Population Demographics Research Articles

Spatial Accessibility and Uptake of Pediatric COVID-19 Vaccinations by Social Vulnerability.

Geographic accessibility predicts pediatric preventive care utilization, including vaccine uptake. However, spatial inequities in the pediatric coronavirus disease 2019 (COVID-19) vaccination rollout remain underexplored. We assessed the spatial accessibility of vaccination sites and analyzed predictors of vaccine uptake. In this cross-sectional study of pediatric COVID-19 vaccinations from the US Vaccine Tracking System as of July 29, 2022, we described spatial accessibility by geocoding vaccination sites, measuring travel times from each Census tract population center to the nearest site, and weighting tracts by their population demographics to obtain nationally representative estimates. We used quasi-Poisson regressions to calculate incidence rate ratios, comparing vaccine uptake between counties with highest and lowest quartile Social Vulnerability Index scores: socioeconomic status (SES), household composition and disability (HCD), minority status and language (MSL), and housing type and transportation. We analyzed 15 233 956 doses administered across 27 526 sites. Rural, uninsured, white, and Native American populations experienced longer travel times to the nearest site than urban, insured, Hispanic, Black, and Asian American populations. Overall Social Vulnerability Index, SES, and HCD were associated with decreased vaccine uptake among children aged 6 months to 4 years (overall: incidence rate ratio 0.70 [95% confidence interval 0.60-0.81]; SES: 0.66 [0.58-0.75]; HCD: 0.38 [0.33-0.44]) and 5 years to 11 years (overall: 0.85 [0.77-0.95]; SES: 0.71 [0.65-0.78]; HCD: 0.67 [0.61-0.74]), whereas social vulnerability by MSL was associated with increased uptake (6 months-4 years: 5.16 [3.59-7.42]; 5 years-11 years: 1.73 [1.44-2.08]). Pediatric COVID-19 vaccine uptake and accessibility differed by race, rurality, and social vulnerability. National supply data, spatial accessibility measurement, and place-based vulnerability indices can be applied throughout public health resource allocation, surveillance, and research.

Smallmouth buffalo (Ictiobus bubalus Rafinesque) population trends and demographics in the Upper Mississippi River System

AbstractSmallmouth buffalo (Ictiobus bubalus Rafinesque) are a large-bodied fish highly valued and commercially exploited across most of their range. Despite this, relatively little is known of their population demographics compared to other exploited species. To fill these knowledge gaps, we analyzed two independent long-term datasets (30 and 57 years, respectively) and population demographic data (age structure, growth, mortality, age at maturity, and recruitment) from multiple pools of the Upper Mississippi River System (UMRS) and Illinois River (Illinois, USA). Long-term data (30-year dataset) generally show downward trends or significant declines in catch per unit effort in the UMRS, while the 57-year dataset shows a stable trend or a significant increase in the Illinois River. The oldest smallmouth buffalo were estimated to be 39 years old, with nearly every pool sampled having individuals estimated to exceed 30 years of age. Except for Pool 13 of the UMRS, 90% of smallmouth buffalo were estimated to mature between 411 and 470 mm in length or between 8.7 and 11.2 years old. Recruitment was variable: strong year classes were generally preceded by multiple years of weak year classes. Our results indicate that the smallmouth buffalo population may be stable in portions of the UMRS and Illinois River systems, but significant declines in the northern extent of the UMRS may warrant conservation concern. Recent research into ages of buffalofishes shows that consideration should be given to the idea that the UMRS population could be age truncated. Results also emphasize the importance of long-term data and the ability to show changes in exploited populations over time.

Initial responses of Chinook salmon (Oncorhynchus tshawytscha) and steelhead (Oncorhynchus mykiss) to removal of two dams on the Elwha River, Washington State, U.S.A.

