You know you're in Brownsville, TX when:

1. You never know what language you will use at the grocery store check out, maybe Spanish, maybe English, yet probably Spanglish
2. All the local restaurants serve tacos.
3. Another country is closer than another state.
4. You can only drive one way on the highway (North).
5. You live one mile from four different border crossings.
6. You drive past multiple “you may not bring firearms into Mexico” signs while only trying to drive home.
7. There are both “hump”s and “dip”s in the road, some are marked... most are not.
8. Border Patrol vehicles are more common than Police vehicles.
9. The Texas flag is flown at the same level as both the USA and Mexico flags.
10. People have fence sales instead of garage sales.
11. Going to “the island” means going to the beach at South Padre Island.
12. You can pay in pesos or dollars at the grocery store.
13. 100+ degree, 99% humidity weather is normal.
14. Most radio stations are in Spanish, and even if it’s an English station, they still play Spanish music.

Country Dancing, Texas style

This past Friday I went with a group of friends to a Country Bar "in the boonies" outside of Brownsville, it's called Winks. I'd been told that Texas had a bunch of cowboys, but had thus far only seen one, but this is where all of the cowboys hang out. The culture at this bar was really different than much of the culture in Brownsville. I guess this is Texas culture in comparison to Border culture (a strong mix of Mexican and Texan culture). I love dancing, I do ballroom dancing, salsa, meringue, bachata, cumbia, and every once and a while I even do a couple of line dances, but country dancing is way more than line dancing!!

They do the 2 step, the 16 step, the country cha cha, the country polka, the east coast swing (jitterbug), the west coast swing, and then line dances on top of that!! I had such a fun time learning a couple of new dances and even got to show off my swing dancing skills on a relatively empty floor, because it's one of the least known dances among people at Winks. Too bad I didn't find out about this place a couple of months ago, I would have been able to return to Michigan as a Cowgirl country dancer :)

Where is Superman?

With the 100+ degree temperatures down here in the Valley, you'd imagine there would be many an occasion where eating ice cream sounds like the best thing ever!! So I figured that I wouldn't be able to find Mackinac Island Fudge or Traverse City Cherry, two great Michigan flavors, but there would be Superman ice cream.

Yes yes, I know, Superman flavor is for little kids, all the fun colors and weird flavors. But you can't deny that every once and a while Superman sounds like the best idea, or at least Blue Moon, if you want to pretend that you're a bit more of an adult. :) Guess what!?!? No one down here has ever even heard of Superman or Blue Moon, what they ate as I child I do not know, but seriously who hasn't even heard of Superman. After scowling the grocery store, sure that they had to have something with all of the colors and odd flavors of Superman, just maybe under a different name, but no, they don't have it down here, so I came home and did some research on it. And guess what I found...



Superman and Blue Moon ice cream are Michigan things: created, made, and enjoyed all in Michigan, no where else. So where in Michigan you ask... "The best answer I’ve found so far comes from Jim Karnopp, owner of Ypsilanti’s Cafe Luwak, who says he’s pretty sure the original recipe came from Stroh's, the famous (now defunct) Detroit brewery, who began producing ice cream during prohibition." Who knew?

Presentation Day

So this week for the Monday series all of the interns had to present what they had been working on all summer. So here's what I presented:










I found out right after this presentation that there had been some issues in recruiting people for this program, so instead of the intervention being run on the dates listed above it will be run later in September/October.

So with a little over three weeks left of my internship, I've started two new projects, focusing one evaluation. One will be looking at some of the data collected at the Farmer's Market here in Brownsville. This data will be used as baseline data to convince funders of the potential that this market has in this area and the need for their continued support.

The second new project is policy based. The short of a long story is the Southern Texas Counties were given a large amount of money (after they went through the legislature to get it) that goes into action on September 1st. The counties get money for the next two years and is to be used for community health in these counties. Some counties have proper programs already set up to do community health and others will be starting up these programs. Cameron County will be at the forefront of this action, since there is a community-involved School of Public Health in the county. Not only does there need to be programs set up, there also has to be ways to measure how the money is being used in relation to community health--this is where an evaluation program comes in. Within the next year, individuals will have to begin reapplying for the state grant.

