Top Health Research Articles

Cumulative Risk and Externalizing Behaviors during Infancy in a Predominantly Latine Sample

Externalizing behavior problems are among the top mental health concerns in early childhood, and many parenting interventions have been developed to address this issue. To better understand predictors of parenting intervention outcomes in high-risk families, this secondary data analysis evaluated the moderating effect of cumulative risk on child externalizing behaviors, parenting skills, and intervention dropout after completion of a home-based adaptation of the child-directed interaction phase of parent-child interaction therapy (PCIT) called the Infant Behavior Program (IBP). The participants included 58 toddlers (53% male; average age of 13.5 months; and 95% Hispanic or Latine) who were part of a larger randomized control trial in which families were randomly assigned to receive the IBP or treatment as usual (TAU). Cumulative risk was found to moderate the effect of the intervention group on child externalizing behaviors such that the participants in the intervention group with higher cumulative risk scores had greater reductions in externalizing behaviors. A potential explanation for these unexpected findings may be that the obstacles to treatment that were previously imposed by comorbid risk factors (i.e., lack of transportation, time commitment, and language barriers) were adequately addressed such that the families who most needed the intervention were able to remain fully engaged.

Tooth brushing practice in Ethiopia: a systematic review and meta-analysis

Oral hygiene refers to taking care and maintaining the cleanness of gum and teeth; a good oral hygiene practice promotes better oral health in general. Oral hygiene is the top public health concern of the population. Tooth brushing is a technique to keep oral hygiene from related complications. Therefore, this study provides the pooled prevalence of tooth brushing practice in Ethiopia. Databases searched for articles systematically across PubMed, Google Scholar, Hinari, EMBASE, and African Journals Online. Two reviewers independently conducted the selection, screening, reviewing, and data extraction using a Microsoft Excel spreadsheet and used the Joanna Briggs Institute prevalence critical appraisal tools to assess the quality of evidence. All studies conducted in Ethiopia from 2010 to 2020, reporting tooth-brushing practices extracted for and imported into the Comprehensive meta-analysis version 3.0 for further analysis. Beggs and Eggers’s tests evaluated for publication bias with Higgins’s method evaluated for heterogeneity. A random-effects meta-analysis model with a 95% confidence interval was computed to estimate the pooled effect size (prevalence). Furthermore, the authors employed subgroup analysis based on the study area and sample size. After reviewing 36, 10 articles fulfilled the inclusion criteria, and were included in the meta-analysis. The pooled prevalence of tooth brushing practice was 12.2% (95% CI 7.6–19.2%). The review reported a lower level of tooth-brushing practice in Ethiopia. We recommended that special attention should be given to the oral hygiene of the Ethiopian people.

Disease prevention and mitigation in US finfish aquaculture: A review of current approaches and new strategies

AbstractIn the United States, the aquaculture industry has not seen the same levels of growth in production as other countries—made evident by the $17 billion seafood trade deficit estimated in 2020. Nevertheless, aquaculture remains an important industry fully capable of supplementing the domestic seafood supply and reducing the US seafood trade deficit. Infectious diseases is one of several factors that threatens the capability and sustainability of the aquaculture industry, highlighting the importance of effective control strategies for these pathogens. Antimicrobial products are often used to control and eliminate undesirable microbes in effort to prevent or mitigate the impacts of infectious diseases. Some pathogens are capable of adapting to and resisting the antimicrobial effects, escalating the challenges associated with disease management in aquaculture. Antimicrobial resistance (AMR) is now recognised by numerous national and international agencies as a top global health concern and is problematic for US aquaculture. Currently, disease prevention and mitigation strategies utilised by US finfish aquaculture can be broken down into three levels; comprehensive protocols (biosecurity, disease response), good husbandry strategies (stress management, proper diet, optimal environment) and effective antimicrobial products (biocides, therapeutics). This review will discuss how each level contributes differently to the overall protection of fish from pathogens. In the era of AMR, this review will also highlight current and emerging alternative strategies that do not rely on traditional antimicrobial products (e.g., vaccines, dietary supplements, novel antimicrobial, stock selection) for disease prevention and mitigation.

