Priority Groups Research Articles

Who smokes in Australia? Cross-sectional analysis of Australian Bureau of Statistics survey data, 2017-19.

To assess the socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked in Australia. Cross-sectional analysis of Australian Bureau of Statistics (ABS) survey data. Adult participants (16 370 people aged 18 years or older) in the ABS 2017-18 National Health Survey (NHS); adult participants in the ABS 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) (6423 people aged 18 years or older). Socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked, expressed as population-weighted proportions, overall and by Indigeneity. Among adult NHS respondents, an estimated 58.8% of people who smoked daily (95% confidence interval [CI], 56.2-61.4%) were men, 61.3% (95% CI, 58.7-63.9%) were 25-54 years old, 72.5% (95% CI, 70.0-74.8%) were born in Australia, and 65.4% (95% CI, 62.8-67.8%) lived in major cities and 54.3% (95% CI, 51.6-57.0%) in areas in the two socio-economically most disadvantaged quintiles; 75.9% (95% CI, 73.5-78.1%) reported good to excellent health, 73.0% (95% CI, 70.5-75.4%) reported low to moderate psychological distress, 69.0% of those aged 25-64 years (ie, of working age) had completed year 12 (high school), and 68.5% were currently employed. An estimated 2.57 million people smoke daily in Australia: 2.37 million non-Indigenous people (92%) and 195 700 Aboriginal or Torres Strait Islander people (8%). While smoking is more frequent among people living in socio-economically disadvantaged areas and in certain population sub-groups, this first quantitative national profile indicates that most people who smoke daily are in paid employment, are non-Indigenous, are in good physical and mental health, and have completed year 12. Improved comprehensive structural supply- and demand-based tobacco control, informed by the needs of priority groups and the overall profile of people who smoke, is needed to reduce daily smoking prevalence among adults to the 2030 targets of 5% or less for all Australians and 27% or less for Aboriginal and Torres Strait Islander people.

Territory: meanings produced by primary care nurses

Know the meaning of territory from the perspective of primary care nurses. An exploratory-descriptive study with a qualitative approach was conducted in ten primary healthcare units located in the city of Boa Vista, Roraima, Brazil. The social group consisted of eight permanent municipal employees who are nurses. Data collection took place from December 2022 to February 2023 through semi-structured interviews. The audio recordings amounted to approximately one hour and twenty minutes, which were transcribed manually and analyzed according to Bardin's theoretical framework. The meanings related to territory from the perspective of nurses working in primary care were organized into three thematic categories, namely: territory understood as the area of coverage for professional healthcare services, territory seen as a meeting place for healthcare professionals with priority groups, and territory interpreted as a space for care management. The meanings regarding territory have been decoded as the geographical space for the activities of the primary healthcare team professionals. Territory as the care location for priority groups, with emphasis on children, pregnant women, elderly individuals diagnosed with hypertension and diabetes, bedridden patients, migrants, individuals with disabilities, disadvantaged and vulnerable groups. Finally, (re)recognized as the place where action planning, organization of healthcare practices, service coordination, primary team supervision, and care evaluation take place.

The impact of polymorphic variants of interferon receptor genes on COVID-19 severity and antibiotic resistance

