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Banana bract mosaic virus (BBrMV) infection results in characteristic reddish streaks on pseudostem and chlorotic spindle lesions on leaves leading to traveler's palm appearance and complete crop loss depending on the stage of infection in banana plants. Here, we discuss the influence of P. indica colonization (a beneficial fungal root endophyte) on BBrMV infection, specific viral component genes responsible for symptom development, chlorophyll and carotenoid biosynthesis, and degradation in BBrMV-infected banana plants. P. indica colonization significantly and substantially reduced the severity of Banana bract mosaic disease (BBrMD) in addition to increased growth, development and yield of banana plants. The percent disease incidence (PDI) of BBrMV ranges from 50 to 70 per cent in plants raised from suckers and from 58 to 92 per cent in TC plants under artificial inoculation. P. indica-colonized plants inoculated with BBrMV resulted in an enhanced plant height, root length, leaf width, and leaf length of 72, 88, 90, and 60 per cent, respectively, compared to BBrMV alone-infected banana plants along with the reduced disease severity. BBrMV infection showed a drastic decrease of chlorophyll a, chlorophyll b, and total chlorophyll contents by down-regulating chlorophyll biosynthesis (Chlorophyll synthase-CHLG) and upregulating chlorophyll degradation (Chlorophyllase-CLH1 and CLH2 and Pheophytin pheophorbide hydrolase-PPH) genes; and by up-regulating carotenoids biosynthesis (Phytoene synthases-PSY1 and PSY2) and down-regulating its degradation (Phytoene desaturase-PDS) genes compared to P. indica-colonized banana plants challenge inoculated with BBrMV. P. indica also inhibited the expression of the viral genes (P3 and HC-Pro) involved in symptom development. P. indica-colonized banana plants reduced the BBrMV symptoms severity by enhancing chlorophyll biosynthesis; and decreasing chlorophyll degradation and carotenoid biosynthesis and degradation; and inhibiting the viral genes responsible for symptom development in addition to enhanced growth and yield of banana plants. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-024-03983-y.
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Clinical trials during public health emergencies of novel medical products such as therapeutics and vaccines in resource-limited settings are daunting due to the limited capacity for regulatory assessment. Regulating clinical trials during the Ebola outbreak in Sierra Leone required expedited evaluation to identify medical products that could be promptly introduced to combat the epidemic in the absence of approved treatment or prevention. This article explored the decisions taken by the Pharmacy Board of Sierra Leone through its Expert Committee on Medicine Safety and Clinical Trials regarding clinical trials oversight during the Ebola epidemic and the lessons learned. This independent expert committee assessed and provided scientific opinions to the Pharmacy Board of Sierra Leone to inform approval of all clinical trials within 10-15 working days. We also requested for assisted review from the African Vaccine Regulatory Forum and support from the US Food and Drug Administration through a unilateral recognition and reliance memorandum of understanding. In addition, the Agency-ensured structures and systems were in place for reporting and reviewing adverse events and serious adverse events, management of biological samples, submission and review of progress reports, and good clinical practice inspections. Unfortunately, the Ebola epidemic revealed many weaknesses in the country's clinical trials regulatory structure and processes. Government and partners should further offer more resources to build the clinical trial structures and systems so that the Agency will be better poised to handle future public health emergencies.
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Epidemias , Fiebre Hemorrágica Ebola , Urgencias Médicas , Epidemias/prevención & control , Fiebre Hemorrágica Ebola/diagnóstico , Fiebre Hemorrágica Ebola/epidemiología , Fiebre Hemorrágica Ebola/terapia , Humanos , Salud Pública , Sierra Leona/epidemiologíaRESUMEN
Peach ( Prunus persica ) trees with a mutation in the weep gene exhibit a weeping branch phenotype. In contrast, Arabidopsis ( Arabidopsis thaliana ) weep mutants do not have a shoot architecture phenotype. A recent report revealed that barley ( Hordeum vulgare ) and wheat ( Triticum aestivum ) with mutations in EGT2, a WEEP homolog, have steeper root angles than standard varieties. We investigated the root architecture of three Arabidopsis weep mutant lines. All three lines exhibited steeper root angles and a smaller convex hull area, indicating that the total area explored by the root system is reduced. These results reveal WEEP is important for regulating lateral root angles in a dicot.
