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Women of color are disproportionately impacted by HIV. Although PrEP effectively prevents HIV infection, PrEP coverage and knowledge remain low in this population. To address barriers to PrEP, we implemented women-centered and culturally appropriate Information Sessions (IS) delivered by staff from the population they serve to increase knowledge, awareness, and use of PrEP through telemedicine (e.g., PlushCare). Our analysis focuses on Latina women (LW) participants, given the dearth of literature dedicated to the needs of LW. We partnered with a woman-led community-based organization (CBO) to implement the strategy with LW clients. Health educators conducted 26 IS with 94 LW (20 in Spanish and 6 in English). Participants who completed the IS were invited for interviews to assess the acceptability and appropriateness of the IS to increase knowledge and awareness of PrEP and PlushCare. Four themes emerged from the thematic analysis: (1) IS increased knowledge and awareness of PrEP and PlushCare; (2) perceived acceptability and appropriateness of IS; (3) insufficient reasons to warrant use of PrEP; and (4) positive attitudes about PlushCare. Our findings suggest that a women-centered and culturally appropriate IS implemented through a trusted, woman-led CBO is an acceptable and appropriate implementation strategy to inform LW about PrEP.
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Infecciones por VIH , Conocimientos, Actitudes y Práctica en Salud , Hispánicos o Latinos , Aceptación de la Atención de Salud , Profilaxis Pre-Exposición , Telemedicina , Humanos , Femenino , Hispánicos o Latinos/psicología , Infecciones por VIH/prevención & control , Infecciones por VIH/etnología , Adulto , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Adulto Joven , Investigación CualitativaRESUMEN
In the United States, immigrant Latino men who have sex with men (ILMSM) are, compared to white MSM, disproportionately burdened by HIV and lack access to highly effective HIV prevention strategies, such as pre-exposure prophylaxis (PrEP). Qualitative research centered on exploring barriers that ILMSM experience in accessing PrEP and other sexual services is extremely limited, despite a high prevalence of HIV in this population. In this study, a purposive sample of ILMSM (n = 25) was recruited to participate in a semi-structured in-depth interview to identify the distinct barriers and facilitators ILMSM experience in accessing sexual health services given their complex intersectional identities of being an immigrant, Latino, and a sexual minority man. Using a thematic analysis approach, nine themes were generated from the data representing barriers and facilitators. Barriers included: (1) cost and a lack of health insurance, (2) complexity of PrEP assistance programs; (3) challenges related to the immigrant experience; (4) impact of gay stigma; and (5) communication challenges. Facilitators included: (1) improving affordability and accessibility of PrEP services; (2) receiving services from LGBT- or Latine LGBT-centered clinics; (3) receiving services from medical providers who are gay and/or Latino; and (4) providing targeted community outreach, education, and promotion of PrEP to ILMSM. While many of the barriers illuminated in the study were structural (e.g., cost and lack of health insurance), and not easy to overcome, the findings highlight a range of facilitators that can support access to PrEP and other sexual health services for ILMSM. Considering these findings, we suggest strategies that may enhance access to needed sexual health services among ILMSM.
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Due to the elevated incidence of HIV among Black American women, effective sexual health interventions are needed. To explore beauty salons as settings for such interventions, we examined Black American women stylists' experiences discussing sex-related topics with Black American women clients. Constructivist Grounded Theory methodology guided data collection and analysis. Individual intensive interviews were conducted in 2019 with 16 Black women cosmetologists and/or aestheticians who served Black women in Southern California. Analyses generated grounded theory which we refer to as Relating 'to her Human Side': Black American cosmetologist-client relationship building model. The model highlights the importance of three sets of practices: 1) playing different roles to appeal to clients' varying wants and needs, 2) creating a comfortable atmosphere, and 3) establishing a judgement-free zone. Stylists put clients at ease and consequently, clients shared stories regarding sex and relationships freely. Stylists' actions built trusting relationships with clients, thus crafting beauty salons as atmospheres favourable for sex-related conversations and potential sexual health interventions.
