Blacks Research Articles

Impact of Poverty on Stroke Recurrence: A Population-Based Study.

Poverty is associated with greater stroke incidence. The relationship between poverty and stroke recurrence is less clear. In this population-based study, incident strokes within the Greater Cincinnati/Northern Kentucky region were ascertained during the 2015 study period and followed up for recurrence until December 31, 2018. The primary exposure was neighborhood socioeconomic status (nSES), defined by the percentage of households below the federal poverty line in each census tract in 4 categories (≤5%, >5%-10%, >10%-25%, >25%). Poisson regression models provided recurrence rate estimates per 100,000 residents using population data from the 2015 5-year American Community Survey, adjusting for age, sex, and race. In a secondary analysis, Cox models allowed for the inclusion of vascular risk factors in the assessment of recurrence risk by nSES among those with incident stroke. Of 2,125 patients with incident stroke, 245 had a recurrent stroke during the study period. Poorer nSES was associated with increased stroke recurrence, with rates of 12.5, 17.5, 25.4, and 29.9 per 100,000 in census tracts with ≤5%, >5%-10%, >10%-25%, and >25% below the poverty line, respectively (p < 0.01). The relative risk (95% CI) for recurrent stroke among Black vs White individuals was 2.54 (1.91-3.37) before adjusting for nSES, and 2.00 (1.47-2.74) after adjusting for nSES, a 35.1% decrease. In the secondary analysis, poorer nSES (HR 1.74, 95% CI 1.10-2.76 for lowest vs highest category) and Black race (HR 1.31, 95% CI 1.01-1.70) were both independently associated with recurrence risk, though neither retained significance after full adjustment. Age, diabetes, and left ventricular hypertrophy were associated with increased recurrence risk in fully adjusted models. Residents of poorer neighborhoods had a dose-dependent increase in stroke recurrence risk, and neighborhood poverty accounted for approximately one-third of the excess risk among Black individuals. These results highlight the importance of poverty, race, and the intersection of the 2 as potent drivers of stroke recurrence.

Impact of ventricular assist device use on pediatric heart transplant waitlist mortality: Analysis of the scientific registry of transplant recipients database.

Children awaiting heart transplant (Tx) have a high risk of death due to donor organ scarcity. Historically, ventricular assist devices (VADs) reduced waitlist mortality, prompting increased VAD use. We sought to determine whether the VAD survival benefit persists in the current era. Using the Scientific Registry of Transplant Recipients, we identified patients listed for Tx between 3/22/2016 and 9/1/2020. We compared characteristics of VAD and non-VAD groups at Tx listing. Cox proportional hazards models were used to identify risk factors for 1-year waitlist mortality. Among 5054 patients, 764 (15%) had a VAD at Tx listing. The VAD group was older with more mechanical ventilation and renal impairment. Unadjusted waitlist mortality was similar between groups; the curves crossed ~90 days after listing (p = .55). In multivariable analysis, infant age (HR 2.77, 95%CI 2.13-3.60), Black race (HR 1.57, 95%CI 1.31-1.88), congenital heart disease (HR 1.23, 95%CI 1.04-1.46), renal impairment (HR 2.67, 95%CI 2.19-3.26), inotropes (HR 1.28, 95%CI 1.09-1.52), and mechanical ventilation (HR 2.23, 95%CI 1.84-2.70) were associated with 1-year waitlist mortality. VADs were not associated with mortality in the first 90 waitlist days but were protective for those waiting ≥90 days (HR 0.43, 95%CI 0.26-0.71). In the current era, VADs reduce waitlist mortality, but only for those waitlisted ≥90 days. The differential effect by race, size, and VAD type is less clear. These findings suggest that Tx listing without VAD may be reasonable if a short waitlist time is anticipated, but VADs may benefit those expected to wait >90 days.