Large dam removal is being used to restore river systems, but questions remain regarding their outcomes. We examine how the removal of two large dams in the Elwha River, coupled with hatchery production and fishing closures, affected population attributes of Chinook salmon (Oncorhynchus tshawytscha) and steelhead (O. mykiss). Initial responses by returning adult Chinook salmon and steelhead was an increase in the number and spatial extent of natural and hatchery origin fish. Although few naturally produced juvenile Chinook salmon and steelhead outmigrants were observed prior to and during dam removal, abundances increased three years after adult fish passage was restored, suggesting that impacts due to downstream sedimentation after dam removal were reduced. The Chinook salmon population demographics remain dominated by hatchery production, while increases in winter steelhead abundance included both hatchery and natural-origin spawners. The spatial expansion of winter steelhead upstream of former dam sites was predominantly by natural-origin spawners. We also observed a natural “reawakening” of summer steelhead that were in part derived from an up-river resident population that returned to the Upper Elwha. Our results showed that a combination of habitat, hatchery, and harvest actions can result in positive responses for salmonid populations.

Access to clinical genetic services: An evaluation of patient referral characteristics and identifying barriers in Michigan.

The utilization of genetics in medical care has enhanced the utility of precision medicine and hence increased the need for clinical genetic services. These services have reduced the costs and expanded the availability of genetic testing, but their use is limited in certain populations. This study explores the access to clinical genetic services for Michigan patients referred to a genetics clinic on the western side of the state. Factors included the travel distance (miles), wait time for appointment (days from the referral date to the date of first appointment), population demographics, and cultural characteristics. A retrospective record review of all aged patients (n = 568) referred to a genetics clinic in 2018 demonstrated that all patients were insured (100%), of which majority were white-non-Hispanic (90.7%), more than half were < 10 years of age at referral (53.3%), and most of them kept their first appointment (93.5%). Our analysis showed that the wait time was associated with referral non-compliance, p < 0.01. Adjusting for all variables, for each additional day in wait time, patients had 1% increased risk of not seeking clinical genetic services (OR = 1.01, 90% CI [1.01, 1.02]). Policies to encourage genetic service utilization and improve equitable access to precision health are needed. An opportunity exists for strategies that broaden and add diverse populations to those receiving genetic services.

Gaps in Long COVID treatments research: A scoping review

Background Long COVID affects 6 to 10% of people following SARS-CoV-2 infection. It has been documented worldwide, with over 200 symptoms reported. This scoping review assesses the evidence on Long COVID treatments to identify gaps in the evidence-base to inform research prioritisation. Methods We searched four databases (MEDLINE, Embase, Cochrane’s Trial register, Epistemonikos) supplemented by a grey literature search up to April 2023. Two reviewers screened articles and extracted data. Data were analysed using a thematic approach. Results Of 3675 records identified, 26 studies were included. Most were in high-income countries (92%), with two in upper-middle-income countries (8%). None reported inclusion of children, nor pregnant women and only 37.5% included adults over 64 years. Five (20.8%) presented ethnicity data, of these 92.9% of participants were of white ethnicity. Treatments included nutritional supplements (46%), conventional medicines (38%), hyperbaric medicine (8%), COVID-19 vaccination (4%) and complementary, alternative medicine (4%). Conclusion This scoping review highlights that more than four years after the start of the pandemic, research gaps remain for Long COVID treatments. There is a lack of research in low-income countries, despite trials being best placed locally to reflect different population demographics. There is a lack of inclusion of population sub-groups, particularly children, pregnant women and ethnic minority groups. Inclusion of these groups in future research is important given they may be at a higher risk of adverse outcomes of COVID-19, and a lack of appropriate treatments for Long COVID may contribute to the widening of health inequalities.

Relating gut microbiome composition and life history metrics for pronghorn (Antilocapra americana) in the Red Desert, Wyoming.

Host microbial communities (hereafter, the 'microbiome') are recognized as an important aspect of host health and are gaining attention as a useful biomarker to understand the ecology and demographics of wildlife populations. Several studies indicate that the microbiome may contribute to the adaptive capacity of animals to changing environments associated with increasing habitat fragmentation and rapid climate change. To this end, we investigated the gut microbiome of pronghorn (Antilocapra americana), an iconic species in an environment that is undergoing both climatic and anthropogenic change. The bacterial composition of the pronghorn gut microbiome has yet to be described in the literature, and thus our study provides important baseline information about this species. We used 16S rRNA amplicon sequencing of fecal samples to characterize the gut microbiome of pronghorn-a facultative sagebrush (Artemisia spp.) specialist in many regions where they occur in western North America. We collected fecal pellets from 159 captured female pronghorn from four herds in the Red Desert of Wyoming during winters of 2013 and 2014. We found small, but significant differences in diversity of the gut microbiome relative to study area, capture period, and body fat measurements. In addition, we found a difference in gut microbiome composition in pronghorn across two regions separated by Interstate 80. Results indicated that the fecal microbiome may be a potential biomarker for the spatial ecology of free-ranging ungulates. The core gut microbiome of these animals-including bacteria in the phyla Firmicutes (now Bacillota) and Bacteroidota-remained relatively stable across populations and biological metrics. These findings provide a baseline for the gut microbiome of pronghorn that could potentially be used as a target in monitoring health and population structure of pronghorn relative to habitat fragmentation, climate change, and management practices.

