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1.
PLoS One ; 16(1): e0244419, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33406085

RESUMEN

We use the UK Household Longitudinal Study and compare pre-COVID-19 pandemic (2017-2019) and during-COVID-19 pandemic data (April 2020) for the same group of individuals to assess and quantify changes in mental health as measured by changes in the GHQ-12 (General Health Questionnaire), among ethnic groups in the UK. We confirm the previously documented average deterioration in mental health for the whole sample of individuals interviewed before and during the COVID-19 pandemic. In addition, we find that the average increase in mental distress varies by ethnicity and gender. Both women -regardless of their ethnicity- and Black, Asian, and minority ethnic (BAME) men experienced a higher average increase in mental distress than White British men, so that the gender gap in mental health increases only among White British individuals. These ethnic-gender specific changes in mental health persist after controlling for demographic and socioeconomic characteristics. Finally, we find some evidence that, among men, Bangladeshi, Indian and Pakistani individuals have experienced the highest average increase in mental distress with respect to White British men.


Asunto(s)
/psicología , Grupos Étnicos/psicología , Salud Mental/tendencias , Adulto , Grupos de Población Continentales/psicología , Grupos de Población Continentales/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Femenino , Humanos , Estudios Longitudinales , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Pandemias/estadística & datos numéricos , Reino Unido/epidemiología
2.
BMC Infect Dis ; 21(1): 40, 2021 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-33421991

RESUMEN

BACKGROUND: COVID-19 studies are primarily from the inpatient setting, skewing towards severe disease. Race and comorbidities predict hospitalization, however, ambulatory presentation of milder COVID-19 disease and characteristics associated with progression to severe disease is not well-understood. METHODS: We conducted a retrospective chart review including all COVID-19 positive cases from Stanford Health Care (SHC) in March 2020 to assess demographics, comorbidities and symptoms in relationship to: 1) their access point of testing (outpatient, inpatient, and emergency room (ER)) and 2) development of severe disease. RESULTS: Two hundred fifty-seven patients tested positive: 127 (49%), 96 (37%), and 34 (13%) at outpatient, ER and inpatient, respectively. Overall, 61% were age < 55; age > 75 was rarer in outpatient setting (11%) than ER (14%) or inpatient (24%). Most patients presented with cough (86%), fever/chills (76%), or fatigue (63%). 65% of inpatients reported shortness of breath compared to 30-32% of outpatients and ER patients. Ethnic/minority patients had a significantly higher risk of developing severe disease (Asian OR = 4.8 [1.6-14.2], Hispanic OR = 3.6 [1.1-11.9]). Medicare-insured patients were marginally more likely (OR = 4.0 [0.9-17.8]). Other factors associated with developing severe disease included kidney disease (OR = 6.1 [1.0-38.1]), cardiovascular disease (OR = 4.7 [1.0-22.1], shortness of breath (OR = 5.4 [2.3-12.6]) and GI symptoms (OR = 3.3 [1.4-7.7]; hypertension without concomitant CVD or kidney disease was marginally significant (OR = 2.3 [0.8-6.5]). CONCLUSIONS: Early widespread symptomatic testing for COVID-19 in Silicon Valley included many less severely ill patients. Thorough manual review of symptomatology reconfirms the heterogeneity of COVID-19 symptoms, and challenges in using clinical characteristics to predict decline. We re-demonstrate that socio-demographics are consistently associated with severity.


