Health Disparities Among Sexual and Gender Minority Adults in Ohio

Background: Many documented disparities associated with health behaviors and access to health care impact the health outcomes of sexual and gender minorities (SGM). The current study aimed to gain insight into the health dispari-ties experienced by SGM adults living in Ohio to obtain data to plan future health-related programs. Methods: A secondary data analysis was conducted using 2018 Ohio Behavior Risk Factor Surveillance System (BRFSS) data. Health behaviors, health care access, and health outcomes were analyzed by sexual orientation (n=11 301) and gender identity (n=11 426) to determine health disparities faced by sexual minority males, sexual minority females and transgender individuals. Results: Significant SGM health disparities in Ohio are related to substance use (ie, binge drinking, current smoking status, e-cigarette use, and marijuana use); poor physical and mental health status; lack of health care coverage; and experiencing COPD, emphysema, or chronic bronchitis (all p < 0.001). In addition, fewer sexual minority females reported being within recommended breast cancer screening guidelines than heterosexual females (p < 0.05). Conclusion: Sexual and gender minority adults in Ohio report disparities associated with several health behaviors and access to health care. These findings may be due to factors at the patient level (eg, experiencing minority stress), provider level (eg, implicit bias), system level (eg, discrimination), and/or society level (eg, lack of legal protections). Study results will be used to plan health campaigns and programs targeted to SGM adults and providers to achieve health equity for the SGM population in Ohio

Venous outflow of the leg: Anatomy and physiologic mechanism of the plantar venous plexus

AbstractPurpose: Mechanisms of venous outflow from the leg and foot have not been clearly defined. The purpose of this study was to evaluate the anatomy and physiologic mechanism of the plantar venous plexus and its impact on venous drainage from the tibial veins.Methods: Fifty phlebograms that contained complete foot and calf films were reviewed. On lateral films, the number of veins in the plantar venous plexus and its tibial outflow tract were counted. The length and diameter of the longest vein in the plantar venous system and the length of the foot arch were measured. The ratio of the length of the plantar venous plexus to the arch length was calculated. The presence or absence of valves within the plexus was recorded. Plantar venous plexus outflow was evaluated by an duplex ultrasonographic scan of the posterior tibial, anterior tibial, and peroneal veins during intermittent external pneumatic compression of the plantar surface of the foot.Results: The plantar venous plexus was composed of one to four large veins (mean, 2.7 veins) within the plantar aspect of the foot. The diameter of these veins was 4.0 ± 1.2 mm. The veins coursed diagonally from a lateral position in the forefoot to a medial position at the level of the ankle, spanning 75% of the foot arch. Prominent valves were recognized within the plantar veins in 22 of 50 patients. The plexus coalesced into an outflow tract of one to four veins (mean, 2.5 veins) that flowed exclusively into the posterior tibial venous system. Small accessory veins that drained the plantar surface of the forefoot flowed into either the posterior tibial or peroneal veins. This pattern of selective drainage of the plantar venous plexus was confirmed by duplex imaging. Mechanical compression of the plantar venous plexus produced a mean peak velocity in the posterior tibial veins of 123 ± 71 cm/sec, in the anterior tibial veins of 24 ± 14 cm/sec, and in the peroneal veins of 29 ± 26 cm/sec.Conclusions: The plantar venous plexus is composed of multiple large-diameter veins that span the arch of the foot. Compression of the plantar venous plexus, such as that which occurs during ambulation, is capable of significantly increasing flow through the posterior tibial venous system into the popliteal vein. Its function may be integral to venous outflow from the calf and priming of the more proximal calf muscle pump. (J Vasc Surg 1996;24:819-24.

Colorectal Cancer Prevention: Perspectives of Key Players from Social Networks in a Low-Income Rural US Region

Social networks influence health behavior and health status. Within social networks, “key players” often influence those around them, particularly in traditionally underserved areas like the Appalachian region in the USA. From a total sample of 787 Appalachian residents, we identified and interviewed 10 key players in complex networks, asking them what comprises a key player, their role in their network and community, and ideas to overcome and increase colorectal cancer (CRC) screening. Key players emphasized their communication skills, resourcefulness, and special occupational and educational status in the community. Barriers to CRC screening included negative perceptions of the colonoscopy screening procedure, discomfort with the medical system, and misinformed perspectives on screening. Ideas to improve screening focused on increasing awareness of women\u27s susceptibility to CRC, providing information on different screening tests, improving access, and the key role of health-care providers and key players themselves. We provide recommendations to leverage these vital community resources