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Proponents of autism intervention and those of the neurodiversity movement often appear at odds, the former advocating for intensive treatments and the latter arguing that autism must be accepted as a form of diversity. The history of behavioral intervention has understandably outraged many in the Autistic community, though many still value supports focused on quality of life. This commentary argues that Naturalistic Developmental Behavioral Interventions (NDBIs) hold promise for bridging the gap between early intervention and the neurodiversity movement. However, we recognize NDBIs have much room to grow and suggest multiple strategies for improvement. We believe these updates are not only feasible for clinicians and researchers to implement but will ultimately lead to improved quality of life for Autistic individuals.
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Trastorno del Espectro Autista , Trastorno Autístico , Trastorno del Espectro Autista/terapia , Trastorno Autístico/terapia , Terapia Conductista , Intervención Educativa Precoz , Humanos , Calidad de VidaRESUMEN
Monitoring antibiotic consumption is crucial to tackling antimicrobial resistance. However, currently there is no system in Sierra Leone for recording and reporting on antibiotic consumption. We therefore conducted a cross-sectional study to assess national antibiotic consumption expressed as defined daily dose (DDD) per 1000 inhabitants per day using all registered and imported antibiotics (categorized under the subgroup J01 under the anatomical and therapeutic classification (ATC) system) as a proxy. Between 2017-2019, total cumulative consumption of antibiotics was 19 DDD per 1000 inhabitants per day. The vast majority consisted of oral antibiotics (98.4%), while parenteral antibiotics made up 1.6%. According to therapeutic/pharmacological subgroups (ATC level 3), beta-lactam/penicillins, quinolones, and other antibacterials (mainly oral metronidazole) comprised 65% of total consumption. According to WHO Access, Watch, and Reserve (AWaRe), 65% of antibiotics consumed were Access, 31% were Watch, and no Reserve antibiotics were reported. The top ten oral antibiotics represented 97% of total oral antibiotics consumed, with metronidazole (35%) and ciprofloxacin (15%) together constituting half of the total. Of parenteral antibiotics consumed, procaine penicillin (32%) and ceftriaxone (19%) together comprised half of the total. Policy recommendations at global and national levels have been made to improve monitoring of antibiotic consumption and antibiotic stewardship.
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During a survey performed in sapota orchards of India, from 2015 to 2018, symptoms of phyllody, little leaf, flat stem and witches' broom were observed in three states: Karnataka, Kerala and Tripura. The association of phytoplasmas was confirmed in all the symptomatic sapota samples by using nested PCR specific primers (P1/P7, R16F2n/R16R2 and 3Far/3Rev) with amplification of fragments of ~ 1.25 kb and ~ 1.3 kb. Association of three phytoplasma groups, aster yellows with flat stem from Tripura (Lembucherra), clover proliferation with phyllody symptoms at Karnataka (Bengaluru) and bermuda grass white leaf with flat stem and little leaf from Kerala (Thiruvananthapuram) and Tripura (Cocotilla) were confirmed by 16S rRNA gene sequence comparison analysis. Virtual RFLP analysis of 16S rRNA gene sequences using pDRAW32 further classified the sapota phytoplasma isolates into 16SrI-B, 16SrVI-D and 16SrXIV-A subgroups. This is the first report on identification of three phytoplasma groups in sapota in world.
