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1.
Pathogens ; 13(5)2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38787230

RESUMEN

Deer are susceptible to infection with parasitic helminths, including species which are of increasing economic concern to the livestock industry due to anthelmintic drug resistance. This paper systematically collates helminth prevalence data from deer across Europe and explores patterns in relation to host and parasite species, as well as landscape factors. A livestock pasture contact index (LPCI) is developed to predict epidemiological overlap between deer and livestock, and hence to examine deer helminth fauna in the context of their surrounding environment. Fifty-eight studies comprising fallow (Dama dama), red (Cervus elaphus), roe (Capreolus capreolus) and sika (Cervus nippon) deer were identified. Deer populations in "likely" contact with livestock pasture had a higher mean prevalence of the abomasal nematodes Haemonchus contortus, Ostertagia ostertagi, Teladorsagia circumcincta and Trichostrongylus axei (p = 0.01), which are common in livestock and not primarily associated with deer. Roe deer populations had a higher prevalence of T. circumcincta (p = 0.02) and T. axei (p = 0.01) than fallow deer and a higher prevalence of H. contortus than both red (p = 0.01) and fallow deer (p = 0.02). Liver fluke and lungworm species were present sporadically at low prevalence, while the abomasal nematode Ashworthius sidemi occurred locally at high prevalence. Insights from this research suggest that deer helminth fauna is reflective of their surrounding environment, including the livestock species which inhabit areas of shared grazing. This is explored from an epidemiological perspective, and the prospect of helminth transmission between wild and domestic hosts is discussed, including drug-resistant strains, alongside the role of helminths as indicators relevant to the transmission of other pathogens at the wildlife-livestock interface.

2.
Parasit Vectors ; 17(1): 141, 2024 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-38500187

RESUMEN

BACKGROUND: Wild deer populations utilizing livestock grazing areas risk cross-species transmission of gastrointestinal nematode parasites (GINs), including GINs with anthelmintic resistance (AR) traits. Wild deer have been shown to carry problematic GIN species such as Haemonchus contortus and Trichostrongylus species in the UK, but the presence of livestock GINs in Northern Ireland deer populations is unknown. Also, is it not known whether AR traits exist among GINs of deer such as Ostertagia leptospicularis and Spiculopteragia asymmetrica in pastureland where anthelmintics are heavily used. METHODS: Adult-stage GIN samples were retrieved from Northern Irish wild fallow deer abomasa. Individual specimens were subject to a species-specific PCR analysis for common sheep and cattle GIN species with ITS-2 sequence analysis to validate species identities. In addition, the beta-tubulin gene was subject to sequencing to identify benzimidazole (BZ) resistance markers. RESULTS: ITS-2 sequencing revealed O. leptospicularis and S. asymmetrica, but species-specific PCR yielded false-positive hits for H. contortus, Teladorsagia circimcincta, Trichostrongylus axei, T. colubriformis, T. vitrinus and Ostertagia ostertagi. For beta-tubulin, O. leptospicularis and S. asymmetrica yielded species-specific sequences at the E198 codon, but no resistance markers were identified in either species at positions 167, 198 or 200 of the coding region. DISCUSSION: From this report, no GIN species of significance in livestock were identified among Northern Ireland fallow deer. However, false-positive PCR hits for sheep and cattle-associated GINs is concerning as the presence of deer species in livestock areas could impact both deer and livestock diagnostics and lead to overestimation of both GIN burden in deer and the role as of deer as drivers of these pathogens. ITS-2 sequences from both O. leptospicularis and S. asymmetrica show minor sequence variations to geographically distinct isolates. AR has been noted among GINs of deer but molecular analyses are lacking for GINs of wildlife. In producing the first beta-tubulin sequences for both O. leptospicularis and S. asymmetrica, we report no BZ resistance in this cohort. CONCLUSIONS: This work contributes to genetic resources for wildlife species and considers the implications of such species when performing livestock GIN diagnostics.


