Search

Purpose: The Deaf community is an ethnolinguistic minority whose lack of access to mainstream health information limits health literacy. This study describes barriers to teaching high school health education in US K-12 Deaf schools. Methods: An online survey with English and American Sign Language (ASL) instructions were emailed to administrators at sixty schools for the Deaf. Descriptive statistics were conducted to describe study sample, health class curriculum topics and perceived student knowledge of said topics. All statistical analyses were completed using SAS version 9.4 (SAS Institute, Inc., Cary, NC). Results: Twenty-five schools (42%) anonymously responded. Ninety-two percent of schools reported a lack of resources for teaching health education. Only 12% of schools reported having a nationally certified health teacher. Student knowledge was perceived to be poor to satisfactory regarding mental health, self-advocacy, and family medical history. Conclusions: This study found the most notable barriers to health education were difficulty hiring qualified health teachers and severe lack of resources for teaching. The subjects with the greatest lack of resources were also among topics in which students had the poorest perceived knowledge. Recommendations: Additional opportunities for future research could include a comparison to hearing schools in the US, assessing health care knowledge among deaf students in mainstream schools, or completing a similar survey to compare results to comparable schools for the Deaf outside of the United States. Additionally, future research could assess actual student knowledge of the subjects that were queried and compare to existing health disparities in the community. [The volume number (12) shown on the PDF is incorrect. The correct volume number for this article is 13.]

Purpose of reviewChimeric antigen receptor (CAR) T cell therapy has been successful in some haematologic malignancies, but the central nervous system (CNS) presents unique obstacles to its use against tumours arising therein. This review discusses recent improvements in the delivery and design of these cells to improve the efficacy and safety of this treatment against malignant gliomas.Recent findingsThe immunosuppressive environment of the CNS affects the functionality of CAR T cells, but recent developments using metabolic manipulation and cytokine delivery have shown that the performance of CAR T cells can be improved in this environment. Emerging techniques can improve the delivery of CAR T cells to the CNS parenchyma, which is normally well protected from peripheral immune cells. The implementation of novel antigens and CAR-expression regulation strategies will improve the specificity and efficacy of these cells. Finally, although autologous T cells have historically been the standard, recent developments have made the use of allogeneic T cells or natural killer (NK) cells more clinically feasible.SummaryThe discoveries highlighted in this review will aid the development of CAR cells that are safer, more resilient against immunosuppressive signals in the CNS, and able to specifically target intracranial tumour cells.

Introduction: The use of personal protective equipment (PPE) is a salient component of reducing occupational risk in many fields. Emergency medical services (EMS) personnel use PPE to reduce risk of exposure and defend against various pathogens they come in contact with while providing patient care. Currently, the understanding of factors that predict the use of PPE by an EMS responder during a pandemic is limited. In this study our objective was to identify factors that influenced PPE use by EMS responders during the coronavirus disease 2019 (COVID-19) pandemic, which may guide future planning for responders in similar austere or personal risk situations.  Methods: We conducted a retrospective chart review among all EMS encounters across an EMS agency affiliated with a large New York health system from March 16–June 30, 2020. All adult, emergency encounters with available prehospital record data were analyzed. We assessed patient- and EMS encounter-level data as possible factors that influence PPE utilization. The use of PPE was defined and guided by the literature as being either full or partial PPE, or “not documented.” We used multinomial logistic regression to identify factors that influence PPE use among EMS responders. Results: We identified 28,693 eligible EMS encounters during the study period; 54.2% of patients were male, the median patient age was 58 years, and 66.9% of patients had at least one chronic medical condition. The use of PPE was documented in 92.8% of encounters, with full PPE used in 17.8% of these encounters. Full PPE utilization, relative to partial, was most strongly influenced by dispatch codes indicative of “breathing problems” (odds ratio [OR] 4.89; 95% confidence interval [CI]: 4.40, 5.46) and “cardiac/respiratory arrest” (OR 3.82; 95% CI: 2.99, 4.88), in addition to a patient’s positive screening for COVID-19 on 9-1-1 dispatch (OR 3.97; 95% CI: 3.66, 4.32). Conclusion: Emergency medical services responders more frequently used full PPE for calls with dispatch codes indicative of respiratory distress or cardiac arrest. Understanding factors that influence PPE use among EMS personnel, particularly during times of public health emergencies, is essential to mitigate exposure and ensure the safety of frontline responders.

