The influenza (popularly known as Flu) season is around the corner. The flu vaccine is your best shot at preventing influenza. Trust me, there are many important reasons to get vaccinated. We recommend that you talk to your doctor to make sure you are up to date on the vaccines that are right for you.

Did you know that adults need vaccines too? If you didn’t, you’re not alone. Many adults in the U.S. are not aware of the vaccines recommended for them – and that means they are not taking advantage of the best protection available against a number of serious diseases.

There are many reasons to get vaccinated; here are just 10 of those reasons.

1) You may be at risk for serious diseases that could be prevented by vaccines. Many of these diseases (like influenza, pertussis, and shingles) are common in the U.S., and many can be spread easily.

2) You may be at increased risk for complications from certain diseases if you have a chronic health condition or weakened immune system. Adults with chronic conditions such as heart disease, diabetes, or lung disease and those with weakened immune systems are more likely to develop complications from certain vaccine-preventable diseases. These complications can include long-term illness, hospitalization, and even death.

3) You can reduce the chance that you’ll pass on a serious disease to your loved ones. Most vaccine-preventable disease can be contagious, like influenza, meningitis, and whooping cough. Receiving your recommended vaccines can reduce the risk that you get sick and spread disease on to others.

4) You can help protect those who can’t get vaccinated. Some people may not be able to get certain vaccines based on age, health conditions, or other factors even though they are vulnerable to illness. Vaccines can help prevent the spread of contagious diseases to them. For example, newborns who are too young to get vaccinated for whooping cough are also most at risk of severe illness from the disease. By getting vaccinated when you’re pregnant, you can pass on protection to your baby.

5) You don’t have time to get sick. You have too much responsibility to risk getting sick, including people counting on you at work and at home. Vaccines can help you stay healthy so you don’t waste time being sick.

6) You don’t want to miss what’s important to you. Spending time with family and friends or taking time out for your hobbies may not be possible if you get sick. Vaccines can help you stay healthy and enjoy the things you like to do.

7) You don’t want to pay the price of getting sick. Adults who get a vaccine-preventable disease face the financial costs of medical visits and treatment, in addition to other costs like taking time off work, hiring babysitters, and traveling to and from doctors’ offices.

8) You like to travel – or have to travel for work. Travel can present exciting opportunities, but it can also put you at risk for certain diseases. Make sure you only bring back great memories, not illness! If you are going to travel internationally, you might need additional vaccines. See the vaccinations and travel checklist.

9) You want the peace of mind that comes with protecting your health. People sometimes wait to get vaccines until they hear of outbreaks of disease like pertussis or influenza in their community. The time to be vaccinated is before disease arrives. It’s important to stay up to date on your immunizations because no one can predict when disease will appear.

10) You don’t want to feel crummy if you can prevent it! No one wants to feel sick. There are more than a dozen diseases that you can protect against simply by getting vaccinated! Adult vaccines are available at doctor’s offices, health departments, pharmacies, and even workplaces.

Courtesy: U.S. Centers for Disease Control and Prevention, U.S. Department of Health and Human Services.

Choosing the right school and teaching program that meets one’s needs for education and preparation for career can both be equally onerous. But not any more. Three free guides from our publishing partners can assist you in making the right choices. Check them out.

The guides inform prospective students on what to expect from a teaching program and what to consider when choosing the right school. The guides also explore financing options and review job outlook & career opportunities that come with a degree in education.

These guides are great for current professionals who want to advance professionally as well as for aspiring teachers and education professionals. With one out of the 81% of online students working while pursuing their collegiate goals, these guides can be helpful in crunch times when the cost of making decisions are truly high.

Guide to Bachelor’sMaster’s & Doctorate Programs in Education

Courtesy: BestColleges.com

Washington, DC — About 61 percent of people with Nigerian ancestry age 25 and older had a bachelor’s degree or higher — more than twice the U.S. rate of 28.5 percent, according to a recent U.S. Census Bureau report on Characteristics of Selected Sub-Saharan African and Caribbean Ancestry Groups in the United States: 2008-2012.

