scholarly journals Too Little, Too Late?

2018 ◽  
Vol 25 (2) ◽  
pp. 13-23
Author(s):  
Lilian Milanés ◽  
Joanna Mishtal
Keyword(s):  
Critical Role ◽  
Healthcare Providers ◽  
Young Men ◽  
The United States ◽  
Clinical Environment ◽  
Sexually Transmitted ◽  
Low Expectations ◽  
Research Findings ◽  
Reproductive Healthcare

AbstractScholarship and advocacy work regarding reproductive health have often focused on women’s experiences. Concerns about men’s sexual and reproductive healthcare (SRH) have historically been on the margins in this context. In the United States, young men are at the greatest risk for sexually transmitted infections (STIs), yet are the least likely to seek SRH. Based on research with 18 healthcare providers in a large public Florida university clinic, we examined providers’ perspectives about expanding men’s SRH provision and utilisation. Research findings demonstrate inconsistent provider strategies in treating men’s SRH needs and a clinical environment that has low expectations of men receiving preventive care, further perpetuating the placement of SRH responsibility upon women. This article contributes to applied and medical anthropology scholarship on health inequalities through its discussion of the challenges and barriers that contribute to poor SRH for young men and the critical role of providers in this context.

A taxonomy of the scope and organization of local sexually transmitted disease services for policy and practice

2018 ◽  
Vol 29 (14) ◽  
pp. 1375-1383
Author(s):  
Hector P Rodriguez ◽  
Summer Starling ◽  
Zosha Kandel ◽  
Robert Weech-Maldonado ◽  
Nicholas J Moss ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Discriminant Analysis ◽  
Critical Role ◽  
Transmitted Disease ◽  
The United States ◽  
Incidence Rates ◽  
Contact Tracing ◽  
Cluster Solution ◽  
Local Health ◽  
Sexually Transmitted

Local health departments (LHDs) and their organizational partners play a critical role in controlling sexually transmitted diseases (STDs) in the United States. We examine variation in the differentiation, integration, and concentration (DIC) of STD services and develop a taxonomy describing the scope and organization of local STD services. LHD STD programs (n = 115) in Alabama (AL) and California (CA) responded to surveys assessing STD services available in 2014. K-means cluster analysis identified LHD groupings based on DIC variation. Discriminant analysis validated cluster solutions. Differences in organizational partnerships and scope of STD services were compared by taxonomy category. Multivariable regression models estimated the association of the STD services organization taxonomy and five-year (2010–2014) gonorrhea incidence rates, controlling for county-level sociodemographics and resources. A three-cluster solution was identified: (1) low DIC (n = 74), (2) moderate DIC (n = 31), and (3) high DIC (n = 10). In discriminant analysis, 95% of jurisdictions were classified into the same types as originally assigned through K-means cluster analysis. High DIC jurisdictions were more likely (p < 0.001) to partner with most organizations than moderate and low DIC jurisdictions, and more likely (p < 0.001) to conduct STD needs assessment, comprehensive sex education, and targeted screening. In contrast, contact tracing, case management, and investigations were conducted similarly across jurisdictions. In adjusted analyses, there were no differences in gonorrhea incidence rates by category. Jurisdictions in CA and AL can be characterized into three distinct clusters based on the DIC of STD services. Taxonomic analyses may aid in improving the reach and effectiveness of STD services.

scholarly journals The Emerging Role of Glucagon-like Peptide-1 Receptor Agonists for the Management of NAFLD

2021 ◽  
Author(s):  
Chandani Patel Chavez ◽  
Kenneth Cusi ◽  
Sushma Kadiyala
Keyword(s):  
Evidence Synthesis ◽  
Clinical Care ◽  
Treatment Options ◽  
Critical Role ◽  
Risk Groups ◽  
The United States ◽  
Multidisciplinary Teams ◽  
Consensus Statements ◽  
Meta Analyses