Population density and vegetation resources influence demography in a hibernating herbivorous mammal.

Demography of herbivorous mammal populations may be affected by changes in predation, population density, harvesting, and climate. Whereas numerous studies have focused on the effect of single environmental variables on individual demographic processes, attempts to integrate the consequences of several environmental variables on numerous functional traits and demographic rates are rare. Over a 32-year period, we examined how forage availability (vegetation assessed through NDVI) and population density affected the functional traits and demographic rates of a population of Columbian ground squirrels (Urocitellus columbianus), a herbivorous hibernating rodent. We focused on mean population phenology, body mass, breeding success, and survival. We found a negative effect of population density on demographic rates, including on breeding success and pup and adult survival to the next year. We found diverging effects of vegetation phenology on demographic rates: positive effects of alater start of the growing season on adultand yearling femalesurvival, and juvenile survival, but no clear effect on male survival. Interestingly, neither population density nor vegetation affected population phenology or body condition in the following year. Vegetative growth rate had a positive influence on female mass gain (somatic investment) over a season, but bothvegetative growth rate and biomass, surprisingly, had negative effects on the survival of young through their first hibernation. Thus, ground squirrels appeared to benefit more from later timing of vegetation than increases in vegetative biomass per se. Our study provides evidence for complex ecological effects of vegetation and population density on functional traits and demographic rates of small mammal populations.

Overview of geographical indications in northeast Brazil

The Geographical Indication (GI) is a distinctive signo f recognition of the quality and/or notoriety of a product or service. It is a legal tool that provides protection to na asset. It has two species: Designation of Origin (DO) and Indication of Origin (IP). Brazil has heterogeneous geographical characteristics according to its socioecnomic and territorial development, making some of them producer and consumer centers. The country is divided into five region. The Northeast region is composed of nine states and currently has 16 GIs in the IP modality, which represent 18.18% of the total granted in Brazil, and two in the DO modality, which represent 7.69% of the national total. The present work aims to prospect GI registration in the IP modality in the Northeast Region of Brazil and its growth over time. The methodology used was exploratory and descriptive, using as a tool the bibliographic review in scientific journals and on the website of the National Institute of Industrial Property (INPI). The first of IP occurred in 2009, while in the DO species it was in 2011. In 2012 there was the highest number of registrations, with 4 concessions. Bahia leads in the number with five, two of which are shared with Pernambuco. Maranhão does not yet have any IP granted. The Northeast Region has grat potential to register other products as GI, due to its demographic area, population, tradition, culture, ethnic diversity, rich biodiversity, traditional peoples, quilombolas and indigenous people with their vast knowledge of arts, drinks and plant cultivation.

Geographic Access to Urogynecology Care in the United States.

Although access to urogynecologic care is known to influence patient outcomes, less is known regarding geographic access to care and how it may vary by population characteristics. The primary objective of this study was to estimate geographic accessibility of urogynecologic services in terms of drive time and by population demographics. We performed a descriptive study using practice location data by zip code for all board-certified urogynecologists who are American Urogynecologic Society members (n = 497) and pelvic floor physical therapists (n = 985). Drive times from each zip code to the nearest health care professional zip code were calculated. These data were then overlaid onto a map of the continental United States. Race/ethnicity, age, education, poverty status, disability status, health insurance coverage, and rurality were compared across travel times. Of the 31,754 zip codes of the continental United States, 389 (1.23%) had at least 1 urogynecologist, and 785 (2.47%) had at least 1 pelvic floor physical therapist; 92.29 million women older than 35 years were represented in the demographic analyses. Seventy-nine percent of the studied population live within 1 hour of a urogynecologist, and 85% live within 1 hour of a pelvic floor physical therapist. Seven percent and 3% live >2 hours from urogynecologic services, respectively. Values for drive times to all health care professionals indicate that American Indian/Alaska Native individuals have a much greater travel burden than other racial/ethnic groups. There are population groups with limited geographic access to urogynecologic services. Pelvic floor physical therapists are more geographically accessible to the population studied than urogynecologists.

