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1.
Medicine (Baltimore) ; 99(18): e19542, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32358343

RESUMEN

BACKGROUND: Data of non-vitamin K antagonist oral anticoagulants (NOACs) in current management of atrial fibrillation (AF) are predominantly derived from North American and European regions. However, the effects of NOACs for stroke prevention in Latin America remain unclear. Therefore, we aimed to compare the efficacy and safety of NOACs with warfarin in Latin American patients with AF. METHODS: The PubMed and Embase databases were systematically searched until July 12, 2019 for applicable randomized clinical trials. The risk ratios (RRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. RESULTS: Four trials involving 8943 Latin American patients were included in this meta-analysis. In anticoagulated patients with AF, Latin American patients had higher rates of stroke or systemic embolism and all-cause death compared with non-Latin American subjects. Compared with warfarin use, the use of NOACs was significantly associated with reduced risks of stroke or systemic embolism, major bleeding, intracranial bleeding, and any bleeding in Latin American patients. There were no significant differences in the risks of ischemic stroke, all-cause death, and gastrointestinal bleeding between Latin and non-Latin American groups. All the interactions between Latin and non-Latin American groups about efficacy and safety outcomes of NOACs compared with warfarin were non-significant (all Pinteraction > .05). CONCLUSIONS: Our meta-analysis suggested that the use of NOACs was at least non-inferior to warfarin use for stroke prevention in Latin American patients with AF.


Asunto(s)
Anticoagulantes/uso terapéutico , Fibrilación Atrial/tratamiento farmacológico , Hispanoamericanos/estadística & datos numéricos , Accidente Cerebrovascular/prevención & control , Warfarina/uso terapéutico , Administración Oral , Adulto , Fibrilación Atrial/complicaciones , Fibrilación Atrial/etnología , Embolia/etnología , Embolia/prevención & control , Femenino , Hemorragia/inducido químicamente , Hemorragia/etnología , Humanos , América Latina , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Accidente Cerebrovascular/etnología , Resultado del Tratamiento
2.
J Racial Ethn Health Disparities ; 7(3): 398-402, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32306369

RESUMEN

The Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted and devastated the world. As the infection spreads, the projected mortality and economic devastation are unprecedented. In particular, racial and ethnic minorities may be at a particular disadvantage as many already assume the status of a marginalized group. Black Americans have a long-standing history of disadvantage and are in a vulnerable position to experience the impact of this crisis and the myth of Black immunity to COVID-19 is detrimental to promoting and maintaining preventative measures. We are the first to present the earliest available data in the peer-reviewed literature on the racial and ethnic distribution of COVID-19-confirmed cases and fatalities in the state of Connecticut. We also seek to explode the myth of Black immunity to the virus. Finally, we call for a National Commission on COVID-19 Racial and Ethnic Health Disparities to further explore and respond to the unique challenges that the crisis presents for Black and Brown communities.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Coronavirus , Grupos Étnicos/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Disparidades en el Estado de Salud , Disparidades en Atención de Salud , Pandemias , Neumonía Viral/epidemiología , Afroamericanos , Grupo de Ascendencia Continental Africana , Betacoronavirus , Connecticut/epidemiología , Grupos de Población Continentales , Infecciones por Coronavirus/prevención & control , Grupo de Ascendencia Continental Europea , Hispanoamericanos , Humanos , Masculino , Neumonía Viral/prevención & control
3.
Am Surg ; 86(3): 213-219, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-32223800

RESUMEN

Grady Memorial Hospital is a pillar of public medical and surgical care in the Southeast. The evolution of this institution, both in its physical structure as well as its approach to patient care, mirrors the cultural and social changes that have occurred in the American South. Grady Memorial Hospital opened its doors in 1892 built in the heart of Atlanta's black community. With its separate and unequal facilities and services for black and white patients, the concept of "the Gradies" was born. Virtually, every aspect of care at Grady continued to be segregated by race until the mid-20th century. In 1958, the opening of the "New Grady" further cemented this legacy of the separate "Gradies," with patients segregated by hospital wing. By the 1960s, civil rights activists brought change to Atlanta. The Atlanta Student Movement, with the support of Dr. Martin Luther King Jr., led protests outside of Grady, and a series of judicial and legislative rulings integrated medical boards and public hospitals. Eventually, the desegregation of Grady occurred with a quiet memo that belied years of struggle: on June 1, 1965, a memo from hospital superintendent Bill Pinkston read "All phases of the hospital are on a non-racial basis, effective today." The future of Grady is deeply rooted in its past, and Grady's mission is unchanged from its inception in 1892: "It will nurse the poor and rich alike and will be an asylum for black and white."


