catalyzing Climate Change Education.

Climate change is a well-recognized threat to human health with impacts on every organ system and with implications for disease processes across subspecialties. Climate-driven environmental exposures influence the pathophysiologic underpinnings of disease emphasized in the pre-clinical years of medical school. While medical schools are beginning to offer climate change and health electives, medical education is lagging in providing fundamental climate-and-health content to adequately prepare the next generation of physicians for the challenges that they will face in the provision of healthcare and the prevention and treatment of disease. This perspective piece highlights the unique role of medical students in catalyzing the incorporation of climate content into the pre-clinical medical school curriculum and provides topics for disseminated curricular integration with the concepts emphasized in the pre-clinical years of medical education.

Antibiotic That Inhibits the ATPase Activity of an ATP-Binding Cassette Transporter by Binding to a Remote Extracellular Site.

Antibiotic-resistant strains of Staphylococcus aureus pose a major threat to human health and there is an ongoing need for new antibiotics to treat resistant infections. In a high throughput screen (HTS) of 230 000 small molecules designed to identify bioactive wall teichoic acid (WTA) inhibitors, we identified one hit, which was expanded through chemical synthesis into a small panel of potent compounds. We showed that these compounds target TarG, the transmembrane component of the two-component ATP-binding cassette (ABC) transporter TarGH, which exports WTA precursors to the cell surface for attachment to peptidoglycan. We purified, for the first time, a WTA transporter and have reconstituted ATPase activity in proteoliposomes. We showed that this new compound series inhibits TarH-catalyzed ATP hydrolysis even though the binding site maps to TarG near the opposite side of the membrane. These are the first ABC transporter inhibitors shown to block ATPase activity by binding to the transmembrane domain. The compounds have potential as therapeutic agents to treat S. aureus infections, and purification of the transmembrane transporter will enable further development.