Smoking behavior among Asian Americans during the initial phase of the COVID-19 pandemic: The influence of pandemic stressors and depression.

INTRODUCTION: Heightened levels of distress among Asian Americans during the initial phases of the pandemic may be associated with current smoking behavior. In this study, we examine differences in current smoking among Asian Americans from two different ethnic backgrounds before and during the COVID-19 pandemic. METHODS: We analyzed cross-sectional survey data (n=202) from Chinese and South Asian adults in Chicago, collected between February and May 2020. We conducted logistic regression models to estimate the relationship between exposure to the COVID-19 pandemic and current smoking. We tested whether the association varied by Asian American ethnic group, unemployment, racial discrimination, and depression symptoms. RESULTS: We found that current smoking increased from 28% to 48% among Asian Americans (i.e. Chinese and South Asians) during the pandemic. We found a statistically significant interaction between the COVID-19 period indicator variable and current smoking by Asian American ethnic groups (p=0.014), such that current smoking was lower for Chinese compared to South Asians before COVID-19, but was comparable for both groups during the pandemic. We also found a statistically significant interaction between the period indicator variable and current smoking by racial discrimination (p=0.047) and depression symptoms (p=0.02). Results from these interactions suggest that Asian Americans who experienced racial discrimination and depression during the pandemic may be more likely to be current smokers compared to their pre-pandemic counterparts. CONCLUSIONS: The findings of the study highlight the need for culturally tailored smoking cessation interventions for Asian American communities that address pandemic-related stressors such as discrimination that may trigger cigarette use.

A Mixed-methods Approach to Understanding Language Interpretation Services in Health Care Settings among Asian American Immigrants from Diverse Ethnic Backgrounds.

BACKGROUND: Asian Americans (AA) face cultural and linguistic barriers to health care access, resulting in poor health outcomes. This study investigates the experiences of AAs using language interpretation services (LIS) in health care settings. METHODS: Using a mixed-methods approach, we conducted a community survey (N=401) and seven focus groups between April and September 2023. We use the Andersen model to understand the experience around LIS for AAs and calculated descriptive statistics for predisposing (i.e., sociodemographic factors and attitudes toward LIS), enabling (i.e., perceived barriers), and need factors (i.e., perceived need for LIS). Focus groups were analyzed using a modified template approach to text analysis. RESULTS: Quantitative and qualitative analyses found that although AAs recognize the benefits and need for LIS, various barriers (e.g., lack of interpreters when booking an appointment) preclude these communities from accessing these services. CONCLUSIONS: Results from this study will help inform interventions that seek to improve LIS within health care systems.

Sustaining connections: feasibility and impact of long-term virtual patient engagement.

BACKGROUND: Virtual patient engagement has become more common in recent years. Emerging research suggests virtual engagement can increase accessibility for patients managing long-term health conditions and those living in larger geographic areas, but it can also be challenging to establish relationships and maintain engagement over time. Little is known about virtual engagement lasting more than two years, nor about the specific contributions of patients to virtual engagement projects. Here we describe a project where virtual engagement was sustained over a long period of time (3.5 years), measure patients' contributions to the work, and describe the facilitators and challenges of the project using the Valuing All Voices (VAV) patient engagement framework. METHODS: Five researchers recruited four patient partners living with persistent pain to work together virtually on a project to improve care for others with long-term pain. Researchers documented engagement activities and patient partner contributions and categorized them using Carman et al.'s 3 types of engagement. They also collected data via semi-structured group interviews with patient partners about the facilitators and challenges of the project using the VAV framework. RESULTS: In 3.5 years, patient partners contributed 487 h to the project, averaging 3.0 h per month, and participated in 40 meetings. They contributed to 17 products for patients, health care teams, and researchers. Most products (12 of 17) were created using the more in-depth engagement approaches of involvement or partnership and shared leadership. The group identified facilitators of the project across the five VAV domains of relationship-building, trust, understanding & acceptance, education & communication, and self-awareness, as well as some specific challenges such as keeping track of products across virtual platforms and managing the high volume of project information. CONCLUSIONS: Long-term virtual patient engagement is feasible and can use more in-depth engagement approaches. Additionally, it can result in substantial contributions from patients in terms of time, effort, and products. These findings can inform future long-term virtual patient engagement efforts and provide insight into how researchers can structure their activities to encourage and maintain deep engagement over time.

BACKGROUND: Virtual patient engagement has become more common in recent years. Virtual engagement can make it easier for people with long-term health conditions and from larger geographic areas to be involved, but it can also be challenging to establish relationships and maintain engagement over time. There are not many examples of virtual engagement projects lasting more than two years, and many projects do not describe patients' specific contributions to the work. Here we describe a 3.5-year project where we measured patients' contributions and described the facilitators and challenges of the project using the Valuing All Voices (VAV) patient engagement framework. METHODS: Five researchers worked with four patient partners living with persistent pain to improve health care for others with long-term pain. We tracked how we worked together and how patient partners contributed to the project. We categorized the products we created together using three types of engagement that range from less to more in-depth. Researchers also interviewed patient partners about the facilitators and challenges of working together virtually. RESULTS: In 3.5 years, patient partners contributed 487 h to the project, averaging 3.0 h per month, and participated in 40 meetings. They contributed to 17 different products. Twelve of the products used more in-depth engagement approaches. The group identified facilitators of the project across the five VAV domains, as well as some specific challenges. CONCLUSIONS: We found that long-term virtual patient engagement is feasible, can use in-depth engagement strategies, and can result in important contributions from patients in terms of time, effort, and products.

