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Given the theoretical link between fear of crime and broader quality of life indicators, fear of violent crime is examined within the context of residents’ satisfaction with characteristics of their local area. Fear of violent crime is assessed in terms of worry for personal violent victimization as well as worry for the violent victimization of loved ones. We measure satisfaction with nine local area characteristics: utilities, transit, employment, first responders, shopping, housing, leisure, education, and amenities for special populations. Findings from analyses suggest that those who are less satisfied with first responders or leisure activities are more concerned with personal violent victimization. Those who report being less satisfied with housing or leisure activities are more concerned for the victimization of loved ones. The implications of these findings are discussed.

The concept of "one size fits all" followed by the conventional healthcare system has drawbacks in providing precise pharmacotherapy due to variation in the pharmacokinetics of different patients leading to serious consequences such as side effects. In this regard, digital-based three-dimensional printing (3DP), which refers to fabricating 3D printed pharmaceutical dosage forms with variable geometry in a layer-by-layer fashion, has become one of the most powerful and innovative tools in fabricating "personalized medicine" to cater to the need of therapeutic benefits for patients to the maximum extent. This is achieved due to the tremendous potential of 3DP in tailoring various drug delivery systems (DDS) in terms of size, shape, drug loading, and drug release. In addition, 3DP has a huge impact on special populations including pediatrics, geriatrics, and pregnant women with unique or frequently changing medical needs. The areas covered in the present article are as follows: (i) the difference between traditional and 3DP manufacturing tool, (ii) the basic processing steps involved in 3DP, (iii) common 3DP methods with their pros and cons, (iv) various DDS fabricated by 3DP till date with discussing few research studies in each class of DDS, (v) the drug loading principles into 3D printed dosage forms, and (vi) regulatory compliance.

Introduction Dupilumab is approved to treat moderate-to-severe atopic dermatitis (AD) in several countries in patients as young as 6 years of age. Since its approval, practical issues related to the use of dupilumab for AD have arisen, with particular interest in transitioning from current therapies and managing medication overlap, considerations for special populations of patients with AD, and management of potential adverse events. Methods This article aims to review the literature addressing several practical management issues related to dupilumab use for AD and to provide a framework for clinical decision-making in these circumstances and sub-populations. Each statement was reviewed, revised and voted on by authors to provide their level of agreement and degree of uncertainty for each statement. Results An agreement level > 80% was achieved for all of the statements. Conclusion The expert panel provides statements considering the practical management of patients with AD taking dupilumab to inform clinical decision-making in specific but frequently encountered clinical situations. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00586-w.

This manuscript illustrates general concepts of mentoring in low- and middle-income countries (LMICs). The focus of this manuscript is on public health research based on our experiences with the Cancer Epidemiology Education in Special Populations (CEESP) Program which is further illustrated in this Supplement. While the CEESP Program provides research training in global and US minority settings, this manuscript is focused on the global aspects of the program. We describe the process of selecting students into the CEESP Program, the process of mentoring them, and the preparation of the mentoring sites. We emphasize the review of the CEESP mentors in LMICs and put forward recommendations for enhancing their mentoring skills and disseminating the experience to other US and global institutions interested in global cancer education.

This study aimed to identify factors that influence the decision to take safety regulatory actions in routine signal management based on spontaneous reports. For this purpose, we analyzed the safety signals identified from the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) and related information. From the signals that the FDA identified in the FAERS between 2008 1Q and 2014 4Q, we selected 216 signals for which regulatory action was or was not taken. Characteristics of the signals were extracted from the FAERS quarterly reports that give information about what signals were identified from the FAERS and what actions were taken for them, and the FAERS data released in the same quarter when the signal was published. Univariate and multivariable logistic regression analysis was used to assess the relationship between the characteristics of each of the signals and the decision on regulatory action. As a result of the univariate logistic regression analysis, we selected 5 factors (positive rechallenge, number of cases accumulated in the last one-year period before the signal indication, previous awareness, serious outcome, risk for special populations) to include in the multivariable logistic regression model (p

We examined affective consequences arising from the kinds of memory retrieval failures that often accompany social interaction. To do so, we measured the influence of cued-recall outcomes for biographical information on the rated attractiveness of faces. The data demonstrate that retrieval of names (Experiment 1a) and professions (Experiment 1b) increases the rated attractiveness of target faces relative to faces that failed to produce recall of associative information. This was predicted by a confirmation of search (COS) model originally developed on verbal memoranda, which assumes that confirmation bias during memory search leads to affective consequences depending upon retrieval's success or failure. The current study extends this model, showing that evaluative judgments of individuals are in part contingent upon the memory retrieval skills of their assessors. We conclude by discussing potential extensions of the COS paradigm to the measurement of implicit attitudes and special populations.

