A plea for making brown bandages stick.

The act of healing is a uniquely humanizing experience ubiquitously symbolized by the application of a bandage, an action that occurs daily in dermatology and pediatric clinics. The beige bandages we use in clinics are merely a visible symbol and reinforcement of what is considered standard and what is a deviation from the norm. One hundred years ago, Johnson & Johnson was a pioneer in the field when they invented the adhesive bandage. One hundred years ago, they set an industry standard by creating, exporting, and upholding a normative standard for practically all adhesive bandages in medicine, including birth control and nicotine patches to nasal strips. It took one hundred years after its inception and with over 100 billion Band-Aids produced with cartoons and superheroes, and in countless forms, for the inventors of bandages to offer a multitude of skin tones. Can we as healers stick with them? Or, can we implore ourselves to decolonize our clinics with a seemingly insignificant yet powerful symbolic gesture that lets our patients know that they are seen and not deviations from the norm? The conversation of diversity and inclusion in health and healing and institutional racism is obviously much deeper and profound than adhesive bandages. However, we can choose to acknowledge and celebrate diversity and inclusion in our practices as much as we can because it is significant to all of our patients, children, and adults alike.

The Association of Posttraumatic Stress Disorder With Clinic and Ambulatory Blood Pressure in Healthy Adults.

OBJECTIVE: Posttraumatic stress disorder (PTSD) is associated with incident cardiovascular risk. We tested the association of PTSD with clinic and ambulatory blood pressure (ABP) in a sample of healthy participants and tested ABP reactivity to anxiety as a mechanism by which PTSD may influence blood pressure (BP). METHODS: Participants were originally enrolled during workplace BP screenings at three sites; approximately 6 years (standard deviation = 1.0) later, they completed nine clinic BP assessments within three visits, 1 week apart. Before the third visit, participants were screened for PTSD (≥33 on the PTSD Checklist-Civilian) and depression (Beck Depression Inventory) and then completed 24-hour ABP monitoring with electronic diary assessment of anxiety (0-100) at each awake reading. RESULTS: Of 440 participants, 92 (21%) screened positive for PTSD. In regression models adjusted for depression and demographic and clinical variables, PTSD was associated with greater mean systolic BP (3.8 mm Hg clinic [95% confidence interval {CI}] = 1.1-6.5, p = .006), 3.0 mm Hg awake ABP [95% CI = 0.1-5.9, p = .04], and a nonsignificant 2.1 mm Hg ABP during sleep [95% CI = -1.0 to 5.1, p = .18]). PTSD was associated with greater 24-hour median anxiety (p < .001), and changes in anxiety were positively associated with concurrent systolic ABP (p < .001). ABP reactivity to anxiety was greater in participants with PTSD, which partially explained the association of PTSD with ABP. CONCLUSIONS: PTSD is associated with greater systolic BP, partly because of greater anxiety, and systolic BP reactivity to anxiety throughout the day. Daily anxiety and related BP reactivity may be targets for interventions to reduce the cardiovascular risk associated with PTSD.

Developing a Platform for Global Health Dermatology Mentorship and Collaboration: Introducing the International Alliance for Global Health Dermatology.

The International Alliance for Global Health Dermatology (GLODERM) was formed in 2019 with the aim to unite efforts toward skin health, open to members from any health profession, any country, and at any stage of training. This article highlights the case for such an alliance; discusses existing opportunities and gaps in global health dermatology; describes the development of a new international alliance; proposes future directions; and reflects on lessons learned.

Novel Diagnostics for Kaposi Sarcoma and Other Skin Diseases in Resource-Limited Settings.

In resource-limited settings, point-of-care diagnostic devices have the potential to reduce diagnostic delays and improve epidemiologic surveillance of dermatologic conditions. We outline novel-point-of care diagnostics that have recently been developed for dermatologic conditions that primarily affect patients living in resource-limited settings, namely, Kaposi sarcoma, cutaneous leishmaniasis, leprosy, Buruli ulcer, yaws, onchocerciasis, and lymphatic filariasis. All of the technologies described in this article are prototypes, and some have undergone field testing. These devices still require validation in real-world settings and effective pricing to have a major impact on dermatologic care in resource-limited settings.

Life after lockdown: Zooming out on perceptions in the post-videoconferencing era.

BACKGROUND: The COVID-19 pandemic has deeply disrupted daily life across the globe, with profound effects on mental and physical health. After more than a year of isolation and communication via videoconferencing, people are returning to in-person activities. OBJECTIVE: This study aimed to investigate worsening self-perception, mental health, and anxiety with the return to in-person activities, with a focus on the influence of videoconferencing, social media, and the use of filters. METHODS: An anonymous survey was distributed online through social media platforms and student network pages. RESULTS: A total of 7295 participants responded to the survey. Seventy-one precent reported anxiety or stress related to returning to in-person activities, and nearly 64% sought mental health support services. Thirty-percent stated they plan to invest in their appearance as a coping strategy to deal with the anxiety of returning to in-person, and >30% plan to take action in changing their appearance. The most reported dermatologic concerns were skin discoloration (32.36%), wrinkles (24.45%), and acne (14.85%). The prevalence of anxiety and mental health services increased relative to the use of filters in 18- to 24 year-olds. CONCLUSION: This survey study of >7000 participants across the country elucidates worsening self-perception, anxiety, and mental health as we return to in-person activities in relation to increased videoconferencing, social media usage, and the use of filters. Physicians should be aware of these effects to better serve their patients.

Highland Guatemalan women are extremely short of stature, and no lactation duration effects on body composition are observed in a cross-sectional survey.

Early linear growth in Guatemala has historically been compromised, resulting in adults of short stature. We hypothesized that the rate of short stature among mothers in the Western Highlands would have tracked from their own childhood when younger than 5 years, and that maternal weight declines progressively from delivery through lactation. Maternal weight and height were collected in 542 lactating mothers of infant and toddlers, ranging in age from 15 to 48 years, with subsequent classification of mothers for short stature (relative to the 1977 World Health Organization/National Center for Health Statistics growth curves) and for underweight (body mass index [BMI], <18.5 kg/m²), overweight (BMI, 25-30 kg/m²), or obesity (BMI, ≥30 kg/m²). The mean stature for the sample of adult women was 149.3 ± 5.9 cm, with a median of 149.0 cm. Women classified of Mayan descent were significantly (P < .001) shorter (147.0 ± 5.1 cm) than others (150.5 ± 6.0 cm). In terms of height percentiles for the age-specific female reference, 410 (76%) of mothers were below the fifth percentile and only 8 (1.5%) reached the median. Respective partition for underweight, normal weight, overweight, and obesity was as follows: 5%, 50%, 36%, and 9%. Variation in BMI with respect to the age of the offspring as the indicator of the duration of lactation was not significant, by analysis of variance or correlation analysis. Insofar as short stature is a risk factor for a series of adverse health consequences, including obesity and obstructed labor at childbirth, among others, it is time to direct public health attention toward resolving the causal factors for short stature in Guatemala.