Predictors of Lung Cancer Screening Recommendation in Virginia Using the Community Health Assessment Survey

Purpose: The purpose of this analysis was to determine the factors that may influence the probability of being recommended a lung cancer screening by a health professional in Virginia. Methods: Data were obtained from the Community Health Assessment Survey conducted by the University of Virginia (UVA) Health System and Cancer System in collaboration with Virginia Commonwealth University (VCU) Cancer Center. SAS software was used to conduct a logistic regression with the following variables: age, sex, race, current smoking status, cancer history, education level, income level, insurance, and rurality. Results: Statistically significant positive predictors included being a current smoker (OR: 3.504, CI: 1.576 - 7.794), having previous cancer history (OR: 2.159, CI: 1.090 - 4.278), and living in an urban environment (OR: 1.939, CI: 1.009 - 3.724). Conclusion: Smoking, cancer history, and rurality were considered significant predictors of lung cancer screening recommendations by a health professional in Virginia while age, sex, race, education level, income level, and insurance were not considered significant predictors in this model. This study suggests that key mechanisms underlying lung cancer outcome disparities among racial minorities and socioeconomically disadvantaged groups may lie beyond the level of screening recommendations. Further research investigating when along the disease progression these disparities tend to arise could help in creating more targeted public health interventions and improving health equity

Knowledge of the Human Papillomavirus Vaccine: An Analysis using Together for Health Virginia Population Health Survey

Purpose: The purpose of this analysis was to identify key predictors which impact knowledge of the Human Papillomavirus vaccine in adults aged 21 to 45 in Virginia. Methods: Data was collected from the Together for Health Virginia Population Surveys administered by Virginia Commonwealth University and the University of Virginia. Logistic regression was performed on data using the variables sex, age, rurality, race, education, income, occupation, and type of health insurance coverage. Results: There was a statistically significant positive relationship between knowledge of the HPV vaccine and part-time occupation (OR: 4.288, CI: 1.492-13.325), younger age (OR: 2.31, CI: 1.088-4.905), and higher education (OR: 2.683, CI: 1.227-5.870). There was a statistically significant negative relationship between knowledge of the vaccine and being male (OR: 0.437, CI: 0.248-0.771), living in an urban area (OR: 0.511, CI: 0.267-0.977), and identifying in the lower income category (OR: 0.246, CI: 0.093-0.651). Conclusion: This study identified 6 key predictors in knowledge of the HPV vaccine among adults in Virginia. Future studies should explore, in particular, the category of students and residents of urban areas. Despite these results, knowledge of the HPV vaccine does not translate to intention to receive the vaccine. Therefore, future studies should additionally study attitudes, behaviors, and potential barriers

Addressing obstacles to the inclusion of palliative care in humanitarian health projects: a qualitative study of humanitarian health professionals’ and policy makers’ perceptions

© 2020, The Author(s). Background: Humanitarian non-governmental organizations provide assistance to communities affected by war, disaster and epidemic. A primary focus of healthcare provision by these organizations is saving lives; however, curative care will not be sufficient, appropriate, or available for some patients. In these instances, palliative care approaches to ease suffering and promote dignity are needed. Though several recent initiatives have increased the probability of palliative care being included in humanitarian healthcare response, palliative care remains minimally integrated in humanitarian health projects. Methods: We conducted a qualitative study using interpretive description methodology to investigate humanitarian policy-makers’ and health care professionals’ experiences and perceptions of palliative care during humanitarian crises. In this article, we report on the analysis of in-depth interviews with 24 participants related to their perceptions of obstacles to providing palliative care in humanitarian crises, and opportunities for overcoming these obstacles. Among the participants, 23 had experience as humanitarian health professionals, and 12 had experience with policy development and organizational decision-making. Results: Participants discussed various obstacles to the provision of palliative care in humanitarian crises. More prominent obstacles were linked to the life-saving ethos of humanitarian organizations, priority setting of scarce resources, institutional and donor funding, availability of guidance and expertise in palliative care, access to medication, and cultural specificity around death and dying. Less prominent obstacles related to continuity of care after project closure, equity, security concerns, and terminology. Conclusion: Opportunities exist for overcoming the obstacles to providing palliative care in humanitarian crises. Doing so is necessary to ensure that humanitarian healthcare can fulfill its objectives not only of saving lives, but also of alleviating suffering and promoting dignity of individuals who are ill or injured during a humanitarian crises, including persons who are dying or likely to die

Dietary Cholesterol Concentration and Duration Degrade Long-Term Memory of Classical Conditioning of the Rabbit's Nictitating Membrane Response