Dean's Talk

The Dean at the University of Texas School of Public Health at Brownsville is Dr. Joseph McCormick. He spoke on Monday about "The Origin of the HIV Epidemic." Dr. McCormick was involved in the early 1980's with the Center for Disease Control (CDC) as part of their AIDS studies. After his involvement in the first African investigation in Kinshasa where they found that the number of partners highly correlated to AIDS. Also while in Africa, he discovered the long history of disease that had been in primates which he connects to the start of AIDS. Primates were hunted for meat and sold in bush meat markets. Dr. McCormick proposes that as humans hunted, cut, and handled monkey meat, a primate disease was passed to humans.

This infection still wouldn't create the HIV/AIDS that we have today. Due to the large diversity and different tribes, there was not much contact between groups. Urbanization in the 1980's created lifestyle changes that allowed for easy spread of HIV/AIDS. Multiple wars also hightened HIV/AIDS and allowed for the epidemic we have now.

Dr. Joe McCormick and his wife Dr. Sue Fisher-Hoch wrote the book "Level 4: Virus Hunters of the CDC" from there many experiences in Public Health. All of the interns here are reading the book and learning about all of the cool things these two have done.

Dodge Ball!!

The Recreation Center here on campus had a dodge ball tournament this past Friday. Since physical activity is emphasized so much at the School of Public Health, the interns all decided that we should create a team and compete. Our team efficacy was low, having not played dodge ball in years (probably not since Junior High for all of us), but we were up for the challenge and just said that we would be happy if we stayed in for longer than 20 seconds. And we did!!! We actually took 2nd in the whole competition, 1st place got a t-shirt so we were fighting for that in our last round. But the opponent team had clearly more experienced dodge ball players. Here's some photos though for your enjoyment. :)

Our Fearless Dodge Ball team-- the "Level 4 Virus Hunters"

Waiting for the whistle

Celebrating a victory!! Woohoo

Why Brownsville?

Monday's lecture was back to behavioral science, yay!! This lecture by Dr Jennifer L. Gay focused on why she decided to come to Brownsville and what projects she's working on here. Most of her work here at the University focuses on obesity and exercise. Studies on physical activity have shown decreases in cancer rates, diabetes rates, depression and increased mood.

Some of Dr. Gay's research has shown that 26.1% or above of Texan's report not doing any physical activity in the past month. In Michigan the rates are 21.3-23.2%. Only 1/3 of kids are reported being physically active, this leads quite directly to the 80% of adults who are obese. This is a national issue, with the top 3 reasons people die being due to tobacco use, poor nutrition, and a lack of physical activity.

Although it's easy just to tell someone "go exercise" it's not as simple to actually follow through. The Ecological Model shows there are intrapersonal, interpersonal, community, institutional, and policy levels to any change. Specifically motivation, social support, and a proper built environment. Here in Brownsville, factors against a proper built environment include extreme heat in the summer, stray dogs on the streets, a lack of sidewalks, and improper use of bike lanes (drivers use them as right turn lanes here).

Dr. Gay also does some research with youth on their perceptions of their bodies "not fitting into the various athlete categories" right before puberty and the decrease in physical activity that also occurs around this time.

At the rate obesity has been growing for the past few years, by "2030 all Americans will be obese if we don't do anything!" This leaves so much room for individuals in public health to work.

An interesting quote: "With the invention of the washing machine, we have engineered physical activity out of our lives."

Independence Day--Brownsville Style

The July 4th weekend was a lot of fun. The one and only Jessica Schulte came to visit for the weekend and to experience Brownsville for herself :) We had a great time, discovering a new beachfront.