MP52-05 BLADDER MANAGEMENT IS THE TOP HEALTH CONCERN AMONG ADULTS WITH A SPINAL CORD INJURY

You have accessJournal of UrologyCME1 Apr 2023MP52-05 BLADDER MANAGEMENT IS THE TOP HEALTH CONCERN AMONG ADULTS WITH A SPINAL CORD INJURY John P. Ratanawong, Christopher J. Loftus, Jeremy B. Myers, Sara M. Lenherr, John T. Stoffel, Blayne Welk, and Sean P. Elliott John P. RatanawongJohn P. Ratanawong More articles by this author , Christopher J. LoftusChristopher J. Loftus More articles by this author , Jeremy B. MyersJeremy B. Myers More articles by this author , Sara M. LenherrSara M. Lenherr More articles by this author , John T. StoffelJohn T. Stoffel More articles by this author , Blayne WelkBlayne Welk More articles by this author , and Sean P. ElliottSean P. Elliott More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bladder management has been shown to be the most important health concern for people with spinal cord injury (SCI), outranking even ambulation. Incontinence, urinary tract infections (UTI) and clean intermittent catheterization (CIC) compared to other bladder management methods, have been shown to predict poor urinary quality of life (QoL) in people with SCI. But, it is unclear if these factors impact ranking bladder management as a top health concern. Using the Neurogenic Bladder Research Group (NBRG) SCI registry, our objective was to confirm whether bladder management is the top health concern and whether this is associated with urinary incontinence, UTI, or CIC utilization. METHODS: Participants in the NBRG registry were asked: “What are the top 3 problems that affect you on a daily basis? (Rank top 3): bladder management/issues, bowel management/issues, pressure ulcer, mobility issues, autonomic dysreflexia, spasticity/stiffness, pain, depression/anxiety, heart problems, lung problems, sexual function, fertility, or other.” Incontinence and urinary QoL were assessed using the Neurogenic Bladder Symptom Score (NBSS). We performed a multivariate regression to identify factors related to their primary choice. RESULTS: Among our 1460 participants, 882 (60%) were men, mean age was 44.9 years, and mean time since injury was 14.4 years. 574 (39%) ranked bladder management as their primary issue, followed by pain and bowel management (Figure 1). Factors associated with choosing bladder as the top concern included more years since injury (OR 1.02 [1.00,1.03], p<0.02), worse NBSS incontinence domain score (OR 1.06 [1.02, 1.09], p<0.01), and worse NBSS QoL (OR 1.20 [1.04, 1.37], p=0.01); UTI≥1/year (OR 1.03 [0.70, 1.50], p=0.89) and CIC (OR 1.40 [0.92, 2.14], p=0.12) were not significant. CONCLUSIONS: In this group, bladder management was ranked as the top health issue, over other sequelae of SCI. The farther out from injury people are, the more important bladder management becomes. Bladder QoL and, in particular, incontinence also drive people to view bladder issues as their top health concern. By managing incontinence in people with SCI, urologists can impact the top health concern of people with SCI. Source of Funding: PCORI-1409-21348 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e704 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information John P. Ratanawong More articles by this author Christopher J. Loftus More articles by this author Jeremy B. Myers More articles by this author Sara M. Lenherr More articles by this author John T. Stoffel More articles by this author Blayne Welk More articles by this author Sean P. Elliott More articles by this author Expand All Advertisement PDF downloadLoading ...

Peroxisome proliferator-activated receptor ɣ agonist mediated inhibition of heparanase expression reduces proteinuria.

Proteinuria is associated with many glomerular diseases and a risk factor for the progression to renal failure. We previously showed that heparanase (HPSE) is essential for the development of proteinuria, whereas peroxisome proliferator-activated receptor ɣ (PPARɣ) agonists can ameliorate proteinuria. Since a recent study showed that PPARɣ regulates HPSE expression in liver cancer cells, we hypothesized that PPARɣ agonists exert their reno-protective effect by inhibiting glomerular HPSE expression. Regulation of HPSE by PPARɣ was assessed in the adriamycin nephropathy rat model, and cultured glomerular endothelial cells and podocytes. Analyses included immunofluorescence staining, real-time PCR, heparanase activity assay and transendothelial albumin passage assay. Direct binding of PPARɣ to the HPSE promoter was evaluated by the luciferase reporter assay and chromatin immunoprecipitation assay. Furthermore, HPSE activity was assessed in 38 type 2 diabetes mellitus (T2DM) patients before and after 16/24 weeks treatment with the PPARɣ agonist pioglitazone. Adriamycin-exposed rats developed proteinuria, an increased cortical HPSE and decreased heparan sulfate (HS) expression, which was ameliorated by treatment with pioglitazone. In line, the PPARɣ antagonist GW9662 increased cortical HPSE and decreased HS expression, accompanied with proteinuria in healthy rats, as previously shown. Invitro, GW9662 induced HPSE expression in both endothelial cells and podocytes, and increased transendothelial albumin passage in a HPSE-dependent manner. Pioglitazone normalized HPSE expression in adriamycin-injured human endothelial cells and mouse podocytes, and adriamycin-induced transendothelial albumin passage was reduced as well. Importantly, we demonstrated a regulatory effect of PPARɣ on HPSE promoter activity and direct PPARy binding to the HPSE promoter region. Plasma HPSE activity of T2DM patients treated with pioglitazone for 16/24 weeks was related to their hemoglobin A1c and showed a moderate, near significant correlation with plasma creatinine levels. PPARɣ-mediated regulation of HPSE expression appears an additional mechanism explaining the anti-proteinuric and renoprotective effects of thiazolidinediones in clinical practice. This study was financially supported by the Dutch Kidney Foundation, by grants 15OI36, 13OKS023 and 15OP13. Consortium grant LSHM16058-SGF (GLYCOTREAT; a collaboration project financed by the PPP allowance made available by Top Sector Life Sciences & Health to the Dutch Kidney Foundation to stimulate public-private partnerships).