Asunto(s)
Derechos Civiles/historia , Desegregación/historia , Desegregación/legislación & jurisprudencia , Afroamericanos/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Georgia , Hispanoamericanos/estadística & datos numéricos , Historia del Siglo XX , Hospitales Públicos/historia , Humanos
5.
J Dent Hyg ; 94(1): 14-20, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32127425

RESUMEN

Purpose: The purpose of this study was to understand the beliefs, experiences and practices regarding drinking water among the North Carolina (NC) Latino community, and to gather information on what would make effective messages to promote fluoridated community water (CW) consumption among Latino families.Methods: Phone interviews were conducted with Latino stakeholders, consisting of parents of young children and key community informants (n=15). The interviews were audio-recorded, and transcripts were analyzed qualitatively using Atlas. ti.8 software.Results: Major themes emerging from the interviews included: poor characteristics of CW misconceptions and lack of knowledge about CW fluoridation and safety, ingrained culture/upbringing that devalued CW consumption, and reasons for consuming CW. Participants suggested that effective efforts to promote fluoridated CW consumption among the NC Latino community should be implemented in a variety of formats and involve a collaborative approach between Spanish-speaking health professionals and community workers.Conclusion: Successful promotion of fluoridated CW consumption among NC Latino communities requires engagement of both health professionals and community stakeholders. Effective interventions aimed to promote fluoridated CW consumption need to be widespread, informative, persuasive, credible, culturally sensitive, and interactive.


Asunto(s)
Caries Dental , Agua Potable , Niño , Preescolar , Fluoruración , Hispanoamericanos , Humanos , North Carolina , Investigación Cualitativa
6.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 77-86, Jan.-Feb. 2020. graf
Artículo en Inglés | LILACS | ID: biblio-1055361

RESUMEN

The multi-faceted phenomenon known as globalization has a particular impact on the conceptual and practical development of mental health disciplines in general, and psychiatry in particular, across different world regions. To be theoretically and functionally effective, global psychiatry requires an integration of its different components. To such objective, and after a brief review of continental European and Anglo-Saxon contributions, this article examines the history, characteristics, and contributions of Latin/Iberian American and Spanish-speaking psychiatry, in order to substantiate its role in world psychiatry. The Latin American proper (including Portuguese-speaking Brazil), Spain, and U.S.-based Hispanic components are described, revealing an identity that is based on a humanistic tradition, a value-based, culturally-determined clinical approach to patient care, and a pragmatic adaptation of different treatment resources and techniques. These may constitute supportive elements of an instrumental inter-regional bond in the present and future of our discipline.


Asunto(s)
Humanos , Psiquiatría/tendencias , Salud Mental , Internacionalidad , España , Hispanoamericanos , Europa (Continente) , Lenguaje , América Latina
7.
Am J Public Health ; 110(4): 560-566, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32078345

RESUMEN

Objectives. To investigate how personally knowing a deported migrant relates to past-year prescription drug misuse among US-citizen Latinos.Methods. Between April and May 2019, a national sample (n = 3446) was recruited to complete an online survey. Multivariate and multinomial logistic regression models examined the role of (1) personally knowing a deported migrant and (2) the relationship to the deportee (e.g., family, friend) on (1) any past-year prescription drug misuse and (2) the frequency of prescription drug misuse. I limited analyses to US citizens only (n = 3282).Results. Overall, 19% of all participants reported any past-year prescription drug misuse. Latinos who had a family member who was deported reported significantly higher odds of past-year prescription drug misuse and were exceedingly at higher risk for misusing prescription drugs 3 or more days in the past year as compared with Whites and Latinos who did not personally know a deported migrant.Conclusions. Public health prevention strategies and deportation policies need to consider and address how the deportation of an individual will affect the health of that individual's US-citizen family members.