This new report from the 2008-2012 American Community Survey covers the population who reported Sub-Saharan African ancestry — Ethiopian and Nigerian — and Caribbean (West Indian) ancestry — Haitian, Jamaican, and Trinidadian and Tobagonian. These ancestry groups were selected due to their relatively small populations and being under researched compared to their counterparts. About 2.5 million people in the United States identified as one of these ancestry groups, or around 0.8 percent of the total U.S. population. This represents an increase of about 2.1 million, or around 469 percent, since the 1980 Census.

“Acquiring a college or other advanced degree was a major factor for many people of Nigerian ancestry coming to the United States, so it is not surprising that twice as many had a bachelor’s degree or higher compared to all people and the other selected ancestry groups,” said Dr. Stella Ogunwole, a demographer in the Population Division.

The report also found the rate of labor force participation was 71 percent or higher for all of the selected groups compared to the U.S. rate of 64.7 percent. Thirty-six percent of the civilian employed population age 16 and older in the United States worked in management, business, science and arts occupations, but the Nigerians — the most educated group — had the largest share in this type of occupation at 52 percent.

“Each of these ancestries carved a different immigration path to the United States: many sought technical training, advanced education, political asylum and better opportunities with the thriving labor market,” added Ogunwole.

Ethiopians were the fastest growing among these ancestry groups — growing from 1980 to 2008-2012 by around 2,400 percent, and Haitians had the largest numeric change over the same period, with an increase of about 777,000 (862 percent).

“The New York and Miami metro areas in particular had large concentrations of people of Jamaican or Haitian ancestry,” said Darryl Cohen, a geographer in the Population Division.

These findings came from the 2008-2012 American Community Survey. The report also used decennial censuses back to 1980 to compare changes in population for given ancestry groups, since ancestry was first measured in the 1980 Census. The findings from the report include the geographic distribution of the population in these ancestry groups, as well as various demographic and socio-economic characteristics, such as age and sex, household type, nativity, educational attainment, labor force participation, occupation, earnings, poverty and homeownership.

Other highlights from the report:

Age

The two Sub-Saharan African ancestry groups (Nigerian and Ethiopian) and those of Haitian ancestry each had a median age of about 30 years, younger than the other two Caribbean groups (Jamaican at 34.5 years, and Trinidadian and Tobagonian at 35.8 years).

Labor Force
Nationally about two-thirds (65 percent) of the population age 16 and older was in the labor force. People who reported Nigerian or Ethiopian ancestries had the highest participation rates (76 percent each) among all the selected ancestry groups.

At least 71 percent of people age 16 and older with Haitian, Jamaican, and Trinidadian and Tobagonian ancestries participated in the labor force.

Geography
The geographic distributions of these ancestry groups vary considerably, with those of Haitian, Jamaican, and Trinidadian and Tobagonian ancestries most concentrated in Florida and New York. The Ethiopian and Nigerian ancestry groups are more widely dispersed across the United States.

Language diversity
Even though English is the official language of Nigeria, less than half of the population reporting Nigerian ancestry spoke only English at home (43 percent).

Eighty percent of the U.S. population age 5 and older spoke only English at home. Among the selected ancestry groups, those with Trinidadian and Tobagonian (95.5 percent) and Jamaican (92.7 percent) ancestries were most likely to speak only English at home.

Foreign-Born Status
In 2012, 13 percent of people residing in the United States were foreign-born. By comparison, almost three-quarters of the population reporting Ethiopian ancestry (72 percent) were foreign-born, the highest among the selected ancestry groups.

Approximately six out of every 10 people among the other ancestry groups (Trinidadian and Tobagonian, Nigerian, Jamaican and Haitian ancestries) were foreign-born.

Homeownership
Those with Jamaican ancestry had the highest rate of homeownership among the five groups, at 53.7 percent; the national rate was 65.5 percent.

The American Community Survey is a nationwide survey designed to provide communities with reliable and timely demographic, social, economic and housing data for congressional districts, counties, places and other localities every year.

The world has become increasingly interconnected, demonstrating a nation’s dependency on the global economic, security, and health status. Diseases, especially infectious and contagious diseases, do not recognize borders. Thus, a disease for example, can easily migrate to bordering countries if not contained. Nations must find educated and collaborative measures to resolve local and regional disease outbreaks before they have a major impact on resources and before they become pandemic. When health challenges do present an impact on resources, nations rely on others for support, further exemplifying the importance of education and collaboration.

