This cross-sectional study examines the association of prices for drugs to treat hookworm and pinworm with prescribing and prescription-filling behaviors and total outpatient treatment costs.
•88% of healthcare workers were accepting of COVID-19 vaccines.•Healthcare workers who work with immigrant communities were more vaccine acceptant.•Healthcare workers with a vaccine concern were more ...likely to report patients with concerns.•Educational information was helpful for healthcare workers making a vaccine decision.•A healthcare provider vaccine recommendation was considered helpful for patients making a vaccine decision.
To understand COVID-19 vaccine perspectives among healthcare workers serving diverse communities.
A dual English/Spanish survey was distributed to healthcare workers in the United States from 3/12/2021–4/22/2021 by the Migrant Clinicians Network, Society of Refugee Healthcare Providers, a Federally Qualified Healthcare Center, and social media advertisement to general primary care workers.
517 responses were at least 50% complete and included in the analysis. Among these, 88% (457/517) indicated vaccine acceptance. Factors associated with acceptance included not reporting any vaccine concerns, identifying as male, ≥65 years of age, being a physician or advanced practice provider, and interacting directly with patients from refugee, immigrant, and migrant (RIM) communities. Participants identified educational information as most helpful for themselves when making a vaccine decision, but a healthcare provider’s recommendation as most helpful for their patients.
Healthcare workers, especially those serving RIM communities, are vaccine accepting. Tailoring vaccine-related information to healthcare workers may improve vaccine confidence for both themselves and patients who rely on them for information.
The knowledge, attitudes, and practices surrounding bushmeat consumption and importation in the United States are not well described. Focus groups of West African persons living in Minnesota, USA, ...found that perceived risks are low and unlikely to deter consumers. Incentives for importation and consumption were multifactorial in this community.
In the field of neural tissue engineering, electrically conducting, biocompatible surfaces are of great interest. Over the past several decades conducting polymers have been studied as candidate ...surfaces because they fit these criteria. Several attempts have been made to combine the conductivity and biocompatibility of conducting polymers with biomolecules that could promote specific cell attachment and growth. In this report the laminin fragments CDPGYIGSR (p31) and RNIAEIIKDI (p20) are used as dopants in electropolymerization of the conducting polymer polypyrrole (PPy). The electrical properties of the resulting films are analyzed by impedance spectroscopy and cyclic voltammetry and compared to gold. PPy/p20 surfaces consistently demonstrate the lowest impedance and largest charge capacity for a given deposition charge. Next, in vitro studies using primary neurons cultured in a defined media and primary astrocytes in a serum containing media were performed; neuron density and neurite length, as well as astrocyte density, were quantified. Surfaces doped with a combination of the two peptides (PPy/p20-p31) consistently supported the highest neuronal density. It is shown that surfaces doped with the laminin fragment p20 had significantly longer primary neurites than either the p31 doped or poly(styrenesulfonate) doped PPy surfaces. Finally, the astrocyte studies demonstrate that PPy surfaces have significantly less astrocyte adhesion in culture than the common electrode material, gold.
Abstract Background The risk of developing strongyloidiasis hyperinfection syndrome appears to be elevated among individuals who initiate corticosteroid treatment. Presumptive treatment or treatment ...after screening for populations from Strongyloides stercoralis-endemic areas has been suggested before initiating corticosteroids. However, potential clinical and economic impacts of preventative strategies have not been evaluated. Methods Using a decision tree model for a hypothetical cohort of 1000 individuals from S. stercoralis-endemic areas globally initiating corticosteroid treatment, we evaluated the clinical and economic impacts of two interventions, ‘Screen and Treat’ (i.e. screening and ivermectin treatment after a positive test), and ‘Presumptively Treat’, compared to current practice (i.e. ‘No Intervention’). We evaluated the cost-effectiveness (net cost per death averted) of each strategy using broad ranges of pre-intervention prevalence and hospitalization rates for chronic strongyloidiasis patients initiating corticosteroid treatment. Results For the baseline parameter estimates, ‘Presumptively Treat’ was cost-effective (i.e. clinically superior with cost per death averted less than a threshold of $10.6 million per life) compared to ‘No Intervention’ ($532 000 per death averted) or ‘Screen and Treat’ ($39 000 per death averted). The two parameters contributing the most uncertainty to the analysis were the hospitalization rate for individuals with chronic strongyloidiasis who initiate corticosteroids (baseline 0.166%) and prevalence of chronic strongyloidiasis (baseline 17.3%) according to a series of one-way sensitivity analyses. For hospitalization rates ≥0.022%, ‘Presumptively Treat’ would remain cost-effective. Similarly, ‘Presumptively Treat’ remained preferred at prevalence rates of ≥4%; ‘Screen and Treat’ was preferred for prevalence between 2 and 4% and ‘No Intervention’ was preferred for prevalence <2%. Conclusions The findings support decision-making for interventions for populations from S. stercoralis-endemic areas before initiating corticosteroid treatment. Although some input parameters are highly uncertain and prevalence varies across endemic countries, ‘Presumptively Treat’ would likely be preferred across a range for many populations, given plausible parameters.