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Industria de la Belleza , Promoción de la Salud , Salud Sexual , Femenino , Humanos , Negro o Afroamericano , Teoría Fundamentada , Promoción de la Salud/métodosRESUMEN
INTRODUCTION: Early-onset Alzheimer disease (EOAD) is an earlier Alzheimer disease form which is characterized by the mutations in the amyloid precursor protein, presenilin-1/2 (PSEN1/2), and triggering receptor expressed on myeloid cells 2 (TREM2). However, it is still necessary to report mutational screening in multiethnic groups to improve the genetic background of EOAD due to the variant classification challenge. METHODS: We performed targeted sequencing for the amyloid precursor protein, PSEN1, PSEN2, and TREM2 genes in 74 patients and 1 family diagnosed with EOAD. RESULTS: Among the detected variants, 8 were coding and 6 were noncoding in 15 of 74 patients. In PSEN1, 2 pathogenic coding variants (T274K and L364P) detected in 2 patients were novel and 3 coding variants (G183V, E318G, and L219P) detected in 2 patients were previously reported. We found 4 patients with the compound heterozygosity for the PSEN2 A23= and N43= and a family with the coexistence of them, and 1 patient with TREM2 Y38C. The coding variation frequency was 12.1%. In silico analysis indicated pathogenic potentials and clinical interpretations of the detected variants. CONCLUSION: Our study reveals the rare gene variants including novel ones from the Turkish EOAD cohort and provides to clinicians the list of detected variants in the screened genes, which may also be useful for accurate genetic counseling.
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Enfermedad de Alzheimer/genética , Predisposición Genética a la Enfermedad , Glicoproteínas de Membrana/genética , Mutación/genética , Presenilina-1/genética , Presenilina-2/genética , Receptores Inmunológicos/genética , Enfermedad de Alzheimer/sangre , Precursor de Proteína beta-Amiloide/genética , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , TurquíaRESUMEN
Tannery workers are at potential exposure to detrimental agents rendering them vulnerable to respiratory and dermal problems. Thus by performing pulmonary functions among leather tannery workers, we can decipher the effect of chromium and leather dust on lung functions and also the decline of respiratory functions with increasing years of exposure to leather dust. Pulmonary functions were assessed for 130 tannery workers and compared with the 130 unexposed office workers. Pulmonary function measurements namely FVC, FEV1, FEF25-75% and PEFR were measured using portable data logging Spirometer (KOKO Spirometer). The observed pulmonary functions of Tannery-workers in this study showed a reduction in FEV1, FVC, FEV1/FVC ratio, FEF25-75 and PEFR in relation to their predicted values and also compared to the unexposed. Smokers showed a decline in pulmonary functions compared to the non smokers because smoking acts as an additional risk factor in the development of respiratory illnesses. It is worthy to mention that the pulmonary function values correlate negatively with the duration of exposure to leather dust. So this study could provide base line information based upon which legal implementation of preventive measures could be undertaken.
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Pulmón/fisiología , Exposición Profesional/efectos adversos , Curtiembre , Estudios Transversales , Volumen Espiratorio Forzado , Humanos , Masculino , Capacidad VitalRESUMEN
INTRODUCTION: Diabetic peripheral neuropathy is the most common complication of diabetes producing metabolic disruptions in the peripheral nervous system. Alteration in the predictable nature of tendon reflexes is the most common indicator suggesting the possibility of diabetic neuropathy. Evaluation of tendon reflexes is a part of various clinical scoring systems that assess neuropathy. The conventional reflex grading scales are subjective, lack temporal data, and have high inter-rater variability. Hence, an indigenous quantification tool was developed to evaluate the tendon reflexes in order to assess diabetic peripheral neuropathy. MATERIALS AND METHODS: A cross-sectional study was carried out in 140 healthy volunteers and 140 patients with type 2 diabetes. The mean age of controls and diabetics (49.1 ± 8.9, 50.7 ± 7.5) years, weight (66.9 ± 9.4, 69.8 ± 11.5) kilograms and BMI (24.5 ± 3.8, 26.1 ± 4.7), respectively. All of them are subjected to evaluation of tendon reflexes using the reflex quantification tool comprised of surface mechanomyography and electrogoniometry that can provide various static and dynamic variables of tendon reflex. RESULTS: The dynamic variables such as reflex amplitude, muscle velocity and angular velocity were significantly low in diabetic patients (p: <0.001) whereas latency and duration (p: <0.001) were prolonged. Furthermore, no significant difference was observed in the application of tendon striking force (p: 0.934) among the participants. CONCLUSION: The current study demonstrates that the proposed reflex quantification tool provides several dynamic variables of patellar tendon reflex, which are significantly affected and altered in diabetic patients suggesting the involvement of peripheral neurons.