Asunto(s)
Antihelmínticos , Ciervos , Nematodos , Trichostrongyloidea , Humanos , Animales , Bovinos , Ovinos , Ciervos/parasitología , Ostertagia/genética , Animales Salvajes , Ganado , Tubulina (Proteína)/genética , Irlanda del Norte/epidemiología , Trichostrongyloidea/genética , Antihelmínticos/uso terapéutico , Trichostrongylus
3.
Sex Transm Dis ; 51(2): 96-101, 2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-37963336

RESUMEN

BACKGROUND: Increasing rates of bacterial sexually transmitted infections (STIs) may lead to increased HIV rates, as the STI and HIV epidemics are syndemic. Centers for Disease Control and Prevention guidelines recommend including extragenital (i.e., rectal and/or pharyngeal) STI screenings for certain populations at increased risk of STIs and concurrent infections with HIV. METHODS: A descriptive study was conducted by interviewing staff members from 4 rural primary care clinics in areas of high need for STI and HIV services in South Carolina. Qualitative data about their clinical practices in 2021 were obtained. The primary outcome was to determine the awareness and availability of health care services associated with STI and HIV care in these locations. RESULTS: Clinics in target counties provided limited STI and HIV testing and treatment services, especially for populations at risk of infection, indicating the need for additional clinical training and professional development for all clinic staff. Specifically, only 1 of 4 clinics provided extragenital STI testing, and no clinics reported prescribing preexposure prophylaxis. CONCLUSIONS: Rural primary care clinics can fill important gaps in the availability of STI and HIV services with appropriate support and incentives. Findings from this study may aid in facilitating policy (state Medicaid agency) and program (state health department) decisions related to STI and HIV testing and treatment.


Asunto(s)
Infecciones por VIH , Enfermedades de Transmisión Sexual , Humanos , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Medicina Basada en la Evidencia , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/epidemiología , Motivación , Atención Primaria de Salud
4.
Am J Mens Health ; 17(3): 15579883231177981, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37249084

RESUMEN

Addressing the psychosocial concerns of Black men who have sex with men (MSM), such as HIV disclosure, is critical for effective HIV treatment efforts. Black MSM living with HIV experience multiple psychosocial challenges, such as "triple stigma" due to their sexual orientation, racial minority status, and HIV status, which hinder their HIV disclosure and subsequent HIV care-seeking behavior. Our study sought to examine the HIV disclosure patterns and their impact on the HIV care continuum among Black MSM using a qualitative approach. Semi-structured interviews were carried out among 28 Black MSM aged ≥18 years old living in South Carolina. A thematic analysis process was employed for data analysis. The emerging themes of facilitators of HIV disclosure included the sense of personal responsibility to disclose one's HIV status within the context of a relationship and having other family members living with HIV, while the barriers included fear of family rejection or religious reasons. A few participants preferred to disclose to friends due to the less shame in sharing their status to friends than other confidants (e.g., family members). HIV disclosure was found to be a facilitator for linkage to care and retention in care through social support obtained from disclosure confidants. Helping patients to identify a single person (e.g., family member) to share their HIV status may offer equivalent benefits to wider disclosure. Interventions occurring at multiple levels (e.g., targeting religious groups) and within multiple contexts are needed to promote HIV disclosure and improve clinical outcomes in the Black MSM community.


Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Humanos , Masculino , Femenino , Adolescente , Adulto , Revelación , Homosexualidad Masculina/psicología , Infecciones por VIH/psicología , South Carolina , Conducta Sexual , Estigma Social
5.
Biol Lett ; 18(5): 20220057, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-35506237

RESUMEN

Wild ruminants are susceptible to infection from generalist helminth species, which can also infect domestic ruminants. A better understanding is required of the conditions under which wild ruminants can act as a source of helminths (including anthelmintic-resistant genotypes) for domestic ruminants, and vice versa, with the added possibility that wildlife could act as refugia for drug-susceptible genotypes and hence buffer the spread and development of resistance. Helminth infections cause significant productivity losses in domestic ruminants and a growing resistance to all classes of anthelmintic drug escalates concerns around helminth infection in the livestock industry. Previous research demonstrates that drug-resistant strains of the pathogenic nematode Haemonchus contortus can be transmitted between wild and domestic ruminants, and that gastro-intestinal nematode infections are more intense in wild ruminants within areas of high livestock density. In this article, the factors likely to influence the role of wild ruminants in helminth infections and anthelmintic resistance in livestock are considered, including host population movement across heterogeneous landscapes, and the effects of climate and environment on parasite dynamics. Methods of predicting and validating suspected drivers of helminth transmission in this context are considered based on advances in predictive modelling and molecular tools.


Asunto(s)
Antihelmínticos , Haemonchus , Animales , Antihelmínticos/farmacología , Antihelmínticos/uso terapéutico , Resistencia a Medicamentos/genética , Haemonchus/genética , Ganado , Rumiantes
6.
J Law Med ; 29(1): 203-207, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35362288

RESUMEN

In 2020 the New South Wales Liquor Act was amended to allow the Independent Liquor and Gaming Authority (ILGA) to approve new liquor authorisations in parts of the Sydney CBD otherwise subject to a freeze. The vehicle for this was called Cumulative Impact Assessment (CIA). The Amendment added promotion of business vitality to an established list of considerations previously set out by ILGA in its Guideline (6) on social impact assessment. The strategy set out in a new Guideline (18) appears to use an impartial and objective methodology while advocating reliance on intangible criteria and selective use of data in order to increase applicant chances of success against a rebuttable presumption against approval. While CIA is an established method in other professional areas, its use in the amendment influenced by the industry risks exacerbating alcohol-related harm.


Asunto(s)
Bebidas Alcohólicas , Reducción del Daño , Comercio , Nueva Gales del Sur , Cambio Social
7.
PNAS Nexus ; 1(5): pgac209, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36712342

RESUMEN

Population size has increasingly been taken as the driver of past human environmental impact worldwide, and particularly in the Arctic. However, sedimentary ancient DNA (sedaDNA), pollen and archaeological data show that over the last 12,000 years, paleoeconomy and culture determined human impacts on the terrestrial ecology of Arctic Norway. The large Mortensnes site complex (Ceavccageadgi, 70°N) has yielded the most comprehensive multiproxy record in the Arctic to date. The site saw occupation from the Pioneer period (c. 10,000 cal. years BP) with more intensive use from c. 4,200 to 2,000 cal. years BP and after 1,600 cal. years BP. Here, we combine on-site environmental archaeology with a near-site lake record of plant and animal sedaDNA. The rich animal sedaDNA data (42 taxa) and on-site faunal analyses reveal switches in human dietary composition from early-Holocene fish + marine mammals, to mixed marine + reindeer, then finally to marine + reindeer + domesticates (sheep, cattle, pigs), with highest reindeer concentrations in the last millennium. Archaeological evidence suggests these changes are not directly driven by climate or variation in population densities at the site or in the region, but rather are the result of changing socio-economic activities and culture, probably reflecting settlers' origins. This large settlement only had discernable effects on its hinterland in the last 3,600 years (grazing) and more markedly in the last 1,000 years through reindeer keeping/herding and, possibly domestic stock. Near-site sedaDNA can be linked to and validate the faunal record from archaeological excavations, demonstrating that environmental impacts can be assessed at a landscape scale.

