Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 39.060
Filtrar
1.
J Affect Disord ; 320: 381-389, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36206877

RESUMO

BACKGROUND AND AIMS: Although previous studies have discussed the association between mobile phone use addiction (MPUA) and depressive symptoms in adolescents, studies on Chinese adolescents are limited, with no studies being reported on adolescents from ethnic minority areas within Yunnan. This study aimed to explore the mediating mechanism of insomnia in the association between MPUA and depressive symptoms among Yunnan college students. METHODS: A sample survey was conducted among 10,121 college students from four colleges in Yunnan province, China, from November to December 2021 via cluster sampling. Insomnia was assessed using the Insomnia Severity Index Scale, MPUA was assessed using the Self-Rating Questionnaire for Adolescent Problematic Mobile Phone Use, and depressive symptoms were assessed using the Patient Health Questionnaire-9 items. A generalized linear model was used to analyze the association between MPUA, insomnia, and depressive symptoms. The structural equation model was used to analyze the mediating effect of insomnia. RESULTS: The positive rates of depressive symptoms, MPUA, and insomnia were 39.2 %, 30.8 %, and 22.3 %, respectively. After adjusting for the demographic and confounding variables, MPUA (ß = 0.14, 95 % CI: 0.13-0.15, P < 0.01) and insomnia (ß = 0.44, 95 % CI: 0.43-0.46, P < 0.01) were associated with depressive symptoms (P < 0.05). The mediating effect of insomnia accounted for 34.7 % of the total effect in the mediating model of MPUA associated with depressive symptoms. CONCLUSION: Our findings suggest that insomnia partially mediates the association between MPUA and depressive symptoms among Yunnan college students.


Assuntos
Uso do Telefone Celular , Telefone Celular , Distúrbios do Início e da Manutenção do Sono , Humanos , Adolescente , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Depressão/epidemiologia , China/epidemiologia , Minorias Étnicas e Raciais , Etnicidade , Grupos Minoritários
2.
J Affect Disord ; 320: 638-646, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36208687

RESUMO

Suicide, suicide ideations, and psychiatric disorder rates tend to increase after natural disasters such as earthquake. In 2016 Ecuador experienced a 7.8Mw earthquake and, more recently, the Covid-19 confinement. Both events may have negatively affected the mental health of the Ecuadorian population. Therefore, the present study aimed to evaluate the suicide rates and choice of suicide method in the Ecuadorian population between January 2011 and December 2020. The dataset used is publicly available on the Ecuadorian National Institute of Statistics and Censuses. Multivariate logistic regression models were used to calculate adjusted odds ratios (OR) for potential sociodemographic factors associated with each suicide method compared to other reported suicide methods. There were 10,380 registered cases of suicide in Ecuador between 2011 and 2020. Significant suicide rates per provinces were seen in Napo with 12.63 and Azuay with 12.52, followed by Bolívar with 12.30, and Orellana with 11.36 suicides/100,000 habitants. Hanging accounted for 7082 cases (68.2 %). The mestizos (82 %) were the most prevalent ethnicity of all suicide cases. School-age children with 6-12 years (OR 8.83, 95 % CI 5.34-14.59) and adolescents with 13-19 years (OR 1.46, 95 % CI 1.29-1.66) were more likely to use hanging as method of suicide. In conclusion, we observed an increase of suicide rates from 8.15 per 100,000 in 2011 to 8.81 in 2020. The confinement of COVID-19 pandemic in the period evaluated did not significantly affect the suicide rates. An increased suicide rate was observed in the province hardest hit by the 2016 earthquake.


Assuntos
COVID-19 , Terremotos , Humanos , Adolescente , Criança , Equador/epidemiologia , Pandemias , COVID-19/epidemiologia , Etnicidade
3.
Pediatr Clin North Am ; 70(1): 83-90, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36402473

RESUMO

Many groups have historically been excluded from clinical research. It has required vigorous, long-term advocacy efforts for better inclusion of women and children across racial and ethnic groups. To understand who is included in clinical research, data are required. A personal journey of advocacy requiring the National Institutes of Health to report inclusion in clinical studies by age was ultimately accomplished by federal legislation.


