(In)Equity and Primary Health Care: The Case of Costa Rica and Panama.

The 1970s marked a significant opportunity for improving primary health care globally. Yet, political will and widescale investment to achieve "health for all" vastly diverged in countries across the Americas in the decades that followed. Distinct ideologies and models of health care emerged following commitments to social investment, equity, and community participation at Alma-Ata.

Development and Validation of a Model to Predict Malignancy Within the First Year After Adult Heart Transplantation.

Malignancy after heart transplantation is associated with poor outcomes. At present, no prediction model exists for any malignancy within the first year after transplant. We studied adults who underwent heart transplantation included in the multicenter, national Scientific Registry of Transplant Recipients from January 2000 through April 2021.

A RIVA-DM Subanalysis Investigating Patients With Nonvalvular Atrial Fibrillation and Type 2 Diabetes Aged Under Versus Over 80 Years.

Background: Advanced age and type 2 diabetes (T2D) are common in patients with nonvalvular atrial fibrillation (NVAF). We evaluated the impact of age on the effectiveness and safety of rivaroxaban versus warfarin in this population.

Methods: We analyzed electronic health record data from November 2010, to December 2019 including adults with NVAF and T2D, newly started on rivaroxaban or warfarin.

Informing Parents as Caregivers With a Symptom Assessment App Developed for Children With Cancer.

Mobile health technologies can assist children to communicate their symptom experiences in a developmentally appropriate format. However, few investigations have examined how mHealth resources may also assist parents in their caregiver role. The purpose of this study was to explore how a symptom assessment app designed for school-age children with cancer could further inform parents as caregivers.

Exploring drivers of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in Malaysia.

Background: Pre-exposure prophylaxis (PrEP) is a valuable HIV prevention strategy, particularly among men who have sex with men (MSM); however, PrEP uptake is below the threshold needed to curb the HIV epidemic among this group, especially in settings like Malaysia, where same-sex sexual behavior is illegal.

Methods: A sample of 355 participants completed an online survey between June and July 2020, recruited through geosocial networking apps for MSM and social networking websites (e.g.

County-Level Factors Matter: The Role of Contextual Factors in Foster Youths' Extended Foster Care Participation and Human Capital Outcomes.

Extended foster care (EFC) is an important policy that supports human capital attainment for foster youth transitioning to adult independence. Previous studies have examined youth- and policy-level factors' influence on EFC participation and human capital outcomes (e.g.

The Multi-Caregiver Role and Its Relationship to Behavioral Adherence and Weight Among Treatment Engaged Black Women.

Purpose: To examine the relationship between the multiple caregiver role and its perceived barriers to self-care on behavioral adherence in a weight loss intervention.

Design: A secondary analysis of data from a behavioral weight loss intervention.

Setting: The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill.

Miranda Warning Comprehension: The Influence of Verbal Aptitude and Hearing Status.

The Miranda warning was drafted in order to inform people of their rights upon arrest in an easy to understand manner. However, to understand the warning a person needs a high school level reading comprehension (which is above the level of most offenders). Among these offenders, deaf and hard-of-hearing (DHH) individuals are particularly prone to misinterpreting the Miranda warning due to language barriers with law enforcement and below average English literacy compared to hearing individuals.

Feeling Not Wanted/Loved and Depression: Does Gender Matter?

Depression affects over 17 million American adults yearly and has been identified as the leading cause of disability in people between the ages of 15 and 44 years. There is evidence that feeling neglect or a lack of parental attachment during childhood is associated with depression. One construct that has been overlooked is love from a parent.

Tempo and Mode in Cultural Macroevolution.

Evolutionary scientists studying social and cultural evolution have proposed a multitude of mechanisms by which cultural change can be effected. In this article we discuss two influential ideas from the theory of biological evolution that can inform this debate: the contrast between the micro- and macro-evolution, and the distinction between the tempo and mode of evolution. We add the empirical depth to these ideas by summarizing recent results from the analyses of data on past societies in .

Implementation of Return to Learn Protocols for Student Athletes with Sport and Recreation Related Concussion: An Integrative Review of Perceptions, Challenges and Successes.

Concussion or mild traumatic brain injury (mTBI) is a common phenomenon in the United States, with up to 3.6 million sport-related mTBIs diagnosed annually. Return to learn protocols have been developed to facilitate the reintegration of students into school after mTBI, however, the implementation of return to learn protocols varies significantly across geographic regions and school districts.

A semiparametric mixed-effects model for censored longitudinal data.

In longitudinal studies involving laboratory-based outcomes, repeated measurements can be censored due to assay detection limits. Linear mixed-effects (LMEs) models are a powerful tool to model the relationship between a response variable and covariates in longitudinal studies. However, the linear parametric form of linear mixed-effect models is often too restrictive to characterize the complex relationship between a response variable and covariates.

Undetected anogenital sexually transmitted infections among young adults living with HIV and receiving antiretroviral therapy: Implications for HIV treatment as prevention.

Undetected sexually transmitted infections (STIs) pose health threats to people living with HIV and when combined with uncontrolled HIV can amplify HIV transmission. The current study screened 174 self-identified men under age 36 living with HIV and receiving antiretroviral therapy (ART) for urethral and rectal incident chlamydia and gonorrhea infections. Participants were also screened for biomarkers indicating alcohol and other drug use, subclinical genital inflammation, and HIV viral load.

