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Climatic changes pose significant risks to the demand stability of coastal community-based small businesses (CSBs) due to the inherent vulnerability of their catchment areas. Given such threats, it is imperative for urban and regional spatial planning to incorporate CSB adaptation with a thorough assessment of their vulnerabilities. However, the extant assessments of CSB vulnerabilities have focused on internal business patterns, lacking a quantitative understanding of catchment vulnerabilities that affected customer visitations. We thus quantify CSB vulnerability by assessing the social and spatial characteristics of catchment areas through an access-based, data-driven approach using the CSB-Catchment Vulnerability Index (CCVI). The CCVI integrates indicators of social vulnerability and predicted hazard exposure to holistically evaluate CSB catchment vulnerability to flood disturbances. Our analysis across Florida's 17 coastal metropolitan areas reveals notable disparities in catchment vulnerability, highlighting the "coastal fringe trap"—a pattern where CSBs on coastal fringes have more socially vulnerable catchments than those near the coast. We also identify significant vulnerabilities in CSBs across three sectoral groups—tourism-related, essential retail, and social services—each differing in their exposure to hazards, social vulnerability, and combined risks. The findings inform local and regional spatial adaptation planning to enhance the economic resilience of CSBs in coastal areas. The data-driven CCVI framework also offers a versatile tool for assessing catchment vulnerabilities of other social infrastructures that serve at-risk populations. [ABSTRACT FROM AUTHOR]

Housing credit inflows are a substantial contributor to the economic opportunities and vitality of a community. However, these opportunities have not been dispersed equitably across diverse subpopulations and neighborhoods. Although various public and private initiatives have been launched to address inequitable access to mortgage capital, the role of localized and decentralized housing programs in achieving racially equitable outcomes remains understudied. As a case study, this study examines whether a decentralized and localized housing policy without explicit regulations for resource distribution across racial and ethnic groups promotes racial and neighborhood equity, focusing on its role in serving racial minority households and neighborhoods underserved by private mortgage markets. By incorporating various statistical methods, this study provides evidence that controlling for other factors, the program disproportionately supports racial minority households and neighborhoods that are underserved by private mortgage capital, although this positive role can vary across localities. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To introduce a multi-site assessment of oral health literacy and to describe preliminary analyses of the relationships between health literacy and selected oral health outcomes within the context of a comprehensive conceptual model. METHODS: Data for this analysis came from the Multi-Site Oral Health Literacy Research Study (MOHLRS), a federally funded investigation of health literacy and oral health. MOHLRS consisted of a broad survey, including several health literacy assessments, and measures of attitudes, knowledge, and other factors. The survey was administered to 922 initial care-seeking adult patients presenting to university-based dental clinics in California and Maryland. For this descriptive analysis, confidence filling out forms, word recognition, and reading comprehension comprised the health literacy assessments. Dental visits, oral health functioning, and dental self-efficacy were the outcomes. RESULTS: Overall, up to 21% of participants reported having difficulties with practical health literacy tasks. After controlling for sociodemographic confounders, no health literacy assessment was associated with dental visits or dental caries self-efficacy. However, confidence filling out forms and word recognition were each associated with oral health functioning and periodontal disease self-efficacy. CONCLUSIONS: Our analysis showed that dental school patients exhibit a range of health literacy abilities. It also revealed that the relationship between health literacy and oral health is not straightforward, depending on patient characteristics and the unique circumstances of the encounter. We anticipate future analyses of MOHLRS data will answer questions about the role that health literacy and various mediating factors play in explaining oral health disparities.