Asunto(s)
/epidemiología , Adulto , Anciano , Grupo de Ascendencia Continental Asiática , /etnología , Comorbilidad , Tos , Disnea , Grupos Étnicos , Femenino , Fiebre , Accesibilidad a los Servicios de Salud , Hispanoamericanos , Hospitalización , Humanos , Masculino , Medicare , Persona de Mediana Edad , Grupos Minoritarios , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Estados Unidos
6.
Gene ; 766: 145092, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-32916247

RESUMEN

Cigarette smoking is a major lifestyle factor leading to different human diseases. The DNA repair gene, thymine DNA glycosylase, is important to cell survival because it stops cells from becoming cancerous protecting/preventing DNA. Exposure to CS may induce genetic changes such as single nucleotide polymorphisms in DNA repair genes. Therefore, the purpose of this study was to investigate the genotype and allele distributions of four TDG SNPs with only smoking behavior in normal patients. Four TDG SNPs-rs4135066 (C/T), rs3751209 (A/G), rs1866074 (C/T), and rs1882018 (C/T) were analyzed by genotyping 235 and 239 blood samples collected from cigarette smokers and non-smokers, among the Saudi population. The results showed that TDG rs4135066 has a significant susceptibility effect observed in long-term smokers (>5 years; OR = 4.53; P = 0.0347) but not in short-term smokers (≤5 years) in contrast with non-smokers. Also, in smokers aged less than 29 years, the "CT," "TT," and "CT + TT" alleles of rs1882018 increased the risk of developing all diseases related to smoking by approximately 6, 4, and 5 times, respectively, in contrast with the ancestral "CC" homozygous allele. A comparison of the allele distributions of TDG SNPs in a Saudi population with those in other populations represented in the HapMap project showed that the genetic makeup of the Saudi Arabian population appears to differ from that of other ethnicities. Exceptions include the Yoruba people in Ibadan, Nigeria; those of Mexican ancestry in Los Angeles, California; the Luhya population in Webuye, Kenya; Gujarati Indians in Houston, Texas; and the Tuscan population in Italy, which showed similar allelic frequencies for rs3751209 compared to our Saudi population. In this ethnic, we have found a high variation in the distribution of the alleles and genotype frequencies on TDG gene. This variation on TDG SNP's with smoking could lead to increase the susceptibility to many diseases related to smoking habits in this population.


Asunto(s)
Predisposición Genética a la Enfermedad/genética , Polimorfismo de Nucleótido Simple/genética , Fumar/genética , Timina ADN Glicosilasa/genética , Adulto , Alelos , Grupos Étnicos/genética , Femenino , Frecuencia de los Genes/genética , Genotipo , Humanos , Masculino
7.
Cultur Divers Ethnic Minor Psychol ; 27(1): 47-59, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32804521

RESUMEN

OBJECTIVE: The Brief Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CVB) is a widely used, multidimensional measure of exposure to ethnic/racial discrimination. The PEDQ-CVB has not been previously validated for use with American Indians, who have endured a unique history of colonization, cultural oppression, and ongoing discrimination. This study examined the measurement invariance of the PEDQ-CVB in American Indians (AIs) and 4 other groups. Additional analyses assessed the scale's convergent and discriminant validity and provided initial evidence of associations with mental and physical health in AIs. METHOD: Primary data were collected from a community sample of urban-dwelling AIs (n = 222), which included measures of ethnic/racial identity, other life stressors, and mental and physical health, along with the PEDQ-CVB. These were supplemented by secondary analysis of PEDQ-CVB data from African Americans (n = 1176), Latinos (n = 564), East Asian Americans (n = 274), and South Asian Americans (n = 242). RESULTS: The PEDQ-CVB demonstrated measurement invariance across the 5 ethnic/racial groups and convergent and discriminant validity in AIs. The PEDQ-CVB was significantly associated with depressive symptoms and physical limitations in AIs, after controlling for relevant demographics. CONCLUSION: This study provides strong evidence that the PEDQ-CVB behaves consistently for AIs and other underrepresented ethnic/racial groups. As such, the PEDQ-CVB allows for documentation of the experiences of different ethnic/racial groups and provides a means to test theoretical models of the antecedents and consequences of perceived discrimination within and across groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Racismo , Afroamericanos , Grupos Étnicos , Hispanoamericanos , Humanos , Encuestas y Cuestionarios , Estados Unidos
8.
Ann Epidemiol ; 53: 56-62.e2, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32927056

