Signals in Health Inequity: Examining Social Needs and Costs in a Large Health System.

Previous research has demonstrated that social determinants of health are drivers of medical utilization, cost, and health outcomes. In this study, we compared the mean annual total cost to deliver health services per patient by health-related social need (HRSN) status and total HRSNs using linear regression and ANOVA, respectively. Patients with ≥1 HRSN (n = 8409) yielded $1772 higher annual costs compared to patients without HRSNs (n = 34 775) (P < .

A rural ambulance service in Northern Togo improves access to emergency care for women with obstetric complications.

Background: Maternal mortality remains high in sub-Saharan Africa, with little progress made in the last 20 years. The provision of emergency obstetric care has been shown to have the greatest effect in reducing maternal mortality in countries with high maternal mortality ratios, especially when paired with an emergency transport service. Integrate Health has partnered with the Togolese Ministry of Health to improve maternal and child health via the integration of a free ambulance service into a pre-existing primary care model.

Damping excessive viral-induced IFN-γ rescues the impaired anti-Aspergillus host immune response in influenza-associated pulmonary aspergillosis.

Background: Influenza-associated pulmonary aspergillosis (IAPA) is a severe fungal superinfection in critically ill influenza patients that is of incompletely understood pathogenesis. Despite the use of contemporary therapies with antifungal and antivirals, mortality rates remain unacceptably high. We aimed to unravel the IAPA immunopathogenesis as a means to develop adjunctive immunomodulatory therapies.

OTULIN haploinsufficiency predisposes to environmentally directed inflammation.

Recently, OTULIN haploinsufficiency was linked to enhanced susceptibility to infections accompanied by local necrosis and systemic inflammation. The pathogenesis observed in haploinsufficient patients differs from the hyperinflammation seen in classical OTULIN-related autoinflammatory syndrome (ORAS) patients and is characterized by increased susceptibility of dermal fibroblasts to alpha toxin-inflicted cytotoxic damage. Immunological abnormalities were not observed in OTULIN haploinsufficient patients, suggesting a non-hematopoietic basis.

Understanding individual health-related social needs in the context of area-level social determinants of health: The case for granularity.

Introduction: Screening for health-related social needs (HRSNs) within health systems is a widely accepted recommendation, however challenging to implement. Aggregate area-level metrics of social determinants of health (SDoH) are easily accessible and have been used as proxies in the interim. However, gaps remain in our understanding of the relationships between these measurement methodologies.

Advancing social care integration in health systems with community health workers: an implementation evaluation based in Bronx, New York.

Background: In recent years, health systems have expanded the focus on health equity to include health-related social needs (HRSNs) screening. Community health workers (CHWs) are positioned to address HRSNs by serving as linkages between health systems, social services, and the community. This study describes a health system's 12-month experience integrating CHWs to navigate HRSNs among primary care patients in Bronx County, NY.

Barriers and facilitators to implementing a multilevel, multicomponent intervention promoting colorectal cancer screening in health centers: a qualitative study of key informant perspectives.

Background: Colorectal cancer (CRC) continues to be a major cause of death in the U.S. despite the availability of effective screening tools.

Identifying determinants of under-five child mortality in northern Togo.

Background: Although global rates of under-five mortality have declined, many low- and middle-income countries (LMICs), including Togo, have not achieved sufficient progress. We aimed to identify the structural and intermediary determinants associated with under-five mortality in northern Togo.

Methods: We collected population-representative cross-sectional household surveys adapted from the Demographic Household Survey (DHS) and Multiple Indicator Cluster Survey from women of reproductive age in northern Togo in 2018.

Learning in real world practice: Identifying implementation strategies to integrate health-related social needs screening within a large health system.

Introduction: Health systems have many incentives to screen patients for health-related social needs (HRSNs) due to growing evidence that social determinants of health impact outcomes and a new regulatory context that requires health equity measures. This study describes the experience of one large urban health system in scaling HRSN screening by implementing improvement strategies over five years, from 2018 to 2023.

Methods: In 2018, the health system adapted a 10-item HRSN screening tool from a widely used, validated instrument.

Labour conditions in dual-cadre community health worker programmes: a systematic review.

Background: Health care delivered by community health workers reduces morbidity and mortality while providing a considerable return on investment. Despite growing consensus that community health workers, a predominantly female workforce, should receive a salary, many community health worker programmes take the form of dual-cadre systems, where a salaried cadre of community health workers works alongside a cadre of unsalaried community health workers. We aimed to determine the presence, prevalence, and magnitude of exploitation in national dual-cadre programmes.

CTLA4-Ig Effectively Controls Clinical Deterioration and Immune Condition in a Murine Model of Foxp3 Deficiency.

Purpose: FOXP3 deficiency results in severe multisystem autoimmunity in both mice and humans, driven by the absence of functional regulatory T cells. Patients typically present with early and severe autoimmune polyendocrinopathy, dermatitis, and severe inflammation of the gut, leading to villous atrophy and ultimately malabsorption, wasting, and failure to thrive. In the absence of successful treatment, FOXP3-deficient patients usually die within the first 2 years of life.

Unmet Social Needs and Pediatric Asthma Severity in an Urban Primary Care Setting.

Objective: Community-level social determinants of health impact asthma outcomes among children; however, individual patient's priorities are not often included in designing social care interventions. Identifying connections between patient-prioritized unmet social needs and asthma severity status may allow for improved patient-centered approaches to asthma management. In this analysis, we examined the association between unmet social needs and asthma severity in an urban population of children.

Gene Delivery of Manf to Beta-Cells of the Pancreatic Islets Protects NOD Mice from Type 1 Diabetes Development.