Abstract Context The burden of cirrhosis from NAFLD is reaching epidemic proportions in the United States. This calls for greater awareness among endocrinologists, who often see but may miss the diagnosis in adults with obesity or type 2 diabetes mellitus (T2D) who are at the highest risk. At the same time, recent studies suggest that GLP-1RAs are beneficial versus steatohepatitis (NASH) in this population. This minireview aims to assist endocrinologists to recognize the condition and recent work on the role of GLP-1RAs in NAFLD/NASH. Evidence acquisition Evidence from observational studies, randomized controlled trials, and meta-analyses. Evidence Synthesis Endocrinologists should lead multidisciplinary teams to implement recent consensus statements on NAFLD that call for screening and treatment of clinically significant fibrosis to prevent cirrhosis, especially in the high-risk groups (i.e., people with obesity, prediabetes or T2D). With no FDA-approved agents, weight loss is central to their successful management, with pharmacological treatment options limited today to vitamin E (in people without T2D) and diabetes medications that reverse steatohepatitis, such as pioglitazone or GLP-1RA. Recently the benefit of GLP-1RAs in NAFLD, suggested from earlier trials, has been confirmed in adults with biopsy-proven NASH. In 2021, the FDA also approved semaglutide for obesity management. Conclusion A paradigm change is developing between the endocrinologist’s greater awareness about their critical role to curve the epidemic of NAFLD and new clinical care pathways that include a broader use of GLP-1RAs in the management of these complex patients.

scholarly journals Men and sexual and reproductive healthcare in the Nordic countries: a scoping review

2021 ◽  
Author(s):  
Mazen Baroudi ◽  
Jon Petter Stoor ◽  
Hanna Blåhed ◽  
Kerstin Edin ◽  
Anna-Karin Hurtig
Keyword(s):  
Medical Education ◽  
Healthcare Providers ◽  
Nordic Countries ◽  
Health Policies ◽  
Sexually Transmitted ◽  
Pregnancy And Childbirth ◽  
Knowledge And Attitudes ◽  
Factors Influencing ◽  
Reproductive Healthcare ◽  
The Impact

AbstractContextMen generally seek healthcare less often than women and, other than traditional gender norms, less is known about the explanation. The aim was to identify knowledge gaps and factors influencing men regarding sexual and reproductive healthcare (SRHC) in the Nordic countries.MethodsWe searched PubMed and SveMed+ for peer-reviewed articles published between 2010 and 2020. The analyses identified factors influencing men’s experiences of and access to SRHC.ResultsThe majority of the 68 articles included focused on pregnancy, birth, infertility, and sexually transmitted infections including HIV. During pregnancy and childbirth, men were treated as accompanying partners rather than individuals with their own needs. The knowledge and attitudes of healthcare providers were crucial for their ability to provide SRHC and for the experiences of men. Organizational obstacles, such as women-centred SRHC and no assigned profession, hindered men’s access to SRHC. Lastly, the literature rarely discussed the impact of health policies on men’s access to SRHC.ConclusionsThe identified knowledge gap indicates the necessity of the improved health and medical education of healthcare providers, as well as of health system interventions.

scholarly journals May the force be with you: Transfer of healthy mitochondria from stem cells to stroke cells

2018 ◽  
Vol 39 (2) ◽  
pp. 367-370 ◽  
Author(s):  
Cesar V Borlongan ◽  
Hung Nguyen ◽  
Trenton Lippert ◽  
Eleonora Russo ◽  
Julian Tuazon ◽  
...  
Keyword(s):  
United States ◽  
Stem Cells ◽  
Therapeutic Option ◽  
Critical Role ◽  
The United States ◽  
Brain Disorders ◽  
Mitochondrial Dysfunctions ◽  
Limited Therapeutic Option ◽  
The World

Stroke is a major cause of death and disability in the United States and around the world with limited therapeutic option. Here, we discuss the critical role of mitochondria in stem cell-mediated rescue of stroke brain by highlighting the concept that deleting the mitochondria from stem cells abolishes the cells’ regenerative potency. The application of innovative approaches entailing generation of mitochondria-voided stem cells as well as pharmacological inhibition of mitochondrial function may elucidate the mechanism underlying transfer of healthy mitochondria to ischemic cells, thereby providing key insights in the pathology and treatment of stroke and other brain disorders plagued with mitochondrial dysfunctions.