Asunto(s)
Hispanoamericanos/estadística & datos numéricos , Mal Uso de Medicamentos de Venta con Receta/estadística & datos numéricos , Migrantes/legislación & jurisprudencia , Adulto , Familia , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Migrantes/estadística & datos numéricos , Estados Unidos/epidemiología
8.
Am J Public Health ; 110(4): 587-594, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32078353

RESUMEN

Objectives. To compare usual care, inreach consisting of one-on-one education, mailed outreach offering a fecal immunochemical test (FIT), and a combination of outreach and inreach for promoting colorectal cancer (CRC) screening.Methods. We conducted a 4-arm randomized controlled trial from 2015 to 2018 at a US federally qualified health center near the California-Mexico border primarily serving low-income Hispanics/Latinos. A total of 673 individuals aged 50 to 75 years not up to date with screening were assigned to 1 of the 4 intervention groups. The primary outcome was CRC screening through 6 months follow-up.Results. A total of 671 patients were included in intention-to-screen analyses. Their mean age was 59.9 years, 48.9% were male, and 86.3% were primarily Spanish-speaking. Screening was 27.5% for usual care (95% confidence interval [CI] = 0.21, 0.34), 52.7% for inreach (95% CI = 0.45, 0.60), 77.2% for outreach (95% CI = 0.71, 0.83), and 78.9% for combination of inreach and outreach (95% CI = 0.73, 0.85; P < .001 for all comparisons except P = .793 for outreach vs combination).Conclusions. Among individuals at high risk for noncompletion, inreach with one-on-one education nearly doubled, and outreach offering mailed FIT alone or in combination with inreach nearly tripled screening compared with usual care. Mailed FIT outreach was superior to inreach for promoting screening.


Asunto(s)
Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer/estadística & datos numéricos , Cooperación del Paciente/estadística & datos numéricos , Educación del Paciente como Asunto/métodos , Anciano , California , Femenino , Hispanoamericanos , Humanos , Inmunoquímica , Masculino , Persona de Mediana Edad , Sangre Oculta
9.
BMC Public Health ; 20(1): 248, 2020 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-32070318

RESUMEN

BACKGROUND: Peer navigation is a promising strategy to link at-risk minority men who have sex with men (MSM) to HIV prevention services including pre-exposure prophylaxis (PrEP). METHODS: Thirty-two Black and 63 Latinx HIV-negative MSM living in western Washington completed a survey examining attitudes towards peer navigation and PrEP. Factor analysis derived a score for peer navigator acceptability, and linear regression identified associations with this outcome. RESULTS: Forty-eight percent were interested in peer navigation. Being insured, higher sexual stigma, and higher PHQ-9 score were associated with higher acceptability, while higher income and having a regular medical provider were associated with lower acceptability. In multivariable analysis, higher sexual stigma predicted higher acceptability, while higher income predicted lower acceptability. Men preferred that peers be matched on sexual orientation, race, age and culture. CONCLUSION: Peer navigation interventions to reach minority men should address stigma, focus on lower-income men, and try to match peers to clients to the extent possible.


Asunto(s)
Infecciones por VIH/prevención & control , Homosexualidad Masculina/etnología , Grupos Minoritarios/psicología , Aceptación de la Atención de Salud/etnología , Navegación de Pacientes , Grupo Paritario , Profilaxis Pre-Exposición , Adulto , Afroamericanos/psicología , Afroamericanos/estadística & datos numéricos , Hispanoamericanos/psicología , Hispanoamericanos/estadística & datos numéricos , Homosexualidad Masculina/psicología , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Grupos Minoritarios/estadística & datos numéricos , Encuestas y Cuestionarios , Washingtón
10.
BMC Public Health ; 20(1): 185, 2020 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-32024491