You follow a road here, called Boca Chica, going east and then after quite a while you see a sign that says road ends in 1500 feet and then, boom the road ends (just like it said it would, haha). We attempted to drive a bit on the sand like the other vechicles did, but then realized it wasn't going to happen when we saw our friends pushing their 4-wheel drive vechicle and we only had 2-wheel drive... not good. Unlike the Island, there's nothing around, so it's more of a private beach, would be great for beach camping.



Later that evening we went to the Brownsville Sports Park for food, fireworks, and fun. :) There was the Texas Army National Guard 36th Infantry Division Band playing marches for the first while and then as it got dark, fireworks were launched off to patriotic, country music, in true Texas style. Afterwards a hip-hop/cumbia group called Kingz-1, formally called the Kumbia Kings, played a concert.



It was a unique evening of American/Hispanic celebration, in true Brownsville-style.

Michigan Mitten, how do the other states live?

Everyone who lives in Michigan knows just how cool and handy, only slight pun intended, using your hand(s) as a map of the state is.
For instance, home for me is on the left side of my palm, and I go to school over in the crease of my thumb and palm, Mackinac Island is at the tip of my middle finger, and Traverse City is over by my pinky finger :)

Here’s some Texans who wish their state was as cool as Michigan, thanks Katie!!



Enjoy!! More updates to come soon!

101 degrees

Yes you read that correct, we went into the triple digits this week. Hot stuff!!

This past week has been fairly busy, two other interns and I moved into a house that we’re house sitting at. I went from this to this . Here are some other photos from the house. I think my favorite room is the kitchen, we can actually cook meals, no more microwave meals, yay!! Plus they have all of these cookbooks from around the world, so there's lots of different things to try. And the three patios are awesome, they're all screened in. The only stipulations that the owners have are that we water their plants and trees (which you can see there are a lot) and that we don’t turn the A/C below 80 degrees. :(

Monday morning in Matamoros, Mexico makes for a nice alliteration and a made for a fun morning. This Monday I went with two UT SPH staff to do a focus group with a group of women in a colonia at the border. The television station that gives the Tu Salud Si Cuenta program free airtime, asks the University to do these focus groups. We focused on participants opinions of canal siete and other television channels that they like/dislike and why they feel the way they do. We showed clips of the Tu Salud Si Cuenta segment and asked for their thoughts of the content, the set, and the people within the clips. We also asked a few questions about the radionovela program that we’ll be starting this month. It was really interesting talking with all of the women and hearing their thoughts on the television clips and radio episodes and how their lives and their family’s lives relate or don’t relate to the media around them. They were extremely open with us.

Monday afternoon, as a part of the lecture series, Dr. Loubna Tazi spoke about Molecular Epidemiology of Mycobacterium tuberculosis in Casablanca, Morocco. There are 14 million deaths due to infectious diseases including HIV/AIDS, TB, and Malaria. There are two different clarifications of TB, MDR (multiple drug resistance) and XDR (extensively drug resistant). MDR-TB is resistant to two of the first-line drugs, where as XDR-TB is resistant to all first-line drugs (3) and at least one secondary-line drug. In Morocco there are 30,000 new cases yearly, 1/5^th of these cases are in Casablanca. Dr. Tazi has made a strong report for the ancient orient of TB in Morocco. There was lots of biology to get to this point, which I can’t exactly say I understood. However, I can say that it’s a good thing that some people enjoy and understand biology. There’s a lot of work in the field to be done and this type of work is not exactly cut out for the entire population, so it’s a good thing those involved really enjoy it. Good news though, we go back to behavioral health topics on Monday, yay!!

Howdy!

Hey y'all

I had my first encounter with a Texan cowboy on campus today, he had the hat, the boots, and even said "howdy" to me. :)

Yesterday was the third part of the Monday Lecture Series. Dr. Blanca Restrepo spoke on the correlation between Diabetes and Tuberculosis. Texas has 10/100,000 TB cases and the state of Tamaulipas in Mexico has 45/100,000 TB cases. TB is a disease without borders and needs to be controlled on both sides of the border. The Rio Grande River may provide a boundary between the US and Mexico, but it doesn't prevent the spread of disease.

