RESUMO
Cancer genomic services (CGS) can support genetic risk-stratified cancer prevention and treatment. Racial/ethnic minority groups are less likely to access and utilize CGS compared with non-Hispanic Whites. Little research has described characteristics of interventions targeted at CGS among Latinos. This scoping review aimed to (1) describe interventions promoting uptake of CGS among Latinos in the United States and Latin America, (2) describe intervention adaptations for Latino participants, and (3) summarize intervention implementation factors suggested by reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework. We conducted a search in English and Spanish of literature published between 2005 and 2022 across PubMed and Latin American and Caribbean Health Sciences Literature databases. Sixteen of 2344 papers met the inclusion criteria of the analysis. Efforts to promote CGS among Latino communities were limited in the US and lower in Latin America. This review highlights the need for in-depth exploration of acculturation-informed interventions and better reporting on implementation factors to enhance their scalability across diverse settings.
Assuntos
Genômica , Hispânico ou Latino , Neoplasias , Humanos , Neoplasias/genética , Neoplasias/terapia , Neoplasias/etnologia , Genômica/métodos , Estados Unidos , América LatinaRESUMO
PURPOSE: Methods for assessing the structural mechanisms of health inequity are not well established. This study applies a phased approach to modeling racial, occupational, and rural disparities on the county level. METHODS: Rural counties with disparately high rates of COVID-19 incidence or mortality were randomly paired with in-state control counties with the same rural-urban continuum code. Analysis was restricted to the first six months of the pandemic to represent the baseline structural reserves for each county and reduce biases related to the disruption of these reserves over time. Conditional logistic regression was applied in two phases-first, to examine the demographic distribution of disparities and then, to examine the relationships between these disparities and county-level social and structural reserves. RESULTS: In over 200 rural county pairs (205 for incidence, 209 for mortality), disparities were associated with structural variables representing economic factors, healthcare infrastructure, and local industry. Modeling results were sensitive to assumptions about the relationships between race and other social and structural variables measured at the county level, particularly in models intended to reflect effect modification or mediation. CONCLUSIONS: Multivariable modeling of health disparities should reflect the social and structural mechanisms of inequity and anticipate interventions that can advance equity.
Assuntos
COVID-19 , Disparidades nos Níveis de Saúde , População Rural , SARS-CoV-2 , Humanos , COVID-19/epidemiologia , COVID-19/etnologia , População Rural/estatística & dados numéricos , Ocupações/estatística & dados numéricos , Pandemias , Masculino , Feminino , Fatores Socioeconômicos , Estados Unidos/epidemiologia , Grupos Raciais/estatística & dados numéricos , Desigualdades de Saúde , Disparidades em Assistência à Saúde/etnologia , Incidência , AdultoRESUMO
Underrepresented faculty have higher burnout rates and lower grant attainment rates when compared with their non-minority counterparts. Many in science, technology, engineering, mathematics, and medicine (STEMM) disciplines, including underrepresented individuals, often have difficulty dedicating time to the writing process, with trainees often being relegated to laboratory tasks in their training years, resulting in a lack of practice in academic writing. Notably, past studies have shown that grant attainment rates of underrepresented individuals are lower than their majority counterparts. Here, we sought to consider a mechanism targeted to underrepresented individuals, although applicable to everyone, to help overcome traditional barriers to writing in STEMM. The authors have hosted a writing accountability group (WAG) that uniquely provides a format focused on physical activity and different forms of writing to strengthen both career development and award/funding attainment. Our objectives were to evaluate this unique format, thus creating a resource for individuals and institutions to learn about WAGs and expand upon the framework to formulate their own WAG. To do this, we performed a small pilot study (n = 21) to investigate attitudes towards the WAG. We present the results of a survey conducted among underrepresented WAG participants, which spanned different career stages and was highly diverse demographically. Our results show that following attendance of our WAG, individuals did not note a significant change in scales pertaining to John Henryism (high-effort coping), resilience, sense of belonging, or grit. However, significant increases were noted in the self-perceived ability to handle stress, confidence in applying for awards, appreciation for mentoring, and satisfaction of WAGs. Taken together, the results of this study suggest that our unique WAG format can have some positive results as a career and writing development opportunity and may be able to support underrepresented individuals in attaining funding at higher education institutions.
RESUMO
OBJETIVO: Determinar la utilidad diagnóstica y la validez interna del Eating Disorder Inventory (EDI-2) en mujeres mexicanas. MATERIAL Y MÉTODOS: De octubre de 2000 a enero de 2001 se invitó a participar a todas las mujeres que a juicio de los psiquiatras de la consulta de anorexia del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, de la Ciudad de México, padecían anorexia nervosa o bulimia, sin otra patología psiquiátrica. Es un estudio observacional, comparativo, transversal y prolectivo de dos grupos de mujeres: pacientes de la Clínica de Anorexia del Instituto y de una escuela de la Ciudad de México. Se realizó una entrevista clínica estructurada como estándar de oro (SCID/Manual Diagnóstico y Estadístico de los Trastornos Mentales) y la aplicación del Eating Disorder Inventory. El análisis estadístico incluyó t de Student para muestras independientes, coeficiente alpha de Cronbach, sensibilidad, especificidad, valor predictivo positivo y negativo. RESULTADOS: No hubo diferencias significativas en peso, talla e índice de masa corporal entre los grupos. La edad de las mujeres sin trastorno alimentario fue menor (16.7±2.8 vs. 19.9±4.3, p=0.004). La calificación total del Eating Disorder Inventory fue claramente diferente (53.8±32.4 mujeres sin trastorno alimentario vs. 146.3±45.6 pacientes, p<0.001). Para todas las subescalas los coeficientes alpha de Cronbach fueron superiores a 0.85. Para la calificación total se sugiere un punto de corte sensible de 80 [sensibilidad 90.9 (IC 95 por ciento 69.4-98.4, especificidad 80 (IC 95 por ciento 58.7-92.4)], y uno específico de 105 [sensibilidad 81.8 (IC 95 por ciento 59-94), especificidad 89.3 (IC 95 por ciento 70.6-97.2)]. CONCLUSIONES: El Eating Disorder Inventory es útil para investigar trastorno alimentario, con coeficientes de validez interna altos en la población estudiada
Assuntos
Adolescente , Adulto , Feminino , Humanos , Anorexia Nervosa/diagnóstico , Bulimia/diagnóstico , Inquéritos e Questionários , Fatores Etários , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/psicologia , Antropometria , Bulimia/epidemiologia , Bulimia/psicologia , Intervalos de Confiança , México/epidemiologia , Valor Preditivo dos Testes , Reprodutibilidade dos TestesRESUMO
Neste relato foram descritos os passos clínicos empregados durante a técnica mediata para clareamento de dentes desvitalizados, sem aplicação de calor. O objetivo foi comparar clinicamente o resultado obtido no clareamento dos dentes 11 e 21, utilizando como agentes clareadores pasta de perborato de sódio + água destilada e peróxido de carbamida a 37 por cento, respectivamente. Concluiu-se que a técnica mediata utilizando o peróxido de carbamida a 37 por cento em cinco sessões, com intervalos de uma semana, mostrou-se mais eficaz para o clareamento de dentes desvitalizados que a mesma técnica utilizando a pasta de perborato de sódio + água destilada