Connected After Care: Youth Characteristics, Policy, and Programs Associated With Postsecondary Education and Employment for Youth With Foster Care Histories.

Recent federal laws and state policies reflect the government's investment in improving education and employment outcomes for youth with foster care histories. However, little research has assessed the roles of these programs using national data. Drawing on data from the National Youth in Transitions Database (NYTD) ( = 7797), this study examines the roles that state-level policies and programs, youth-level participation in programs and services, and youth characteristics play in youths' connection to employment and education ("connectedness") at age 21.

Does Targeted Temperature Management Improve Neurological Outcome in Extracorporeal Cardiopulmonary Resuscitation (ECPR)?

Purpose: Targeted temperature management (TTM) is a standard of care in patients after cardiac arrest for neuroprotection. Currently, the effectiveness and efficacy of TTM after extracorporeal cardiopulmonary resuscitation (ECPR) is unknown. We aimed to compare neurological and survival outcomes between TTM vs non-TTM in patients undergoing ECPR for refractory cardiac arrest.

Community Coalition Efforts to Prevent Adolescent Substance Use: A Systematic Review.

A systematic review explored the creation and maintenance of community coalitions as effective for alcohol and other drug (AOD) prevention in adolescence. Community coalitions influence the implementation of effective and sustainable community-based prevention via infrastructure supporting development, delivery, and assessment of human service issues. For this review, 1,435 articles were identified, most including insufficient detail on the purposes and activities of coalitions or focus on adolescents.

Integration of the Screening, Brief Intervention, and Referral to Treatment Screening Instrument Into School Nurse Practice.

Substance abuse in adolescents has been recognized as a public health problem at the national and global levels. Adolescents are at risk for experimenting with substances. School nurses in secondary schools are well positioned to screen and counsel students on substance use.

Analysis of the Theory of Integrative Nurse Coaching.

The Theory of Integrative Nurse Coaching (TINC) has been analyzed according to the method of Walker and Avant. We have found that TINC is a well-constructed mid-range theory in the discipline of nursing. Within the domain of holistic nursing, it is focused on the goal of healing the whole person, synthesizing a large amount of theoretical material related to the concept of healing and placing it within the context of nursing as a discipline.

Behavioral Activation and Therapeutic Exposure vs. Cognitive Therapy for Grief Among Combat Veterans: A Randomized Clinical Trial of Bereavement Interventions.

Approximately two-thirds of Operations Enduring Freedom, Iraqi Freedom, and New Veterans reported knowing someone who was killed or seriously injured, lost someone in their immediate unit, or personally saw dead or seriously injured Americans (Hoge et al., 2004; Thomas et al., 2010; Toblin et al.

The Role of Angioembolization in Hepatic Trauma.

The liver is one of the most commonly injured solid organs in blunt abdominal trauma. Non-operative management is considered to be the gold standard for the care of most blunt liver injuries. Angioembolization has emerged as an important adjunct that is vital to the success of the non-operative management strategy for blunt hepatic injuries.

Understanding Children's Emotions: Differences in Mothers With a History of Childhood Maltreatment.

Experiencing maltreatment in childhood can have a lasting impact on how individuals identify and understand emotions in others. Research in this area has not examined parents' understanding of children's emotions, although emotion processing deficits may be one mechanism linking childhood maltreatment to subsequent parenting problems. In a matched case-control design, we test whether mothers with ( = 50) and without ( = 96) childhood maltreatment differ in their understanding of children's emotions on self-report measures and computer-based tasks.

Overestimation of Postpartum Depression Prevalence Based on a 5-item Version of the EPDS: Systematic Review and Individual Participant Data Meta-analysis.

Objective: The Maternal Mental Health in Canada, 2018/2019, survey reported that 18% of 7,085 mothers who recently gave birth reported "feelings consistent with postpartum depression" based on scores ≥7 on a 5-item version of the Edinburgh Postpartum Depression Scale (EPDS-5). The EPDS-5 was designed as a screening questionnaire, not to classify disorders or estimate prevalence; the extent to which EPDS-5 results reflect depression prevalence is unknown. We investigated EPDS-5 ≥7 performance relative to major depression prevalence based on a validated diagnostic interview, the Structured Clinical Interview for DSM (SCID).

Sex Hormones, BDNF, Leptin, and TGF-β1 in Females With IBS: A Pilot Investigation.

Background: Irritable bowel syndrome (IBS) is a chronic gastrointestinal condition predominantly affecting the female sex, and is characterized by brain-gut axis dysregulation. Relevance of hormones along the hypothalamic-pituitary gonadal axis and hypothalamic-pituitary adrenal axis to IBS symptomatology remain unclear, as does the significance of other modulators including brain derived neurotrophic factor (BDNF), leptin, and transforming growth factor βeta 1 (TGF-β1).

Methods: Females with IBS were compared with female healthy controls (HC) on age, race, hormonal contraceptive use, body mass index, adrenocorticotropic hormone, cortisol, estradiol, follicular stimulating hormone, luteinizing hormone, progesterone, total cholesterol, Center for Epidemiological Studies Depression Scale (CES-D) and Perceived Stress Scale (PSS).