RESUMEN

PURPOSE: To evaluate associations between counties' COVID-19 cases and racial-ethnic and nativity composition, considering heterogeneity across Latin American-origin subgroups and regions of the United States. METHODS: Using county-level data and multilevel negative binomial models, we evaluate associations between COVID-19 cases and percentages of residents that are foreign-born, Latinx, Black, or Asian, presenting estimates for all counties combined and stratifying across regions. Given varying risk factors among Latinx, we also evaluate associations for percentages of residents from specific Latin American-origin groups. RESULTS: Percentage of foreign-born residents is positively associated with COVID-19 case rate (IRR = 1.106; 95% CI: 1.074-1.139). Adjusted associations for percentage Latinx are nonsignificant for all counties combined, but this obscures heterogeneity. Counties with more Central Americans have higher case rates (IRR = 1.130; 95% CI: 1.067-1.197). And, in the Northeast and Midwest, counties with more Puerto Ricans have higher case rates. Associations with percentage Asians are nonsignificant after adjusting for percentage foreign-born. With the confirmation of prior evidence, the percentage of Black residents is positively and robustly associated with COVID-19 case rate (IRR = 1.031; 95% CI: 1.025-1.036). CONCLUSIONS: Counties with more immigrants, as well as more Central American or Black residents, have more COVID-19 cases. In the Northeast and Midwest, counties with more Puerto Rican residents also have more COVID-19 cases.


Asunto(s)
/etnología , Emigrantes e Inmigrantes/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud/etnología , Características de la Residencia/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Gobierno Local , Masculino , Persona de Mediana Edad , Pandemias , Clase Social , Estados Unidos/epidemiología , Adulto Joven
9.
J Surg Res ; 257: 128-134, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32823010

RESUMEN

BACKGROUND: Despite increasing the number of women and ethnic minority groups in surgery, the academic advancement of such individuals within surgical fields lags behind Caucasian men. We sought to identify gender and ethnic inequalities in the receipt of surgical society research grants for young faculty investigators and compare the scholarly productivity of these groups. MATERIALS AND METHODS: In this cross-sectional and retrospective study, the gender and race of surgical society grant recipients were determined from surgical society Web sites. Surgical society grants aimed at providing research grants for junior faculty investigators were analyzed. Using the Scopus database, each recipient's scholarly productivity was determined by means of h-index, a standardized measure of the quantity and impact of an individual's published articles. We generated descriptive statistics to compare the gender, race, and h-index of grant recipients in the years 2006-2008 and 2016-2018. RESULTS: Between 2006 and 2008, there were 68 research grant recipients. Of these recipients, 79% were men and 21% were women. The racial breakdown was 54% Caucasian men, 22% Asian men, 1.4% African American men, 1.4% Hispanic men, 12% Caucasian women, 7% Asian Women, and 1.4% African American women. The average h-index of the male and female recipients is 25 (±14) and 24 (±14), respectively (P = 0.81). Between 2016 and 2018, there were 113 research grant recipients. Of these recipients, 66% were men and 34% were women. The racial breakdown was 47% Caucasian men, 16% Asian men, 3.5% African American men, 1% Hispanic men, 26% Caucasian women, 3.5% Asian women, and 3.5% African American women. The average h-index of the male and female recipients is 12 (±8) and 9 (±6), respectively (P = 0.046). Caucasian women had the only statistically significant change in the proportion of grant recipients from 2006-2008 to 2016-2018, with an increase from 12% to 26% (P = 0.02). CONCLUSIONS: Most surgical society research grants for young investigators continue to be awarded to Caucasian men, with Caucasian women earning a distant second in the 2016-2018 cohort. Ethnic minorities continue to be awarded less research grants than Caucasian recipients. Overall, the average h-index of women was less than men. This study highlights the persistent need for surgical societies to consider gender and ethnic disparities when awarding junior investigator grants, including barriers minority groups may face in achieving the same h-index as Caucasian men.