The International Journal of MCH and AIDS, one of the Global Health and Education Projects’ (GHEP) peer-reviewed journals, published a study by Mondal et al. that attempted to examine life expectancy (LE) in the least developed countries and the health factors associated with LE. From the identified factors, Mondal and colleagues (2015) found that education was an important predictor of LE and that higher education levels among a population had a positive impact on LE. Educated people tend to better understand information on proper nutrition, hygiene, healthcare services, and common illness prevention measures (Mondal, 2015). Take the health outcome of mental disorders for example. Research conducted in epidemiology, clinical presentation, and interventions early in life is indispensable to strengthen the scientific bases of child and adolescent mental health clinical practice. In this sense, knowledge disseminated by scientific journals such as GHEP’s International Journal of MCH and AIDS (IJMA) and the International Journal of Translational Medical Research and Public Health (IJTMRPH) lay the foundations for evidence based measures (Kieling & Martin, 2013).

Unfortunately, developing countries lack the scientific resources to produce and create evidence based strategies to combat health issues. At the same time, developed countries sometimes lack focus or are hindered by challenges when dealing with specific health issues. These challenges and examples highlight the need that must be filled. It is from this urgency that we have global organizations such as GHEP that function to advance global health and education through journal publication.

How can journal publication advance global health and education? Let’s review some of the journal articles in GHEP’s journal database to see how they contribute to global health and education advancement. It was noted earlier that Mondal et al. attempted to identify health factors contributing to LE in developing countries. International efforts can now focus on LE in developing countries by increasing income and health facilities, improving the overall situation, and by decreasing deaths, fertility, and HIV prevalence rate.  In an article in IJTMRPH, Islam et al. (2016) identified the need for the Bangladeshi government to create economic opportunities for women to enhance contraceptive use, since there was a gap among employed and unemployed women regarding using contraceptives. Ayaaba et al. (2017) in IJTMRPH concluded that mining regulations and health and environmental surveillance systems needed to be updated and implemented to protect the safety of minors from Coal Worker’s Pneumoconiosis, a rising global concern.

GHEP’s published journal articles reflect some of the various approaches in how journal publication advances global health and education by:

  1. publicizing a health outcome and its factors to make them publicly known,
  2.  advocating international and collaborative measures to address health outcomes and their factors,
  3. pinpointing governmental flaws in health strategies (or lack thereof) to better support current or new health objectives,
  4. advertising a health outcome to create a sense of urgency and national/international support,
  5. identifying failing health systems and policies to create pressure for change, and
  6. identifying gaps in safety regulations and practices for workers and communities.

These approaches represent the importance of global health publications such as GHEP in their journal publication endeavors. With the current state of global health affairs, hopefully we see the benefit of these organizations’ mission efforts. I welcome your comments.


Contributor Mr. Hilliard, a PhD student in global health at Nova Southeastern University, is an intern with the Center for Global Health and Health Policy, Global Health and Education Projects, Inc.  He can be reached at dh1463@mynsu.nova.edu.

In our Special Blog Post, Guest Writer and author Hanif S. Abdul-Amin of Maryland, USA, reflects on the need to build bridges between the haves and have-nots in addressing parity in health and education not only here in the US but across the world by supporting organizations such as the Global Health and Education Projects, Inc.  

IN an attempt to avoid naming specific individuals (in fear of not naming them all), I would like to believe if I stop and thought for a moment, I could name celebrities who advocate equality in health and education, around the globe. On the other hand, I know no other US 501(c)(3) non-profit, non-partisan, non-religious, charitable, educational, research, and development organization dedicated to eliminating inequalities in health and education among local communities in the USA and worldwide, other than, the Global Health and Education Projects (GHEP), Inc. 

At this time, the world needs GHEP. In the areas of health and education, parity among the citizens of the earth is paramount. The fervent pledge in GHEP’s resolve to abolish these disparities is noble.

I am a cancer survivor. Fortunately, I had quality health insurance, which enabled me to afford superb cancer treatment. The same is true for my education. In spite of my humble beginnings, I have attained well-accepted global certifications and college credentials. Many, throughout the world, are unfortunately not so blessed. The GHEP functions as the liaison, which bridges that gap between inequalities in health and education among local communities in the USA and worldwide and potential resources aiding the disadvantaged.