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Diabetes Mellitus Tipo 2 , Neuropatías Diabéticas , Reflejo de Estiramiento , Humanos , Diabetes Mellitus Tipo 2/fisiopatología , Diabetes Mellitus Tipo 2/complicaciones , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Neuropatías Diabéticas/diagnóstico , Neuropatías Diabéticas/fisiopatología , Neuropatías Diabéticas/etiología , Reflejo de Estiramiento/fisiología , Adulto , Estudios de Casos y Controles , Estudios de Seguimiento , Pronóstico , Miografía/métodos , Músculo Esquelético/fisiopatologíaRESUMEN
Objectives: To analyze community experiences involving COVID-19 vaccination access and equity in Black and Latina/o/x communities within South Los Angeles, using a socioecological framework. Methods: We conducted four virtual focus groups (n = 33 total participants) in 2021, with Black and Latina/o/x community members, community leaders, and community-based providers in South Los Angeles, a region highly impacted by the COVID-19 pandemic. We used a grounded theory approach to guide the analysis and generate data shaped by participant perspectives. Results: Participants across groups consistently emphasized medical mistrust, fear/skepticism, misinformation, accessibility, and feelings of pressure and blame as factors influencing COVID-19 vaccination decisions. The need to address pandemic-related socioeconomic hardships in underresourced communities was equally highlighted. Conclusions: Findings show that building trust, providing tailored information, and continued investment into diversity and equity initiatives can support Black and Latino/a/x communities in making informed health decisions. Community-centered support services should address the economic, social, and structural impact of the pandemic on vulnerable communities. Furthermore, public health and policy efforts must prioritize funding to equip social and health care systems with infrastructure investment in racial and ethnic minority communities.
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On April 28, 2023, the University of California Office of the President, in partnership with the California Department of Cannabis Control (DCC), hosted the California Cannabis Research Briefing. The California Cannabis Research Briefing brought together researchers and state agencies/policymakers to discuss pertinent policy issues on cannabis within the state. Researchers across six different topic areas (environment, cannabis markets, social equity matters, public health, medicinal cannabis use, and public safety) provided brief explanations of their research and its policy implications. A moderated discussion with stakeholders followed these presentations. The goals of this event were to highlight research that can inform policy issues relevant to the state, and to discuss how research can be incorporated into the cannabis policy landscape.
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Nigella sativa (N. sativa) (Family Ranunculaceae) is a popular therapeutic herb in many parts of the world. It is widely used in traditional medical systems such as Unani, Ayurveda and Siddha. Seeds and oil have a long history of folkloric use in many medicinal and culinary systems. The seeds of N. sativa have long been used to treat a variety of illnesses and disorders. Studies on N. sativa and its therapeutic potential have been investigated. This includes anti-diabetic, anticancer, immune-modulatory, analgesic, antimicrobial, anti-inflammatory, spasmolytic, bronchodilator, hepato-protective, renal protective, gastro-protective, antioxidant properties, and several others. Nigella sativa contains thymoquinone. This is a bioactive component of the essential oil with medicinal benefits. Therefore, it is of interest to report a comprehensive data on the therapeutic usefulness of N. sativa in hypo-cholesterolemic activity.