166 Community Driven Research Day: Addressing Community Needs in Rural Pennsylvania

OBJECTIVES/GOALS: Describe the community of Norther Dauphin County, PA and increase awareness of this community’s health related needs. Establish partnerships between Penn State faculty and Northern Dauphin County community-based organizations to develop an optimal approach to address identified health related needs. METHODS/STUDY POPULATION: Northern Dauphin is located in the rural Northern Tier of Dauphin County, PA and has roughly 30,000 residents within 272 square miles. Of those residents, approximately 1 in 4 families live below the poverty level. Although over 6,000 residents receive Medical Assistance (MA), only one local provider accepts MA covered patients. Residents have limited access to health care due to the rurality of the area when paired with a lack of public transportation. The Penn State Clinical and Translational Science Institute (CTSI) Community Engaged Research Core (CERC) has partnered with Northern Dauphin County community- based organizations to explore the needs of community members and how partnerships with Penn State Faculty could help to address the community needs. RESULTS/ANTICIPATED RESULTS: A Community Advisory Board (CAB) of leaders (e.g., school officials, business owners) was created to identify community needs. After an initial workshop with the CAB, an assessment was created and distributed to the larger community to identify the top community health needs. Details from the assessment were then used to prioritize the themes for the Community Driven Research Day (CDRD). The CERC team identified Penn State University faculty with research interests related to these prioritized themes. The faculty identified and community leaders were then invited to the CDRD. The agenda for the event included an introduction to Community Engaged Research, a presentation from a researcher and community partner working together, round table discussions based on the themes selected, and an overview of pilot grants. DISCUSSION/SIGNIFICANCE: The CDRD will facilitate partnerships between the Penn State faculty and local community leaders to help effectively move forward addressing the community’s health needs. The PSU CTSI will offer pilot grants to formalize and strengthen these partnerships and conduct community engaged research initiatives to discover optimal ways to address them.

Study Natural Compound of Eleutherine americana as a SaR-CoV-2 Therapeutic Agent : In Silico Approach

Sar-CoV-2 (COVID-19) has rapidly spread globally where it has killed thousands of individuals and infected almost 1,016,395 others. Numerous people have died as a result of what the World Health Organization (WHO) has deemed a top worldwide health issue, which has also had severe detrimental social and economic impacts. Some Eleutherin americana are said to possess antiviral effects. Children's colds and nasal congestion can be treated with eleutherin americana. Naphthalene, anthraquinone, and naphtoquinone are the three main chemical families that have been identified from E. americana. Eleutherol, hongconin, isoeleutherol, and eleutherin were the compounds that were identified from E. Americana. Drug-receptor interactions are simulated using computational techniques toward 14 compounds isolated from E. americana. The docking method has been validated by redocking the N3 molecule as a native ligand to the Mpro of Sar-CoV-2 (PDB ID: 7BQY) as a receptor protein. The smaller the RMSD value 0.651 Å, the better the pose obtained through the docking process. Compound 12 has a more negative binding energy are showed -8.6 kcal mol-1, regarding to hydrogen bond interaction toward Thr26, His41, Leu141, Asn142, Gly143, Ser144, His163. The stability of the association between the ligand and receptor increases with decreasing binding energy value (∆G). On the other hand, Compounds 11 and 2 are depicted -8.2 kcal mol-1 and -8.1 kcal mol-1 respectively which close to N3 -8.3 kcal mol-1. Undergoing hydrogen bond interaction between 11 with Gly143,Thr26, Leu141, Glu166, Ser144, Cys145, His163, and less hydrogen bond interaction 2 toward Arg188 and Asn 142. Those result resembling hydroxy group have the best interaction with 7BQY. According to fulfilled data from three candidates 2, 11, 12, it can be expected that compound with many hydroxy groups are within realm of possibility as antiviral agent for Sar-CoV-2 through inhibit replication of this virus.

