Health Needs Research Articles

A digital aptasensor for the ultrasensitive detection of T-2 toxin by using single molecule array

T-2 toxin is a low molecular weight, refractory mycotoxin, often contaminating cereal-based foods, and can cause detrimental effects on human health such as nausea, vomiting, and long-term immune suppression. Therefore, highly sensitive detection platform for T-2 toxin test at the molecular level is an urgent need for food safety and public health. In this work, a digital aptasensor is developed for the ultrasensitive detection of T-2 toxin by combining aptamer and single-molecule array technology. Initially, T-2 toxin competed with the biotin-labeled complementary sequence probe to bind the T-2 toxin aptamer. The free biotin-labeled probe was then hybridized with a capture probe modified on the magnetic beads to form a stable double-stranded structure. After combining with streptavidin-enzyme, the structure was used for fluorescence imaging analysis via single-molecule microwell arrays. By correlating the concentration of T-2 toxin with the number of fluorescent microtiter wells, the ultra-sensitive detection of the T-2 toxin was realized. The developed digital aptasensor has demonstrated remarkable sensitivity toward T-2 toxin, with a detection range between 0.16 and 300 pM (approximately 0.075–140 pg/mL) and a detection limit of 44.5 fM (approximately 20.8 fg/mL). Additionally, 87.0 %-103.1 % recoveries were obtained from spiked samples in corn. This work offers a highly effective approach to detecting trace amounts of T-2 toxin, which has the potential to be used for enhancing food safety protocols, providing a powerful tool for industries and regulatory agencies to protect public health.

Gerrymandering and the Packing and Cracking of Medical Uninsurance Rates in the United States.

Technological innovation and access to big data have allowed partisan gerrymandering to increase dramatically in recent redistricting cycles. To understand whether and how partisan gerrymandering, including "packing" and "cracking" (ie, respectively concentrating within or dividing specified social groups across political boundaries), distorts understanding of public health need when health statistics are calculated for congressional districts (CDs). Cross-sectional study using 2020 CDs and nonpartisan simulated districts. United States, 2017-2021. United States residents. Percent with no medical insurance (uninsured), within-district variance of percent uninsured, and between-district variance of percent uninsured. At the state level, states where partisan redistricting plans showed greater evidence of partisan gerrymandering were more likely to contain CDs with more extreme values of uninsurance rates than districts in states with less evidence for gerrymandering (association between z-scores for gerrymandering and between-district variation in uninsurance=0.25 (-0.04, 0.53), P=.10). Comparing variation in uninsurance rates for observed CDs vs nonpartisan simulated districts across all states with more than 1 CD, in analyses stratified by state gerrymander status (no gerrymander, Democratic gerrymander, and Republican gerrymander), we found evidence of particularly extreme distortion of rates in Republican gerrymandered states, whereby Republican-leaning districts tended to have lower uninsurance rates (the percentage of Republican-leaning districts that were significantly lower than nonpartisan simulated districts was 5.1 times that of Democratic-leaning districts) and Democrat-leaning districts had higher uninsurance rates (the percentage of Democrat-leaning districts that were significantly higher than nonpartisan simulated districts was 3.0 times that of Republican-leaning districts). Partisan gerrymandering can affect determination of CD-level uninsurance rates and distort understanding of public health burdens.

How We Feel: COVID-19 Pandemic Experiences Among Intergenerational Cambodian, Laotian, and Vietnamese Americans in San Francisco

The COVID-19 pandemic has exacerbated many social determinants of health and barriers to health care for Southeast Asian Americans. The objective of this study is to understand the impact of the COVID-19 pandemic on Southeast Asian American communities’ health care utilization and need for support. This cross-sectional study administered surveys and conducted focus groups with 78 participants (>= 14 years) across generations and Cambodian, Laotian, and Vietnamese ethnicity in partnership with the Southeast Asian Development Center in San Francisco, California between July and September 2021. We identified two themes in health care utilization: barriers to health care and fear of anti-Asian violence; two themes in COVID-19 prevention: utilization of COVID-19 services and COVID-19 safety precautions; and two themes in the role of community and community centers: intergenerational community and crucial services provided by community centers. Despite the challenges posed by the duality of the COVID-19 pandemic and fear of anti-Asian violence, Southeast Asian Americans persisted with resilience to seek health services with intergenerational support and the guidance of community centers. This highlights the significance of community-oriented health among Southeast Asian Americans and the value of community-led health interventions in advancing health for a historically underserved population.