Single nucleotide substitutions in gene sequence associated with conformational changes in protein receptor or in expression of interferon receptors may explain variations in human susceptibility to infection and severity of COVID-19 along with other well-known risk factors. The study aimed to investigate associations between polymorphic variants of interferon receptor genes, COVID-19 severity and prevalence of antibiotic resistance genes in the gut microbiota. Materials and methods. The study was conducted using a random sample of Arkhangelsk population aged 42 to 76 years (n = 305). The research involved gathering COVID-19 data from the Federal Register, conducting blood tests for SARS-CoV-2 antibodies and polymorphic interferon receptor gene variants, and identifying antibiotic resistance genes in stool samples. Results. During the first 12–15 months of the COVID-19 pandemic, 17.4% of the study participants had symptomatic COVID-19, while 32.8% were asymptomatic. By the Autumn of 2022, symptomatic COVID-19 cases rose up to 36.4%, while asymptomatic cases increased to 61.3%. We reveal an association between the CC genotype of the IFNAR1 gene rs2257167 variant, the presence of the T allele of IFNAR2 gene rs2229207 variant, the CCTT haplotype and symptomatic COVID-19. The GCTC haplotype was associated with pneumonia and COVID-19 severity. In November 2022, macrolide resistance genes were observed in 98.4% of cases, whereas those to beta-lactams and glycopeptides — in 26.9% and 13.8% cases, respectively. Resistance to three classes of antibiotics was observed in 4.9% and was more frequently detected in individuals with the ССТТ haplotype. Genes encoding beta-lactamases were more often found in individuals with the GCTC haplotype, those who had COVID-19 with pneumonia and those who received hospital treatment. Glycopeptide resistance genes were associated with the CC genotype of the rs2257167 variant of IFNAR1 gene. Conclusion. We identified genetic determinants of susceptibility, symptomatic infection and COVID-19 severity. The associations between polymorphic variants of interferon receptor genes and COVID-19 severity can be used to identify people with a genetic predisposition to severe infection and to determine priority groups for vaccination, including the prevention of antibiotic resistance in complicated course of viral infections.

Determination of SARS-CoV-2 IgG antibody levels in hematology-oncology patients after COVID-19 vaccination.

Cancer patients are among the high-risk groups where COVID-19 infection tends to be severe and can lead to increased mortality. Therefore, they are included in the priority groups for COVID-19 vaccination. This study aimed to compare the levels of SARS-CoV-2 immunoglobulin G (IgG) antibodies following two different COVID-19 vaccinations between hematology-oncology patients and healthcare personnel and to identify factors associated with these antibody levels. A prospective study was conducted with 91 hematology-oncology patients (cancer group) and 75 healthcare personnel (control group) from January 2020 to June 2023. The cancer and control groups comprised adults who had received a booster dose, with either a single dose of BNT162b2 or two doses of CoronaVac™ spaced one month apart, following their primary vaccination with two doses of either CoronaVac™ or BNT162b2. Four weeks after the administration of the booster dose, levels of SARS-CoV-2 IgG antibodies were assessed using an ELISA kit. Antibody levels above 50 AU/mL were accepted as signifying seropositivity. The median SARS-CoV-2 IgG antibody level was lower in the cancer group compared to the control group (4,509 vs. 7,268, p = 0.004), while the rate of seroconversion was similar between the groups (97.8% vs. 100%, p = 0.564). In the cancer group, no association was found between SARS-CoV-2 IgG antibody levels and age, sex, comorbidity, type of malignancy, stage and duration, or type of vaccine. In cancer patients, the seroconversion positivity rate was about 98%. However, antibody responses were still lower compared to the control group. No difference was detected in antibody levels among cancer patients based on the type of vaccine.

Updates in Air Pollution: Current Research and Future Challenges.

The United Nations has declared that humans have a right to clean air. Despite this, many deaths and disability-adjusted life years are attributed to air pollution exposure each year. We face both challenges to air quality and opportunities to improve, but several areas need to be addressed with urgency. This paper summarises the recent research presented at the Pacific Basin Consortium for Environment and Health Symposium and focuses on three key areas of air pollution that are important to human health and require more research. Indoor spaces are commonly places of exposure to poor air quality and are difficult to monitor and regulate. Global climate change risks worsening air quality in a bi-directional fashion. The rising use of electric vehicles may offer opportunities to improve air quality, but it also presents new challenges. Government policies and initiatives could lead to improved air and environmental justice. Several populations, such as older people and children, face increased harm from air pollution and should become priority groups for action.

