Sexual Dysfunction among Latino men and women with poorly controlled diabetes

Latinos are the largest minority population in the United States and are diagnosed with diabetes at nearly twice the rate of non-Hispanic whites. Latinos not only suffer disproportionately from diabetes but also from diabetes related complications, including sexual dysfunction. Much of the existing literature on sexual dysfunction among Latinos with diabetes has focused on erectile dysfunction (ED). There is a dearth of information on sexual functioning among Latina women with diabetes or information on both genders in other sexual domains. Our study examined the prevalence of sexual dysfunction among a cohort of 106 poorly controlled Latino diabetics in South Florida who participated in the Miami Healthy Heart Initiative, an NIH/NLBI sponsored clinical trial addressing diabetes management among Latinos. We explored gender differences in various domains of sexual health and examined the role of poor glycemic control and depression on sexual dysfunction. A large proportion of both genders in our sample met the criteria for sexual dysfunction though females exhibited a greater prevalence than males. Depression affected more than one third of our sample, but we did not find any significant associations between sexual dysfunction and depression. We also did not find a linear correlation between glycemic control and sexual dysfunction. We concluded that interventions are needed to address high rates of sexual dysfunction among Latinos with diabetes with particular emphasis on Latina women, who were much more likely than men to report problems with desire and other areas of sexual functioning. Until effective pharmacologic agents to improve desire among women with diabetes become available, clinicians caring for this population should consider behavioral approaches that may limit the impact of sexual dysfunction

Using a Role-Driven Race Equity Reform Approach to Mitigate the Effects of America\u27s History of Racism on Food Insecurity

Abstract Food insecurity, or the lack of reliable access to sufficient quantities of nutritious food, affects African Americans and other minorities disproportionately. This paper examines how America’s history of racism created and sustains the Nation’s racially disparate food system. Food insecurity contributes to hunger. This paper contemplates disparities in other American systems, including education and criminal justice, as exemplars of the broader ramifications of hunger. Finally, the paper examines the potential of individual action to address problems in any system. It champions the adoption of a role-driven race equity reform strategy as a tool to confront the current food insecurity. The strategy emphasizes the capacity of individuals to use the inherent authority of roles at any level of an organization to create change. The paper contends that individual actors, both within and without the food system, can work toward achieving more equitable outcomes in the Nation’s food system

Challenges and lessons from a primary care intervention in a Brazilian municipality

OBJECTIVE: To address the implementation of the Lab for Innovation in Chronic Conditions in Santo Antonio do Monte, indicating the main challenges and lessons of a new chronic condition model. METHODS: This is an observational study based on two sources of data: 1) two cross-sectional household surveys, 2013 (2012 as reference year) and 2015 (2014 as reference year), representative for the entire population and four target groups (pregnant women; children under two years old; individuals with hypertension and diabetes); medical records of individuals who self-reported having hypertension or diabetes in the household survey of 2013. A descriptive statistics analysis was performed. RESULTS: The main findings showed that the public health system is the main provider of health services, mainly primary care, in Santo Antonio do Monte. Besides, the implementation of Lab for Innovation in Chronic Conditions showed the importance of building a Primary Health Care network in small municipalities. CONCLUSIONS: Community health agents and health managers played a fundamental role in the Primary Health Care network. The case study of Santo Antonio do Monte poses some challenges and lessons that clarify future interventions on building a Primary Health Care network that is essential to provide an adequate and longitudinal care to chronic conditions

Comparative analysis of economic growth in Nigeria and Kenya: A fractional integration approach

This paper is a comparative analysis of Nigeria and Kenya, the largest economies in West and East Africa respectively, on the basis of the time series properties of their economic activities through the Gross Domestic Product (GDP) and growth rate series. It further analyses how differing policy and political economy processes contributed to the two countries' economic growth trajectories despite becoming independent republics at almost the same time. We study the two economies using a long‐memory‐fractionally integrated approach. The results show a high degree of persistence in both cases. When non‐linearities are taken into account, evidence of mean reversion is found in the GDP series in the two countries. This is indicative of how the two countries in very distinct African contexts followed broadly different but, in some ways, similar paths toward economic growth since independence.pre-print277 K

Exploring the effectiveness of the output-based aid voucher program to increase uptake of gender-based violence recovery services in Kenya: a qualitative evaluation

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Few studies in Africa have explored in detail the ability of output-based aid (OBA) voucher programs to increase access to gender-based violence recovery (GBVR) services. Methods: A qualitative study was conducted in 2010 and involved: (i) in-depth interviews (IDIs) with health managers, service providers, voucher management agency (VMA) managers and (ii) focus group discussions (FGDs) with voucher users, voucher non-users, voucher distributors and opinion leaders drawn from five program sites in Kenya. Results: The findings showed promising prospects for the uptake of OBA GBVR services among target population. However, a number of factors affect the uptake of the services. These include lack of general awareness of the GBVR services vouchers, lack of understanding of the benefit package, immediate financial needs of survivors, as well as stigma and cultural beliefs that undermine reporting of cases or seeking essential medical services. Moreover, accreditation of only hospitals to offer GBVR services undermines access to the services in rural areas. Poor responsiveness from law enforcement agencies and fear of reprisal from perpetrators also undermine treatment options and access to medical services. Low provider knowledge on GBVR services and lack of supplies also affect effective provision and management of GBVR services. Conclusions: The above findings suggest that there is a need to build the capacity of health care providers and police officers, strengthen the community strategy component of the OBA program to promote the GBVR services voucher, and conduct widespread community education programs aimed at prevention, ensuring survivors know how and where to access services and addressing stigma and cultural barriers.The Bill and Melinda Gates Foundatio

Firm-Level Institutions and Performance of Publicly Quoted Companies in Kenya

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