All U.S.-bound refugees from sub-Saharan Africa receive presumptive antimalarial treatment before departing for the United States. Among U.S.-bound Congolese refugees, breakthrough malaria cases and ...persistent splenomegaly have been reported. In response, an enhanced malaria diagnostic program was instituted. Here, we report the prevalence of plasmodial infection among 803 U.S.-bound Congolese refugees who received enhanced diagnostics. Infections by either rapid diagnostic test (RDT) or PCR were detected in 187 (23%) refugees, with 78 (10%) by RDT only, 35 (4%) by PCR only, and 74 (9%) by both. Infections identified by PCR included 103 monoinfections (87 Plasmodium falciparum, eight Plasmodium ovale, seven Plasmodium vivax, and one Plasmodium malariae) and six mixed infections. Splenomegaly was associated with malaria detectable by RDT (odds ratio: 1.8, 95% CI: 1.0-3.0), but not by PCR. Splenomegaly was not strongly associated with parasitemia, indicating that active malaria parasitemia is not necessary for splenomegaly.
We conducted a large-scale study of newly arrived refugee children in the United States with data from 2006 to 2012 domestic medical examinations in 4 sites: Colorado; Minnesota; Philadelphia, ...Pennsylvania; and Washington State.
Blood lead level, anemia, hepatitis B virus (HBV) infection, tuberculosis infection or disease, and Strongyloides seropositivity data were available for 8148 refugee children (aged < 19 years) from Bhutan, Burma, Democratic Republic of Congo, Ethiopia, Iraq, and Somalia.
We identified distinct health profiles for each country of origin, as well as for Burmese children who arrived in the United States from Thailand compared with Burmese children who arrived from Malaysia. Hepatitis B was more prevalent among male children than female children and among children aged 5 years and older. The odds of HBV, tuberculosis, and Strongyloides decreased over the study period.
Medical screening remains an important part of health care for newly arrived refugee children in the United States, and disease risk varies by population.
Rewards are fundamental to everyday life. They confer pleasure, support learning, and mediate decisions. Dopamine-releasing neurons in the midbrain are critical for reward processing. These neurons ...receive input from more than 30 brain areas and send widespread projections to the basal ganglia and frontal cortex. Their phasic responses are tuned to rewards. Specifically, dopamine signals code reward prediction error, the difference between received and predicted rewards. Decades of research in awake, behaving non-human primates (NHP), have shown the importance of these neural signals for learning and decision making. In this review, we will provide an overview of the bedrock findings that support the reward prediction error hypothesis and examine evidence that this signal plays a role in learning and decision making. In addition, we will highlight some of the conceptual challenges in dopamine neurophysiology and identify future areas of research to address these challenges. Keeping with the theme of this special issue, we will focus on the role of NHP studies in understanding dopamine neurophysiology and make the argument that primate models are essential to this line of research.
Understanding of COVID-19–related disparities in the U.S. is largely informed by traditional race/ethnicity categories that mask important social group differences. This analysis utilizes granular ...information on patients’ country of birth and preferred language from a large health system to provide more nuanced insights into health disparities.
Data from patients seeking care from a large Midwestern health system between January 1, 2019 and July 31, 2021 and COVID-19–related events occurring from March 18, 2020 to July 31, 2021 were used to describe COVID-19 disparities. Statistics were performed between January 1, 2022 and March 15, 2023. Age-adjusted generalized linear models estimated RR across race/ethnicity, country of birth grouping, preferred language, and multiple stratified groups.
The majority of the 1,114,895 patients were born in western advanced economies (58.6%). Those who were Hispanic/Latino, were born in Latin America and the Caribbean, and preferred Spanish language had highest RRs of infection and hospitalization. Black-identifying patients born in sub-Saharan African countries had a higher risk of infection than their western advanced economies counterparts. Subanalyses revealed elevated hospitalization and death risk for White-identifying patients from Eastern Europe and Central Asia and Asian-identifying patients from Southeast Asia and the Pacific. All non-English languages had a higher risk of all COVID-19 outcomes, most notably Hmong and languages from Burma/Myanmar.
Stratifications by country of birth grouping and preferred language identified culturally distinct groups whose vulnerability to COVID-19 would have otherwise been masked by traditional racial/ethnic labels. Routine collection of these data is critical for identifying social groups at high risk and for informing linguistically and culturally relevant interventions.
PDF