Immune checkpoint inhibitors are a revolution in cancer treatment, having a better toxicity profile than chemotherapy. However, many mechanisms and management of immune-related adverse events are still unknown, and guidelines are a crucial tool to take clinical decisions. However, even the most recent guidelines lack information about alternative treatments for steroid-refractory immune-related adverse events, safety in special populations, biomarkers and therapy reinstitution. The aim of this article is to review the management of immune checkpoint inhibitors immunotoxicity and analyse the possible gaps in the clinical practice guidelines. Search on PubMed, Scopus and Clarivate Analytics of articles related to immune-related adverse events’ management. The summary of product characteristics of each immune checkpoint inhibitor approved by EMA and/or FDA was also considered. Based on this general literature search, an analysis of what is included in the most cited guidelines was made. Overall, 83 records were included in the descriptive review. The least developed topics in guidelines that are important to consider in future versions of the guidelines are the conditions to reinstitute immunotherapy after adverse events, possible biomarkers useful for clinical practice, if special populations such as patients with prior autoimmune diseases and elderly are eligible for treatment and options in the management of steroid-refractory adverse events. Furthermore, the grading system used for immunotoxicity classification may underestimate toxicity, and it is not optimized for immunotherapy. Clinical practice guidelines need to be updated and include information about special populations, biomarkers, treatment reinstitution and steroid-refractory immune adverse events.

As two different modalities of medical images, Magnetic Resonance (MR) and Computer Tomography (CT), provide mutually-complementary information to doctors in clinical applications. However, to obtain both images sometimes is cost-consuming and unavailable, particularly for special populations. For example, patients with metal implants are not suitable for MR scanning. Also, it is probably infeasible to acquire multi-contrast MR images during once clinical scanning. In this context, to synthesize needed MR images for patients whose CT images are available becomes valuable. To this end, we present a novel generative network, called CAE-ACGAN, which incorporates the advantages of Variational Auto-Encoder (VAE) and Generative Adversarial Network (GAN) with an auxiliary discriminative classifier network. We apply this network to synthesize multi-contrast MR images from single CT and conduct experiments on brain datasets. Our main contributions can be summarized as follows: 1)We alleviate the problems of images blurriness and mode collapse by integrating the advantages of VAE and GAN; 2) We solve the complicated cross-domain, multi-contrast MR synthesis task using the proposed network; 3) The technique of random-extraction-patches is used to lower the limit of insufficient training data, enabling to obtain promising results even with limited available data; 4) By comparing with other typical networks, we are able to yield nearer-real, higher-quality synthetic MR images, demonstrating the effectiveness and stability of our proposed network.

Traditional in-person discussion alone is often used for preoperative education in Mohs micrographic surgery (MMS). The appropriate use of more modern education techniques is not well defined in the MMS literature. The authors aim to evaluate patient education techniques for MMS, address education in special populations, and highlight opportunities for improvement. We performed a PubMed literature search with keywords “Mohs” and “education”, “teaching”, “understanding”, “explanation”, “preoperative”, or “consent” with no restriction on publication time frame due to literature scarcity. Teledermatology consultation, MMS videos, 3D models, pamphlets/online materials, and shared medical appointments appear to be effective techniques (GRADE B). Analogies are also anecdotally helpful when integrated into traditional verbal education (GRADE C). The role of preoperative educational phone calls is more controversial (GRADE C). Regardless of the education technique utilized, no singular technique entirely replaces the traditional in-person discussion. Having access to multiple modalities can be beneficial for patients, allowing them options to choose their preferred method(s) of education. MMS is a difficult topic to conceptualize, and further research into educational techniques is needed to provide clear guidelines for Mohs surgeons.

The purpose of this review was to assess the advancement of applications for physiologically based pharmacokinetic (PBPK) modeling in various therapeutic areas. We conducted a PubMed search, and 166 articles published between 2012 and 2018 on FDA-approved drug products were selected for further review. Qualifying publications were summarized according to therapeutic area, medication(s) studied, pharmacokinetic model type utilized, simulator program used, and the applications of that modeling. The results showed a 13-fold increase in the number of papers published from 2012 to 2018, with the largest proportion of articles dedicated to the areas of infectious diseases, oncology, and neurology, and application extensions including prediction of drug-drug interactions due to metabolism and/or transporter-mediated effects and understanding drug kinetics in special populations. In addition, we profiled several high-impact studies whose results were used to guide package insert information and formulate dose recommendations. These results show that while utilization of PBPK modeling has drastically increased over the past several years, regulatory support, lack of easy-to-use systems for clinicians, and challenges with model validation remain major challenges for the widespread adoption of this practice in institutional and ambulatory settings. However, PBPK modeling will continue to be a useful tool in the future to assess therapeutic drug monitoring and the growing field of personalized medicine. Electronic supplementary material The online version of this article (10.1007/s40495-020-00212-x) contains supplementary material, which is available to authorized users.