Asunto(s)
Investigación Biomédica/estadística & datos numéricos , Cirugía General/educación , Grupos Minoritarios/estadística & datos numéricos , Investigadores/estadística & datos numéricos , Apoyo a la Investigación como Asunto/estadística & datos numéricos , Éxito Académico , Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Grupo de Ascendencia Continental Asiática/estadística & datos numéricos , Estudios Transversales , Eficiencia , Grupos Étnicos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Estudios Retrospectivos , Factores Sexuales , Sociedades Médicas/estadística & datos numéricos
10.
J Public Health Manag Pract ; 27 Suppl 1, COVID-19 and Public Health: Looking Back, Moving Forward: S43-S56, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32956299

RESUMEN

OBJECTIVE: To overcome the absence of national, state, and local public health data on the unequal economic and social burden of COVID-19 in the United States. DESIGN: We analyze US county COVID-19 deaths and confirmed COVID-19 cases and positive COVID-19 tests in Illinois and New York City zip codes by area percent poverty, percent crowding, percent population of color, and the Index of Concentration at the Extremes. SETTING: US counties and zip codes in Illinois and New York City, as of May 5, 2020. MAIN OUTCOME MEASURES: Rates, rate differences, and rate ratios of COVID-19 mortality, confirmed cases, and positive tests by category of county and zip code-level area-based socioeconomic measures. RESULTS: As of May 5, 2020, the COVID-19 death rate per 100 000 person-years equaled the following: 143.2 (95% confidence interval [CI]: 140.9, 145.5) vs 83.3 (95% CI: 78.3, 88.4) in high versus low poverty counties (≥20% vs <5% of persons below poverty); 124.4 (95% CI: 122.7, 126.0) versus 48.2 (95% CI: 47.2, 49.2) in counties in the top versus bottom quintile for household crowding; and 127.7 (95% CI: 126.0, 129.4) versus 25.9 (95% CI: 25.1, 26.6) for counties in the top versus bottom quintile for the percentage of persons who are people of color. Socioeconomic gradients in Illinois confirmed cases and New York City positive tests by zip code-level area-based socioeconomic measures were also observed. CONCLUSIONS: Stark social inequities exist in the United States for COVID-19 outcomes. We recommend that public health departments use these straightforward cost-effective methods to report on social inequities in COVID-19 outcomes to provide an evidence base for policy and resource allocation.


Asunto(s)
/epidemiología , Costo de Enfermedad , Grupos Étnicos/estadística & datos numéricos , Renta/estadística & datos numéricos , Gobierno Local , Pandemias/estadística & datos numéricos , Características de la Residencia/estadística & datos numéricos , Factores Socioeconómicos , Estudios Transversales , Humanos , Illinois/epidemiología , Ciudad de Nueva York/epidemiología , Factores Raciales , Estados Unidos/epidemiología
11.
Cultur Divers Ethnic Minor Psychol ; 27(1): 107-117, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32309971

