45 research outputs found

    How Discrimination, Social Support, And English Proficiency Impact Depression In South Asian Immigrants: The Mediators Of Atherosclerosis In South Asians Living In America Study

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    Objectives: Discrimination, low social support, and low English proficiency negatively impact the mental health of immigrants. More work is needed to investigate the relationship between these factors and depression in South Asian immigrants. We examined the cross-sectional associations between chronic discrimination, low social support, low English proficiency, and depression in South Asians using data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Methods: We fit logistic regression models to evaluate the associations between discrimination, social support, English proficiency, and depression in a sample of 887 South Asian adults. We also explored how discrimination, social support, and language proficiency may interact to synergistically increase the odds of depression. Results: We found that 131 people, or 14.8% of the sample, were depressed. High chronic discrimination and low social support led to a higher odds of depression; low English proficiency was not significantly correlated with depression after adjusting for education. Low English proficiency and low social support interacted synergistically with discrimination: both factors increased the impact of discrimination on the odds of depression. However, these interactions were not statistically significant. English proficiency and social support did not interact to increase the odds of depression. Conclusions: Discrimination and social support are correlated with depression in South Asian immigrants, and discrimination interacts with social support and English proficiency to impact mental health. Given the stressors that South Asians face as immigrants and the growing South Asian community in the United States, it is essential for clinicians to consider work that examines how discrimination, social support, and language proficiency affect the mental health of this population

    Renal Diseases in Children Attending Pediatric Nephrology Centers of Dhaka City

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    Introduction: Renal diseases in children can be congenital or acquired. In Bangladesh, pediatric nephrology care is available for last 2 decades, but there was no epidemiological study to see the pattern of renal diseases in children of the country. So, this study was carried out to observe the pattern of renal diseases in children of pediatric nephrology centers of Dhaka city.Materials and Methods: The children aged 1 day to 18 years with renal problems attended at selected four pediatric nephrology centers of Dhaka city (BSMMU, DMCH, DSH and NIKDU).Results: Among 6453 patients, 1123 were admitted in IPD and 5330 were visited at OPD. Mean age was 5.8¬Ī3.5 years in IPD patients and 6.90¬Ī1.37 years in OPD patients. In IPD among 1123 patients, 720 (64.1%) were male and 403 (35.8%) were female and in OPD among 5330 patients 3336 (62.59%) were male and 1994 (37.4%) were female. Nephrotic Syndrome (76% in IPD and 74% in OPD) was the most common disease followed by chronic kidney disease (CKD 6%) in IPD and urinary tract infections (UTI 9.4%)in OPD were the next common disease. Common presentations were proteinuria (27.6%), oliguria or anuria (26.2%) and edema (25.7%).Conclusions: The current pattern of renal diseases shows, that the most common renal diseases are NS followed by CKD and UTI. In the study male patients are more common than female.¬†Keywords: Nephrotic Syndrome; Chronic Kidney Disease; Congenital Anomalies of Kidney and Urinary Tract; Acute kidney injury

    ‚ÄėStray appetites‚Äô: a socio-ecological analysis of free-ranging dogs living alongside human communities in Bangalore, India

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    Across the developing world, humans and free-ranging domestic dogs share common spaces. The relationship between these dogs and humans can range from one of dependence, to apathy, to conflict. Given the high number of humans attacked by dogs every year in India, and the lack of an effective population control strategy, we seek to provide insights into the conflict and propose alternative population management options based on reducing the carrying capacity of the environment. We used a mixed methods approach to understand both ecological and sociological underpinnings of free-ranging dog-human relationships in Bangalore, India. We conducted a photographic capture-recapture survey of free-ranging dogs to estimate population size and linked it to the availability of potential food sources. We also conducted a qualitative sur

    Racial disparities in the SOFA score among patients hospitalized with COVID-19

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    BACKGROUND: Sequential Organ Failure Assessment (SOFA) score predicts probability of in-hospital mortality. Many crisis standards of care suggest the use of SOFA scores to allocate medical resources during the COVID-19 pandemic. RESEARCH QUESTION: Are SOFA scores elevated among Non-Hispanic Black and Hispanic patients hospitalized with COVID-19, compared to Non-Hispanic White patients? STUDY DESIGN AND METHODS: Retrospective cohort study conducted in Yale New Haven Health System, including 5 hospitals with total of 2681 beds. Study population drawn from consecutive patients aged ‚Č•18 admitted with COVID-19 from March 29th to August 1st, 2020. Patients excluded from the analysis if not their first admission with COVID-19, if they did not have SOFA score recorded within 24 hours of admission, if race and ethnicity data were not Non-Hispanic Black, Non-Hispanic White, or Hispanic, or if they had other missing data. The primary outcome was SOFA score, with peak score within 24 hours of admission dichotomized as \u3c6 or ‚Č•6. RESULTS: Of 2982 patients admitted with COVID-19, 2320 met inclusion criteria and were analyzed, of whom 1058 (45.6%) were Non-Hispanic White, 645 (27.8%) were Hispanic, and 617 (26.6%) were Non-Hispanic Black. Median age was 65.0 and 1226 (52.8%) were female. In univariate logistic screen and in full multivariate model, Non-Hispanic Black patients but not Hispanic patients had greater odds of an elevated SOFA score ‚Č•6 when compared to Non-Hispanic White patients (OR 1.49, 95%CI 1.11-1.99). INTERPRETATION: Given current unequal patterns in social determinants of health, US crisis standards of care utilizing the SOFA score to allocate medical resources would be more likely to deny these resources to Non-Hispanic Black patients

    Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

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    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

    Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990‚Äď2015: a systematic analysis for the Global Burden of Disease Study 2015

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    BACKGROUND: Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological p ..

    Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study