RESUMEN

BACKGROUND: Accurately measuring parents' attitudes and beliefs regarding limiting their children's TV viewing is important to inform the design and evaluation of effective interventions. This manuscript assesses the internal consistency reliability, test-retest reliability, convergent validity, and construct validity of the Model of Goal Directed Behavior (MGDB) scales among parents of Latino preschoolers to characterize Latino parents' attitudes and beliefs toward limiting their preschoolers' TV viewing. METHOD: Participants included parents of Latino preschoolers in the United States, 3-5 years old (n = 186). Parents completed a socio-demographic survey and the 105-item MGDB questionnaire (Attitudes, Perceived Positive/Negative Behavioral Control, Subjective Norms, Positive and Negative Anticipated Emotions, Habits, Self-Efficacy, Desires, and Intentions surrounding their child's TV viewing) which was used to measure internal consistency reliability and construct validity. A subsample of participants completed the questionnaire twice to measure test-retest reliability. Further, parents completed a 7-day TV viewing diary for their preschooler, and a TV parenting practices questionnaire as measures of convergent validity. RESULTS: Internal consistency reliability was generally acceptable for the MGDB scales (Cronbach's alphas> 0.7), except for the Desires scale, which was revealed to have two factors and the Attitudes and Perceived Behavioral Control scales. Test-retest reliability over 2 months had negligible to moderate correlations (r's = 0.28 to 0.61). Two structural equation models were conducted. One yielded acceptable model fit (x2 (97) = 113.65, p = .119) and the other had questionable model fit (x2 (97) = 125.39; p = .028). Testing convergent validity, only two MGDB scales (Habits and Self-Efficacy) were positively correlated with the TV parenting practices questionnaire (r's = 0.33 to 0.51), and none were meaningfully correlated with preschoolers' mean daily TV viewing. CONCLUSIONS: Initial reliability and validity for some of the MGDB scales appear acceptable among parents of Latino preschoolers. Refinement of the instrument and testing among larger samples is necessary to fully evaluate psychometric properties. This instrument may be useful for characterizing Latino parents' attitudes and beliefs toward limiting their preschoolers' TV viewing and informing future TV reduction interventions. TRIAL REGISTRATION: Clinical Trials NCT01216306 Registered October 6, 2010.


Asunto(s)
Objetivos , Conocimientos, Actitudes y Práctica en Salud/etnología , Hispanoamericanos/psicología , Modelos Psicológicos , Padres/psicología , Televisión/estadística & datos numéricos , Preescolar , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Masculino , Responsabilidad Parental/psicología , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
11.
Am Heart J ; 222: 208-219, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32105987

RESUMEN

BACKGROUND: Experimental evidence suggests that sedentary time (ST) may contribute to cardiovascular disease by eliciting detrimental hemodynamic changes in the lower limbs. However, little is known about objectively measured ST and lower extremity peripheral artery disease (PAD). METHODS: We included 7,609 Hispanic/Latinos (ages 45-74) from the Hispanic Community Health Study/Study of Latinos. PAD was measured using the ankle brachial index (≤0.9). ST was measured using accelerometry. We used multivariable logistic regression to assess associations of quartiles of ST and PAD, and then used the same logistic models with restricted cubic splines to investigate continuous nonlinear associations of ST and PAD. Models were sequentially adjusted for traditional PAD risk factors, leg pain, and moderate- to vigorous-intensity physical activity (MVPA). RESULTS: Median ST was 12.2 h/d, and 5.4% of individuals had PAD. In fully adjusted restricted cubic splines models accounting for traditional PAD risk factors, leg pain, and MVPA, ST had a significant overall (P = .048) and nonlinear (P = .024) association with PAD. A threshold effect was seen such that time spent above median ST was associated with higher odds of PAD. That is, compared to median ST, 1, 2, and 3 hours above median ST were associated with a PAD odds ratio of 1.16 (95% CI = 1.02-1.31), 1.44 (1.06-1.94), and 1.80 (1.11-2.90), respectively. CONCLUSIONS: Among Hispanic/Latino adults, ST was associated with higher odds of PAD, independent of leg pain, MVPA, and traditional PAD risk factors. Notably, we observed a threshold effect such that these associations were only observed at the highest levels of ST.


