Publications by authors named "Grace R"

Background And Objective: Migrant and refugee women, families, and their children can experience significant language, cultural, and psychosocial barriers to engage with child and family services. Integrated child and family health Hubs are increasingly promoted as a potential solution to address access barriers; however, there is scant literature on how to best implement them with migrant and refugee populations. Our aim was to explore with service providers and consumers the barriers, enablers, and experiences with Hubs and the resulting building blocks required for acceptable Hub implementation for migrant and refugee families.

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Background: Venomous snakes are among the most lethal animals worldwide and envenomation survivors face lifelong morbidities. Envenomation is colloquially considered highly prevalent in the US state of Florida, yet envenomation trends here are currently unassessed.

Methods: We present a comprehensive analysis of causes, characteristics and treatments of Florida's snake envenomations via medical records review of envenomated patients presenting to a major academic medical centre between 2002 and 2022.

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Background: Diaphorina citri is an insect vector of "Candidatus Liberibacter asiaticus" (CLas), the gram-negative bacterial pathogen associated with citrus greening disease. Control measures rely on pesticides with negative impacts on the environment, natural ecosystems, and human and animal health. In contrast, gene-targeting methods have the potential to specifically target the vector species and/or reduce pathogen transmission.

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Objectives: The coronavirus disease 2019 (COVID-19) pandemic had many downstream effects, including, for some women, altering the wish to become pregnant. This study examines the effects on pregnancy intention and Edinburgh Postnatal Depression Scale (EPDS) score at the initiation of prenatal care in a low-income population during the COVID-19 pandemic.

Methods: A retrospective review of cohorts of women initiating prenatal care at two large Medicaid clinics between May and November 2019 and May and November 2020 was performed.

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Article Synopsis
  • Research explored how methamphetamine affects impulsive decision-making in rats using a task with variable reward delays and constant reward sizes.
  • Results showed that acute methamphetamine reduces both sensitivity to delays and the "magnitude effect," where larger rewards are chosen more often if delays are longer.
  • Chronic methamphetamine use had little impact on decision-making, indicating that acute doses specifically alter how rewards are valued based on timing.
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Objectives: Evidence-based protocols for managing bleeding emergencies in patients with immune thrombocytopenia (ITP) are lacking. We conducted a systematic review of treatments for critical bleeding in patients with ITP.

Methods: We included all study designs and extracted data in aggregate or individually for patients who received one or more interventions and for whom any of the following outcomes were reported: platelet count response, bleeding, disability, or death.

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This study evaluated the associations between positive and adverse experiences and environments in adolescence and health, education and employment outcomes in early adulthood. Data were extracted from the Longitudinal Studies of Australian Youth cohort that commenced in 2003. The items were conceptually mapped to Positive and Adverse Youth Experiences and environments (PYEs and AYEs) at 15, 16 and 17 years old and outcomes at 25 years old.

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Background: Oral squamous cell carcinoma (OSCC) is a leading cause of cancer-related deaths in developing countries. The oral tongue is the most common site involved by OSCC. About one-third of the patients have neck nodal metastasis at presentation.

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The ability of nervous systems to filter out irrelevant and repetitive stimuli may prevent animals from becoming 'saturated' with excess information. However, animals must be particular about which stimuli to attend to and which to ignore, as mistakes may be costly. Using a comparative approach, we explored the effect of interstimulus interval (ISI) between repeated presentations of visual stimuli presented on a screen to test the decrease in responses (response decrement) of both Trite planiceps jumping spiders and untrained Columba livia pigeons, animals with comparable visual ability despite having structurally different visual systems and brain size.

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  • Researchers conducted a genome-wide association study to identify genetic variants linked to pediatric immune thrombocytopenia (ITP) in a large group of patients.
  • Six significant genetic variants were found, particularly in the genes NAV2 and NKD1, which are associated with the Wnt signaling pathway and inversely correlated with ITP.
  • The study highlighted that no significant genetic variants were found to differentiate between those with ITP who recovered quickly and those who developed chronic ITP, suggesting a complex genetic influence on disease outcomes.
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Background: Children and families from priority populations experienced significant psychosocial and mental health issues to the COVID-19 pandemic. Yet they also faced significant barriers to service access, particularly families from culturally and linguistically diverse (CALD) backgrounds. With most child and family health nurse clinics ceasing in-person consultations due to the pandemic, many children missed out on health and developmental checks.

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  • Pyruvate kinase (PK) deficiency is a rare genetic anemia linked to the PKLR gene, leading to various health issues; however, its full impact is not fully understood.* -
  • The Peak Registry study analyzed 241 patients with PK deficiency, noting significant treatments like splenectomy (48.3%) and chelation therapy (50.5%), as well as common complications like iron overload and neonatal issues.* -
  • Adult patients also face serious complications, such as bone health problems and pulmonary hypertension, highlighting the need for better awareness and management strategies among healthcare providers.*
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The Kids ITP Tools (KIT) is a health-related quality of life (HRQoL) questionnaire that evaluates quality of life in children with immune thrombocytopenia (ITP). There are three formats: Child Self-Report, Parent Proxy-Report and Parent Impact-Report. This study aimed to develop a domain structure by grouping-related questions from the questionnaire into domains that independently reflect various aspects of HRQoL.

