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2.
Sci Rep ; 14(1): 5773, 2024 03 09.
Artigo em Inglês | MEDLINE | ID: mdl-38459081

RESUMO

Here we report on the relationship between measures of social capital, and their association with changes in self-reported measures of psychological distress during the early period of the COVID-19 pandemic. We analyze data from an existing cluster randomized control trial (the Healthy Neighborhoods Project) with 244 participants from New Orleans, Louisiana. Changes in self-reported scores between baseline (January 2019-March 2020) and participant's second survey (March 20, 2020, and onwards) are calculated. Logistic regression is employed to examine the association between social capital indicators and measures of psychological distress adjusting for key covariates and controlling for residential clustering effects. Participants reporting higher than average scores for social capital indicators are significantly less likely to report increases in psychosocial distress between pre and during the early stage of the COVID-19 pandemic. Those who report higher than average sense of community were approximately 1.2 times less likely than those who report lower than average sense of community scores to experience increases in psychological distress before and during the global pandemic (OR 0.79; 95% CI 0.70,0.88, p ≤ 0.001), even after controlling for key covariates. Findings highlight the potentially important role that community social capital and related factors may play in the health of underrepresented populations during times of major stress. Specifically, the results suggest an important role of cognitive social capital and perceptions of community membership, belonging, and influence in buffering changes of mental health distress experienced during the initial period of the COVID-19 pandemic among a sample of residents.


Assuntos
COVID-19 , Angústia Psicológica , Capital Social , Humanos , COVID-19/epidemiologia , Nova Orleans , Pandemias , Estresse Psicológico/psicologia
3.
AIDS Patient Care STDS ; 38(3): 144-150, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38471093

RESUMO

There is an unmet need for HIV prevention among Black cisgender women. From January to November 2020, we conducted formative research to develop locally informed implementation strategies to enhance pre-exposure prophylaxis (PrEP) uptake among Black cisgender women in New Orleans, Louisiana. Following an iterative process, we conducted in-depth interviews (IDIs) with Black women who were not taking PrEP and used those findings to inform IDIs with Black women taking PrEP. We asked about PrEP awareness, social support, PrEP-related norms, medical mistrust, motivation to take PrEP, and potential implementation strategies. Data were analyzed using applied thematic analysis. We established the Black Women and PrEP (BWAP) Task Force-a diverse group of 25 Black female community representatives who reviewed the IDI findings and identified strategies to address these determinants of PrEP uptake. We interviewed 12 Black women who were not taking PrEP and 13 Black women who were taking PrEP. Two main PrEP uptake barriers were identified from the IDI findings and Task Force discussions. First, Black women do not know of other Black women taking PrEP. Women perceived PrEP as a drug for gay men. Most said that testimonials from Black women taking PrEP would make its use more relatable. Second, Black women are not frequently offered PrEP by their providers. Many preferred accessing PrEP through women's health providers. The Task Force identified two strategies to address these barriers: a social media campaign for women and an educational initiative to train providers to discuss and prescribe PrEP. These implementation strategies require further study.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Masculino , Humanos , Feminino , Infecções por HIV/tratamento farmacológico , Nova Orleans , Confiança , Fármacos Anti-HIV/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Louisiana
4.
Sci Rep ; 14(1): 6539, 2024 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-38503862