Anesthetic challenges in patients with ankylosing spondylitis requiring lower limb surgery – A case report and literature review

Ankylosing spondylitis is one of the global top health burdens and patients affected by it frequently require surgery related to disease progression, such as orthopedic surgery. These patients may prove difficult to manage from an anesthetic standpoint, regardless of the anesthetic technique employed, mainly given the potential for difficult airway access and related comorbidities. We present the case of a 52-year-old male posted for urgent cemented total hip arthroplasty with associated bilateral pulmonary fibrosis and an anticipated difficult airway in whom regional anesthesia was performed with satisfactory results, with a favorable intraoperative and postoperative course. The literature review explores the anesthetic techniques employed when a tailored approach is required in managing patients with ankylosing spondylitis.

Endovascular treatment versus no endovascular treatment after 6–24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands: a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial

Endovascular treatment for anterior circulation ischaemic stroke is effective and safe within a 6 h window. MR CLEAN-LATE aimed to assess efficacy and safety of endovascular treatment for patients treated in the late window (6-24 h from symptom onset or last seen well) selected on the basis of the presence of collateral flow on CT angiography (CTA). MR CLEAN-LATE was a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial done in 18 stroke intervention centres in the Netherlands. Patients aged 18 years or older with ischaemic stroke, presenting in the late window with an anterior circulation large-vessel occlusion and collateral flow on CTA, and a neurological deficit score of at least 2 on the National Institutes of Health Stroke Scale were included. Patients who were eligible for late-window endovascular treatment were treated according to national guidelines (based on clinical and perfusion imaging criteria derived from the DAWN and DEFUSE-3 trials) and excluded from MR CLEAN-LATE enrolment. Patients were randomly assigned (1:1) to receive endovascular treatment or no endovascular treatment (control), in addition to best medical treatment. Randomisation was web based, with block sizes ranging from eight to 20, and stratified by centre. The primary outcome was the modified Rankin Scale (mRS) score at 90 days after randomisation. Safety outcomes included all-cause mortality at 90 days after randomisation and symptomatic intracranial haemorrhage. All randomly assigned patients who provided deferred consent or died before consent could be obtained comprised the modified intention-to-treat population, in which the primary and safety outcomes were assessed. Analyses were adjusted for predefined confounders. Treatment effect was estimated with ordinal logistic regression and reported as an adjusted common odds ratio (OR) with a 95% CI. This trial was registered with the ISRCTN, ISRCTN19922220. Between Feb 2, 2018, and Jan 27, 2022, 535 patients were randomly assigned, and 502 (94%) patients provided deferred consent or died before consent was obtained (255 in the endovascular treatment group and 247 in the control group; 261 [52%] females). The median mRS score at 90 days was lower in the endovascular treatment group than in the control group (3 [IQR 2-5] vs 4 [2-6]), and we observed a shift towards better outcomes on the mRS for the endovascular treatment group (adjusted common OR 1·67 [95% CI 1·20-2·32]). All-cause mortality did not differ significantly between groups (62 [24%] of 255 patients vs 74 [30%] of 247 patients; adjusted OR 0·72 [95% CI 0·44-1·18]). Symptomatic intracranial haemorrhage occurred more often in the endovascular treatment group than in the control group (17 [7%] vs four [2%]; adjusted OR 4·59 [95% CI 1·49-14·10]). In this study, endovascular treatment was efficacious and safe for patients with ischaemic stroke caused by an anterior circulation large-vessel occlusion who presented 6-24 h from onset or last seen well, and who were selected on the basis of the presence of collateral flow on CTA. Selection of patients for endovascular treatment in the late window could be primarily based on the presence of collateral flow. Collaboration for New Treatments of Acute Stroke consortium, Dutch Heart Foundation, Stryker, Medtronic, Cerenovus, Top Sector Life Sciences & Health, and the Netherlands Brain Foundation.