Hometown Heroes: Onshoring, Promoting Local Content & WTO Law

Abstract This article examines the complexities and challenges associated with onshoring manufacturing through local content requirements within the context of World Trade Organization (WTO) law. Governments have intensified efforts to relocate production within their territories, leveraging local content requirements and incentives. This shift is primarily justified by the need for supply chain resilience, public health, and national security, aiming to mitigate risks associated with reliance on foreign suppliers during crises. However, these strategies may conflict with WTO obligations, particularly those concerning trade-related investment measures and subsidies. Using pharmaceuticals as a case study, this article explores the rationale, scope, and implications of WTO rules on local content policies. The analysis provides insights into how nations navigate the delicate balance between enhancing domestic capabilities and adhering to international trade laws.

Health Needs Assessment of Unhoused Youth in Charleston, South Carolina.

Over 35000 youth experience homelessness on any given night in the United States (US). Unhoused youth experience unique physical and mental health challenges and face barriers in every social determinant of health (SDoH), which may be amplified in the LGBTQ+population. The objective of this study was to define characteristics of the unhoused youth population and their utilization of healthcare to inform programs to meet their needs. Secondary analysis of data from the College of Charleston's YOUth Count survey was conducted, focusing on health-related characteristics, challenges, healthcare utilization, and SDoH of youth aged 18 to 25 experiencing homelessness in Charleston, SC. Almost three-quarters of respondents (74.6%) reported mental health challenges and 35% reported physical health challenges. A significantly higher proportion of those who engaged in survival sex were LGBTQ+. More than half (68.4%) visited the emergency department (ED) and 29.3% were admitted to the hospital in the past 12months. Housing status, safety, food insecurity, sexual orientation, prior foster care, and survival sex were all significantly associated with ED utilization. Housing status and survival sex were significantly associated with hospital admission. Addressing SDoH is essential to improving health outcomes and healthcare utilization among unhoused youth, particularly in the LGBTQ+population.

AWARENESS ON MENTAL HEALTH AMONG THE STUDENTS OF HIGHER SECONDARY LEVEL: A STUDY

In formal educational system the most important stage of education is the secondary stage. Especially the higher secondary stage can be considered as the gateway of building a better career in the life of any student. All students of this stage feel pressure in their study for securing good marks in the exam. Moreover they feel anxiety as well as stress because of preparing themselves for entrance exams. Apart from these there are so many students which use to face several problems, like- poverty, lack of transportation, gender disparity, parent’s illiteracy, natural calamities and superstitions and so on. So it is very difficult to adjust with these kind of situations along with their heavy pressure of study. Sometime the students of secondary level cannot cope up with such type of overloaded situations. Therefore it is very important to keep their mental health in a sound position so that they can tackle their problems and perform their duties properly. They should know about their mental health problems and they should be aware about the importance of mental health. Especially the students of secondary level need to know the various means of development of their mental health. The present study is aimed at creating awareness about the need and importance of mental health among the students. The objectives are-1. To study the problems of mental health of the students. 2. To study the awareness towards mental health among the students. 3. To study the difference between boy and girl students in mental health awareness.

CYCLONES IDAI AND KENNETH

This research addresses the effects of cyclones Idai and Kenneth on the health and social equity of the populations of Mozambique. These populations suffered from these extreme weather events in 2019. Thus, this study used a qualitative approach, which involved an interpretation of social phenomena based on the meanings that the subjects attribute to them. For this, two data collection methods were used: bibliographic review and document analysis. The research used concepts and norms of social determinants of health and human rights and was based on data and sources from international organizations, such as UNICEF and ILO. The results of the research show that the cyclones caused damage to the physical, mental, and social health of the affected people, in a differentiated and unequal way, according to their sociocultural and territorial conditions, but also and in social terms some groups were more marginalized than others, because of the social and structural inequalities pre-existing in the country. It was also highlighted the need for health, public policies, and civil society to respond to the emergency and medium- term demands of the affected people, through the creation and strengthening of services, plans, strategies, partnerships and initiatives of humanitarian and solidarity assistance. The research also points out the challenges, limitations and lessons learned in the response to the cyclones, as well as the recommendations to increase the resilience and equity of the affected communities.

Existential Needs in Mental Health - Who Cares? A Mixed Methods Study in Norway.

Mental health care that is open to patients' existential needs requires well-trained professionals who work in teams and use an open conceptualization of spirituality, religion and other meaning-making domains. Using a mixed methods approach, this article explores how professionals (n = 262) in secular Norway perceive obstacles and opportunities in existential care. The results show correlations between age group, personal religiosity, terminology and perceived expertise. Commitment is high, but collaboration with chaplains and team training are neglected.

Addressing the Health Needs of Indian Americans in the Greater Philadelphia Region Through a Scoping Survey: Cancer Screening Assessment.