RESUMO

Louisiana experienced high morbidity and mortality from COVID-19. To assess possible explanatory factors, we conducted a cohort study (ClinSeqSer) of patients hospitalized with COVID-19 in New Orleans during August 2020-September 2021. Following enrollment, we reviewed medical charts, and performed SARS-CoV-2 RT-PCR testing on nasal and saliva specimens. We used multivariable logistic regression to assess associations between patient characteristics and severe illness, defined as ≥ 6 L/min oxygen or intubation. Among 456 patients, median age was 56 years, 277 (60.5%) were Black non-Hispanic, 436 (95.2%) had underlying health conditions, and 358 were unvaccinated (92.0% of 389 verified). Overall, 187 patients (40.1%) had severe illness; 60 (13.1%) died during admission. In multivariable models, severe illness was associated with age ≥ 65 years (OR 2.08, 95% CI 1.22-3.56), hospitalization > 5 days after illness onset (OR 1.49, 95% CI 1.01-2.21), and SARS CoV-2 cycle threshold (Ct) result of < 32 in saliva (OR 4.79, 95% CI 1.22-18.77). Among patients who were predominantly Black non-Hispanic, unvaccinated and with underlying health conditions, approximately 1 in 3 patients had severe COVID-19. Older age and delayed time to admission might have contributed to high case-severity. An association between case-severity and low Ct value in saliva warrants further investigation.


Assuntos
COVID-19 , Humanos , Pessoa de Meia-Idade , Idoso , COVID-19/diagnóstico , COVID-19/epidemiologia , SARS-CoV-2 , Estudos de Coortes , Nova Orleans , Hospitalização
5.
Sex Transm Dis ; 51(2): 85-89, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37963340

RESUMO

BACKGROUND: Current US syphilis screening focuses on men who have sex with men (MSM), because of the increased risk of infection in their sexual networks, and on pregnant people, because of complications associated with congenital syphilis. However, screening for men who have sex with women (MSW) who are at increased risk of syphilis is also recommended. Factors associated with syphilis testing and positivity were assessed among young, Black MSW. METHODS: Data from the Check It study-a seek, test, and treat study for chlamydia in New Orleans, LA, among Black MSW aged 15 to 26 years-were used. Survey data were used to elicit self-reported syphilis testing, self-reported testing results, and sociodemographic and behavioral factors associated with these 2 outcomes. RESULTS: Per the Centers for Disease Control and Prevention, all men in the study were recommended for syphilis screening because of their age, race, and geographic location. Of the 1458 men included, 272 (18.7%) reported ever having been syphilis tested, 267 men reported their results, and 23 (8.6%) reported testing positive. In logistic regression, older age (odds ratio [OR], 1.21 per year older; P < 0.001), prior Chlamydia trachomatis , Neisseria gonorrhoeae , and/or HIV testing (OR, 50.32; P < 0.001), and younger age at sexual debut (0.90 per year older, P = 0.005) were significantly associated with prior syphilis testing. In addition, testing positive for C. trachomatis and/or N. gonorrhoeae during the study was significantly associated with a history of syphilis positivity (OR, 3.08; P = 0.031). CONCLUSIONS: Although syphilis testing was associated with factors that might increase the risk of acquisition, only 19% of individuals meeting Centers for Disease Control and Prevention testing recommendations had ever been screened.


Assuntos
Infecções por Chlamydia , Gonorreia , Infecções por HIV , Minorias Sexuais e de Gênero , Sífilis , Masculino , Feminino , Humanos , Sífilis/diagnóstico , Sífilis/epidemiologia , Homossexualidade Masculina , Nova Orleans , Gonorreia/diagnóstico , Neisseria gonorrhoeae , Chlamydia trachomatis , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/epidemiologia , Prevalência
6.
Am J Med Sci ; 367(4): 215-227, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38160710

RESUMO

Academic medicine provides physicians an opportunity for long-term career satisfaction and fulfillment. However, despite the potential for great reward, academic careers can be challenging. To better define approaches to successfully navigate academic medicine, the Southern Society for Clinical Investigation sponsored a workshop titled 'Successful Careers in Academic Medicine' during the 2023 Southern Regional Meeting held in New Orleans; the critical elements of which are highlighted in the following summary. Participants discussed the benefits of an academic career, summarized strategies for negotiating a job, listed critical tools for career development, and discussed key concepts about planning and navigating the academic medicine promotion process. The information provides a roadmap for physicians to develop successful careers in academic medicine.