This review describes recent, relevant articles published regarding urinary tract infections (UTI). It reviews papers regarding the pathology, diagnosis, management, and prevention of urinary tract infections in addition to developments in the area of pediatric UTIs. Several new papers demonstrated findings on antibiotic resistance of UTI pathogens. Diagnostic equipment and detection techniques were a significant area of focus in recent publications including one paper that reported a drastic reduction in time to identify bacteria compared with traditional culturing. A set of new guidelines jointly published by several medical organizations discussed diagnosis, management, and prevention. Prevention of UTI in special populations was highlighted in multiple articles. Research on the topic of UTI is active, and advances are being made in all aspects of this common patient complaint. Many of the recent publications are relevant to care providers in their daily practice.

To present recent developments in pediatric regional anesthesia (RA) including safety, complications, special populations, evidence-based trends, and ultrasound guidance. The data presented should be used to improve outcomes of children receiving RA. Current data demonstrates a very low occurrence of serious complications and validates the use of GA for block placement in children. Fewer neuraxial blocks are performed in favor of peripheral blocks as the use of ultrasound guidance has made new blocks possible and old blocks better and safer. Neonates and infants have more RA options. Adjuvant medications and ambulatory catheters increase the duration of RA and facilitate cost-effective, low-risk hospital discharge. The local anesthetic systemic toxicity checklist reinforces new guidelines. Increasing pediatric-specific RA data shows increased analgesic choices and improving patient care. Large well-designed studies to precisely define the risks and benefits and appropriate applications of novel ideas and technologies are needed.

This manuscript provides a brief overview of the global aspects of the Cancer Epidemiology Education in Special Populations (CEESP) Program. The overview illustrates program history, aims, progress, evaluation, and dissemination. This manuscript sets the stage for the CEESP manuscripts included in this supplement that illustrate in the program infrastructure, mentoring, the student experiences, and unique features of students for achieving success. In this manuscript, we briefly outline some of the dissemination examples that resulted from utilizing the CEESP infrastructure, as outlined in some of the articles reporting on global research training sites from Egypt, Morocco, Oman, and Tanzania.

Medical education lags with respect to care for lesbian, gay, bisexual, and transgender populations, all of which experience disparities around access to care and health outcomes. (1) To evaluate M1 students’ perceived preparedness to care for transgender patients compared to LGB populations, (2) to identify knowledge and skills gaps, and (3) to recommend curricular developments. An online survey was administered to M1 students (N = 137) and assessed knowledge of and comfort levels with special populations. Responses were compared regarding transgender and nonbinary populations to those regarding LGB ones. Analyses consisted of t tests of response means and natural language processing of a free-text field querying for knowledge and skills needed to work with these subpopulations. With a 100% response rate, students expressed significantly lower levels of knowledge and comfort regarding transgender and nonbinary populations compared to LGB ones. Natural language processing of the sentiment of the free-text field revealed greater magnitude for transgender populations (83.7 vs. 62.1) and equal average sentiment scores (0.2). Content also revealed a greater emphasis on direct interaction with trans and nonbinary persons in order to develop gender-affirming language and skills whereas LGB content focused on acquiring knowledge of LGB health issues. M1 students feel less knowledgeable about and comfort with transgender persons compared to LGB ones; they want more exposure to and interaction with trans-patient experiences in order to develop gender-affirming language and clinical practices that address the range of healthcare needs.

Procedures to evaluate the communication of individuals with severe intellectual disabilities have grown to include myriad nonstandardized tests and procedures. This article examines the utility of existing nonstandardized assessment methods for generating representative and reliable findings for individuals with severe disabilities limited to nonsymbolic or emergent symbolic communicative abilities. Specifically, the use of informants, observations, and structured sampling are explored as to their strengths and limitations as assessment tools. Strategies for improving these methods are provided including preassessment planning, efforts to minimize observer subjectivity, and informant/observer training. Potential new directions for nonstandardized communication evaluation with this special population including applications of eye gaze and digital recording technology are also proposed.

Background Once-daily, orally administered, co-formulated glecaprevir (NS3/4A protease inhibitor) and pibrentasvir (NS5A inhibitor) (G/P) demonstrated pangenotypic activity and high sustained virologic response (SVR) rates in studies outside Japan. Here we report safety and efficacy in a subset of Japanese patients with chronic HCV infection who received G/P 300/120 mg in a phase 3, open-label, multicenter study (CERTAIN-1). Methods This analysis focuses on three difficult-to-treat subgroups: HCV GT1/2-infected patients who failed to achieve SVR after treatment with a direct acting antiviral (DAA)-containing regimen; GT1/2-infected patients with severe renal impairment (estimated glomerular filtration rate