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  • * In 2023, the Pediatric ITP Consortium defined refractory pediatric ITP as no platelet response after treatment with all eligible emergent therapies.
  • * Patients with high disease burden or lack of platelet response, despite various treatments, are identified as a challenging group that requires further research and the potential for new treatment options.
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The ratio of two magnitudes can take one of two values depending on the order they are operated on: a 'big' ratio of the larger to smaller magnitude, or a 'small' ratio of the smaller to larger. Although big and small ratio scales have different metric properties and carry divergent predictions for perceptual comparison tasks, no psychophysical studies have directly compared them. Two experiments are reported in which subjects implicitly learned to compare pairs of brightnesses and line lengths by non-symbolic feedback based on the scaled big ratio, small ratio or difference of the magnitudes presented.

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  • Mitapivat treatment showed significant improvements in the signs and symptoms of PK Deficiency in adult patients.* -
  • The results were based on data collected from disease-specific patient-reported outcome measures.* -
  • These findings were observed in two separate phase 3 clinical trials, indicating the potential effectiveness of mitapivat.*
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Background: Despite frequently providing non-military services in times of crisis, little systematic research has examined the perspectives of crisis-affected community members on the role of armed actors responding to humanitarian crises and public health emergencies.

Methods: To address this research gap, 175 interviews were conducted (2020-2021) amongst humanitarian and public health practitioners; armed actors; and crisis-affected community members across three country and four crisis contexts. Specifically, this effort included an Ebola outbreak in the Democratic Republic of the Congo; a refugee crisis on the Jordanian-Syrian border; and a volcanic eruption and COVID-19 outbreak in the Philippines.

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The 2019 American Society of Hematology (ASH) guidelines for immune thrombocytopenia (ITP) included recommendations on the management of adults (recommendations 1-9) and children (recommendations 10-21) with primary ITP . We describe here the results of a review of the 2019 guidelines by a working group of experts requested by ASH to inform decision-making about the need for and timing of a guideline revision. An updated Medline and Embase search applied the same search terms as in the 2019 ASH guidelines, limited to systematic reviews and clinical trials, from May 2017 to July 2022.

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  • The research looks at a program called 'Young Doctors for Life' (YDFL) that aims to help improve the health of Aboriginal children.
  • It talks about how the program was designed by working with kids, parents, teachers, and community members to make sure it fits their needs and culture.
  • The results show that projects are more likely to succeed when the community works together and focuses on both the problems kids face and the good things that can help them grow.
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Introduction: Autoimmune diseases are heterogeneous and often lack specific or sensitive diagnostic tests. Increased percentages of CD4CXCR5PD1 circulating T follicular helper (cTfh) cells and skewed distributions of cTfh subtypes have been associated with autoimmunity. However, cTfh cell percentages can normalize with immunomodulatory treatment despite persistent disease activity, indicating the need for identifying additional cellular and/or serologic features correlating with autoimmunity.

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Introduction: Medical facilities are civilian objects specially protected during armed conflict by international humanitarian law (IHL). These protections are customarily applied regardless of the conflict, parties or contexts involved. Attacks on medical care have characterised the bombardment campaign of the Gaza Strip beginning 7 October 2023.

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  • Pyruvate kinase deficiency is a common cause of chronic congenital non-spherocytic hemolytic anemia, affecting about 1 in 100,000 to 1 in 300,000 people, leading to serious health issues.
  • The International Guidelines for the Diagnosis and Management of Pyruvate Kinase Deficiency were created to provide evidence-based recommendations for treating patients, developed by a global panel of 29 experts across multiple specialties.
  • The guidelines cover five key areas, including diagnosis, management of complications, anemia treatment, advanced therapies, and special populations, with a total of 31 recommendations aimed at improving patient care.
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Pyruvate kinase (PK) deficiency is a rare, hereditary disease characterized by chronic hemolytic anemia. Iron overload is a common complication regardless of age, genotype, or transfusion history. Mitapivat, an oral, allosteric PK activator, improves anemia and hemolysis in adult patients with PK deficiency.

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Continuity planning prepares organizations to maintain essential functions despite disruptions to critical infrastructure that occur during crises. Continuity planning is especially important for Public-Safety Answering Points (PSAPs), which must prepare to answer 911 calls and dispatch first responders in all-hazard environments, including public health crises such as the COVID-19 pandemic. However, continuity planning typically focuses on disruptions to cyber-physical infrastructure rather than social infrastructure disruptions that occur when outbreaks of communicable disease limit the ability of essential personnel to perform an organization's essential functions.

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