Assuntos
Medicina , Médicos , Humanos , Escolha da Profissão , Nova Orleans , Docentes de Medicina
7.
Sex Transm Dis ; 51(2): 90-95, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-38100815

RESUMO

INTRODUCTION: Profound sexual health disparities exist for Black men who have sex with men (MSM) in the US South, including a high prevalence of sexually transmitted infections (STIs). Sexually transmitted infection prevention strategies beyond condoms are needed for Black MSM taking preexposure prophylaxis (PrEP). METHODS: We conducted in-depth interviews with Black MSM taking PrEP in New Orleans, Louisiana. Informed by the Health Belief Model, we asked about participants' perceived susceptibility, severity, and concerns regarding STIs, and perceived benefits of STI prevention. We also asked about willingness to use various STI prevention strategies, including antibiotic prophylaxis. Interviews were audio-recorded and analyzed using applied thematic analysis. RESULTS: We interviewed 24 Black MSM aged 18 to 36 years; half had a recent STI diagnosis. Most participants were concerned about receiving an STI diagnosis, noting shame or disappointment; physical effects were concerning but infrequently considered. Participants described being less likely to use condoms with routine partners or those taking PrEP. Most reported being willing to engage in each of the 6 prevention strategies discussed. CONCLUSIONS: Black MSM taking PrEP voiced concern about STIs, and many noted that they infrequently use condoms. They were willing to engage in methods focused on preventing STIs on an individual or population level.


Assuntos
Infecções por HIV , Profilaxia Pré-Exposição , Minorias Sexuais e de Gênero , Infecções Sexualmente Transmissíveis , Masculino , Humanos , Homossexualidade Masculina , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Nova Orleans , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Profilaxia Pré-Exposição/métodos
8.
J Am Mosq Control Assoc ; 39(4): 243-250, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-38108429

RESUMO

Mosquitoes are a known public nuisance and can vector various diseases. Historically, New Orleans, LA, has long been acquainted with the burden of mosquito-borne diseases, such as malaria and yellow fever in the 20th century and West Nile virus in the 21st century. Government mosquito control awareness campaigns have been around for decades as has the use of organophosphate and pyrethroid insecticides by mosquito abatement districts. However, few data are available on public perception of mosquito control and public usage of insecticides to kill mosquitoes in New Orleans. We conducted a survey from August 2020 to July 2021 to evaluate New Orleans residents' 1) general knowledge regarding mosquito control and 2) what measures and products they use to control mosquitoes. The aim of this survey was to determine how residents contribute to backyard mosquito control by do-it-yourself or professional applications of insecticides. The survey was disseminated both online and via mail. Of the 396 survey participants, nearly all (99.48%) agreed that mosquito control is important in New Orleans because it prevents mosquito bites (30.85%), prevents mosquito borne-diseases (38.51%), and prevents nuisance mosquitoes (29.17%). More than one-third (35%) of survey participants indicated that they empty containers to reduce adult mosquitoes on their own property. More than two-thirds of the participants (69.95%) would not hire a pest management professional to spray their yard for adult mosquitoes, and only 20% of survey participants do apply a pesticide to kill adult mosquitoes on their own property. None of our findings were associated with the level of education, gender, or age of participants. This study suggests that the City of New Orleans Mosquito, Termite and Rodent Control Board educational and outreach campaigns may be an effective tool in spreading mosquito control awareness and contribute to residents' knowledge of mosquito control. The data we collected indicate that residents understand what mosquito control is and why it is important in New Orleans.


