Challenges to immunization: the experiences of homeless youth

<p>Abstract</p> <p>Background</p> <p>Homelessness is a critical social issue, both a product of, and contributing to, poor mental and physical health. Over 150,000 young Canadians live on the streets. Homeless youth experience a high incidence of infectious diseases, many of which are vaccine preventable. Early departure from school and limited access to public health services makes them a particularly vulnerable high-risk group. This study explores challenges to obtaining essential vaccines experienced by homeless youth.</p> <p>Methods</p> <p>A qualitative research study to explore knowledge, attitudes, beliefs, and experiences surrounding immunization of hard-to-reach homeless youth was designed. Participants were recruited for focus groups from Phoenix House and Shelter, a non-profit, community-based organization assisting homeless youth in Halifax, Nova Scotia, Canada. An experienced facilitator guided the recorded discussions. Transcripts of audiotapes were analyzed using a constant comparative method until data revealed a set of exemplars and themes that best captured participants’ knowledge, attitudes, beliefs and experiences surrounding immunization and infectious diseases.</p> <p>Results</p> <p>Important themes emerged from our analysis. Considerable variability in knowledge about immunization and vaccine preventable diseases was found. The homeless youth in the study had limited awareness of meningitis in contrast to a greater knowledge about sexually transmitted infections and influenza, gained during the H1N1/09 public health campaign. They recognized their poverty as a risk for contracting infectious diseases, along with their inability to always employ known strategies to prevent infectious diseases, due to circumstances. They showed considerable insight into the detrimental effects of poor hygiene, sleeping locations and risk behaviour. Interviewed homeless youth regarded themselves as good compliers of health professional advice and offered valuable suggestions to improve immunization in their population.</p> <p>Conclusions</p> <p>To provide effective public health interventions, it is necessary to consider the knowledge, attitudes, beliefs, and experiences of hard to reach, high risk groups. Our study shows that homeless youth are interested and capable in discussing immunization. Active targeting of homeless youth for public health immunization programs is needed. Working collaboratively with non-profit organizations that assist homeless youth provides an opportunity to increase their knowledge of infectious risks and to improve immunization strategies in this vulnerable group.</p

Diagnosis and management of adhesive capsulitis

Adhesive capsulitis is a musculoskeletal condition that has a disabling capability. This review discusses the diagnosis and both operative and nonoperative management of this shoulder condition that causes significant morbidity. Issues related to medications, rehabilitation, and post surgical considerations are discussed

The nature of organic records in impact excavated rocks on Mars

Impact ejected rocks are targets for life detection missions to Mars. The Martian subsurface is more favourable to organic preservation than the surface owing to an attenuation of radiation and physical separation from oxidising materials with increasing depth. Impact events bring materials to the surface where they may be accessed without complicated drilling procedures. On Earth, different assemblages of organic matter types are derived from varying depositional environments. Here we assess whether these different types of organic materials can survive impact events without corruption. We subjected four terrestrial organic matter types to elevated pressures and temperatures in piston-cylinder experiments followed by chemical characterisation using whole-rock pyrolysis-gas chromatography-mass spectrometry. Our data reveal that long chain hydrocarbon-dominated organic matter (types I and II; mainly microbial or algal) are unresistant to pressure whereas aromatic hydrocarbondominated organic matter types (types III and IV; mainly land plant, metamorphosed or degraded, displaying some superficial chemical similarities to abiotic meteoritic organic matter) are relatively resistant. This suggests that the impact excavated record of potential biology on Mars will be unavoidably biased, with microbial organic matter underrepresented while metamorphosed, degraded or abiotic meteoritic organic matter types will be selectively preserved