Individual and community level factors associated with medical treatment-seeking behavior for childhood diarrhea among the Gambian mothers: evidence from the Gambian demographic and health survey data, 2019/2020

IntroductionIn less developed countries, including the Gambia, childhood diarrhea is one of the leading causes of serious illness and death among children. Studies on wider determinants of behaviors in medical treatment seeking for diarrheal illnesses in poor resource settings are limited. However, the challenges are continuing and, there is a gap in research work about it in the Gambia. Therefore, the rationale of this study was to assess the individual and community level factors of medical treatment-seeking behaviors for childhood diarrhea among mothers in the Gambia.MethodsData from the 2019–20 Gambia demographic and health survey were used in this study, which was based on secondary data analysis. A total of 1,403 weighted samples of under-five children’s mothers were included in the study for diarrhea medical treatment-seeking behaviors. Because of the hierarchical nature of the data, a multi-level logistic regression model was applied to identify individual and community-level factors that may influence mothers’ medical treatment-seeking behaviors of diarrhea. Data were analyzed using multilevel logistic regression analysis. In the multivariable multilevel logistic regression analysis, variables were judged significantly linked with medical treatment-seeking behavior of diarrhea if their p-value was less than 0. 05.ResultsMedical treatment-seeking behaviors for diarrhea were discovered in 62.24% (95% CI: 59.67,64.74) of mothers of under five children. Being a female child has shown odds of (AOR = 0.79, (CI 95%: (0.62,0.98)) times less treatment-seeking behavior than the counterparts. Moreover, compared to mothers whose children were of average size, those whose children were smaller, and larger than average at birth were more likely to seek out pediatric medical treatment (AOR = 1.53, 95% CI (1.08–2.16), and (AOR = 1.31, 95% CI (1.01,1.169)) respectively. On the other side, mothers who have exposure to listening to the radio, and heard about oral rehydration have shown an odds of (AOR = 1.34, CI 95%, (1.05,1.72)), (AOR = 2.21, CI 95%, (1.14,4.30)), being from the middle, and rich household wealth have also shown (AOR = 2.15, CI 95%, (1.32,3.51)), and (AOR = 1.92, (CI 95%, (1.11,3.32)), a child with cough, and fever (AOR = 1.44, CI 95%, (1.09,1.89)), and (AOR = 1.73, CI 95%, (1.33,2.25)) were individual-level factors that have shown association statistically with the outcome variable. Similarly, regarding community level factors mothers who had a postnatal checkup, and those from the Kerewan region have revealed more odds of (AOR = 1.48, CI 95%, (1.08,2.02)), and (AOR = 2.99, CI 95%, (1.32,6.78)) times significantly with treatment seeking behavior of mothers respectively.ConclusionDiarrhea medical treatment-seeking behavior was found low. Hence, it remains among the top public health challenges in the Gambia. Strengthening mothers’ healthcare-seeking behavior and skills on home remedies, and childhood illnesses, advocating mass media exposure, assisting financially disadvantaged mothers, and postnatal checkups after delivery will enhance medical treatment-seeking behavior. Furthermore, coordinating with regional states, and designing timely policies and interventions are highly advisable in the country.

Concomitant use of medicinal plants and pharmaceutical drugs among pregnant women in southern Ethiopia

BackgroundIn several African nations, including Ethiopia, improving mother and child health is a top public health concern. Unfortunately, there is a dearth of study on pregnant women in Ethiopia who concomitantly utilize pharmaceutical drugs and medicinal plants. Hence, the objective of this research was to assess the concomitant use of pharmaceutical drugs and medicinal plants among pregnant women in Southern Ethiopia in 2021. MethodsA community-based cross-sectional study was conducted among systematically selected 400 pregnant women in Shashamane town, Southern Ethiopia, from July 1–30/2021. An interviewer-administered structured questionnaire was used to collect data. Binary logistic regression was performed to examine the association between a dependent variable and independent variables. ResultsAccording to this study, among those who self-medicated, 90 (22.5%) reported using at least one pharmaceutical drug, while 180 (45%) reported using at least one medicinal plant. Moreover, 68 (17%) of the participants who had taken drugs while pregnant also used pharmaceutical drugs and medicinal plants concomitantly. Having a medical condition during pregnancy (AOR = 5.6, 95% CI: 2.7–11.6), not having ANC follow up (AOR = 2.9, 95% CI: 1.3–6.2), gestational age (AOR = 4.2, 95% CI: 1.6–10.7), and not having a formal education (AOR = 4.2, 95% CI: 1.3–13.4) were all significantly associated with concomitant use of pharmaceutical drugs and medicinal plants during pregnancy. ConclusionThis study showed that nearly one in five pregnant women used medicinal plants concomitantly with pharmaceutical drugs. Mother's educational status, medical illness during pregnancy, having ANC follow up and gestational period were significantly associated with concomitant use of medicinal plants and pharmaceutical drugs. Therefore, health care providers and concerned stakeholders should consider these factors to minimize the risks associated with drug use during pregnancy on both mother and fetus.