RESUMEN

OBJECTIVES: Studies of discrimination and sleep have largely focused on between-person differences in discrimination as a correlate of sleep outcomes. A common criticism of this research is that standard questionnaire measures of discrimination may be confounded by personality and identity and are subject to recall bias. Partially addressing these limitations, the current study examined within-person, day-to-day fluctuations in perceived discrimination as a predictor of day-to-day fluctuations in sleep. The role of internalized racism as a moderator of the within-person association between discrimination and sleep was also considered. METHOD: Participants were African American college students attending a predominantly White institution (N = 124, 26% male, Mage = 20.1, SD = 1.6). Each student was asked to complete a baseline questionnaire and a 9-day diary. Experiences of discrimination were assessed in the questionnaire and daily diary format. Sleep problems were measured each day using self-report measures focusing on sleep quality. Internalized racism was assessed with the miseducation scale, which captures the degree to which individuals associate negative characteristics such as laziness and criminality with their racial/ethnic group. Established measures of racial identity were considered as covariates. RESULTS: Multilevel analyses indicated that on days when participants experienced more discrimination, subsequent sleep problems increased (B = .037, SE = .017, p = .034). Furthermore, this within-person association was moderated by internalized racism such that the effects of daily discrimination on sleep were stronger among those who scored higher on miseducation (B = .046, SE = .021, p = .033). CONCLUSIONS: Overall, results suggest that ongoing efforts to reduce discrimination, support the adjustment of racial/ethnic minority students, and address internalized racism are warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Racismo , Afroamericanos , Grupos Étnicos , Femenino , Humanos , Masculino , Grupos Minoritarios , Sueño , Estudiantes
12.
Cultur Divers Ethnic Minor Psychol ; 27(1): 60-71, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32352808

RESUMEN

OBJECTIVES: We examined ethnic-racial and gender identities and their relations to self-esteem and well-being among Cherokee early adolescents. We also explored gender differences in the significance to boys and girls of ethnic-racial and gender identities. METHOD: The sample consisted of 212 Cherokee 6th, 7th, and 8th grade girls and boys (Mage = 12.7 years). Adolescents completed survey measures of gender and ethnic-racial centrality, gender private regard, ethnic-racial private regard, ethnic-racial public regard, self-esteem, and three measures of well-being. RESULTS: Both genders reported high levels of the importance of being Cherokee to their identity (i.e., centrality), and strong positive attitudes toward being Cherokee (i.e., ethnic-racial private regard). Boys perceived gender as more important and more positive than girls. Among girls, ethnic-racial identity was more central and was viewed more positively than their gender identity. Mean levels of ethnic-racial and gender centrality did not differ for boys, nor did their reports of ethnic-racial and gender private regard. Youth's perceptions that others hold Cherokees in high regard (public regard) decreased across the grade levels. For both boys and girls, gender identity dimensions had stronger relations than ethnic-racial identity to psychosocial outcomes. CONCLUSIONS: For this sample of Cherokee adolescents, ethnic-racial identity held more prominence for girls than for boys, although aspects of gender identity were more strongly related to well-being for both genders. Results of the study indicate the significance of considering multiple identities in understanding identity development in American Indian adolescents. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Identidad de Género , Identificación Social , Adolescente , Grupos de Población Continentales , Grupos Étnicos , Femenino , Humanos , Masculino , Autoimagen
13.
Cultur Divers Ethnic Minor Psychol ; 27(1): 18-36, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32378929

RESUMEN

OBJECTIVES: The present mixed-methods study examines allyship as a politicized collective identity and its associations with ethnic identity, personality traits, and sociopolitical engagement among IPPOC. METHOD: Participants in two samples in 2016 (n = 256) and 2017 (n = 305) completed measures of ally identity, ethnic identity, personality traits, and political engagement. RESULTS: Results indicate two factors of ally identity (ally beliefs and behaviors). Quantitative findings suggest a) ethnic identity exploration predicts ally beliefs and behaviors, b) extraversion predicts ally behaviors, while agreeableness and neuroticism predicts ally beliefs, and c) ally beliefs and behaviors predict awareness, while ethnic identity exploration predicts involvement in political action, even when personality traits are considered. Thematic analysis findings suggest IPPOC allies are politically engaged through social media, individual actions, protests, and civic engagement. CONCLUSIONS: Ethnic and ally identity provide different paths to sociopolitical awareness and involvement. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Asunto(s)
Grupos Étnicos , Pigmentación de la Piel , Humanos , Pueblos Indígenas , Política , Identificación Social
16.
Womens Health Issues ; 31(1): 65-74, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33234388

