Assessing Barriers to Health Care Access for New Americans

Introduction. Healthcare within the United States has been at the forefront of public discussion and political representation in recent years, particularly as it relates to healthcare access and barriers to said access. Focus has been placed on low-income groups that most generally represent the face of the average American, but this leaves the question: How are new Americans faring, and do their struggles match those faced by the rest of the country? The new Americans of Burlington, Vermont serve as a small window into a unique refugee population’s experiences with healthcare in the United States. Methods. A focus group consisting of 8 women was hosted on-site at the Burlington Housing Authority Franklin Square apartments. Questions were designed to determine demographic data as well facilitate subjective discussion on participants’ healthcare experiences. Translation services were provided by the resident manager. Results. Languages spoken were Mai Mai, Swahili, and English. Five major themes for healthcare access barriers were identified: language barriers, having children, transportation barriers, financial barriers, and a lack of preventative care. Sub- themes were also identified, which formed a taxonomy of barriers to healthcare access among the representative population. Discussion/Conclusions. The difficulties faced by new Americans are numerous and interrelated, leading to a perpetual cycle of insufficient healthcare. Throughout the discussion, the financial burden of healthcare was regularly raised as one of the most prominent issues faced. This concern matches with those found in similar, previous studies, that have analyzed the difficulties faced by the rest of America.https://scholarworks.uvm.edu/comphp_gallery/1254/thumbnail.jp

Impact of Particle and Equipment Properties on Residence Time Distribution of Pharmaceutical Excipients in Rotary Tablet Presses

Paddle feeders are devices commonly used in rotary tablet presses to facilitate constant and efficient die filling. Adversely, the shear stress applied by the rotating paddles is known to affect the bulk properties of the processed powder dependent on the residence time. This study focuses on the residence time distribution (RTD) of two commonly applied excipients (microcrystalline cellulose, MCC; dicalcium phosphate, DCP), which exhibit different flow properties inside rotary tablet presses. To realistically depict the powder flow inside rotary tablet presses, custom-made tracer powder was developed. The applied method was proven to be appropriate as the tracer and bulk powder showed comparable properties. The RTDs of both materials were examined in two differently scaled rotary tablet presses and the influence of process parameters was determined. To analyze RTDs independent of the mass flow, the normalized variance was used to quantify intermixing. Substantial differences between both materials and tablet presses were found. Broader RTDs were measured for the poorer flowing MCC as well as for the production scale press. The obtained results can be used to improve the general understanding of powder flow inside rotary tablet presses and amplify scale-up and continuous production process development

Scaling Tableting Processes from Compaction Simulator to Rotary Presses - Mind the Sub-Processes

Compaction simulators are frequently used in the formulation and process development of tablets, bringing about the advantages of flexibility, low material consumption, and high instrumentation to generate the most possible process understanding. However, their capability of resembling general aspects of rotary press compaction and their precision in simulating or mimicking sub-processes such as feeding and filling need to be systematically studied. The effect of material deformation behavior, blend composition, and feeding on tensile strength and simulation precision as compared with rotary presses of different scales is evaluated in this study. Generally, good simulation performance was found for the studied compaction simulator. Compaction profile-sensitivity was demonstrated for highly visco-plastic materials while shear-sensitivity in feeding was demonstrated for lubricated blends of ductile particles. Strategies for the compensation of both in compaction simulator experiments are presented by careful investigation of the compaction stress over time profiles and introduction of a compaction simulator-adapted shear number approach to account for differences in layout and operation mode between compaction simulator and rotary press, respectively. These approaches support the general aim of this study to provide a more straightforward determination of scaling process parameters between rotary press and compaction simulator and facilitate a quicker and more reliable process transfer

