2,723 results on '"Special populations"'
Search Results
202. Characterization of Maternal and Neonatal Pharmacokinetic Behavior of Ceftazidime.
- Author
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Dallmann, André, Koch, Gilbert, den Anker, John, and Pfister, Marc
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INFANT psychology , *PREMATURE infants , *INTRAVENOUS therapy , *MOTHERHOOD , *PARENTING , *PLACENTA , *SECOND trimester of pregnancy , *THIRD trimester of pregnancy , *PREGNANT women , *URINARY tract infections , *WOMEN'S health , *CEFTAZIDIME , *CORDOCENTESIS , *THERAPEUTICS - Abstract
Ceftazidime is a parenteral cephalosporin frequently used in pregnant women for treatment of urinary tract or intrauterine infections. Despite its regular use in pregnant women, ceftazidime disposition in both mother and fetus is not well understood, and a pharmacokinetic (PK) model that allows characterization and simulation of both maternal and preterm neonatal ceftazidime disposition is not available. In this study, 10 pregnant women with suspected or proven intrauterine infections in the late second and early third trimester were treated with 1 g of ceftazidime intravenously every 6 hours. During ceftazidime treatment, one maternal and umbilical cord blood sample was taken at delivery to quantify ceftazidime concentrations in the mother and preterm neonate. Data showed that ceftazidime concentrations in the mother were comparable to those observed in the neonate. Based on these data, a PK model was developed to describe maternal disposition, ceftazidime distribution over the placenta, and elimination in the neonate. The maternal substructure of the model was parameterized according to a previously reported ceftazidime model with minor adjustments to account for pregnancy‐related effects on renal elimination of ceftazidime. The expanded population PK model with an additional neonatal compartment was fitted to measured drug concentrations in the neonate. The neonatal elimination rate constant at delivery was close to that estimated for the mother. The presented results show that ceftazidime readily crosses the placenta and indicate that perinatal PK behavior of ceftazidime in preterm neonates can be expected to be similar to those observed in their mothers. [ABSTRACT FROM AUTHOR]
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- 2019
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203. Bioequivalence Comparison of Pediatric Dasatinib Formulations and Elucidation of Absorption Mechanisms Through Integrated PBPK Modeling.
- Author
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Vaidhyanathan, Shruthi, Wang, Xiaoning, Crison, John, Varia, Sailesh, Gao, Julia Z.H., Saxena, Ajay, and Good, David
- Subjects
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DASATINIB , *THERAPEUTIC equivalency in drugs , *DRUG absorption , *DRUG tablets , *DRUG formularies - Abstract
Abstract SPRYCEL® (Dasatinib) is a Biopharmaceutical Classification System II weakly basic drug that exhibits strong pH-dependent solubility. Dasatinib is currently presented in 2 drug product formulations as an adult immediate release tablet and a pediatric powder for oral suspension. A bioequivalence study comparing the formulations in adult healthy subjects found that overall exposure (AUC 0-24) from suspension treatments was ∼9% to 13% lower, Cmax was similar, and median Tmax from powder for oral suspension was ∼30 min earlier. To understand the mechanism contributing to this behavior, a combination of biorelevant dissolution studies and physiologically based pharmacokinetic modeling was used to simulate in vivo performance. In vitro biorelevant dissolution confirmed that the rate and extent of release was similar between tablet and suspension formulations (>90% release within first 15 min). Physiologically based pharmacokinetic parameter sensitivity analysis demonstrated particular sensitivity to dosage form gastric residence time. A 12% higher AUC 0-24 was simulated for tablet dosage forms with 10 to 15 min longer gastric transit relative to solutions or suspensions of small particulates (rapid gastric emptying). The corresponding narrow simulated Cmax range also agreed with observed tablet and suspension bioequivalence data. The unique physicochemical properties, absorption characteristics, and inherent differences in dosage form transit behavior are attributed to influence the dasatinib bioequivalence. [ABSTRACT FROM AUTHOR]
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- 2019
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204. Global Trends and Prostate Cancer: A Review of Incidence, Detection, and Mortality as Influenced by Race, Ethnicity, and Geographic Location.
- Author
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Taitt, Harold Evelyn
- Abstract
Although research has reported that prostate cancer (PCa) incidence and mortality rates are among the highest for African Americans, the data is inconclusive regarding PCa rates in native African men, Black men residing in other countries, and men in Asia, Europe, and the Americas. Data reveals that prostate-specific antigen (PSA) testing and disease incidence have risen significantly in developing and Asian countries, and PCa has become one of the leading male cancers in many of those nations.The objective of this study was to review published peer-reviewed studies that address PCa in different regions of the world to get a better understanding of how PCa incidence, prevalence, detection, and mortality are influenced by race, ethnicity, and geography. A secondary goal was to compare PCa data from various world regions to contextualize how disproportionate the incidence and mortality rates are among men from the African diaspora versus men of European, Hispanic, and Asian descent, as well as to highlight the need for more robust screening and treatment guidelines in developing countries.There are differences in incidence and mortality rates between men of African, Asian, Hispanic, and European ancestry, confirming the involvement of genetic factors. However, differences between men of the same race and ethnicity who live in different countries suggest that environmental factors may also be implicated. Availability and access to diagnostic and health-care services as well as recommendations regarding PCa testing vary from country to country and contribute to the variability in incidence and mortality rates. [ABSTRACT FROM AUTHOR]
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- 2018
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205. Effects of Discrimination on HIV-Related Symptoms in Heterosexual Men of Color.
- Author
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Braksmajer, Amy, Simmons, Janie, Aidala, Angela, and McMahon, James M.
- Abstract
HIV-related symptoms have a deleterious effect on quality of life. One determinant of HIV symptom burden among individuals of color may be discrimination. The aim of this study was to explore whether multiple lifetime discrimination events are associated with a greater number of HIV-related symptoms among heterosexual HIV-positive men of color and to examine the influence of anxiety and social support on this relationship. Data for this study were drawn from a cross-sectional survey of 307 heterosexual HIV-positive men recruited from health and social service agencies in New York City (NYC). This study indicated that the number of discrimination events experienced in one’s lifetime was positively associated with the number of HIV-related symptoms experienced in the past month. Moreover, the direct effect of discrimination on HIV symptoms remained significant after anxiety was included as a mediator in the model, and there was a significant indirect effect of discrimination on HIV symptoms through anxiety. Evidence supported a potential moderated mediation effect involving social support: As social support increased, the indirect effect of discrimination on HIV symptoms through anxiety decreased. The results of this study suggest an association between discrimination and HIV-related symptom burden. Furthermore, the relationship between number of major discrimination experiences and HIV symptom burden was partially mediated by anxiety. Future research should consider how lifetime discrimination might be associated with negative health outcomes among HIV-positive individuals of color. [ABSTRACT FROM AUTHOR]
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- 2018
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206. The Experiences of Gay and Bisexual Men Post-Prostate Cancer Treatment: A Meta-Synthesis of Qualitative Studies.