I support these Global Health and Education Projects’ determinations and call on you, my friends and readers to also consider supporting GHEP in its noble works of addressing health and education disparities in US and across the world.

Want to write for us? Click here and let us know. 

The Maryland Environmental Health Network (MdEHN) seeks to fill the position of Director in early 2017.

MdEHN was formed 5 years ago through the support and vision of key funders, with guidance from a Steering Committee of issue experts, and under the leadership of Rebecca Ruggles. MdEHN functions under the auspices of the Association of Baltimore Area Grantmakers which serves as its fiscal agent.

MdEHN has three full-time staff:  Rebecca Ruggles, Director; Allison Rich, Children’s Environmental Health Specialist, and Rebecca Rehr, Public Health Advocacy Coordinator.

Rebecca Ruggles will leave her role as founding director at the end of 2016 or in early 2017. The Director position is responsible for strategic planning, project oversight, partner and funder relations, grant-writing, and staff coordination.

We seek candidates who are able to support our strong staff and enable their work to continue, as guided by our strategic plan, vision, mission, and values. The new director will be a professional with knowledge of public health, advocacy, environmental health, and/or non-profit management.  Passion for issues of environmental justice and equity in Maryland is central to our organization.  The next director will also take MdEHN in new directions, forging new partnerships, and competing successfully for new funding streams.

The position can be structured to accommodate schedule preferences, including the possibility of working on a part-time basis and with flexibility for the work to be performed both on-site and remotely.

Applicants should send a confidential letter of inquiry to the email address below discussing the following:

  • Your background or training in public health, environmental health, or related fields
  • Your knowledge of the Maryland landscape (or a similar state)
  • Your philosophy of leadership and team management
  • Specific skills, contacts, or relevant knowledge that you can offer – particularly in
    • Strategic Planning for small non-profits
    • Funder Relations and Grant Writing
    • Advocacy
  • Why you would like to join MdEHN

Further Information

Rebecca Ruggles is available to talk by phone or email to discuss this opportunity informally.

Please review the organization website MdEHN.org and the summary below of our vision, mission, values, roles, and strategic priorities before contacting Rebecca to schedule a time to speak.

PUBLIC NOTICE

REQUEST FOR INDEPENDENT CONTRACTORS AND CONSULTANTS

public-notice2We are pleased to announce our call for experts and companies to join our list of pre-qualified independent contractors and consultants. Vetted contractors and consultants will provide services that support our organization in the successful and efficient implementation of its community-based projects. Consultancy services will be on an ad hoc and as needed basis.

Independent Contractor/Consultant
An independent contractor/consultant is an individual or organization providing primarily professional services, technical advice, or outreach services under an agreement with the organization. Such a relationship is distinct from an employment relationship.

Eligibility
Independent contractors/consultants do not have employment relationships with the organization, therefore, GHEP Directors, volunteers, fellows, and interns can serve as independent contractors/consultants if they ordinarily possess the qualification to discharge the duties and responsibilities of the vacant consulting position. In keeping with the voluntary mission of our organization, our existing independent contractors and consultants work a combination of compensated and uncompensated hours.

GHEP, Inc. is committed to supporting Minority, Woman, and Local Business Participation Program in Prince George’s County and State of Maryland. Therefore, preference will be given to PG and MD-based companies and individuals. GHEP shall reserve the right to use or not use consultants from this proposed list.

How to Apply
Interested individuals and organization interested in this opportunity should send a letter of interest for consideration to:
The Executive Director, GHEP, Inc., P. O. Box 234, Riverdale, MD 20738 or via email to info@globalhealthprojects.org. Upon receipt of letter of interest, we will reach out to individuals and organizations for the requisite registration documents, resumes, and diplomas.

Applications and letters of intent will be accepted on a rolling basis.

pubmed-logoThe International Journal of MCH and AIDS (IJMA), one of the two scholarly journals published by GHEP, has been accepted for indexing in PubMed and PubMed Central, two prestigious journal indexing and abstracting services and databases of the National Library of Medicine (NLM) at the U.S. National Institutes of Health (NIH), Bethesda, Maryland, USA.

This means that the full text of all articles published in IJMA will become available on PMC and PubMed effective immediately. For authors this means greater discoverability, potentially increased readership and citations in the field of research.