8.
Soc Curr ; 9(5): 486-505, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38603136

RESUMEN

This study analyzes five publicly posted videos wherein Asians experience interpersonal discrimination because of COVID-19. We think social scientists ignore how videos provide data for investigating interpersonal discrimination. We characterize the videos according to multiple features including context, characteristics, and responses of individuals involved, type of threat or mistreatment, and level of psychological and physical harm. We then summarize features across the videos. Among other things, analyses uncover implicit, explicit, and historically specific anti-Asian sentiment alongside evidence perpetrators are men and bystanders do not intervene typically. The Discussion contrasts Asians' experiences of interpersonal discrimination because of COVID-19 against the interpersonal and institutional discrimination faced by American Indians, blacks, and Hispanics in the United States. That contrast brings Asians' positionality into sharp relief.

9.
J Community Psychol ; 49(8): 3162-3177, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34766632

RESUMEN

Culture shapes and animates how community organizing is understood and carried out in specific contexts. Many frameworks for examining organizing, however, do not effectively attend to the influences of culture. Greater understanding of how culture can be imbued in organizing can help to ground it in the social realities of organizing participants and can advance approaches to organizing that honor the past and present of specific cultures. This study details local culturally grounded community organizing work rooted in Indigenous, and specifically Menominee, culture. First, it provides a description of the formation of the organization Menikanaehkem in the Menominee Nation and includes examples of how current organizing practices of Menikanaehkem build from long-standing Menominee cultural practices. It then highlights the reinvigoration of cultural practices, or re-indigenization, as an important goal for community power building in Menikanaehkem. It ends with a discussion of the importance of culture in frameworks for understanding, analyzing, and promoting organizing as an endeavor to advance well-being in a way that also interrupts cycles of structural oppression, such as legacies of settler colonialism.


Asunto(s)
Colonialismo , Grupos de Población , Humanos
10.
Sociol Race Ethn (Thousand Oaks) ; 7(1): 101-115, 2021 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34084872

RESUMEN

This study examines the mental health significance of Barack Obama's 2008 presidential election for black adults. His election was a milestone moment. Hence, we expect black adults would experience improved mental health after the first self-identified black person wins election to the most powerful position in the United States. Using nationally representative survey data from the Behavioral Risk Factor Surveillance System (BRFSS), we address this expectation by predicting poor mental health days that black adults report pre-election and post-election. We find no overall difference in poor mental health days between the time periods. However, a statistical interaction between gender and time period demonstrates black men report 1.01 fewer poor mental health days after the election, whereas black women report .45 more poor mental health days after the election.

11.
Soc Sci Med ; 265: 113552, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33277068

RESUMEN

We examined how sociopolitical context (marked by generational cohort) and maternal skin color interacted to influence preterm delivery (PTD) rates in sample of Black women. Data were from 1410 Black women, ages 18-45 years, residing in Metropolitan Detroit, MI enrolled (2009-2011) in the Life-course Influences on Fetal Environments (LIFE) Study. Because we hypothesized that generational differences marked by changes in the sociopolitical context would influence exposure to racism, we categorized women into two cohorts by maternal birth year: a) Generation X, 1964-1983 and b) Millennial, 1984-1993. Descriptive results showed similar PTD rates by generational cohort, Generation X: 16.3% vs. Millennials: 16.1%. Yet, within each generation, PTD rates varied by women's skin tone (categorized: light, medium, and dark brown). Poisson regression models confirmed a significant interaction between generational cohort and maternal skin tone predicting PTD (P = 0.001); suggesting a salubrious association between light brown skin tone (compared to medium and dark) and PTD for Generation X. However, Millennials with medium and dark brown skin experienced lower PTD rates than their light Millennial counterparts. Research should consider sociopolitical context and the salience of skin tone bias when investigating racial health disparities, including those in perinatal health.