- Author
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Alexis, Obrey and Worsley, Aaron James
- Abstract
Studies suggest that gay and bisexual men are affected by the psychological aspects of prostate cancer treatment differently than that of heterosexual men; however the data have not yet been synthesized. The focus of this meta-synthesis is to explore gay and bisexual men’s experiences of prostate cancer posttreatment. Empirical research published in peer reviewed journals between January 1990 and January 2018 were identified in six databases: CINAHL, Cochrane, Medline, PsycINFO, PubMed, and Web of Science. Titles and abstracts were checked by two reviewers. The six studies that met the inclusion criteria were selected and reviewed for quality and the extracted data were then synthesized. The main themes that emerged were sexual impact, physical and psychological difficulties, challenges to intimacy, and support mechanisms. Gay and bisexual men can have specific sexual roles and developing prostate cancer and undergoing treatment may compromise their ability to perform their sexual role. The needs of heterosexual men were perceived to be accommodated more often than that of gay and bisexual men because of engrained heteronormativity in the health-care system. The review suggests that more support groups specifically for gay and bisexual men should be established, while urologists should cater to the sexual and masculine implications of treatment, and not frame problems for gay and bisexual men in heterosexual terms. By failing to address the salient needs and concerns of gay and bisexual men, health-care professionals are reinforcing invisibility and marginalization of gay and bisexual men with prostate cancer. [ABSTRACT FROM AUTHOR]
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- 2018
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207. Secondary Adrenal Insufficiency: Recent Updates and New Directions for Diagnosis and Management
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Irina Bancos and Lucinda Gruber
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Pediatrics ,medicine.medical_specialty ,Special populations ,Hydrocortisone ,business.industry ,Secondary adrenal insufficiency ,Endocrinology, Diabetes and Metabolism ,General Medicine ,medicine.disease ,Endocrinology ,Epidemiology ,Adrenal insufficiency ,medicine ,Etiology ,Humans ,business ,Adrenal Insufficiency - Abstract
Secondary adrenal insufficiency is the most common subtype of adrenal insufficiency that can be caused by certain medications, pituitary destruction (as in pituitary masses, inflammation, or infiltration), or, rarely, associated with certain germline variants. In this review, we discuss the etiology, epidemiology, and clinical presentation of secondary adrenal insufficiency, and focus on the diagnostic and management challenges. We also review management of selected special populations of patients and discuss patient-important outcomes associated with secondary adrenal insufficiency.
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- 2022
208. The effect of HCV serological status on Doxorubicin based chemotherapy induced toxicity and disease-free survival in breast cancer patients
- Author
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Karim Yousri Welaya, Shabaan El-Assal, Ossama Eisa Salama, Hamdy Mohamad Ghanem, and Salah-Eldin Abdelmoneim
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Adjuvant chemotherapy ,Anthracyclines ,Operable breast cancer ,HCV ,Special populations ,Medicine - Abstract
Background: Breast cancer and HCV are two frequent diseases in Egypt. There is a considerable probability of concurrent affection. This concurrence creates a subpopulation, which needs special evaluation and care. Objective: To evaluate a subset of Egyptian breast cancer patients receiving Doxorubicin based adjuvant chemotherapy, with HCV seropositivity (group 2) compared to HCV seronegative patients (group 1). Methods: 102 breast cancer patients, planned to receive Doxorubicin based adjuvant chemotherapy, at the Oncology Department, Alexandria Faculty of Medicine, were recruited since June 2009. Pretreatment evaluation included serological testing for HCV. FAC Adjuvant chemotherapy was given for six cycles. Results: HCV seropositivity was detected in 52 cases. Two cases in the seropositive group developed toxic hepatitis and discontinued treatment and follow up. The remaining 100 patients suffered comparable toxicities, except for more frequent liver enzyme elevations in the seropositive group. Diarrhea was also more frequent in the seropositive group. Treatment delays and dose reductions were more frequently observed in the seropositive group. The 36 month disease-free survival and relapse pattern were not significantly different between the two groups. Conclusion: Patients receiving chemotherapy should undergo screening for the virus. Most patients with HCV were able to tolerate chemotherapy and continue the initial chemotherapy plan, without a significant change in the toxicity profile or the natural course of their malignancy. Dose or regimen adjustments may be of help to less tolerant patients. A preemptive 10% initial Doxorubicin dose reduction might reduce the frequency of severe toxicity for selected patients. The assistance of a gastroenterologist in HCV positive breast cancer patients, planned for chemotherapy is important.
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- 2015
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209. Breast Imaging in Special Populations: Indications and Findings in Pregnant and Lactating, Male, and Transgender Patients
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Erica B. Pollack and Mary C. O’Keefe
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medicine.medical_specialty ,Special populations ,Breast cancer ,Oncology ,Obstetrics ,Breast imaging ,business.industry ,Transgender ,medicine ,medicine.disease ,business - Published
- 2021
210. Linking Fear of Violent Crime for Oneself and Loved Ones to Satisfaction with Local Area Characteristics
- Author
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Sarah A. Steele, Julie D. Garman, Lisa L. Sample, Sara N. Toto, and David J. Drozd
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Special populations ,media_common.quotation_subject ,Fear of crime ,Context (language use) ,Worry ,Psychology ,Violent crime ,Law ,Social psychology ,media_common - Abstract
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.
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- 2021
211. Physiologically Based Pharmacokinetic Modeling of Transdermal Selegiline and Its Metabolites for the Evaluation of Disposition Differences between Healthy and Special Populations
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Santosh Kumar Puttrevu, Sumit Arora, Sebastian Polak, and Nikunj Kumar Patel
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selegiline ,transdermal ,multi-phase multi-layer mechanistic dermal absorption (mpml-mechderma) model ,parent and metabolite PBPK model ,special populations ,Pharmacy and materia medica ,RS1-441 - Abstract
A physiologically based pharmacokinetic (PBPK) model of selegiline (SEL), and its metabolites, was developed in silico to evaluate the disposition differences between healthy and special populations. SEL is metabolized to methamphetamine (MAP) and desmethyl selegiline (DMS) by several CYP enzymes. CYP2D6 metabolizes the conversion of MAP to amphetamine (AMP), while CYP2B6 and CYP3A4 predominantly mediate the conversion of DMS to AMP. The overall prediction error in simulated PK, using the developed PBPK model, was within 0.5–1.5-fold after intravenous and transdermal dosing in healthy and elderly populations. Simulation results generated in the special populations demonstrated that a decrease in cardiac output is a potential covariate that affects the SEL exposure in renally impaired (RI) and hepatic impaired (HI) subjects. A decrease in CYP2D6 levels increased the systemic exposure of MAP. DMS exposure increased due to a reduction in the abundance of CYP2B6 and CYP3A4 in RI and HI subjects. In addition, an increase in the exposure of the primary metabolites decreased the exposure of AMP. No significant difference between the adult and adolescent populations, in terms of PK, were observed. The current PBPK model predictions indicate that subjects with HI or RI may require closer clinical monitoring to identify any untoward effects associated with the administration of transdermal SEL patch.
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- 2020
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212. Natural American Spirit brand preference among smokers with mental illness
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Anna E. Epperson, Nicole Anzai, and Judith J. Prochaska
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mental health disorders ,marketing ,smoking/harm reduction ,special populations ,tobacco industry ,Diseases of the respiratory system ,RC705-779 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Introduction Despite a steady decline in the US smoking prevalence over the past 50 years, Natural American Spirit cigarettes (NAS), marketed as ‘natural’ and ‘organic’, have seen a 400% rise in sales. In a sample of smokers with mental illness, based on previous research, we hypothesized that preference for NAS would be associated with younger age, higher education, and a stronger health-orientation. Material and Methods Adult smokers were interviewed during acute psychiatric hospitalization in California between 2009–2013, reporting their preferred top three brands of cigarettes, smoking behaviors, self-rated health, and dietary and physical activity behaviors. The sample (N=956; Mean age=38.7 years, SD=13.5; 48.7% women) identified as 14.5% Hispanic ethnicity, 49.6% White, 23.7% African American, and 23.8% other. Results NAS was identified as a top preferred brand by 15.2% of the participants and was the fourth most popular brand for the sample overall. In a multivariate logistic regression, preference for NAS was significantly greater among participants who were younger (OR=0.97), had some college education or more (OR=2.64 to 4.31), ate a low-fat diet (OR=1.56) and reported better overall health (OR=1.26), with p
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- 2018
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213. Tildrakizumab for treatment of moderate to severe psoriasis: an expert opinion of efficacy, safety, and use in special populations
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Chiara Franchi, Giuseppe Argenziano, G. Malara, Rossana Tiberio, Stefano Piaserico, Maria Esposito, Marco Galluzzo, Gabriella Fabbrocini, Alessandra Narcisi, Andrea Chiricozzi, Maurizio Congedo, Elisa Cinotti, Giovanna Brunasso, Aurora Parodi, Galluzzo, M., Chiricozzi, A., Cinotti, E., Brunasso, G., Congedo, M., Esposito, M., Franchi, C., Malara, G., Narcisi, A., Piaserico, S., Tiberio, R., Argenziano, G., Fabbrocini, G., and Parodi, A.