Asunto(s)
Ejercicio Físico/fisiología , Hispanoamericanos , Extremidad Inferior/irrigación sanguínea , Enfermedad Arterial Periférica/etnología , Salud Pública , Conducta Sedentaria/etnología , Adolescente , Adulto , Anciano , Índice Tobillo Braquial , Causas de Muerte/tendencias , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Enfermedad Arterial Periférica/diagnóstico , Enfermedad Arterial Periférica/fisiopatología , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia/tendencias , Ultrasonografía Doppler , Estados Unidos/epidemiología , Adulto Joven
12.
Health Qual Life Outcomes ; 18(1): 38, 2020 Feb 22.
Artículo en Inglés | MEDLINE | ID: mdl-32087734

RESUMEN

BACKGROUND: Area-level socioeconomic characteristics have been shown to be related to health status and mortality however, little is known about the association between residential community characteristics in relation to postpartum women's health. METHODS: Data from the longitudinal, multi-site Community Child Health Network (CCHN) study were used. Postpartum women (n = 2510), aged 18-40 were recruited from 2008 to 2012 within a month of delivery. Socioeconomic data was used to create deprivation indices. Census data were analysed using principal components analysis (PCA) and logistic regression to assess the association between deprivation indices (DIs) and various health indicators. RESULTS: PCA resulted in two unique DIs that accounted for 67.5% of the total variance of the combined all-site area deprivation. The first DI was comprised of variables representing a high percentage of Hispanic or Latina, foreign-born individuals, dense households (more than one person per room of residence), with less than a high-school education, and who spent more than 30% of their income on housing costs. The second DI was comprised of a high percentage of African-Americans, single mothers, and high levels of unemployment. In a multivariate logistic regression model, using the quartiles of each DI, women who reside in the geographic area of Q4-Q2 of the second DI, were almost twice as likely to have more than three adverse health conditions compared to those who resided in the least deprived areas. (Q2vs.Q1:OR = 2.09,P = 0.001,Q3vs.Q1:OR = 1.89,P = 0.006,Q4vs.Q1:OR = 1.95,P = 0.004 respectively). CONCLUSIONS: Our results support the utility of examining deprivation indices as predictors of maternal postpartum health.


Asunto(s)
Pobreza/psicología , Calidad de Vida , Características de la Residencia , Salud de la Mujer/etnología , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Niño , Femenino , Hispanoamericanos/estadística & datos numéricos , Humanos , Modelos Logísticos , Estudios Longitudinales , Periodo Posparto , Pobreza/estadística & datos numéricos , Adulto Joven
13.
Anticancer Res ; 40(2): 857-864, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32014929

RESUMEN

AIM: The purpose of this study was to determine the level of adherence to adjuvant aromatase inhibitor (AI) therapy and factors associated with non-adherence among Hispanic/Latino women with hormonal receptor-positive breast cancer (BC) treated at an academic center at the American-Mexican border city of El Paso, TX. PATIENTS AND METHODS: Institutional Review Board approval was obtained in this cross-sectional study using the validated Morisky Medication Adherence Scale to assess patient adherence to AI therapy. Patients diagnosed with stage I-III hormonal receptor-positive, human epidermal growth factor receptor 2-negative BC who were on adjuvant AIs therapy were recruited from the Texas Tech University Health Sciences Center El Paso breast clinic. RESULTS: Between September 2017 and August 2018, 122 consecutive patients were enrolled; 119 were analyzed, three were lost to follow up. The mean age was 61.6±9.4 years, and 109 (91.6%) self-identified as Hispanic/Latino. A total of 58% reported an annual income of $15,000 or less. Overall, 40.3% had completed eighth grade or less education, 31.9% high school, and 12% had obtained a technical degree. The majority of patients (56%) had either a medium (45%) or a low level of adherence (11%). High adherence was noted in 44% of participants. Seven (5.6%) patients scored 2 or below on a 4-point scale for intentional adherence, and 18 (13.5%) scored 2 or below on a 4-point scale for unintentional adherence. CONCLUSION: These data suggest that the majority of Hispanic/Latino women with breast cancer have medium or low levels of adherence to therapy with AIs. Factors associated with medium and low adherence were unintentional (forgetfulness), but also included intentional factors, such as avoidance of adverse effects and delays with obtaining refills (cost-related nonadherence).