There is limited data characterizing the risk and impact of surgical site infection (SSI) in neonates; this makes it difficult to identify factors that increase neonatal SSI risk and to determine how SSI affects outcomes in this special population. The American College of Surgeons National Surgical Improvement Program Pediatric (NSQIP-P) collected data on children undergoing surgery at children’s hospitals from 2012 to 2014. Neonates undergoing general surgical procedures were characterized with regard to demographic characteristics and comorbidities. Perioperative variables such as wound class, type of surgery and length of operation were also evaluated. Seven thousand three hundred and seventy-nine neonates were identified in the NSQIP-P participant user file. The overall SSI rate was 2.6%. Only wound class and length of surgery were significantly associated with SSI. Furthermore, SSI was independently associated with longer length of stay, even after adjusting for covariates. This is the largest study to date analyzing SSI in neonates. We found that perioperative variables have a more significant impact on SSI than patient factors, suggesting that operation-related characteristics are influencing SSI. Furthermore, neonates with SSI are more likely to have prolonged hospitalizations even after adjusting for patient comorbidities.

The investigation of Health-Related Quality of Life (HRQOL) of Orthodox Christian monks who live at the Holy Mount Athos in Greece, and its correlation with demographic characteristics and Sense of Coherence (SOC-13). A cross-sectional study was designed. The seven monasteries and five scetes with the largest number of monk population were invited to participate. Two monasteries and 1 scete gave their permission for the study. The final monks sample was formed by 166 monks from 215 who participated to the study. HRQOL was assessed using the SF-12 and Sense of Coherence the SOC-13 scales that were completed by monks from May to August 2012. Μultiple linear regression analyses were conducted to explore the association of the HRQOL subscales with the demographics and SOC-13. The mean age was 45.5 ± 13.0 years; 83.7% lived in communal monasteries, and the mean number of years in monasticism was 18.4 ± 12.1. The mean value of their Physical Component Summary (PCS) score was 47.3 ± 5.3, which is lower than in the general Greek men population, while their Mental Component Summary (MCS) score was 56.4 ± 5.8, which is higher than in the general Greek men population. The mean value of SOC-13 was 65.7 ± 6.5. Positive association for PCS appeared for place of living (β = 5.43, SE = 1.27, p

We review the evidence for the reported increase in disordered eating and body image disturbance occurring in women in middle age and later life. We describe the contributing factors that relate to the unique experience of eating disorders (EDs) at midlife and beyond. We review evidence for several key factors in this observation, specifically the bio-psycho-social and relational components of later life EDs. We present treatment considerations, screening tools for evaluation, and treatment recommendations for this special population suffering with EDs. Eating disorder symptoms and body image preoccupation have been identified in increasing numbers of women over age 50. Reports indicate that women are seeking treatment for chronic, recurrent, or late onset EDs. However, health care providers generally have not screened for these conditions, and often pursue other medical diagnoses. Age does not immunize women from body image preoccupation, weight and shape concerns, disordered eating, and eating disorders.

Radionuclide myocardial perfusion imaging (MPI) continues to be the most reliable modality for diagnosis of hemodynamically significant coronary artery disease (CAD). The application of radionuclide MPI using single photon emission computed tomography (SEPCT) and positron emission tomography (PET) for CAD is reviewed, with emphasis on diagnosis and risk stratification. Contemporary studies have reported the diagnostic and prognostic value of novel imaging protocols, employing stress-first or stress-only approach. In addition, the superior diagnostic value of PET has been established with a role of assessment of myocardial blood flow to improve risk stratification. The utility of MPI in special populations, such as the elderly, women, and diabetic patients has also been recently evaluated. Furthermore, multicenter studies have reported a similar diagnostic and prognostic value of radionuclide MPI compared with other functional and anatomical techniques for CAD. Radionuclide MPI with SPECT and PET are efficacious for diagnosis and prognosis of CAD. Its universal application in varied patient populations highlights its excellent clinical effectiveness.

One recent line of research in the literature on mind wandering has been concerned with examining rates of mind wandering in special populations, such as those characterized by attention-deficit/hyperactivity disorder, dysphoria, and schizophrenia. To best conceptualize mind wandering in studies examining special populations, it has recently been suggested that researchers distinguish between deliberate and spontaneous subtypes of this experience. Extending this line of research on mind wandering in special populations, in a large non-clinical sample (N = 2636), we examined how rates of deliberate and spontaneous mind wandering vary with symptoms of obsessive-compulsive disorder (OCD). Results indicate that, whereas deliberate mind wandering is not associated with OCD symptomatology, spontaneous mind wandering is, with higher reports of spontaneous mind wandering being associated with higher reports of OCD symptoms. We discuss the implications of these results for understanding both mind wandering and OCD.