Despite higher income and education, there are profound health disparities among Asian Americans. These disparities are highlighted in particular by screening behaviors for cancer. Between 1998 and 2008, cancer rates increased threefold among Indian Americans, raising concern that cancer screening in this group may be especially low. To better understand cancer screening behavior, we collected data from a total of 157 self-identifying Indian Americans residing in the greater Philadelphia area. Nearly all participants reported having health insurance (98.7%), and most had received a physical exam within a year (87.3%). Only17.4% of the participants were referred for mammography, while 30% of participants over age 30 were referred for ovarian cancer screening. Just 4 participants were recommended for pancreatic cancer screening. The findings contribute new information to the understanding of health needs of Indian Americans residing in the greater Philadelphia region and reveal a need for greater focus on preventive care.

Understanding the Behavioral Health Needs of Hospice Patients and Their Family Caregivers: Perspectives of Hospice Medical Directors.

Behavioral health disorders are common among patients and caregivers in the hospice setting. Yet, limited data exist regarding what hospice providers perceive as the most common and challenging behavioral health disorders they encounter and how they manage these issues in practice. To characterize the perspectives of hospice medical directors (HMDs) on addressing the behavioral health challenges when caring for patients enrolled in home hospice care and their family caregivers. Semistructured interviews with seventeen certified HMDs were conducted. Data were analyzed using thematic analysis. Many HMDs agreed that delivering high-quality behavioral health care is a tenet for good end-of-life (EoL) care. HMDs shared that depression and anxiety were the most common behavioral health challenges they encountered, while among caregivers, substance use disorder was the most challenging. Participants mentioned that nurses and social workers played a vital role in detecting and managing behavioral health problems. HMDs also stated that providing additional training for frontline staff and incorporating behavioral health experts are potential solutions to help address current challenges. HMDs emphasized the importance of addressing behavioral health challenges among patients and caregivers to provide effective end-of-life care. Future studies should examine the viewpoints of additional key stakeholder groups (e.g., hospice interdisciplinary team members, family caregivers) and confirm them in quantitative studies. Designing and implementing evidence-based assessments and interventions to improve behavioral health care by addressing anxiety, depression, and caregiver substance use disorders is essential to improving care and care outcomes in the hospice setting.

Association between impaired diffusion capacity and small airway dysfunction: a cross-sectional study

BackgroundSmall airway dysfunction (SAD) and impaired diffusion capacity of the lungs for carbon monoxide (DLCO) are positively associated with a worse prognosis. Individuals with both dysfunctions have been identified in clinical, and it is unknown whether they had worse health status or need management. We conducted this study to explore the association between SAD and impaired DLCO, and the difference between the groups with two dysfunctions, with either one dysfunction, and with no dysfunction.MethodsThis study involved subjects partly from those who had returned for the third-year follow-up (up to December 2022) of the ECOPD Study and those who newly participated. We assessed the diffusion capacity, questionnaire, exacerbations, spirometry, impulse oscillometry (IOS), and computed tomography (CT). Impaired DLCOwas defined as DLCO%predicted <80%. Spirometry-defined SAD was defined using MMEF %predicted, FEF50%predicted, and FEF75%predicted; at least two of the three being <65% using post-bronchodilator spirometry. IOS-defined SAD was defined as R5-R20 >0.07 kPa·L−1·s−1. CT-defined SAD was defined by LAA−856% comprising ≥15% of the total lung volume. Covariate analyses and logistic regression were performed to assess the association between impaired DLCOand SAD.ResultsThis study involved 581 subjects. The occurrence of both spirometry- and CT-defined SAD was significantly higher in subjects with impaired than normal DLCOSubjects with two dysfunctions were associated with worse preceding-year exacerbations than controls.ConclusionsImpaired diffusion capacity is positively associated with SAD. Subjects with impaired diffusion capacity and SAD may have a worse health status and need additional management.

Legal Recognition, Protection, and Health: A Socio-legal Framework for Assessing Determinants of Health in the Jamaican Trans Community

Abstract: In Jamaica and the wider Caribbean, the legal system allows for discrimination based on gender and sexual identity with impunity. This exposes trans people to disparate risks of violence and barriers to accessing social services such as health care. In this paper we assess the social determinants of health in the Jamaican trans population using a modified social-ecological model of transgender stigma and stigma interventions. To conduct this assessment, we situated the findings of the 2021 Jamaican Trans Health Needs Assessment and Trans Health Strategy within the socio-ecological framework with direct application to rights-based health services as well as the Jamaican legal system to develop a model for understanding the socio-legal determinants of health. The social determinants of health identified within the Jamaican trans community are all influenced by a lack of legal protection suggesting a need for legal reform toward nondiscrimination of sexual and gender-diverse populations.