Assuntos
Etnicidade , National Institutes of Health (U.S.) , Criança , Estados Unidos , Humanos , Feminino
4.
Hand Clin ; 39(1): 9-15, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36402531

RESUMO

Patient race and ethnicity are important factors in health-care inequity, including care for the patient with hand and upper extremity pathologic condition. Physician diversity has been shown to promote better access, improve health-care quality, and improve satisfaction for underserved populations. Concordance, most often defined as a similarity or shared identity between physician and patient, has been shown to have a positive influence on health-care disparities. Although diversity among Hand surgeons is increasing, it is not matching the diversity of the population as a whole. It is imperative that we work to increase and maintain diversity in order to provide the best care for our patients.


Assuntos
Etnicidade , Disparidades em Assistência à Saúde , Humanos , Qualidade da Assistência à Saúde
5.
Addict Behav ; 136: 107475, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36081247

RESUMO

BACKGROUND: Although the data on racial/ethnic associations with gambling disorder are limited, studies suggest that ethnicity may have associations with both symptom severity and psychosocial impairment linked to gambling disorder. Based on the current literature, we hypothesized that there would be a difference in gambling symptom severity, and co-occurring disorders, as a function of racial-ethnic group. METHODS: 475 adults (mean age = 47.6 (±11.6) years; 54.3 % females) with gambling disorder who had participated in clinical trials on pharmacotherapy or psychotherapy were included. Participants were assessed for gambling severity, comorbidities, health issues, quality of life and psychosocial functioning. Participants who self-identified as Black, Asian or Minority Ethnic (BAME) were compared to those who self-identified as white Caucasian (non-BAME). Significance was defined as p < 0.01. RESULTS: The BAME group had significantly earlier age of first gambling. The two groups did not differ significantly in terms of age when gambling first became problematic, disability, current gambling disorder symptom severity, previous suicide attempt(s), quality of life, percent of salary in past year lost to gambling, or likelihood of having received treatment for gambling disorder in the past, nor in terms of having used Gamblers Anonymous. CONCLUSIONS: These data show that having gambling disorder and being from a minority racial-ethnic group was associated with significantly earlier age at first gambling, in clinical trial settings. Future work should further examine differences in the clinical features of gambling disorder in different minority groups in larger sample sizes, ideally also longitudinally, across a range of settings. Identification of the reasons/mechanisms for differences in earlier age of first gambling may lead to new public health and treatment targets to minimize gambling harms.


Assuntos
Jogo de Azar , Adulto , Ensaios Clínicos como Assunto , Etnicidade , Feminino , Jogo de Azar/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Grupos Minoritários , Qualidade de Vida , Brancos
6.
J Exp Child Psychol ; 225: 105520, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35964447

RESUMO

With increasing immigration, it is increasingly important to understand whether and when children consider immigrant peers as co-nationals. Using an experimental design, we examined among native-born preadolescents (8-13 years of age) in the Netherlands whether and when they perceive immigrant peers as co-nationals. First, and in agreement with the social categorization account, we expected that the use of dual identity (vs single ethnic identity) labels for immigrant peers leads to stronger co-nationality perceptions and a related stronger desire for close social contact. Second, and in line with the acculturation account, we expected that an early age of arrival in the country (vs a later age of arrival) leads to stronger perceived co-nationality and related contact desire. The findings support the acculturation account, especially among native-born children with higher national identification. There was no evidence for the social categorization account.


Assuntos
Aculturação , Emigrantes e Imigrantes , Criança , Emigração e Imigração , Etnicidade , Humanos , Grupo Associado
7.
Curr Probl Cardiol ; 48(1): 101397, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36100097

