Perspectives on Lung Cancer Screening in the Philadelphia LGBTQ Community

Introduction: Lung cancer is the leading cause of cancer deaths in the United States, but there are low screening rates across the country. While the prevalence of smoking in the LGBTQ population is disproportionately high, the LGBTQ community may have decreased access to screening, since they are reported to be less likely to have health insurance, more likely to receive inferior care or be denied care. The objective of this project was to better understand the knowledge, beliefs, and attitudes toward lung cancer screening in the LGBTQ community in Philadelphia in order to develop appropriate, community-focused educational materials to increase lung cancer screening in this population. Methods: In-depth interviews were conducted with three key informants and one community member. Key informants were healthcare providers or community leaders with extensive experience working with the LGBTQ community. The community member was an individual who identifies as LGBTQ and fits the lung cancer screening eligibility criteria (age 55-80, 30 pack-year history, current/former smoker who has quit in the past 15 years). Interviewees were asked about their or the LGBTQ community’s knowledge, attitudes, and beliefs about lung cancer and screening. Motivational factors, barriers to screening, suggested messengers of information, and potential education strategies were also discussed in the interviews. The qualitative data from interviews was analyzed using direct content analysis through NVIVO Pro 12. Results: Preliminary data indicate that there is an overall lack of knowledge and awareness about lung cancer screening. Key informants cited fear and perceived cost or insurance issues as barriers, while the community member emphasized lack of time. Taking control of one’s health and the chance to improve longevity were identified as motivating factors. Additional interviews are pending. Conclusion: There is a need for LGBTQ-centered materials to educate the community about lung cancer and screening. Information should be delivered by individuals or groups who are trusted by the community. Materials should address basic information about lung cancer, its risk factors, and the screening process, and should empower individuals to play an active role in their health and their care

Perspectives of Asian/Pacific Islanders on Lung Cancer Screening in Philadelphia: A Qualitative Study

Introduction: Even though rates of smoking, the leading cause of cancer, are lower in Asian/Pacific Islanders (API), the rates of lung cancer deaths are still one of the highest compared to those of other minority groups in the US. However, little is known about the beliefs and attitudes that influence lung cancer screening behaviors of APIs. Objective: The objective of this study is to better understand the current beliefs, attitudes, and knowledge of APIs in Philadelphia towards lung cancer and lung cancer screening. Methods: Six in-depth interviews were conducted with key informants, who all had extensive experience working with the Asian community in Philadelphia. The content of interviews included the interviewee’s knowledge of the attitudes and beliefs about lung cancer and lung cancer screening held by the API community. Motivational factors, barriers to screening, and effective educational/communication strategies were also assessed. Content analysis was used to analyze the qualitative data. Results: A majority of the participants felt that fatalism, no concept of preventive care, and not wanting to know a bad diagnosis were strong beliefs associated with lung cancer screenings that are held by the API community. Work, cost, language, fear, and a lack of knowledge were identified as barriers to lung cancer screenings, while family and doctors’ recommendation were identified as motivational factors. Conclusion: Culturally and linguistically appropriate education programs and materials in the future need to address these specific barriers, include basic information about and risk factors for lung cancer, and target messaging towards family to encourage lung cancer screening for APIs at risk

Understanding the Attitudes and Perceptions Towards Lung Cancer Screening Amongst United States Veterans: A Qualitative Study