In type 1 diabetes, dysfunctional glucose regulation occurs due to the death of insulin-producing beta-cells in the pancreatic islets. Initiation of this process is caused by the inheritance of an adaptive immune system that is predisposed to responding to beta-cell antigens, most notably to insulin itself, coupled with unknown environmental insults priming the autoimmune reaction. While autoimmunity is a primary driver in beta-cell death, there is growing evidence that cellular stress participates in the loss of beta-cells.

Two-year outcomes of Faith in Action/Fe en Acción: a randomized controlled trial of physical activity promotion in Latinas.

Background: Latina women are less likely to report engaging in leisure-time physical activity (PA) than non-Latina white women. This study evaluated the 24-month impact of a faith-based PA intervention targeting Latinas.

Methods: The study is a cluster randomized controlled trial of a PA intervention or cancer screening comparison condition, with churches as the randomization unit.

Bayesian inference on a microstructural, hyperelastic model of tendon deformation.

Microstructural models of soft-tissue deformation are important in applications including artificial tissue design and surgical planning. The basis of these models, and their advantage over their phenomenological counterparts, is that they incorporate parameters that are directly linked to the tissue's microscale structure and constitutive behaviour and can therefore be used to predict the effects of structural changes to the tissue. Although studies have attempted to determine such parameters using diverse, state-of-the-art, experimental techniques, values ranging over several orders of magnitude have been reported, leading to uncertainty in the true parameter values and creating a need for models that can handle such uncertainty.

Comparing Latino Community Members' and Clinical Staff's Perspectives on Barriers and Facilitators to Colorectal Cancer Screening.

Latinos in the United States have low rates of colorectal cancer (CRC) screening even though CRC is the third leading cause of cancer death among Latinos. This qualitative study aimed to understand and compare the perspectives of clinical staff (CS) and Latino community members (LCMs) in an urban Southern California community regarding barriers and facilitators of CRC screening. Through purposive sampling, 39 LCMs (mean age: 59.

Psychosocial Correlates of Meeting National Guidelines for Muscle-Strengthening Activities in Latinas.

Background: Performing regular muscle-strengthening activity has numerous health benefits, including improvements in blood pressure, hemoglobin A1c, and lean body mass. Despite the disproportionate prevalence of lifestyle-related chronic disease in Latinas (diabetes, hypertension, obesity), most do not report meeting the national guidelines for muscle-strengthening activity. Existing physical activity (PA) research in Latinas has focused almost exclusively on aerobic PA.

The experience of nutritional care according to patients with head and neck cancer involved with a combined dietitian, specialist nurse and speech pathologist clinic in a regional Australia: a qualitative longitudinal study.

Purpose: Malnutrition is a co-morbidity of head and neck cancer (HNC) that has negative consequences for patients. Evidence-based guidelines (EBGs) provide recommendations to prevent and manage malnutrition. A clinic that combines the services of a dietitian, specialist oncology nurse and speech pathologist may promote the implementation of nutritional EBGs in regional Australia.

Real-world experience with caplacizumab in the management of acute TTP.

The cornerstone of life-saving therapy in immune-mediated thrombotic thrombocytopenic purpura (iTTP) has been plasma exchange (PEX) combined with immunomodulatory strategies. Caplacizumab, a novel anti-von Willebrand factor nanobody trialed in 2 multicenter randomized controlled trials (RCTs) leading to European Union and US Food and Drug Administration approval, has been available in the United Kingdom (UK) through a patient access scheme. Data were collected retrospectively from 2018 to 2020 for 85 patients (4 children) receiving caplacizumab from 22 UK hospitals.

Real-world Outcomes With Rituximab-based Therapy for Posttransplant Lymphoproliferative Disease Arising After Solid Organ Transplant.

Background: Optimal upfront therapy for posttransplant lymphoproliferative disease (PTLD) arising after solid organ transplant remains contentious. Rituximab monotherapy (R-Mono) in unselected patients has shown a lack of durable remissions. Cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP)-based chemotherapy confers improved response rates, although concerns exist about toxicity.

Identifying barriers, facilitators, and implementation strategies for a faith-based physical activity program.

Background: Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale-up, and sustainment of evidence-based interventions. () is an evidence-based -led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women.

Development of a Group-Based Community Health Worker Intervention to Increase Colorectal Cancer Screening Among Latinos.

Introduction: Latinos are at higher risk of colorectal cancer (CRC) mortality than non-Hispanic Whites due, in part, to disparities in cancer screening. There is a need to evaluate community-based CRC interventions as they may reach underinsured communities and those at highest risk for CRC. This article describes the development of a group-based CRC intervention ().

A -Led Pilot Study to Increase Colorectal Cancer Screening in Latinos: The Program.

Latinos have lower colorectal cancer (CRC) screening rates compared to other racial/ethnic groups in the United States, despite an overall increase in CRC screening over the past 10 years. To address this disparity, we implemented a -led intervention to increase CRC screening test adherence in community-based settings, connecting community members with a partnering federally qualified health center. .

Effects of 90Sr on Tree Swallow Nestlings Near Groundwater Contaminant Plumes.

Discharge of groundwater contaminant plumes has created elevated concentrations of Sr in some aquatic sediments at Chalk River Laboratories. Tree swallows (Tachycenita bicolor) feed and supply their nestlings almost exclusively with airborne insects that developed as larvae in aquatic sediments. To monitor the uptake and test for potential detriment due to Sr in a terrestrial animal, we measured the gross beta concentrations in the bone of 12-d-old tree swallow nestlings in areas having sediments with elevated levels of gross beta (Sr and Y) and in several control areas where sediment gross beta was primarily due to naturally occurring K.