RESUMO

We sought to identify temporal, geographic, age and sex-based mortality trends of IE in the US over the past 2 decades. This population-based study utilized the CDC WONDER database to identify IE-related deaths occurring within the US between 1999 and 2019. IE-related crude and age-adjusted mortality rates (CMRs and AAMRs, respectively) were determined. Joinpoint regression was used to determine trends in CMR/AAMR using annual percent change (APC) in the overall sample in addition to demographic (sex, race/ethnicity, age) and geographic (rural/urban, statewide) subgroups. Between 1999 and 2019, a total of 279,154 deaths related to IE were reported. The overall AAMR declined from 54.2/1,000,000 in 1999 to 51.4 in 2019. However, AAMRs increased among several sub-groups over the past decade including men [2009-2019 APC = 0.4%, 95%CI, 0.1%-0.6%], non-Hispanic (NH) whites [APC of 0.8% from 2009 to 2019 (95%CI 0.5%-1.1%)], NH American Indians or Alaskan Natives [APC of 1.4% during the study period (95%CI, 0.7%-2.0%)], and those in rural areas [APC of 1.0% from 2009 to 2019 (95%CI 0.5%-1.5%)]. The CMRs increased among subjects 40-64 years old [APC of 2.8% from 2010 to 2019 (95%CI 2.2%-3.5%)] and 15-39 years old [APC of 16.4% from 2010 to 2017 (95%CI 13.5%-19.4%)]. IE-related CMR/AAMR increased among men, NH whites, NH American Indian or Alaskan Natives, those <65-year-old, and those from rural areas. Discerning the reasons for the increase in IE-related mortality among these groups and examining the impact of the social determinants of health may represent important opportunities to enhance care.


Assuntos
Endocardite , Etnicidade , Masculino , Estados Unidos/epidemiologia , Humanos , Adulto , Pessoa de Meia-Idade , Idoso
8.
Sci Rep ; 12(1): 18311, 2022 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-36316450

RESUMO

Social face evaluation is a common and consequential element of everyday life based on the judgement of trustworthiness. However, the particular facial regions that guide such trustworthiness judgements are largely unknown. It is also unclear whether different facial regions are consistently utilized to guide judgments for different ethnic groups, and whether previous exposure to specific ethnicities in one's social environment has an influence on trustworthiness judgements made from faces or facial regions. This registered report addressed these questions through a global online survey study that recruited Asian, Black, Latino, and White raters (N = 4580). Raters were shown full faces and specific parts of the face for an ethnically diverse, sex-balanced set of 32 targets and rated targets' trustworthiness. Multilevel modelling showed that in forming trustworthiness judgements, raters relied most strongly on the eyes (with no substantial information loss vis-à-vis full faces). Corroborating ingroup-outgroup effects, raters rated faces and facial parts of targets with whom they shared their ethnicity, sex, or eye color as significantly more trustworthy. Exposure to ethnic groups in raters' social environment predicted trustworthiness ratings of other ethnic groups in nuanced ways. That is, raters from the ambient ethnic majority provided slightly higher trustworthiness ratings for stimuli of their own ethnicity compared to minority ethnicities. In contrast, raters from an ambient ethnic minority (e.g., immigrants) provided substantially lower trustworthiness ratings for stimuli of the ethnic majority. Taken together, the current study provides a new window into the psychological processes underlying social face evaluation and its cultural generalizability. PROTOCOL REGISTRATION: The stage 1 protocol for this Registered Report was accepted in principle on 7 January 2022. The protocol, as accepted by the journal, can be found at: https://doi.org/10.6084/m9.figshare.18319244 .


Assuntos
Etnicidade , Julgamento , Humanos , Confiança/psicologia , Grupos Minoritários , Face , Expressão Facial
9.
BMC Public Health ; 22(1): 1988, 2022 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-36316668