Introduction: Lung cancer is the leading cause of cancer mortality in the United States, with this rate disproportionately affecting the veteran population. Despite USPSTF recommendations, screening rates are low and underutilized. The purpose of this study is to understand veterans’ knowledge, attitudes and beliefs surrounding lung cancer and lung cancer screening to better address barriers to screening. Methods: Five interviews were conducted with veteran community members, and three were conducted with key informants for a current total of eight interviews. Key informants included Philadelphia community leaders who work with veterans. Interviews explored lung cancer screening knowledge, motivating factors and barriers to care, tobacco use, and potential educational strategies. Interviews were transcribed and coded through NVivo Pro 12 for direct content analysis. Results: Analysis revealed a lack of knowledge and awareness surrounding lung cancer screening amongst veterans. Cancer screening beliefs echoed themes of fatalism and personal experience. Multiple barriers to care were identified, including lack of concern, fear, and patient navigation. Despite these barriers, interviewees believed that screening is necessary. Smoking is highly prevalent in this community due to social, cultural, and habitual factors. Potential educational strategies include group classes with both medical providers and lung cancer survivors. Conclusion: This study provides insight into understanding veterans’ knowledge and beliefs surrounding lung cancer screening. Understanding these values are important in addressing barriers to care and reducing the disproportionate lung cancer burden. In the future, this knowledge can be utilized to facilitate the development of culturally and linguistically appropriate educational programs and materials

2020-04-24 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NYT praises NM. NM Governor update. NM cases. NM antibody tests. State hiring freeze. Navajo Nation sues. Navajo Nation CA doctors. Mental health funding. Balloon Fiesta proceeding. Trump Lysol remarks. $484B business relief. 50k US deaths. US no to WHO initiatives. US crime reductions. Moscow 10% infections. Quebec elderly deaths. Italy psychiatric sequelae. Global vaccines summit. French nicotine sales restrictions. Adaptive cyclic exit strategies. Mask reuse techniques. Mask steaming method. Legionnaire’s reopening risks. Youth mental health. US disease models. Covid phobia treatment avoidance. Nursing home testing. Home nursing demand. CDC home cleaning. Guidelines on: convalescent plasma transfusion, H2O2 nasal use, pre-op testing, respiratory distress, ophthalmological practice, GI department reopening. FDA hydroxychloroquine cautions. Chloroquine high-dose mortality. HCQ+azithromycin long-QT. Iron reduction adjuvant. Repurposing prioritization. Pediatric HCQ dosing. HCQ enrollment up. 107 trials registered. PPE skin injuries. LDL and severity. 32 ECMO patients. Worse outcomes older monkeys

2020-05-11 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM case counts. Navajo Nation documentary. Medicaid reimbursement increase. Excess NYC mortality. German R0\u3e1. Chile COVID-19 certificates. High female incidence in Quebec. Swab 3D printing. Evidence lacking school reopening. Cloth mask review. WHO 2nd wave warning. Higher mortality in minorities. Environmental transmission controls. Behavior change. Correctional environment guidelines. Wuhan hospital transformation. Maximizing GI training. Threat and conformity. Recommendations on managing COVID-19 (first Italian SARS patients), and obesity and metabolic syndrome. Guidelines for neurologists. Ethics of off-label drugs use. Abbott antibody test approval. CRISPR test FDA approval. Viral sample inactivation. HCQ+azithromycin no benefit. Public-Private partnership for clinical trials. Drug repurposing. Cancer patient considerations. 35 new COVID-19 trials. Hyperinflammatory shock in children. Symptom app

2020-05-04 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM convalescent plasma call. NM case counts. Gallup lockdown continues. Tribal federal relief delay. Childcare demand drops. Polling open for primaries. Non-US world funds R&D. South Korea eases more. Soft quarantine inefficiency. Chinese interventions. Transmission window. December French case. CDC on law enforcement, essential errands. NEJM on telemedicine. Practice guidelines for: ECMO, pneumonia, nuclear medicine SOP. FDA antibody test restrictions. Africa testing differences. PCR assay sensitivity. Wuhan antibody tracking. Hydroxychloroquine toxicity. Remdesivir mechanism. Tocilzumab study inconclusive. SARs-CoV-2 structure. 28 new trials. Immunology and exercise. Synthetic SARS-CoV-2. IgM and IgG responses. Bacterial and fungal coinfection. Youth mental health challenges

Airway Microbiota Dynamics Uncover a Critical Window for Interplay of Pathogenic Bacteria and Allergy in Childhood Respiratory Disease.

