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Alexander P Decilveo, Bartlomiej W Szczech, Jacob Topfer, James C Wittig
Expandable endoprostheses have become an acceptable modality to address the issue of limb-length inequality in limb-sparing procedures for skeletally immature patients afflicted with lower extremity bone sarcomas. This study retrospectively analyzed postoperative outcomes and complications for 7 patients (8 limbs) who underwent minimally invasive or noninvasive reconstruction during a 12-year period. Musculoskeletal Tumor Society (MSTS) scores and complication rates were reported. Mean functional outcome (MSTS scores) at final follow-up was 93...
October 25, 2016: Orthopedics
Clarissa Altina Cunha de Araújo, Berta Paz-Lourido, Sebastià Verger Gelabert
Different types of supports to families are among the aspects that contribute to family quality of life. This study aims to identify the types of supports that families of children with disabilities, users of early intervention services, consider relevant and how public administration influences the quality of this support. This is a qualitative study based on a critical social paradigm. Sixteen mothers and four fathers were interviewed and their contributions were analyzed using discourse analysis. The importance of family support and networks of parents of children with disabilities were highlighted...
October 2016: Ciência & Saúde Coletiva
Wederson Santos
This article discusses the main advances and challenges for understanding and evaluating disability as a restriction for social participation. This new understanding has its origins in the 2006 WHO International Classification of Functioning, Disability, and Health - ICF, the 2001 UN Convention on the Rights of Persons with Disabilities, and more recently, the July 2015 Brazilian Inclusion of People with Disabilities Act (IPDA), also known as the Statute on Persons with Disabilities. The change in the understanding of disability from a merely biomedical perspective, to an understanding that is based on oppression and social inequality reinforces the idea that disability is not an individual attribute, but the result of a society that is not prepared for human diversity...
October 2016: Ciência & Saúde Coletiva
Bianca de Cássia Alvarez Brancaglioni, Rosa Maria Godoy Serpa da Fonseca
Objective: to analyze the intimate partner violence in adolescence from the perspective of gender and generation. Method: Quantitative, descriptive, and exploratory research. 111 adolescents participated in this study, with ages from 15 to 19 years old. Results: We found that 91% of participants have perpetrated and 90.1% have undergone at least one of the natures of violence. The intimate partner violence in adolescence constitutes a form of gender violence, and gender constructions have determined the suffered and perpetrated aggressions, possibly also determining the naturalization and legitimization of such aggressions...
September 2016: Revista Brasileira de Enfermagem
Jaroslava Voráčová, Erik Sigmund, Dagmar Sigmundová, Michal Kalman
Socioeconomic inequalities in eating habits have a profound impact on the health of adolescents. The aim of the present study was to evaluate socioeconomic disparities in the eating habits of Czech adolescents and to compare their change between 2002 and 2014. The data from the Czech Health Behavior in School-aged Children (HBSC) study conducted in 2002 and 2014 was utilized. The Family Affluence Scale (FAS) was used to assess socioeconomic disparities. Higher odds of daily consumption of fruit (2002: OR = 1...
October 24, 2016: International Journal of Environmental Research and Public Health
Alan Bleakley
Inequalities in society are reflected in patterns of disease and access to health care, where the disadvantaged suffer most. Traditionally, doctors have kept politics out of their work, even though politics often shape medicine. What political responsibilities, then, should doctors have as they facilitate the learning of medical students? The article in this issue by Kumagai, Jackson, and Razack goes straight to the heart of this question. These authors ask whether educators should be wary of "cutting close to the bone" in discussing issues that may restimulate trauma in some medical students...
October 25, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Arno K Kumagai, Brittani Jackson, Saleem Razack
Learning the societal roles and responsibilities of the physician may involve difficult, contentious conversations about topics such as race, gender, sexual orientation, and class, as well as violence, inequities, sexual assault, and child abuse. If not done well, these discussions may be deeply traumatizing to learners for whom these subjects "cut close to the bone." Equally traumatizing is exposure to injustice and mistreatment, as well as to the sights, sounds, and smells of suffering and pain in the clinical years...