RESUMO

BACKGROUND: Women have been especially impacted by the COVID-19 pandemic. This exploratory study aimed to characterize women's adverse experiences related to their work, home lives, and wellbeing during the height of the COVID-19 pandemic and to describe demographic differences of those lived experiences. METHODS: Using the validated Epidemic-Pandemic Impacts Inventory, we collected data from reproductive-aged women in the state of Georgia about their exposure to adverse events during the pandemic. A latent class analysis (LCA) was performed to identify subgroups of women reporting similar adverse experiences and describe their sociodemographic characteristics. An optional open-ended question yielded qualitative data that were analyzed thematically and merged with subgroup findings. Data were collected from September 2020 to January 2021. RESULTS: 423 individuals aged 18-49 completed the survey with 314 (74.2%) providing qualitative responses. The LCA yielded 4 subgroups: (1) a "low exposure" subgroup (n = 123, 29.1%) with relatively low probability of adverse experiences across domains (e.g. financial insecurity, health challenges, barriers to access to healthcare, intimate partner violence (IPV)); (2) a "high exposure" subgroup (n = 46, 10.9%) with high probability of experiencing multiple adversities across domains including the loss of loved ones to COVID-19; (3) a "caregiving stress" subgroup (n = 104, 24.6%) with high probability of experiencing challenges with home and work life including increased partner conflict; and (4) a "mental health changes" subgroup (n = 150, 35.5%) characterized by relatively low probability of adverse experiences but high probability of negative changes in mental health and lifestyle. Individuals in subgroups 1 and 4, which had low probabilities of adverse experiences, were significantly more likely to be non-Hispanic white. Individuals in subgroup 2 were more likely to identify with a sexual or racial/ethnic minority population. Inductive coding of qualitative data yielded themes such as stress, mental health, financial impact, and adaptation/resilience, providing context for pandemic-related adversity. CONCLUSION: Though many individuals in our sample experienced hardship, minority populations were unequally impacted by pandemic-related adversity in work life, home life, and wellbeing. Recovery and future emergency preparedness efforts in Georgia must incorporate support mechanisms for mental health and IPV, focusing especially on the intersectional needs of racial, ethnic, and sexual minorities.


Assuntos
COVID-19 , Violência por Parceiro Íntimo , Feminino , Humanos , Adulto , Pandemias , COVID-19/epidemiologia , Etnicidade , Georgia/epidemiologia , Grupos Minoritários
10.
PLoS One ; 17(11): e0276806, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36318576

RESUMO

BACKGROUND: Racial and ethnic disparities in COVID-19 outcomes exist, but whether in-hospital care explains this difference is not known. We sought to determine racial and ethnic differences in demographics, comorbidities, in-hospital treatments, and in-hospital outcomes of patients hospitalized with COVID-19. METHODS AND FINDINGS: This was a cohort study using MiCOVID-19, a multi-center, retrospective, collaborative quality improvement registry, which included data on patients hospitalized with COVID-19 across 38 hospitals in the State of Michigan. 2,639 adult patients with COVID-19 hospitalized at a site participating in the MiCOVID-19 Registry were randomly selected. Outcomes included in-hospital mortality, age at death, intensive care unit admission, and need for invasive mechanical ventilation by race and ethnicity. Baseline comorbidities differed by race and ethnicity. In addition, Black patients had higher lactate dehydrogenase, erythrocyte sedimentation rate, C-reactive protein, creatine phosphokinase, and ferritin levels. Black patients were less likely to receive dexamethasone and remdesivir compared with White patients (4.2% vs 14.3% and 2.2% vs. 11.8%, p < 0.001 for each). Black (18.7%) and White (19.6%) patients experienced greater mortality compared with Asian (13.0%) and Latino (5.9%) patients (p < 0.01). The mean age at death was significantly lower by 8 years for Black patients (69.4 ± 13.3 years) compared with White (77.9 ± 12.6), Asian (77.6 ± 6.6), and Latino patients (77.4 ± 15.5) (p < 0.001). CONCLUSIONS: COVID-19 mortality appears to be driven by both pre-hospitalization clinical and social factors and potentially in-hospital care. Policies aimed at population health and equitable application of evidence-based medical therapy are needed to alleviate the burden of COVID-19.


Assuntos
COVID-19 , Adulto , Humanos , Criança , Etnicidade , Estudos Retrospectivos , Estudos de Coortes , Brancos , Hospitalização , Sistema de Registros
11.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 39(11): 1192-1199, 2022 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-36317202