RESUMEN

INTRODUCTION: Prior research has found that some preconception health risks are more prevalent among women in historically minoritized racial and ethnic groups. Preconception health risks are also increased among women with disabilities. Risks could be even greater among women who both have a disability and belong to a minoritized racial or ethnic group. The purpose of this study was to assess preconception health at the intersection of disability and race or ethnicity. METHODS: We analyzed data from the 2016 Behavioral Risk Factor Surveillance System to estimate the prevalence of health behaviors, health status indicators, and preventive healthcare receipt among nonpregnant women 18-44 years of age. We used modified Poisson regression to compare non-Hispanic White women with disabilities and women with and without disabilities in three other race/ethnicity groups (non-Hispanic Black, Hispanic, other race) to a reference group of non-Hispanic White women without disabilities. Disability status was defined based on affirmative response to at least one of six questions about difficulty with seeing, hearing, mobility, cognition, personal care, or independent living tasks. Multivariate analyses adjusted for other sociodemographic characteristics such as age and marital status. RESULTS: In every racial and ethnic group, women with disabilities had a significantly higher prevalence of most preconception health risks than their counterparts without disabilities. The disparity in obesity for Black women with disabilities was additive, with the adjusted prevalence ratio (PR, 1.77; 95% confidence interval [CI], 1.57-2.00) equal to the sum of the prevalence ratios for disability alone (PR, 1.29; 95% CI, 1.19-1.41) and Black race alone (PR, 1.47; 95% CI, 1.36-1.58). CONCLUSIONS: Women at the intersection of disability and minoritized race or ethnicity may be at especially high risk of adverse outcomes. Targeted efforts are needed to improve the health of women of reproductive age in these doubly marginalized populations.


Asunto(s)
Personas con Discapacidad , Grupos Étnicos , Adolescente , Adulto , Afroamericanos , Femenino , Hispanoamericanos , Humanos , Atención Preconceptiva , Embarazo , Estados Unidos/epidemiología , Adulto Joven
17.
Gene ; 765: 145070, 2021 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-32898607

RESUMEN

BACKGROUND: Rheumatoid arthritis (RA) is complex autoimmune system disease and significant impact on the health of population in our world. Numerous studies confirmed that genetic factors play a crucial role in the pathogenesis of RA. In this current study, we aimed to investigate IL-6 polymorphisms and RA risk in Chinese Han population. METHODS: 508 RA patients and 494 age- and gender- matched healthy controls were recruited, all subjects were genotyped with an Agena MassARRAY platform. Subsequently, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by unconditional logistic regression after adjusting for age and gender. RESULTS: Our results suggested that IL-6 rs2243289 allele and genotype frequencies were associated with reduced RA risk under all genetic models (all p < 0.05). Stratification analysis revealed that IL-6 rs2243289 polymorphism was significant associated with decreased the risk of RA in the old groups (age > 54) (all p < 0.05). However, IL-6 rs2069837 and rs1800796 polymorphisms were associated with increased risk of RA among the young groups (age ≤ 54) (all p < 0.05). In addition, subgroup analysis by gender suggested that IL-6 rs2069837 and rs1800796 polymorphism were interacted with increased the risk of RA in males (all p < 0.05). Besides, IL-6 rs2243289 was associated with reduced RA risk in females. CONCLUSIONS: In conclusion, our results demonstrated the correlation between IL and 6 polymorphisms and RA susceptibility and confirmed for the first time that the relationship was restricted to age and gender in Chinese Han population.