A STUDY ON UTILIZATION OF MATERNAL AND CHILD HEALTH CARE SERVICES IN RURAL FIELD PRACTICE AREA OF KHAJABANDANAWAZ INSTITUTE OF MEDICAL SCIENCES, KALABURAGI-KARNTAKA

Background: In any community, mothers and children constitute a priority group. In sheer numbers, they comprise approximately 71.14% of the population of the developing countries. In India, women of the childbearing age (15-44 years) constitute 22.2% and children under 15 years of age about 35.3% of the total population. Together, they constitute nearly 57.5% of the total population. Mothers and children not only constitute a large group, but they are also a vulnerable or special-risk group. The main aim of MCH Services remains to ensure that, throughout pregnancy and puerperium, every mother maintain optimal health, and at the end of pregnancy, a healthy mother and a healthy baby and promote the child health throughout the infancy and childhood. Methodology: A community based cross sectional study was done among 400 pregnant and lactating mothers having infant residing in rural field practice area of Aurad, department of Community Medicine of KhajaBandanawaz Institute of Medical Sciences, Kalaburagi from January -December 2017 for a duration of one year. A predesigned and pretested proforma was used to collect the sociodemographic details, utilization of Mother and child service at Aurad . Result: Majority of the subjects 184 (46.0%) were in age group 21-25 years and the mean age of mothers in present study is 24.53 ± 2.85 years. While, 30% Utilized ANC service and around 56% Utilized PNC service. Religion and utilization of antenatal services was found to be statistically significant. Conclusion: The better utilization of the maternal health services can be achieved by overall socio-economic development including focus on women empowerment and education, incorporation of religious norms and faiths in the health policies.

Adoption and Sustained Use of Primary Care Video Visits Among Veterans with VA Video-Enabled Tablets.

In 2020, the U.S. Department of Veterans Affairs (VA) expanded an initiative to distribute video-enabled tablets to Veterans with limited virtual care access. We examined patient characteristics associated with adoption and sustained use of video-based primary care among Veterans. We conducted a retrospective cohort study of Veterans who received VA-issued tablets between 3/11/2020-9/10/2020. We used generalized linear models to evaluate the sociodemographic and clinical factors associated with video-based primary care adoption (i.e., likelihood of having a primary care video visit) and sustained use (i.e., rate of video care) in the six months after a Veteran received a VA-issued tablet. Of the 36,077 Veterans who received a tablet, 69% had at least one video-based visit within six months, and 24% had a video-based visit in primary care. Veterans with a history of housing instability or a mental health condition, and those meeting VA enrollment criteria for low-income were significantly less likely to adopt video-based primary care. However, among Veterans who had a video visit in primary care (e.g., those with at least one video visit), older Veterans, and Veterans with a mental health condition had more sustained use (higher rate) than younger Veterans or those without a mental health condition. We found no differences in adoption of video-based primary care by rurality, age, race, ethnicity, or low/moderate disability and high disability priority groups compared to Veterans with no special enrollment category. VA's tablet initiative has supported many Veterans with complex needs in accessing primary care by video. While Veterans with certain social and clinical challenges were less likely to have a video visit, those who adopted video telehealth generally had similar or higher rates of sustained use. These patterns suggest opportunities for tailored interventions that focus on needs specific to initial uptake vs. sustained use of video care.

Aortic arch branch-prioritized reconstruction for type A aortic dissection surgery.

Acute Stanford type A aortic dissection (STAAD) is a fatal condition requiring urgent surgical intervention. Owing to the complexity of the surgical process, various complications, such as neurological disorders, are common. In this study, we prioritized the reconstruction of aortic arch branches during surgery and investigated the association between prioritizing the branches and the postoperative outcomes of patients with STAAD. Ninety-seven patients were included in the observational study and underwent total arch replacement and frozen elephant trunk technique between January 2018 and June 2021. Of these, 35 patients underwent the branch-priority technique, and 62 patients underwent the classic technique. By analyzing the perioperative outcomes, we compared the differences between the two techniques. The branch priority group had significantly shorter cardiopulmonary bypass and ventilator times and earlier postoperative wake-up times than the classic group. Additionally, the ICU stay time was shorter, with a significant decrease in neurological complications and 24 h drainage in the branch priority group compared to the classic group. The branch priority technique can effectively provide better brain protection, resulting in earlier awakening of patients after surgery, reduced neurological complications, shorter ventilation time and decreased ICU hospitalization time. Therefore, it is recommended for use in aortic dissection surgeries.