Measuring cervical cancer risk: development and validation of the CARE Risky Sexual Behavior Index

To develop and validate a risky sexual behavior index specific to cervical cancer research

Anomaly Mediated Supersymmetry Breaking without R-Parity

We analyze the low energy features of a supersymmetric standard model where the anomaly--induced contributions to the soft parameters are dominant in a scenario with bilinear $R$--parity violation. This class of models leads to mixings between the standard model particles and supersymmetric ones which change the low energy phenomenology and searches for supersymmetry. In addition, $R$--parity violation interactions give rise to small neutrino masses which we show to be consistent with the present observations.Comment: 38 pages, 15 figures. For higher resolution figures go to http://www.fma.if.usp.br/~magro/figures

Is transcranial Doppler a worthwhile addition to screening tests for cerebrovascular disease?

Abstract Purpose: Carotid duplex imaging has become the standard diagnostic evaluation for patients with suspected cerebrovascular disease. Transcranial Doppler ultrasonography expands the noninvasive diagnostic capabilities to the intracranial circulation. The purpose of this study was to evaluate the results of routine transcranial Doppler studies on patients referred for noninvasive cerebrovascular evaluation. Methods: A total of 670 patients had routine transcranial Doppler examinations as part of their noninvasive cerebrovascular evaluation. Patients were categorized clinically and according to their severity of extracranial internal carotid artery stenosis (30% velocity difference between sides, flow reversal, and velocities ± 2 SD from normal). Results: Forty-eight percent of the patients were women, and 52% were men. The average age was 65.5 years. Fifty-four percent of the patients were white, 42% were black, 3% were Hispanic, and 1% were other. Forty-eight percent presented with hemispheric symptoms, 34% had no symptoms, and 18% had nonhemispheric symptoms. Forty-five percent (304 of 670) had an interpretable transcranial Doppler examination. The ability to insonate the basal cerebral arteries through the temporal bone was significantly reduced in women ( p < 0.0001), black patients ( p < 0.0001), and older patients ( p < 0.0001). The results of forty-four percent of interpretable examinations were normal, 19% demonstrated side-to-side velocity differences, 13% showed collateral pathways, 11% showed velocities ± 2 SD, 10% showed an intracranial stenosis, and 4% showed reversed flow pattern. Although 56% of the patients had notable findings, no patient had their diagnostic or therapeutic plan altered by the transcranial Doppler results. Conclusion: Less than 50% of the patients referred for first-time cerebrovascular examination had access for an interpretable transcranial Doppler examination. Though the number of positive findings is reasonably high, no material impact on diagnostic or treatment plans was seen in the patients in this series. These results indicate that selection criteria for examination of the intracranial arteries should be refined and that transcranial Doppler scanning should not be incorporated as part of the "routine" noninvasive cerebrovascular examination. (J VASC SURG 1995;21:90-7.

Are rural Ohio Appalachia cancer survivors needs different than urban cancer survivors?

Limited information is available about rural cancer survivors’ needs and if they differ from urban cancer survivors

Provider-Verified HPV Vaccine Coverage among a National Sample of Hispanic Adolescent Females

Hispanic females have the highest cervical cancer incidence rate of any racial or ethnic group in the US, yet relatively little research has examined HPV vaccination among this fast-growing population. We examined HPV vaccination among a national sample of Hispanic adolescent females

Neutrino Physics from Charged Higgs and Slepton Associated Production in AMSB

In the Minimal Supersymmetric Standard Model with bilinear R-Parity violation, terms that violate R-Parity and lepton number are introduced in the superpotential, and sneutrino vacuum expectation values are induced. As a result, neutrino masses and mixing angles are generated via a low energy see-saw mechanism. We show that this model embedded into an anomaly mediated supersymmetry breaking scenario is testable at a linear collider using charged Higgs boson production in association with a stau. This is possible in regions of parameter space where the charged Higgs and stau have similar mass, producing an enhancement of the charged scalar mixing angles. We show that the bilinear parameter and the sneutrino vev can be determined from charged scalar observables, and estimate the precision of this determination.Comment: 21 pages, including 8 figure