Asunto(s)
Artritis Reumatoide/genética , Interleucina-6/genética , Adulto , Anciano , Alelos , Artritis Reumatoide/fisiopatología , Grupo de Ascendencia Continental Asiática/genética , Estudios de Casos y Controles , China , Grupos Étnicos/genética , Femenino , Frecuencia de los Genes/genética , Estudios de Asociación Genética/métodos , Predisposición Genética a la Enfermedad/genética , Genotipo , Haplotipos , Humanos , Interleucina-6/metabolismo , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Polimorfismo de Nucleótido Simple/genética , Factores de Riesgo
18.
Womens Health Issues ; 31(1): 75-81, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33069559

RESUMEN

INTRODUCTION: Racial and ethnic disparities in rates of maternal morbidity and mortality in the United States are striking and persistent. Despite evidence that variation in the quality of care contributes substantially to these disparities, we do not sufficiently understand how experiences of perinatal care differ by race and ethnicity among women with severe maternal morbidity. METHODS: We conducted focus groups with women who experienced a severe maternal morbidity event in a New York City hospital during their most recent pregnancy (n = 20). We organized three focus groups by self-identified race/ethnicity ([1] Black, [2] Latina, and [3] White or Asian) to detect any within- and between-group differences. Discussions were audiotaped and transcribed. The research team coded the transcripts and used content analysis to identify key themes and to compare findings across racial and ethnic groups. RESULTS: Participants reported distressing experiences and lasting emotional consequences after having a severe childbirth complication. Many women appreciated the life-saving care they received. However, poor continuity of care, communication gaps, and a perceived lack of attentiveness to participants' physical and emotional needs led to substantial concern and disappointment in care. Black and Latina women in particular emphasized these themes. CONCLUSIONS: This study highlights missed opportunities for improved clinician communication and continuity of care to address emotional trauma when severe obstetric complications occur, particularly for Black and Latina women. Enhancing communication to ensure that women feel heard and informed throughout the birth process and addressing implicit bias, as a part of the more systemic issue of institutionalized racism, could both decrease disparities in obstetric care quality and improve the patient experience for women of all races and ethnicities.


Asunto(s)
Grupos Étnicos , Periodo Periparto , Afroamericanos , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Ciudad de Nueva York , Embarazo , Estados Unidos
19.
Rev. enferm. UERJ ; 28: e44773, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1119608

RESUMEN

Objetivo:descrever a frequência dos fatores de risco cardiovascular em idosos de uma comunidade quilombola. Método: estudo transversal desenvolvido com idosos quilombolas cadastrados na Estratégia Saúde da Família. A coleta foi realizada com uma amostra de 62 idosos, utilizando-se o teste do qui-quadrado para análise dos dados. Resultados: as frequências dos fatores de risco foram: 67,7% de hipertensão arterial, 54,8% de adiposidade abdominal, 22,6% de glicemia capilar elevada, 19,4% de excesso de peso, 3,2% de sedentarismo e 3,2% de tabagismo, com diferença estatística apenas para adiposidade abdominal em idosas de cor branca (p<0,05). Conclusão: o estudo identificou elevada frequência de fatores de risco cardiovasculares nos idosos quilombolas atendidos na atenção primária à saúde, com destaque para hipertensão arterial, adiposidade abdominal e glicemia capilar elevada. Os resultados apontam a necessidade de melhoria de acesso da comunidade quilombola aos serviços de saúde.


Objective: to describe the frequency of cardiovascular risk factors in the older adults of a quilombola community. Method: in this cross-sectional study of 62 older adults of a quilombo registered with Brazil's Family Health Strategy, the data collected were analyzed using the Chi-square test. Results: risk factor frequencies were: 67.7% for arterial hypertension; 54.8%, abdominal adiposity; 22.6%, high capillary blood glucose; 19.4%, overweight; 3.2%, sedentary lifestyle; and 3.2%, smoking. Statistical difference was observed only for abdominal adiposity in older, white women (p<0.05). Conclusion: this study identified a high frequency of cardiovascular risk factors in quilombola older adults treated in primary health care, particularly arterial hypertension, abdominal adiposity, and high capillary blood glucose. These results indicate the need to improve quilombola communities' access to health services.


