88 research outputs found
Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice to describe the assets and barriers to sexual and reproductive health among Latinos in North Carolina
Latinos in North Carolina experience disparities in sexual and reproductive health. To identify and explore assets for and barriers to sexual and reproductive health in the Latino community, an academic-community partnership engaged community health workers (CHW) in Photovoice, a participatory qualitative research methodology. Five sessions were completed in which CHW agreed on photo assignments and discussed the photos. Themes included the role of men, cultural taboos, and the effect of undocumented immigrant status on access to resources. Findings were presented at a community forum. Building on the strengths of CHW to reduce barriers to sexual and reproductive health is a viable strategy to address disparities
A cross-cultural collaboration to improve healthy retail practices in tiendas : the Shop Healthy Iowa initiative
"Chronic diseases, such as obesity and diabetes, disproportionately affect Latinx populations as compared to white populations. For example, estimates suggest that Latinx individuals are 50 [percent] more likely to die from diabetes, they have higher rates of uncontrolled hypertension, and higher obesity rates compared to white populations. Latinx diets being low in fruits further exacerbates their risk of suffering from chronic diseases. Latinx households are more likely to be food insecure than white households and purchase more calorie-dense, high fat and sodium, and low fiber foods. Part of this insecurity is due to poor community nutrition environments with Latinx populations having low access to nutritious foods which increases health disparities in health outcomes and behaviors among these populations. To address these disparities, policy and environmental solutions need to address the low availability and affordability of healthy products in Latinx communities."--Background.Includes bibliographical reference
Efficacy of a store-based environmental change intervention compared with a delayed treatment control condition on store customers’ intake of fruits and vegetables
The present store-based intervention was designed to promote sales of fruits and vegetables (F&V) to increase intake among store customers – specifically customers of tiendas, small-to-medium-sized Latino food stores
What influences Latino grocery shopping behavior? Perspectives on the small food store environment from managers and employees in San Diego, California
To inform the design of a multilevel in-store intervention, this qualitative study utilized in-depth semistructured interviews with 28 managers and 10 employees of small-to-medium-sized Latino food stores (tiendas) in San Diego, California, to identify factors within the tienda that may influence Latino customers’ grocery-shopping experiences and behaviors. Qualitative data analysis, guided by grounded theory, was performed using open coding. Results suggest that future interventions should focus on the physical (i.e., built structures) and social (i.e., economic and socio-cultural) dimensions of store environments, including areas where the two dimensions interact, to promote the purchase of healthy food among customers
Demographic, Psychosocial and Perceived Environmental Factors Associated with Depression Severity in a Midwest Micropolitan Community
The purpose of this study was to inform a community-engaged partnership concerned with mental health in their community by exploring factors associated with depression among a sample of residents in a micropolitan city in a rural state. Social and contextual factors are important influences on depression risk, but most research in this area has focused on urban settings. Micropolitan areas (midsize rural communities centered around a population core of 10,000-50,000 people) are home to the majority of rural residents and this specific social and economic context may have unique influences on depression risk. Using a random-digit-dial sampling method, adult residents completed a phone interview that assessed a range of health behaviors and measures of quality of life, social support, neighborhood context, and discrimination (n = 1101). Results indicated that being male, having a partner, and being a high school graduate protected against moderate to severe depression, whereas inadequate social support, perceived unfair treatment, and lower neighborhood cohesion were associated with moderate to severe depression. Increases in poverty were significantly associated with greater odds of reporting moderate to severe depression. This study demonstrated that factors associated with depression are similar factors in rural and urban areas, however, the prevalence of these factors may differ along the rural-urban continuum, and should be considered when developing and implementing mental health prevention and control interventions
The first two community ID programs in the Midwest : organizing, evaluation, and community health in Johnson County, IA and Washtenaw County, mi