Gender Stratification, Racial Disparities, and Student Debt Trajectories in the United States

In the United States, post-secondary educational outcomes are stratified by gender, with women attending college and completing their degrees at higher rates. At the same time, student loan debt has become an ubiquitous part of the college process for many pursuing higher education, increasing the financial risks associated with the pursuit of higher education while lessening the financial rewards. Using data from the National Longitudinal Survey of Youth 1997 (NLSY97) of young adults who ever attended a post-secondary institution and growth curve models, we estimate gender disparities in student debt trajectories throughout young adulthood. Building on work on the racialization of the student debt landscape (Houle & Addo 2022), we also investigate the intersection of race and gender, and include both within race gender analyses and within gender racial analyses. Gender differences in student debt at baseline, or at the age of first college enrollment, are large and the gender debt gap grows at 1.2% per year. We document evidence of a curvilinear relationship in student debt in young adulthood, with student debt accumulating at the beginning of the college enrollment period and the rate of increase declining over time as adults age. Women, who start the period with larger amounts of student debt, experience faster growth in their debt accumulation followed by lower declines relative to young adult men. These patterns are magnified among Black young adults, with the gender debt disparity between Black women and Black men growing 3.4% annually. We find no association between gender and student debt trajectories among Latinx and White young adults. Within-gender models highlight the prevalence of the student debt crisis among Black women and Black men. Additional analyses suggest gender differences in debt trajectories are a function of postsecondary and young adult socioeconomic characteristics, reflecting broader societal inequalities that stem from structural elements related to post-secondary schooling and economic status. These patterns may inhibit wealth-building among women and Black adults in the United States.

Black people in Ukraine: A content analysis of TikTok videos documenting discrimination against Black people attempting to flee at the onset of the 2022 Russo-Ukrainian war

This cross-sectional, descriptive study conducted on in June 2022 reviewed 100 TikTok videos using the hashtag #africansinukriane that depicted discrimination against Black people attempting to flee Ukraine at the onset of the war in February 2022. Two of the 16 themes were significant and present in over 50% of videos: raising awareness (67%) and racial discrimination (64%). Videos with elements of physical contact (N = 16, 76.2%), violence (N = 12, 75%), and dehumanization (N = 11, 68.8%) had higher shares than overall media shares. Less than 10% of the videos included dark humor (8%), sharing helpful resources (7%), and appreciation of countries that offered support (5%). Results indicate that videos that include raising awareness (p = .02), racial discrimination (p = .001), on-scene clips or war scenes (p = .007), physical contact (p = .006), and denied entry (p = .022). Their estimated differences in locations indicate that all of these themes were related to higher median shares of the videos. This study supports that TikTok is a place where marginalized groups can raise awareness about injustice and create counternarratives. This study exemplifies international anti-blackness, with implications for health marketing and communication, human rights efforts, refugee health, and targeted mental health and policy support for those displaced by war.

The inescapable haunt(ing): Dressing trans life after death

This article traces the material effects of Black trans death on Black trans life, particularly in the dimensions of aesthetics, fashion and beauty. I use a Black trans hauntological approach to analyse recordings of Balls, film and television, and personal anecdotes of Black transness in order to develop a transtemporal mapping between ghosts and their haunted subjects. On the one hand, my research builds upon a growing field of work in Black queer and trans studies that looks at Black trans life and its relationship with the ‘afterlife’. On the other, it critiques the liberal humanism that grounds much of fashion studies, thus foregrounding subjects, methodologies and worlds that are still under-researched within the field. By focusing on the practice of dressing, and specifically on the autonomous garmenting of trans people, I show how the violated and murdered Black trans person’s haunting can be traced materially. At the centrepiece of this article is the interrogation of how contemporary dressing practices of ‘living’ Black trans people invoke and are possessed by the ghosts of anti-trans violence. Found in the reciprocal relationship of invocation and possession is the mutual care transmitted between and through the barriers of Black trans life and death.