Association of transcription factor 7-like 2 (TCF7L2) polymorphisms with worse survival in three independent cohorts from the United States, Austria, and Japan in patients with gastric cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4111-4111
Author(s):  
Rita Elie El-Khoueiry ◽  
Takeru Wakatsuki ◽  
Yan Ning ◽  
Wu Zhang ◽  
Dongyun Yang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Target Genes ◽  
Critical Role ◽  
The United States ◽  
Japanese Cohort ◽  
Cell Proliferation And Differentiation ◽  
Negative Prognostic Factor ◽  
The Us ◽  
Pathway Interaction

4111 Background: The Wnt/β-catenin signaling pathwaycontrols cell proliferation and differentiation. Disruption of this pathway has been shown in the majority of colorectal (CRC) and gastric cancer (GC). The TCF7L2 complex plays a critical role in this pathway. Interaction of TCF7L2 and β-catenin results in translocation to the nucleus and leads to up-regulation of target genes, including c-myc and cyclin D1. Previous reports have shown that TCF7L2 polymorphism rs7903146 C/T is associated with CRC risk and outcome; however, the prognostic role of this polymorphism in GC is unknown. Therefore, we tested the hypothesis of whether this polymorphism could predict outcome in GC in three independent cohorts. Methods: A total of 369 patients (pts) with histopathologically-confirmed localized GC were enrolled from Japan (n=169), the US (n=137), and Austria (n=63) between 2002 and 2010. Results: In the US cohort, pts with at least one-T allele ((T/T or C/T; n=46) showed a median TTR of 1.7 yrs vs. 4.4 yrs compared to pts homozygous C/C (n=76) (HR: 2.09 95%CI: 1.21- 3.59, p=0.0053). A similar trend was shown in the Austrian cohort, where pts harboring at least one-T allele (n=25) showed a median DFS of 2.08 yrs vs. 5.42 yrs for pts homozygous C/C (n=38) (HR: 1.79 [95%CI: 0.90-3.55], p=0.092). Moreover, in the Japanese cohort, pts homozygous for T/T demonstrated (n=2) a median DFS of 0.15 yrs vs. 4.82 yrs for pts harboring at least one-C allele (n=165) (HR: 10.5 [95%CI: 2.46-45.5], p=0.001). These results were confirmed in the OS in the US and Japanese cohorts. Pts at least one-T allele (n=46) showed a median OS of 3.3 yrs vs. 5.5 yrs for pts homozygous C/C (n=76) (HR: 2.41 95%CI: 1.28-4.53, p=0.0043) in the US cohort, while pts homozygous T/T showed (n=2) a median OS of 0.22 yrs vs 5.76 yrs for pts harboring at least one-C allele (n=165) (HR: 15.2 [95%CI: 3.50-66.7], p<0.001). Conclusions: TCF7L2 polymorphism was associated with worse prognosis in recurrence in pts with GC in three independently global cohorts. This polymorphism may be negative prognostic factor in GC regardless of ethnicity and etiology, suggesting the importance role of Wnt/β-Catenin signaling in GC.

scholarly journals A Review of Visiting Policies in Intensive Care Units

2015 ◽  
Vol 8 (6) ◽  
pp. 267 ◽  
Author(s):  
Shiva Khaleghparast ◽  
Soodabeh Joolaee ◽  
Behrooz Ghanbari ◽  
Majid Maleki ◽  
Hamid Peyrovi ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Physiological Responses ◽  
Scientific Information ◽  
The United States ◽  
Emotional Function ◽  
Research Findings ◽  
Different Dimensions ◽  
The 1960S

<p>Admission to intensive care units is potentially stressful and usually goes together with disruption in physiological and emotional function of the patient. The role of the families in improving ill patients’ conditions is important. So this study investigates the strategies, potential challenges and also the different dimensions of visiting hours’ policies with a narrative review. The search was carried out in scientific information databases using keywords “visiting policy”, “visiting hours” and “intensive care unit” with no time limitation on accessing the published studies in English or Farsi. Of a total of 42 articles, 22 conformed to our study objectives from 1997 to 2013. The trajectory of current research shows that visiting in intensive care units has, since their inception in the 1960s, always considered the nurses’ perspectives, patients’ preferences and physiological responses, and the outlook for families. However, little research has been carried out and most of that originates from the United States, Europe and since 2010, a few from Iran. It seems that the need to use the research findings and emerging theories and practices is necessary to discover and challenge the beliefs and views of nurses about family-oriented care and visiting in intensive care units.</p>

scholarly journals Dating Behavior and Age at First Time having Premarital Sexual Intercourse on Young Men in Indonesia