RESUMO

OBJECTIVE: To assess the value of high-throughput sequencing for the detection of thalassemia-associated variants in ethnic Li minority areas of Hainan, China. METHODS: In Baoting Li and Miao Autonomous County of Hainan Province, 1842 middle school students were randomly selected as the subjects, which included 1249 ethnic Lis, 454 ethnic Hans, and 139 individuals from other ethnic minorities. With DNA extracted from peripheral blood samples, gap-PCR combined with high-throughput sequencing were carried out to detect potential variants of the globin genes. RESULTS: In total 22 α-thalassemia genotypes, 5ß-thalassemia genotypes, and 21 α-composite ß-thalassemia genotypes were detected. The carrier rates for ethnic Li, ethnic Han and other ethnic minorities were 78.14%, 24.01%, and 28.06%, respectively. In addition, 22 fusion genes, 8 variants leading to abnormal hemoglobin, and 10 rare mutations were identified. CONCLUSION: High-throughput sequencing can detect a wide range of genetic variants associated with thalassemia in the ethnic Li minority areas and has played an important role for the identification of fusion genes, variants underlying hemoglobin anomalies and rare mutations.


Assuntos
Talassemia alfa , Talassemia beta , Humanos , Talassemia alfa/genética , Genótipo , Etnicidade/genética , Mutação , Sequenciamento de Nucleotídeos em Larga Escala , China , Talassemia beta/diagnóstico , Talassemia beta/genética
12.
Nat Commun ; 13(1): 6329, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36319637

RESUMO

Persons of color have been exposed to a disproportionate burden of air pollution across the United States for decades. Yet, the inequality in exposure to known toxic elements of air pollution is unclear. Here, we find that populations living in racially segregated communities are exposed to a form of fine particulate matter with over three times higher mass proportions of known toxic and carcinogenic metals. While concentrations of total fine particulate matter are two times higher in racially segregated communities, concentrations of metals from anthropogenic sources are nearly ten times higher. Populations living in racially segregated communities have been disproportionately exposed to these environmental stressors throughout the past decade. We find evidence, however, that these disproportionate exposures may be abated though targeted regulatory action. For example, recent regulations on marine fuel oil not only reduced vanadium concentrations in coastal cities, but also sharply lessened differences in vanadium exposure by segregation.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Estados Unidos , Humanos , Poluentes Atmosféricos/análise , Etnicidade , Vanádio , Poluição do Ar/análise , Material Particulado/análise , Monitoramento Ambiental , Exposição Ambiental/análise
15.
JAMA Netw Open ; 5(11): e2240817, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36367730

RESUMO

Importance: The lack of racial and ethnic diversity in the US medical profession is a well-recognized problem, and racial and ethnic representation is highly variable across the medical specialties. Residency selection is a crucial juncture at which diversity and representation in specialties can be increased. Objective: To identify factors associated with residency application rates for medical specialties by race and ethnicity. Design, Setting, and Participants: This national cross-sectional study of medical student residency applications used American Association of Medical Colleges data on 2019-2020 applicants and information about the racial and ethnic characteristics of practicing physicians (including medical school faculty) and department chairs. A total of 26 320 applicants to medical residency programs, 592 296 practicing physicians, and 2121 department chairs across the US were included. Residency application rates for 18 medical specialties were evaluated. Main Outcomes and Measures: The main outcome was the specialty representation quotient (SRQ), which estimated the extent to which students from a racial or ethnic group were overrepresented (an SRQ >1) or underrepresented (an SRQ <1) in a given specialty compared with the racial and ethnic demographic characteristics of the corresponding graduating class. Covariates included the racial and ethnic demographic characteristics of practicing physicians and department chairs by specialty based on American Association of Medical Colleges data and student academic factors (mean United States Medical Licensing Examination step 1 score, number of research experiences, and AΩA honor society membership among matched students from the previous application cycle). Multivariable logistic regression analysis was used to examine associations between these covariates and application rates by race and ethnicity. Results: Among 26 320 specialty-specific applications to medical residency programs in 18 specialties, 90 (0.3%) were from American Indian or Alaska Native students, 6718 (25.5%) were from Asian students, 2575 (9.8%) were from Black students, 1896 (7.2%) were from Hispanic students, and 15 041 (57.1%) were from White students. Among 592 296 practicing physicians, 2777 (0.5%) were American Indian or Alaska Native, 117 358 (19.8%) were Asian, 36 639 (6.2%) were Black, 41 071 (6.9%) were Hispanic, and 394 451 (66.6%) were White. Among 2121 department chairs, 5 (0.2%) were American Indian or Alaska Native, 212 (10.0%) were Asian, 86 (4.1%) were Black, 88 (4.1%) were Hispanic, and 1730 (81.6%) were White. The specialties with the greatest representation among applicants from racial and ethnic groups underrepresented in medicine (URM) were family medicine (SRQ, 1.70), physical medicine and rehabilitation (SRQ, 1.60), and obstetrics and gynecology (SRQ, 1.47). The specialties with the lowest URM representation among applicants were plastic surgery (SRQ, 0.47), otolaryngology (SRQ, 0.53), and orthopedic surgery (SRQ, 0.86). Membership in AΩA was negatively associated with SRQ among American Indian or Alaska Native students only (ß = -0.11; 95% CI, -0.17 to -0.05; P = .002). Racial and ethnic representation among practicing physicians was positively associated with SRQ for American Indian or Alaska Native students (ß = 6.05; 95% CI, 4.26-7.85; P < .001), Asian students (ß = 0.07; 95% CI, 0.06-0.09; P < .001), Black students (ß = 0.10; 95% CI, 0.06-0.15; P < .001), and URM students overall (ß = 0.05; 95% CI, 0.01-0.08; P = .02). Conclusions and Relevance: This study's findings suggest that the propensity of medical students, particularly those from racial and ethnic minority groups, to apply to a given specialty for residency was associated with the representation of their racial or ethnic group among the specialty's practicing physicians. Future work to characterize the mechanisms of occupational sorting may guide interventions to improve equity within the physician workforce.