Asunto(s)
Nacimiento Prematuro , Racismo , Adolescente , Adulto , Negro o Afroamericano , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Persona de Mediana Edad , Embarazo , Nacimiento Prematuro/epidemiología , Atención Prenatal , Pigmentación de la Piel , Adulto Joven
12.
J Law Med ; 27(4): 1047-1073, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32880418

RESUMEN

This article confirms that industry compliance and enforcement processes are an essential consideration in the growing pantheon of legal and commercial determinants of public health. While alcohol control laws vary between individual jurisdictions, their development and application are confronted by a common threat of undue industry influence or capture. This necessitates a greater understanding of this phenomenon to better inform a collective and effective international public health response. New South Wales Australia, has developed a layer of alcohol industry compliance laws in the form of disciplinary schemes. This article critically explicates the first of these, the Violent Venues Scheme (VVS), to determine the nature and extent of any capture. This would significantly compromise harm minimisation statutory objects and disrupt the democratic process and the rule of law. In contrast, an influential industry identity, attributed the earlier last drinks laws, VVS and a related scheme as causing the alleged destruction of Sydney's nighttime economy and fun. The research also analyses the indispensible role of a neoliberal paradigm in legitimising exclusive relationships between governments and industry. This is indelibly imprinted on the alcohol regulatory landscape.


Asunto(s)
Bebidas Alcohólicas , Industrias , Salud Pública , Consumo de Bebidas Alcohólicas , Bebidas Alcohólicas/normas , Australia , Humanos , Industrias/normas , Nueva Gales del Sur
13.
J Autism Dev Disord ; 50(5): 1470-1478, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-30051187

RESUMEN

This study explored the social-cognitive profile of 173 adults referred for an autism assessment. We considered key dimensional traits (autism, empathy and systemising) to understand social cognition in adults diagnosed with an autism spectrum condition compared with those who were referred for, but did not receive a diagnosis. There were no significant social cognitive differences between groups on measures of emotion recognition and social inference. Adults with a confirmed diagnosis, however, reported fewer empathising traits which were positively associated with social-cognitive understanding. Empathising partially mediated the relationship between diagnostic group and social-cognition. Lower empathising traits in individuals diagnosed in adulthood may be important in understanding challenges with social adaptability. The findings have implications for assessment and highlight the role of empathy in developing social understanding in autism.


Asunto(s)
Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/psicología , Cognición , Empatía , Conducta Social , Adulto , Femenino , Humanos , Masculino , Adulto Joven
14.
J Law Med ; 26(4): 764-785, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31682356

RESUMEN

Contemporary public health literature contains an increasing emphasis on the commercial determinants of health including the influence of unhealthy food, beverage and tobacco industries on government harm prevention policy agendas and global sustainable development goals. Effective capture by the industries of the crucial legislative process associated with the harm prevention initiatives would have a detrimental impact on public health. This article proposes a qualitative multi-spectrum prototype legislative capture test with broad application to a range of industries and jurisdictions at all levels of government where legislative capture may be suspected. It is predicated on a finding of significant encroachment of the public interest (PI) by special interest groups and reciprocating beneficial conduct between the lawmakers and the group. The test is populated from a critical case study of key New South Wales (NSW) alcohol industry statutory amendments within a doctrinal and social inquiry/power framework. It relies upon parliamentary records and secondary data to analyse critically the 2015 "fit for purpose" (FFP) reforms to NSW alcohol supply laws and their consistency with the PI and other constitutional safeguards. It aligns the reforms with other research relating to the magnitude of alcohol and gambling industry political donations and the operation of the alcohol outlet post reform approval process. The application of the test to the case study finds that the 2015 FFP amendments are indicative of legislative capture and associated clientele corruption - critical new considerations in the commercial determination of health. It also identifies the commodification of the PI.