Contextual factors influencing the association between the Affordable Care Act's Medicaid expansion and Veteran VA-Medicaid dual enrollment.

To evaluate changes in dual enrollment after Affordable Care Act Medicaid expansion by VA priority group, (e.g., service connection), sex, and type of state expansion. Our cohort was all Veterans ages 18-64 enrolled in VA and eligible for benefits due to military service-connection or low income from 2011 to 2016; the unit of analysis was person-year. Difference-in-difference and event-study analysis. The outcome was dual VA-Medicaid enrollment for at least 1 month annually. Medicaid expansion, VA priority status, whether a state expanded by a Section 1115 waiver, and sex were independent variables. We controlled for race, ethnicity, age, disease burden, distance to VA facilities, state, and year. We used data from the VA Corporate Data Warehouse (CDW) regarding age and VA Priority Group to select our cohort of VA-enrolled individuals. We then took the cohort and crossed checked it with Medicaid Analytic Extract (MAX) and T-MSIS Analytic Files (TAF) to determine Medicaid enrollment status. Service-connected Veterans experienced lower dual-enrollment increases across all sex and state-waiver groups (3.44 percentage points (95% CI: 1.83, 5.05 pp) for women, 3.93 pp (2.98, 4.98) for men, 4.06 pp (2.85, 5.27) for non-waiver states, and 3.00 pp (1.58 to 4.41) for waiver states) than Veterans who enrolled in the VA due to low income (8.19 pp (5.43, 10.95) for women, 9.80 pp (7.06, 12.54) for men, 10.21 pp (7.17, 13.25) for non-waiver states, and 7.39 pp (5.28, 9.50) for waiver states). Medicaid expansion is associated with dual enrollment. Dual-enrollment changes are greatest in those enrolled in the VA due to low income, but do not differ by sex or expansion type. Results can help VA identify groups disproportionately likely to have potential care-coordination issues due to usage of multiple health care systems.

TeRa: Ternary and Range based packet classification engine

This work proposes a novel approach to the hardware implementation of packet classification in ASICs, using NAND-NOR logic at each stage. The proposed design utilizes modified ternary encoding to process the prefix field, resulting in a two-level NAND-NOR logic for prefix processing. The field representation based on classbench rules helps reduce memory usage by almost 45% compared to conventional prefix representations. Additionally, an efficient range matching solution is implemented using a carry tree logic that relies on 1’s and 2’s Complement subtraction. The integration of a carry-based range comparator enhances hardware optimization for range processing without the need for prefix conversion. Additionally, match inversion logic streamlines the processing of exceptional or inverse fields without incurring extra hardware overhead. This work also presents a specialized logic circuit for ternary and range matching, complemented by a specialized priority grouping technique. The proposed architecture, including TYPE1 and TYPE2, achieves throughput rates of 9.9 BPPS and 6.6 BPPS, respectively, while supporting both best-match and multi-match addresses within the same hardware environment.

Changes in incidence of hepatitis C virus reinfection and access to direct-acting antiviral therapies in people with HIV from six countries, 2010–19: an analysis of data from a consortium of prospective cohort studies