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Commercial businesses in an area affected by a natural hazard can have significant interruption and disruption because of damage and impeding factors including financing delays. The recovery of commercial buildings is a necessary but not solely sufficient condition for owners to reopen their businesses. At the community-level modeling scale for planning, the ability to model commercial recovery across the entire community, including short-term business operation disruption, is critical to understanding the interdependent recovery across engineering, economics, and social science. This study proposes a probabilistic commercial building recovery model to predict the recovery of commercial buildings over time following a hazard event and considers two critical types of downtime: (1) impeding factors such as financing delays, and (2) the repair process. A typical recovery resource portfolio available to business owners was developed and quantitatively incorporated into the proposed probabilistic commercial building recovery model. The ability to model commercial building recovery will inform decision makers of the entire recovery process for upcoming business recovery and community resilience metrics related to physical services stability, thereby improving community resilience planning. [ABSTRACT FROM AUTHOR]

Latino youths completed surveys about their knowledge of risk factors for oral cancer and tobacco and alcohol use. Additionally, trained youths attempted to purchase cigarettes from local stores. Respondents were ill-informed about oral cancer. Over half knew risk factors for smoking and alcohol use. Over half of the stores would have sold cigarettes to minors without asking for identification. (SM)

Food pantries play a growing role in supporting households facing or at risk of food insecurity in the United States. They also support emergency response and recovery following disasters and extreme weather events. Although food pantries are often placed in close proximity to communities with the highest rates of poverty and risk of food insecurity, access to these facilities can be disrupted during and after extreme events. Decreased access to food pantries following disasters can be particularly problematic as the need for these services is also likely to grow after such events. Despite the vast body of research on food retail access and food environments, relatively little research has utilized spatial analysis to understand food pantry access, particularly after extreme events. Using Geographic Information Systems (GIS), we characterize changes in access to food pantries following flooding events in Harris County, Texas—a highly populated and flood prone region with high levels of food insecurity and poverty. Specifically, our study models disruptions in road networks due to flooding and assesses the impacts of these disruptions on proximity to food pantries. The results reveal that much of Harris County sees only small increases in travel distance to food pantries due to extreme flooding, but some areas may be unable to access food pantries at all. This research highlights the potential and some of the limits of private food assistance networks to support emergency response efforts. [ABSTRACT FROM AUTHOR]

Screening for HLA-B*5701 reduces the risk of developing an abacavir hypersensitivity reaction (ABC HSR) and is recommended in all patients before initiating highly active antiretroviral therapy (HAART) with abacavir. Between September 2007 and March 2008 we conducted a study of the attitudes and practice patterns of HIV providers in the United States to identify barriers to HLA-B*5701 testing in clinical practice. Study participants who completed an educational program could receive HLA-B*5701 test kits for use in their clinical practice. Surveys were administered before and after the educational program. A total of 477 HIV providers registered to participate in the survey, and 134 providers tested a total of 874 HIV-infected subjects, of which 6% (49/874) were HLA-B*5701 positive. Of 433 providers who completed the preeducation survey, 97% indicated that the test provided clinical value and 77% anticipated barriers to testing, with cost/reimbursement the most frequently cited. Among 202 providers who completed the posteducation survey, perceptions of the test's value remained largely unchanged while the proportion of providers who anticipated or encountered barriers to testing decreased. Of providers who used HLA-B*5701 test kits, 86% (115/134) found it 'very easy' or 'easy' to obtain test results, 95% (127/134) found it 'very easy' or 'easy' to interpret results, and 89% (119/134) indicated that they planned to continue HLA-B*5701 testing after the study. The results of this study suggest that HLA-B*5701 testing is easy to use in clinical practice and is a valuable tool to help reduce the risk of developing ABC HSR. DOI: 10.1089/apc.2008.0245

