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Vulnerable populations

Bin Wang, Qian Chen, Lixiao Shen, Shasha Zhao, Weiyi Pang, Jun Zhang
Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are commonly used in industrial applications and consumer products, and their potential health impacts are of concern, especially for vulnerable population like fetuses. However, in utero exposure to PFASs and health implications are far from fully characterized in China. To fill in the gap, we analyzed 10 PFASs in cord plasma samples (N=687) collected in Shanghai between 2011 and 2012, one of the regions widely polluted with PFASs in China. A questionnaire survey on maternal and diet-related factors was conducted...
October 19, 2016: Environment International
Daniel Shane Wright, Nicolle Demandt, Jeroen T Alkema, Ole Seehausen, Ton G G Groothuis, Martine E Maan
Local adaptation can be a potent force in speciation, with environmental heterogeneity leading to niche specialization and population divergence. However, local adaption often requires non-random mating in order to generate reproductive isolation. Population divergence in sensory properties can be particularly consequential in speciation, affecting both ecological adaptation and sexual communication. Pundamilia pundamila and Pundamilia nyererei are two closely related African cichlid species that differ in male coloration, blue vs...
October 22, 2016: Journal of Evolutionary Biology
Ljiljana Zmak, Mihaela Obrovac, Zvjezdana Lovric, Mateja Jankovic Makek, Vera Katalinic Jankovic
As tuberculosis incidence decreases, the possibility of overlooking the disease increases, especially in vulnerable populations. We describe here a major tuberculosis outbreak among mentally ill patients in Croatia, focusing on 1 regional hospital where most patients were hospitalized. The outbreak emphasizes the vulnerability of mentally ill patients to tuberculosis infection and the complexity of infection control measures in psychiatric institutions. The awareness of tuberculosis in these settings should be maintained to interrupt prolonged exposure and avoid unnecessary infection...
October 18, 2016: American Journal of Infection Control
Lauretta Ovadje, Jerome Nriagu
BACKGROUND: Poor malaria knowledge can negatively impact malaria control programmes. This study evaluates knowledge distribution in the domains of causation, transmission, vulnerability, symptoms, and treatment of malaria. It assesses the association between a caregiver's knowledge about malaria and ownership and use of insecticide-treated nets (ITNs) by children. METHODS: Some 1939 caregivers of young children were recruited through a school-based survey in two Nigerian states...
October 21, 2016: Malaria Journal
Philip M Massey, Brent A Langellier, Tetine Sentell, Jennifer Manganello
OBJECTIVE: To examine differences in health information seeking between U.S.-born and foreign-born populations in the U.S. DESIGN: Data from 2008 to 2014 from the Health Information National Trends Survey were used in this study (n = 15,249). Bivariate analyses, logistic regression, and predicted probabilities were used to examine health information seeking and sources of health information. RESULTS: Findings demonstrate that 59.3% of the Hispanic foreign-born population reported looking for health information, fewer than other racial/ethnic groups in the sample...
October 21, 2016: Ethnicity & Health
Jina Choo, Hye-Jin Kim, Melanie T Turk, Eun-Kyung Kim, Kyung-Sook Yang
AIM: Based on McLeroy's ecological perspective, this study aimed to identify the factors that are associated with behavioral problems among children who were enrolled in community child centers that provide public welfare services for vulnerable children. METHODS: A cross-sectional survey was conducted among 175 children aged 6-12 years and their parents who were recruited from 16 community child centers in a municipal county of Seoul, South Korea. The children's behavioral problems were reported by their parents and measured by the Child Behavior Checklist/6-18...
October 21, 2016: Japan Journal of Nursing Science: JJNS
Sandra Bouma
The publication of the landmark paper "Defining Pediatric Malnutrition: A Paradigm Shift Toward Etiology-Related Definitions" launched a new era in diagnosing pediatric malnutrition. This work introduced the paradigm shift of etiology-related definitions-nonillness and illness related-and the use of anthropometric z scores to help identify and describe children with malnutrition (undernutrition) in the developed world. Putting the new definition into practice resulted in some interesting observations: (1) Etiology-related definitions result in etiology-related interventions...