Prevalence and Risk Factors of Distal Symmetric Polyneuropathy Among Predominantly Non-Hispanic Black, Low-Income Patients.

Distal symmetric polyneuropathy (DSP) is a disabling, often painful condition associated with falls and reduced quality of life. Non-Hispanic Black people and people with low income are underrepresented in existing DSP studies; therefore, it is unknown whether data accurately reflect the prevalence, risk factors, and burden of disease in these populations. Patients older than 40 years presenting to an outpatient internal medicine clinic predominantly serving Medicaid patients in Flint, Michigan, were enrolled in a cross-sectional study. Demographics, clinical characteristics, including medication use, anthropomorphic measurements, fasting lipids, and hemoglobin A1c were collected. DSP was defined using the modified Toronto Clinical Neuropathy Score (mTCNS). Multivariable logistic regression was performed to model DSP and undiagnosed DSP as a function of potential risk factors age, metabolic syndrome, and race. DSP burden was measured using Peripheral Neuropathy Quality of Life Instrument-97. Two hundred participants were enrolled, and 169 (85%) completed all data collection. The population was 55% female of mean age (SD) 58.2 years (10.4) and 69% non-Hispanic Black. Among the population, 50% had diabetes, 67% had metabolic syndrome, and 47% had a household income <$20,000. DSP was present in 73% of the population, of which 75% were previously undiagnosed. Neuropathic pain was documented in 57% of participants with DSP. DSP based on mTCNS criteria was associated with older age (odds ratio [OR] 1.1 [95% confidence interval (CI) 1.03-1.2]) and metabolic syndrome (OR 4.4 [1.1-18.1]). Non-Hispanic Black participants had lower odds of DSP (OR 0.1 [0.01-0.4]) than non-Hispanic White and Hispanic participants. DSP burden was high, including increased pain, health-related worry, and poorer quality of life (all p < 0.001). DSP is extremely common and often underrecognized in this predominantly non-Hispanic Black, low-income population and leads to substantial disease burden. Metabolic syndrome is a highly prevalent, modifiable risk factor in this population that should be managed to lower DSP prevalence.

Inequities in naloxone administration among fatal overdose decedents by race and ethnicity in Pennsylvania, 2019-21.

The aim of this study was to characterize the circumstances of drug overdose deaths and determine whether naloxone administration differed by overdose decedent race and ethnicity. Analysis of data on unintentional and undetermined intent drug overdose deaths in Pennsylvania (2019-21) was collected from death certificates and the State Unintentional Drug Overdose Reporting System. Multivariable logistic regression models were adjusted for overdose death circumstances and the odds of naloxone administration were estimated by race/ethnicity and year. The analytical sample included 3386 fatal overdose decedents in 2019, 3864 in 2020 and 3816 in 2021. Evidence of naloxone administration (yes/no) was defined using scene evidence and toxicology reports from coroner and medical examiner records, while race/ethnicity (Hispanic, non-Hispanic Black, non-Hispanic White) was based on the death certificate. In the analytic sample, overdose death rates were the highest among Black people and increased over time (rate per 10 000 population, 2019: 4.3; 2020: 6.1; 2021: 6.5); rates were lowest among White people and remained constant over time (rate per 10 000 population, 2019: 2.6; 2020: 2.7; 2021: 2.6). Throughout all years, Black decedents had approximately 40-50% lower odds of naloxone administration compared with White decedents as referent [2019: odds ratio (OR) = 0.7, 95% confidence interval (CI) = 0.5-0.9; 2020: OR = 0.5, 95% CI = 0.4-0.7; 2021: OR = 0.6, 95% CI = 0.5-0.8], while Hispanic decedents had similar odds of naloxone administration to that of White decedents. After controlling for overdose circumstances in drug overdose deaths in Pennsylvania, USA, from 2019 to 2021, Black people had lower odds of naloxone administration compared with White people, while there were no differences between Hispanic and White people.