Cross-sectional analysis for lymphedema epidemiology in South Korea by HIRA data: An observational study.

Lymphedema is known to affect as many as 140 to 250 million people worldwide. Approximately 99% of lymphedemas are secondary cases after lymphadenectomy, radiation, or parasite infection. There has been no accurate estimate of the lymphedema population size in South Korea. This study aimed to quantify the epidemiology of lymphedema in South Korea and analyze the clinical characteristics of patients with lymphedema using a nationwide database. This large-scale cross-sectional study included patients who received one of the following three diagnostic codes - Q82.0 (hereditary lymphedema), I97.2 (breast cancer-related lymphedema), and I89.0 (unclassified lymphedema) from the Korean Health Insurance Review and Assessment service between January 2019 and July 2022 at tertiary hospitals, general hospitals, or other hospitals. The demographics of the lymphedema population, medication use, and medical characteristics were identified. Over the last 4 years, the annual incidence of lymphedema has steadily increased and peaked in 2021 with the number 1.85 out of 1000. Of all patients, 81% were located in the upper extremity, and 10.6% had previous cancer. Most patients were diagnosed in general hospitals (53.2%), at orthopedic surgery department (41.9%). On average, lymphedema patients spent 70.17 US dollar for medication and hospitalized for 16.9 days annually after diagnosis. Commonly prescribed medications were Entelon® (Vitis vinifera seed extract) (66.9%), steroids (40.5%), non-steroidal anti-inflammatory drugs (26.5%) and diuretics (21.8%). Only 5.7% of patients received surgery and 19.2% received herbal medicine. This is the first study in South Korea to quantify demographic and medical characteristics of lymphedema patients. These results will contribute to a comprehensive understanding of lymphedema diagnosis and treatment in our nation.

Emerging Nanozymes in Neurological Disorder Therapeutics: Bridging Oxidoreductase Mimicry and Antioxidant Chemistry

AbstractThe prevalence of neurological dieases, including neurodegenerative, neurotraumatic disorders, and neuroinflammatory conditions, has been rising due to global population and aging demographics. A key factor in the pathogenesis of these disorders is the hyperaccumulation of reactive oxygen and nitrogen species (RONS). Nanozymes have emerged as promising candidates for neurotherapeutic applications owing to their exceptional catalytic activity and stability. Of particular note is their ability to cross the blood‐brain barrier and counteract the production of reactive oxygen species via their enzyme‐mimicking characteristics. In this review, the latest advancements and theoretical knowledge in this research domain are summarized. Using the inherent functionalities of the Web of Science and bibliometric methodologies, annual publication trends are identified and extensively explored the most researched topics and neurological disorders in this field. The antioxidant reduction chemistry of the nanozymes is discussed, highlighting their ability to mimic natural oxidoreductase activity and inhibit RONS production at the source. Moreover, this review delves into the current limitations and future prospects of these mechanisms in addressing neurological disorders. The significant benefits and recent developments in the use of RONS‐regulating nanozymes for the treatment of neurological diseases are emphasized, offering insights into their therapeutic applications and broader implications for neurology.

Clinical characteristics of a COVID-19 cohort treated at UCLA Ronald Reagan Medical Center during the breaking phase of the pandemic: A retrospective study