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This article presents findings from a grounded theory study in which we explored how self-identifying gay men between 40 and 76 years of age manage their health in the context of homophobia, heteronormativity and discrimination. Data were collected with 25 men over a 6-month period in a large urban setting in Western Canada. A preliminary theory of health management is discussed, consisting of the central phenomenon of overcoming adversity. Three thematic processes are considered that illustrate how adversity and health management are situated within the interrelationships of historical and ongoing discrimination inclusive of and external to the healthcare encounter, the complexity of men's illnesses, and the temporal aspects of HIV epidemics and treatments that occurred throughout their lives. These themes include: advocating for health needs, knowing about health issues and treatments, and engaging in health promoting practices. These findings help to address a gap in knowledge concerning health management among older gay men and support that initiatives aimed at health care with gay men must appreciate the systemic role of discrimination, while supporting men's individual efforts in actively managing their health.
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Homosexualidad Masculina , Minorías Sexuales y de Género , Anciano , Canadá , Teoría Fundamentada , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana EdadRESUMEN
The evolution of phage resistance poses an inevitable threat to the efficacy of phage therapy. The strategic selection of phage combinations that impose high genetic barriers to resistance and/or high compensatory fitness costs may mitigate this threat. However, for such a strategy to be effective, the evolution of phage resistance must be sufficiently constrained to be consistent. In this study, we isolated lytic phages capable of infecting a modified Klebsiella pneumoniae clinical isolate and characterized a total of 57 phage-resistant mutants that evolved from their prolonged coculture in vitro Single- and double-phage-resistant mutants were isolated from independently evolved replicate cocultures grown in broth or on plates. Among resistant isolates evolved against the same phage under the same conditions, mutations conferring resistance occurred in different genes, yet in each case, the putative functions of these genes clustered around the synthesis or assembly of specific cell surface structures. All resistant mutants demonstrated impaired phage adsorption, providing a strong indication that these cell surface structures functioned as phage receptors. Combinations of phages targeting different host receptors reduced the incidence of resistance, while, conversely, one three-phage cocktail containing two phages targeting the same receptor increased the incidence of resistance (relative to its two-phage, nonredundant receptor-targeting counterpart). Together, these data suggest that laboratory characterization of phage-resistant mutants is a useful tool to help optimize therapeutic phage selection and cocktail design.IMPORTANCE The therapeutic use of bacteriophage (phage) is garnering renewed interest in the setting of difficult-to-treat infections. Phage resistance is one major limitation of phage therapy; therefore, developing effective strategies to avert or lessen its impact is critical. Characterization of in vitro phage resistance may be an important first step in evaluating the relative likelihood with which phage-resistant populations emerge, the most likely phenotypes of resistant mutants, and the effect of certain phage cocktail combinations in increasing or decreasing the genetic barrier to resistance. If this information confers predictive power in vivo, then routine studies of phage-resistant mutants and their in vitro evolution should be a valuable means for improving the safety and efficacy of phage therapy in humans.
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Antibacterianos/farmacología , Bacteriófagos/fisiología , Farmacorresistencia Bacteriana Múltiple , Interacciones Huésped-Patógeno , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/virología , Mutación , Bacteriófagos/ultraestructura , Evolución Molecular , Prueba de Complementación Genética , Interacciones Huésped-Patógeno/genética , Humanos , Pruebas de Sensibilidad Microbiana , Porinas/genética , Porinas/metabolismo , Acoplamiento ViralRESUMEN
Background: Gay men, particularly middle aged and older men (over 40 years of age) experience a disproportionate burden of mental health issues compared to heterosexual men. Despite ample evidence that chronic exposure to structural and interpersonal discrimination negatively affect their mental health, little is known from gay men's perspectives how they understand mental health or their strategies to address their mental health concerns.Aim: This study's aim was to investigate how middle aged and older gay men experience their mental health and the mitigation strategies used to promote mental health.Method: Semi-structured interviews were conducted with 25 men who self-identified as gay. Data were analyzed using an interpretive descriptive approach.Results: Three overarching themes that best illustrate how men perceived their mental health and manage their mental health concerns were identified: gaining perspective, engaging with health services, and promoting and maintaining mental health.Conclusions: This study provides insight into how gay men come to acknowledge the validity of their mental health concerns, engage with health services, and their participation in other activities deemed essential for mental health promotion. These findings are ideally poised to inform development of health resources to promote and protect the mental health of aging gay men.
