How Journalists Characterize Health Inequalities and Redefine Solutions for Native American Audiences

Many Native American communities experience severe health inequalities, including shorter average lifespan and higher rates of chronic illnesses. Journalism that serves Native Americans is a promising channel for heath communication, but only if scholars first understand the particular cultural contexts of indigenous communities. This research contributes to that goal by investigating how journalists serving Native American communities characterize health and the issues they identify with covering determinants of health. In in-depth interviews (N = 24), journalists contrasted how they cover health issues as embedded in cultural context with shallow, more negative coverage by non-Native media organizations. Interviews also revealed a tension between “medical” and “cultural” models of health, contributing to the oversaturation of certain issues, like diabetes, while other health topics are underrepresented. The journalists also expressed how social determinants and histories of oppression shape health inequalities, illuminating the roles of historical trauma and the destruction of indigenous health beliefs and behaviors. Failure to recognize these issues could stymie efforts to communicate about health issues facing Native American audiences.     

基于多组分分析的痢泻灵片质量标准研究

目的 建立痢泻灵片的质量标准。方法 采用薄层色谱法对痢泻灵片中拳参、穿心莲、苦参进行定性鉴别;采用HPLC对痢泻灵片中穿心莲类成分和苦参碱类成分进行测定。结果 拳参、穿心莲、苦参薄层斑点清晰,分离效果良好,重复性好。穿心莲内酯、新穿心莲内酯、14-去氧穿心莲内酯、脱水穿心莲内酯、苦参碱、氧化苦参碱、槐果碱、氧化槐果碱在各自的浓度范围内线性关系良好,仪器精密度、重复性、稳定性、加样回收率的RSD值均符合要求。结论 建立的方法简单易操作,可用于控制痢泻灵片的质量。     

Incense Use and Cardiovascular Mortality among Chinese in Singapore: The Singapore Chinese Health Study

Background: Incense burning is common in many parts of the world. Although it is perceived that particulate matter from incense smoke is deleterious to health, there is no epidemiologic evidence linking domestic exposure to cardiovascular mortality.Objective: We examined the association between exposure to incense burning and cardiovascular mortality in the Singapore Chinese Health Study.Methods: We enrolled a total of 63,257 Singapore Chinese 45–74 years of age during 1993–1998. All participants were interviewed in person to collect information about lifestyle behaviors, including the practice of burning incense at home. We identified cardiovascular deaths via record linkage with the nationwide death registry through 31 December 2011.Results: In this cohort, 76.9% were current incense users, and most of the current users (89.9%) had burned incense daily for ≥ 20 years. Relative to noncurrent users, current users had a 12% higher risk of cardiovascular mortality [multivariable adjusted hazard ratio (HR) = 1.12; 95% CI: 1.04, 1.20]. The HR was 1.19 (95% CI: 1.03, 1.37) for mortality due to stroke and 1.10 (95% CI: 1.00, 1.21) for mortality due to coronary heart disease. The association between current incense use and cardiovascular mortality appeared to be limited to participants without a history of cardiovascular disease at baseline (HR = 1.16; 95% CI: 1.07, 1.26) but not linked to those with a history (HR = 1.00; 95% CI: 0.86, 1.17). In addition, the association was stronger in never-smokers (HR = 1.12; 95% CI: 1.02, 1.23) and former smokers (HR = 1.19; 95% CI: 1.00, 1.42) than in current smokers (HR = 1.05; 95% CI: 0.91, 1.22).Conclusions: Long-term exposure to incense burning in the home environment was associated with an increased risk of cardiovascular mortality in the study population.Citation: Pan A, Clark ML, Ang LW, Yu MC, Yuan JM, Koh WP. 2014. Incense use and cardiovascular mortality among Chinese in Singapore: The Singapore Chinese Health Study. Environ Health Perspect 122:1279–1284; http://dx.doi.org/10.1289/ehp.1307662     