October 25, 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Chang-O Kim
BACKGROUND: This study aimed to evaluate whether social capital could alleviate health inequality against racial discrimination and identify the critical nature of social capital that generates health inequality differences within the social context of South Korea. METHODS: Using the data of the 2009 National Survey of Multicultural Families, a nationally representative sample in which 40,430 foreign wives participated, the concentration index (CI) was used to measure the discrimination-related inequalities in self-rated health and was decomposed into contributing factors...
October 26, 2016: International Journal for Equity in Health
Anh Nguyen Duc, Marcel Wolbers
Composite endpoints are widely used as primary endpoints of randomized controlled trials across clinical disciplines. A common critique of the conventional analysis of composite endpoints is that all disease events are weighted equally, whereas their clinical relevance may differ substantially. We address this by introducing a framework for the weighted analysis of composite endpoints and interpretable test statistics, which are applicable to both binary and time-to-event data. To cope with the difficulty of selecting an exact set of weights, we propose a method for constructing simultaneous confidence intervals and tests that asymptotically preserve the family-wise type I error in the strong sense across families of weights satisfying flexible inequality or order constraints based on the theory of χ¯2-distributions...
October 26, 2016: Statistics in Medicine
Teresa Iacono, Cheryl Dissanayake, David Trembath, Kristelle Hudry, Shane Erickson, Jo Spong
Telehealth offers the potential to address inequalities in autism service access for young children living in regional and rural areas with limited access to autism specialists. Our aim was to explore parent and practitioner uses of technology, and views about telehealth, including perceived barriers, for autism early intervention service delivery in a regional town in Australia. Fifteen mothers and 19 front-line autism practitioners completed surveys distributed by local autism service and support providers in the regional town; eight front-line practitioners from one service participated in interviews...
2016: Studies in Health Technology and Informatics
João Biehl, Mariana P Socal, Joseph J Amon
The impact of increasing numbers of lawsuits for access to medicines in Brazil is hotly debated. Government officials and scholars assert that the "judicialization of health" is driven by urban elites and private interests, and is used primarily to access high-cost drugs. Using a systematic sample of 1,262 lawsuits for access to medicines filed against the southern Brazilian state of Rio Grande do Sul, we assess these claims, offering empirical evidence that counters prevailing myths and affirms the heterogeneity of the judicialization phenomenon...
June 2016: Health and Human Rights
Eugene T Richardson, Mohamed Bailor Barrie, J Daniel Kelly, Yusupha Dibba, Songor Koedoyoma, Paul E Farmer
Despite more than 25 documented outbreaks of Ebola since 1976, our understanding of the disease is limited, in particular the social, political, ecological, and economic forces that promote (or limit) its spread. In the following study, we seek to provide new ways of understanding the 2013-2016 Ebola pandemic. We use the term, 'pandemic,' instead of 'epidemic,' so as not to elide the global forces that shape every localized outbreak of infectious disease. By situating life histories via a biosocial approach, the forces promoting or retarding Ebola transmission come into sharper focus...
June 2016: Health and Human Rights
Gitau Mburu, Enrique Restoy, Evaline Kibuchi, Paula Holland, Anthony D Harries
Adherence to treatment is a key element for global TB control. Public health laws can be used to enforce isolation, adherence, and completion of TB treatment. However, the practical application of public health laws can potentially range from voluntary measures to involuntary detention approaches. This paper explores the potential risks and impacts of using detention approaches to enforce TB treatment adherence. In August 2015, we conducted a literature search regarding the application of public health laws to enforce adherence to TB treatment globally, and specifically in Kenya...
June 2016: Health and Human Rights
L Lafferty, C Treloar, J Guthrie, G M Chambers, T Butler
Prisoner populations are characterized by high rates of hepatitis C (HCV), up to thirty times that of the general population in Australia. Within Australian prisons, less than 1% of eligible inmates access treatment. Public health strategies informed by social capital could be important in addressing this inequality in access to HCV treatment. Twenty-eight male inmates participated in qualitative interviews across three correctional centres in New South Wales, Australia. All participants had recently tested as HCV RNA positive or were receiving HCV treatment...