Reinfection after successful treatment with direct-acting antivirals is hypothesised to undermine efforts to eliminate hepatitis C virus (HCV) infection among people with HIV. We aimed to assess changes in incidence of HCV reinfection among people with HIV following the introduction of direct-acting antivirals, and the proportion of all incident cases attributable to reinfection. We pooled individual-level data on HCV reinfection in people with HIV after spontaneous or treatment-induced clearance of HCV from six cohorts contributing data to the International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC) in Australia, Canada, France, the Netherlands, Spain, and Switzerland between Jan 1, 2010, and Dec 31, 2019. Participants were eligible if they had evidence of an HCV infection (HCV antibody or RNA positive test) followed by spontaneous clearance or treatment-induced clearance, with at least one HCV RNA test after clearance enabling measurement of reinfection. We assessed differences in first reinfection incidence between direct-acting antiviral access periods (pre-direct-acting antiviral, limited access [access restricted to people with moderate or severe liver disease and other priority groups], and broad access [access for all patients with chronic HCV]) using Poisson regression. We estimated changes in combined HCV incidence (primary and reinfection) and the relative contribution of infection type by calendar year. Overall, 6144 people with HIV who were at risk of HCV reinfection (median age 49 years [IQR 42-54]; 4989 [81%] male; 2836 [46%] men who have sex with men; 2360 [38%] people who inject drugs) were followed up for 17 303 person-years and were included in this analysis. The incidence of first HCV reinfection was stable during the period before the introduction of direct-acting antivirals (pre-introduction period; 4·1 cases per 100 person-years, 95% CI 2·8-6·0). Compared with the pre-introduction period, the average incidence of reinfection was 4% lower during the period of limited access (incidence rate ratio [IRR] 0·96, 95% CI 0·78-1·19), and 28% lower during the period of broad access (0·72, 0·60-0·86). Between 2015 and 2019, the proportion of incident HCV infections due to reinfection increased, but combined incidence declined by 34%, from 1·02 cases per 100 person-years (95% CI 0·96-1·07) in 2015 to 0·67 cases per 100 person-years (95% CI 0·59-0·75) in 2019. HCV reinfection incidence and combined incidence declined in people with HIV following direct-acting antiviral introduction, suggesting reinfection has not affected elimination efforts among people with HIV in InCHEHC countries. The proportion of incident HCV cases due to reinfection was highest during periods of broad access to direct-acting antivirals, highlighting the importance of reducing ongoing risks and continuing testing in people at risk. Australian National Health and Medical Research Council.

Knowledge, attitudes, and adherence of the Cape Verdean population to the COVID-19 vaccine

BackgroundThe spread of the COVID-19 pandemic at the end of 2019, with its well-known consequences in terms of morbidity and mortality, has triggered an intense mobilization of the scientific community in the search for knowledge about the SARS-Cov2 virus and the development of a vaccine. ObjectiveThis study aims to investigate the knowledge, perceptions, attitudes, and intentions of the resident Cape Verdean population regarding the COVID-19 vaccine. MethodsThis was a descriptive, cross-sectional, and analytical study involving 1704 resident Cape Verdeans, whose ages ranged from 16 to 60 years old and the majority of participants were male (52.6%). The data was collected using the Google form platform between March 9 and 15, 2021. ResultsThe data indicated that the majority of participants (95.8%) knew of at least one approved vaccine against COVID-19, and this knowledge (74.9%) was obtained from television, radio, and newspapers. The Oxford-AstraZeneca vaccine was the best known (54.1%) among the study subjects and the majority of respondents (69.7%) had enough information to consciously decide whether or not to get vaccinated against COVID-19. The majority (68.0%) of participants were in favor of the COVID-19 vaccine being administered to all interested people. About 59% of participants considered the COVID-19 vaccine to be safe and 49.6% of participants intended to get vaccinated when the time came. The greatest vaccine hesitancy was related to fear of side effects (21.4%), followed by the fact that it was developed too quickly (12.8%). Health professionals were seen as the priority group (81.5%) to be vaccinated. ConclusionsThe results show that the Cape Verdean population had a good level of knowledge about the COVID-19 vaccine. Despite initial hesitation, the vast majority of participants were willing to get vaccinated. These data suggest that awareness-raising, education, and information campaigns about the COVID-19 vaccine should be strengthened to reduce hesitation and increase confidence and adherence to the COVID-19 vaccine among Cape Verdean residents.