- Subjects
Adult ,safety ,Special populations ,efficacy ,Long-term ,psoriasis ,real life ,special populations ,tildrakizumab ,Antibodies, Monoclonal, Humanized ,Expert Testimony ,Humans ,Severity of Illness Index ,Treatment Outcome ,Psoriasis ,Quality of Life ,medicine.drug_class ,medicine.medical_treatment ,Clinical Biochemistry ,Tildrakizumab ,Monoclonal antibody ,Antibodies ,Settore MED/35 ,Monoclonal ,Drug Discovery ,medicine ,Humanized ,special population ,Psoriasi ,Pharmacology ,business.industry ,Moderate to severe psoriasis ,medicine.disease ,Clinical trial ,Cytokine ,Expert opinion ,Immunology ,Settore MED/35 - MALATTIE CUTANEE E VENEREE ,business ,Human - Abstract
Introduction: Tildrakizumab is a monoclonal antibody that targets the p19 subunit of IL-23, a crucial cytokine for Th17 cells. Tildrakizumab has been assessed in several Phase I, II, and III clinical trials and is approved for treatment of adults with moderate to severe plaque psoriasis who are indicated for systemic therapy. Areas covered: The available evidence on the efficacy, safety, and use of tildrakizumab in special populations was evaluated by 14 experts who critically reviewed the current literature. Expert opinion: Tildrakizumab has good efficacy that lasts for at least 5years in patients with moderate to severe psoriasis, and appears to be safe and well tolerated in the long-term with no apparent dose-related differences in adverse events, a low incidence of discontinuation due to adverse events, and no evidence of increased risk of malignancies. The safety and the efficacy of tildrakizumab has also been confirmed in special populations such as those with inflammatory bowel disease, cardiovascular disease, metabolic syndrome, and advanced age. Early intervention with IL-23-inhibitors, such as tildrakizumab, may help to control symptoms and change the long-term course of the disease in patients affected by plaque psoriasis, while improving the quality of life and potentially minimizing the risk of developing comorbidities.
- Published
- 2021
214. An updated review on application of 3D printing in fabricating pharmaceutical dosage forms
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Rabinarayan Parhi and Goutam Kumar Jena
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3d printed ,Special populations ,business.industry ,Computer science ,Pharmaceutical Science ,3D printing ,Dosage form ,Drug Liberation ,Drug Delivery Systems ,Pharmaceutical Preparations ,Risk analysis (engineering) ,Pregnancy ,Printing, Three-Dimensional ,Drug delivery ,Research studies ,Humans ,Technology, Pharmaceutical ,Female ,Variable geometry ,Personalized medicine ,Precision Medicine ,Child ,business - Abstract
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.
- Published
- 2021
215. Advanced Heart Failure in a Special Population
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Angelo Giuseppe Caponetti, Giulia Saturi, Elena Biagini, Christian Gagliardi, and Simone Longhi
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medicine.medical_specialty ,Ejection fraction ,Special populations ,business.industry ,Signs and symptoms ,General Medicine ,medicine.disease ,Clinical trial ,Internal medicine ,Heart failure ,medicine ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,Heart failure with preserved ejection fraction ,business ,Clinical syndrome - Abstract
Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome that has become a global health issue, with mortality ranging from 53% to 74% at 5 years. It is defined as the presence of signs and symptoms of heart failure associated with left ventricular ejection fraction greater than or equal to 50%. The definition and diagnosis of HFpEF in patients with unexplained dyspnea remain a clinical challenge in the absence of a unique diagnostic algorithm universally recognized. Clinical trials conducted so far did not show a significant improvement of prognosis, but forthcoming therapies could provide innovative solutions.
- Published
- 2021
216. Evaluating Patients for Nutritional Deficiencies
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Tenell Zahodnik
- Subjects
Malnutrition ,Water soluble ,Special populations ,business.industry ,Environmental health ,medicine ,General Medicine ,medicine.disease ,business - Published
- 2021
217. Advanced Heart Failure in Special Population
- Author
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Davide Stolfo, Gianfranco Sinagra, and Valentino Collini
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medicine.medical_specialty ,Heterogeneous group ,Myocarditis ,Special populations ,business.industry ,Fulminant ,Hypertrophic cardiomyopathy ,Restrictive cardiomyopathy ,Dilated cardiomyopathy ,General Medicine ,medicine.disease ,Heart failure ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Cardiomyopathies are a heterogeneous group of heart muscle diseases and an important cause of heart failure (HF) in young populations. The variety of causes, multiple underlying pathophysiological mechanisms, and different phenotypic expressions influence their presentation and response to treatment. Dilated cardiomyopathy is the most prevalent cause of HF. Advanced HF in hypertrophic, restrictive, and arrhythmogenic cardiomyopathies is rare, but its development portends a poor prognosis. The active phase of fulminant myocarditis may result in acute HF requiring advanced strategies to support the systemic circulation or may determine an irreversible persisting left ventricular failure with end-stage HF.
- Published
- 2021
218. Impacts of Incarceration on Health Focusing on Minority Males: Considerations for COVID-19 and Future Pandemics
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Mary H. Hughes and Nicole Prior
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2019-20 coronavirus outbreak ,Special populations ,Geography ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Environmental health ,Pandemic ,Social inequality ,Law - Abstract
Long-standing health and social inequalities associated with minorities have increased their risk for infection, hospitalization, and death related to COVID-19. This disparity is further exacerbated with incarcerated individuals, yet little attention, both prepandemic and presently, has been devoted to collecting up-to-date data. This study uses the 2004 Survey of Inmates in State Correctional Facilities (SISCF), the most recent data, to explore the general offender population and self-reported chronic and medical health conditions to highlight how COVID-19 will impact marginalized populations. Results from the four binary regression models found that minority males are more likely to have chronic illnesses which increase in probability with longer sentences, number of incarcerations, and advancement in age. Our findings advocate for the development of recent data sets on inmate health, particularly minority individuals, as well as the construction of more precise health measures to address these health disparities, including COVID-19.
- Published
- 2021
219. Practical Management of Patients with Atopic Dermatitis on Dupilumab
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Melinda Gooderham, Neil H. Shear, M Perla Lansang, Jennifer Beecker, Carolyn Jack, Kim A. Papp, Charles Lynde, Irina Turchin, Chih-Ho Hong, David N. Adam, Marissa Joseph, and Robert Bissonnette
- Subjects
medicine.medical_specialty ,2019-20 coronavirus outbreak ,Special populations ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Dermatology ,Atopic dermatitis ,Dupilumab ,medicine.disease ,Practical management ,medicine ,In patient ,Intensive care medicine ,business ,Adverse effect ,Original Research ,Quality of Life Research - Abstract
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.
- Published
- 2021
220. Vaccines for COVID-19: Where do we stand in 2021?
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Archana Koirala, Philip N Britton, Clayton Chiu, Katrina Nicolopoulos, Nicholas Wood, and Ketaki Sharma
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Pulmonary and Respiratory Medicine ,COVID-19 Vaccines ,Special populations ,Adolescent ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Distribution (economics) ,Environmental health ,Humans ,Medicine ,Child ,Drug Approval ,Pandemics ,11 Medical and Health Sciences ,Vaccines ,SARS-CoV-2 ,business.industry ,COVID-19 ,Coronavirus ,Clinical trial ,Vaccination ,1107 Immunology ,Pediatrics, Perinatology and Child Health ,Observational study ,Mini-symposium: COVID 19: The second year ,business ,High income countries - Abstract
As of July 2021, over 3 billion doses of a COVID-19 vaccines have been administered globally, and there are now 19 COVID-19 vaccines approved for use in at least one country. Several of these have been shown to be highly effective both in clinical trials and real-world observational studies, some of which have included special populations of interest. A small number of countries have approved a COVID-19 vaccine for use in adolescents or children. These are laudable achievements, but the global vaccination effort has been challenged by inequitable distribution of vaccines predominantly to high income countries, with only 0.9% of people in low-income countries having received at least one dose of a COVID-19 vaccine. Addressing this inequity is of critical importance and will result in better control of SARS-CoV-2 globally. Other challenges include: the reduced protection from COVID-19 vaccines against some strains of SARS-CoV-2, necessitating the development of variant specific vaccines; and uncertainties around the duration of protection from vaccine-induced immunity.