Asunto(s)
Inhibidores de la Aromatasa/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Cumplimiento de la Medicación/estadística & datos numéricos , Inhibidores de la Aromatasa/farmacología , Estudios Transversales , Femenino , Hispanoamericanos , Humanos , Persona de Mediana Edad , Posmenopausia , Estudios Prospectivos , Encuestas y Cuestionarios
15.
Arch. med ; 20(1): 86-96, 2020-01-18.
Artículo en Inglés | LILACS | ID: biblio-1053236

RESUMEN

Objective: this paper aims to perform diagnostic screening of HPV in healthy Ecuadorian mestizo women, from seven provinces, and compare the findings with other Latin American populations. Material and methods: genotyping was done with two different oligonucleotides MY09 and MY11; a fragment of 450 base pairs was amplified,L1 region of the viral genome. Results: it analyzed 555 women, 35 were positive for HPV (6.3%). Genotypes found in relation to oncogenic risk, were 6, 11, 16, 18, 31, 33, 35, 42, 45, 51, 52, 53, 58, 59, 61, 81. 12/35 women (34.3%) presented high-risk genotypes. Four positive cases were also observed in women older than 55 years (0.36%). The 14 published studies of Ecuadorian women showed that the most prevalent genotypes are 16, 18, 31, 52, 53, 56 and 58; while in the eight Latin American Studies the most prevalent are 16, 18, 31, 45, 52 and 58. Conclusion: although there are several studies on HPV genotyping on Latin American populations, there is an important gap related to ethnicity and the prevalence of the virus. In addition, most of them have not compared similar and common subtypes in the population. The general prevalence of HPV in the studied population was 6.3%. It found that genotypes 16, 18, 31, 52, 53, 56 and 58 are the most prevalent in Ecuadorian normal mestizo women. Genotypes 53 and 56 are common in Latino populations. Larger studies, in different ethnic groups are needed to identify other prevalent genotypes in certain geographical areas..(AU)


Objetivo: realizar tamizaje diagnóstico de VPH en mujeres mestizas ecuatorianas sanas, de siete provincias, y comparar los hallazgos con otras poblaciones latinoamericanas. Material y métodos: el genotipado se realizó con dos oligonucleótidos diferentes MY09 y MY11; se amplificó un fragmento de 450 pares de bases, correspondiente a la región L1 del genoma viral. Resultados: se analizó 555 mujeres, 35 fueron positivas para VPH (6,3%). Los genotipos encontrados en relación con el riesgo oncogénico fueron 6, 11, 16, 18, 31, 33, 35, 42, 45, 51, 52, 53, 58, 59, 61, 81. 12/35 mujeres (34,3%) presentaron genotipos de alto riesgo. También se observaron cuatro casos positivos en mujeres mayores de 55 años (0,36%). Los 14 estudios publicados de mujeres ecuatorianas mostraron que los genotipos más prevalentes son 16, 18, 31, 52, 53, 56 y 58; mientras que en los ocho estudios latinoamericanos los más prevalentes son 16, 18, 31, 45, 52 y 58. Conclusión: aunque existen estudios sobre la prevalencia de VPH, aún existe una brecha sobre la relación entre la etnicidad y la prevalencia del virus. Además, los estudios en América Latina no han comparado subtipos similares y comunes en la población. La prevalencia general del VPH en la población estudiada fue del 6,3%. Este estudio encontró que los genotipos 16, 18, 31, 52, 53, 56 y 58 son los más prevalentes en las mujeres mestizas ecuatorianas sanas. Los genotipos 53 y 56 son los más comunes en las poblaciones latinas. Se necesitan estudios más grandes, en diferentes grupos étnicos para identificar otros genotipos prevalentes en ciertas áreas geográficas..(AU)


Asunto(s)
Femenino , Infecciones por Papillomavirus , Genotipo , Hispanoamericanos
16.
Ann Allergy Asthma Immunol ; 124(5): 487-493.e1, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31923550