October 24, 2016: Journal of Viral Hepatitis
James W N Steenberg, Andrew A Millward, David J Nowak, Pamela J Robinson, Alexis Ellis
The benefits derived from urban forest ecosystems are garnering increasing attention in ecological research and municipal planning. However, because of their location in heterogeneous and highly-altered urban landscapes, urban forests are vulnerable and commonly suffer disproportionate and varying levels of stress and disturbance. The objective of this study is to assess and analyze the spatial and temporal changes, and potential vulnerability, of the urban forest resource in Toronto, Canada. This research was conducted using a spatially-explicit, indicator-based assessment of vulnerability and i-Tree Forecast modeling of temporal changes in forest structure and function...
October 24, 2016: Environmental Management
Jo Hunter-Adams, Landon Myer, Hanna-Andrea Rother
BACKGROUND: Infant feeding recommendations are of health importance, yet the extent to which migrant communities in low- and middle-income countries know or implement these recommendations is poorly understood. This study explores the perspectives of infant feeding amongst cross-border migrants in Cape Town, South Africa. METHODS: Between February and October 2013, semi-structured in-depth interviews (n = 23) were conducted face-to-face with Congolese, Somali and Zimbabwean mothers living in Cape Town...
2016: International Breastfeeding Journal
Dale Fisher, Paul Wicks, Zaheer-Ud-Din Babar
The development of new therapies has a rich history, evolves quickly with societal trends, and will have an exciting future. The last century has seen an exponential increase in complex interactions between medical practitioners, pharmaceutical companies, governments and patients. We believe technology and societal expectations will open up the opportunity for more individuals to participate as information becomes more freely available and inequality less acceptable. Corporations must recognize that usual market forces do not function ideally in a setting where health is regarded as a human right, and as modern consumers, patients will increasingly take control of their own data, wellbeing, and even the means of production for developing their own treatments...
October 25, 2016: BMC Medicine
Amare Deribew, John Ojal, Boniface Karia, Evasius Bauni, Mark Oteinde
BACKGROUND: Several low and middle-income countries (LMIC) use Demographic and Health Surveys (DHS) and/or Health and Demographic Surveillance System (HDSS) to monitor the health of their population. The level and trends of under-five mortality rates could be different in the HDSS sites compared to the DHS reports. In this study, we investigated the change in under-five mortality rates overtime in the HDSS sites and the corresponding DHS reports in eight countries and 13 sites. METHODS: Under-five mortality rates in the HDSS sites were determined using number of under-five deaths (numerator) and live births (denominator)...
October 24, 2016: BMC Public Health
Zhenjie Wang, Gong Chen, Chao Guo, Lihua Pang, Xiaoying Zheng
Socioeconomic inequalities associated with multiple disabilities have not been explored in China. This is the first study to explore changes in multiple disabilities among persons aged 15-64 years in China. Data were derived from the 1987 and 2006 China National Sample Surveys on Disability, which are nationally representative population-based surveys. Both surveys used multistage, stratified, cluster random sampling with probability proportional to size to derive nationally representative samples. We used standard weighting procedures to construct sample weights considering the multistage stratified cluster sampling survey scheme...
October 21, 2016: International Journal of Environmental Research and Public Health
Le Van Hien, Doan Thai Son, Hieu Trinh
This brief addresses the problem of global dissipativity analysis of nonautonomous neural networks with multiple proportional delays. By using a novel constructive approach based on some comparison techniques for differential inequalities, new explicit delay-independent conditions are derived using M-matrix theory to ensure the existence of generalized exponential attracting sets and the global dissipativity of the system. The method presented in this brief is also utilized to derive a generalized exponential estimate for a class of Halanay-type inequalities with proportional delays...
October 19, 2016: IEEE Transactions on Neural Networks and Learning Systems
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