Assuntos
Internato e Residência , Obstetrícia , Estados Unidos , Humanos , Etnicidade , Grupos Minoritários , Estudos Transversais
16.
JAMA Health Forum ; 3(11): e224102, 2022 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-36367736

RESUMO

This Viewpoint discusses unresolved barriers in US medical school matriculation for racial and ethnic minority groups and other historically marginalized communities and proposes policy changes to recalibrate admissions with an equity focus.


Assuntos
Grupos Minoritários , Faculdades de Medicina , Humanos , Etnicidade
17.
AIDS Patient Care STDS ; 36(11): 416-424, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36367994

RESUMO

The rate of syphilis infections among sexual minority men (SMM) has continued to increase in recent decades. As such, this analysis sought to identify demographic, biological, and behavioral factors associated with recent syphilis infection in emerging adult SMM. Data were drawn from a 3-year cohort study of emerging adult SMM (n = 665), from July 2014 to March 2019. Biannual study assessments included rapid HIV testing and behavioral surveys. At baseline, and at the 18- and 36-month time points, participants underwent chlamydia, gonorrhea, and syphilis screening. Generalized estimating equations were used to generate four models of repeated syphilis screening. In this racially/ethnically and socioeconomically diverse sample of SMM, 5.0% of participants tested positive for syphilis at baseline and 9.0% had an infection at the subsequent time points. Across all models, racial/ethnic minority SMM had higher odds of syphilis. Higher odds of syphilis infection were also significantly associated with more frequent condomless anal sex, more frequent marijuana use, HIV seropositivity, not currently using pre-exposure prophylaxis (PrEP), and not receiving syphilis testing in the previous 6 months; lower odds were associated with more frequent oral sex and more frequent alcohol use. These findings support current screening guidelines based on SMM who may be at increased risk for sexually transmitted infection (STI) acquisition, such as people living with HIV or those who engage in condomless sex. Further, our findings of reduced syphilis incidence among those who are on PrEP and engaged in regular STI testing support existing efforts to increase the availability and accessibility of preventive sexual health care for SMM.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Sífilis , Adulto , Masculino , Humanos , Sífilis/epidemiologia , Sífilis/diagnóstico , Estudos de Coortes , Cidade de Nova Iorque/epidemiologia , Etnicidade , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Grupos Minoritários , Infecções Sexualmente Transmissíveis/epidemiologia , Comportamento Sexual , Homossexualidade Masculina
18.
JCO Precis Oncol ; 6: e2200517, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36370464