Objetivo: describir la frecuencia de factores de riesgo cardiovascular en los adultos mayores de una comunidad quilombola. Método: en este estudio transversal de 62 adultos mayores de un quilombo inscrito en la Estrategia de Salud de la Familia de Brasil, los datos recolectados se analizaron mediante la prueba de Chi-cuadrado. Resultados: las frecuencias de los factores de riesgo fueron: 67,7% para la hipertensión arterial; 54,8%, adiposidad abdominal; 22,6%, glucemia capilar elevada; 19,4%, sobrepeso; 3,2%, sedentarismo; y 3,2%, tabaquismo. Se observó diferencia estadística solo para la adiposidad abdominal en mujeres blancas mayores (p<0,05). Conclusión: este estudio identificó una alta frecuencia de factores de riesgo cardiovascular en adultos mayores quilombolas tratados en atención primaria de salud, particularmente hipertensión arterial, adiposidad abdominal y glucemia capilar alta. Estos resultados indican la necesidad de mejorar el acceso de las comunidades quilombolas a los servicios de salud.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares , Grupos Étnicos , Factores de Riesgo , Accesibilidad a los Servicios de Salud , Tabaquismo , Glucemia , Brasil , Epidemiología Descriptiva , Estrategia de Salud Familiar , Circunferencia Abdominal , Conducta Sedentaria , Hipertensión , Obesidad
20.
Rev. enferm. UERJ ; 28: e50968, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1122751

RESUMEN

Objetivo: descrever as práticas culturais de cuidado no puerpério de mulheres quilombolas. Método: estudo descritivo, de abordagem qualitativa e delineado por meio da Teoria da Diversidade e Universalidade do Cuidado de Madeleine Leininger. Participaram do estudo quatorze mulheres quilombolas que já tinham vivenciado o período puerperal. A coleta das informações ocorreu de junho a setembro de 2018. Projeto aprovado por Comitê de Ética em Pesquisa. Resultados: observou-se a manutenção das crenças e valores, considerando a cultura local relacionada às práticas de cuidado de puérperas quilombolas. Considerações finais: as práticas de cuidado desenvolvidas por mulheres quilombolas no pós-parto se caracterizam por receber influência das crenças, valores e modos de vida que foram transmitidas por meio da oralidade por outras mulheres que já tinham vivenciado esse período.


Objective: to describe cultural practices of health care for quilombola women in puerperium. Method: this qualitative, descriptive study was framed by Madeleine Leininger's Theory of Culture Care Diversity and Universality. Fourteen quilombola women who had already experienced the puerperal period participated in the study. Information was collected from June to September 2018. The project was approved by the research ethics committee. Results: beliefs and values were observed to be maintained in the local culture as regards practices of care for puerperal quilombola women. Final considerations: the postpartum care practices applied by quilombola women were characteristically influenced by the beliefs, values and ways of life transmitted orally by other women who had already experienced puerperium.


Objetivo: describir las prácticas culturales de atención a la salud de las mujeres quilombolas en el puerperio. Método: este estudio cualitativo y descriptivo fue enmarcado por la Teoría de la Cultura Cuidado de la Diversidad y Universalidad de Madeleine Leininger. Participaron del estudio catorce mujeres quilombolas que ya habían pasado por el puerperio. La información se recopiló de junio a septiembre de 2018. El proyecto fue aprobado por el comité de ética en investigación. Resultados: se observó el mantenimiento de creencias y valores en la cultura local en cuanto a prácticas de cuidado de las puérperas quilombolas. Consideraciones finales: las prácticas de atención posparto aplicadas por las mujeres quilombolas estuvieron característicamente influenciadas por las creencias, valores y formas de vida transmitidas oralmente por otras mujeres que ya habían experimentado el puerperio.


Asunto(s)
Humanos , Femenino , Grupos Étnicos , Características Culturales , Periodo Posparto , Salud Materna , Reposo en Cama , Brasil , Higiene , Epidemiología Descriptiva , Investigación Cualitativa , Conducta Alimentaria , Normas Sociales
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