Risk factors for cooking-related burn injuries in children,WHO Global Burn Registry

ObjectiveTo assess the characteristics of cooking-related burn injuries in children reported to the World Health Organization Global Burn Registry.MethodsOn 1 February 2021, we downloaded data from the Global Burn Registry on demographic and clinical characteristics of patients younger than 19 years. We performed multivariate regressions to identify risk factors predictive of mortality and total body surface area affected by burns.FindingsOf the 2957 paediatric patients with burn injuries, 974 involved cooking (32.9%). More burns occurred in boys (532 patients; 54.6%) than in girls, and in children 2 years and younger (489 patients; 50.2%). Accidental contact and liquefied petroleum caused most burn injuries (729 patients; 74.8% and 293 patients; 30.1%, respectively). Burn contact by explosions (odds ratio, OR: 2.8; 95% confidence interval, CI: 1.4–5.7) or fires in the cooking area (OR: 3.0; 95% CI: 1.3–6.8), as well as the cooking fuels wood (OR: 2.2; 95 CI%: 1.3–3.4), kerosene (OR: 1.9; 95% CI: 1.0–3.6) or natural gas (OR: 1.5; 95% CI: 1.0–2.2) were associated with larger body surface area affected. Mortality was associated with explosions (OR: 7.5; 95% CI: 2.2–25.9) and fires in the cooking area (OR: 6.9; 95% CI: 1.9–25.7), charcoal (OR: 4.6; 95% CI: 2.0–10.5), kerosene (OR: 3.9; 95% CI: 1.4–10.8), natural gas (OR: 3.0; 95% CI: 1.5–6.1) or wood (OR: 2.8; 95% CI: 1.1–7.1).ConclusionPreventive interventions directed against explosions, fires in cooking areas and hazardous cooking fuels should be implemented to reduce morbidity and mortality from cooking-related burn injuries.     

Comparing health and mental health needs, service use, and barriers to services among sexual minority youths and their peers

Using a representative national sample (N = 20,745), this article explores health and mental health needs, service use, and barriers to services among sexual minority youths (SMYs) and heterosexual peers. SMYs were defined by ever having a same-sex romantic attraction or having a recent same-sex romantic relationship or sexual partner. SMYs accounted for 7.5 percent of the sample. Data were analyzed to ascertain prevalence of risks and explore group differences. Compared with peers, SMY self-reports indicated higher prevalence rates on all indicators of health and mental health need. SMYs reported more sexual activity, more sexually transmitted disease diagnoses, a higher perceived risk for HIV/AIDS, and more forgone medical care than peers.Also compared with peers, SMYs reported higher levels of anxiety depression, suicidality, and physical and sexual victimization and higher rates of unmet mental health need. SMYs also reported greater concerns about confidentiality and were less likely to use school-based services.The majority of SMYs reported same-sex attraction only. Social work and other helping professionals should incorporate same-sex attraction questions into assessment protocols to target services for this population. School- and office-based providers must consider whether their services are welcoming and offer sufficient assurances of confidentiality to facilitate access by SMYs.     

Discovery of 1-(3'-aminobenzisoxazol-5'-yl)-3-trifluoromethyl-N-[2-fluoro-4- [(2'-dimethylaminomethyl)imidazol-1-yl]phenyl]-1H-pyrazole-5-carboxyamide hydrochloride (razaxaban), a highly potent, selective, and orally bioavailable factor Xa inhibitor

Modification of a series of pyrazole factor Xa inhibitors to incorporate an aminobenzisoxazole as the P(1) ligand resulted in compounds with improved selectivity for factor Xa relative to trypsin and plasma kallikrein. Further optimization of the P(4) moiety led to compounds with enhanced permeability and reduced protein binding. The SAR and pharmacokinetic profile of this series of compounds is described herein. These efforts culminated in 1-(3'-aminobenzisoxazol-5'-yl)-3-trifluoromethyl-N-[2-fluoro-4-[(2'-dimethylaminomethyl)imidazol-1-yl]phenyl]-1H-pyrazole-5-carboxyamide (11d), a potent, selective, and orally bioavailable inhibitor of factor Xa. On the basis of its excellent in vitro potency and selectivity profile, high free fraction in human plasma, good oral bioavailability, and in vivo efficacy in antithrombotic models, the HCl salt of this compound was selected for clinical development as razaxaban (DPC 906, BMS-561389).     