Building an International One Health Strain Level Database to Characterise the Epidemiology of AMR Threats: ESBL—AmpC Producing E. coli as An Example—Challenges and Perspectives

Antimicrobial resistance (AMR) is one of the top public health threats nowadays. Among the most important AMR pathogens, Escherichia coli resistant to extended spectrum cephalosporins (ESC-EC) is a perfect example of the One Health problem due to its global distribution in animal, human, and environmental sources and its resistant phenotype, derived from the carriage of plasmid-borne extended-spectrum and AmpC β-lactamases, which limits the choice of effective antimicrobial therapies. The epidemiology of ESC-EC infection is complex as a result of the multiple possible sources involved in its transmission, and its study would require databases ideally comprising information from animal (livestock, companion, wildlife), human, and environmental sources. Here, we present the steps taken to assemble a database with phenotypic and genetic information on 10,763 ESC-EC isolates retrieved from multiple sources provided by 13 partners located in eight European countries, in the frame of the DiSCoVeR Joint Research project funded by the One Health European Joint Programme (OH-EJP), along with its strengths and limitations. This database represents a first step to help in the assessment of different geographical and temporal trends and transmission dynamics in animals and humans. The work performed highlights aspects that should be considered in future international efforts, such as the one presented here.

Contributors

Previous articleNext article FreeContributorsPDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreMiloš Broćić is a Ph.D. candidate from the Department of Sociology at the University of Toronto. His work lies at the intersection of political sociology, culture, and sociological theory. His primary research interests include exploring the social bases of moral conflict and assessing intellectual movements in sociology.Jonah Stuart Brundage is assistant professor of sociology at the University of Michigan. His research interests include historical and comparative sociology, political sociology, economic sociology, and social theory. He is currently writing a book on the role of diplomats and treaty-making in the rise of the British Empire.Kristopher Velasco is assistant professor of sociology at Princeton University. He uses the case of LGBT+ rights to illuminate changes within international organizations, transnational processes, and world culture. Kristopher received his B.A. from the University of Kansas and M.A. and Ph.D. from the University of Texas at Austin.Carly R. Knight is assistant professor of sociology at New York University. She is an economic sociologist with interest in organizations, law, culture, and markets. Her research examines the history of American corporate capitalism and the cultural processes through which economic actors are constructed.Adam Goldstein is assistant professor jointly appointed in the Department of Sociology and the School of Public and International Affairs at Princeton University. His primary research focuses on the social consequences of financial capitalism in the United States. He holds a Ph.D. in sociology from the University of California, Berkeley.Geoffrey T. Wodtke is associate professor of sociology at the University of Chicago and associate director of the Stone Center for Research on Wealth Inequality and Mobility at the Harris School of Public Policy.Ugur Yildirim is a data scientist at Slingshot Finance. He earned his Ph.D. in Sociology from the University of California, Berkeley, in 2020.David J. Harding is professor of sociology at University of California, Berkeley, and the faculty director of the Berkeley D-Lab.Emma Zang, Ph.D., is assistant professor of sociology, biostatistics, and global affairs at Yale University. Her research interests lie at the intersection of health and aging, family demography, and inequality. She is also interested in developing and evaluating statistical methods to model trajectories and life transitions. She has published articles in the top sociology, demography, family, methodology, and health journals.Poh Lin Tan is an assistant professor at the Lee Kuan Yew School of Public Policy, National University of Singapore. Her research focuses on women’s fertility, health and work-life balance in the contexts of extremely low fertility rates in Singapore and Asia, with publications across sociology, demography, economics and social policy journals. She serves as the secretary of the Population Association of Singapore.Philip J. Cook is professor emeritus of public policy and economics at Duke University. His research interests include education, criminal behavior, income inequality, and other topics. Previous articleNext article DetailsFiguresReferencesCited by American Journal of Sociology Volume 128, Number 5March 2023 Article DOIhttps://doi.org/10.1086/725539 © 2023 The University of Chicago. All rights reserved.PDF download Crossref reports no articles citing this article.

Implementation of Precision Oncology in Clinical Practice: Results of a National Survey for Health Care Professionals.

Two main aspects lead the implementation of precision oncology into clinical practice: the adoption of extended genome sequencing technologies and the institution of the Molecular Tumor Boards (MTBs). CIPOMO (Italian Association of Heads of Oncology Department) promoted a national survey across top health care professionals to gain an understanding of the current state of precision oncology in Italy. Nineteen questions were sent via the SurveyMonkey platform to 169 heads of oncology departments. Their answers were collected in February 2022. Overall, 129 directors participated; 113 sets of answers were analyzed. Nineteen regions out of 21 participated as a representative sample of the Italian health care system. The use of next-generation sequencing (NGS) is unevenly distributed; informed consent and clinical reports are managed differently, as the integration of medical, biologic, and informatics domains in a patient-centered workflow is inconsistent. A heterogeneous MTB environment emerged. A total of 33.6% of the responding professionals did not have access to MTBs while 76% of those who have did not refer cases. NGS technologies and MTBs are not homogeneously implemented in Italy. This fact potentially jeopardizes equal access chances to innovative therapies for patients. This survey was carried out as part of an organizational research project, pursuing a bottom-up approach to identify the needs and possible solutions to optimize the process. These results could be a starting point for clinicians, scientific societies, and health care institutions to outline the best practices and offer shared recommendations for precision oncology implementation in current clinical practice.