2020 ◽  
Vol 8 (T2) ◽  
pp. 119-122
Author(s):  
Uswatun Hasanah Purnama Sari ◽  
Apik Indarty Moedjiono ◽  
Nadjib M. Bustan
Keyword(s):  
Sexual Behavior ◽  
Unwanted Pregnancy ◽  
Young Men ◽  
Health Problems ◽  
Sexual Relations ◽  
Sexually Transmitted ◽  
Role Of Parents ◽  
Premarital Sexual ◽  
First Time

BACKGROUND: Adolescence is a period of growth and development that occurs dynamically and rapidly both physically, psychologically, intellectually, socially, and sexual behavior that is associated with the onset of puberty. Health problems in adolescence are one of the important problems in the lifecycle. One of the health problems of adolescents today is sexual conduct before marriage. This behavior is a sexual behavior that is very risky to cause unwanted pregnancy problems, and risks causing various diseases such as sexually transmitted diseases, and even HIV/AIDS. AIM: The aim of the study was to describe dating behavior and age at first having premarital sexual relations for adolescent boys in Indonesia in 2017. METHODS: This study uses data from the Indonesian Demographic Health Survey (SDKI) in 2017 with the number of male respondents who are not married aged 15–24 years as many as 12,523 person. RESULTS: The results showed that more adolescents who are dating are 7047 people (56.3%) compared to those who are dating who are as many as 5476 people (43.7%). The most age at first having sexual relations with young men is at the age of 17 years, namely, as many as 254 people (20.2%), while the age at first having sexual relations with young at least is at the age of 11 years, as many as two people (0.2%). CONCLUSION: It is suggested to the role of parents, schools, health centers, and health offices in providing information related to comprehensive reproductive health education.

scholarly journals Men and sexual and reproductive healthcare in the Nordic countries: a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e052600
Author(s):  
Mazen Baroudi ◽  
Jon Petter Stoor ◽  
Hanna Blåhed ◽  
Kerstin Edin ◽  
Anna-Karin Hurtig
Keyword(s):  
Contraceptive Use ◽  
Healthcare Providers ◽  
Nordic Countries ◽  
Gender Based Violence ◽  
Knowledge Gaps ◽  
Sexually Transmitted ◽  
Pregnancy And Childbirth ◽  
Factors Influencing ◽  
Reproductive Healthcare ◽  
The Impact

ContextMen generally seek healthcare less often than women and, other than traditional gender norms, less is known about the explanation. The aim was to identify knowledge gaps and factors influencing men regarding sexual and reproductive healthcare (SRHC) in the Nordic countries.MethodsWe searched PubMed and SveMed+ for peer-reviewed articles published between January 2010 and May 2020. The analyses identified factors influencing men’s experiences of and access to SRHC.ResultsThe majority of the 68 articles included focused on pregnancy, birth, infertility and sexually transmitted infections including HIV. During pregnancy and childbirth, men were treated as accompanying partners rather than individuals with their own needs. The knowledge and attitudes of healthcare providers were crucial for their ability to provide SRHC and for the experiences of men. Organisational obstacles, such as women-centred SRHC and no assigned healthcare profession for men’s sexual and reproductive health issues, hindered men’s access to SRHC. Lastly, the literature rarely discussed the impact of health policies on men’s access to SRHC.ConclusionsThe literature lacked the perspectives of specific groups of men such as migrants, men who have sex with men and transmen, as well as the experiences of men in SRHC related to sexual function, contraceptive use and gender-based violence. These knowledge gaps, taken together with the lack of a clear entry point for men into SRHC, indicate the necessity of an improved health and medical education of healthcare providers, as well as of health system interventions.

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