RESUMO
In Tanzania, about 600 000 youth between 5 and 24 years old have a disability. Individuals with disabilities face numerous obstacles due to social stigma. The aim of this formative evaluation is to assess how caregivers of children with correctable disabilities (e.g., cleft lip/palate, club foot, and burn scar contractures) in Tanzania perceive their community's acceptance of their child before and after surgical treatment. Semi-structured interviews were conducted with 80 caregivers of children with disabilities treated at Kafika House in Arusha, Tanzania. The constant comparative method identified themes regarding the caregivers' feelings on their child's functional abilities and experiences of stigma in their community. Caregiver perceptions of stigma before and after surgical treatment were categorized and quantified as 'positive', 'neutral' and 'negative'. Thematic analysis of the 80 interviews resulted in five major themes: (1) stigma and acceptance (pre-treatment) and (2) post-treatment; (3) functional abilities (pre-treatment) and (4) post-treatment; and (5) emotional impact (pre- and post-treatment). These themes indicate caregivers and their children experience a range of emotional impacts before and after treatment, more severe stigma before treatment, and overall better social, emotional and functional status after treatment. Frequency analysis of caregiver experiences indicated that stigma experienced by children and their families decreased from 75% before surgical treatment to 2.5% after surgery. Surgical intervention and rehabilitation of physical disabilities mitigated experiences of social stigma for both children and their caregivers. Findings support the need for expanded treatment of correctable disabilities, larger investments in community-based rehabilitation programmes and further interventions to support stigmatized parents and their children.
Assuntos
Fenda Labial , Fissura Palatina , Pessoas com Deficiência , Criança , Adolescente , Humanos , Pré-Escolar , Adulto Jovem , Adulto , Cuidadores/psicologia , Tanzânia , Estigma SocialRESUMO
Interprofessional education is vital to prepare students in healthcare-related fields for future practice to improve participation in teams and enhance client/patient outcomes. This study aimed to evaluate the impact of a half-day interprofessional education workshop on aging based on students' self-rated confidence in working in interprofessional teams, with aging, and culturally diverse clients/patients. Students from eight healthcare-related disciplines at a private mid-western university attended an interprofessional workshop. Afterward, students completed a reflective survey to evaluate pre- and post-workshop perceptions about interprofessional collaboration and caring for aging and diverse clients/patients. Quantitative methods using paired sample t-tests revealed a statistically significant difference in students' self-reported level of preparedness in the areas of interprofessional education, aging, and cultural fluency (P < .001). In addition, qualitative methods were used to organize data into themes. Additional insights were gained to inform future workshops.
Assuntos
Educação Interprofissional , Estudantes de Ciências da Saúde , Envelhecimento , Ocupações em Saúde , Humanos , Relações InterprofissionaisRESUMO
Individuals who migrate from their home country face a variety of challenges while adapting to the culture in the United States. Immigrant communities are at a significantly higher risk for poor health outcomes; therefore, assessing healthcare treatment for diverse and resilient immigrant populations, including Hispanic/Latine communities, is crucial to preserving their health, culture, and spirit. A paucity of literature exists surrounding perceptions of well-being in immigrant, Hispanic/Latine adults managing chronic diseases. Past studies have shown a discrepancy between providers' and patients' perceptions of healthcare options for overall well-being. We aim to share varying perspectives found within our work geared towards improving the quality of life for Hispanic/Latine immigrants managing chronic disease, especially type 2 diabetes mellitus and hypertension. The primary objective of this article is to strengthen the understanding of intersections between social, physical, financial, and spiritual health within an (im)migrant Hispanic/Latine community using semi-structured ethnographic interviews. These interviews have highlighted community resilience, demonstrating that individuals can adapt to major life transitions while maintaining balance across dimensions of health. This knowledge could be implemented by actively listening to patient concerns regarding their health dimensions to improve individualized and patient-centric care.
RESUMO
The Dietary Approaches to Stop Hypertension (DASH) eating plan is the most effective dietary intervention for cardiovascular disease (CVD), but it excludes the consideration of culture and cost. The Hispanic/Latine population is disproportionately affected by CVD, with risks increasing if persons are accustomed to a Westernized diet. This research aims to understand the cultural dietary practices aligned with a DASH eating plan and the social determinants of health impacting fruit and vegetable (F/V) consumption among immigrant Hispanic/Latine individuals at a community-based clinic in Minnesota. Utilizing community-based participatory research methods, a community survey informed the development of DASH-focused, medically tailored food kits of varying F/V modalities. Qualitative feedback was sought out regarding the kits when presented to 15 individuals during in-depth interview sessions to validate the cultural appropriateness of food kits for clinical use. Box A was the highest rated kit (66.7%) and consisted of fresh F/V. The average F/V consumption per day was 2.6 ± 1.4 servings. The food insecurity questionnaires showed high/marginal (40%), low (53.3%), and very low (6.7%) food security. The barriers to consuming F/V were money, time, and transportation. Understanding cultural dietary practices related to the DASH eating plan is necessary to mitigate CVD risk and provide inclusive medical nutrition therapy for Hispanic/Latine populations.
