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tcomes through careful selection of donor candidates.
Minimally invasive aortic valve replacement (MIAVR) requires changes in cannulation strategy and cardiopulmonary bypass (CPB) management when compared to the conventional approach (CAVR). We aimed at evaluating if these differences could influence perfusion-related quality parameters and impair postoperative outcomes.
Overall, 339 consecutive patients underwent MIAVR or CAVR between 2014 and 2020 and were analyzed retrospectively. To account for baseline differences, a propensity-matching analysis was performed, obtaining two groups of 97 patients each.
MIAVR group had longer CPB time [107 (95-120) vs 95 (86-105) min, p = .003] than CAVR group. Of note, average pump flow rate index [2.4 (2.2-2.5) vs 2.7 (2.4-2.8) l/min/m
, p = .004] was lower in the MIAVR group. Mean arterial pressure was 73 = 9 mmHg vs 62 = 11 mmHg for the MIAVR and CAVR group, respectively (p < .001). Cell-salvaged blood was most commonly used in the MIAVR group (25.8% vs 11.3%, p = .02). Finally, CPB temperature was 32.8°C (32.1-34.8) for MIAVR group vs 34.9°C (33.2-36.1) for the CAVR group (p = .02). Postoperative complications were similar between groups.
In conclusion, despite differences in CPB parameters in patients undergoing CAVR and MIAVR, the incidences of adverse outcomes were similar. However, compared to CAVR, MIAVR was associated with shorter durations of mechanical ventilation and hospital stay as well as less transfusion of blood products.
In conclusion, despite differences in CPB parameters in patients undergoing CAVR and MIAVR, the incidences of adverse outcomes were similar. However, compared to CAVR, MIAVR was associated with shorter durations of mechanical ventilation and hospital stay as well as less transfusion of blood products.We tested if Latinx and Black individuals are more likely to somaticize depression compared with their White counterparts. We analyzed 14,745 depression ratings from 4,101 people living with HIV from 2007 to 2014. We calculated the percentage of each depression score accounted for by somatic symptom items (e.g., feeling tired). We analyzed depression scores using generalized estimation equations, which accounts for repeated measures within each person. Somatic symptoms accounted for 70% of depression scores for White patients, 66% for Latinx patients, and 68% for Black patients. Across the 14,745 assessments, adjusting for age and sex, and within-person correlation, the percentage of the depression scores made up of somatic items was lower for Latinx (b = -.03, p less then .0001) and Black patients (b = -.02, p less then .001), compared with White patients. The idea that Latinx and Black individuals are likely to somaticize depression may lead to underdiagnoses and perpetuate stereotypes and inequities that are not supported by empirical data.Immigration has been historically and contemporarily racialized in the United States. Although each immigrant group has unique histories, current patterns, and specific experiences, racialized immigrant groups such as Latino, Asian, and Arab immigrants all experience health inequities that are not solely due to nativity or years of residence but also influenced by conditional citizenship and subjective sense of belonging or othering. Critical race theory and intersectionality provide a critical lens to consider how structural racism might uniquely impact the health of racialized immigrants, and to understand and intervene on the interlocking systems that shape these shared experiences and health consequences. We build on and synthesize the work of prior scholars to advance how society codifies structural disadvantages for racialized immigrants into governmental and institutional policies and how that affects health via three key pathways that emerged from our review of the literature (1) formal racialization via immigration policy and citizenship status that curtails access to material and health resources and political and civic participation; (2) informal racialization via disproportionate immigration enforcement and criminalization including ongoing threats of detention and deportation; and (3) intersections with economic exploitation and disinvestment such as labor exploitation and neighborhood disinvestment. We hope this serves as a call to action to change the dominant narratives around immigrant health, provides conceptual and methodological recommendations to advance research, and illuminates the essential role of the public health sector to advocate for changes in other sectors including immigration policy, political rights, law enforcement, labor protections, and neighborhood investment, among others.Purpose. Indigenous (Diné) communities have long endured high rates of behavioral and mental health diseases like depression, drug and alcohol dependency, and suicide due to historical trauma and posttraumatic stress disorders. Western research methods used to address these issues have often failed to provide sufficient understanding of the culturally nuanced dynamics underpinning these health disparities in Indigenous contexts. As a result, Indigenous health disparities have actually increased and complex culture-based relationships that influence health outcomes are underconceptualized. Aim. For the first time a community-based participatory research approach from a Diné perspective is introduced to three Navajo communities in New Mexico to collaboratively explore their perspectives about community-engaged research and community well-being from a Diné lens. The overarching research question was Can a community-based participatory research approach embedded within a Diné research paradigm be utilized to develop a culturally centered intervention approach? Methods. The study utilized a mixed method approach that included surveys and focus groups. Results. Six overarching themes emerged that underscored the important role of utilizing a