To this date, COVID-19 remains an unresolved pandemic, and the impairment of redox homeostasis dictates the severity of clinical outcomes. Here we examined initial UCLA cohort of 440 COVID-19 patients hospitalized between March 1st and April 1st, 2020, representing the first wave of the pandemic. The mean age was 58.88 ± 21.12, among which males were significantly more than females (55.5 % vs. 44.5 %), most distinctively in age group of 50–69. The age groups of 50–69 (33.6 %) and ≥70 (34.8 %) dominated. The racial composition was in general agreement with Census data with slight under-representation of Hispanics and Asians, and over-representation of Caucasians. Smoking was a significant factor (28.8 % vs. 11.0 % in LA population), likewise for obesity (BMI ≥30) (37.4 % vs. 27.7 % in LA population). Patients suffering from obesity or BMI<18.5 checked into ICU at a significantly higher rate. A 74.5 % of the patients had comorbidities including diabetes, chronic kidney disease, chronic pulmonary disease, congestive heart failure and peripheral vascular disease. The levels of d-dimer were drastically upregulated (1159.5 ng/mL), indicating hypercoagulative state. Upregulated LDH (328 IU/L) indicated significant tissue damages. A distorted redox hemeostasis is a common trait associated with these risk factors and clinical markers. A quarter of the patients received antivirals, among which Remdesivir most prescribed (23.6 %). Majority received antithrombotics (75 %), and antibiotics. Upon admission, 67 patients were intubated or received CPR; 177 patients eventually received intensive care (40.2 %). While 290 were discharged alive, 10 remained hospitalized, 73 were transferred, and 36 died with 3 palliatively discharged. In summary, our data fully characterized a Californian cohort of COVID-19 at the breaking phase of the pandemic, indicating that population demographics, biophysical characters, comorbidities and molecular pathological parameters have significant impacts on the evolvement of a pandemic. These provide critical insights into effective management of COVID-19, and future break from another pathogen.

Population Demographics of Native Red-Bellied Cooters and Invasive Red-Eared Sliders in a Virginia Lake

Population Demographics of Native Red-Bellied Cooters and Invasive Red-Eared Sliders in a Virginia Lake

Movement of juvenile migratory birds from settlement to adulthood across the non-breeding range.

Among migratory vertebrates, high levels of fidelity to non-breeding sites during adulthood are common. If occupied sites vary in quality, strong site fidelity can have profound consequences for individual fitness and population demography. Given the prevalence of adult site fidelity, the regions of the non-breeding range to which juveniles first migrate, and the scale of any subsequent movements, are likely to be pivotal in shaping distributions and demographic processes across population ranges. However, inherent difficulties in tracking migratory individuals through early life mean that opportunities to quantify juvenile settlement and movements across non-breeding ranges, and the mechanisms involved, are extremely rare. Through long-term, range-wide resightings of hundreds of colour-marked individuals from their first migration to adulthood and the application of state-space models, we quantify levels of juvenile and adult regional-scale movements and distances at different life stages across the whole non-breeding distribution range in a migratory shorebird, the Black-tailed Godwit (Limosa limosa islandica). We show that the probability of individuals changing non-breeding regions (seven historical wintering regions spanning the Western Europe range) at all ages is very low (mean movement probability = 10.9% from first to subsequent winter, and 8.3% from first adult winter to later winters). Movement between regions was also low between autumn and winter of the same year for both juveniles (mean movement probability = 17.0%) and adults (10.4%). The great majority of non-breeding movements from the first autumn to adulthood were within regions and less than 100 km. The scarcity of regional-scale non-breeding movements from the first autumn to adulthood means that the factors influencing where juveniles settle will be key determinants of non-breeding distributions and of the rate and direction of changes in distributions.

Customized Music Therapy Combined With the Counseling and Follow-Up System: Stratified Results for Tinnitus Efficacy.

Chronic subjective tinnitus is a worldwide intractable problem. In our previous studies, customized music therapy combined with a follow-up system can reduce tinnitus perception and improve anxiety/depression. This study aims to explore which characteristics of tinnitus patients are more likely to benefit from our therapy. This study included 1031 patients with chronic subjective tinnitus, all of whom completed customized music therapy with the follow-up system. Population demographics, tinnitus characteristics, and tinnitus-related scales at pretherapy and posttherapy were collected. Huadong Hospital affiliated Fudan University, Department of Otorhinolaryngology-Head & Neck Surgery from 2018 to 2022. A paired t test and the one-way analysis of variance were utilized to the overall efficacy and stratified difference based on tinnitus duration/age/tinnitus frequency. There were significant statistical differences in the Tinnitus Handicap Inventory (THI), Tinnitus Loudness Visual Analog Scale (VAS), and Hospital Anxiety and Depression Scale (HADS)-A/D scores between pretherapy and 3 months posttherapy. THI and HADS (A/D) scores decreased the most in the 1-year duration tinnitus group. The most significant decrease in THI and VAS scores was observed in the 31- to 50-year-old tinnitus group. Patients with high-frequency tinnitus and extended high-frequency tinnitus had greater decreases generally than those with low-frequency tinnitus though no significance. Group with severe and prolonged tinnitus, shorter duration of tinnitus onset, and 31 to 50 years old benefit more from our therapy. Therefore, standardized personalized music and consulting and follow-up systems while promoting early treatment can reduce tinnitus and its comorbidities.