Mixed methods approach to understanding COVID-19 vaccine hesitancy among immigrants in the Chicago.

BACKGROUND: COVID-19 vaccine hesitancy has been particularly high among immigrant populations, whose experience is shaped by a history of racism and discriminations, and distrust of the healthcare system. In this study we draw from the Theory of Planned Behavior to examine COVID-19 vaccine hesitancy among immigrants in Chicago. METHODS: A mixed-methods approach comprising of both focus groups and a health survey was conducted from February to August 2022. Five focus groups were held (N = 35) among Black, Asian and Arab/Palestine participants to understand attitudes and beliefs around the COVID-19 vaccine. Focus groups were analyzed using a modified template approach to text analysis. Based on these findings and themes, we developed a survey that was conducted among 413 immigrants from the mentioned communities. We used hierarchical ordinal regression analyses to examine the relationship between COVID-19 vaccine hesitancy and vaccination status. RESULTS: Qualitative analysis suggest that the major factors influencing COVID-19 vaccine hesitancy included fear of adverse reactions, misinformation around COVID-19 and the vaccine, negative social norms around vaccination, and external pressure to get vaccinated. From our quantitative analysis we found that 24% of participants were unvaccinated, 5% were partially vaccinated, 32.3% were vaccinated but not boosted, and 39% were vaccinated and boosted for COVID-19. Hierarchical regression models suggest that immigrants who hold negative attitudes and social norms around the COVID-19 vaccine are less likely to vaccinate. CONCLUSIONS: Understanding vaccine hesitancy among immigrants allows for the creation of culturally and linguistically tailored education that can be utilized to increase vaccine confidence and uptake.

Residential Density Is Associated With BMI Trajectories in Children and Adolescents: Findings From the Moving to Health Study.

Introduction: This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents. Methods: This retrospective cohort study utilized electronic health records of individuals aged 5-18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers. Linear mixed-effects models performed in 2022 tested whether built environment variables at baseline were associated with BMI change within age cohorts (5, 9, and 13 years), adjusting for sex, age, race/ethnicity, Medicaid, BMI, and residential property values (SES measure). Results: At 3-year follow-up, higher residential density was associated with lower BMI increase for girls across all age cohorts and for boys in age cohorts of 5 and 13 years but not for the age cohort of 9 years. Presence of fast food was associated with higher BMI increase for boys in the age cohort of 5 years and for girls in the age cohort of 9 years. There were no significant associations between BMI change and counts of parks, and park area was only significantly associated with BMI change among boys in the age cohort of 5 years. Conclusions: Higher residential density was associated with lower BMI increase in children and adolescents. The effect was small but may accumulate over the life course. Built environment factors have limited independent impact on 3-year BMI trajectories in children and adolescents.

Neighborhood built and food environment in relation to glycemic control in people with type 2 diabetes in the moving to health study.

OBJECTIVE: To examine whether built environment and food metrics are associated with glycemic control in people with type 2 diabetes. RESEARCH DESIGN AND METHODS: We included 14,985 patients with type 2 diabetes using electronic health records from Kaiser Permanente Washington. Patient addresses were geocoded with ArcGIS using King County and Esri reference data. Built environment exposures estimated from geocoded locations included residential unit density, transit threshold residential unit density, park access, and having supermarkets and fast food restaurants within 1600-m Euclidean buffers. Linear mixed effects models compared mean changes of HbA1c from baseline at 1, 3 (primary) and 5 years by each built environment variable. RESULTS: Patients (mean age = 59.4 SD = 13.2, 49.5% female, 16.6% Asian, 9.8% Black, 5.5% Latino/Hispanic, 57.1% White, 20% insulin dependent, mean BMI = 32.7±7.7) had an average of 6 HbA1c measures available. Participants in the 1st tertile of residential density (lowest) had a greater decline in HbA1c (-0.42, -0.43, and -0.44 in years 1, 3, and 5 respectively) than those in the 3rd tertile (HbA1c = -0.37 at 1- and 3-years and -0.36 at 5-years; all p-values <0.05). Having any supermarkets within 1600 m of home was associated with a greater decrease in HbA1c at 1-year and 3-years compared to having none (all p-values <0.05). CONCLUSIONS: Lower residential density and better proximity to supermarkets may benefit HbA1c control in people with people with type 2 diabetes. However, effects were small and indicate limited clinical significance.