Using the Ophelia (Optimising Health Literacy and Access to Health Services) process as a practical tool for health promotion program delivery in various Philippine communities.

The Ophelia (Optimising Health Literacy and Access to Health Services) process can be used as a practical tool for effective health promotion program delivery because of its multi-sector and pragmatic approach to designing health interventions. An initial case study showed how its first phase was successfully adapted in a pilot community in Leyte, Philippines. In this study, the three phases of the Ophelia process were implemented in Leyte, along with additional communities in Mindoro and Surigao. After conducting needs assessment and community profiling in phase 1, the results were transformed into vignettes, hypothetical personas representing the health needs of the community. These were used in phase 2, which involved focus group discussions and workshops to cocreate intervention ideas with government organisations, practitioners, and community representatives. A rapid realist review was conducted in phase 3 to check for the feasibility of interventions. Through this, the top evidence-based health interventions for each life stage were listed and presented for prioritisation. Program implementation and impact evaluation plans were created for the top health intervention prior to implementation. The Ophelia process ensured that health promotion interventions addressed community needs and were designed using community resources and the wisdom of health practitioners that have been immersed in the local health system. SO WHAT?: The study demonstrated the usefulness of vignettes in presenting data to lay people and how the rapid realist review approach is a practical tool for policy-makers to ensure that program plans designed by the communities and health practitioners are evidence-based without sacrificing the timeliness of implementation.

Magnitude, associated factors, and antimicrobial susceptibility pattern of bacterial isolates among adult dental caries patients attending Hiwot Fana comprehensive specialized university hospital, Harar, Eastern Ethiopia.

Dental caries is defined as a dynamic diet microbial disease of teeth, which results in localized dissolution and destruction of the mineralized tissues of the teeth. Dental caries develops when there is a susceptible tooth exposed to pathogenic bacteria in the presence of substrate. Under these conditions, the bacteria metabolize substrate to form acid, which decalcifies teeth. Dental caries is among the top oral health problem in both developing and developed nations affecting around 20-50% of the population globally. This study was conducted to assess the magnitude, associated factors, and antimicrobial susceptibility pattern of bacterial isolates among adult dental caries patients visiting Hiwot Fana specialized university hospital dental clinic from April 23 to-June 23, 2021. An institutional-based cross-sectional study was conducted among 290 study participants. Convenient sampling techniques were used to select the study participants. Data was entered into Epi-info version 7.2.4.0 and exported to Statistical Package for the Social Sciences version 20 for analysis. The result was explained by using summary measures of texts, tables, and graphs after analysis by using bivariate and multivariate logistic regression. Statistical significance was defined at a p-value of less than 0.05. The overall magnitude of bacteria among dental caries patients was 68.3%. S mutans 74(37.4%) and Lactobacillus spp 58(29.3%) were the most predominant isolated bacteria. Lack of teeth brushing (AOR: 2.8, 95% CI:1.6, 4.6), the habit of chewing khat always (AOR:4.8, 95%CI:2.10,8.80), the habit of chewing khat sometimes (AOR: 3.8: 95% CI: 2.520,9.48) and consumption of soft drinks (AOR: 1.9, 95% CI:1.2,3.1) were significantly associated with bacterial dental caries. Almost, all bacterial isolates were susceptible to ceftriaxone and ciprofloxacin compared to Amoxicillin, Azithromycin, chloramphenicol, clindamycin, doxycycline, erythromycin, gentamycin, penicillin, tetracycline, vancomycin and tobramycin. Teeth brushing habit, consumption of soft drink and a habit of chewing khat affects dental health and they are associated with bacterial dental caries. Harari regional health bureau better to focus by giving health education to the community about dental caries based on identified associated factors with dental caries.