Asunto(s)
Salud Pública/legislación & jurisprudencia , Juego de Azar , Política de Salud , Humanos , Nueva Gales del Sur , Salud Pública/economía , Industria del Tabaco
15.
J Law Med ; 26(4): 786-799, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31682357

RESUMEN

In 2004 legislators in New South Wales relied on Australia's National Competition Policy to change the reason for determining alcohol outlet approvals from a "needs" to a "harm minimisation" basis. This was predicated on the application of a rational social impact assessment (SIA) process. Within a short time, however, the volume of liquor licence applications began to erode that intention and the delays that applicants encountered placed politicians under pressure to fast-track the process. Subsequent liquor legislation retained the statutory obligation on decision-makers to ensure no overall detrimental social impact associated with the approval of an alcohol outlet licence. However, legislative amendments to the approval process reduced the number and kinds of licences and authorisations to which the social impact test applied and encouraged other shortcuts which undermine the validity of these assessments. The resulting statutory approval system in practice relegates SIA to an exception rather than the rule and has revealed the relative weakness of SIA as a public health safeguard.


Asunto(s)
Consumo de Bebidas Alcohólicas , Cambio Social , Bebidas Alcohólicas , Australia , Comercio , Nueva Gales del Sur
16.
J Clin Aesthet Dermatol ; 12(1): 16-23, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30881572

RESUMEN

Increased incidence of comorbidity in advanced metastatic melanoma (AMM) is emerging as an important factor in patient prognosis, treatment, and survival. This paper reviews the impact of comorbidities on the prognosis and survival outcomes of patients diagnosed with AMM. Our search initially yielded limited results. We then broadened our search to include breast, colorectal, and prostate cancer and covered malignancies in which screening (like melanoma) is associated with the detection of early-stage disease. Most studies showed that a higher prevalence of comorbidity was associated with more advanced cancer stage. Both treatment and survival of patients were influenced by age and the extent of comorbidity. Racial differences in survival were greatest for patients with no comorbidities and less evident at higher levels of comorbidity. Comorbid conditions showed differential effects for prognosis, treatment, and survival. Limited Information in the literature demonstrates that more research is warranted with respect to comorbidities and AMM.

17.
BMJ Case Rep ; 20182018 Aug 17.
Artículo en Inglés | MEDLINE | ID: mdl-30121567

RESUMEN

This is a single case of a 65-year-old American woman who presented with substantial weight gain and insulin resistance (IR) post-Roux-en-Y gastric bypass (RYGB) surgery. Before RYGB, she had reached 340 lbs (155 kg) and a body mass index (BMI) of 56.6 kg/m2 The surgery resulted in a 70 lbs (32 kg) weight loss, bringing her BMI, per cent total weight loss (%TWL) and per cent excess weight loss (%EWL) to 44.9 kg/m2, 20.6% and 36.8%, respectively. Unfortunately, her BMI would return to 53.6 kg/m2, nearly her pre-RYGB BMI. It was then she sought the guidance of a primary care physician with expertise in nutrition and medical management of obesity, who placed her on a ketogenic diet. One year later, she had lost 102 lbs (46.4 kg), resulting in a BMI, %TWL and %EWL of 36.6 kg/m2, 31.7%, and 63.1%, respectively, also further resulting in significant improvements of her inflammatory biomarkers. This case presentation will explore current literature, covering the effects of obesity on IR, pre-diabetes and other disease-provoking inflammatory biomarkers.


Asunto(s)
Dieta Cetogénica , Resistencia a la Insulina , Obesidad Mórbida/cirugía , Anciano , Diagnóstico Diferencial , Femenino , Derivación Gástrica , Humanos , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/dietoterapia
18.
Ethn Dis ; 28(2): 69-74, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29725190

RESUMEN

Objective: To build upon research that investigates the health significance of familial and former incarceration with special emphasis on obesity risk among native-born Black (ie, African American) men. Methods: We analyzed data from the 2001-2003 National Survey of American Life (NSAL), focusing on native-born Black men (n=1140), the demographic group that bears the brunt of mass incarceration. The outcome of interest was obesity as measured by body mass index (BMI)>30. Principal predictors were familial and former incarceration, and their statistical interaction. Results: In survey-adjusted binomial logistic regression models, familial incarceration appeared an unimportant predictor; whereas, former incarceration associated with a lower risk of obesity. However, former incarceration modifies the association between familial incarceration and obesity, such that native-born Black men experiencing both familial and former incarceration were significantly more likely to be obese. Conclusions: Public health researchers should treat former incarceration with greater care in studies including native-born Black men because time spent incarcerated has lingering physical health significance.