Orchid epiphytes, a group containing at least 18,000 species, thrive in habitats that often undergo periodic drought stress. However, few global gene expression profiling datasets have been published for studies addressing the drought-resistant mechanism of this special population. In this study, an experiment involving the effect of continuous drought treatments on an epiphytic orchid, Dendrobium catenatum, was designed to generate 39 mature-leaf-tissue RNA-seq sequencing datasets with over two billion reads. These datasets were validated by a series of quality assessments including RNA sample quality, RNA-seq read quality, and global gene expression profiling. We believe that these comprehensive transcriptomic resources will allow a better understanding of the drought-resistant mechanisms of orchid epiphytes.

Global health education and training of biomedical students in international and minority health research is expending through U.S. academic institutions. This study addresses the short- and long-term outcomes of an NCI-funded R25 short-term summer field research training program. This program is designed for MPH and Ph.D. students in cancer epidemiology and related disciplines, in international and minority settings (special populations) in a recent 7-year period. Positive short-term outcome of 73 students was measured as publishing a manuscript from the field research data and having a job in special populations. Positive long-term outcome was measured as having a post-doc position, being in a doctoral program, and/or employment in special populations at least 3 years from finishing the program. Significant factors associated with both short- and long-term success included resourcefulness of the student and compatibility of personalities and interests between the student and the on-campus and off-campus mentors. Short-term-success of students who conducted international filed research was associated with visits of the on-campus mentor to the field site. Short-term success was also associated with extent of mentorship in the field site and with long-term success. Future studies should investigate how field research sites could enhance careers of students, appropriateness of the sites for specific training competencies, and how to maximize the learning experience of students in international and minority research sites.

Children represent a special population characterized by dynamic changes which may affect drug safety and efficacy. The interplay of pharmacogenetics with physiological alterations that occur throughout development is an area of increasing research focus. Given the translational nature of pharmacogenetic research, it is possible that pharmacogenetic research results may possess clinically actionable information. The potential long-term implications of pharmacogenetic test results throughout the lifespan of the child, and the potential impact of the results for other members of the family need to be considered. Comprehensive counselling and communication strategies may need to be integrated as part of pharmacogenetic research studies in children.

The NOACs are increasingly prescribed in France. Their effectiveness and their adverse effects appear to be in line with initial randomized studies. However, studies are missing in special populations, geriatric population for example, before their widespread prescription. Under medical supervision provided, these drugs can be started in the ER, in well-targeted patients.

Primary central nervous system lymphoma (PCNSL) is a rare type of lymphoma that requires a specialised approach to management. An initial evaluation should determine the extent of disease within the CNS compartment and must exclude the presence of systemic lymphoma. Methotrexate (MTX)-based chemotherapy is the standard of care but questions remain about the optimal drugs for use in conjunction with MTX as well as the best approach to consolidation. Furthermore, several special populations may require a modified approach to therapy.

In the past, cancer incidence and mortality for American Indian/Alaska Native populations have been suppressed in some publications based on small numbers and racial misclassification. Regional differences in cancer incidence and mortality in Native Americans have been observed as early as 1984. The cancer incidence, mortality, and survival data for American Indian/Alaska Native population have been better documented. Good stable models for the state tumor registries for cancer surveillance exist in the New Mexico and Alaska tumor registries. The Network for Cancer Control Research in American Indian/Alaska Natives was supported by the Special Populations branch of the National Cancer Institute. The Network formulated a plan for reducing cancer incidence and mortality in Native Americans and also to improve their survival. This Strategic Plan which proposed to educate federal agencies and state agencies about the increased incidence and mortality of cancer in American Indian/Alaska Natives also informed the Native American population of the specific risks of cancer in their communities. The Strategic Plan was published and implemented by the Network, and its goals have been continued by the Spirit of Eagles.

Individuals with Body Dysmorphic Disorder (BDD) have distressing or impairing preoccupations with imagined or slight defects in their appearance (e.g., nose too big). BDD is a severe psychiatric disorder often associated with high rates of suicidality as well as social and occupational impairment (Phillips, Coles et al., 2005). Researchers have only recently begun to investigate psychological treatments for BDD, with available data suggesting that cognitive behavioral therapy (CBT) appears efficacious for BDD (Williams, Hadjistavropoulos, & Sharpe, 2006). To our knowledge, however, there are no reports of whether CBT for BDD can be effectively generalized to ethnic minority and other special populations. The current report suggests specific modifications within the CBT for BDD framework that might improve the effectiveness and retention rates of CBT among ethnic minority patients with BDD. Specifically, the present study describes the cases of Ben*, a 40-year-old, Jewish, married male, and John, a 30-year-old, African American, single male, both with a primary diagnosis of BDD. Various treatment techniques were used to make the course of CBT more culturally responsive. This case report illustrates the challenges and benefits of integrating cultural variables into a CBT framework for BDD, and it highlights the need for more work in this area.