October 20, 2016: Nutrition in Clinical Practice
Joseph E Tanenbaum, Vincent J Alentado, Jacob A Miller, Daniel Lubelski, Edward C Benzel, Thomas E Mroz
BACKGROUND CONTEXT: Lumbar fusion is a common and costly procedure in the United States. Reimbursement for surgical procedures is increasingly tied to care quality and patient safety as part of value-based reimbursement programs. The incidence of adverse quality events among lumbar fusion patients is unknown using the definition of care quality (patient safety indicators [PSI]) utilized by the Centers for Medicare and Medicaid Services (CMS). The association between insurance status and the incidence of PSI is similarly unknown in lumbar fusion patients...
October 17, 2016: Spine Journal: Official Journal of the North American Spine Society
John L Semple, G W Kent Moore, Petros Koutrakis, Jack M Wolfson, Paolo Cristofanelli, Paolo Bonasoni
: Semple, John L., G.W. Kent Moore, Petros Koutrakis, Jack M. Wolfson, Paolo Cristofanelli, and Paolo Bonasoni. High concentrations of ozone air pollution on Mount Everest: health implications for Sherpa communities and mountaineers. High Alt Med Biol. 00:000-000, 2016.-Introduction: Populations in remote mountain regions are increasingly vulnerable to multiple climate mechanisms that influence levels of air pollution. Few studies have reported on climate-sensitive health outcomes unique to high altitude ecosystems...
October 20, 2016: High Altitude Medicine & Biology
Iulia D Ursan, Jerry A Krishnan, A Simon Pickard, Elizabeth Calhoun, Robert DiDomenico, Valentin Prieto-Centurion, Jamie B Sullivan, Lauren Valentino, Mark V Williams, Min Joo
Limited socioeconomic resources contribute to high readmission rates at minority serving institutions (MSIs). A better understanding of patient-level factors and need for patient navigators could inform approaches to enhance care transitions tailored to these vulnerable patient populations. We sought to understand the perspectives of patients and their caregivers about hospital to home transitions from an MSI, as well as their attitudes about patient navigators to facilitate care transitions. We conducted qualitative research using focus groups (FGs)-five disease-specific patient FGs and two caregiver FGs, including 23 patients and 10 caregivers...
2016: Journal of Health Care for the Poor and Underserved
Darrell L Hudson, Kimberly A Kaphingst, Merriah A Croston, Melvin S Blanchard, Melody S Goodman
We examined the prevalence of mental disorders in a primary care setting affiliated with a large academic medical center. We also examined whether there were racial differences in mental health disorders. Patients were seeking medical care in an outpatient medical clinic; mental health data were available for them via medical records (n=767). Overall, 45% of patients had a diagnosed mental health problem; the most commonly reported form of mental disorder was depression. African Americans (OR= 1.88; CI: 1.21-2...
2016: Journal of Health Care for the Poor and Underserved
Tawandra L Rowell-Cunsolo, Nabila El-Bassel, Carl L Hart
Black Americans are incarcerated at disproportionate rates, largely due to racial differences in the application of drug laws. Human immunodeficiency virus (HIV) prevalence rates among Black Americans are also disproportionately high. Moreover, availability of and access to HIV prevention services in correctional settings are limited. Recognizing that Blacks are at an elevated risk of contracting HIV, and that incarceration worsens health outcomes, this paper addresses the importance of implementing comprehensive prison-based HIV programs and prevention interventions to improve the health of this vulnerable population...
2016: Journal of Health Care for the Poor and Underserved
Chad K Gentry, Robin P Parker, Christian Ketel, S Trent Rosenbloom, Terri D Crutcher, Aaron W Scott, Jannyse L Starks, Heather A Davidson, Bonita A Pilon
This report describes the role of a clinical pharmacist serving onsite in an interprofessional collaborative practice care model at an urban underserved primary care clinic. It also overviews current health care legislative policy as it relates to expanding pharmacists roles as an integrated team member in medically underserved, vulnerable populations.