Assuntos
Inseticidas , 60509 , Adulto , Animais , Humanos , Nova Orleans , Controle de Mosquitos , Conhecimento
9.
Support Care Cancer ; 31(12): 712, 2023 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-37982868

RESUMO

INTRODUCTION: Food pantries have the potential to improve health outcomes and quality of life for individuals living with cancer. Gender has been linked to certain cancer symptoms and dietary patterns. Nevertheless, the extent of research on the utilization of food pantries among this population, particularly with regard to gender differences, remains limited. The objective of this study is to explore the demographic characteristics and gender differences in quality of life, as well as the impact of cancer on the lives of individuals who utilize food pantry services. METHODS: Between February 26, 2019 and July 24, 2022, 400 people living with cancer were eligible to participate the University Medical Center New Orleans (UMC) food pantry. Participants were asked to provide demographic information and completed two health assessments related to the challenges in daily activities, nutrition, and mental health. RESULTS: The study participants had a mean age of 54.1, and the majority of the participants were female. More than half of the participants did not have access to a vehicle or use public transportation to access grocery stores. People living with cancer reported several quality of life issues, with the most prevalent challenges being interference of cancer with work, lack of energy, difficulty affording food, pain, and sleep problems. Additionally, less than half of the patients reported consuming fruits and vegetables on a daily basis, and males were found to be less likely to consume them compared to females. DISCUSSION: The current study sheds light on the characteristics and quality of life of individuals who utilize UMC food pantry services, as well as the impact of cancer on their lives. The findings reveal a gender disparity in fruit and vegetable consumption, with male individuals living with cancer reporting lower levels of consumption. IMPLICATIONS FOR RESEARCH AND PRACTICE: Identifying and addressing food insecurity among people living with cancer are necessary. Meanwhile, partnerships with community organizations may be valuable in finding ways to assist cancer survivors in returning to work. Future studies could also focus on encouraging fruit and vegetable consumption, particularly among male individuals living with cancer.


Assuntos
Neoplasias , Qualidade de Vida , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Nova Orleans , Frutas , Verduras , Neoplasias/terapia , Hospitais
10.
J Am Mosq Control Assoc ; 36(4)2023 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-37866823

RESUMO

Mosquitoes are a known public nuisance and can vector various diseases. Historically, New Orleans, LA, has long been acquainted with the burden of mosquito-borne diseases, such as malaria and yellow fever in the 20th century and West Nile virus in the 21st century. Government mosquito control awareness campaigns have been around for decades as has the use of organophosphate and pyrethroid insecticides by mosquito abatement districts. However, few data are available on public perception of mosquito control and public usage of insecticides to kill mosquitoes in New Orleans. We conducted a survey from August 2020 to July 2021 to evaluate New Orleans residents' 1) general knowledge regarding mosquito control and 2) what measures and products they use to control mosquitoes. The aim of this survey was to determine how residents contribute to backyard mosquito control by do-it-yourself or professional applications of insecticides. The survey was disseminated both online and via mail. Of the 396 survey participants, nearly all (99.48%) agreed that mosquito control is important in New Orleans because it prevents mosquito bites (30.85%), prevents mosquito borne-diseases (38.51%), and prevents nuisance mosquitoes (29.17%). More than one-third (35%) of survey participants indicated that they empty containers to reduce adult mosquitoes on their own property. More than two-thirds of the participants (69.95%) would not hire a pest management professional to spray their yard for adult mosquitoes, and only 20% of survey participants do apply a pesticide to kill adult mosquitoes on their own property. None of our findings were associated with the level of education, gender, or age of participants. This study suggests that the City of New Orleans Mosquito, Termite and Rodent Control Board educational and outreach campaigns may be an effective tool in spreading mosquito control awareness and contribute to residents' knowledge of mosquito control. The data we collected indicate that residents understand what mosquito control is and why it is important in New Orleans.


