Derivation and application of indoor air screening values for inhalation exposure to semi-volatile organic compounds.

Semi-volatile organic compounds (SVOCs) are being increasingly studied in indoor air. The absence of health-based inhalation exposure guidelines for most SVOCs impedes the interpretation of indoor air concentrations from a health risk context. To accelerate the derivation of screening values for a large number of SVOCs, a tiered framework was developed to evaluate and adjust published hazard assessments for SVOCs to calculate benchmarks relevant for evaluation of inhalation risk. Inhalation screening values were derived for 43 SVOCs considered in this study, most of which required extrapolation from oral exposure guidelines. The screening values were compared to published SVOC concentrations in homes in Canada to evaluate the potential health risks of chronic exposure to SVOCs in indoor residential environments. SVOCs that could be prioritized for further evaluation were dibutyl phthalates (DBP), di(2-ethylhexyl) phthalate (DEHP) and polybrominated diphenyl ethers (PBDEs). The framework could be applied more broadly in the future to derive screening values for other non-traditional indoor air contaminants with limited inhalation hazard data or assessments.

Patient-Centered Care, Diabetes Empowerment, and Type 2 Diabetes Medication Adherence Among American Indian Patients.

IN BRIEF Type 2 diabetes has been labeled an epidemic in many American Indian communities. Thus, identifying factors that improve medication adherence for American Indian patients is crucial. We found significant and positive relationships among patient-centered care, medication adherence, and diabetes empowerment. In addition, diabetes empowerment partially mediated the relationship between patient-centered care and medication adherence.

Barriers to Healthcare for American Indians Experiencing Homelessness.

Members of American Indian (AI) communities face many barriers to receiving both mental and physical healthcare. These barriers can have a negative effect on overall health. Barriers are compounded for AIs who are also experiencing homelessness, and AI make up a disproportionate percentage of the homeless population nationwide. In-depth semi-structured interviews were conducted with 12 service providers and 16 homeless participants in a mid-size Midwestern city to identify barriers to care for homeless participants. Key barriers identified in this study for homeless participants were: transportation, phone accessibility, discrimination, and cold and bureaucratic cultures of healthcare systems. Major barriers identified by service providers were: access to care, discrimination and mistrust, and restrictive policies. Given generally higher disease prevalence within the homeless population and health disparities within the AI community, steps should be taken to reduce barriers to healthcare.