Medicine, Reproduction, and Women’s Health at the Orange Valley Plantation, Jamaica

ABSTRACT This article explores the role of hospitals constructed for enslaved people in pre-emancipation Jamaica as inherently conflicted spaces, where health care was provided to the sick and injured while, at the same time, the horrific system of human bondage was reproduced. Hospitals for the enslaved were sites of conflict in terms of their vision, their practices, and the materia medica they employed. We explore these practices and argue that the result was a therapeutic regime and a blended health care experience, provided by free and enslaved health care providers. They employed European, Indigenous, and Afro-Caribbean medicines, which provided a measure of medical assistance, while also serving to increase the enslaved population, and assuage the guilt of white plantation owners. Disturbing as these historical conclusions are, profound health care inequities persist today and disproportionately affect the reproductive health of women of African descent in the Americas.

Race has no impact on prostate cancer-specific mortality, when comparing patients with similar risk of other-cause mortality: An analysis of a population-based cohort.

Other-cause mortality (OCM) can serve as a surrogate for access-to-care. The authors sought to compare prostate cancer-specific mortality (PCSM) in Black versus White men matched based on their calculated OCM risk. The Surveillance, Epidemiology, and End Results (SEER) database was queried for Black and White men diagnosed with prostate cancer between 2004 to 2009, to collect long-term follow-up. A Cox regression was used to calculate the OCM risk using all available covariates. This calculated OCM risk was used to construct a 1:1 propensity score matched (PSM) cohort. Then, a competing-risks multivariable tested the impact of race on PCSM. A total of 94,363 patients were identified, with 19,398 Black men and 74,965 White men. The median (IQR) follow-up was 11.3 years (9.8-12.8). In the unmatched-cohort at 10-years, PCSM and OCM were 5.5% versus 3.5% and 13.8% versus 8.4% in non-Hispanic Black (NHB) versus non-Hispanic White (NHW) patients (all p<.0001). The standardized mean difference was <0.15 for all covariates, indicating a good match. In the matched cohort at 10-years, OCM was 13.6% and 10.0% in NHB versus NHW (p<.0001), whereas the PCSM was 5.3% versus 4.7% (p<.01). On competing-risks multivariable analysis on PCSM, Black men had a hazard ratio of 1.08 (95% confidence interval, 0.98-1.20) compared to White men with a p=.13. The results of this study showed similar PCSM in Black and White patients, when matched with their calculated OCM risk. This report is the first to indicate at a population-based level that race has no impact on PCSM. Prostate cancer is a very common cancer among men and it is associated with health disparities that disproportionately impact Black men compared to White men. There is an on-going discussion of whether disparities between these two groups stem from genetic or environmental factors. This study sought to examine if matching based on overall health status, a proxy for the impact of social determinants of health, mitigated significant differences in outcomes. When matched using risk of death from any cause other than prostate cancer, Black and White men had no significant differences in prostate cancer death.

Reclaiming narratives of empowerment around Black maternal health: a strengths-based, community-informed focus group study

ABSTRACT Objectives Research on Black maternal populations often focuses on deficits that can reinforce biases against Black individuals and communities. The research landscape must shift towards a strengths-based approach focused on the protective assets of Black individuals and communities to counteract bias. This study engaged the local Black community using a strengths-based approach to discuss the assets of Black maternal populations and to inform the design of a future clinical trial focused on reducing Black maternal health disparities. Design Guided by the Theory of Maternal Adaptive Capacity, we conducted three purposive focus group sessions with Black adult community members. The focus groups were semi-structured to cover specific topics, including the strengths of the local community, strengths specific to pregnant community members, how the strengths of community members can support pregnant individuals, and how the strengths of pregnant community members can facilitate a healthy pregnancy. The focus group interviews were transcribed verbatim and analyzed using thematic content analysis. Results Three focus group sessions were conducted with sixteen female individuals identifying as Black or African American. Central themes include (1) the power of pregnancy and motherhood in Black women, (2) challenging negative perceptions and media representation of Black mothers, (3) recognizing history and reclaiming cultural traditions surrounding birth, and (4) community as the foundation of Black motherhood. Conclusion Black community members identified powerful themes on Black maternal health through a strengths-based lens. These focus groups fostered relationships with the Black community, elucidated possible solutions to improve Black women’s health and wellness, and offered direction on our research design and intervention.