Background Health-focused research funders increasingly support multi-country research partnerships that study health, urban development and equity in global settings. To develop new knowledge that benefits society, these grants require researchers to integrate diverse knowledges and data, and to manage research-related aspects of coloniality, such as power imbalances and epistemic injustices. We conducted research to develop a transdisciplinary study proposal with partners in multiple middle and high income countries, aiming to embed equity into the methodology and funding model. Methods Parallel to literature review, we used participatory and social research methods to identify case study cities for our primary study and to inform our study design. We conducted semi-structured interviews with informed and consented sustainable urban development experts in the USA (n=23). We co-developed our research approach with our global advisory group (n=14) and conducted a participatory workshop (n=30) to identify case study sites, also informed by conversations with international academic experts in sustainable development (n=27). Results Through literature review we found that there is a need to study the contextual pre-conditions of urban transformation, the influence of coloniality on understandings of how cities can change and the failure of standard development practices to meet the needs of all residents and the planet. Through expert input and literature we found that decolonial and storytelling methods may help us show the complexities behind stories of urban transformation, particularly the role of marginalized populations in creating long-term change. Conclusions There are multiple benefits of conducting research to develop an equitably designed multi-country research collaboration. We built new partnerships and co-developed our research approach, creating new understanding of diverse collaborators’ disciplinary perspectives and institutional requirements. By investigating the informational needs of U.S. sustainable development actors and designing our study to meet these needs, we have increased the likelihood that our research will create impact.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The use of personal protective equipment (PPE) is a salient component of reducing occupational risk in many fields. Emergency medical services (EMS) personnel use PPE to reduce risk of exposure and defend against various pathogens they come in contact with while providing patient care. Currently, the understanding of factors that predict the use of PPE by an EMS responder during a pandemic is limited. In this study our objective was to identify factors that influenced PPE use by EMS responders during the coronavirus disease 2019 (COVID-19) pandemic, which may guide future planning for responders in similar austere or personal risk situations. Methods: We conducted a retrospective chart review among all EMS encounters across an EMS agency affiliated with a large New York health system from March 16–June 30, 2020. All adult, emergency encounters with available prehospital record data were analyzed. We assessed patient- and EMS encounter-level data as possible factors that influence PPE utilization. The use of PPE was defined and guided by the literature as being either full or partial PPE, or “not documented.” We used multinomial logistic regression to identify factors that influence PPE use among EMS responders. Results: We identified 28,693 eligible EMS encounters during the study period; 54.2% of patients were male, the median patient age was 58 years, and 66.9% of patients had at least one chronic medical condition. The use of PPE was documented in 92.8% of encounters, with full PPE used in 17.8% of these encounters. Full PPE utilization, relative to partial, was most strongly influenced by dispatch codes indicative of “breathing problems” (odds ratio [OR] 4.89; 95% confidence interval [CI]: 4.40, 5.46) and “cardiac/respiratory arrest” (OR 3.82; 95% CI: 2.99, 4.88), in addition to a patient’s positive screening for COVID-19 on 9-1-1 dispatch (OR 3.97; 95% CI: 3.66, 4.32). Conclusion: Emergency medical services responders more frequently used full PPE for calls with dispatch codes indicative of respiratory distress or cardiac arrest. Understanding factors that influence PPE use among EMS personnel, particularly during times of public health emergencies, is essential to mitigate exposure and ensure the safety of frontline responders.

Impacts of housing on health are well-recognised. Despite this, housing standards have been neglected and there are gaps in healthy housing policies, particularly in low and middle-income countries. Given the recent publication of the WHO Housing and health guidelines, and the need to implement these into policy at all scales, we carried out a focused search and thematic synthesis of available literature on the barriers and enablers to recent housing and health policy. We aimed to generate lessons of what works to support healthy housing policy development and implementation elsewhere. Twenty-three studies representing four countries were eligible for inclusion and covered housing-related risks of air quality, lead, accessible design, and housing conditions. Findings demonstrated that policy development and implementation were facilitated through awareness of housing and health, evidence of existing housing conditions and health impacts, collaborations across sectors and between residents and decision-makers and effective enforcement systems that employed incentives, tools such as certificates for compliance, and housing inspections. Concerns about economic viability and tensions between housing rights and responsibilities limited healthy housing policy for the 'common good'. Despite limitations in the diversity of available evidence, this thematic synthesis provides a starting point for healthy and equitable housing for all. [ABSTRACT FROM AUTHOR]