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1.
Health Aff (Millwood) ; 41(10): 1433-1441, 2022 10.
Article in English | MEDLINE | ID: covidwho-2114455

ABSTRACT

The Affordable Care Act mandated data collection standards to identify people with disabilities in federal surveys to better understand and address health disparities within this population. Most federal surveys use six questions from the American Community Survey (ACS-6) to identify people with disabilities, whereas many international surveys use the six-item Washington Group Short Set (WG-SS). The National Survey on Health and Disability (NSHD), which focuses on working-age adults ages 18-64, uses both question sets and contains other disability questions. We compared ACS-6 and WG-SS responses with self-reported disability types. The ACS-6 and WG-SS failed to identify 20 percent and 43 percent, respectively, of respondents who reported disabilities in response to other NSHD questions (a broader WG-SS version missed 4.4 percent of respondents). The ACS-6 and the WG-SS performed especially poorly in capturing respondents with psychiatric disabilities or chronic health conditions. Researchers and policy makers must augment or strengthen federal disability questions to improve the accuracy of disability prevalence counts, understanding of health disparities, and planning of appropriate services for a diverse and growing population.


Subject(s)
Disabled Persons , Patient Protection and Affordable Care Act , Adolescent , Adult , Health Policy , Health Surveys , Humans , Middle Aged , Surveys and Questionnaires , United States , Young Adult
2.
Sci Adv ; 7(52): eabk1755, 2021 Dec 24.
Article in English | MEDLINE | ID: covidwho-1608794

ABSTRACT

The 2020 U.S. election saw a record turnout, saw a huge increase in absentee voting, and brought unified national Democratic control­yet these facts alone do not imply that vote-by-mail increased turnout or benefited Democrats. Using new microdata on millions of individual voters and aggregated turnout data across all 50 states, this paper offers a causal analysis of the impact of absentee vote-by-mail during the COVID-19 (coronavirus disease 2019) pandemic. Focusing on natural experiments in Texas and Indiana, we find that 65-year-olds voted at nearly the same rate as 64-year-olds, despite the fact that only 65-year-olds could vote absentee without an excuse. Being just old enough to vote no-excuse absentee did not substantially increase Democratic turnout relative to Republican turnout. Voter interest appeared to be more important in driving turnout across vote modes, neutralizing the electoral impact of Democrats voting by mail at higher rates during the historic pandemic.

3.
Disabil Health J ; 15(1): 101223, 2022 01.
Article in English | MEDLINE | ID: covidwho-1568629

ABSTRACT

BACKGROUND: It is important for people with disabilities to be vaccinated against COVID-19 because, as a group, they are at increased risk of severe outcomes. While there are multiple vaccines available to prevent COVID-19, a considerable proportion of Americans report some hesitancy to becoming vaccinated, including people with disabilities. OBJECTIVE: We conducted a study to explore what factors may contribute to COVID-19 vaccination hesitancy among Americans with disabilities. METHODS: We used Amazon's Mechanical Turk to survey 439 people with disabilities (ages 18+) about their concerns of the COVID-19 disease, vaccines, and hesitancy toward vaccination to learn more about factors that influence vaccination hesitancy. Concerns about vaccines were analyzed as a composite variable representing different dimensions such as: side effects, too new, developed too quickly, influenced by politics, and effectiveness. RESULTS: Results from a logistic regression indicate that concern about vaccines was the most significant predictor of hesitancy, even after considering demographic, economic, and geographic factors. Concerns about getting COVID-19, getting tested for COVID-19, trust in experts, education, and being a Democrat were negatively associated with hesitancy. CONCLUSIONS: These findings indicate that some groups of individuals may be more vaccination hesitant because they are more concerned about vaccine safety than COVID-19 infection. Public health messaging that focuses on the risks of vaccines relative to the risks of COVID-19 might be one strategy to reduce hesitancy and increase vaccination uptake. Messaging should also be tailored to specific disabilities (i.e. physical, mental, sensory), written in plain language, and disseminated in accessible formats.


Subject(s)
COVID-19 , Disabled Persons , Adolescent , COVID-19 Vaccines , Humans , SARS-CoV-2 , Vaccination , Vaccination Hesitancy
4.
Nature ; : 1-6, 2021.
Article in English | EuropePMC | ID: covidwho-1489898

ABSTRACT

The dearth of new medicines effective against antibiotic-resistant bacteria presents a growing global public health concern1. For more than five decades, the search for new antibiotics has relied heavily on the chemical modification of natural products (semisynthesis), a method ill-equipped to combat rapidly evolving resistance threats. Semisynthetic modifications are typically of limited scope within polyfunctional antibiotics, usually increase molecular weight, and seldom permit modifications of the underlying scaffold. When properly designed, fully synthetic routes can easily address these shortcomings2. Here we report the structure-guided design and component-based synthesis of a rigid oxepanoproline scaffold which, when linked to the aminooctose residue of clindamycin, produces an antibiotic of exceptional potency and spectrum of activity, which we name iboxamycin. Iboxamycin is effective against ESKAPE pathogens including strains expressing Erm and Cfr ribosomal RNA methyltransferase enzymes, products of genes that confer resistance to all clinically relevant antibiotics targeting the large ribosomal subunit, namely macrolides, lincosamides, phenicols, oxazolidinones, pleuromutilins and streptogramins. X-ray crystallographic studies of iboxamycin in complex with the native bacterial ribosome, as well as with the Erm-methylated ribosome, uncover the structural basis for this enhanced activity, including a displacement of the Structure-guided design and component-based synthesis are used to produce iboxamycin, a novel ribosome-binding antibiotic with potent activity against Gram-positive and Gram-negative bacteria.

5.
Disabil Health J ; 14(2): 101062, 2021 04.
Article in English | MEDLINE | ID: covidwho-1064992

ABSTRACT

BACKGROUND: Trust of information shapes adherence to recommended practices and speed of public compliance during public health crises. This is particularly important for groups with higher rates of high-risk health conditions, including those aged 65 and over and people with disabilities. OBJECTIVE: We examined trust in information sources and associated adherence to COVID-19 public health recommendations among people with disabilities living in metropolitan, micropolitan, and noncore counties. METHODS: We recruited participants using Amazon's Mechanical Turk (MTurk) and screened for disability status (n = 408). We compared sociodemographic groups with t-tests, Pearson's correlations, and Chi-square, as appropriate. We used linear regression to examine factors associated with trust in information and compliance with CDC recommended COVID-19 practices. RESULTS: Nonmetro respondents had the lowest trust ratings among all demographic groups, and reported significantly less trust in most information sources. Respondents aged 65 and over reported the highest compliance with CDC recommended practices, while those from nonmetro areas reported the lowest. A regression model for adherence to CDC recommended practices was significant (F = 11.87, P ≤ .001), and explained 33% of the variance. Specifically, increased adherence was associated with being over 65, female, and higher general trust scores. Decreased practices were associated with being nonwhite, nonmetro, higher trust scores in President Trump, and having a communication disability. CONCLUSIONS: Trust in information sources is associated with action. It is important to provide clear, consistent, and non-polarizing messages during public health emergencies to promote widespread community action.


Subject(s)
COVID-19/prevention & control , Disabled Persons/psychology , Health Behavior , Health Communication , SARS-CoV-2 , Trust/psychology , Adolescent , Adult , Aged , Cross-Sectional Studies , Disabled Persons/statistics & numerical data , Female , Humans , Male , Middle Aged , Young Adult
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