- Published
- 2021
221. Clostridioides difficile Infection in Pediatric Inflammatory Bowel Disease: A Clinician’s Dilemma
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Maire A. Conrad and Judith R. Kelsen
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medicine.medical_specialty ,genetic structures ,Population ,Inflammatory bowel disease ,Clostridioides ,medicine ,Humans ,Effective treatment ,Vulnerable population ,Child ,Intensive care medicine ,education ,education.field_of_study ,Clostridioides difficile ,business.industry ,Diagnostic test ,General Medicine ,Inflammatory Bowel Diseases ,medicine.disease ,digestive system diseases ,Special Populations ,Treatment Outcome ,Infectious Diseases ,Underlying disease ,Pediatrics, Perinatology and Child Health ,Clostridium Infections ,Etiology ,business - Abstract
Clostridioides difficile infection (CDI) in children with inflammatory bowel disease (IBD) can present and manifest differently from the general population with CDI, and it can worsen the underlying disease course. Furthermore, current clinical assays used to test for CDI do not accurately distinguish between true CDI or colonization. This uncertainty leads to difficulty in identifying the etiology and therapy for symptomatic patients with IBD. Improved diagnostic tests, biomarkers, and safe and effective treatment options are greatly needed for this vulnerable population.
- Published
- 2021
222. Technology-Dependent Children
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Alamelu Natesan and Solomon Behar
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Special populations ,Vagus Nerve Stimulation ,medicine.medical_treatment ,Vagal nerve ,Central nervous system ,Infections ,Enteral Nutrition ,Basic knowledge ,Cochlear implant ,medicine ,Humans ,Child ,Medical History Taking ,Physical Examination ,Feeding tube ,Gastrostomy ,Technology dependent ,Pediatric Emergency Medicine ,business.industry ,Brain ,Cerebrospinal Fluid Shunts ,Cochlear Implants ,medicine.anatomical_structure ,Gastrostomy tube ,Anesthesia ,Emergency Medicine ,Equipment Failure ,Emergency Service, Hospital ,business - Abstract
There are a growing number of medically complex children with implanted devices. Emergency physicians with a basic knowledge of these devices can troubleshoot and fix many of the issues that may arise. Recognition of malfunction of these devices can reduce morbidity and mortality among this special population. In this article, we review common issues that may arise in children with gastrostomy tubes, central nervous system shunts, cochlear implants, and vagal nerve stimulators.
- Published
- 2021
223. Measles: Contemporary considerations for the emergency physician.
- Author
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Blutinger E, Schmitz G, Kang C, Comp G, Wagner E, Finnell JT, Cozzi N, and Haddock A
- Abstract
Measles, or rubeola, is a highly contagious acute febrile viral illness. Despite the availability of an effective vaccine since 1963, measles outbreaks continue worldwide. This article seeks to provide emergency physicians with the contemporary knowledge required to rapidly diagnose potential measles cases and bolster public health measures to reduce ongoing transmission., Competing Interests: The authors have no conflicts of interest to disclose. There was no external funding for this publication. Open access journal funds were paid for by the author and reimbursed from departmental reserve funds., (© 2023 The Authors. Journal of the American College of Emergency Physicians Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)
- Published
- 2023
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224. Barriers and facilitators to recruitment of underrepresented research participants: Perspectives of clinical research coordinators.
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Heffernan ME, Barrera L, Guzman ZR, Golbeck E, Jedraszko AM, Hays PT, Herzog KA, D'Aquila RT, Ison MG, and McColley SA
- Abstract
Background: Insufficient recruitment of groups underrepresented in medical research threatens the generalizability of research findings and compounds inequity in research and medicine. In the present study, we examined barriers and facilitators to recruitment of underrepresented research participants from the perspective of clinical research coordinators (CRCs)., Methods: CRCs from one adult and one pediatric academic medical centers completed an online survey in April-May 2022. Survey topics included: participant language and translations, cultural competency training, incentives for research participation, study location, and participant research literacy. CRCs also reported their success in recruiting individuals from various backgrounds and completed an implicit bias measure., Results: Surveys were completed by 220 CRCs. CRCs indicated that recruitment is improved by having translated study materials, providing incentives to compensate participants, and reducing the number of in-person study visits. Most CRCs had completed some form of cultural competency training, but most also felt that the training either had no effect or made them feel less confident in approaching prospective participants from backgrounds different than their own. In general, CRCs reported having greater success in recruiting prospective participants from groups that are not underrepresented in research. Results of the implicit bias measure did not indicate that bias was associated with intentions to approach a prospective participant., Conclusions: CRCs identified several strategies to improve recruitment of underrepresented research participants, and CRC insights aligned with insights from research participants in previous work. Further research is needed to understand the impact of cultural competency training on recruitment of underrepresented research participants., Competing Interests: The authors have no conflicts of interest to declare., (© The Author(s) 2023.)
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- 2023
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225. Cardiac Arrest in Special Populations.
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Sumer RW and Woods WA
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- Female, Pregnancy, Humans, Heart Arrest therapy, Asthma, Heart-Assist Devices, Hypersensitivity, Pulmonary Embolism
- Abstract
Best practices in cardiac arrest depend on continuous high-quality chest compressions, appropriate ventilatory management, early defibrillation of shockable rhythms, and identification and treatment of reversible causes. Although most patients can be treated according to highly vetted treatment guidelines, some special situations in cardiac arrest arise where additional skills and preparation can improve outcomes. Situations covered in this section involve cardiac arrest in context of electrical injuries, asthma, allergic reactions, pregnancy, trauma, electrolyte imbalances, toxic exposures, hypothermia, drowning, pulmonary embolism, and left ventricular assist devices., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2023
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226. From Signal to Substance and Back: Insights from Environmental Sound Research to Auditory Display Design
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Gygi, Brian, Shafiro, Valeriy, Hutchison, David, editor, Kanade, Takeo, editor, Kittler, Josef, editor, Kleinberg, Jon M., editor, Mattern, Friedemann, editor, Mitchell, John C., editor, Naor, Moni, editor, Nierstrasz, Oscar, editor, Pandu Rangan, C., editor, Steffen, Bernhard, editor, Sudan, Madhu, editor, Terzopoulos, Demetri, editor, Tygar, Doug, editor, Vardi, Moshe Y., editor, Weikum, Gerhard, editor, Ystad, Sølvi, editor, Aramaki, Mitsuko, editor, Kronland-Martinet, Richard, editor, and Jensen, Kristoffer, editor
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- 2010
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227. The ethical concerns of seeking consent from critically ill, mechanically ventilated patients for research – A matter of possessing capacity or surrogate insight.
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Verceles, Avelino C. and Bhatti, Waqas
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- *
INFORMED consent & ethics , *CRITICALLY ill , *MEDICAL research ethics , *HUMAN experimentation , *INTENSIVE care units , *DELIRIUM , *COMA , *TERMINAL sedation , *ETHICS - Abstract
Conducting clinical research on subjects admitted to intensive care units is challenging, as they frequently lack the capacity to provide informed consent due to multiple factors including intensive care unit acquired delirium, coma, the need for sedation, or underlying critical illness. However, the presence of one or more of these characteristics does not automatically designate a potential subject as lacking capacity to provide their own informed consent. We review the ethical issues involved in obtaining informed consent for medical research from mechanically ventilated, critically ill patients, in addition to the concerns that may arise when a legally authorized representative is asked to provide informed consent on behalf of these patients. [ABSTRACT FROM AUTHOR]
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- 2018
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228. Hormone Therapy: Key Points From NAMS 2017 Position Statement.