Assuntos
Inseticidas , Piretrinas , Adulto , Animais , Humanos , Controle de Mosquitos , Nova Orleans , Inquéritos e Questionários
11.
Disaster Med Public Health Prep ; 17: e473, 2023 08 31.
Artigo em Inglês | MEDLINE | ID: mdl-37650226

RESUMO

OBJECTIVE: The effects of named weather storms on the rates of penetrating trauma is poorly understood with only case reports of single events currently guiding public health policy. This study examines whether tropical storms and hurricanes contribute to trauma services and volume. METHODS: This was a cross-sectional review of tropical storms/hurricanes affecting New Orleans, Louisiana, during hurricane seasons (June 1-November 30) from 2010-2021, and their association with the rate of penetrating trauma. Authors sought to determine how penetrating trauma rates changed during hurricane seasons and associate them with demographic variables. RESULTS: There were 5531 penetrating injuries, with 412 (7.4%) occurring during landfall and 554 (10.0%) in the aftermath. Black/African Americans were the most affected. There was an increase in the rate of penetrating events during landfall (3.4 events/day) and aftermath (3.5 events/day) compared to the baseline (2.8 events/day) (P = < 0.001). Using multivariate analysis, wind speed was positively related to firearm injury, whereas the rainfall total was inversely related to firearm violence rates during landfall and aftermath periods. Self-harm was positively related to distance from the trauma center. CONCLUSIONS: Cities at risk for named weather storms may face increasing gun violence in the landfall and aftermath periods. Black/African Americans are most affected, worsening existing disparities. Self-harm may also increase following these weather events.


Assuntos
Tempestades Ciclônicas , Armas de Fogo , Ferimentos por Arma de Fogo , Humanos , Nova Orleans/epidemiologia , Estudos Transversais
12.
J Acquir Immune Defic Syndr ; 94(3): 220-226, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37643417

RESUMO

INTRODUCTION: Expanding HIV pre-exposure prophylaxis (PrEP) use is key to goals for lowering new HIV infections in the U.S. by 90% between 2022 and 2030. Unfortunately, youth aged 16-24 have the lowest PrEP use of any age group and the highest HIV incidence rates. METHODS: To examine the relationship between HIV seroconversion and PrEP uptake, adherence, and continuity, we used survival analysis and multivariable logistic regression on data of 895 youth at-risk for HIV infection enrolled in Adolescent Trials Network for HIV Medicine protocol 149 in Los Angeles and New Orleans, assessed at 4-month intervals over 24 months. RESULTS: The sample was diverse in race/ethnicity (40% Black, 28% Latine, 20% White). Most participants (79%) were cis-gender gay/bisexual male but also included 7% transgender female and 14% trans masculine and nonbinary youth. Self-reported weekly PrEP adherence was high (98%). Twenty-seven participants acquired HIV during the study. HIV incidence among PrEP users (3.12 per 100 person year [PY]) was higher than those who never used PrEP (2.53/100 PY). The seroconversion incidence was highest among PrEP users with discontinuous use (3.36/100 PY). If oral PrEP users were adherent using 2-monthly long-acting injectables, our estimate suggests 2.06 infections per 100 PY could be averted. CONCLUSIONS: Discontinuous use of PrEP may increase risk of HIV acquisition among youth at higher risk for HIV infection and indications for PrEP. Thus, to realize the promise of PrEP in reducing new HIV infections, reducing clinical burdens for PrEP continuation are warranted.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Soropositividade para HIV , Profilaxia Pré-Exposição , Pessoas Transgênero , Masculino , Humanos , Adolescente , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Infecções por HIV/tratamento farmacológico , Incidência , Los Angeles/epidemiologia , Nova Orleans , Fármacos Anti-HIV/uso terapêutico , Homossexualidade Masculina , Soropositividade para HIV/tratamento farmacológico , Profilaxia Pré-Exposição/métodos
13.
Front Public Health ; 11: 1191325, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37427255