Projected Thermally Driven Elderly Mortality for Beijing Under Greenhouse Gas and Stratospheric Aerosol Geoengineering Scenarios

AbstractBeijing is undergoing multiple challenges including urbanization, warming and aging. The Beijing megalopolis of 20 million people now suffers more cold‐related than heat‐related deaths. Stratospheric aerosol injection (SAI) geoengineering is designed to lower surface temperatures, so if SAI were ever done, it may reduce future heat‐related mortality, while also increasing cold‐related mortality. Here we use four Earth System Models (ESM) downscaled to 10 km resolution with the Weather Research and Forecasting (WRF) system to capture urban temperature, humidity and wind speeds. Temperature‐related mortality risk were calculated using a distributed lag nonlinear model (DLNM) of the elderly (over 65s) under the dynamically downscaled moderate (RCP4.5) and extreme (RCP8.5) greenhouse gas, and the G4 SAI scenarios. We used population demographics for all five shared socioeconomic pathways (SSP) and various adaptation measures. Heat‐related excess deaths under G4 are 630∼3,160 per year fewer than RCP4.5, while cold‐related deaths are 370∼1,990 more than RCP4.5 during 2060–2069, with a marginally significant net reduction. G4 significantly reduces the excess deaths relative to RCP8.5. Both heat‐related and cold‐related mortality will increase by 240∼490% when the aging population is accounted for, and decrease by 11%, 23% and 44% under low, medium and high adaptation relative to a no adaptation scenario. Dynamical downscaling produces better quality climate simulations than commonly used statistical approaches, and in the case of Beijing, significantly fewer heat‐related deaths. The marginal health benefits of modest future SAI in Beijing may be representative of the population impacts in the extra‐tropics where deaths due to cold are more than those caused by heat.

Clinical characteristics and outcomes of Australian and Indian ST-segment elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (PCI)

IntroductionThe incidence of STEMI and subsequent mortality has been reported to be higher in Indian populations compared to developed countries. However, there is limited data directly comparing contemporary primary percutaneous coronary intervention (pPCI) treatment strategies and clinical outcomes for STEMI patients between developed and developing countries. Materials and methodsWe compared population demographics, procedural characteristics, times to reperfusion and mortality in STEMI patients treated with pPCI between two tertiary referral centers in India and Australia respectively over a 3-year period (1st Jan 2017–31st Dec 2019). ResultsA total of 1293 STEMI presentations (896 Indian vs 397 Australian) were included. On average, Indian patients had lower median BMI than Australian patients (BMI 25.4 vs 27.8; p < 0.001), were significantly younger (mean age 56.0 vs 63.2 years; p < 0.001), more likely male (84 % vs 80 %; p = 0.046) and diabetic (48 % vs 18 %); p < 0.001). Radial access (50 % vs 88 %; p < 0.001) and TIMI III flow post PCI was also significantly lower (85 % vs 96 %; p < 0.001) with median door-to-balloon time significantly shorter in the Indian cohort (20mins vs 43mins; p < 0.001); however, median symptom to balloon time was significantly longer (245mins vs 160mins; p < 0.001). No significant differences in 30-day mortality (4.0 % vs 2.8 % Australian; p = 0.209) or 1-year mortality (6.5 % vs 4.3 %; p = 0.120) were observed. ConclusionSignificant differences in demographics and presentation characteristics exist between Indian and Australian STEMI patients treated with pPCI. Indian patients had significantly longer pre-hospital delays and lower achievement of TIMI III flow post PCI, yet shorter in-hospital time to treatment.

Utilization of Head Imaging in Children and Adolescents With First-Episode Psychosis: A Retrospective Analysis.