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BACKGROUND: A combination of yoga practices has been documented to reduce stress and stress-induced cortisol levels. The objective of the current study is to examine the effects of six months of a single pranayama practice (Bhramari [Bhr. P]) on reducing salivary cortisol response to the cold pressor test (CPT) among adolescents. METHODS: Twenty-six healthy adolescents between the ages of 11 and 19 were randomly assigned to either yoga group (n-13) or control group (n-13). Yoga group participants were trained to do Bhr. P for 45 min, thrice a week for six months. All participants underwent CPT at baseline and at end of six months. Saliva samples were collected at baseline (t0), at 20 min (t1), 40 min (t2), and 60 min after the CPT (t3). RESULTS: Contradictory to our hypothesis, participants in the yoga group exhibited a higher salivary cortisol response to the CPT at t1 (p = 0.04) when compared to the control group. However, the t3 salivary cortisol levels showed a statistically significant reduction (p = 0.03) in yoga group when compared to the control group. A significant interaction with time (F (1, 88) = 316.5, p = .001, ηp2:0.91) and between the group × time (F (3, 88) = 2.83, p = 0.04, ηp2:0.8) was found after the intervention. CONCLUSIONS: An increase in the cortisol responsiveness observed in the study is an indication of the adaptive capability achieved through regular yoga training, evidenced by an initial rise in cortisol followed by a rapid fall below baseline after 60 min. Further research is required to conclusively determine the changes in cortisol levels over time in response to stress in long-term yoga practitioners.
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Meditación , Yoga , Adolescente , Adulto , Niño , Humanos , Hidrocortisona , Proyectos de Investigación , Saliva , Adulto JovenRESUMEN
BACKGROUND: Black and Latina cisgender women (BLCW) experience disproportionately high rates of HIV infection compared with White women. BLCW also experience disparities in uptake of pre-exposure prophylaxis (PrEP), a highly effective HIV prevention strategy. Digital technology interventions may help to improve PrEP accessibility among BLCW and address barriers to receiving PrEP services in clinical settings. METHODS: We conducted a formative implementation research project with service providers to explore the use of digital technology interventions to improve PrEP care continuum outcomes among priority populations in Los Angeles County. A thematic analysis approach was then used to assess the perceived acceptability and appropriateness of digital PrEP interventions for BLCW. RESULTS: Of the five technology products presented, service providers viewed the stand-alone telemedicine platforms as the most acceptable intervention type for BLCW. Service providers also noted perceived benefits and barriers that BLCW may experience in using stand-alone telemedicine platforms, and offered recommendations for tailoring the products to meet the individual needs of BLCW. CONCLUSIONS: Digital PrEP interventions may help address barriers BLCW experience in accessing PrEP in clinical settings. We offer suggestions of implementation strategies to optimize the use of digital PrEP interventions among BLCW.
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Fármacos Anti-VIH , Infecciones por VIH , Profilaxis Pre-Exposición , Fármacos Anti-VIH/uso terapéutico , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Hispánicos o Latinos , Humanos , Los AngelesRESUMEN
BACKGROUND: Postgraduate medical curriculum is usually devoted to developing competencies in the specialty concerned, patient care, and submitting dissertations. The need to impart teaching skills during postgraduation has gone unnoticed, hence Ramachandra Annual Postgraduate Teaching Skills (RAPTS), a teaching skills workshop, was conceptualized and implemented as postgraduate students serve as tutors/residents in the department to teach undergraduate medical students. This study is aimed to evaluate the effectiveness of the teaching skills workshop for postgraduates. MATERIALS AND METHODS: One hundred and seventy-eight postgraduate students of pre- and paraclinical department underwent the training in medical education principles and participated in the feedback. RAPTS Workshop was implemented as per the six-step approach. The learning was evaluated through a pre- and posttest scores. Student feedback was also obtained on the process overall objectives and contents of the workshop. Force-field analysis was performed. RESULTS: There was a significant learning by the postgraduates on various medical education principles as evidenced by significant improvement in the posttest scores (P < 0.05). Feedback regarding the general aspects of the workshop showed that 92% of the participants felt that the contents of the workshop suited their learning. Eighty-four percent of the participants opined that the presentations of the sessions were good and 91% felt that time management was good. Force-field analysis indicated that the factors favoring teaching skills workshop were higher. CONCLUSION: This study has highlighted the importance of including teaching methodology training in the postgraduate curriculum that helps in grooming the future teachers in the right direction, in the right time. Competencies related to teaching skills based on medical education principles can be included in the postgraduate curriculum.