A few TB stats:
-there are 8.8 million new TB cases a year;
-every 19 seconds someone dies from TB;
-1/3 of the world population is infected with TB.

Diabetes is the first non-contagious disease to be given a pandemic level title. Diabetes occurs across the world and has only hightened due to urbanization. Movement from rural to urban creates health altering lifestyle changes. Individuals who used to farm and live from the crops off their land are now purchasing food in grocery stores. Also individuals who used to depend on walking as their key mode of transporation now have urban transportation.

Dr. Blanca Restrepo's research shows that Diabetes is a contributing risk factor to TB. She is researching whether individuals with Diabetes are more infectious and also if individuals with Diabetes are more prone to TB. An interesting finding is that individuals with Diabetes and TB are more likely to have Multiple Drug Resistant TB, but not because they're not compliant with drug therapy, there's something unique to Diabetes.

I understood everything thus far, then Professor Restrepo started talking about flurochrome, primer, loop, stem, target, PCR, mutation, strains, isolates, beacons, CAC, TTT, GTC, and GAG... I got lost somewhere amongst all of the microbiology terms and figures.

By the end, all I got was "those who are naive are more likely to be susceptible to TB." Hum, I think I missed something, there were some letters before "naive," but maybe this is why health education is so important. So there ya have it, the correlation between Diabetes and TB proves the importance of health education, ta-da!! :)

This lecture in combination with the diabetes class for patients that I've been attending on Tuesdays at the Health Center have made me realize the extreme importance of understanding, preventing, and maintaining diabetes!

Tu Salud ¡Sí Cuenta!

Your Health Matters!

Today's Monday afternoon lecture was on the Community Based Participatory Research (CBPR) method. "CBPR focuses on involving researchers and community representatives in all phases of a research process. The joint effort engages community members, employs local knowledge in the understanding of health problems and the design of interventions, and invests community members in the processes and products of research. In addition, the collaborative is invested in the dissemination and use of research findings to improve community health and reduce health disparities." [CDC-PRC Program, 2007] Working with the community, the two major issues that were raised as a part of were physical activity and healthful eating.

Brownsville, TX is a very unique community. In the city I grew up in and many other cities, individuals going door to door is generally not receptive in the community. At home, people going door to door are either Avon sales ladies, the newspaper girl asking for her dollar, or religious groups such as Jehova's Witnesses. For the first two groups you may answer the door to say thank you but you're not interested and for the last group, at least in my home, we'd turn off the lights and pretend no one was home. This community is different though, much of the door to door interactions are accepted here which makes for a great health education method. Promotoras (community health promoters) go out into the community with various health materials as a part of the Tu Salud ¡Sí Cuenta! project.

Tu Salud ¡Sí Cuenta! is involved beyond the door way also. They run television health segments, radio novelas, newspaper articles in the Brownsville Herald, and monthly newsletters that are passed out door to door as well as at health centers. All of these materials include healthier food options, ways and locations to exercise, community role models, and public health professions and experts.

Here's some health stats that has come out of the research that's been done here... this shows how much there is to do with health here, and if these problems are now, that means things will more than likely get worse for a generation before they'll get better. 37% of the U.S. average is obese compared to 52% obese in Cameron County. The county has a 9% extreme obesity as compared to the national average of 4.5%. Only 16% of Cameron county is normal weight. Interesting stat: 27% of Texans speak only Spanish, here in Brownsville 87% speak only Spanish.

Also interesting is the high unemployment rate here, which has been fairly recession resistant, due to the lower paying jobs, works to encourage health here in the Valley. Since such a high number of women do not work here, they are more easily reached by health educators. They and their families, since most of the women are in charge of the health of their family, can take advantage of health improving activities and trainings that occur mostly during the day time or early evening.