Brief interventions for smoking and alcohol associated with the COVID-19 pandemic: a population survey in England

BackgroundFollowing the onset of the COVID-19 pandemic, in March 2020 health care delivery underwent considerable changes. It is unclear how this may have affected the delivery of Brief Interventions (BIs) for smoking and alcohol. We examined the impact of the COVID-19 pandemic on the receipt of BIs for smoking and alcohol in primary care in England and whether certain priority groups (e.g., less advantaged socioeconomic positions, or a history of a mental health condition) were differentially affected.MethodsWe used nationally representative data from a monthly cross-sectional survey in England between 03/2014 and 06/2022. Monthly trends in the receipt of BIs for smoking and alcohol were examined using generalised additive models among adults who smoked in the past-year (weighted N = 31,390) and those using alcohol at increasing and higher risk levels (AUDIT score 38, weighted N = 22,386), respectively. Interactions were tested between social grade and the change in slope after the onset of the COVID-19 pandemic, and results reported stratified by social grade. Further logistic regression models assessed whether changes in the of receipt of BIs for smoking and alcohol, respectively, from 12/2016 to 01/2017 and 10/2020 to 06/2022 (or 03/2022 in the case of BIs for alcohol), depended on history of a mental health condition.ResultsThe receipt of smoking BIs declined from an average prevalence of 31.8% (95%CI 29.4–35.0) pre-March 2020 to 24.4% (95%CI 23.5–25.4) post-March 2020. The best-fitting model found that after March 2020 there was a 12-month decline before stabilising by June 2022 in social grade ABC1 at a lower level (~ 20%) and rebounding among social grade C2DE (~ 27%). Receipt of BIs for alcohol was low (overall: 4.1%, 95%CI 3.9–4.4) and the prevalence was similar pre- and post-March 2020.ConclusionsThe receipt of BIs for smoking declined following March 2020 but rebounded among priority socioeconomic groups of people who smoked. BIs for alcohol among those who use alcohol at increasing and higher risk levels were low and there was no appreciable change over time. Maintaining higher BI delivery among socioeconomic and mental health priority groups of smokers and increasing and higher risk alcohol users is important to support reductions in smoking and alcohol related inequalities.

Vaccination against COVID-19: the view of Brazilian federal judges.

The aim was to analyze the perception of Brazilian federal judges on the implications of COVID-19 vaccination. A study was carried out with Brazilian federal judges, who received a survey designed with multiple-choice questions on COVID-19 vaccination, covering topics such as its mandatory aspect, the application of coercive measures, hesitation to vaccinate, priority groups, the duties of Brazilian Health Regulatory Agency (Anvisa, acronym in Portuguese), the role of the Judiciary branch, and immunity passports. A total of 254 out of 1,300 federal judges from all states responded to the survey. Most respondents have a Bachelor's degree or a specialization (59.1%) and have been judges for more than 10 years (63.8%). A great majority of the judges (87.7%) agree with vaccine mandates for adults and for children and adolescents (66.1%). Over 75% of judges believe that all levels of government can impose sanctions on those who refuse to get vaccinated. The judges trust vaccination 93% of the time, 56.1% reject anti-vaccination movements, and 75.2% believe that Anvisa duties should be respected. The Judiciary branch actions concerning the COVID-19 pandemic are approved by 62.6% of judges, and 88.2% support immunity passports. There is a direct connection among mandatory vaccination, trust in the vaccine, and the adoption of immunity passports. Most federal judges agree with vaccine mandates for children and adults, support the application of sanctions for vaccination refusal, disapprove of anti-vaccination movements, agree with Anvisa's duties, and support judicial intervention in relation to the COVID-19 pandemic.

Priority populations’ experiences of isolation, quarantine and distancing for COVID-19: protocol for a longitudinal cohort study (Optimise Study)

IntroductionLongitudinal studies can provide timely and accurate information to evaluate and inform COVID-19 control and mitigation strategies and future pandemic preparedness. The Optimise Study is a multidisciplinary research platform established...

