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Research has documented the need for mental health services among refugee and immigrant youth. A joint collaboration on a community-based participatory research (CBPR) research project between a university, a local art and health collective, and an immigrant and refugee organization sought to identify and understand the mental health needs and strategies for immigrant youth in Philadelphia through youth discussion and engagement in a variety of art workshops. As a result of the COVID-19 pandemic, this CBPR research project was forced to make several programmatic changes, such as shifting to a virtual setting, that impacted project implementation and intended outcomes. These changes highlight valuable lessons and practical implications in pivoting a program during COVID-19 to continue working with marginalized communities with limited resources, including barriers to technology access, at a time when effectively addressing mental health for immigrant youth has become both more challenging and pressing.
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COVID-19 , Emigrantes e Imigrantes , Adolescente , Pesquisa Participativa Baseada na Comunidade , Humanos , Saúde Mental , Pandemias , Philadelphia , SARS-CoV-2RESUMO
BACKGROUND: While there has been a marked increase in measurement and scholarship surrounding social norms in recent years, there is little evidence related to social norms measurement in the context of health campaigns utilizing entertainment-education. Entertainment-education goals and objectives have shifted over time to include social norms and an update is needed to merge contemporary practice with the most recent measures from the literature. The aim of the present study was to analyze commonly used quantitative measures and their properties for social norms and entertainment-education, specifically on the topic of family planning, to bolster ongoing research and practice efforts by validating items for social norms measurement in entertainment-education programs. METHODS: The study used data from a survey conducted with 438 married women aged 19-34 in the Central Province of Zambia in 2019 who were exposed to the entertainment-education initiative Kwishilya (Over the Horizon), a Bemba-language, 156-episode radio program designed to shift social norms on family planning. Multiple items were included to measure descriptive norms, injunctive norms, and outcome expectations. Exploratory factor analysis and estimates of scale reliability were conducted to understand the properties and structure of the social norms items. RESULTS: Results showed a five-factor solution best fit the data, which accounted for 45.7% of the variance, exhibited fair reliability, and loaded largely as expected. CONCLUSIONS: This study provides a useful tool for practitioners and scholars to use globally to measure important social norms constructs in entertainment-education.
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OBJECTIVE: To describe postpartum experiences of women who gave birth during the coronavirus disease 2019 (COVID-19) pandemic, to identify short-term and long-term opportunities to address maternal-child health during this pandemic. METHODS: This qualitative photo-elicitation study asked 30 women between 3 and 10 weeks postpartum to take photographs that encompassed their experience as a new mother during the pandemic. Two trained interviewers elicited elements of this experience using the photos as an anchor during virtual, hour-long interviews. Interview transcripts were analyzed using directed content analysis, including open coding to identify key ideas, codebook development, and codebook refinement. Half of transcripts were team coded to ensure coding accuracy. After coding, the study team organized codes to inform the development of an explanatory model. RESULTS: Interviews identified important stressors new mothers experienced that were worsened during the pandemic, namely fear, child care, older children, loss, isolation, and employment. Interviews also highlighted key support structures (self-care, interpersonal, and structural supports) that were at times helpful in alleviating stressors and at others were inadequate to counter stress and even enhanced stress. CONCLUSION: For postpartum individuals overall, the pandemic resulted in increased strain during an already stressful time. These findings demonstrate inadequacy of support systems for postpartum women and may highlight action items for stakeholders to improve postpartum care during the pandemic and in the future.
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COVID-19/psicologia , Mães/psicologia , Período Pós-Parto/psicologia , Adulto , Feminino , Humanos , Pennsylvania/epidemiologia , Fotografação , Pesquisa Qualitativa , SARS-CoV-2RESUMO
Evolutionary responses to selection for bipedalism and childbirth have shaped the human pelvis, a structure that differs substantially from that in apes. Morphology related to these factors is present by birth, yet the developmental-genetic mechanisms governing pelvic shape remain largely unknown. Here, we pinpoint and characterize a key gestational window when human-specific pelvic morphology becomes recognizable, as the ilium and the entire pelvis acquire traits essential for human walking and birth. We next use functional genomics to molecularly characterize chondrocytes from different pelvic subelements during this window to reveal their developmental-genetic architectures. We then find notable evidence of ancient selection and genetic constraint on regulatory sequences involved in ilium expansion and growth, findings complemented by our phenotypic analyses showing that variation in iliac traits is reduced in humans compared to African apes. Our datasets provide important resources for musculoskeletal biology and begin to elucidate developmental mechanisms that shape human-specific morphology.
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Hominidae , Pelve , Animais , Evolução Biológica , Feminino , Hominidae/anatomia & histologia , Humanos , Parto , Pelve/anatomia & histologia , Gravidez , Seleção GenéticaRESUMO
BACKGROUND: The treatment of wide-necked and bifurcation aneurysms has become a common indication for the Woven Endobridge (WEB) device. In many instances, WEB embolization fails and retreatment strategies for the recanalized aneurysms have not been established and may be challenging. OBJECTIVE: To report an experience with retreatment strategies after WEB failure in 7 cases involving various aneurysm shapes, sizes, and location using multiple strategies including endovascular modalities and microsurgical clip ligation. METHODS: Data were retrospectively collected from 1 high-volume cerebrovascular center for 7 patients treated with a WEB device for an aneurysm who subsequently required retreatment for that same aneurysm from 2015 through January 2021. RESULTS: We identified 7 patients with WEB recurrences over a period of 6 years. Four patients initially presented with incidental findings, whereas 3 patients presented with subarachnoid hemorrhage. One patient was lost to follow-up and presented with a rerupture, whereas the 6 other patients were diagnosed with routine follow-up. Two patients received clip ligation, 2 had simple coil embolization, 1 had stent-assisted coil embolization, 1 had a flow-diverting stent, and 1 patient required 2 retreatments; he received stent-assisted coil embolization for the first retreatment and a simple coil embolization for the second retreatment. All patients had excellent angiographic outcomes and no complications. CONCLUSION: The authors conclude that aneurysm recurrence after WEB is very diverse, and no single modality can properly address all recurrences. Rather, an individualized approach based on aneurysm features, neurointerventionalist expertise, and patient preference should be implemented.