BackgroundEpidemiological studies focused on primary healthcare needs of persons experiencing homelessness (PEH) are often based on data from specialist homeless healthcare services.AimThe aim of this study is to explore the presentation of PEH, coding of homelessness and associated health conditions in mainstream primary care general practices in England.Design & settingEMIS electronic database search of medical records was conducted across 48 general practices in a Clinical Commissioning Group (CCG), representing one of the most socioeconomically deprived regions in England, which also lacks a specialist primary healthcare service for PEH.MethodKey terms and codes were used to identify PEH, their respective diagnoses across 22 health conditions and prescribed medications over the past 4 years.ResultsFrom a population of approximately 321,000, 43 (0.013%) persons were coded as PEH compared to a homelessness prevalence of 0.5% in the English general population. Mental health conditions were the most prevalent diagnoses amongst the PEH registrants (62.3%); the recorded prevalence of other common long-term conditions in PEH was lower than the levels observed in PEH registered with specialist homelessness health services.ConclusionIn a population with approximately four times higher rate of statutory homelessness, PEH representation in mainstream general practices was underrepresented by several folds. As homelessness overlaps with mental health, substance misuse and long term health conditions, consistent coding of homelessness in medical records is imperative to offer tailored support and prevention actions when patients present for services.
We identified 11 conserved stretches in over 6.3 million SARS-CoV-2 genomes including all the major variants of concerns. Each conserved stretch is ≥100 nucleotides in length with ≥99.9% conservation at each nucleotide position. Interestingly, six of the eight conserved stretches in ORF1ab overlapped significantly with well-folded experimentally verified RNA secondary structures. Furthermore, two of the conserved stretches were mapped to regions within the S2-subunit that undergo dynamic structural rearrangements during viral fusion. In addition, the conserved stretches were significantly depleted for zinc-finger antiviral protein (ZAP) binding sites, which facilitated the recognition and degradation of viral RNA. These highly conserved stretches in the SARS-CoV-2 genome were poorly conserved at the nucleotide level among closely related β-coronaviruses, thus representing ideal targets for highly specific and discriminatory diagnostic assays. Our findings highlight the role of structural constraints at both RNA and protein levels that contribute to the sequence conservation of specific genomic regions in SARS-CoV-2.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.