RESUMO

Introduction: To facilitate continuation of school feeding during COVID-19 school lockdowns, U.S. Congress authorized waivers to allow for school meals to be picked up by parents/guardians in non-school settings. We summarized school meals distribution and characterized reach in socially vulnerable neighborhoods in New Orleans, a city prone to environmental disasters, with a city-wide charter school system, and historically high levels of child poverty and food insecurity. Methods: School meals operations data were obtained from New Orleans, Louisiana (NOLA) Public Schools for 3/16/2020-5/31/2020. For each pick-up location, we estimated: average meals available (weekly), average meals served (weekly), number of weeks of operation, and rate of meal pick-up ([meals served/meals available]*100). These characteristics were mapped in QGIS v3.28.3, along with neighborhoods' Social Vulnerability Index (SVI). Pearson correlation and ANOVA were run to assess differences between operations characteristics and neighborhood SVI. Results: From 38 meal sites, 884,929 meals were available for pick-up; 74% of pick-up sites were in moderately/highly socially vulnerable areas. Correlations between average meals available and served, weeks of operation, rate of meal pick-up, and SVI were weak and not statistically significant. SVI was associated with average rate of meal pick-up but not other operations characteristics. Discussion: Despite the disaggregated nature of the charter school system, NOLA Public Schools successfully pivoted to providing children with pick-up meals due to COVID-19 lockdowns, with 74% of sites located in socially vulnerable neighborhoods. Future studies should describe the types of meals provided to students during COVID-19, in terms of diet quality and nutrient adequacy.


Assuntos
COVID-19 , Serviços de Alimentação , Refeições , Vulnerabilidade Social , COVID-19/epidemiologia , Pandemias , Humanos , Controle de Doenças Transmissíveis , Segurança Alimentar , Nova Orleans , Instituições Acadêmicas , Quarentena
14.
Head Neck Pathol ; 17(2): 313-324, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37278887

RESUMO

BACKGROUND: The World Health Organization's (WHO) chapter on odontogenic and maxillofacial bone tumors provides a global reference for diagnosis of these tumors. In the fifth edition, the inclusion of consensus definitions and development of essential and desirable diagnostic criteria help improve recognition of distinct entities. These are key enhancements since the diagnosis of odontogenic tumors is largely based on histomorphology which is taken in combination with clinical and radiographic appearances. METHODS: Review. RESULTS: Despite delineation of diagnostic criteria for ameloblastoma, adenoid ameloblastoma, and dentinogenic ghost cell tumor, a subset of these tumors continues to show overlapping histological features that can potentially lead to misdiagnosis. Accurate classification may be challenging on small biopsies, but potentially enhanced by refining existing diagnostic criteria and utilization of immunohistochemistry and/or molecular techniques in a specific cases. It has become clear that the clinical and histologic features of the non-calcifying Langerhans cell-rich subtype of calcifying epithelial odontogenic tumor and the amyloid-rich variant of odontogenic fibroma converge into a single tumor description. In addition, this tumor shows remarkable clinical, histological overlap with a subset of sclerosing odontogenic carcinoma located in the maxilla. Benign perineural involvement vs perineural invasion is an underexplored concept in odontogenic neoplasia and warrants clarification to reduce diagnostic confusion with sclerosing odontogenic carcinoma. CONCLUSION: While controversial issues surrounding classification and discrete tumor entities are addressed in the WHO chapter, ambiguities inevitably remain. This review will examine several groups of odontogenic tumors to highlight persistent knowledge gaps, unmet needs and unresolved controversies.


Assuntos
Ameloblastoma , Carcinoma , Neoplasias Bucais , Tumores Odontogênicos , Humanos , Ameloblastoma/patologia , Nova Orleans , Tumores Odontogênicos/diagnóstico , Tumores Odontogênicos/patologia
15.
Eur J Psychotraumatol ; 14(2): 2211355, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37334999