RESUMO

PURPOSE: Whether germline multigene panel testing (MGPT) should be performed in all individuals with colorectal cancer (CRC) remains uncertain. Therefore, we aimed to determine the yield and potential clinical impact of MGPT across a large, diverse CRC cohort. METHODS: This was a retrospective cohort study of adults with CRC who underwent MGPT of > 10 genes at a commercial laboratory between March 2015 and May 2021. All data were prospectively collected through a single commercial laboratory and retrospectively analyzed. RESULTS: A total of 34,244 individuals with a history of CRC underwent germline MPGT and were included in the analysis. This cohort was predominantly female (60.7%), White (70.6%), and age 50 years or older (68.9%), with 35.5% also reporting a noncolorectal malignancy. At least one pathogenic/likely pathogenic germline variant (PGV) was found in 4,864 (14.2%), with 3,111 (9.1%) having a PGV associated with increased CRC/polyposis risk and 1,048 (3.1%) having an otherwise clinically actionable PGV. Larger gene panels were not clearly associated with higher yield of clinically actionable PGVs. PGVs were more prevalent in individuals of Ashkenazi Jewish descent (P < .001) and Hispanic ethnicity (P < .001). Across all ages, panel sizes, and races/ethnicities, the rate of clinically actionable PGVs on MGPT was 7.9% or greater. A variant of uncertain significance was identified in 13,094 individuals (38.2%). Identification of a variant of uncertain significance associated with panel size (P < .001) and was lower in individuals of Ashkenazi Jewish descent (P < .001), but higher in Black, Asian, and Hispanic individuals (P < .001). CONCLUSION: To our knowledge, this is the largest study to date examining MGPT in CRC, demonstrating high rates of clinically actionable variants detected across all age groups, panel sizes, and racial/ethnic groups. This work supports consideration of broadening germline genetic testing criteria for individuals with CRC.


Assuntos
Neoplasias Colorretais , Testes Genéticos , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Neoplasias Colorretais/diagnóstico , Asiáticos , Etnicidade
19.
J Sch Psychol ; 95: 1-24, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36371120

RESUMO

School climate measures are increasingly utilized as one indicator of school quality within educational accountability systems. However, concerns have been raised about the accuracy of these indicators given that school climate surveys are often not validated using multilevel methods. Further, cross-school comparisons in climate may not be trustworthy because the school-level invariance of climate surveys has not been investigated. There is a need to examine the validity of school-level climate constructs and to determine if surveys measure climate equitably for schools that serve underrepresented populations. The aim of the current study was to examine the multilevel factor structure of a statewide school climate survey to determine whether it measured climate equitably for students of different races/ethnicities and across schools with varying racial/ethnic and socioeconomic compositions. Participants included 259,778 students from 427 middle schools throughout a southeastern U.S. state. Cross-level invariance analyses revealed that the climate constructs were measured differently across levels of analysis, and school-level climate could not be interpreted as merely the aggregate of individual-level climate. Student- and school-level factorial invariance was tested using multilevel modeling procedures. Results revealed item bias with respect to student and school characteristics, and the relationships between school climate and student and school demographics changed after accounting for identified bias. As more educational agencies consider including school climate surveys in their accountability systems, these findings suggest that multilevel validation procedures and school-level invariance analyses are necessary to ensure accurate and equitable measurement.


Assuntos
Instituições Acadêmicas , Estudantes , Humanos , Georgia , Inquéritos e Questionários , Etnicidade
20.
J Sch Psychol ; 95: 58-71, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36371125

RESUMO

The current study addressed the need for experimental research on Restorative Practices (RP) in its evaluation of the Morningside Center for Teaching Social Responsibility's Whole School RP Project. The study was conducted in a large Northeastern city using a cluster randomized controlled design in 18 elementary, middle, and high schools. In a single year, before the COVID-19 pandemic, and with data from 5878 students, the study found that overall, students in the RP Project schools were less likely to receive a discipline incident record (11.1%) as compared to students in the comparison schools (18.2%). However, differential treatment effects based on sex, race/ethnicity, and disability status were not found. The findings suggest prevention efforts are a cornerstone of practice/policy reforms to reduce the use of exclusionary discipline. Findings also suggest multi-year initiatives are needed to address discipline disparities.


Assuntos
COVID-19 , Pandemias , Humanos , COVID-19/prevenção & controle , Instituições Acadêmicas , Estudantes , Etnicidade
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...