With its acceptance, IJMA joins the league of other prestigious global health journals who use the PubMed and PMC platforms to disseminate their work to millions of readers around the world who rely on the integrity of NLM and NIH who curate these indexing services following intense scrutiny and pre-acceptance technical and academic reviews.

Dr. Romuladus Azuine, IJMA Editor-in-Chief, said that he was excited about the tremendous visibility that the PubMed and PMC indexing would bestow upon the journal, adding that he looks forward to pushing forward in his efforts to distinguish the journal and its acceptability to the wider research community.

“Our indexing in these two services also sets the stage for the next phase of the journal’s development in the dissemination of pioneering work in the field of MCH and AIDS, as well as global health,” Dr. Azuine said while reacting to the news in Washington, DC, USA.

GHEP’s second scholarly journal, the International Journal of Translational Medical Research and Public Health (IJTMRPH) is currently reviewing manuscripts for its first volume set to publish in mid-to late Fall 2016. Readers can read more about the journals by clicking on IJMA and on IJTMRPH.

PUBMED CENTRAL

PubMed Central® (PMC) is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM)sections are noted with plus and minus signs so that you can add and subtract content blocks.

pmc-logo-downloadIn keeping with NLM’s legislative mandate to collect and preserve the biomedical literature, PMC serves as a digital counterpart to NLM’s extensive print journal collection. Launched in February 2000, PMC was developed and is managed by NLM’s National Center for Biotechnology Information (NCBI). Readers can learn more by clicking on the PMC link.

 

PUBMED

PubMed comprises more than 26 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites sections are noted with plus and minus signs so that you can add and subtract content blocks.

pubmed-logoPubMed also provides access to additional relevant web sites and links to the other NCBI molecular biology resources. PubMed is a free resource that is developed and maintained by the National Center for Biotechnology Information (NCBI), at the U.S. National Library of Medicine (NLM), located at the National Institutes of Health (NIH). Readers can learn more by clicking on PubMed link.

 

globenewsNearly 300 people from different parts of the Washington, DC metro region received direct services and other life-saving public health information at the 2016 Community Health and Environment Fair held Saturday, May 14 at the Riverdale Elementary School in Prince George’s County, MD.

The health fair was organized by the non-profit Global Health and Education Projects, Inc. (GHEP), in collaboration with a coalition of 34 notable government and non-governmental organizations and health care and social services professionals drawn from Maryland, DC, and Virginia, including Georgetown University Hospital, Howard University Hospital, Doctor’s Community Hospital, and several agencies of the State of Maryland and Prince George’s County.  The health fair comprised of a general workshop session, care delivery, and health information and awareness exhibitions by participating agencies.

GHEP Executive Director, Romuladus E. Azuine, DrPH, MPH, RN, said that the theme of the health fair and workshops was: “Health and Environment: Connections for Healthy Lives, Healthy Communities” was important in highlighting the intricate connection between human health and the environment which is the foundation for improving individual and community health and wellness.

“We do not have to wait for diseases and calamities such as the Zika Virus to jolt us into understanding the importance of health and environmental education and information empowerment for our people and communities. That is why we are holding this health fair today which has brought for-profit and non-profit partners together for a common cause,” Dr. Azuine said.

According to Dr. Azuine, “once we understand the triangle of health, environment and diseases,  we will fully understand that the health of each and every one of us is related to each other and that we must build our health together as healthy people and healthy communities.”

guest-speaker-img_0398In his welcome remarks, the Deputy Mayor of the City of Riverdale Park, Dr. Alan Thompson, praised GHEP for its commitment to the community and for bringing enormous resources to the city which will lead to improvement in not only health of the individuals, but also health of the city.

Special Guest at the event and Council Member Deni Taveras representing District 2 at Prince George’s County Council decried the lack of mental health professionals serving minorities who are at higher risk of suffering mental health problems. She said that it was time for individuals and communities to come together and shatter the stereotypes and break stigma around mental health treatment and help-seeking for mental health in our minority communities.

Community leaders at the event include MD State Delegate Alonzo T. Washington representing District 22, PG County; Mr. Martin Ezemma, Director of International Business at PG County Economic Development Corporation; Mr. James Morrow of the PG County Community Emergency Response Team; Dr. Clifford Thomas, a community activist; Lt. CDR Lawrence Momodu of the US Public Health Service; Earl Harley, MD, FAAP from Georgetown University Hospital and Millicent Collins, MD, FAAP, a Pediatrician from the Howard University Hospital..