community-based participatory Diné-centered approach to define community well-being and increase community agency to address their own health disparities. Conclusion. Indigenous-centered community-engaged research can potentially become an intervention approach for informing Indigenous communities' understandings of well-being by drawing upon local cultural Indigenous knowledge. This study demonstrated that developing an effective community-engaged research partnership to address health disparities in a Diné context must be informed by a Diné paradigm grounded in local community cultural knowledge.Understanding and addressing health inequities calls for enhanced theoretical and empirical attention to multiple forms of stigma and its influence on health behaviors and health outcomes within marginalized communities. While recent scholarship highlights the role of structural stigma on between-group health disparities, the extant literature has yet to elucidate the mechanisms through which structural stigma gives rise to within-group health disparities. In this article, we review and use relevant literature to inform the development of a conceptual model outlining how structural stigma contributes to within-group health disparities by creating division and tension within communities marginalized due to their social statuses and identities. We specifically focus on disparities among (1) communities of color due to White supremacy, (2) gender and sexual minority communities due to patriarchy and heterosexism, and (3) the disability community due to ableism. We argue that the nature and extent of the stigma members of stigmatized communities face are intricately tied to how visible the stigmatized characteristic is to others. By visibility, we refer to characteristics that are more easily perceived by others, and reveal a person's social identity (e.g., race/ethnicity, nativity, relationship status, gender expression, and disability status). This paper advances the literature by discussing the implications of the model for future research, practice, and policy, including the importance of acknowledging the ways in which structural stigma intentionally disrupts the collective identity and solidarity of communities and consequently threatens health equity.Black and Latino sexual minority men (BLSMM) scholars are well positioned to draw on their unique perspectives and expertise to address the health status and life opportunities (HSLO) of BLSMM. Increasingly, research related to the positionality of scholars of color suggests that the scholar's stance in relation to the community being researched has important implications for the research. Despite growing recognition of the importance of scholar positionality, limited attention has been paid to the relationship between scholar-of-color positionality and improving HSLO trajectories of BLSMM. Furthermore, extant literature fails to specify the mechanisms by which scholar-of-color positionality can improve HSLO among BLSMM. This article seeks to fill this gap in research by arguing that an inadequate consideration of scholar positionality in health and life opportunity research has important implications for the HSLO of BLSMM. A multilevel, mediational model addressing factors at the micro-level (i.e., intrapersonal resources)-BLSMM scholars' personal commitments to BLSMM communities, cultural knowledge and expertise, and shared life experiences; meso-level (i.e., scholar and affected community interactions)-historical membership, mutual interdependency and trust, and community and organizational gatekeeping; and macro-level (i.e., national policies and priorities regarding BLSMM)-national priorities regarding the health and social welfare of BLSMM, allocation of BLSMM research and program funding, societal sentiment, and national investment in the workforce development of BLSMM scholars and clinicians are detailed. In conclusion, we identify recommendations and strategies for advancing scientific, programmatic, and policy efforts, aimed at improving HSLO among communities of BLSMM.Background. Hispanics/Latinos in the United States experience both a health advantage and disadvantage in developing diabetes. Ethnic identity, a predictor of psychological well-being, has not been widely applied to physical health outcomes. The objective of this study is to apply what is known regarding ethnic identity and psychological health to physical health outcomes (diabetes) and to explore the moderating effect of education as a possible underlying mechanism of the Hispanic Health Advantage/Disadvantage. Specifically, this study examines (a) the association between ethnic identity and diabetes prevalence among adult Hispanics/Latinos and (b) determines whether education modifies this relationship. Method. Data come from the nationally representative adult U.S. household study, National Latino and Asian American Study (NLAAS), collected in 2001 to 2003 (N = 1,746). LJH685 Multiple logistic regression was conducted to examine the relationship between ethnic identity, education, and their interaction with likelihood of diabetes. Results. Hispanics/Latinos with high ethnic identity have a higher odds of reporting diabetes among those with 13 to 15 years of education (odds ratio 1.84; 95% confidence interval 1.16-2.92) and a lower odds among those with 16+ years of education (odds ratio 0.53; 95% confidence interval 0.34-0.84). Ethnic identity is associated with diabetes prevalence and the relationship is moderated by educational attainment. Conclusion. Given the growth, diversity, and diabetes disparities among Hispanics/Latinos, our buffering and exacerbating findings exemplify the complexity and fluidity of theory in understanding psychological/behavioral processes. The findings highlight the importance of designing targeted health interventions that take into account the diverse psychosocial and educational experiences of Hispanics/Latinos.
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