Assuntos
Doenças Cardiovasculares , Abordagens Dietéticas para Conter a Hipertensão , Hispânico ou Latino , Hipertensão , Adulto , Humanos , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/prevenção & controle , Pesquisa Participativa Baseada na Comunidade , Hipertensão/dietoterapia , Hipertensão/etnologia , Hipertensão/prevenção & controle , Verduras , Abordagens Dietéticas para Conter a Hipertensão/economia , Abordagens Dietéticas para Conter a Hipertensão/etnologia , Abordagens Dietéticas para Conter a Hipertensão/métodos , Pesquisa Qualitativa , Frutas , Ingestão de Alimentos/etnologia , Assistência à Saúde Culturalmente Competente/economia , Assistência à Saúde Culturalmente Competente/etnologiaRESUMO
This report describes a One Health approach to address food insecurity among two distinct campus populations-college students and patients at a campus-based community health clinic serving Latine adults. The multidisciplinary collaboration includes college staff, faculty, and students, and the founders, both women-centered institutions. Organic community gardens located on and near campus property, pollinated by campus-based beehives, contribute local organic produce to a campus-based food shelf increasing food security and nutritional health for both populations. The One Health system modeled in this report is a step toward building a vibrant community and demonstrates how others can be a part of the larger One Health movement.
RESUMO
Background: A Mediterranean-style diet pattern (MSDP) is a recommended diet pattern in the 2020-2025 Dietary Guidelines for Americans. Few studies report widespread adherence to the diet, which suggests Americans may benefit from strategies to help them improve alignment to an MSDP. Objectives: The purpose of this study was to assess the impact of isocaloric food substitutions on adherence to an MSDP in US adults. Methods: Using data from NHANES (2007-2018), alignment to an MSDP was determined by calculation of a Mediterranean diet scoring index appropriate for non-Mediterranean populations (0-100 points for the total score, with higher scores indicating greater adherence). The sample was divided into 2 groups, a high-adherence group (HA) and a non-high-adherence group (nHA), to differentiate food groups to be used for isocaloric food substitution modeling. Substitution modeling via multiple regression analyses determined food selections that have the greatest impact on MSDP scores. Honey was added to the substitutions in recipe form and evaluated for its impact on MSDP scores. Results: The study consisted of 19,978 adults, ages 25-65, with complete dietary data. The nHA had a lower mean total MSDP score (7.07 ± 0.04 points) compared to the HA (16.45 ± 0.09 points). Increasing olive oil from nonuse to partial use had the greatest impact (>+2 points) for both groups. Other isocaloric substitutions also improved adherence, albeit to a lesser degree, including substituting 1 oz of whole grains for 1 oz of refined grains, 4 oz of fish for 4 oz of red meat, and 4.9 cups of kale for 0.7 cups of starchy or root vegetables. Improved MSDP scores were sustained when honey was added to the substitutions. Conclusions: Simple dietary substitutions can help a diet more closely align with an MSDP. Adding honey to the simple substitutions may increase palatability without sacrificing nutritional benefits.
RESUMO
Bioavailability of dietary ß-carotene (BC) is dependent on dose, quantity, dispersion, and presence of fat in the diet. Fats are comprised of a variety of fatty acids, which may impact the bioavailability of carotenoids. However, there is a gap in research on whether specific fatty acid classes affect serum BC concentrations in population samples. The primary objective of this study was to assess the association between reported fat and fatty acid intake and serum BC concentrations utilizing data from the National Health and Nutrition Examination Surveys (NHANES) 2003-2006. Data from 3278 NHANES participants 20-85 years old were analyzed to estimate the relationships between serum BC concentrations and reported saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acid intakes. Multiple linear regression estimated ln(serum BC) based on reported fatty acid intakes adjusted for age, sex, race/ethnicity, and reported dietary BC intakes. Mean and standard error (SE) for serum BC concentrations were 14.31 ± 0.05 µg/dl. Means and SE for total fat, SFA, MUFA, and PUFA were 85.7 ± 1.3, 26.9 ± 0.4, 31.1 ± 0.5, and 17.8 ± 0.4 g, respectively. There was a significant trend for association between serum BC and reported total fat intakes (r = -0.002, p < 0.0001), but the association was not strong. Multiple linear regression showed positive associations between serum BC concentrations and higher reported dietary PUFA consumption. PUFA alpha-linolenic acid intakes are positively associated with serum BC concentrations, while MUFA palmitoleic acid and SFA stearic acid were inversely associated with serum BC. The inverse association between MUFA and SFA suggests there may be multiple post-digestion factors affecting serum carotenoid concentrations.