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PINKERTON, JOANN V.
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BREAST tumor risk factors , *UTERINE tumors , *BONE fractures , *ATTITUDE (Psychology) , *FEAR , *RISK assessment , *THERAPEUTICS , *PERIMENOPAUSE , *AT-risk people , *TREATMENT effectiveness , *TREATMENT duration , *TUMOR risk factors , *INJURY risk factors - Abstract
The goal of the 2017 North American Menopause Society Hormone Therapy (HT) Position Statement is to remove fear about HT and encourage individualized shared decision making, using best available evidence. Systemic HT is safe and effective for symptomatic menopausal women aged younger than 60 years and within 10 years of menopause. Special populations of early menopause, high risk for fracture, risk of breast or uterine cancer, and extended duration are discussed. With longer duration of use, periodic evaluation and reassessment of health risks are needed. Lowered doses, transdermal therapies or newer options may enhance the benefit:risk ratio for HT. [ABSTRACT FROM AUTHOR]
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- 2018
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229. “Centering the Margins”: Moving Equity to the Center of Men’s Health Research.
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Griffith, Derek M.
- Abstract
How might the science of men’s health progress if research on marginalized or subordinated men is moved from the margins of the literature to the center? This commentary seeks to answer this question, suggesting that if more attention is paid to men of color and other marginalized men, the field will be greatly enriched in its ability to understand determinants of men’s health. Reimagining men’s health by moving men’s health disparities to a primary focus of the field may yield critical new insights that would be essential to moving men’s health to the center of health equity research. Focusing on the dual goals of improving the health of marginalized men and examining the determinants of disparities among men and between men and women will yield insights into mechanisms, pathways, and strategies to improve men’s health and address health disparities. Current definitions of health disparities limit the nation’s ability to dedicate resources to populations that need attention—men of color and other marginalized men—that do not fit these definitions. Moving marginalized men to the center of research in men’s health will foster new ways of understanding determinants of men’s health that cannot be identified without focusing on populations of men whose health is as influenced by race, ethnicity, and other structures of marginalization as it is by gender and masculinities. Using Black men as a case example, the article illustrates how studying marginalized men can refine the study of men’s health and health equity. [ABSTRACT FROM AUTHOR]
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- 2018
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230. Direct oral anticoagulants for stroke prevention in atrial fibrillation: treatment outcomes and dosing in special populations.
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Stacy, Zachary A. and Richter, Sara K.
- Abstract
Background: To review data from the pivotal phase III trials evaluating the efficacy and safety of direct oral anticoagulants (DOACs) versus warfarin for stroke prevention in patients with nonvalvular atrial fibrillation (NVAF), and to summarize the major findings with regards to patient subgroups that are at an increased risk for stroke or bleeding. Methods: A PubMed literature search (January 2009 to January 2017) was performed using the terms ‘dabigatran’, ‘rivaroxaban’, ‘apixaban’, ‘edoxaban’, ‘atrial fibrillation’, ‘RE-LY’, ‘ROCKET AF’, ‘ARISTOTLE’, and ‘ENGAGE AF-TIMI 48’. All primary publications and secondary analyses in special populations at increased risk of stroke or bleeding from the pivotal phase III clinical trials were evaluated. Results: Available secondary analyses indicate no treatment interactions with regards to stroke or systemic embolic event (SEE) prevention for any of the DOACs in the patient subgroups, including patients with advanced age, impaired renal function, diabetes, prior stroke, concomitant antiplatelet therapy, heart failure, prior stroke, history of hypertension, myocardial infarction (MI), coronary artery disease, and peripheral artery disease (PAD). Although higher bleeding incidence was reported with dabigatran and rivaroxaban in patients aged 75 years and over with apixaban in patients with diabetes, and with rivaroxaban in patients with previous MI or PAD, no changes in dosing are recommended. Conclusions: Overall, results of secondary analyses indicate that the recommended dosing strategy for each of the DOACs produces a consistent anticoagulant effect across a diverse patient population, including those at increased risk of stroke or bleeding. [ABSTRACT FROM AUTHOR]
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- 2018
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231. White paper from a CTSA workshop series on special and underserved populations: Enhancing investigator readiness to conduct research involving LGBT populations.
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Matthews, Alicia K., Rak, Kevin, Anderson, Emily, Bostwick, Wendy, Ramirez-Valles, Jesus, Ruiz, Raymond A., Macapagal, Kathryn, Watson, Karriem S., Jeremiah, Rohan D., Castillo, Amparo, and Choure, Wendy
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HEALTH equity ,PUBLIC health ,MEDICAL care ,SEXUAL orientation ,GENDER identity - Published
- 2018
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232. Gay and Bisexual Men’s Perceptions of HIV Risk in Various Relationships.
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Shaver, John, Freeland, Ryan, Goldenberg, Tamar, and Stephenson, Rob
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Men who have sex with men (MSM) bear a disproportionate burden of HIV incidence in the United States. Previous study of sexual decision-making and HIV risk among MSM has not accounted for relationship dynamics. Further research must examine this connection between relationship dynamics and sexual decision-making, especially regarding condomless anal intercourse. This study analyzes data gathered from gay and bisexual men regarding their sexual partners and sexual decision-making over a 10-week period through personal relationship diaries (PRDs) and a follow-up in-depth interview (IDI). Through coding and extraction of relationship dynamics, key patterns of participants’ sexual decision-making processes were examined based on relationship type, which was categorized by commitment, formality, and sexual agreement. Participants’ sexual relationships can be divided into five categories: (a) Uncommitted, one time, (b) Uncommitted, ongoing, (c) Transitioning or unknown commitment, (d) Committed, nonmonogamous, and (e) Committed, monogamous. These five categories correspond to patterns in sexual decision making and consequent sexual risk-taking behaviors. Each of these influence HIV risk within male–male sexual encounters in a particular manner, and understanding these is important for appropriately tailored HIV prevention interventions for MSM. Recommendations are included for interventions seeking to address HIV risk across a wide variety of MSM sexual relationships. [ABSTRACT FROM AUTHOR]
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- 2018
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233. Gender Expression, Violence, and Bullying Victimization: Findings From Probability Samples of High School Students in 4 US School Districts.
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Gordon, Allegra R., Conron, Kerith J., Calzo, Jerel P., White, Matthew T., Reisner, Sari L., and Austin, S. Bryn
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- *
CLUSTER sampling , *HISPANIC Americans , *RACE , *DESCRIPTIVE statistics , *SCHOOL violence , *VICTIMS , *WHITE people , *LOGISTIC regression analysis , *BULLYING , *GENDER expression , *HIGH school students , *AFRICAN Americans - Abstract
ABSTRACT: BACKGROUND: Young people may experience school‐based violence and bullying victimization related to their gender expression, independent of sexual orientation identity. However, the associations between gender expression and bullying and violence have not been examined in racially and ethnically diverse population‐based samples of high school students. METHODS: This study includes 5469 students (13–18 years) from the 2013 Youth Risk Behavior Surveys conducted in 4 urban school districts. Respondents were 51% Hispanic/Latino, 21% black/African American, 14% white. Generalized additive models were used to examine the functional form of relationships between self‐reported gender expression (range: 1 = Most gender conforming, 7 = Most gender nonconforming) and 5 indicators of violence and bullying victimization. We estimated predicted probabilities across gender expression by sex, adjusting for sexual orientation identity and potential confounders. RESULTS: Statistically significant quadratic associations indicated that girls and boys at the most gender conforming and nonconforming ends of the scale had elevated probabilities of fighting and fighting‐related injury, compared to those in the middle of the scale (p < .05). There was a significant linear relationship between gender expression and bullying victimization; every unit increase in gender nonconformity was associated with 15% greater odds of experiencing bullying (p < .0001). CONCLUSIONS: School‐based victimization is associated with conformity and nonconformity to gender norms. School violence prevention programs should include gender diversity education. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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234. Past, Present and Future Approaches to the Prevention and Treatment of Respiratory Syncytial Virus Infection in Children.