Asunto(s)
Obesidad , Adulto , Negro o Afroamericano/estadística & datos numéricos , Índice de Masa Corporal , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Obesidad/diagnóstico , Obesidad/etnología , Prisioneros/estadística & datos numéricos , Salud Pública/métodos , Salud Pública/estadística & datos numéricos , Estados Unidos/epidemiología
19.
BMJ Case Rep ; 20182018 Apr 25.
Artículo en Inglés | MEDLINE | ID: mdl-29695389

RESUMEN

This is the case of a 25-year-old African American woman with a 3-week history of itching with burning, blistering lesions on her torso and extremities. Medical history was unremarkable. Medical treatments included three visits to urgent care, where she was treated with antivirals, oral and topical steroids, antibiotics and antifungals unsuccessfully. We performed a skin biopsy, and immunoflorescent studies revealed a linear deposition of IgA antigen at the basement membrane. The clinical diagnosis of linear IgA dermatosis (LAD) was established, with no eliciting cause, other than potential occupational exposure to Chlamydophila psittaci via her employment in a pet store. This is the first case to our knowledge to report such an association. However, confirmation of the exposure would only establish correlation, not causality. Resolution of symptoms and blisters was achieved with dapsone treatment. Accordingly, we highlight the crucial importance of reviewing exposures, along with the potential aetiology of LAD.


Asunto(s)
Antiinfecciosos/administración & dosificación , Dapsona/administración & dosificación , Inmunoglobulina A/análisis , Dermatosis Bullosa IgA Lineal/diagnóstico , Dermatosis Bullosa IgA Lineal/tratamiento farmacológico , Administración Oral , Adulto , Biopsia , Vesícula/etiología , Errores Diagnósticos , Femenino , Técnica del Anticuerpo Fluorescente Directa , Humanos , Dermatosis Bullosa IgA Lineal/patología
20.
Soc Sci Med ; 196: 158-165, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29190536

RESUMEN

How social and legal climate influence LGB health is an under-studied topic. In response, this study examines whether the lesbian/gay/bisexual (LGB) climate index and presence of anti-discrimination law show population health significance for U.S. sexual minorities. The LGB climate index uses survey data collected between 2012 and 2013 to gauge states' support of lesbian, gay, and bisexual individuals, whereas anti-discrimination law captures any state-level law that makes it illegal to discriminate because of sexual orientation in employment, housing, and public accommodations. We merge these two contextual measures with 2011-2015 Behavioral Risk Factor Surveillance System (BRFSS) aggregated, individual-level survey data, from which we generate three measures of state-level rates: excellent self-rated health, routine health care utilization, and health insurance among self-identified lesbian/gay and bisexual adults. We find that the LGB climate index associates positively with rates of excellent self-rated health, routine health care utilization, and health insurance-but only for states with anti-discrimination laws, and only among lesbian/gay adults. Analyses confirm salubrious synergism between a sexually-minority-friendly climate and anti-discrimination law-together these two contextual measures interact to protect lesbian/gay population health.


Asunto(s)
Salud de las Minorías/estadística & datos numéricos , Prejuicio/legislación & jurisprudencia , Minorías Sexuales y de Género/estadística & datos numéricos , Medio Social , Adulto , Sistema de Vigilancia de Factor de Riesgo Conductual , Estudios Transversales , Femenino , Accesibilidad a los Servicios de Salud , Encuestas Epidemiológicas , Humanos , Seguro de Salud/estadística & datos numéricos , Masculino , Aceptación de la Atención de Salud/estadística & datos numéricos , Estados Unidos
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