#Wematter: Creating culturally tailored health promotion content for Black and Latina college women on Instagram.

Although students at Minority-Serving Institutions (HBCUs, HSIs, TCUs, AAPISIs) have been found to make sound health choices as compared to their counterparts at Predominately White Institutions and have positive expectancy outcomes of physical activity engagement, it is consistently suggested that MSIs examine and bolster health enhancing avenues. Black and Latina women frequently use social media platforms to connect to content that can initiate and support lifestyle changes or improvements. Thus, establishing culturally relevant health related social media content geared toward Black and Latina College Women (BLCW) may be successful in achieving health-related goals. Therefore, the purpose of this study using social identity theory as a theoretical lens, was to identify the fundamental characteristics of culturally tailored health-related content for BLCW. This study employed a qualitative approach to ascertain the characteristics of culturally tailored health-related content for BLCW. Black and Latina college women were asked to provide feedback on mock culturally tailored health-related content in semi-structured focus groups. Participants discussed the authenticity and cultural relevancy of images designed to promote physical activity engagement and other healthy behaviors. Results indicated that at a minimum, culturally tailored health-related content should include an array of body shapes, authentic language and messaging, in relevant settings. Moreover, BLCW prefer content that is realistic, reflects their experiences, and embodies their relevant identities. Social media content designed to attract and promote healthy lifestyles of BLCW must be comprised of imagery and language that represent the diversity of the priority group. The findings from this study can help to establish best practices when designing content intended to strengthen wellness among college students and young adults.

О генетическом тестировании лиц на предрасположенность к инфаркту миокарда в практической медицине: Международный опыт

In Kazakhstan, the main burden in the structure of the incidence of diseases of the circulatory system is made by myocardial infarction, the overall incidence of which tends to increase (from 71.9‰ in 2016 to 127.6‰ in 2020). Therefore, according to the national health project of the Republic of Kazakhstan, reducing mortality from diseases of the circulatory system in Kazakhstan is one of the main vectors of the national health policy. The article presents a literature review of scientific publications on genetic testing for predisposition to myocardial infarction in a number of countries, such as the USA, Great Britain, the Netherlands, Spain, Russia, Korea, Japan, France, Thailand, Ukraine, Belarus. The review of scientific publications was carried out by keywords in Russian and English in scientific databases such as PubMed, Google Scholar, Elsevier, Cochrane, Web of Science and Cyberleninka. Testing makes it possible to identify a priority group of patients at increased risk of developing myocardial infarction, and further develop personalized programs for primary and secondary prevention of cardiovascular diseases in practical healthcare.

Loss of Opi3 causes a lipid imbalance that influences the virulence traits of Cryptococcus neoformans but not cryptococcosis.

The basidiomycete fungus Cryptococcus neoformans is a useful model for investigating mechanisms of fungal pathogenesis in mammalian hosts. This pathogen is the causative agent of cryptococcal meningitis in immunocompromised patients and is in the critical priority group of the World Health Organization fungal priority pathogens list. In this study, we employed a mutant lacking the OPI3 gene encoding a methylene-fatty-acyl-phospholipid synthase to characterize the role of phosphatidylcholine (PC) and lipid homeostasis in the virulence of C. neoformans. We first confirmed that OPI3 was required for growth in nutrient limiting conditions, a phenotype that could be rescued with exogenous choline and PC. Additionally, we established that loss of Opi3 and the lack of PC lead to an accumulation of neutral lipids in lipid droplets and alterations in major lipid classes. The growth defect of the opi3Δ mutant was also rescued by sorbitol and polyethylene glycol (PEG), a result consistent with protection of ER function from the stress caused by lipid imbalance. We then examined the impact of Opi3 on virulence and found that the dependence of PC synthesis on Opi3 caused reduced capsule size and this was accompanied by an increase in shed capsule polysaccharide and changes in cell wall composition. Further tests of virulence demonstrated that survival in alveolar macrophages and the ability to cause disease in mice were not impacted by loss of Opi3 despite the choline auxotrophy of the mutant in vitro. Overall, this work establishes the contribution of lipid balance to virulence factor elaboration by C. neoformans and suggests that host choline is sufficient to support proliferation during disease.