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Simões, Eric A. F., Bont, Louis, Manzoni, Paolo, Fauroux, Brigitte, Paes, Bosco, Figueras-Aloy, Josep, Checchia, Paul A., and Carbonell-Estrany, Xavier
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- *
JUVENILE diseases , *RESPIRATORY syncytial virus infections , *PALIVIZUMAB , *THERAPEUTIC use of monoclonal antibodies , *SYSTEMATIC reviews , *THERAPEUTICS , *PREVENTION - Abstract
Introduction: The REGAL (RSV Evidence - A Geographical Archive of the Literature) series has provided a comprehensive review of the published evidence in the field of respiratory syncytial virus (RSV) in Western countries over the last 20 years. This seventh and final publication covers the past, present and future approaches to the prevention and treatment of RSV infection among infants and children.Methods: A systematic review was undertaken of publications between January 1, 1995 and December 31, 2017 across PubMed, Embase and The Cochrane Library. Studies reporting data on the effectiveness and tolerability of prophylactic and therapeutic agents for RSV infection were included. Study quality and strength of evidence (SOE) were graded using recognized criteria. A further nonsystematic search of the published literature and Clinicaltrials.gov on antiviral therapies and RSV vaccines currently in development was also undertaken.Results: The systematic review identified 1441 studies of which 161 were included. Management of RSV remains centered around prophylaxis with the monoclonal antibody palivizumab, which has proven effective in reducing RSV hospitalization (RSVH) in preterm infants < 36 weeks’ gestational age (72% reduction), children with bronchopulmonary dysplasia (65% reduction), and infants with hemodynamically significant congenital heart disease (53% reduction) (high SOE). Palivizumab has also shown to be effective in reducing recurrent wheezing following RSVH (high SOE). Treatment of RSV with ribavirin has conflicting success (moderate SOE). Antibodies with increased potency and extended half-life are currently entering phase 3 trials. There are approximately 15 RSV vaccines in clinical development targeting the infant directly or indirectly via the mother.Conclusion: Palivizumab remains the only product licensed for RSV prophylaxis, and only available for high-risk infants. For the general population, there are several promising vaccines and monoclonal antibodies in various stages of clinical development, with the aim to significantly reduce the global healthcare impact of this common viral infection.Funding: AbbVie. [ABSTRACT FROM AUTHOR]
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- 2018
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235. Address‐Based Sampling for Recruiting Rural Subpopulations: A 2‐Phase, Multimode Approach.
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Thomson, Tiffany L., Nemeth, Julianna M., Peng, Juan, Lu, Bo, Ferketich, Amy K., Paskett, Electra D., and Wewers, Mary Ellen
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INTERVIEWING ,QUESTIONNAIRES ,RURAL population ,STATISTICAL sampling ,SURVEYS ,WOMEN'S health ,HUMAN research subjects ,PATIENT selection - Abstract
Abstract: Purpose: This article describes recruitment of a subpopulation of women in a rural area, extending an existing method of a 2‐phase address‐based sampling protocol to include a mixed‐mode approach. Methods: Phase 1 included a household enumeration questionnaire mailed to randomly selected households (n = 1,950) in 3 Ohio Appalachian counties to identify members of the eligible subgroup. The second phase of recruitment involved contacting 1 randomly selected eligible woman enumerated by each household, based on return of the questionnaire. These women (n = 599) were invited by field interviewers to participate in a one‐time in‐person health survey. Findings: Of the women invited to participate, a total of 408 completed the interview. Based on American Association for Public Opinion Research Response Rate 1 calculations, the response rates were 44.4% and 70.3% for phases 1 and 2, respectively. Response rates in this study were encouraging, especially for the second phase in‐person interview. Conclusion: We discuss implications for future research using a mixed‐mode approach in this subpopulation. [ABSTRACT FROM AUTHOR]
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- 2018
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236. “Just as Canadian as Anyone Else”? Experiences of Second-Class Citizenship and the Mental Health of Young Immigrant and Refugee Men in Canada.
- Author
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Hilario, Carla T., Oliffe, John L., Wong, Josephine P., Browne, Annette J., and Johnson, Joy L.
- Abstract
In recent years, the experiences of immigrant and refugee young men have drawn attention worldwide. Human-induced environmental disasters, local and global conflicts, and increasingly inequitable distributions of wealth have shaped transnational migration patterns. Canada is home to a large immigrant and refugee population, particularly in its urban areas, and supporting the mental health and well-being of these communities is of critical importance. The aim of this article is to report findings from a qualitative study on the social context of mental health among immigrant and refugee young men, with a focus on their migration and resettlement experiences. Informed by the conceptual lens of social context, a thematic narrative analysis approach was used to examine qualitative data from individual and group interviews with 33 young men (age 15 to 22 years) self-identified as immigrants or refugees and were living in Greater Vancouver, western Canada. Three thematic narratives were identified: a better life, living the (immigrant) dream, and starting again from way below. The narratives characterized the social context for immigrant and refugee young men and were connected by a central theme of negotiating second-class citizenship. Implications include the need for mental health frameworks that address marginalization and take into account the contexts and discourses that shape the mental health of immigrant and refugee populations in Canada and worldwide. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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237. How Healthy Is Homeschool? An Analysis of Body Composition and Cardiovascular Disease Risk.
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Kabiri, Laura S., Mitchell, Katy, Brewer, Wayne, and Ortiz, Alexis
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- *
ALTERNATIVE education , *BODY composition , *CARDIOVASCULAR diseases risk factors , *CHI-squared test , *CHILDREN'S health , *SOCIOECONOMIC factors , *BODY mass index , *CROSS-sectional method , *PHYSICAL activity , *DESCRIPTIVE statistics , *MANN Whitney U Test - Abstract
ABSTRACT: BACKGROUND: Public school children regularly participate in school‐based physical activity, physical education, and fitness testing. However, almost 2 million American children are homeschooled. The purpose of this research was to assess the body composition of elementary school‐aged homeschool children and their corresponding cardiovascular disease (CVD) risk. METHODS: This research explored the body composition and CVD risk of 145 homeschool children aged 5–11 years using body mass index (BMI), percent body fat, and waist circumference. Chi‐square and Mann‐Whitney U tests examined differences in CVD risk within the homeschool population. RESULTS: Overall, homeschool children had average BMI z‐scores (SD [range]) with a mean of −0.11 (0.97 [−3.47 to 2.53]). Unhealthy classifications were seen in 11.2% of the sample by BMI, 19.6% by percent body fat, and 49.7% by waist circumference. Statistical analysis revealed no difference in CVD risk between sexes (χ2(1) = 0.062, p = .804) or ethnicities (χ2(1) = 0.927, p = .336) but increased prevalence in children aged 5–9 years (U = 1427, z = −4.559, p < .001). CONCLUSIONS: Almost half of elementary school‐aged homeschool children showed increased risk for CVD and need regular assessment of central adiposity. [ABSTRACT FROM AUTHOR]
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- 2018
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238. Design and Validation of a Satisfaction Questionnaire with Sports Programmes in Penitentiaries.
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VILA, GEMA ORTEGA, ROBLES, MANUEL TOMÁS ABAD, FUENTES-GUERRA, FRANCISCO JAVIER GIMÉNEZ, GONZÁLEZ, LUIS JAVIER DURÁN, MARTÍN, JORGE FRANCO, SÁNCHEZ, ANA CONCEPCIÓN JIMÉNEZ, and RODRÍGUEZ, JOSÉ ROBLES
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- 2018
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239. Validating a shortened form of the ARC for special populations.