The post-9/11 sociopolitical climate has led to an increase in anti-immigrant policies and practices, including the federal REAL ID Act of 2005, which established standards requiring proof of "legal presence" for state identification cards (IDs) and driver's licenses to be used for federal purposes such as air travel. This has led several states to revise their ID eligibility requirements, and undocumented immigrants cannot access state IDs or driver's licenses in any Midwestern state except Illinois (Mathema, 2015; Park, 2015). Lack of photo ID limits access to important resources including bank and check-cashing services, pharmacies, libraries, housing, and police services (Lagunes, Levin, and Ditlmann, 2012). Undocumented parents face additional challenges as IDs may be required to volunteer at children's schools or pick them up from childcare (de Graauw, 2014). In 2015 two Midwestern counties (Washtenaw County, Michigan and Johnson County, Iowa) became the eighth and ninth U.S. localities to issue ID cards regardless of immigration status. These grassroots initiatives, the first local government-issued ID programs in the Midwest, were spearheaded by local activists and advocates who had witnessed -- or experienced firsthand -- the challenges of living without locally accepted IDs. The Washtenaw ID Project and the Center for Worker Justice of Eastern Iowa each worked with community members, county officials, and law enforcement with the goal of developing IDs that were accessible, secure from fraud, and widely accepted by area businesses, service providers, and law enforcement. These programs are well suited to the 2016 Cambio de Colores theme, "Building Bridges." Local IDs were designed to serve not only undocumented immigrants but also others that face challenges in accessing ID: the elderly, transgender individuals, individuals with chronic mental illness, residentially unstable individuals, and those displaced by natural disaster or domestic violence. This panel included several perspectives on these innovative programs. Representatives from the Center for Worker Justice of Eastern Iowa and the Washtenaw ID Project shared lessons from years of organizing, advocacy, and policy development. They discussed each county's process of identifying the need for local IDs, organizing to promote local ID policies, and implement the ID policies. Both groups worked to promote local IDs widely, including to those with state-issued IDs, so that local IDs were not stigmatized as substandard forms of identification. Researchers from University of Michigan School of Public Health and Social Work and University of Iowa College of Public Health shared findings from a multi-site, mixed-methods longitudinal evaluation of these programs. The objective was to evaluate whether community IDs increased access to community resources. Researchers partnered with the community agencies above to develop and administer surveys to ID applicants on the day they applied for ID (n=407). In Washtenaw County, qualitative interviews on the day of ID application (n=18) provided richer data about applicants' day-to-day experiences prior to accessing ID. Researchers presented preliminary findings about changes in participants' day-to-day experiences and access to resources since being issued ID. The panelists concluded with recommendations for designing local ID policies in other communities, including eligibility criteria, administration process and community engagement
A store-based intervention to increase fruit and vegetable consumption: The El Valor de Nuestra Salud cluster randomized controlled trial
Most evidence-based interventions to improve fruit and vegetable (FV) consumption target individual behaviors and family systems; however, these changes are difficult to sustain without environmental support. This paper describes an innovative social and structural food store-based intervention to increase availability and accessibility of FVs in tiendas (small-to medium-sized Latino food stores) and purchasing and consumption of FVs among tienda customers
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Common variants in Alzheimer’s disease and risk stratification by polygenic risk scores
Funder: Funder: Fundación bancaria ‘La Caixa’ Number: LCF/PR/PR16/51110003 Funder: Grifols SA Number: LCF/PR/PR16/51110003 Funder: European Union/EFPIA Innovative Medicines Initiative Joint Number: 115975 Funder: JPco-fuND FP-829-029 Number: 733051061Genetic discoveries of Alzheimer's disease are the drivers of our understanding, and together with polygenetic risk stratification can contribute towards planning of feasible and efficient preventive and curative clinical trials. We first perform a large genetic association study by merging all available case-control datasets and by-proxy study results (discovery n = 409,435 and validation size n = 58,190). Here, we add six variants associated with Alzheimer's disease risk (near APP, CHRNE, PRKD3/NDUFAF7, PLCG2 and two exonic variants in the SHARPIN gene). Assessment of the polygenic risk score and stratifying by APOE reveal a 4 to 5.5 years difference in median age at onset of Alzheimer's disease patients in APOE ɛ4 carriers. Because of this study, the underlying mechanisms of APP can be studied to refine the amyloid cascade and the polygenic risk score provides a tool to select individuals at high risk of Alzheimer's disease
New insights into the genetic etiology of Alzheimer's disease and related dementias
Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele
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