And final side note for this posting... Theories make so much more sense in context and when they can be seen in use within community health programs. I finally understand the importance of being theory based. This internship is really helping my to apply this past year of classes... I guess that's the point of an internship :)

I'm Moving!

To Historical Brownsville!!

Before I moved here to Texas, I'd been looking for housing, something other than the dorms, but found relatively few possibilities. The dorms here on campus are fine, although quite creepy and never lacking in bugs, but they're very expensive for a little room and no access to a kitchen. But exciting news... someone down here is looking for a house sitter from June 24 to August 14, which is perfect!! So I'll be moving into their home with two other interns and enjoying the high life, we'll have a washer and a line to dry clothes on, a dishwasher, a kitchen (complete with stove and sink), a screened in porch, and a bathroom with a jacuzzi. We're living there for free in exchange for keeping an eye on their place, taking in the mail, and watering their plants and trees. I couldn't have found anything better!

FYI... Texas has way too many creepy-crawlies, I've seen way too many cockroaches, a scorpion, and lots of large spiders, gross!!

I'm now trained in anthropometrics. Ooooh ahhh, yes it does sound impressive, but really it's just that I've been trained how to take height, weight, hip, and waist measurements correctly. I know, i know, not as exciting but as far as research goes it's fairly important to measure people correctly. And a fun side note, I've grown. I'm now 162.6 cm tall, yay 5 feet 4 inches. I'll be collecting all of this data from individuals in the community in the near future for a study that one of the professors is doing here.

Also this week, a friend from University of Michigan and I met up for dinner here in the Valley. She's been living in the Valley for a few years now, working down here. It was great to have someone from home here. I'm beginning to really enjoy my time here in the Valley, all of the unique cultural, linguistic, and even temperal differences here.

Well y'all take care, it's a beautiful Saturday here and I'm headin' off to the beach to do some swimmin' and sunbathin'. FYI... Texans talk funny :)

From Texas to Mexico and back again

Today started with the second session of a Diabetes class. This class focused on nutrition for individuals living with diabetes. We focused on the importance of eating balanced food (el plato balanceado). This focuses on a 1/4, 1/4, 1/2 plate portions. Bread, starch, and grains should fill 1/4 of the plate, meat and other proteins should fill another 1/4, and lastly vegetables should fill the 1/2. Fruit and milk/calcium should should also be eaten. We also discussed the importance of reading food labels, watching especially the sodium (sodio), carbohydrates (carbohidratos), fiber (fibra), protein (proteina), fat (grasa), and calories (calorias). Along with the plastic fruits and vegetables on the table were vials filled with the fat, sugar, and sodium in commonly eaten food.

Wow were some of those disgusting!! Especially the double cheeseburger, the vial was filled to the top with a very gross spoiled milk colored, pudding consistancy, yuck that was supposed to represent fat. After discussing what not to eat, we turned to what is good to eat, including fiber, omega 3, and the importance of water (especially down here in Texas!).

For the afternoon, I headed over to Mexico, which is really just a hop, skip, and a jump away (and maybe a few steps too). We went to a filming studio to watch as they filmed sections of a morning talkshow that happens on channel 7 (here at least). These sessions are a part of the Tu Salud, Si Cuenta! (Your Health Matters!) promotion which focuses on healthy food and proper food portions, exercise, and general healthy living. They bring in professionals and community members to share their health stories. It was really cool to see the filming of these shows. Following we went to eat gorditas. They are quite delicious, mine had queso and nopalitos (cactus) in it. Cactus has 5.6 grams of fiber in it, who would have known. This is more fiber than a banana (2.4 grams), bran flakes (4.0 grams), and shredded wheat (3.0 grams). Though Fiber-One beats it with 11.9 grams. But cactus is much more tasty than Fiber-One.

For those interested, cactus tastes a bit like a mix of green pepper and okra and kinda like canned green beans. It's slightly slimy, but not enough to be disgusting and has a crunch to it as cooked green peppers do. It's often cooked up with other spices and vegetables. If you have the chance to try it, I certainly encourage it, yum!