While African Americans in the United States are disproportionately affected by HIV, they are less likely to take antiretroviral therapies. Different first-line antiretroviral therapies are associated with short-term and long-term adverse event (AE) risks. We estimated the willingness of antiretroviral-naive, HIV-positive African Americans to accept risks of acute AEs with known outcomes and long-term AEs with uncertain outcomes in exchange for virologic suppression. We estimated the relative importance of short-term and long-term AE risks. Two hundred thirty-five subjects were recruited through eight clinics in the United States. One hundred fifty-eight subjects met study inclusion criteria. One hundred fifty-three subjects completed a series of choice-format conjoint trade-off tasks. In each task, subjects were asked to choose between two hypothetical treatments with varying levels of virologic failure, risks of hypersensitivity reaction, decreases in bone mineral density (BMD), and renal impairment, and outcome uncertainty associated with the risks of decreased BMD and renal impairment. Attributes were expressed as probabilities of occurrence. We calculated the relative importance of each AE and the level of risk subjects would accept to reduce the risk of virologic failure. Subjects indicated that short-term Aes with relatively certain outcomes are preferred to long-term AEs with uncertain outcomes. Subjects were strongly averse to the risk of decreased BMD that could not be treated successfully or when the outcome was uncertain and to the risk of renal impairment that could not be treated successfully. Subjects were willing to accept increased risks of AEs in exchange for lower risk of virologic failure.

A study to compare the efficacy and safety of the fixed-dose combination group to the separate entities group, in combination with tenofovir and a new protease inhibitor or nonnucleoside reverse transcription inhibitor in antiretroviral-experienced adults experiencing virologic failure is illustrated. Combination antiretroviral therapy has dramatically reduced the morbidity and mortality associated with HIV infection and a one-tablet, once-daily abacavir/lamivudine (FDC) has been recently approved to treat HIV-1 infection.

Abacavir (ABC) and lamivudine (3TC) administered twice daily, were compared with an ABC + 3TC fixed-dose combination administered once daily, both in combination with a protease inhibitor (PI) or nonnucleoside reverse transcriptase inhibitor (NNRTI). It was shown that a dual-nucleoside backbone of ABC and 3TC administered once or twice daily is effective, durable and well tolerated.

The United States Census Bureau in the year 2000 presented that a large group of Hispanic community suffers from the oral health disparities. The Hispanic Dental Association (HDA) and the University of Puerto Rico School of Dentistry developed a scheme for research on Latino oral health in October 2004. The priorities that must be considered for the research are mentioned.

Disaster assistance in the United States has faced criticism for widening the unequal impacts of disasters, but little is known about whether and how this phenomenon applies to businesses. Small businesses make up most businesses in the United States, but they are particularly vulnerable to hazards given their relative lack of capital. Because recovery assistance to businesses is primarily loan based, this lack of capital can create conflicts in how aid is perceived and allocated. Assistance providers must balance aiding the most severely damaged businesses and lending to those that will be able to repay; for small business, the threat of additional debt can make even low-interest loans seem risky. With this research I attempted to better understand how these competing factors play out in recovery through regression analyses of approved loan amounts and loan utilization decisions in Galveston (TX) after Hurricane Ike. I found that businesses with higher repayment ability such as larger businesses, older businesses, and corporations were approved for high loan amounts. Smaller businesses, businesses with higher damage, and businesses with longer loan terms were less likely to use the loans in their recovery, despite being approved. These findings suggest that businesses with the resources to recover were more likely to be the ones benefiting from additional disaster assistance. These findings suggest that planners may need to create their own recovery programs specifically targeting subgroups of businesses that are important to their communities. Although important to many economic development initiatives, very small businesses, entrepreneurs, and sole proprietors may not benefit from federal assistance, particularly if they were severely damaged. [ABSTRACT FROM AUTHOR]

Poor children are less likely to receive preventive dental care than children in upper income brackets. States must do more to encourage Medicaid-eligible families to enroll in Medicaid and the State Children's Health Insurance Program (SCHIP).

Women are poorly informed about oral health and hygiene issues, and receive insufficient dental health care. Researchers interviewed 213 women and found that about 75% were either unaware that antibiotics could compromise the effectiveness of oral contraceptives, or thought there was no such drug interaction. Over one-fourth of women did not know that fluoride prevents tooth cavities in adults, and over 40% were unsure if dental care during pregnancy was safe. Forty-one percent of women did not have a regular dentist, and 43% had not seen a dentist in two years.