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Bond, Mark, Garberoglio, Carrie-Lou, Schoffstall, Sarah, Caemmerer, Jackie, and Cawthon, Stephanie
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DEAF students , *AUTONOMY (Psychology) , *SOCIAL skills , *SELF-determination theory , *CONFIRMATORY factor analysis , *EXPLORATORY factor analysis - Abstract
Autonomy describes cognition or behavior that is self-directed, according to personal interests, and free from external influence. This construct is of importance to students who are deaf because it has been shown to be positively related to their post-school transition outcomes, and this population faces unique challenges in this area. To conduct research with this construct, it is necessary to use measures that are valid and reliable for the population of interest. Therefore, a set of exploratory and confirmatory factor analyses validated the unidimensionality of a shortened form of the ARC Self-Determination Scale’s autonomy dimension. A three-factor solution, including a social skills dimension, was measurement-invariant across many groups of students, including those with learning disabilities, emotional disturbances, speech and language impairments, and other health impairments. Although the shortened form of this scale was not unidimensional, as hypothesized, the generalizability of its measurement properties may prove useful. Discussion highlights the differences between these three dimensions and Wehmeyer's theory of self-determination. [ABSTRACT FROM PUBLISHER]
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- 2018
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240. Acne and Its Variants in Special Populations.
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St. Claire, Kayla and Lake, Eden P.
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AT-risk people ,ACNE ,SYMPTOMS ,DIAGNOSIS ,PSYCHOLOGY - Abstract
Acne vulgaris is one of the most common medical conditions encountered in dermatology and primary care settings, affecting up to 50 million Americans annually. It is a disease of the pilosebaceous unit characterized by microcomedones, papules, pustules, and nodules that primarily affect the face, upper chest, and back. Although acne is commonly considered an oily disease of puberty, it is important to recognize that acne has various presentations, sequelae, and effects on quality of life in different populations. African Americans are more prone to scarring, hyperpigmentation, and keloid formation. Adult women may present clinically with dry skin and have more severe acne flares across the menstrual cycle with a greater psychological impact. Acne presenting in childhood should raise suspicion for various endocrinopathies if other clinical signs of androgen excess are present such as accelerated height velocity, enlarged genitalia, or pubic hair and are concurrent with advanced bone age. It is important for medical practitioners to familiarize themselves with these differing presentations and sequelae in specific populations to provide adequate evaluations and treatment regimens. [ABSTRACT FROM AUTHOR]
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- 2018
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241. Satisfacción de los internos de centros penitenciarios con el programa deportivo educativo de baloncesto desarrollado por la Fundación Real Madrid.
- Author
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Ortega, G., Abad, M. T., Giménez, F. J., Durán, L. J., Franco, J., Jiménez, A. C., and Robles, J.
- Abstract
Copyright of Cuadernos de Psicología del Deporte is the property of Cuadernos de Psicologia del Deporte 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.)
- Published
- 2017
242. Office and Home Blood Pressures as Determinants of Electrocardiographic Left Ventricular Hypertrophy Among Black Nigerians Compared With White Flemish.
- Author
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Odili, Augustine N., Thijs, Lutgarde, Wen-Yi Yang, Ogedengbe, John O., Nwegbu, Maxwell M., Jacobs, Lotte, Fang-Fei Wei, Ying-Mei Feng, Zhen-Yu Zhang, Kuznetsova, Tatiana, Nawrot, Tim S., and Staessen, Jan A.
- Subjects
BLOOD pressure ,VASCULAR resistance ,ARTERIAL abnormalities ,ELECTROCARDIOGRAPHY ,HYPERTROPHY - Abstract
BACKGROUND The association of electrocardiographic left ventricular hypertrophy (ECG-LVH) with blood pressure (BP) in Blacks living in sub-Saharan Africa remains poorly documented. METHODS In 225 Black Nigerians and 729 White Flemish, we analyzed QRS voltages and voltage-duration products and 12 criteria diagnostic of ECGLVH in relation to office BP (mean of 5 consecutive readings) and home BP (duplicate morning and evening readings averaged over 1 week). RESULTS In multivariable analyses, QRS voltage and voltage-duration indexes were generally higher in Blacks than Whites. By using any of 12 criteria, ECGLVH was more prevalent among Black than White men (54.4% vs. 36.0%) with no ethnic difference among women (17.1%). Precordial voltages and voltage-duration products increased with office and home systolic BP (SBP), and increases were up to 3-fold steeper in Blacks. In Blacks vs. Whites, increases in the Sokolow-Lyon voltage associated with a 10-mm Hg higher SBP were 0.18 mV (95% confidence interval [CI], 0.09-0.26) vs. 0.06 mV (0.02-0.09) and 0.17 mV (0.07-0.28) vs. 0.11 mV (CI, 0.07-0.15) for office and home BP, respectively, with a significant ethnic gradient (P < 0.05). The risk of ECG-LVH increased more with office and home BP in Blacks than Whites. CONCLUSIONS Associations of ECG voltages and voltage-duration products and risk of ECG-LVH with BP are steeper in Black Nigerians compared with a White reference population. In resource-poor settings of sub-Saharan Africa, the ECG in combination with office and home BP is an essential instrument in risk stratification across the entire BP range. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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243. Equitable<scp>STEM</scp>Instruction and Assessment: Accessibility and Fairness Considerations for Special Populations
- Author
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Okhee Lee, Cary Supalo, Danielle Guzman-Orth, Teresa King, and Derrick W. Smith
- Subjects
Special populations ,Geography ,Social Psychology ,Public economics ,Statistics, Probability and Uncertainty ,Applied Psychology ,Education - Published
- 2021
244. Efficient Sampling Design in Audit Data
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Yan Liu, Fritz Scheuren, and Mary Batcher
- Subjects
education.field_of_study ,Special populations ,Invoice ,Sample size determination ,Sampling design ,Population ,Statistics ,Sample (statistics) ,Audit ,education ,Mathematics ,Zero (linguistics) - Abstract
Auditors are often faced with reviewing a sample drawn from special populations. One is the special population where invoices are divided into two categories, according to whether or not invoices are qualified. In other words, the qualified amount follows a nonstandard mixture distribu- tion in which the qualified amount is either zero with a certain probability or the same as the known invoice amount with a certain probability. The other is the population where some invoices are partially qualified. In other words, some invoices have a qualified amount between zero and the full invoice amount. For these settings, the typical sample design is stratified random, with the estimation method employing a ratio type method. This paper focuses on efficient sample design for this setting and provides some guidelines in setting up stratum boundaries, calculating sample size and allocating sample size optimally across strata.
- Published
- 2021
245. Heart failure medication dosage and survival in women and men seen at outpatient clinics
- Author
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Bots, SH, Onland-Moret, NC, Tulevski, II, van, der Harst P, Cramer, MJM, Asselbergs, FW, Somsen, GA, den, Ruijter HM, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, and Cardiology
- Subjects
Male ,heart failure ,Angiotensin-Converting Enzyme Inhibitors ,Heart Ventricles/diagnostic imaging ,030204 cardiovascular system & hematology ,Ambulatory Care Facilities ,Ventricular Function, Left ,0302 clinical medicine ,Angiotensin-Converting Enzyme Inhibitors/administration & dosage ,Cause of Death ,Epidemiology ,Ventricular Function ,Outpatient clinic ,Registries ,030212 general & internal medicine ,Mineralocorticoid Receptor Antagonists ,Netherlands ,Survival Rate/trends ,Ejection fraction ,Left/physiology ,Mineralocorticoid Receptor Antagonists/administration & dosage ,Survival Rate ,Population study ,epidemiology ,Female ,Guideline Adherence ,Drug ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,Heart Ventricles ,Adrenergic beta-Antagonists ,Cause of Death/trends ,Netherlands/epidemiology ,Dose-Response Relationship ,Angiotensin Receptor Antagonists ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Medical prescription ,Adrenergic beta-Antagonists/administration & dosage ,Aged ,Retrospective Studies ,Heart Failure ,Dose-Response Relationship, Drug ,Proportional hazards model ,business.industry ,Stroke Volume ,Heart Failure/drug therapy ,medicine.disease ,Ambulatory Care Facilities/statistics & numerical data ,Special Populations ,Target dose ,electronic health records ,Angiotensin Receptor Antagonists/administration & dosage ,Stroke Volume/physiology ,Heart failure ,Ventricular Function, Left/physiology ,business ,Follow-Up Studies - Abstract
ObjectiveWomen with heart failure with reduced ejection fraction (HFrEF) may reach optimal treatment effect at half of the guideline-recommended medication dose. This study investigates prescription practice and its relation with survival of patients with HF in daily care.MethodsElectronic health record data from 13 Dutch outpatient cardiology clinics were extracted for HF receiving at least one guideline-recommended HF medication. Dose changes over consecutive prescriptions were modelled using natural cubic splines. Inverse probability-weighted Cox regression was used to assess the relationship between dose (reference≥50% target dose) and all-cause mortality.ResultsThe study population comprised 561 women (29% HFrEF (ejection fraction (EF)ConclusionPatients with HF seen in outpatient cardiology clinics receive half of the guideline-recommended medication dose. Lower ACEI/ARB dose was associated with improved survival in women with HFrEF. These results underscore the importance of (re)defining optimal medical therapy for women with HFrEF.