RESUMEN

BACKGROUND: Underuse of guideline-recommended inhaled corticosteroids (ICS) controller therapy is a risk factor for greater asthma burden. ICS concomitantly used with rescue inhalers (Patient-Activated Reliever-Triggered ICS ['PARTICS']) reduced asthma exacerbations in efficacy trials, but whether PARTICS is effective in pragmatic trials is unknown. OBJECTIVE: We conducted this pilot to determine the feasibility of executing a large-scale pragmatic PARTICS trial and to improve study protocols. METHODS: Four sites recruited 33 Hispanic or black adults with persistent asthma, randomized them approximately 3:1 to intervention or usual care, and followed them for 12 weeks. All participants received asthma guideline-based educational videos; intervention participants received video-based instructions on implementing PARTICS plus usual medications. The study involved 1 randomization visit and monthly questionnaires. Timely questionnaire responses (±2 weeks) were monitored. Participants underwent qualitative phone interviews to assess self-reported adherence to PARTICS and understand barriers to completing study procedures. RESULTS: Timely questionnaire response rates were 61%, 64%, and 70% at 4, 8, and 12 weeks, respectively. Self-reported adherence to PARTICS was 76% (95% confidence interval [CI], 58%-94% [n = 21]), 88% (95%CI, 72%-100% [n = 16]), and 62% (95%CI, 36%-88% [n = 13]) at weeks 1, 6, and 12, respectively. Barriers to completing study procedures included difficulties with questionnaire access, remembering to use ICS and rescue inhalers together, and obtaining refills. Only 22% of participants recognized their short-acting bronchodilator as "reliever" or "rescue." CONCLUSION: Recruitment was feasible within the allocated period. Adherence to PARTICS was incomplete, questionnaire completion was suboptimal, and common rescue inhaler nomenclature usage was limited. We have modified the full study protocol to attempt to improve adherence to PARTICS and minimize barriers to study procedures. CLINICAL TRIALS REGISTRATION: pilot study for 'PeRson EmPowered Asthma Relief' (PREPARE, NCT02995733).


Asunto(s)
Corticoesteroides/uso terapéutico , Afroamericanos , Asma/epidemiología , Cumplimiento de la Medicación/estadística & datos numéricos , Adulto , Asma/tratamiento farmacológico , Quimioterapia Combinada , Estudios de Factibilidad , Femenino , Hispanoamericanos , Humanos , Masculino , Persona de Mediana Edad , Selección de Paciente , Proyectos Piloto , Guías de Práctica Clínica como Asunto , Ensayos Clínicos Pragmáticos como Asunto , Encuestas y Cuestionarios , Estados Unidos/epidemiología
17.
AIDS Patient Care STDS ; 34(1): 7-15, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31944853

RESUMEN

Young black and Latinx men who have sex with men (YBLMSM) and transgender women (YBLTW) are disproportionately impacted by HIV. Structural and social marginalization, the social barriers, and structures that unevenly distribute benefits and burdens to different groups, may contribute to inability for youth to access prevention and treatment care services. Yet, few reports have examined the community and health care experiences of social marginalization among youth service providers who have multiple roles in the community (i.e., serve as a service provider and are a member or prior member of the YBLMSM and YBLTW population). Eighteen key informants (KIs), defined as youth, young adults, or adults who were members of or connected to the YBLMSM and young black and Latinx transgender (YBLTG) community, participated in a one-time, face-to-face, or telephone key informant interview (KII) lasting ∼45 min. KIs were defined as youth service providers because they described working with the target population and either being a member of or closely connected to the target population. KIs described key themes related to marginalization: lack of competent care among health care providers and both clinical and community spaces that left out key populations. HIV stigma and medical mistrust continues to create a barrier to care in this population and for interventions to be effective interventions will need to use an intersectional approach that simultaneously address all identities, and the social and structural needs of youth.


Asunto(s)
Infecciones por VIH/prevención & control , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Homosexualidad Masculina/psicología , Minorías Sexuales y de Género/psicología , Estigma Social , Personas Transgénero/psicología , Confianza , Adolescente , Adulto , Afroamericanos , Baltimore , District of Columbia , Grupo de Ascendencia Continental Europea , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Accesibilidad a los Servicios de Salud , Hispanoamericanos , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Philadelphia , Minorías Sexuales y de Género/estadística & datos numéricos , Personas Transgénero/estadística & datos numéricos , Transexualidad , Adulto Joven
19.
Artículo en Inglés | MEDLINE | ID: mdl-31947951