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Envejecimiento/psicología , Promoción de la Salud/métodos , Salud Mental , Minorías Sexuales y de Género/psicología , Adulto , Anciano , Humanos , Masculino , Persona de Mediana Edad , Investigación CualitativaRESUMEN
The number of men in the Canadian workforce who have prostate cancer is increasing. The purpose of the study was to explore the processes involved in men's return to work post radical prostatectomy and understand how these events are connected to masculinities. Drawing on data collected through individual interviews with 24 participants, constructivist grounded theory method was used to develop the substantive theory of Reformulating the Worker Identity which comprises two processes, recovering after radical prostatectomy and renegotiating work expectations. Recovering after radical prostatectomy revealed how men overcame side effects at home and evaluated their potential for returning to work. Renegotiating work expectations included participant's strategies for securing graduated return to work accommodations. Study findings revealed that the challenges for fully returning to work post prostatectomy are often underestimated by clinicians and patients. In this context, preempting return to work challenges preoperatively might allay significant anxieties for many men.
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Hombres , Neoplasias de la Próstata , Canadá , Humanos , Masculino , Prostatectomía , Neoplasias de la Próstata/cirugía , Investigación CualitativaRESUMEN
In Canada, the issue of creating safe and inclusive school environments for lesbian, gay, bisexual, transgender, and queer students has been in the spotlight. Several researchers and advocates have pointed out the positive effects of lesbian, gay, bisexual, transgender, and queer-positive policy frameworks on the health and wellbeing of all young people. In this article, we take a critical approach to analyzing narrative findings from qualitative interviews conducted with youth in three communities in British Columbia, Canada: "the North," Vancouver, and Abbotsford. Using a Foucauldian Discourse Analytic Approach and Butler's concept of Citationality, our analysis suggested that although explicit homophobia was largely absent from youth discussions, young people discursively constructed lesbian, gay, bisexual, transgender, and queer identities and "communities" in ways that reified heteronormativity. Youth made references to sociopolitical discourses of libertarianism and liberalism and to homonormative stereotypes regarding gay masculinity. A few young people also alluded to egalitarian, queer-positive discourses, which appeared to interrogate structures of heteronormativity. Since studies suggest a connection between the existence of institutional supports for lesbian, gay, bisexual, transgender, and queer students in schools and their mental and physical wellbeing, we conclude by considering the limitations and possibilities of these sociopolitical discourses in the struggle for sexual and gender equity, and how they might help frame future health-related, anti-homophobia policy frameworks in educational settings.
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Servicios de Salud Escolar/organización & administración , Minorías Sexuales y de Género/psicología , Estrés Psicológico/epidemiología , Adolescente , Colombia Británica , Femenino , Estado de Salud , Homofobia/prevención & control , Humanos , Entrevistas como Asunto , Masculino , Salud Mental , Políticas , Política , Investigación Cualitativa , Resiliencia PsicológicaRESUMEN
BACKGROUND: Many people with congenital heart disease (CHD) experience psychological distress related to medical complications and psychosocial issues related to the disease. Although studies show that social support and coping strategies are closely associated with psychological distress in people struggling with different chronic health challenges, very little is known about whether the same factors hold true for the psychological distress of people living with CHD. OBJECTIVE: The purpose of this study was to examine the relationships between types of social support, coping strategies, and psychological distress for individuals living with CHD. DESIGN: A cross-sectional survey design with self-report questionnaires was used. METHOD: A convenience sample of 272 participants was obtained from the Adult Congenital Heart Disease program at a tertiary care hospital in Western Canada. Structural equation modeling was conducted to examine hypothesized relationships among study variables. RESULTS: Perceived social support was directly related to both anxiety and depression. Received social support influenced anxiety and depression, but its effect was through perceived social support. Wishful-thinking coping strategies mediated the relationships between perceived social support and both anxiety and depression. CONCLUSION: Individuals with CHD who have low perceived and received social support are vulnerable to experiences of psychological distress. Assessments of social support and facilitation of positive coping strategies are integral to nursing care for adults with CHD.
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Ansiedad/psicología , Depresión/psicología , Cardiopatías Congénitas/psicología , Distrés Psicológico , Apoyo Social , Estrés Psicológico/psicología , Adaptación Psicológica , Adulto , Ansiedad/etiología , Canadá , Estudios Transversales , Depresión/etiología , Femenino , Cardiopatías Congénitas/complicaciones , Humanos , Masculino , Estrés Psicológico/etiologíaRESUMEN
The endophytic fungus Mortierella hyalina colonizes the roots of Arabidopsis thaliana and stimulates growth and biomass production of the aerial parts but not of roots. An exudate fraction from the fungus induces rapid and transient cytoplasmic Ca2+elevation in the roots. The Ca2+ response does not require the well-characterized (co)receptors BAK1, CERK1, and FLS2 for pathogen-associated molecular patterns, and the Ca2+ channels GLR-2.4, GLR-2.5, and GLR-3.3 or the vacuolar TWO PORE CHANNEL1, which might be involved in cytoplasmic Ca2+ elevation. We isolated an ethyl-methane-sulfonate-induced Arabidopsis mutant that is impaired in this Ca2+ response. The roots of the mutant are impaired in M. hyalina-mediated suppression of immune responses after Alternaria brassicae infection, i.e., jasmonate accumulation, generation of reactive oxygen species, as well as the activation of jasmonate-related defense genes. Furthermore, they are more colonized by M. hyalina than wild-type roots. We propose that the mutant gene product is involved in a Ca2+-dependent signaling pathway activated by M. hyalina to suppress immune responses in Arabidopsis roots.
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Alternaria , Antibiosis , Proteínas de Arabidopsis , Arabidopsis , Mortierella , Raíces de Plantas , Alternaria/fisiología , Arabidopsis/crecimiento & desarrollo , Arabidopsis/microbiología , Calcio/metabolismo , Mortierella/fisiología , Raíces de Plantas/microbiologíaRESUMEN
Distress among young immigrant and refugee men has drawn increasing research attention in recent years. Nuanced understandings of distress are needed to inform mental health and public health programming. The purpose of this research was to examine distress from the perspectives of young immigrant and refugee men living in Greater Vancouver, British Columbia, Canada. Thirty-three young men (aged 15-22 years) from diverse immigrant and refugee backgrounds participated in interviews, which were conducted between 2014 and 2015. Data were examined using narrative analysis and theories of masculinities. Three narratives were identified-norming distress, acknowledging distress as ongoing, and situating distress. The findings reveal that the narratives offer different frames through which distress was rendered a norm, or acknowledged and situated in relation to the participants' relationships and to masculine discourses that shaped their expressions of distress. The findings can inform initiatives aimed at providing spaces for diverse young men to acknowledge their distress and to receive support for mental health challenges.
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Emigrantes e Inmigrantes/psicología , Masculinidad , Narración , Refugiados/psicología , Estrés Psicológico/psicología , Adolescente , Adulto , Colombia Británica , Humanos , Entrevistas como Asunto , Masculino , Salud Mental , Investigación Cualitativa , Adulto JovenRESUMEN
Jatropha curcas (J. curcas) seeds have been exploited as a source of biodiesel and for its ethnomedicinal uses and agro feed potential, however, toxic properties have been associated with the seeds. The study was aimed at determining the toxic constituents present in J. curcas fruits, seeds and kernels and ethanol seed extract. Standard methods were employed in the investigations, including those of the Association of Analytical Chemists and Trease and Evans. J. curcas fruits, seeds and kernels from Sierra Leone contained cyanogenic glycosides (in mg/100g) of 7.10, 5.10 and 16.96 while the corresponding values for the Nigeria samples were 11.60, 10.15 and 15.92; all greatly above the maximum permissible limits of 0.05-0.35. Similarly, the tannin contents of the fruits, seeds and kernels from Sierra Leone (1.66, 1.46, and 1.80) and of the seeds and kernels from Nigeria (1.40, 1.48) approximated the maximum permissible limits of 1.5 mg/100g or were higher. In contrast, the phytates and saponins which ranged from 1.78-2.14 and 1.64-2.42 for both sources of J. curcas were significantly below the maximum permissible levels of 500 mg/100g (for phytates) and 100 mg/100g (for saponins). Heavy metals like cadmium, copper, chromium and lead were also detected, but their concentrations were below the maximum permissible limits. These constituents were mostly similar regardless of the country source of Jatropha. Ethanol extract of J. curcas seeds was found to contain toxic phytochemicals and heavy metals. J. curcas as food cannot be ruled out especially for animals since cooking, fermentation and heat treatment can significantly reduce some of these antinutritional factors
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Etanol , Jatropha , Nigeria , Fitoquímicos , Sierra LeonaRESUMEN
Prostate cancer diagnosis can occur at a time when men's work and careers are central to their masculine identity, sense of purpose, and family life. In Canada, an aging male population, along with medical advances, has resulted in increasing numbers of working men being diagnosed with, and treated for, prostate cancer. Little is known about the linkages between men's work and their experiences of prostate cancer. In this qualitative study, 24 Western Canadian men were interviewed to distil the connections between work, prostate cancer screening, diagnosis, and the decision to undergo radical prostatectomy. Data were analyzed using constant comparison in the context of masculinities theory. The findings demonstrated that work was central to men's masculine identities and afforded financial security, social status, and a sense of personal growth. However, work-related strain and demands were also found to affect participants' health and distance them from their families. A diagnosis of prostate cancer tended to diminish the importance of work, wherein participants focused on optimizing their health and strengthening family relations. In deciding on radical prostatectomy as a treatment to eradicate prostate cancer, few men considered the implications for returning to work. The current study findings indicate that clinicians and patients should explicitly explore and discuss how surgery side effects may affect work and career plans during treatment decision-making.
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Toma de Decisiones , Empleo , Prioridad del Paciente/psicología , Prostatectomía/métodos , Neoplasias de la Próstata/cirugía , Calidad de Vida , Adulto , Colombia Británica , Detección Precoz del Cáncer , Relaciones Familiares , Humanos , Masculino , Masculinidad , Salud del Hombre , Persona de Mediana Edad , Prioridad del Paciente/estadística & datos numéricos , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/fisiopatología , Neoplasias de la Próstata/diagnóstico , Investigación Cualitativa , Factores de RiesgoRESUMEN
Stress information received by a particular local plant tissue is transferred to other tissues and neighboring plants, but how the information travels is not well understood. Application of Alternaria Brassicae spores to Arabidopsis leaves or roots stimulates local accumulation of jasmonic acid (JA), the expression of JA-responsive genes, as well as of NITRATE TRANSPORTER (NRT)2.5 and REDOX RESPONSIVE TRANSCRIPTION FACTOR1 (RRTF1). Infection information is systemically spread over the entire seedling and propagates radially from infected to non-infected leaves, axially from leaves to roots, and vice versa. The local and systemic NRT2.5 responses are reduced in the jar1 mutant, and the RRTF1 response in the rbohD mutant. Information about A. brassicae infection travels slowly to uninfected neighboring plants via a Piriformospora Indica hyphal network, where NRT2.5 and RRTF1 are up-regulated. The systemic A. brassicae-induced JA response in infected plants is converted to an abscisic acid (ABA) response in the neighboring plant where ABA and ABA-responsive genes are induced. We propose that the local threat information induced by A. brassicae infection is spread over the entire plant and transferred to neighboring plants via a P. indica hyphal network. The JA-specific response is converted to a general ABA-mediated stress response in the neighboring plant.
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Mental health challenges are the leading health issue facing youth globally. To better respond to this health challenge, experts advocate for a population health approach inclusive of mental health promotion; yet this area remains underdeveloped. Further, while there is growing emphasis on youth-engaged research and intervention design, evidence of the outcomes and impacts are lacking. The purpose of this paper is to contribute to addressing these gaps, presenting findings from the Social Networking Action for Resilience (SONAR) study, an exploration of youth-driven mental health promotion in a rural community in British Columbia, Canada. Mixed methods including pre- and post-intervention surveys (nâ¯=â¯175) and qualitative interviews (nâ¯=â¯10) captured the outcomes and impacts of the intervention on indicators of mental health, the relationship between level of engagement and benefit, and community perceptions of impact. Findings demonstrate the feasibility and benefits of youth engaged research and intervention at an individual and community-level.
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Promoción de la Salud/métodos , Salud Mental , Resiliencia Psicológica , Adolescente , Colombia Británica , Femenino , Humanos , Masculino , Investigación Cualitativa , Población Rural/estadística & datos numéricos , Red Social , Encuestas y CuestionariosRESUMEN
Gay men experience marked health disparities compared to heterosexual men, associated with profound discrimination. Resilience as a concept has received growing attention to increase understanding about how gay men promote and protect their health in the presence of adversity. Missing in this literature are the perspectives and experiences of gay men over 40 years. This investigation, drawing on grounded theory methods, examined how gay men over 40 years of age develop resilience over the course of their lives to promote and protect their health. In-depth interviews were undertaken with 25 men ranging between 40 and 76 years of age who experienced an array of health concerns including depression, anxiety, suicidality, and HIV. Men actively resist discrimination via three interrelated protective processes that dynamically influence the development of resilience over their life course: (a) building and sustaining networks, (b) addressing mental health, and (c) advocating for respectful care encounters. Initiatives to promote and protect the health of gay men must be rooted in the recognition of the systemic role of discrimination, while supporting men's resilience in actively resisting discrimination.
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Disparidades en el Estado de Salud , Homosexualidad Masculina/psicología , Calidad de Vida , Resiliencia Psicológica , Adaptación Psicológica , Adulto , Factores de Edad , Anciano , Ansiedad/epidemiología , Ansiedad/psicología , Canadá , Depresión/epidemiología , Depresión/psicología , Discriminación en Psicología , Humanos , Entrevistas como Asunto , Masculino , Salud Mental , Persona de Mediana Edad , Medición de Riesgo , Estigma SocialRESUMEN
As chronic conditions are on the rise in the USA, management initiatives outside of the inpatient setting should be explored to reduce associated cost and access disparities. Chronic conditions disproportionately affect African American public housing residents due to the effects of historical marginalization on the manifestation of economic and social problems exacerbating health disparities and outcomes. Informed by participatory research action tenets, this study focused on identifying the challenges to management of chronic conditions and developing community-envisioned initiatives to address these challenges in a predominantly African American public housing community. Two focus groups were conducted with former and current public housing residents and were analyzed using inductive content analysis. Physical activity, the cost associated with healthy eating, and lack of information were noted as challenges to chronic disease management. Initiatives discussed were the formation of a walking partner's program to promote physical activity, a shopper's club to exchange coupons and learn how to prepare healthy meals, and a natural remedy's book to share information intergenerationally about management tactics. Challenges identified existed predominantly on the individual and the system level, while the initiatives generated target engaging interpersonal and community relationships. These community-envisioned approaches should be explored to facilitate chronic disease management in public housing neighborhoods.