Impact of General Practitioner Education on Acceptance of an Adjuvanted Seasonal Influenza Vaccine among Older Adults in England

Seasonal vaccination against influenza and in-pandemic COVID-19 vaccination are top public health priorities; vaccines are the primary means of reducing infections and also controlling pressures on health systems. During the 2018-2019 influenza season, we conducted a study of the knowledge, attitudes, and behaviours of 159 general practitioners (GPs) and 189 patients aged ≥65 years in England using a combination of qualitative and quantitative approaches to document beliefs about seasonal influenza and seasonal influenza vaccine. GPs were surveyed before and after a continuing medical education (CME) module on influenza disease and vaccination with an adjuvanted trivalent influenza vaccine (aTIV) designed for patients aged ≥65 years, and patients were surveyed before and after a routine visit with a GP who participated in the CME portion of the study. The CME course was associated with significantly increased GP confidence in their ability to address patients' questions and concerns about influenza disease and vaccination (p < 0.001). Patients reported significantly increased confidence in the effectiveness and safety of aTIV after meeting their GP. Overall, 82.2% of the study population were vaccinated against influenza (including 137 patients vaccinated during the GP visit and 15 patients who had been previously vaccinated), a rate higher than the English national average vaccine uptake of 72.0% that season. These findings support the value of GP-patient interactions to foster vaccine acceptance.

Effective communication management in a public health crisis: lessons learned about COVID-19 pandemic through the lens of health communication executives

PurposeThe purpose of the study is to provide insights on the COVID-19 pandemic communication from the lessons learned by health communication executives—how they perceived the COVID-19 pandemic and recommend preparing for communication management of future public health crises.Design/methodology/approachA number of top health communication executives in the United States, who worked in the healthcare industry for at least 25 years and held titles like director, president and chief strategist, were interviewed for their unique perspectives on the COVID-19 pandemic. This study used the contingency theory of strategic conflict management for qualitative deductive analysis of the following segmentations of key factors that drove organizational communication management decision making during the pandemic: organization characteristics, relationship characteristics, general external climate, external publics and the issue under question.FindingsHealth communication executives heavily relied on their past health communication experiences, which led to nuanced understandings of the COVID-19 pandemic. Practically, the health communication executives urged future practitioners to constantly assess risks, hire and use diverse and representative decision-makers; set a communication protocol; and keep the communication in perspective. Theoretically, the contingency theory is furthered—there appears to be a theoretical linkage between the construct of general external climate and the construct of the external public.Originality/valueThe unique perspectives of top health communication executives, based in the United States, provided in-depth insights on the COVID-19 pandemic—its nuances, challenges and main influences (e.g. political, racial, etc.). These takeaways and recommendations can be adapted by other organizations and future health communicators in other parts of the world.

Our Souls Look Back and Wonder: Reflections on Belonging and Being Invisible in Medicine.

Addressing the unequal impact of health disparities on historically marginalized communities is a top public health priority. Diversifying the work force has been lauded as key to addressing this challenge. Contributing to diversity in the workforce is the recruitment and retention of health professionals previously excluded and underrepresented in medicine. A major obstacle to retention, however, is the unequal way in which health professionals experience the learning environment. Through this perspective of 4 generations of physicians and medical students, the authors seek to highlight the similarities that have persisted over 40 years in the experiences of being underrepresented in medicine. Through a series of conversations and reflective writing, the authors reveal themes that spanned generations. Two common themes among the authors are the feeling of not belonging and feeling invisible. This is experienced in various aspects of medical education and academic careers. The lack of representation, unequal expectations, and over taxation contributes to the feeling of not belonging, leading to emotional, physical, and academic fatigue. Feeling invisible, yet paradoxically being hyper-visible, is also common. Despite the challenges, the authors conclude with a sense of hope for the future, if not for them, for the generations to come.

Socioeconomic Inequalities in Cancer Incidence: A Comparative Investigation Based on Population of Iranian Provinces.

Cancer is the second important cause of death worldwide. Cancer is one of the top health priorities in Iran. We aimed to study the socio-economic inequality of cancer incidence in Iran provinces. We conducted this cross-sectional study using provincial data. We obtained the required data from the statistical yearbook report, the Statistics Center Report and the National Cancer Registration Program Report of Iran's Ministry of Health and Medical Education (MoHME) for 2018. Socio-economic inequality of cancer incidence was analyzed by estimating the concentration index and extracting the concentration curve. Statistical analyzes were performed using STATA 14. Our findings revealed that cancer incidence was unequally distributed in terms of the socio-economic status in Iranian provinces. Cancer incidence is slightly concentrated in the provinces with higher than average literacy, per capita income and insurance coverage and household size below average. The concentration of cancer incidence has been to the detriment of the provinces that have a slightly better ranking in terms of the socio-economic index. The employment rate did not significantly affect cancer's distribution burden. We recommend policymakers facilitate early cancer detection by providing insurance coverage for screening services, payment exemptions, and public awareness.