Damage to prefrontal cortex (PFC) impairs decision-making, but the underlying value computations that might cause such impairments remain unclear. Here we report that value computations are doubly dissociable among PFC neurons. Although many PFC neurons encoded chosen value, they used opponent encoding schemes such that averaging the neuronal population extinguished value coding. However, a special population of neurons in anterior cingulate cortex (ACC), but not in orbitofrontal cortex (OFC), multiplexed chosen value across decision parameters using a unified encoding scheme and encoded reward prediction errors. In contrast, neurons in OFC, but not ACC, encoded chosen value relative to the recent history of choice values. Together, these results suggest complementary valuation processes across PFC areas: OFC neurons dynamically evaluate current choices relative to recent choice values, whereas ACC neurons encode choice predictions and prediction errors using a common valuation currency reflecting the integration of multiple decision parameters.

Although there is a substantial amount of research on households’ hurricane evacuation decision making, there is much less research on the logistical issues involved in implementing those evacuations. The limited research on household evacuation logistics has consistently shown that most evacuees stay in the homes of friends and relatives or in commercial facilities rather than in public shelters. However, evacuation logistics—which can be defined as the activities and associated resources needed to reach a safe location and remain there until it is safe to return—encompasses a much broader range of behaviors than this. The present study extends previous research by reporting data on other aspects of evacuation logistics such as departure timing, vehicle use, evacuation routes, travel distance, shelter type, evacuation duration, and evacuation cost. Hurricane Lili evacuation data at the county level are generally consistent with the data from previous hurricanes, but there is notable variation across counties studied here. There were only modest correlations of demographic and geographic variables with the evacuation logistics variables, a result that indicates further research is needed to better understand what happens between the time an evacuation decision is made and the time re-entry is begun. Moreover, research is needed to understand the logistics of evacuation by special populations such as transients and households with disabled members.

One poorly studied question in the pathogenesis of ischemic brain damage is that of the early reorganization of blood vessels at sites of transient ischemia. The aim of the present work was to study the structural organization and cytochemical characteristics of smooth muscle cells(SMC) in the walls of intracerebral blood vessels in 16 Wistar rats during the early postischemic period (48 h after 30-min ischemia). Assessment of damaged hemispheres revealed stellate cells giving reactions for α-smooth muscle actin and thus apparently representing a special population of structurally altered SMC not typical of the intact brain in control animals (n = 5). The functional role of these cells remains unclear.

Youth who are exposed to violence are more likely to perpetrate violence. Incarcerated youth are a special population that is at a significantly greater risk for violent offending because of their relatively greater rates of violence exposure. Two important outcomes of violence exposure that may help explain its link with violence perpetration are posttraumatic stress disorder and problematic anger. The primary aim of the current study is to examine whether these important risk factors mediate the relation between two types of violence exposure (i.e., witnessing and victimization) and various types of violence perpetration in a sample of 373 incarcerated male adolescent offenders. A second aim is to test whether another well-established correlate of violence in youth, callous-unemotional (CU) traits (lack of empathy, guilt), adds unique variance beyond violence exposure, anger, and PTSD symptomatology. Findings suggest that anger is a robust predictor of violence and appears to at least partially act as the mechanism through which violence exposure is linked with violence perpetration. CU traits also contribute unique variance, beyond the significant effect of anger, to the statistical prediction of community, but not institutional, violence.

Linezolid is the first oxazolidinone agent introduced into clinical practice for use against Gram-positive bacteria that are resistant to beta-lactams and glycopeptides, including methicillin (meticillin)-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). An optimal antibacterial effect is achieved when plasma drug concentrations are above the minimum inhibitory concentration (MIC) [T>MIC] for the entire length of treatment and the ratio between the area under the plasma concentration-time curve (AUC) and the MIC (AUC/MIC) is greater than 100, as is most commonly obtained with administration of the standard dosage of linezolid 600 mg twice daily. A wide tissue distribution, including the CNS and respiratory tract, nearly linear pharmacokinetics and good tolerability are additional characteristics of linezolid. However, variability in the drug pharmacokinetics associated with clinical conditions (e.g. sepsis, burn injuries, end-stage renal disease, cystic fibrosis), haemodialysis and/or young age may lower the T>MIC and the AUC/MIC ratio, thus impairing both antibacterial activity and prevention of mutants. In most cases, changes in the dosage or in the schedule of administration (e.g. an additional [third] daily dose) may improve the effectiveness of linezolid. It is worth noting that linezolid could affect its own metabolism as a result of protein synthesis inhibition in mitochondria, and this could lead to high plasma concentrations and an increased risk of non-negligible toxicities. The latter may be reported during long-term administration of linezolid or in the presence of some pathological conditions (e.g. renal disease or kidney transplantation) associated with high plasma drug concentrations. Therefore, treatment optimization should be considered a requirement for more effective and tolerable use of the drug, particularly in special populations.