A rabbit model of Alzheimer's disease based on feeding a cholesterol diet for eight weeks shows sixteen hallmarks of the disease, including learning and memory changes. Although we have shown 2% cholesterol and copper in water can retard learning, other studies show feeding dietary cholesterol before learning can improve acquisition whereas feeding cholesterol after learning can degrade long-term memory. We explored this issue by manipulating cholesterol concentration and duration following classical trace conditioning of the rabbit's nictitating membrane response and assessed conditioned responding after eight weeks on cholesterol. First, rabbits given trace classical conditioning followed by 0.5%, 1%, or 2% cholesterol for eight weeks showed body weight and serum cholesterol levels that were a function of dietary cholesterol. Although all concentrations of cholesterol showed some sign of retarding long-term memory, the level of memory retardation was correlated with serum cholesterol levels. Second, rabbits given trace conditioning followed by different durations of a 2% cholesterol diet combined with different durations of a 0% control diet for 8 weeks showed duration and timing of a 2% cholesterol diet were important in affecting recall. The data support the idea that dietary cholesterol may retard long-term memory

Depression and health-adjusted life expectancy in the Canadian adult population: a descriptive study

Background: Few studies have evaluated the overall population health-related impact of depression in terms of losses to both premature mortality and health-related quality of life (HRQL). Purpose: To estimate health-adjusted life expectancy (HALE) for Canadian adults according to depression status

Genetic dissection of cyclic pyranopterin monophosphate biosynthesis in plant mitochondria

Mitochondria play a key role in the biosynthesis of two metal cofactors, iron-sulfur (FeS) clusters and molybdenum cofactor (Moco). The two pathways intersect at several points, but a scarcity of mutants has hindered studies to better understand these links. We screened a collection of sirtinol-resistant Arabidopsis thaliana mutants for lines with decreased activities of cytosolic FeS enzymes and Moco enzymes. We identified a new mutant allele of ATM3 , encoding the ATP-binding cassette Transporter of the Mitochondria 3 (systematic name ABCB25), confirming the previously reported role of ATM3 in both FeS cluster and Moco biosynthesis. We also identified a mutant allele in CNX2, Cofactor of Nitrate reductase and Xanthine dehydrogenase 2 , encoding GTP 3′,8-cyclase, the first step in Moco biosynthesis which is localized in the mitochondria. A single nucleotide polymorphism in cnx2-2 leads to substitution of Arg88 with Gln in the N-terminal FeS cluster-binding motif. cnx2-2 plants are small and chlorotic, with severely decreased Moco enzyme activities, but they performed better than a cnx2-1 knockout mutant, which could only survive with ammonia as nitrogen source. Measurement of cyclic pyranopterin monophosphate (cPMP) levels by LC-MS/MS showed that this Moco intermediate was below the limit of detection in both cnx2-1 and cnx2-2 , and accumulated more than 10-fold in seedlings mutated in the downstream gene CNX5 . Interestingly, atm3-1 mutants had less cPMP than wild type, correlating with previous reports of a similar decrease in nitrate reductase activity. Taken together, our data functionally characterise CNX2 and suggest that ATM3 is indirectly required for cPMP synthesis

A case analysis of partnered research on palliative care for refugees in Jordan and Rwanda

© 2021, The Author(s). Background: This case analysis describes dilemmas and challenges of ethical partnering encountered in the process of conducting a research study that explored moral and practical dimensions of palliative care in humanitarian crisis settings. Two contexts are the focus of this case analysis: Jordan, an acute conflict-induced refugee situation, and Rwanda, a protracted conflict-induced refugee setting. The study’s main goal was to better understand ways humanitarian organizations and health care providers might best support ethically and contextually appropriate palliative care in humanitarian contexts. An unintended outcome of the research was learning lessons about ethical dimensions of transnational research partnerships, which is the focus of this case analysis. Discussion: There exist ongoing challenges for international collaborative research in humanitarian conflict-induced settings. Research partnerships were crucial for connecting with key stakeholders associated with the full study (e.g., refugees with life limiting illness, local healthcare providers, aid organization representatives). While important relationships were established, obstacles limited our abilities to fully attain the type of mutual partnership we aimed for. Unique challenges faced during the research included: (a) building, nurturing and sustaining respectful and equitable research partnerships between collaborators in contexts of cultural difference and global inequality; (b) appropriate ethics review and challenges of responding to local decision-maker’s research needs; and (c) equity and fairness towards vulnerable populations. Research strategies were adapted and applied to respond to these challenges with a specific focus on (d) research rewards and restitution. Conclusions: This case analysis sheds light on the importance of understanding cultural norms in all research roles, building relationships with decision makers, and developing teams that include researchers from within humanitarian crisis settings to ensure that mutually beneficial research outcomes are ethical as well as culturally and contextually relevant

Practice Guidelines for Teledermatology

Previous American Telemedicine Association (ATA) Teledermatology Practice Guidelines were issued in 2007. This updated version reflects new knowledge in the field, new technologies, and the need to incorporate teledermatology practice in a variety of settings, including hospitals, urgent care centers, Federally Qualified Health Centers, school-based clinics, public health facilities, and patient homes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140294/1/tmj.2016.0137.pd