Tumor maligno de la vaina nerviosa periférica: reporte de un caso / Malignant peripheral nerve sheath tumor, a case report

Resumen El tumor maligno de la vaina nerviosa periférica (TMVNP) es un sarcoma de alto grado de malignidad. Es poco frecuente, agresivo y generalmente se localiza en tronco y miembros inferiores. Se presenta mayormente en pacientes con neurofibormatosis tipo 1, aunque no siempre se encuentra esta asociación. Este tumorcomparte características histológicas e inmunohistoquímicas con el melanoma, lo que puede dificultar el diagnóstico. Presentamos el caso de un paciente con TMVNP, en el cual los hallazgos histológicos iniciales condujeron a un diagnósticoerróneode melanoma.

Abstract Malignant peripheral nerve sheath tumor (MPNST) is a high-grade sarcoma. It is rare, aggressive and generally located on the trunk and lower limbs. It occurs in a high percentage of patients with neurofibormatosis type 1, although this association is not always found. This tumor shares histological and immunohistochemical characteristics with melanoma, which can make diagnosis difficult. We present the case of a patient with MPNST, in whom the initial histological findings led to an erroneous diagnosis of melanoma.

E-cigarette use and its association with smoking reduction and cessation intentions among Mexican smokers / Uso de cigarros electrónicos y su asociación con la reducción en el consumo de cigarros convencionales y la intención de dejar de fumar entre fumadores mexicanos

Abstract: Objective: Evaluate the patterns of e-cigarette use and their association with smoking behavior. Materials and methods: We analyzed data from a population-based representative cohort of adult smokers who participated in the International Tobacco Control Policy Evaluation Surveys in Mexico. The analytic sample (n=760) was restricted to participants who were followed up from wave 6 (2012) to wave 7 (2014-2015). GEE models regressed e-cigarette use at follow-up and changes in cigarettes per day (CPD) between waves, on baseline sociodemographic variables, smoking status (daily, non-daily, quit), e-cigarette trial, and quit intentions. Results: Smokers who were younger, had a higher income, and had tried e-cigarettes at baseline were more likely to be current e-cigarette users at follow-up. E-cigarette use at follow-up was not associated with a change in CPD over time. Conclusions: E-cigarette use does not appear to have promoted smoking cessation or reduction in this sample of Mexican smokers.

Resumen: Objetivo: Evaluar los patrones de uso de cigarros electrónicos y su asociación con el uso de tabaco. Material y métodos: Se usaron datos de una cohorte de fumadores adultos mexicanos de la Encuesta Internacional de Evaluación de Políticas del Control del Tabaco (n=760) con seguimiento de la ronda 6 (2012) a la 7 (2014-2015). Se usaron modelos GEE para evaluar el uso de cigarros electrónicos y el cambio en el número de cigarros por día (CPD) en variables de la basal sobre características sociodemográficas, consumo del cigarro (diario, no diario, haber dejado de fumar), prueba de cigarros electrónicos e intención de dejar de fumar. Resultados: Fumadores jóvenes, con ingresos altos y que probaron cigarros electrónicos en la medición basal tenían más posibilidad de usar cigarros electrónicos. No se encontró relación entre uso de cigarros electrónicos y cambio en CPD. Conclusiones: Los cigarros electrónicos no parecen promover el abandono ni la reducción del consumo de cigarros en esta muestra de fumadores mexicanos.

Relaciones entre conducta y evolución cultural - construcción de nicho / Relations between behavior and cultural evolution - niche construction

Las ciencias de la conducta comprenden diferentes disciplinas tales como la biología, la antropología, la economía, la psicología y las ciencias políticas. Sin embargo, para abordar sus problemáticas, cada una de ellas apela a un modelo teórico distinto, algunos incompatibles entre sí. Superar este estado de cosas es una necesidad urgente ara estas ciencias, si se quiere tener entre ellas una relación científicamente más productiva. Actualmente, los desarrollos conceptuales y empíricos, representan una oportunidad para su redefinición conceptual teniendo como marco de referencia y la teoría de la evolución, como una lógica explicativa aplicable a las ciencias de la conducta. Tal reconceptualización, está relacionada con el papel que tiene la conducta en la evolución biológica y en la evolución cultural y que será el objeto de análisis aquí. Se discutirán las implicaciones teórico-empíricas que tiene la conducta en la construcción del nicho de los organismos. Se señala la importancia de la conducta, resaltando como su variabilidad funcional la convierte en un sistema de amortiguación y ajuste de las relaciones dadas entre organismo y medio, relevantes para la supervivencia de los organismos y cómo a su vez esto se constituye en un factor influyente en la evolución de las especies.

The sciences of the behavior include different disciplines such as biology, anthropology, economy, psychology and political science. However, to deal with their problems, each one of them will appeal to a different theoretical model, some of which are incompatible between them. To remedy this state of things is an urgent need in the sciences of the behavior, if we want to have a scientifically more productive relationship. Currently, the conceptual and empirical developments represent an opportunity to be redefined the problem in the conceptual way, having as a reference framework the theory of evolution, as applicable explicatory logic to behavior. Such reconceptualization is related to the role that behavior has in the biological evolution and in the cultural evolution, which will be the object of analysis herein. It will be discussed what theoretical and empirical implications has the behavior in the construction of the niche. It can be concluded, pointing to the importance of the behavior, highlighting as its variability functional to serve a system damping for the survival of the organisms and in the same way in an influential factor in the evolution of species.