Intersectionality informed and narrative-shifting whole school approaches for LGBTQ+ secondary school student mental health: A UK qualitative study.

School is a key site for prevention and early intervention in public mental health, with sexual and gender minority students being a priority group for action. Context is important in understanding how school inclusion of sexual and gender minorities shapes mental health and well-being, with rapidly changing social and political forces necessitating ongoing research. This coproduced UK secondary school-based study aimed to understand (a) key components of mentally, socially and emotionally healthy school environments for LGBTQ+ students considerate of intersecting minoritised identities; (b) staff information, skills and capacity needs and (c) factors influencing uptake and implementation. Online interviews and focus groups were conducted with 63 participants (22 staff, 32 students (aged 13-19 years), and 9 training providers), diverse in relation to gender and sexual identity, ethnicity, religious and social context. Data were analysed thematically. One overarching theme captured the need for an intersectionality-informed, contextually adaptable, whole school approach which 'shifts the narrative' away from deficit thinking, challenging prevailing cis/heteronormative and White norms. This underpinned four themes: (1) 'Feeling safe, seen and celebrated: embedding intersectional signs, signals and symbols', (2) 'Everyone's business: the need for collaboration', (3) 'Embedding a culture of change', and (4) 'Re-locating the problem: challenging deficit thinking'. Contextually diverse research is needed which critically addresses ways in which social power enacted interpersonally and structurally serves to hinder schools from enacting LGBTQ+ inclusivity. Evidence to inform and develop implementation strategies for institutional changes and to advocate for wider socio-political support is also key to mitigate the potential for widening inequities linked to inequitable school environments.

A mixed-methods study of VA video connect utilization among veterans with diabetes experiencing housing instability during the pandemic.

Prior to the coronavirus disease-2019 (COVID-19) pandemic the U.S. Department of Veterans Affairs (VA) had the largest telehealth program in the United States. The pandemic motivated providers within the VA to expand telehealth in effort to reduce disrupted care while mitigating risks. The pandemic provides a rare opportunity to examine how to better engage veterans experiencing housing instability (HI) in telehealth diabetes care. Mixed methods design to examine VA video connect (VVC) diabetes care utilization among veterans experiencing HI from March 1, 2019, to March 1, 2022, combining multivariable regression analyses of VA administrative data with semi-structured interviews. Study aims included: (a) examine changes in diabetes care delivery mode over the peri-pandemic timeframe; (b) identify sociodemographic and clinical characteristics associated with VVC care among veterans with HI; and (c) understand the facilitators and barriers of VVC utilization. Totally, 5904 veterans were eligible for study analysis. Veterans who are female (OR: 1.63; 95% CI: 1.3, 2.0; p < 0.0001), self-identify as Hispanic (OR: 1.44; 95% CI: 1.1, 1.9; p = 0.02), are married (OR: 1.39; 95% CI: 1.2, 1.6; p < 0.0001), and are in VA priority group 1 (OR: 1.21; 95% CI 1.1, 1.4; p = 0.004) were more likely to use VVC the pandemic. Veterans of older age (OR: 0.97; 95% CI: 0.97, 0.98; p < .0001) and rural dwelling (OR: 0.85; 95% CI: 0.7, 1.2; p = 0.04), were less likely to use VVC. Thirteen VA providers and 15 veterans were interviewed. Veterans reported that decisions about using VVC were driven by limitations in in-person care availability, safety, and convenience. Telehealth played an important role in providing veterans with HI access to diabetes care during the pandemic. Future interventions should seek to increase education and technology in effort to increase VVC uptake into routine diabetes care to ensure veterans' optimal and equitable access.