This article describes the development and evaluation of an NCI-sponsored short-term summer cancer research education program. The study questions examined: the feasibility of conducting a cancer education program in special populations at multiple US and international field sites for masters students; the merit and worth that students and faculty attribute to the program; and students' scholarly and cancer-related career outcomes. Developing a new curriculum, increasing the pool of mentors, utilizing and increasing the number of field sites, and program dissemination were also evaluated. Evidence of the program's success included students' completion of field experiences at multiple sites and their subsequent 70% project-related publication rate, with 79% of trainees reporting themselves as likely to pursue future cancer-related careers. Evaluation-guided future plans for the program include implementing faculty development to further enhance the program outcomes.

Conference Theme: The Dance of Discovery: Research and Innovation in Dance/Movement Therapy

Treatment of hypercholesterolemia in youth is predicated on the knowledge that we can identify those youth with this atherosclerotic risk factor most likely to develop premature cardiovascular disease. Unfortunately, this is not the case. Before we can adequately address appropriate lipid-lowering therapies in this special population, we must address and resolve current barriers related to screening and diagnosis. In this article, we describe some of the opportunities and obstacles that clinicians and policy makers confront when applying the current pediatric guidelines focused on screening and treating hypercholesterolemia in the pediatric population.

Youths who have been maltreated often experience symptoms of posttraumatic stress disorder (PTSD), and this special population has received increased attention from researchers. Pathways toward maladaptive effects of maltreatment and PTSD are remarkably similar and reflect specific biological diatheses and psychological vulnerabilities that produce wide-ranging self-regulation deficits. Developmental models of effects of maltreatment and of PTSD are thus increasingly intertwined and have begun to inform specialized assessment and treatment strategies for this population. This review covers key aspects of posttraumatic stress disorder in maltreated youth, including epidemiology, symptomatology, outcome, and risk factors as well as assessment and treatment strategies and challenges for these youths.

A large body of research supports the use of exercise as a treatment for depression across a wide range of ages and with special populations, such as pregnant women and women who suffer from postpartum depression. However, methodologic limitations have historically limited our ability to interpret and understand previous research findings, which in turn may have hindered acceptance of exercise as treatment for depressed patients. This review provides information on some of the most salient studies of exercise as a treatment for depression and highlights important methodologic issues that have limited this area of research. In addition, several ongoing studies that were designed to address these limitations are reviewed. These and future well-designed trials can better inform the field regarding the utility of exercise in the treatment of depression.

This annual special issue of "Transportation: Planning, Policy, Research, Practice" comprises selected papers presented at the Annual Meeting of the Transportation Research Board (TRB) in January 2008. These papers all focus on segments of the population that face particular mobility challenges. The papers develop and extend hypotheses regarding the determinants of variability in travel behavior of these special groups. The highlighted groups include university workers, immigrants, senior citizens, baby boomers, and children. It is hoped that the findings presented in this issue will increase understanding and stimulate future research in the area of travel behavior of special population groups.

While most of the literature on the experiences of physically disabled offenders in prison is legal or anecdotal, there is next to no epidemiological exploration of this special population in our state and federal correctional facilities. This is particularly troubling because it is estimated that there are over 220,000 inmates who have some degree of physical impairment. The purpose of this article is to set the stage for such future research. This article examines the importance of epidemiological research, problems with existing research, prevalence of the prison population that are physically disabled, characteristics of these offenders (e.g., age, sex, race), the correctional environments in which they are placed, and suggestions for future research.

Playing-related musculoskeletal complaints are often found among musicians, taking a toll in more than 70% of professional musicians in orchestras. Professional musical performance requires a high level of differenciation and efficiency of psychological, mental and physical skills. Many risk factors can contribute to the development of musculoskeletal conditions in this special population, like the individual technique, physical fitness of the musician and the instrument itself. Many rheumatic, neurological, dermatological, and psychiatric problems are reported, as well as dysfunctions of the visual, auditive and oral system. The musculoskeletal complaints often manifest as pain, weakness or tension, and the most common diagnoses of the upper limb are tendinopathies, myalgia and overuse syndromes. It is necessary for the skilfull physician and physical therapist to have a thorough knowledge about potential problems of the performing artist, in order to provide adequate medical examination and treatment to this very special patient.

The purpose of this paper, which utilizes data from the Canadian Community Health Survey (CCHS-Cycle 1.1), is threefold. The first is to examine the health of Canadian immigrants in relation to non-immigrants, focusing on the relationship between key health determinants and health status. Second, it tests whether these data support the well-documented ‘healthy immigrant effect’. The third is to evaluate the usefulness of using a large national database to study ‘special populations’ such as immigrants. Through a comparison of findings from previous studies, the authors highlight the strengths and weaknesses of different datasets for investigating immigrant health and, by extension, the health of other unique populations in Canada.