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Several methods for the stimulation of skin wound repair have been proposed over the last few decades. The most promising among them are gene and stem cell therapy. Our present experiments combined several approaches via the application of human umbilical cord blood mononuclear cells (hUCB-MC) that were transfected with pBud-VEGF165-FGF2 plasmid (gene-cell therapy) and direct gene therapy using pBud-VEGF165-FGF2 plasmid to enhance healing of full thickness skin wounds in rats. The dual expression cassette plasmid pBud-VEGF165-FGF2 encodes both VEGF and FGF2 therapeutic genes, expressing pro-angiogenic growth factors. Our results showed that, with two weeks post-transplantation, some transplanted cells still retained expression of the stem cell and hematopoietic markers C-kit and CD34. Other transplanted cells were found among keratinocytes, hair follicle cells, endothelial cells, and in the derma. PCNA expression studies revealed that transplantation of transfected cells terminated proliferative processes in regenerating wounds earlier than transplantation of untransfected cells. In the direct gene therapy group, four days post-operatively, the processes of flap revascularization, while using Easy LDI Microcirculation Camera, was higher than in control wounded skin. We concluded that hUCB-MC can be used for the treatment of skin wounds and transfection these cells with VEGF and FGF2 genes enhances their regenerative abilities. We also concluded that the application of pBud-VEGF165-FGF2 plasmids is efficient for the direct gene therapy of skin wounds by stimulation of wound revascularization.
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ADN Recombinante/metabolismo , Factor 2 de Crecimiento de Fibroblastos/metabolismo , Neovascularización Fisiológica/genética , Plásmidos/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo , Animales , Femenino , Humanos , Masculino , Ratas , Ratas Wistar , TransfecciónRESUMEN
BACKGROUND: Air pollution due to road traffic is a solemn health hazard and vehicular emissions due to huge population in the cities are the main reason for the air quality crisis. The study was conducted to assess the degree of impairment in lung function in traffic police personnel exposed to traffic pollution compared to less-exposed healthy subjects. MATERIALS AND METHODS: This comparative cross-sectional study was conducted among 250 traffic police personnel, aged 20-55 years, working in Chennai city, as compared to a matched control group, consisting of 250 less-exposed subjects. Measurement of pulmonary function testing was done with an RMS Helio 401. Statistical analysis was carried out with R statistical software. RESULTS: The traffic police personnel had significantly (P < 0.05) declined FEV1 and FEV1/FVC ratio and FEF 25-75% (L/s) as compared to controls. Traffic personnel with longer duration of exposure showed significantly (P < 0.05) reduced lung functions than those with shorter duration. We have found a significant negative correlation with all pulmonary function parameters such as FVC, FEV1, FEV1/FVC, PEFR, and FVC 25%-75% among the traffic police personnel. CONCLUSION: The impairment of pulmonary function among the traffic police personnel might be due to the effect of pollution by vehicular exhausts and they should be offered personal protective or preventive measures.
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CONTEXT: Pranayama, the fourth limb of ancient astanga yoga consists of breathing techniques which produce various physiological and psychological effects. Though various types of pranayama and their effects have been scientifically established, Bhramari pranayama (Bhr.P) is the one whose effects still remain understated. AIMS: The present study was conducted to find the effects of Bhramari pranayama practice on pulmonary function in healthy adolescents. STUDY DESIGN: Randomized control trial. SUBJECTS AND METHODS: 90 healthy adolescents including 32 females and 58 males participated in the study. They were randomly divided into Bhr.P group (n = 45) and Control group (n = 45) by a simple lottery method. Pulmonary function test was done at baseline and at end of 12th week using RMS Helios spirometry. Pranayama group students were trained to do Bhr.P as 3 to 4 breaths/min for 5 min followed by 2 min rest. This was one cycle and in this way, they were instructed to do five cycles each time for 45 minutes five days in a week. Control group students were not allowed to practice any kind of exercise throughout the study period. STATISTICAL ANALYSIS: Student paired and unpaired T tests were used to analyse the intra group and intergroup differences using R statistical software. RESULTS: A significant (P < 0.05) improvement in all pulmonary function parameters; FVC, FEV1, FEV1/FVC ratio, FEF 25%-75% and PEFR was seen in the Bhr.P group than the control group adolescents. Slow vital capacity (SVC) and Maximum Voluntary Volume (MVV) also showed significant improvement in the pranayama group. CONCLUSIONS: Bhramari Pranayama practice is effective in improving the pulmonary function among the adolescents which could be utilized for further clinical studies.