RESUMEN

Hispanic women have a higher prevalence of weight associated complications in pregnancy. This ethnic disparity is likely related to behavior patterns, social circumstances, environmental exposures, and access to healthcare, rather than biologic differences. The objective was to determine associations between sociodemographic characteristics, health behaviors, and psychosocial stressors and gestational weight gain (GWG) in low-income Hispanic women. During pregnancy, information on sociodemographic characteristics, health behaviors, and psychosocial stressors were collected. Linear regression estimated mean differences in GWG by selected predictors. Multinomial logistic regression estimated odds of inadequate and excessive GWG by selected predictors. Five-hundred and eight women were included, 38% had inadequate and 28% had excessive GWG; 57% with a normal pre-pregnancy BMI had inadequate GWG. Compared to women with normal BMI, women with overweight or obesity were more likely to have excessive GWG (aRRR = 1.88, 95% CI: 1.04, 3.40 and aRRR = 1.98, 95% CI: 1.08, 3.62, respectively). Mean total GWG was higher among women who were nulliparous (ß = 1.34 kg, 95% CI: 0.38, 2.29) and those who engaged in ≥3 h of screen time daily (ß = 0.98 kg, 95% CI: 0.02, 1.94), and lower among women who were physically active during pregnancy (ß = -1.00 kg, 95% CI: -1.99, -0.03). Eating breakfast daily was associated with lower risk of inadequate GWG (aRRR = 0.47, 95% CI: 0.26, 0.83). Depressive symptoms and poor adherence to dietary recommendations were prevalent, but none of the psychosocial or dietary variables were associated with GWG. In this cohort of primarily immigrant, low-income, Hispanic women, there were high rates of poor adherence to diet and physical activity recommendations, and a majority of women did not meet GWG guidelines. Modifiable health behaviors were associated with GWG, and their promotion should be included in prenatal care.


Asunto(s)
Ganancia de Peso Gestacional , Conductas Relacionadas con la Salud , Hispanoamericanos/estadística & datos numéricos , Factores Socioeconómicos , Estrés Psicológico/epidemiología , Adulto , Estudios de Cohortes , Femenino , Humanos , América Latina/etnología , Pobreza , Estrés Psicológico/psicología , Estados Unidos/epidemiología , Adulto Joven
20.
BMC Public Health ; 20(1): 111, 2020 Jan 28.
Artículo en Inglés | MEDLINE | ID: mdl-31992248

RESUMEN

BACKGROUND: Oral disease is a serious public health issue, and Hispanic children in the United States (US) are more likely than children of other racial/ethnic groups to experience dental caries. Although Hispanic children are a growing segment of the US population there is limited research on the association between acculturation and oral health outcomes in this population. This study examined the associations between household acculturation and pediatric oral health in the Hispanic population using a nationally representative sample of children. METHODS: Data from the 2011-2012 National Survey of Children's Health were analyzed; analyses included Hispanic children ages 1 to 17. Household acculturation was assessed with a combination of language and parental nativity, while oral health was assessed via parents'/guardians' reports of children's dental caries. Logistic regression was used to examine the association between acculturation and oral health, adjusting for other demographic and social determinants of pediatric oral health. We assessed significance at the p < 0.05 level, and all analyses accounted for the survey's complex sample design. RESULTS: Analyses included 9143 Hispanic children. In total, 24.9% (95% CI: 22.9-27.0%) experienced dental caries, and there were significant associations between household acculturation and oral health. In unadjusted analyses, 32.0% (95% CI: 28.9-35.4%) of children in low acculturation households, 20.3% (95% CI: 16.0-25.4%) of children in moderate acculturation households, and 16.9% (95% CI: 14.2-20.0%) of children in high acculturation households experienced dental caries (p < 0.001). In adjusted analyses, children in high acculturation households were significantly less likely than those in low acculturation households to experience dental caries (p < 0.001; OR = 0.50; 95% CI: 0.35-0.70). The difference between children in moderate and low acculturation households approached but did not reach statistical significance (p = 0.057; OR = 0.69; 95% CI: 0.48-1.01). CONCLUSIONS: A dose-response relationship was observed between household acculturation and the oral health of Hispanic children in the US. As acculturation increases, the likelihood of a child experiencing dental caries decreases. These findings suggest that public health and community-based interventions intended to reduce oral health disparities in Hispanic children would likely be most impactful if the acculturation levels of the children's households are considered during program development.


Asunto(s)
Aculturación , Caries Dental/etnología , Disparidades en el Estado de Salud , Hispanoamericanos/estadística & datos numéricos , Salud Bucal/etnología , Adolescente , Niño , Preescolar , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Masculino , Estados Unidos/epidemiología
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