Adequate access to child and adolescent mental health services for young people in high need populations is an important concern of service systems researchers and program evaluators. We present results of a statewide study of access to community mental health services for eight populations of special concern. The analysis relied exclusively on existing databases in conjunction with innovative statistical techniques to provide comprehensive measures of access to care. Our findings indicate that access to care varied substantially across special populations, although children and adolescents in each of our eight “special populations” had greater access to public mental health services than members of the general population of the state. The interpretation of the findings and directions for future research are discussed.

Previous research indicated that physically disabled children have a low self-efficacy and perceive less control over their own performance than other children. Problem-based learning (PBL) is an educational approach that emphasizes interpersonal skills, self-directed learning and problem-solving skills. Acquiring these skills has been demonstrated to increase self-efficacy. This study examined whether the use of PBL would increase self-efficacy and school-related attitudes in physically disabled teenagers. In a quasi-experimental design, 29 physically disabled teenagers received a 9-week geography course in PBL format or their usual geography education. Contrary to our hypothesis, no positive effects of PBL were found and the PBL group even showed a significant decrease in learning-related self-esteem, as compared with the controls. A possible explanation is that the PBL course was too short and not integrated in the whole curriculum. The results emphasize the importance of experimentally testing the effects of new educational methods for use in other populations then the population for which positive results have been reported (university students). This seems particularly true in special populations such as physically disabled children. Additionally, carefully monitoring the implementation process seems especially important here.

Nurnerous clinical practice guidelines are available to assist clinicians in the management of osteoporosis. These guidelines include the American an Association of Clinical Endocrinologists (AACE), the Scientific Advisory Council of the Osteoporosis Society of Canada (OSC), the National Osteoporosis Foundation (NOF), the National Institutes of Health (NIH) Consensus Development Panel, and the North American Menopause Society (NAMS). Additionally, guidelines for the prevention and treatment of osteoporosis in special populations include recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis from the American College of Rheumatology (ACR) and from the Department of Veterans Affairs. Furthermore, the American Gastroenterological Association (AGA) has issued recommendations for the management of osteoporosis in gastrointestinal and hepatic diseases. This article provides an overview of recommendations contained within the guidelines, as well as a table that summarizes major findings from each of the general guidelines.

Otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) are different in several special populations of subjects. For females having opposite-sex co-twins (OSDZ females) and for homosexual and bisexual females, OAEs are masculinized. Certain AEP measures from homosexual and bisexual females also are masculinized. Certain AEP measures from homosexual males are hypermasculinized. These and other facts can be explained by assuming that these special populations received greater-than-normal exposures to androgens at some point(s) during development, possibly during prenatal development. It is proposed that some differences in androgenization may have been spatially and temporally localized rather than global, and that the localized response to androgen exposure sometimes may be nonmonotonic.

The 18th Annual Conference of the Society on Neuroimmune Pharmacology (SNIP) will be held at the Hawaii Prince Hotel Waikiki in Honolulu, Hawaii from April 25–28, 2012. The conference will focus on defining the role of substances of abuse in modulating neuroimmune processes and determining the physiological and behavioral consequences of such alterations in infectious diseases, with HIV infection as the prime model. This focus will include basic and clinical neuroscience, neuroAIDS, and other neurodegenerative processes, as well as the behavioral sciences. The conference also will address the relationship between substances of abuse and HIV/AIDS, particularly with regard to etiology, genetics, epidemiology, prevention, treatment, health services, and therapeutic developments. A major goal of the conference and SNIP is to promote the professional development of young investigators. Thus, four events will be dedicated to young investigators. In addition, the Asian American Pacific Islander (AAPI) workgroup of the NIDA Special Population Office has collaborated with the Society to sponsor Early Career Investigators who will present their research. An exciting and comprehensive program has been assembled that brings together scientists and practitioners from around the world providing a platform for them to share their research and discuss the translational clinical and epidemiological relevance of this research to the community at large.

Adult congenital heart disease (ACHD) patients represent a special population in modern cardiology: though their numbers are growing, and they represent a high-resource utilization subgroup, a robust evidence-base of randomized trials is lacking. Much of the standard therapy is adapted from the treatment of ischemic and idiopathic left ventricle systolic failure, with a small, but growing body of evidence on medical therapy in select ACHD diagnoses. At our institution, for instance, there is a long tradition of using angiotensin antagonists in patients with a systemic right ventricle to prevent deleterious remodeling. The effects of beta-blockers on functional class in ACHD are yet unproven, but there is promising data on pulmonary vasodilators. Control of coronary risk factors and aerobic exercise should be considered for all. Prevention of arrhythmias is important, and multi-site pacing is an emerging therapy. New prognostic tools including natriuretic peptides and CPET are increasingly used to guide earlier initiation of these therapies.