Smoking among low-income pregnant women: an ethnographic analysis.

This article presents findings from a qualitative study of 53 low-income women who were smokers at the onset of pregnancy. Study participants were interviewed during pregnancy to document smoking trajectories and factors contributing to, or undermining, harm reduction and quit attempts. Thirty percent of women quit smoking completely, 43% engaged in sustained harm reduction, and 26% reduced their smoking levels intermittently. Case studies of women are presented to illustrate reasons for quitting, harm reduction practices, and factors influencing relapse and smoking continuation. Women's motivations to quit are highlighted. Moral identity as a mother was found to be a key motivating factor behind women's quit attempts. Future programs targeting this population would do well to acknowledge moral identity as an issue and recognize the challenges of quitting for women with limited social support and little control over their immediate environment.     

Tobacco use among medical professionals in Kerala, India: the need for enhanced tobacco cessation and control efforts

In developing nations where reductions in tobacco use have not been realized, it is critical that health professionals be encouraged to abstain from tobacco use. Data on tobacco use among health professionals in India are limited. We conducted cross-sectional surveys among 110 male medical school faculty (MSF), 229 physicians (67% male), 1130 medical students (46% male), and 73 female nursing students. Information on tobacco use and quit attempts was collected using structured questionnaires. Among the male respondents, current smokers were 15.1% of MSF, 13.1% of physicians, and 14.1% of medical students. Among current smokers, 42% of MSF and physicians and 51% of medical students had not attempted quitting in the last year. However, one third of MSF and physicians and 16% of medical students had attempted to quit at least 4 times. This is one of the first studies among health care professionals in India. Our findings show that a substantial proportion of physicians and medical students in Kerala continue to smoke. Smoking cessation programs are warranted in medical schools in Kerala. An initiative is presently underway by the authors to incorporate tobacco education into the medical school curriculum.     

Can shelter-based interventions improve treatment engagement in homeless individuals with psychiatric and/or substance misuse disorders?: a randomized controlled trial

BACKGROUND: High proportions of homeless individuals have mental illness and substance use disorders. Few of these individuals engage in consistent treatment, although they are likely to benefit from it. Shelter-based interventions to help this population engage in treatment have not been studied in a rigorous manner. OBJECTIVES: We sought to evaluate the effectiveness of a shelter-based intervention, including intensive outreach by a psychiatric social worker and availability of weekly psychiatrist visits with continuity of care to engage homeless individuals with psychiatric and substance use problems. RESEARCH DESIGN: This was a randomized controlled trial. SUBJECTS: A total of 102 individuals were referred to a shelter-based psychiatric clinic. MEASURES: The primary outcome measure was first appointment attendance at a community mental health center (CMHC). Secondary outcome measures were attendance at second and third CMHC appointments, participation in a substance abuse program, and employment and housing status at shelter exit. RESULTS: Individuals receiving the intervention were more likely to attend > or =1 CMHC appointment (64.7% versus 37.3%, P = 0.006) and to participate in a substance abuse program (51.4% versus 12.5%, P = 0.0006) than those in the control group. There was a trend towards being more likely to attend 2 CMHC visits (33.3% versus 17.7%, P = 0.083), but no significant differences in attending 3 visits, being employed, or having housing. CONCLUSIONS: Shelter-based interventions hold promise for improving treatment engagement in homeless populations with psychiatric and substance use problems. Further study should address how to foster care beyond an initial CMHC appointment and clarify key program components using a wider range of outcome measures.