Quality of life assessment among ethnically diverse Black prostate cancer survivors: a constructivist grounded theory approach.

Prostate cancer (CaP) is the most common cancer in Black men (BM), and the number of Black CaP survivors is rapidly increasing. Although Black immigrants are among the fastest-growing and most heterogeneous ethnic groups in the USA, limited data exist regarding their CaP experiences. Therefore, this study aimed to explore and model the experiences of ethnically diverse Black men with CaP. In-depth interviews were conducted with 34 participants: native-born BM (NBBM) (n = 17), African-born BM (ABBM) (n = 11), and Caribbean-born BM (CBBM) (n = 6) CaP survivors recruited through QR code-embedded flyers posted in Black businesses, clinics, social media platforms, and existing research networks within the USA. Guided by Charmaz's constructivist grounded theory methodology, the interviews were analyzed using constant comparison following key stages of initial, focused, and theoretical coding using Atlas.ti v23. Participants were thirty-four men aged 49-84years (mean ± SD, 66 ± 8). Most were married (77%), likely to be diagnosed at stage I (35%), and treated with radiotherapy (56%). Our study findings explored the complex trajectory of Black prostate cancer (CaP) survivors, unveiling a comprehensive model termed "Journeying through Unfamiliar Terrain." Comprising three phases and 11 sub-phases, this model uniquely captures the pre-diagnosis awareness and post-treatment adaptation among survivors. The resulting theoretical model delineates the entire CaP survivorship process among BM, providing contextual and conceptual understanding for developing interventions and enhancing patient-centered care for ethnically diverse CaP survivors, pivotal in bridging the gaps in survivorship research and healthcare practices. Black CAP survivors experience significant burdens and challenges that impact their overall quality of life.Understsnding the factors that impact the complex survivorship journey can inform design and implementation ofinterventions to address the multiple challenges and thus improve quality of life.

Out of Breath: Toward a New Origin Story of Public Health.

Problems caused by overcrowding and the simple need to breathe represent one of the major consequences of medical racism. With few exceptions, histories of epidemics, disease prevention, and sanitation often focus on municipal reform efforts to clean up gritty urban centers from London to Paris to New York. This article traces how concerns about ventilation emerged during the transatlantic slave trade and continued to be a problem for Black people throughout the eighteenth, nineteenth and twentieth centuries. The article emphasizes that Black people were not just the victims of medical racism but initiatedmany crusades in the United States to promote better ventilation throughout the twentieth century. This article highlights the work of Black reformers, doctors, and thinkers who fought to create healthy living conditions for Black people.

Genetic analysis and natural history of Parkinson's disease due to the LRRK2 G2019S variant.