Microbial Resistance Mechanisms to the Antibiotic and Phytotoxin Fusaric Acid

Fusaric acid (FA) produced by Fusarium oxysporum plays an important role in disease development in plants, including cotton. This non-specific toxin also has antibiotic effects on microorganisms. Thus, one expects a potential pool of diverse detoxification mechanisms of FA in nature. Bacteria and fungi from soils infested with Fusarium and from laboratory sources were evaluated for their ability to grow in the presence of FA and to alter the structure of FA into less toxic compounds.None of the bacterial strains were able to chemically modify FA. Highly FA resistant strains were found only in Gram-negative bacteria, mainly in the genus of Pseudomonas. The FA resistance of the Gram-negative bacteria was positively correlated with the number of predicted genes for FA efflux pumps present in the genome. Phylogenetic analysis of predicted FA resistance proteins (FUSC, an inner membrane transporter component of the efflux pump) revealed that FUSC proteins having high sequence identities with the functionally characterized FA resistance protein FusC or Fdt might be the major contributors of FA resistance. In contrast, most fungi converted FA to less toxic compounds regardless of the level of FA resistance they exhibited. Five derivatives were detected, and the detoxification of FA involved either oxidative reactions on the butyl side chain or reductive reactions on the carboxylic acid group. The production of these metabolites from widely different phyla indicates that resistance to FA by altering its structure is highly conserved. A few FA resistant saprophytic or biocontrol strains of fungi were incapable of altering FA, indicating a possible involvement of efflux transporters. Deployment of both efflux and derivatization mechanisms may be a common feature of fungal FA resistance

Ein Privileg fuer wenige Die deutschsprachige Migration nach Kanada im Schatten des Nationalsozialismus

Gegenstand der Untersuchung ist erzwungene internationale Migration nach Kanada. Drei Hauptgruppen stehen im Mittelpunkt: deutschsprachige Juden, sudetendeutsche Sozialdemokraten und deutschsprachige, aus Grossbritannien deportierte Fluechtlinge. Stellvertretend fuer die drei untersuchten Gruppen werden drei Fluchtbiographien vorgestellt. Die individuellen Migrationsberichte und der subjektive Umgang mit der Fluchterfahrung stellen die Mikroebene der Untersuchung dar. Dem werden auf der Makroebene die Ziele der kanadischen Einwanderungspolitik gegenuebergestellt, um so zu zeigen, wie es zur Aufnahme der deutschsprachigen Fluechtlinge kam. Die Untersuchung zeigt, wie individuelle und gruppenspezifischen Voraussetzungen die Akkulturation der Fluechtlinge in Kanada beeinflusst haben. (ICE2)Available from UB Trier(385)-u52821 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEDEGerman

Microbial Resistance Mechanisms to the Antibiotic and Phytotoxin Fusaric Acid

Fusaric acid (FA) produced by Fusarium oxysporum plays an important role in disease development in plants, including cotton. This non-specific toxin also has antibiotic effects on microorganisms. Thus, one expects a potential pool of diverse detoxification mechanisms of FA in nature. Bacteria and fungi from soils infested with Fusarium and from laboratory sources were evaluated for their ability to grow in the presence of FA and to alter the structure of FA into less toxic compounds.None of the bacterial strains were able to chemically modify FA. Highly FA resistant strains were found only in Gram-negative bacteria, mainly in the genus of Pseudomonas. The FA resistance of the Gram-negative bacteria was positively correlated with the number of predicted genes for FA efflux pumps present in the genome. Phylogenetic analysis of predicted FA resistance proteins (FUSC, an inner membrane transporter component of the efflux pump) revealed that FUSC proteins having high sequence identities with the functionally characterized FA resistance protein FusC or Fdt might be the major contributors of FA resistance. In contrast, most fungi converted FA to less toxic compounds regardless of the level of FA resistance they exhibited. Five derivatives were detected, and the detoxification of FA involved either oxidative reactions on the butyl side chain or reductive reactions on the carboxylic acid group. The production of these metabolites from widely different phyla indicates that resistance to FA by altering its structure is highly conserved. A few FA resistant saprophytic or biocontrol strains of fungi were incapable of altering FA, indicating a possible involvement of efflux transporters. Deployment of both efflux and derivatization mechanisms may be a common feature of fungal FA resistance