- Published
- 2021
246. Thrombectomy in special populations: report of the Society of NeuroInterventional Surgery Standards and Guidelines Committee
- Author
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Stavropoula Tjoumakaris, Neil Haranhalli, Krishna Amuluru, Steven W. Hetts, Neeraj Chaudhary, Isaac Josh Abecassis, Robert M. Starke, Ketan R. Bulsara, Fawaz Al-Mufti, Reade De Leacy, and Clemens M. Schirmer
- Subjects
medicine.medical_specialty ,Special populations ,Arterial Occlusive Diseases ,Brain Ischemia ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,medicine ,Humans ,Endocarditis ,Child ,Stroke ,Ischemic Stroke ,Retrospective Studies ,Thrombectomy ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,General Medicine ,Guideline ,medicine.disease ,Thrombocytopenia ,Surgery ,Mechanical thrombectomy ,Clinical trial ,Treatment Outcome ,Female ,Collagen ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Cerebral angiography ,Large vessel occlusion - Abstract
BackgroundThe purpose of this guideline is to summarize the data available for performing mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO) stroke in special populations not typically included in large randomized controlled clinical trials, including children, the elderly, pregnant women, patients who have recently undergone surgery, and patients with thrombocytopenia, collagen vascular disorders, and endocarditis.MethodsWe performed a literature review for studies examining the indications, efficacy, and outcomes for patients undergoing MT for ischemic stroke aged 80 years, pregnant patients, patients who have recently undergone surgery, and those with thrombocytopenia, collagen vascular diseases, or endocarditis. We graded the quality of the evidence.ResultsMT can be effective for the treatment of ELVO in ischemic stroke for patients over age 80 years and under age 18 years, thrombocytopenic patients, pregnant patients, and patients with endocarditis. While outcomes are worse compared to younger patients and those with normal platelet counts (respectively), there is still a benefit in the elderly (in both mRS and mortality). Data are very limited for patients with collagen vascular diseases; although diagnostic cerebral angiography carries increased risks, MT may be appropriate in carefully selected patients in whom untreated ELVO would likely result in disabling or fatal outcome.
- Published
- 2021
247. Strategies for Optimizing Perioperative Pain Management for the Cancer Patient
- Author
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Breana L. Hill and Carolyn Lefkowits
- Subjects
medicine.medical_specialty ,Special populations ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Neoplasms ,Humans ,Pain Management ,Medicine ,Intensive care medicine ,Pain, Postoperative ,business.industry ,Cancer ,Effective management ,Perioperative ,Pain management ,medicine.disease ,Analgesics, Opioid ,Substance abuse ,Oncology ,030220 oncology & carcinogenesis ,Quality of Life ,030211 gastroenterology & hepatology ,Surgery ,business ,Cancer pain - Abstract
Effective management of pain in patients with cancer impacts quality of life and willingness to receive disease-directed treatment. This review focuses on preoperative, intraoperative, and postoperative strategies for management of perioperative pain in the patient with cancer. Managing perioperative pain in special populations, including patients with preoperative opioid use, those with a history of substance abuse, and patients near the end of life are also addressed.
- Published
- 2021
248. Mentoring in Global Cancer Research Training
- Author
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Amr S. Soliman, Arthur M. Michalek, Joseph F. O'Donnell, Richard E. Gallagher, and Robert M. Chamberlain
- Subjects
Medical education ,medicine.medical_specialty ,Special populations ,Process (engineering) ,business.industry ,Public health ,Pharmacology toxicology ,Public Health, Environmental and Occupational Health ,ComputingMilieux_GENERAL ,Oncology ,Low and middle income countries ,Research based ,Epidemiology of cancer ,ComputingMilieux_COMPUTERSANDEDUCATION ,medicine ,business - Abstract
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.
- Published
- 2021
249. Viral Acute Gastroenteritis in Special Populations
- Author
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Jeffery L. Meier
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Diarrhea ,Rotavirus ,0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,Special populations ,viruses ,medicine.disease_cause ,Astrovirus ,Feces ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Child ,Aged ,biology ,business.industry ,Norovirus ,Gastroenterology ,Infant ,Diagnostic test ,Outbreak ,Sapovirus ,Acute gastroenteritis ,biology.organism_classification ,Gastroenteritis ,030104 developmental biology ,030211 gastroenterology & hepatology ,business - Abstract
Viral acute gastroenteritis (AGE) is common and afflicts people of all ages. Nonviral causes of AGE are less common. Norovirus is a leading cause of sporadic cases and outbreaks of AGE across all ages. Universal rotavirus vaccination of infants has reduced frequency and severity of rotavirus AGE cases in children and indirectly reduced cases in older adults. Severe illness is more likely in persons at age extremes or with immunocompromising conditions. Viral causes of AGE can lead to protracted diarrheal illness in immunocompromised persons. Nucleic acid amplification tests are changing diagnostic testing algorithms.
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- 2021
250. Physicians’ opinions on the necessity of COVID-19 vaccination in patients with epilepsy
- Author
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Ali A. Asadi-Pooya, M.A. Sahraian, Ali Sahraian, and Reza Shervin Badv
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medicine.medical_specialty ,COVID-19 Vaccines ,Special populations ,Coronavirus disease 2019 (COVID-19) ,Attitude of Health Personnel ,seizure ,coronavirus ,Iran ,World health ,Food and drug administration ,Epilepsy ,Risk Factors ,vaccine ,medicine ,Humans ,In patient ,Neurologists ,COVID ,Psychiatry ,SARS-CoV-2 ,business.industry ,COVID-19 ,Survey research ,Original Articles ,General Medicine ,medicine.disease ,Vaccination ,Neurology ,Family medicine ,Original Article ,Neurology (clinical) ,business - Abstract
Objective. The aim of the current study was to investigate the opinions of neurologists and psychiatrists in Iran on the necessity of COVID‐19 vaccination in patients with epilepsy (PWE). These data can help policy makers understand the concerns of these healthcare professionals. Methods. This was a survey study. On September 1st, 2020 we sent a questionnaire (using Google‐forms) to all neurologists and psychiatrists in Iran via WhatsApp. The survey included three general questions (age, sex, and discipline) and six COVID‐specific questions. Results. In total, 202 physicians participated in this study (116 neurologists and 86 psychiatrists). Of the participants, 27% believed that PWE are at increased risk of contracting COVID‐19. The majority (74%) of the participants would confidently recommend COVID‐19 vaccine to their patients. However, only 49% of the physicians would recommend such a vaccine to all patients; others would consider it in special populations only. The overwhelming majority (91%) of the participants would recommend COVID‐19 vaccine only when a reliable vaccine becomes available. Many physicians would trust a vaccine that is approved by the World Health Organization (WHO) (46%) or a vaccine that is approved by the Food and Drug Administration (FDA‐USA) (34%). Significance. Physicians have concerns on the issue of the necessity of (a future) COVID‐19 vaccine in PWE. The most important concern is the reliability of a vaccine and in this regard, two health agencies, the WHO and the FDA, are the most trusted organizations to approve a vaccine against COVID‐19.
- Published
- 2021
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