RESUMO

Background: Weather-related disasters, including hurricanes, are becoming more frequent and severe due to climate change. Vulnerable populations, such as people with low income and racial and ethnic minorities, are particularly prone to increased levels of physical harm and psychiatric adversity from weather-related events.Objectives: We aimed to explore psychosocial resources and coping of survivors with three different posttraumatic stress symptom (PTSS) trajectories (High-Decreasing, Moderate-Decreasing, and High-Stable), after Hurricane Katrina across two different time points: F1 (1-year post-disaster) and F3 (12 years post-disaster).Method: Participants in this multi-method study were part of a larger cohort of the Resilience in Survivors of Katrina (RISK) project. Transcripts of interviews completed at the two time points were analysed using two qualitative methods, combining thematic analysis and narrative analysis, and providing both breadth of perspectives with the depth of specific case studies.Results: Sixteen survivors completed interviews at both F1 and F3. From our in-depth analysis of the data, we derived five inductive themes: 'Hope,' 'Adaptive vs maladaptive avoidance,' 'Emotional delay,' 'Acceptance, Finding Meaning and Being in the Moment,' and 'Coping strategies.' Survivors with High-Decreasing and Moderate-Decreasing PTSS trajectories experienced hope for future, accepted the hurricane and its results, and found efficient ways to cope with their situation. Survivors with High-Stable PTSS trajectories tended to express a lack of hope for future and struggled to be mindful and accept the hurricane and its harm. Unlike survivors with High-Decreasing and Moderate-Decreasing PTSS trajectories, survivors with High-Stable PTSS trajectories also reported less social and family support and faced more discrimination and racism.Conclusion: There are factors beyond individual-level psychosocial resources that may shape post-disaster resilience. When supporting survivors after a weather-related disaster, it is essential to provide ongoing psychological, financial, and physical assistance to bolster these resources.


After Hurricane Katrina, survivors with different posttraumatic stress symptom trajectories reported different levels of hope, mindfulness, and willingness to talk about the hurricane, emotional processing, and coping strategies.These experiences varied over time for survivors in all three trajectories.Survivors who report ongoing high levels of symptoms should be offered additional support to bolster these psychosocial resources.


Assuntos
Tempestades Ciclônicas , Desastres Naturais , Resiliência Psicológica , Transtornos de Estresse Pós-Traumáticos , Sobreviventes , Nova Orleans/epidemiologia , Humanos , Masculino , Feminino , Adulto Jovem , Esperança , Aprendizagem da Esquiva , Emoções , Adaptação Psicológica , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia , Fatores de Tempo , Estudos de Coortes , Pesquisa Qualitativa , Entrevistas como Assunto , Apoio Social/psicologia , Racismo/psicologia , Narração
16.
Head Neck Pathol ; 17(2): 292-298, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37184731

RESUMO

Head and neck squamous cell carcinoma (HNSCC) is the world's 6th most common malignancy. Oral cavity SCC (OCSCC) represents approximately one third of the HNSCC cases diagnosed annually in the United States. Despite therapeutic advances, OCSCC is frequently lethal, with a modest 5-year survival. Because OCSCC is often preceded by premalignant lesions, it is an ideal disease for screening initiatives. The conventional visual and tactile exam (CVTE), coupled with a tissue biopsy, remains the gold standard. However, CVTE alone cannot reliably differentiate between reactive/inflammatory and dysplastic lesions. Further, the histologic diagnosis of dysplasia is subjective in nature and a highly imperfect predictor of malignant transformation. This prognostic uncertainty creates a significant clinical management dilemma-watchful waiting with increased patient psychological and economic burdens versus unnecessary aggressive treatment. As such, the development and validation of novel diagnostic platforms such as Artificial Intelligence (AI) and prognostic molecular biomarkers may help address these critical unmet clinical needs.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Humanos , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Nova Orleans , Inteligência Artificial , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas/patologia , Hiperplasia
17.
Head Neck Pathol ; 17(2): 285-291, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37184732

RESUMO

The salivary gland section in the 5th edition of the World Health Organization Classification of Head and Neck Tumours includes a description of several new entities. In addition, numerous tumor variants were described and new concepts proposed, most of which have been based on recent molecular discoveries. However, there are still some controversial issues that remain to be resolved, and some of them are discussed in this review.