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OBJECTIVE: Prior research suggests that congregational characteristics are associated with the racial attitudes of Black churchgoers. This study examines the relationship between congregational diversity and beliefs about the Black/White socioeconomic gap among Black religious adherents. METHOD: Drawing upon pooled data from the General Social Survey and the National Congregations Study, we fit binary logistic regression models to estimate the association between congregational size and the explanations of Black/White economic inequality among Black religious adherents. RESULTS: Findings from our study reveal that congregational diversity is one factor that accounts for intragroup differences in racial attitudes among Black religious affiliates. Relative to Blacks that attend religious services in overwhelmingly Black congregations, Blacks that attend religious services in congregations that are overwhelmingly White and are overwhelmingly comprised of non-Black racial/ethnic minorities are significantly less likely to attribute Black/White socioeconomic gaps to structural factors. CONCLUSION: Our study demonstrates that congregational diversity is a source of intragroup variation in racial attitudes among Black religious affiliates, which may attenuate the ability of such congregations to bridge racial divisions.
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BACKGROUND: Heart rate variability (HRV) analysis is a simple and noninvasive technique capable of assessing autonomic nervous system modulation on heart rate (HR) in healthy as well as disease conditions. The aim of the present study was to compare (validate) the HRV using a temporal series of electrocardiograms (ECG) obtained by simple analog amplifier with PC-based sound card (audacity) and Biopac MP36 module. MATERIALS AND METHODS: Based on the inclusion criteria, 120 healthy participants, including 72 males and 48 females, participated in the present study. Following standard protocol, 5-min ECG was recorded after 10 min of supine rest by Portable simple analog amplifier PC-based sound card as well as by Biopac module with surface electrodes in Leads II position simultaneously. All the ECG data was visually screened and was found to be free of ectopic beats and noise. RR intervals from both ECG recordings were analyzed separately in Kubios software. Short-term HRV indexes in both time and frequency domain were used. RESULTS: The unpaired Student's t-test and Pearson correlation coefficient test were used for the analysis using the R statistical software. No statistically significant differences were observed when comparing the values analyzed by means of the two devices for HRV. Correlation analysis revealed perfect positive correlation (r = 0.99, P < 0.001) between the values in time and frequency domain obtained by the devices. CONCLUSION: On the basis of the results of the present study, we suggest that the calculation of HRV values in the time and frequency domains by RR series obtained from the PC-based sound card is probably as reliable as those obtained by the gold standard Biopac MP36.
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Oxidative damage has been implicated in pathogenesis of many diseases. It is known that various kinds of stresses accelerate the production of free radicals. As pregnancy being a physiological state accompanied by a high energy demand of many bodily functions and an increased oxygen requirement, increased level of oxidative stress would be expected. The present study was to elucidate the degree of oxidative stress during labour and immediately after delivery. Twenty healthy pregnant women and age matched and 20 healthy non-pregnant women were selected as subjects for this longitudinal study. Plasma malondialdehyde concentration was estimated as thiobarbituric acid reacting substances. A significant (p < 0.01) increase in plasma malondialdehyde concentration was noted in pregnant women during labour than in the non-pregnant women. Plasma malondialdehyde concentration was noted to increase with the progression and duration of labour to immediately following delivery. Labour being stressful state results in oxidative stress, which increased with increase in duration and progression of the labour till immediately following delivery.