Repeated cycles of infection-associated lower airway inflammation drive the pathogenesis of persistent wheezing disease in children. In this study, the occurrence of acute respiratory tract illnesses (ARIs) and the nasopharyngeal microbiome (NPM) were characterized in 244 infants through their first five years of life. Through this analysis, we demonstrate that >80% of infectious events involve viral pathogens, but are accompanied by a shift in the NPM toward dominance by a small range of pathogenic bacterial genera. Unexpectedly, this change frequently precedes the detection of viral pathogens and acute symptoms. Colonization of illness-associated bacteria coupled with early allergic sensitization is associated with persistent wheeze in school-aged children, which is the hallmark of the asthma phenotype. In contrast, these bacterial genera are associated with "transient wheeze" that resolves after age 3 years in non-sensitized children. Thus, to complement early allergic sensitization, monitoring NPM composition may enable early detection and intervention in high-risk children

2020-05-14 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM restrictions loosen. NM case count. Navajo Nation case count. 9 state parks open. Sunport revenue loss. Trump projects vaccine delivery. Wisconsin court case. Smokers quit. Ireland reopening. Danish schools open. Philippine typhoon evacuation. PPE-induced pressure injuries and facial dermatoses. U.S. mask stockpile. PPE for surgeons. Intubation time with aerosol box. Consumer spending with social restrictions. Suicide increase expected. Undetected virus homeless. Chinese infection control. 5% Spain infected. Sanitizing booth. Healthcare worker infection routes. Kawasaki disease France. CDC Kawaski guidance. Italian deaths characterized. CDC reopening school guidance. COVID-19 and epistemology. Monitoring misleading claims. UN mental health policy brief. CDC vaccination schedules. Guidelines on managing endoscopy units. COVID-19 lab testing (for lab professionals). Cancer surgery triage. Operating room practices. Orthodontic treatment. 3D printed NP swabs effective. Salt-water irrigation reduces duration. Corticosteroids ineffectual. Vaccines require biomanufacturing infrastructure. French pharm giant promises fair vaccine distribution. 26 new trials registered. LDH, lymphocytes and hs-CRP predict mortality. Fibrinogen higher in SARS. Insulin resistance. Glycemic monitoring. Hemostasis abnormalities. New phobia scale. OR global consensus. Inpatient cognitive assessments are challenging. Loud speech increases transmission. Monkeys present similarly. Human-to-dog transmission. Cat transmission

Towards Adaptive Technology in Routine Mental Healthcare

This paper summarizes the information technology-related research findings after 5 years with the INTROducing Mental health through Adaptive Technology project. The aim was to improve mental healthcare by introducing new technologies for adaptive interventions in mental healthcare through interdisciplinary research and development. We focus on the challenges related to internet-delivered psychological treatments, emphasising artificial intelligence, human-computer interaction, and software engineering. We present the main research findings, the developed artefacts, and lessons learned from the project before outlining directions for future research. The main findings from this project are encapsulated in a reference architecture that is used for establishing an infrastructure for adaptive internet-delivered psychological treatment systems in clinical contexts. The infrastructure is developed by introducing an interdisciplinary design and development process inspired by domain-driven design, user-centred design, and the person based approach for intervention design. The process aligns the software development with the intervention design and illustrates their mutual dependencies. Finally, we present software artefacts produced within the project and discuss how they are related to the proposed reference architecture. Our results indicate that the proposed development process, the reference architecture and the produced software can be practical means of designing adaptive mental health care treatments in correspondence with the patients’ needs and preferences. In summary, we have created the initial version of an information technology infrastructure to support the development and deployment of Internet-delivered mental health interventions with inherent support for data sharing, data analysis, reusability of treatment content, and adaptation of intervention based on user needs and preferences.publishedVersio