What Should Clinicians in Organizations Without Established MLP Programs Do When Their Patients Need Lawyers to Meet Their Health Needs?

Undocumented people in the United States face innumerable legal and structural barriers to health and health care services, including for kidney failure. Their experiences vary across states and regions due to wide variation in insurance coverage and unreliable access to health-promoting resources, including medical-legal partnerships. This commentary on a case canvasses key policy about structural and legal determinants of health for undocumented persons.

Limited Awareness of Long COVID Despite Common Experience of Symptoms Among African American/Black, Hispanic/Latino, and Indigenous Adults in Arizona.

Communities of color might disproportionately experience long-term consequences of COVID-19, known as Long COVID. We sought to understand the awareness of and experiences with Long COVID among African American/Black (AA/B), Hispanic/Latino (H/L), and Indigenous (Native) adults (18 + years of age) in Arizona who previously tested positive for COVID-19. Between December 2022 and April 2023, the Arizona Community Engagement Alliance (AZCEAL) conducted 12 focus groups and surveys with 65 AA/B, H/L and Native community members. Data from focus groups were analyzed using thematic analysis to identify emerging issues. Survey data provided demographic information about participants and quantitative assessments of Long COVID experienceswere used to augment focus group data. Study participants across all three racial/ethnic groups had limited to no awareness of the term Long COVID, yet many described experiencing or witnessing friends and family endure physical symptoms consistent with Long COVID (e.g., brain fog, loss of memory, fatigue) as well as associated mental health issues (e.g., anxiety, worry, post-traumatic stress disorder). Participants identified a need for Long COVID mental health and other health resources, as well as increased access to Long COVID information. To prevent Long COVID health inequities among AA/B, H/L, and Native adults living in AZ, health-related organizations and providers should increase access to culturally relevant, community-based Long COVID-specific information, mental health services, and other health resources aimed at serving these populations.

Alterations in captive Alexandrine parakeet (Palaeornis eupatria) gut microbiome and metabolome in response to dietary change

The Alexandrine parakeet (Palaeornis eupatria), also known as the Alexandrine parrot, is a critically endangered species in the world and a national second class protected animal. Current knowledge on gut microbiome and metabolome of captive Alexandrine parrots is limited. In the current study, we characterized the effect of dietary change with pellet feeding on the gut microbiome and metaboliome in Alexandrine parrots using 16S gene sequencing and liquid chromatography with tandem mass spectrometry (LC-MS/MS). Total of 12 Alexandrine parrots were used in a cross-over study with each period for 10 days. The results showed that dietary change with pellet feeding did not affect alpha indices of gut microbiota. Cyanobacteria, Firmicutes and Proteobacteria were the predominant bacterial phyla in the gut of Alexandrine parrot with Cynobacteria being the highest. Change of diet significantly increased the relative abundance of Actinobacteria and decreased Spirochaetota. The relative abundance of Fusobacteriota tended to increase with pellet feeding. No treatment effects were observed between the control and pellet feeding groups at the genus level. Based on the annotation results from Clusters of Orthologous Genes (COG) database, dietary change with pellet feeding significantly increased the relative abundance of genes coding for extracellular structures and lipid transport and metabolism. Metabolomics analysis combined with enrichment analysis revealed that dietary change altered the concentrations of gut metabolites as well as the metabolic pattern, and significantly affected the concentrations of fecal metabolites involved in isoflavonoid biosynthesis, flavonoid biosynthesis, nucleotide metabolism etc. In summary, dietary changes with pellet feeding affected the gut microbial composition and metabolites to some extent. The relevance of current findings to Alexandrine parrots' health and potential zoonosis need further exploring.

Quantitative Intersectionality Scoring System (QISS): Opportunities for Enhancing Predictive Modeling, Comparative Analysis, Health Needs Assessment, and Policy Evaluation

Quantitative Intersectionality Scoring System (QISS): Opportunities for Enhancing Predictive Modeling, Comparative Analysis, Health Needs Assessment, and Policy Evaluation

Meeting the Health Needs of Society Through Curricular Innovation in Physical Therapist Education: Examples From 3 Entry-Level Programs.