2016: Journal of Health Care for the Poor and Underserved
Tim Mitchell, Hannah Gooding, Cathy Mews, Leon Adams, Gerry MacQuillan, George Garas, Madhur Ravikumara, Ainslie Lopez, Megan Collins, Gary Jeffrey
Transition to adult care is a vulnerable period for pediatric transplant recipients and is associated with reduced medication compliance, graft loss, and increased mortality. Psychosocial outcomes in young adults differ between pediatric transplant recipients and their healthy peers. We conducted a single-center, retrospective cohort study of all pediatric liver transplant recipients who were transitioned through our center. This study aimed to assess the outcomes of transitioned pediatric liver transplant recipients at an Australian center, including mortality, adherence, and psychosocial morbidity...
October 20, 2016: Pediatric Transplantation
Gerard Pasterkamp, Hester M den Ruijter, Peter Libby
The concept of the 'vulnerable plaque' originated from pathological observations in patients who died from acute coronary syndrome. This recognition spawned a generation of research that led to greater understanding of how complicated atherosclerotic plaques form and precipitate thrombotic events. In current practice, an increasing number of patients who survive their first event present with non-ST-segment elevation myocardial infarction (NSTEMI) rather than myocardial infarction (MI) with ST-segment elevation (STEMI)...
October 20, 2016: Nature Reviews. Cardiology
R D Goodwin, M Robinson, P D Sly, P G Holt
BACKGROUND: Prior studies have suggested a relationship between atopy and mental health, although methodological barriers have limited the generalizability of these findings. The objective of this study was to investigate the relationship between early-life atopy and vulnerability to mental health problems among youth in the community. METHOD: Data were drawn from the Raine Study (N = 2868), a population-based birth cohort study in Western Australia. Logistic regression and generalized estimating equations were used to examine the relationship between atopy at ages 1-5 years [using parent report and objective biological confirmation (sera IgE)], and the range of internalizing and externalizing mental health problems at ages 5-17 years...
October 20, 2016: Psychological Medicine
Elizabeth Marino, Christopher Wolsko, Susan G Keys, Laura Pennavaria
Suicide is a critical public health problem worldwide. In the United States (US), firearm ownership is common, and firearms account for the majority of deaths by suicide. While suicide prevention strategies may include limiting access to firearms, the contentious nature of gun regulations in the US, particularly among members of rural communities, often gives rise to constitutional concerns and political polarization that could inhibit suicidal persons from seeking the help they need. We examine potential outcomes of public health strategies in the US that encourage limiting access to firearms for populations who both value firearm ownership and are vulnerable to suicide...
September 2016: Journal of Public Health Policy
Sybil Hosek, Connie Celum, Craig M Wilson, Bill Kapogiannis, Sinead Delany-Moretlwe, Linda-Gail Bekker
INTRODUCTION: Adolescents and young adults aged <25 are a key population in the HIV epidemic, with very high HIV incidence rates in many geographic settings and a large number who have limited access to prevention services. Thus, any biomedical HIV prevention approach should prepare licensure and implementation strategies for young populations. Oral pre-exposure prophylaxis (PrEP) is the first antiretroviral-based prevention intervention with proven efficacy across many settings and populations, and regulatory and policy approvals at global and national levels are occurring rapidly...
2016: Journal of the International AIDS Society
Jae M Sevelius, Madeline B Deutsch, Robert Grant
INTRODUCTION: Globally, transgender ("trans") women are one of the key populations most disproportionately impacted by HIV. Pre-exposure prophylaxis (PrEP) is the newest and most promising biomedical HIV prevention intervention to date. This paper reviews relevant literature to describe the current state of the science and describes the potential role of PrEP among trans women, including a discussion of unique considerations for maximizing the impact of PrEP for this vulnerable population...
2016: Journal of the International AIDS Society
L Paglia
Despite the general advances in dental care, dental caries is still a global health problem affecting many children. Occlusal surfaces of first permanent molars are the most susceptible sites in the developing permanent dentition. Dentists should use sealants or fluoride varnish - as well as other means - to limit the onset of tooth decay. Application of sealants is a recommended procedure to prevent or control caries. Sealing occlusal surfaces of newly erupted permanent molars in children and teenagers delays caries onset up to 48 months compared with unsealed teeth...
September 2016: European Journal of Paediatric Dentistry: Official Journal of European Academy of Paediatric Dentistry
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