Assuntos
Neoplasias de Cabeça e Pescoço , Neoplasias das Glândulas Salivares , Humanos , Nova Orleans , Neoplasias das Glândulas Salivares/patologia , Glândulas Salivares/patologia
18.
Head Neck Pathol ; 17(2): 299-312, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37184733

RESUMO

Although the definitions of sinonasal neuroendocrine and neuroectodermal neoplasms did not change substantially in the 5th edition WHO Classification of Head and Neck Tumours, the diagnosis of olfactory neuroblastoma (ONB), small cell neuroendocrine carcinoma, and large cell neuroendocrine carcinoma remains quite challenging in practice. Ambiguities surrounding the amount of keratin expression allowable in ONB and the amount of neuroendocrine differentiation seen in sinonasal undifferentiated carcinoma (SNUC) lead to significant diagnostic discrepancies at the high grade end of this tumor spectrum. Furthermore, a group of problematic neuroepithelial tumors that show overlapping features of ONB and neuroendocrine carcinoma have never been recognized in formal classification schemes. Since publication of the 5th edition WHO, two new tumor entities have been proposed that help resolve these problems. Olfactory carcinoma is defined by high grade keratin-positive neuroectodermal cells with frequent intermixed glands and shows recurrent Wnt pathway, ARID1A, and RUNX1 alterations. IDH2-mutant sinonasal carcinoma is a molecularly-defined category that encompasses tumors with undifferentiated (SNUC), large cell neuroendocrine, and neuroepithelial phenotypes. This review will provide a practical overview of these emerging entities and their application to diagnostic challenges in the post-WHO sinonasal neuroendocrine and neuroectodermal tumor classification.


Assuntos
Carcinoma Neuroendócrino , Estesioneuroblastoma Olfatório , Neoplasias do Seio Maxilar , Neoplasias Nasais , Neoplasias dos Seios Paranasais , Humanos , Nova Orleans , Carcinoma Neuroendócrino/patologia , Neoplasias dos Seios Paranasais/patologia , Neoplasias do Seio Maxilar/patologia , Estesioneuroblastoma Olfatório/diagnóstico , Estesioneuroblastoma Olfatório/patologia , Queratinas , Neoplasias Nasais/patologia , Cavidade Nasal/patologia
20.
Front Public Health ; 11: 1114877, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37064683

RESUMO

Background: Young Black men are disproportionately and adversely affected by incarceration and sexually transmitted infections (STIs), both of which share common social and structural determinants. It is well documented that incarcerated individuals, including youth, are more likely to acquire STIs in the carceral setting compared to the general population. However, the effects of imprisonment on sexual health outcomes after imprisonment are not well-understood. The relationship between incarceration history (having ever spent time in a correctional institution such as prison, jail, or juvenile detention) and chlamydia positivity was examined in this study. Methods: A secondary analysis of the Check it Program, a Chlamydia trachomatis (Ct) community-based seek, test, and treat screening program for Black men aged 15-24 who have sex with women in New Orleans was conducted. Participants completed a computer-assisted self-administered questionnaire on relevant sexual and social histories and provided a urine specimen for a Ct urine nucleic acid amplification test. Bivariate and multivariable regressions were used to estimate the association between incarceration history and chlamydia positivity. Results: Participants (N = 1,907) were enrolled from May 2017 to March 2020. Of those, 351/1,816 (19.3%) reported past incarceration and 203/1,888 (10.8%) tested positive for Ct. When adjusted for age, insurance status, and condom use, having a history of incarceration was positively associated with a positive Ct test (adjusted odds ratio (95% confidence interval):1.61 (1.12, 2.31), p = 0.0095). Conclusions: Interacting with the carceral system is associated with a positive Ct test post-incarceration. Incarceration may be an important marker for Ct acquisition in young Black men who have sex with women and those with a history of incarceration should be prioritized for Ct screening after release.


Assuntos
Infecções por Chlamydia , Infecções Sexualmente Transmissíveis , Masculino , Adolescente , Humanos , Feminino , Nova Orleans , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/prevenção & controle , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/diagnóstico , Comportamento Sexual , Chlamydia trachomatis , Estabelecimentos Correcionais
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