Entry-level physical therapist (PT) education programs play a critical role in inspiring future leaders to become moral change agents, capable of understanding and addressing evolving societal health needs. Social reconstructionism represents an educational philosophy focused on alleviating pervasive inequities and improving the health of society; however, its application in PT education is not well understood. The purpose of this article is to describe the approach 3 entry-level PT programs used to manifest social reconstructionism within their curricula to foster social consciousness and strengthen moral agency. The Framework for Educating Health Professionals to Address the Social Determinants of Health informed the development of a conceptual framework that illustrates the role of PT education programs in creating transformative learning environments and preparing learners to meet societal health needs. Concepts within this framework were operationalized according to 5 domains put forth by Jensen et al. and related competencies put forth by the Association of American Medical Colleges. Narratives from each program demonstrate how the design and implementation of curricula, grounded in social reconstructionism, can be accomplished through 1) ongoing modifications, 2) thoughtful reconstruction, and 3) initial design. Sample learning activities, objectives, and assessment strategies are provided. The proposed method was effective in guiding meaningful objectives, learning activities, and assessment strategies grounded in social reconstructionism. Such findings can inform the design of curricula that inspire the next generation of transformative leaders who work to alleviate pervasive inequities and improve the health of society.

Prioritizing Protecting Oneself Over the COVID-19 Virus Versus Other Health and Social Needs Among Older Adults Living Alone: A Qualitative Study.

People aged 65 and older, deemed most "vulnerable" by public health, were targeted by the coronavirus disease 2019 protection measures, which sought to minimize physical contact and social activities. Older adults living alone were particularly affected by these measures. However, such measures meant to protect the older population may not have necessarily reflected older adults' individual prioritization choices. This study therefore aimed to understand how protecting oneself over the virus was considered in the prioritization of other health and social needs of older adults living alone during the pandemic. This study adopted a qualitative design. A total of 17 semistructured interviews were conducted between May 2021 and June 2022 with older adults living alone. All interviews were audio-recorded and transcribed verbatim. A reflexive thematic analysis as defined by Braun and Clarke was performed. Our analysis showed 2 forms of prioritization across 2 themes. This first theme focused on participants who reported prioritizing protecting themselves over the virus by limiting in-person contact and activities. The second theme showed that although several participants reported that protecting themselves over the virus was important to them, the prioritization of this need was not shared by all and, in some cases, evolved over the course of the pandemic. Our study demonstrated heterogeneity in the prioritization of older adults needs. Future public health recommendations should consider these variations in the needs and priorities of older adults when determining public health measures.

A Qualitative Study Exploring Aging Gay and Bisexual Men’s Needs From Healthcare Services in Israel

Abstract Introduction Older gay and bisexual men are exposed to heightened risks of physical and mental health disorders. Therefore, understanding their unique needs from healthcare services is essential and is set at the focus of the present study. Methods The current qualitative study explored aging gay and bisexual men’s unique experiences and needs from healthcare services in Israel. Participants (N = 80, age range 47–82, M = 59.59, SD = 7.40) were interviewed in the years 2018–2020 and queried regarding their needs from and experiences with healthcare services, which were later thematically analyzed using Braun and Clarke’s Thematic Analysis. Results Six themes were identified from participants’ responses: Romantic relationships and parenting, sexuality in old age, ageism, loneliness, the need for a unique support framework for the gay and bisexual communities, and perceived factors preventing accessibility to healthcare services. Conclusions The results revealed certain barriers for attaining healthcare services as well as the need for distinctive health and psychological services for gay and bisexual men. Policy Implications The participants’ unique experiences and needs may aid in offering useful solutions for policy makers, social agents, and clinicians in order to improve healthcare services utilized by aging gay and bisexual men.

The human health burden of climate change: Non-economic losses and ethical considerations towards achieving planetary health

Climate change presents an urgent and growing threat to the health and well-being of people and the planet. More frequent and intense heatwaves, droughts and floods are breaching critical ecosystem boundaries, causing cascading impacts that are increasingly complex to govern. Unsustainable development pathways and economic choices that are fueling the climate crisis are also directly engendering global health issues. Furthermore, the global response to climate change has been uneven and the lack of a conceptual framework for loss and damage has allowed developed countries the latitude to adopt differing takes on its framing, undermining the urgency and progression of the loss and damage mechanism to the detriment of developing countries. Current research on the governance of climate ethics posits that while economic and legal considerations largely influence climate policies, decision-making processes in climate adjacent sectors such as health need to be further grounded on ethically sound principles. Framing the health impacts of climate change as a moral issue can therefore be viewed as an effort to reshape the current political discourse with a humanistic lens and move the international community and state-level actors to action. The framing of this issue is particularly important as it recenters the focus on human health as an imperative for effective climate policies rather than as a contributor to the cache of peripheral co-benefits. It also underscores climate change as an ethical issue, in which failure to respond to the climate impacts can worsen health inequities, especially for socially and economically marginalized communities and vulnerable groups.