The safety of emerging inorganic and carbon nanomaterials

Persistent inorganic and carbon nanoparticles are increasingly being engineered for practical application but can be hazardous to humans. A relatively great deal is known about the human health hazards of inhaled nanoparticles, which may give rise to respiratory disease and to negative effects in other organs, including the cardiovascular system. Determinants of inhaled nanoparticle risk and/or hazard are size, surface characteristics, shape, rigidity, structure, and the formation of assemblages. A major molecular mechanism underlying the inhalation hazard of nanoparticles is the generation of reactive oxygen species, but other mechanisms such as the release of toxic substances and interactions with proteins and DNA may also contribute. Human health hazards might be linked to the ingestion of persistent inorganic and carbon nanoparticles after their clearance from the lungs. Hazards and risks to ecosystems are highly uncertain. Options for reducing the human hazard linked to the inhalation of engineered nanomaterials include the elimination and substitution of hazardous nanoparticles and the use of engineering controls

A community-engaged assessment of barriers and facilitators to rapid stroke treatment

Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stake-holder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome