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1.
JMIR Form Res ; 8: e48371, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38656772

RESUMEN

BACKGROUND: Research has shown that heterosexual African American male individuals aged 18-24 years have a higher prevalence of sexually transmitted infections (STIs) and are more likely to engage in risky sexual behavior. There is a critical need to promote sexual reproductive health (SRH) services among this population, especially in urban settings. Young African American male individuals use social media platforms to access health information, showcasing the potential of social media and web-based links as tools to leverage electronic engagement with this population to promote SRH care. OBJECTIVE: This study aims to explore electronic engagement with young African American male individuals in discussions about SRH care. This paper focuses on the recruitment and social media marketing methods used to recruit young, heterosexual African American male individuals aged 18-24 years for the Stay Safe Project, a larger study that aims to promote SRH services among this population in Detroit, Michigan. We investigate the use of TinyURL, a URL shortener and customized tool, and culturally informed social media marketing strategies to promote electronic engagement within this population. METHODS: Participants were recruited between December 2021 and February 2022 through various modes, including email listserves, Mailchimp, the UMHealthResearch website, X (formerly Twitter), Facebook, and Instagram. Images and vector graphics of African American male individuals were used to create social media advertisements that directed participants to click on a TinyURL that led to a recruitment survey for the study. RESULTS: TinyURL metrics were used to monitor demographic and user data, analyzing the top countries, browsers, operating systems, and devices of individuals who engaged with the customized TinyURL links and the total human and unique clicks from various social media platforms. Mailchimp was the most successful platform for electronic engagement with human and unique clicks on the custom TinyURL link, followed by Instagram and Facebook. In contrast, X, traditional email, and research recruiting websites had the least engagement among our population. Success was determined based on the type of user and follower for each platform, whether gained in the community through sign-ups or promoted at peak user time and embedded and spotlighted on nontraditional media (eg, social media sites, blogs, and podcasts) for the user. Low engagement (eg, traditional email) from the target population, limited visibility, and fewer followers contributed to decreased engagement. CONCLUSIONS: This study provides insight into leveraging customized, shortened URLs, TinyURL metrics, and social media platforms to improve electronic engagement with young African American male individuals seeking information and resources about SRH care. The results of this study have been used to develop a pilot intervention for this population that will contribute to strategies for encouraging sexual well-being, clinic use, and appropriate linkage to SRH care services among young, heterosexual African American male individuals.

2.
J Behav Med ; 2024 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-38460062

RESUMEN

The purpose of this study is to address a significant gap in knowledge on firearm ownership rates and storage characteristics in a national sample of college students. We used 2021-2022 survey data from the Healthy Minds Study, which included approximately 88,500 students at over 100 US colleges and universities. We conducted analyses using descriptive statistics and two-sample proportion tests. About 4% of respondents reported having a firearm on or around campus. Among firearm owners, 68.8% reported storing firearms at their permanent address within an hour's drive from campus, and 43.1% reported storing their firearms unloaded and locked. Firearm ownership rates were significantly higher for respondents who were positive for specific risk factors (i.e., in a relationship, suicide ideation, recent binge drinking, and having been physically assaulted) versus those who were negative. These findings support the need for targeted messaging and firearm safety training for college students to reduce firearm-related risks.

3.
J Am Assoc Nurse Pract ; 35(7): 449-454, 2023 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-36951762

RESUMEN

BACKGROUND: The suicide rate among adolescents has been increasing rapidly over the past several years. LOCAL PROBLEM: Adequate screening for suicide risk in this population, particularly youth of color, is lacking. METHODS: The Ask Suicide-Screening Questions (ASQ) tool was implemented at two adolescent-focused health clinics in a large U.S. city. INTERVENTIONS: This project followed the Ottawa Model of Research Use. Participating clinicians were surveyed before and after receiving an educational module on suicide risk screening, the ASQ tool, and clinical pathways. Clinicians were also asked about the feasibility and acceptability of the ASQ tool in their practice. An electronic medical records software was used to gather data on patients newly screened for suicide risk using the ASQ tool. RESULTS: Among eligible patients, 40.2% were screened using the ASQ tool during the 4-month duration of the project. Most clinicians reported that using the tool was feasible within their practice (66%) and 100% endorsed its acceptability (i.e., reporting that they were comfortable screening for suicide and that the ASQ was easy to use). CONCLUSIONS: The ASQ may be a promising screening tool for clinicians to use to address the mental health needs of at-risk youth. This project supports the universal acceptability and feasibility of its use in inner-city primary care clinics.


Asunto(s)
Suicidio , Humanos , Adolescente , Estudios de Factibilidad , Medición de Riesgo , Ideación Suicida , Encuestas y Cuestionarios , Tamizaje Masivo
4.
Workplace Health Saf ; 71(3): 144-151, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35942581

RESUMEN

OBJECTIVES: The Coronavirus-2019 (COVID-19) pandemic presents a unique burden specifically for workers in service industries. However, limited research on service worker's experience during the onset of COVID-19 exists. We aimed to describe the experiences and concerns of service industry workers during the pandemic's onset. METHODS: This is a mixed-method study. Participants were recruited through social media and completed either a survey or a phone interview during May and June 2020. The survey and transcribed interview data were analyzed using the SPSS software and content analysis, respectively. RESULTS: Twenty-seven individuals completed audio-recorded phone interviews and 28 completed the survey. Participants were mostly women between 19 and 65 years old. Participants worked in food retail (n = 23), restaurant (n = 25), and hospitality (n = 7) industries. There was discordance in perceived threat level of COVID-19. Most participants reported that their workplace complied with their state's mandates for protection measures, while others reported lacking basic supplies such as soap, hand sanitizer, and masks. Job insecurity, change of job tasks, and work hours were the most common ways that COVID-19 affected the workers. Worker's assertiveness to self-protect while at work was influenced by their perceived severity of the pandemic. CONCLUSION/APPLICATION TO PRACTICE: This study highlights the vulnerability of service workers relating to job security and job tasks during the pandemic. Organizational processes are needed to promote safe work environments and facilitate access to resources for these workers. In addition, occupational health practitioners need to be aware of and address the emerging health risks and worker needs.


Asunto(s)
COVID-19 , Salud Laboral , Humanos , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Masculino , Lugar de Trabajo , Industrias , Encuestas y Cuestionarios
5.
Inquiry ; 59: 469580221142488, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36537624

RESUMEN

Community-based participatory research (CBPR) approaches are being leveraged more and more in efforts to improve health equity. Informing the building of community-academic partnerships, CBPR draws on the community's expressed needs and engages stakeholders in future intervention development. To date, however, little has been published on such efforts targeting the health of young Black men (ages 18-24), despite this population's disproportionate need. In this paper, we describe the formation of a community-academic partnership in a federally qualified health center, with the goal of improving the health of young Black men in Detroit, Michigan. After conducting a needs assessment, we built upon existing networks to form a Community Advisory Board (CAB). We held three community forums during which CAB members highlighted key health issues in their community and described how they could be addressed. We developed a plan for future research and community engagement based on community input. Finally, we provide insights on community engagement strategies, forum structure, setting boundaries, trust-building, and valuable information in addressing the inequities in health that affect young Black men.


Asunto(s)
Investigación Participativa Basada en la Comunidad , Salud del Hombre , Masculino , Humanos , Adolescente , Adulto Joven , Adulto , Confianza
6.
J Diabetes Complications ; 36(7): 108220, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35613987

RESUMEN

AIMS: To examine enrollment in the National Diabetes Prevention Program (DPP) by insured adults with prediabetes according to domains of the Health Belief Model (HBM). METHODS: Between 2015 and 2019, University of Michigan employees, retirees, and dependents with prediabetes were offered the National DPP at no out-of-pocket cost. Individuals with prediabetes were identified and mailed letters encouraging them to enroll. We surveyed those who enrolled and a random sample of those who did not using the HBM as a framework to examine factors associated with enrollment. Analyses were performed using multivariable logistic regression models. RESULTS: Of 64,131 employees, retirees, and dependents, 8131 were identified with prediabetes and 776 (9.5%) enrolled in the National DPP. Of those surveyed, 532 of 776 National DPP enrollees and 945 of 2673 non-enrollees responded to the survey (adjusted response rates 74% and 43%, respectively). Among survey respondents, factors associated with National DPP enrollment included older age, female sex, higher BMI, prediabetes awareness, greater perceived benefits of health-protective action, and one or more cues to action. CONCLUSIONS: Optimizing National DPP enrollment among adults with prediabetes will require identifying individuals with prediabetes, increasing personal awareness of the diagnosis, increasing perceived benefits of enrollment, and providing strong cues to action.


Asunto(s)
Diabetes Mellitus Tipo 2 , Estado Prediabético , Adulto , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/prevención & control , Femenino , Modelo de Creencias sobre la Salud , Gastos en Salud , Humanos , Estado Prediabético/complicaciones , Estado Prediabético/epidemiología , Estado Prediabético/terapia , Encuestas y Cuestionarios
7.
Prev Med ; 160: 107089, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-35594927

RESUMEN

The purpose was to examine the degree to which perceived risk for diabetes differed by race and ethnicity among U.S. adults with undiagnosed prediabetes. The study was a cross-sectional analysis of data from 4005 participants (aged ≥20 years) in the National Health and Nutrition Examination Survey (NHANES) program between 2011 and 2018. Individuals with prediabetes were identified using glycohemoglobin (HbA1c) data. Logistic regression was used to estimate the association between race and ethnicity and perceived risk of diabetes while adjusting for age and sex, educational level, family history of diabetes, BMI, and healthcare factors (health insurance coverage and routine place to go for healthcare). Nearly three-quarters (71.8%) of adults with undiagnosed prediabetes reported no perceived risk for diabetes. Rates of perceived risk for diabetes did not change significantly in any racial and ethnic groups from 2011 to 12 to 2017-18. In models adjusted for individual characteristics, identifying as Non-Hispanic Black was associated with a 34% higher likelihood of reporting no perceived risk compared to identifying as Non-Hispanic White (OR 1.34, 95% CI:1.03-1.74). Identifying as Hispanic was associated with a 29% higher likelihood of reporting no perceived risk compared to identifying as Non-Hispanic White (OR 1.29, 95% CI: 1.01, 1.66). Healthcare factors may have less influence on diabetes risk perception. Future public health efforts should improve diabetes risk communication efforts across racial and ethnic groups, emphasizing Non-Hispanic Black and Hispanic populations.


Asunto(s)
Diabetes Mellitus , Estado Prediabético , Adulto , Estudios Transversales , Diabetes Mellitus/diagnóstico , Humanos , Encuestas Nutricionales , Estado Prediabético/diagnóstico , Prevalencia , Estados Unidos/epidemiología
8.
Work ; 71(4): 1063-1071, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35253670

RESUMEN

BACKGROUND: Hotel room cleaners are disproportionately exposed to hazards that increase risk for poor health outcomes. Interventions are needed to improve the health of these workers. Yet we know little about the expressed needs of hotel room cleaners nor do we know about managers' perspectives on how to best optimize employee health. OBJECTIVE: We aimed to develop an understanding of perceived intervention needs among hotel room cleaners and to assess managers' views on the acceptability of the proposed interventions. METHODS: We used a community-based approach to recruit study participants. We conducted five focus groups among hotel room cleaners and individual interviews with hotel managers. Interviews were audio-recorded, transcribed, and analyzed using content analysis. RESULTS: The workers expressed needs centered on pay, workload, appreciation, ergonomics, chemical and biological hazards, nutrition, smoking cessation, exercise, mental health and stress management. In addition to echoing the workers' expressed needs, managers emphasized employee retention and financial literacy. CONCLUSIONS: To our knowledge, this is the first paper to include both workers' and managers' accounts on intervention approaches that will optimize health and wellbeing. This paper offers a guide for future program development among hospitality workers. Effective interventions need to be integrated, encompassing the individual, intrapersonal, organizational, and policy levels.


Asunto(s)
Salud Laboral , Ergonomía , Grupos Focales , Humanos , Salud Mental , Carga de Trabajo
9.
Front Clin Diabetes Healthc ; 3: 1057559, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36992721

RESUMEN

Background: Diabetes stigma is recognized to negatively impact health-related outcomes for people living with type 2 diabetes (T2D), but there is a dearth of evidence among U.S. Latino adults with T2D. Our aim was to develop a Spanish-language translation of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2) and examine its psychometric properties among U.S. Latino adults with T2D. Methods: The translation was developed through a multi-step process, including a focus group with community health workers (n=5) and cognitive debriefing interviews with Latino adults with T2D (n=8). It was field-tested in an online survey of U.S. Latino adults with T2D, recruited via Facebook (October 2018 to June 2019). Exploratory factor analysis examined structural validity. Convergent and divergent validity were assessed by testing hypothesized correlations with measures of general chronic illness stigma, diabetes distress, depressive and anxiety symptoms, loneliness, and self-esteem. Results: Among 817 U.S. Latino adults with T2D who participated in the online survey, 517 completed the Spanish-language DSAS-2 (DSAS Spa-US) and were eligible for the study (mean age 54 ± 10 years, and 72% female). Exploratory factor analysis supported a single-factor solution (eigenvalue=8.20), accounting for 82% of shared variance among the 19 items, all loading ≥ 0.5. Internal consistency reliability was high (α=0.93). As expected, strong, positive correlations were observed between diabetes stigma and general chronic illness stigma (rs=0.65) and diabetes distress (rs=0.57); medium, positive correlations, between diabetes stigma and depressive (rs=0.45) and anxiety (rs=0.43) symptoms, and loneliness (rs=0.41); and a moderate negative correlation between diabetes stigma and self-esteem (rs=-0.50). There was no relationship between diabetes stigma and diabetes duration (rs=0.07, ns). Conclusion: The DSAS-2 Spa-US is a version of the DSAS-2, translated into Spanish, that has good psychometric properties for assessing diabetes stigma in U.S. Latino adults with T2D.

10.
Am J Mens Health ; 15(6): 15579883211062024, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34877895

RESUMEN

Young Black males (YBM) ages 18 to 24 years are more at risk of contracting sexually transmitted infections (STIs) and have a substantially greater need for sexual reproductive health (SRH) services than other groups. Despite this significant need, the extant literature does not provide a comprehensive picture of how YBM seek preventive care services (e.g., STI testing). Therefore, the purpose of this review is to address YBM's SRH access and use of STI/HIV testing and screening in this population, with a specific emphasis on young heterosexual Black males, by identifying barriers and facilitators of engaging with SRH care. An electronic search was performed using Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, PubMed, and Scopus online databases. Keywords were adapted to each database and included variations of "Black males," "sexual reproductive healthcare services," "youth (18-24 years old)," and "healthcare access and utilization." Studies from the review reported that barriers to engaging in SRH care included lack of health insurance, ideas of masculinity that conflict with SRH care, stigma related to accessing services, and lack of knowledge regarding available services and care options. The top facilitators for utilizing SRH care were engagement on behalf of health clinics, confidence gained from social support, access to quality health care in one's community, and trust in the health care system and providers. This review contributes to the current state of the science and is important to the improvement of high-quality services for this population, including respect, choice in care, confidentially, and compassion.


Asunto(s)
Servicios de Salud Reproductiva , Salud Sexual , Adolescente , Adulto , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Salud Reproductiva , Conducta Sexual , Adulto Joven
11.
Sci Diabetes Self Manag Care ; 47(5): 367-381, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34610760

RESUMEN

PURPOSE: To examine youth and parent perspectives on the acceptability of Bright 1 Bodies, a group physical activity and coping intervention for adolescents with type 1 diabetes mellitus (T1DM). METHODS: Adolescents participated in 12 weekly sessions of moderate to vigorous physical activity and discussion with peers with T1DM. Adolescents completed an exit survey measuring satisfaction with the intervention on a 5-point Likert scale. Semistructured interviews were conducted with adolescents and at least one parent. Qualitative description was used to develop themes that summarize the acceptability of the intervention. RESULTS: Mean scores for survey subscales were: 4.5 (SD = 0.39) for program components and strategies, 4.4 (SD = 0.44) for comfort with the intervention, and 4.3 (SD = 0.62) for instructors. Themes included: (1) adolescents and parents valued being around others with T1DM and their families, (2) the intervention helped adolescents gain knowledge and reinforce diabetes self-management behaviors, (3) challenges included convenience and sustaining participant engagement, and (4) adolescents intended to sustain physical activity and diabetes self-management behaviors after the intervention. CONCLUSIONS: Adolescents and parents viewed the intervention as acceptable across multiple domains. Participants valued the group aspect of the intervention, and future interventions would benefit from integrating social interactions with others with T1DM.


Asunto(s)
Diabetes Mellitus Tipo 1 , Adaptación Psicológica , Adolescente , Diabetes Mellitus Tipo 1/terapia , Ejercicio Físico , Humanos , Padres , Encuestas y Cuestionarios
12.
J Occup Environ Hyg ; 18(4-5): 169-179, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33861938

RESUMEN

The coronavirus pandemic has taken a detrimental toll on the lives of individuals globally. In addition to the direct effect (e.g., being infected with the virus), this pandemic has negatively ravaged many industries, particularly food retail, food services, and hospitality. Given the novelty of the disease, the true impact of COVID-19 remains to be determined. Because of the nature of their work, and the characteristics of the workers, individuals in the food retail, food service, and hospitality industries are a group whose vulnerability is at its most fragile state during this pandemic. Through this qualitative study, we explored workers' perspectives on the impact of COVID-19 on their mental health and coping, including screening for post-traumatic stress disorder (PTSD) and alcohol use disorder symptoms. Twenty-seven individual interviews were conducted, audio-recorded, transcribed, and analyzed using qualitative content analysis. Four key themes emerged: being infected and infecting others, the unknown, isolation, and work and customer demands. Considering the many uncertainties of COVID-19, workers in these three industries were experiencing heightened levels of mental distress because of where they worked and the already existing disparities they faced on a daily basis before the pandemic started. Yet they remained hopeful for a better future. More studies are needed to fully understand the magnitude, short-term, and long-term effects of COVID-19. Based on this study's findings, programs are critically needed to promote positive coping behaviors among at-risk and distressed workers. Recommendations for employers, occupational health and safety professionals, and policy stakeholders to further support these service workers are discussed.


Asunto(s)
COVID-19/psicología , Trastornos Mentales/epidemiología , Exposición Profesional/efectos adversos , Estrés Laboral , Adaptación Psicológica , Adulto , Alcoholismo/epidemiología , Comercio , Femenino , Servicios de Alimentación , Humanos , Masculino , Trastornos Mentales/etiología , Persona de Mediana Edad , Investigación Cualitativa , Trastornos por Estrés Postraumático/epidemiología , Encuestas y Cuestionarios , Estados Unidos
13.
Thromb Res ; 200: 64-71, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33540294

RESUMEN

INTRODUCTION: Despite the great promise for therapies using antisense oligonucleotides (ASOs), their adverse effects, which include pro-inflammatory effects and thrombocytopenia, have limited their use. Previously, these effects have been linked to the phosphorothioate (PS) backbone necessary to prevent rapid ASO degradation in plasma. The main aim of this study was to assess the impact of the nucleic acid portion of an ASO-type drug on platelets and determine if it may contribute to thrombosis or thrombocytopenia. METHODS: Platelets were isolated from healthy donors and men with advanced prostate cancer. Effects of antisense oligonucleotides (ASO), oligonucleotides, gDNA, and microRNA on platelet activation and aggregation were evaluated. A mouse model of lung thrombosis was used to confirm the effects of PS-modified oligonucleotides in vivo. RESULTS: Platelet exposure to gDNA, miRNA, and oligonucleotides longer than 16-mer at a concentration above 8 mM resulted in the formation of hypersensitive platelets, characterized by an increased sensitivity to low-dose thrombin (0.1 nM) and increase in p-Selectin expression (6-8 fold greater than control; p < 0.001). The observed nucleic acid (NA) effects on platelets were toll-like receptor (TLR) -7 subfamily dependent. Injection of a p-Selectin inhibitor significantly (p = 0.02) reduced the formation of oligonucleotide-associated pulmonary microthrombosis in vivo. CONCLUSION: Our results suggest that platelet exposure to nucleic acids independent of the presence of a PS modification leads to a generation of hypersensitive platelets and requires TLR-7 subfamily receptors. ASO studies conducted in cancer patients may benefit from testing the ASO effects on platelets ex vivo before initiation of patient treatment.


Asunto(s)
Ácidos Nucleicos , Preparaciones Farmacéuticas , Animales , Plaquetas , Humanos , Ratones , Oligonucleótidos Antisentido , Oligonucleótidos Fosforotioatos
14.
Am J Ind Med ; 63(12): 1095-1103, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33026678

RESUMEN

BACKGROUND: The hospitality industry employs millions of workers and is a key contributor to the US economy. Despite being essential drivers in the industry's success, hotel workers, particularly hotel housekeepers, are exposed to occupational hazards and experience disproportionate rates of injuries and chronic health conditions. Thus there is a significant need for health promotion efforts directed toward these workers. However, little is known about existing interventions targeting their health. METHODS: We conducted a scoping review to identify and appraise workplace health promotion interventions targeting hotel employees. We performed a scoping review following the framework outlined by Arksey and O'Malley (2005). Our literature search process was recorded using the preferred reporting items for systematic reviews and meta-analyses. Basic study information was compiled into a matrix table. Study quality was assessed using the template for intervention description and replication. RESULTS: Eight unique interventions were identified, occurring at over 30 hotels with participants ranging between 16 and 1207 employees. Though many of the reported health outcomes were not statistically significant, studies reported results with clinical implications, including decreased numbers of injury claims, reduced anxiety, improvements in cardiovascular disease risk indicators, such as body mass index, and increased knowledge among participants. CONCLUSIONS: This is the first review to interrogate the literature on existing workplace interventions targeting the health of hotel workers. While some studies found significant improvements in health outcomes, few conducted rigorous program evaluation. The results highlight the need for more and effective interventions targeting these at-risk workers.


Asunto(s)
Promoción de la Salud/métodos , Enfermedades Profesionales/prevención & control , Exposición Profesional/prevención & control , Salud Laboral , Traumatismos Ocupacionales/prevención & control , Femenino , Humanos , Industrias , Lavandería , Masculino
15.
Int J Eat Disord ; 52(11): 1281-1290, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31322755

RESUMEN

OBJECTIVE: This study describes the prevalence of eating disorders among adult patients who present to the emergency department for medical care and examines the relationship between eating disorders, depression, and substance use disorders. METHOD: Emergency department patients aged 21-65 years (n = 1,795) completed a computerized questionnaire that included validated screening tools for eating disorders, risky drinking behavior, other substance use, and depression. Analyses were conducted comparing individuals who screened positive for an eating disorder with those who did not based on demographics (gender, age, race, income, education), body mass index (BMI), risky drinking behavior, other substance use, and depression. RESULTS: Nearly 16% (15.9%) of all patients screened positive for an eating disorder regardless of their reason for presenting to the emergency department. Patients who screened positive for an eating disorder were significantly more likely to have a BMI > 30 (odds ratio [OR] = 2.68, confidence interval [CI] = 1.98, 3.62, p < .001), to also screen positive for depression (OR = 3.19, CI = 2.28, 4.47, p < .001) and to be female (OR = 2.37, CI = 1.76, 3.19, p < .001). No differences in the prevalence of positive screens for eating disorders were seen across age or racial groups, level of education or income, or for any of the included substance use variables. DISCUSSION: Eating disorders are common among adult emergency department patients and are associated with high rates of comorbid depression and higher BMI. Given the significant morbidity and mortality associated with eating disorders, targeted screening may be warranted in the emergency department setting.


Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Adulto , Anciano , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
16.
Am J Vet Res ; 78(10): 1200-1209, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28945124

RESUMEN

OBJECTIVE To compare heat generation and mechanical bone damage for tapered and cylindrical transfixation pins during drilling, tapping, and pin insertion in equine third metacarpal bones. SAMPLE 16 pairs of cadaveric equine third metacarpal bones. PROCEDURES For cylindrical pin insertion, a 6.2-mm hole was drilled and tapped with a cylindrical tap, and then a standard 6.3-mm pin was inserted. For tapered pin insertion, a 6.0-mm hole was drilled, reamed with a tapered reamer, and tapped with a tapered tap, and then a 6.3-mm tapered pin was inserted. Paired t tests and 1-way ANOVAs were used to compare heat generation (measured by use of thermocouples and thermography), macrodamage (assessed by use of stereomicroscopy), and microdamage (assessed by examination of basic fuchsin-stained histologic specimens) between cylindrical and tapered pins and between tapered pins inserted to various insertion torques. RESULTS Tapered pin insertion generated less heat but resulted in more bone damage than did cylindrical pin insertion when pins were inserted to the same insertion torque. Insertion of tapered pins to increasing insertion torques up to 16 N•m resulted in increased heat generation and bone damage. CONCLUSIONS AND CLINICAL RELEVANCE Tapered pin insertion resulted in lower heat production than did cylindrical pin insertion. However, tapered pin insertion resulted in greater bone damage, which likely was attributable to differences in the tapered and cylindrical taps. A tapered pin may be preferable to a cylindrical pin for insertion in equine cortical bone provided that improvements in tap design can reduce bone damage during insertion.


Asunto(s)
Clavos Ortopédicos/veterinaria , Caballos/cirugía , Huesos del Metacarpo/cirugía , Animales , Fenómenos Biomecánicos , Cadáver , Femenino , Calor , Masculino
17.
Neoplasia ; 17(6): 490-6, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-26152357

RESUMEN

Platelets have been long postulated to play a critical role in the pathogenesis of prostate cancer, although relatively little is known regarding the precise mechanisms involved. Androgen deprivation therapy (ADT) for prostate cancer eventually fails with relapse occurring in the form of castration-resistant prostate cancer (CRPC). CRPC tumors typically overexpress androgen receptor (AR), demonstrating continued dependence upon AR signaling. Platelets have been previously demonstrated to contain androgens, and we sought to explore the contribution of platelet-derived androgens in CRPC. In this study, we examined the role of platelet-derived androgens in vitro using platelets from men with CRPC, men with high-risk prostate cancer, and healthy male donors. A series of in vitro assays was performed to elucidate the impact of platelet-derived androgens on androgen-sensitive prostate tumor cells. By examining platelet-derived androgen effects on AR signaling in prostate tumor cells, we found that platelets, from men with CRPC and on ADT, strongly induce AR target genes and tumor cell proliferation. Moreover, we show a fully intact testosterone (T) biosynthetic pathway within platelets from its precursor cholesterol and demonstrate that platelets of CRPC patients with ADT resistance are able to generate T. Overall, our findings reveal an unknown capacity of platelets to synthesize T at functionally relevant levels in patients with lethal prostate cancer. Importantly, it suggests a novel paracrine mechanism of T production that may act to sustain CRPC state and potentiate therapeutic resistance.


Asunto(s)
Andrógenos/farmacología , Plaquetas/metabolismo , Regulación Neoplásica de la Expresión Génica/efectos de los fármacos , Neoplasias de la Próstata Resistentes a la Castración/metabolismo , Receptores Androgénicos/metabolismo , Transducción de Señal/efectos de los fármacos , Testosterona/farmacología , Apoptosis/efectos de los fármacos , Western Blotting , Proliferación Celular/efectos de los fármacos , Humanos , Masculino , Neoplasias de la Próstata Resistentes a la Castración/tratamiento farmacológico , Neoplasias de la Próstata Resistentes a la Castración/genética , ARN Mensajero/genética , Reacción en Cadena en Tiempo Real de la Polimerasa , Receptores Androgénicos/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Células Tumorales Cultivadas
18.
J Immunol ; 188(9): 4181-7, 2012 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-22490443

RESUMEN

The invasive trophoblast cells of the equine placenta migrate into the endometrium to form endometrial cups, dense accumulations of trophoblast cells that produce equine chorionic gonadotropin between days 40 and 120 of normal pregnancy. The mechanisms by which the trophoblast cells invade the endometrium while evading maternal immune destruction are poorly defined. A gene expression microarray analysis performed on placental tissues obtained at day 34 of gestation revealed a >900-fold upregulation of mRNA encoding the cytokine IL-22 in chorionic girdle relative to noninvasive chorion. Quantitative RT-PCR assays were used to verify high expression of IL-22 in chorionic girdle. Additional quantitative RT-PCR analysis showed a striking increase in IL-22 mRNA expression in chorionic girdle from days 32 to 35 and an absence of IL-22 expression in other conceptus tissues. Bioinformatic analysis and cDNA sequencing confirmed the predicted length of horse IL-22, which carries a 3' extension absent in IL-22 genes of humans and mice, but present in the cow and pig. Our discovery of IL-22 in the chorionic girdle is a novel finding, as this cytokine has been previously reported in immune cells only. IL-22 has immunoregulatory functions, with primary action on epithelial cells. mRNA of IL-22R1 was detected in pregnant endometrium at levels similar to other equine epithelia. Based upon these findings, we hypothesize that IL-22 cytokine produced by the chorionic girdle binds IL-22R1 on endometrium, serving as a mechanism of fetal-maternal communication by modulating endometrial responses to trophoblast invasion.


Asunto(s)
Corion/inmunología , Interleucinas/inmunología , Intercambio Materno-Fetal/fisiología , Embarazo/inmunología , Trofoblastos/inmunología , Regulación hacia Arriba/inmunología , Animales , Bovinos , Corion/citología , Corion/metabolismo , Endometrio/citología , Endometrio/inmunología , Endometrio/metabolismo , Femenino , Regulación de la Expresión Génica/fisiología , Caballos/inmunología , Caballos/metabolismo , Humanos , Interleucinas/biosíntesis , Ratones , Embarazo/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Porcinos , Trofoblastos/citología , Trofoblastos/metabolismo , Interleucina-22
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