Attendees at the health fair received several health care services including screening for high blood pressure, blood sugar, eye examination, ear, nose, and throat examinations, well-child visits, immunization information, and several health promotion information and sources of resources for health and social services.

Guest Speaker and Lead Workshop presenter, Lt. CDR Dr. Lawrence Momodu underscored the importance of physical and mental health prevention for individuals and the entire family. Dr. Momodu who is a Pharmacist and Nurse called on the community to get above board and learn to protect themselves from preventable health diseases.

tkdThe highpoint of the event was an outdoor physical activity, anti-bullying, and violence prevention workshop and demonstration facilitated by Dr. Clifford Thomas of the We Lead By Example, Inc./Tae Kwon Do Ramblers Self-Defense Systems based in Bladensburg, MD. Dr. Thomas led the children and members of the community in outdoor exercise that highlighted both physical activity, physical fitness and development of anti-bullying strategies for the entire family.

Editor’s Note: The President of the United States has issued a presidential proclamation to commemorate this year’s Child Health Day celebration. In the proclamation, the President called for a re-commitment to  helping our children make healthy life choices and to providing them with the resources to lead happy and productive lives. This message is not only for Americans, but for all the world’s people to put children at the center of global health policies and programs. Read on…


A PRESIDENTIAL PROCLAMATION
As a Nation, we have a commitment to ensuring our daughters and sons live better lives than we did. They deserve every chance to reach for the brightest futures they can imagine, and with a solid foundation and a clean environment, they can grow up strong, healthy, and prepared to write the next great chapters in the American story. On Child Health Day, we recommit to helping our children make healthy life choices and to providing them with the resources to lead happy and productive lives.

My Administration remains wholly committed to investing in the safety and well-being of our Nation’s kids. First Lady Michelle Obama’s Let’s Move! initiative is bringing together community-based, faith-based, and private sector organizations, along with government at all levels, to provide quality, nutritious food to students, empower parents to make healthy choices, and encourage our youth to become more physically active. We are working at every level to combat bullying so students across our country can live and learn free from fear or intimidation. Under the Affordable Care Act, young people can now stay on their parents’ health plans until age 26 a provision that has already helped millions of young Americans. And the law prohibits insurance companies from denying coverage to individuals with pre-existing conditions, which has already brought greater peace of mind to the parents of up to 17 million children.

Babies Crawling On White BackgroundKeeping our children healthy takes more than promoting good lifestyles today it also rests on leaving them with a stable world to live in tomorrow. That is why my Administration is taking on the critical work of safeguarding our planet from the devastating effects of a changing climate by forging an America with cleaner air, cleaner water, and cleaner energy.

We have taken ambitious steps to limit our Nation’s carbon emissions, wean ourselves off of foreign energy sources, and preserve our planet for generations to come. With the potential for greater incidence of asthma attacks and infectious diseases that can impact growth and learning during critical formative years, we owe it to all who come after us to confront this imminent threat. We are also continuing to encourage Federal agencies to collaborate toward achieving these goals by identifying priority risks to the well-being of our young people and developing strategies to combat them.

Our most profound obligation is to our Nation’s most vulnerable citizens: our children. As we mark Child Health Day, let us reaffirm our commitment to that responsibility by supporting and modeling healthy, active lifestyles, by equipping our youth with the tools and resources they need to seize every opportunity, and by working to leave behind a sustainable planet so our children and theirs can know a future worthy of their limitless potential.

The Congress, by a joint resolution approved May 18, 1928, as amended (36 U.S.C. 105), has called for the designation of the first Monday in October as Child Health Day and has requested that the President issue a proclamation in observance of this day.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, do hereby proclaim Monday, October 5, 2015, as Child Health Day. I call upon families, educators, health professionals, faith-based and community organizations, and all levels of government to help ensure America’s children are healthy.

IN WITNESS WHEREOF, I have hereunto set my hand this second day of October, in the year of our Lord two thousand fifteen, and of the Independence of the United States of America the two hundred and fortieth.

Signed:

BARACK OBAMA

Culled from The White House.