Background Psychotic disorders are commonly diagnosed in the mid-20s but symptoms often emerge earlier during late teenage years to mid-20s. Notably, studies have shownthat psychotic symptoms can also affect younger individuals, with a higher prevalence among preteens than teens. Head imaging via computed tomography (CT) or magnetic resonance imaging (MRI) can be performed to rule out non-psychiatric causes of psychotic symptoms in this population but may pose additional risks and financial burdens. Practice patterns vary regarding when to utilize head imaging in pediatric patients with first-episode psychosis (FEP). The purpose of this study is to better understand the use of head imaging in pediatric FEP and associated patient characteristics. Methods A retrospective cohort study was performed. Eligible patients were <18 years of age with an encounter documented between 2013 and 2023 where a diagnosis code for psychosis was first applied. Medical records were manually reviewed if head imaging was performed during the index encounter or within one month. Descriptive statistics were used to report the study population demographics. Independent t-testing was used to compare characteristics between patients who did and did not receive head imaging. Results A total of 113 patients met the inclusion criteria for the study, of which 12 (10.6%) received head imaging within the specified timeframe. All received CTcriteria head scans, and a significantly higher proportion were African American or Black when compared tothose who did not receive head imaging (10/12 (83.3%) vs. 53/101 (52.5%) p=0.023). None of the imaging tests performed yielded significant neurological findings that suggested an underlying pathology for psychosis. Conclusions Head imaging was rarely utilized for the initial assessment of pediatric FEP in this study. When it was used, CT head scans were the modality of choice but did not yield any remarkable findings to suggest a non-psychiatric cause of psychotic symptoms. This adds to the body of evidence supporting a conservative approach when considering head imaging in pediatric FEP.

Narrative Review on Universal Health Coverage in Thailand and China from the Lens of Social Determinants of Health Theory

This article through the literature review method briefly compares universal health coverage (UHC) in Thailand and China, highlighting their strategies and challenges in achieving UHC through the lens of social determinants of health: a) health financing design and sustainability, b) accessibility of healthcare resources, and c) participatory and responsive governance. While Thailand mainly utilizes a tax-based approach, China employs a health insurance model. Both countries have achieved high insurance coverage. However, some challenges exist. The unmet need for health services due to long waiting times has been a key concern in Thailand, whereas financial hardship from receiving care was a critical concern in the case of China. Thailand has created a mechanism to allow a wide range of stakeholders to participate in the UHC design to ensure responsive governance. In contrast, China has not yet formed comprehensive legal grounds for participatory and responsive governance on UHC. Their experiences and encountered obstacles can offer valuable lessons on how middle-income nations can advance towards UHC, highlighting the critical need for ongoing improvements in health systems to tackle the existing and new health challenges due to the change in population demographics and the continuing increase of population healthcare demand.

Trauma-Informed Care for Children: A Scoping Review

Background: Trauma-informed care involves providing services to traumatized patients with an understanding of and sensitivity to their experiences. This scoping review examines the literature concerning trauma-informed care for children.Methods: We conducted a comprehensive literature search across domestic (RISS, NDSL, KISS, and DBpia) and international (PubMed, Embase, CINAHL, and PsycINFO) databases. The search terms were “trauma,” “PTSD,” “trauma-informed,” “trauma-focused,” “trauma-sensitive,” “newborn,” “neonate,” “premature infant,” “infant,” “child,” “adolescent,” “teen,” “juvenile,” “adolescence,” “pediatric,” and “nursing”. The final selection comprised 18 documents that were analyzed for general characteristics (publication year, study country, academic sector, research design, and data collection method), population demographics, variables, and measurement tools.Results: Literature on this topic considerably increased since 2017, with the United States being the predominant research hub (50.0%) and nursing representing the primary academic sector (55.6%). The research designs were mainly quantitative (33.3%) and mixed-method studies (33.3%). Quantitative studies predominantly utilized surveys, while qualitative research employed observations, in-depth interviews, and focus group discussions. Most of the participants were nurses, doctors, and allied health professionals. As a result of analyzing the main variables measured in the literature through WordCloud, variables such as “stress,” “care,” and “knowledge” had the highest frequency. Three studies incorporated or adapted tools to assess trauma-informed care.Conclusions: The findings of this review serve as foundational data for proposing future research trajectories in trauma-informed care and for enhancing awareness and strategic planning in clinical practice.