The LRRK2 G2019S variant is the most common cause of monogenic Parkinson's disease (PD); however, questions remain regarding the penetrance, clinical phenotype and natural history of carriers. We performed a 3.5-year prospective longitudinal online study in a large number of 1286 genotyped LRRK2 G2019S carriers and 109 154 controls, with and without PD, recruited from the 23andMe Research Cohort. We collected self-reported motor and non-motor symptoms every 6 months, as well as demographics, family histories and environmental risk factors. Incident cases of PD (phenoconverters) were identified at follow-up. We determined lifetime risk of PD using accelerated failure time modelling and explored the impact of polygenic risk on penetrance. We also computed the genetic ancestry of all LRRK2 G2019S carriers in the 23andMe database and identified regions of the world where carrier frequencies are highest. We observed that despite a 1 year longer disease duration (P = 0.016), LRRK2 G2019S carriers with PD had similar burden of motor symptoms, yet significantly fewer non-motor symptoms including cognitive difficulties, REM sleep behaviour disorder (RBD) and hyposmia (all P-values ≤ 0.0002). The cumulative incidence of PD in G2019S carriers by age 80 was 49%. G2019S carriers had a 10-fold risk of developing PD versus non-carriers. This rose to a 27-fold risk in G2019S carriers with a PD polygenic risk score in the top 25% versus non-carriers in the bottom 25%. In addition to identifying ancient founding events in people of North African and Ashkenazi descent, our genetic ancestry analyses infer that the G2019S variant was later introduced to Spanish colonial territories in the Americas. Our results suggest LRRK2 G2019S PD appears to be a slowly progressive predominantly motor subtype of PD with a lower prevalence of hyposmia, RBD and cognitive impairment. This suggests that the current prodromal criteria, which are based on idiopathic PD, may lack sensitivity to detect the early phases of LRRK2 PD in G2019S carriers. We show that polygenic burden may contribute to the development of PD in the LRRK2 G2019S carrier population. Collectively, the results should help support screening programmes and candidate enrichment strategies for upcoming trials of LRRK2 inhibitors in early-stage disease.

Shape analysis of the nasal complex among South African groups from CBCT scans

Three-dimensional (3D) anatomical extraction techniques could help the forensic anthropologist in a precise and inclusive assessment of biological phenotypes for the development of facial reconstruction methods. In this research, the nose morphology and the underlying hard tissue of two South African populations were studied. To this end, a 3D computer-assisted approach based on an automated landmarking workflow was used to generate relevant 3D anatomical components, and shape discrepancies were investigated using a data set of 200 cone-beam computer tomography (CBCT) scans. The anatomical landmarks were placed on the external nose and the mid-facial skeleton (the nasal bones, the anterior nasal aperture, the zygoma, and the maxilla). Shape differences related to population affinity, sex, age, and size were statistically evaluated and visualised using geometric morphometric methods. Population affinity, sexual dimorphism, age, and size affect the nasal complex morphology. Shape variation in the mid-facial region was significantly influenced by population affinity, emphasising that shape variability was specific to the two population groups, along with the expression of sexual dimorphism and the effect of ageing. In addition, nasal complex shape and correlations vary greatly between white and black South Africans, highlighting a need for reliable population-specific 3D statistical nose prediction algorithms.

The importance of developmental assets in HIV prevention behaviors among young black men who have sex with men (MSM)

Developmental assets are critical to the health and wellbeing of youth. The current study examines the influence of developmental assets on PrEP use and HIV testing among YBMSM ages 18–24. Using a cross-sectional survey of YBMSM (N = 225), this study explored the role of external (e.g., family support, other adult support) and internal (e.g., personal responsibility) assets in explaining HIV prevention behaviors. Participants were recruited from Mechanical Turk (M-Turk) internet-based platform, social media sites, and community-based organizations. A path analysis was conducted to investigate the direct/indirect effects of internal and external assets on PrEP use and HIV testing. Family support (β = 0.40, p < 0.001) and other adult support (β = 0.22, p = 0.004) were both associated with personal responsibility. Personal Responsibility (β = 0.15, p = 0.03) and positive identity (β = 0.28, p < 0.001) were both associated with an increase HIV testing. Personal responsibility was positively associated with increased PrEP use (β = 0.30, p < 0.001). Our study results indicated that external assets play a role in helping to build internal assets that support increased HIV testing and PrEP use among YBMSM. Our findings suggest the need for strength-based interventions that help YBMSM build assets and increase HIV prevention behaviors.

Predisposing, Enabling, and Need Factors Driving Palliative Care Use in Head and Neck Cancer.

Characterizing factors associated with palliative care (PC) use in patients with stage III and VI head and neck cancer using Anderson's behavioral model of health service use. A retrospective study of the 2004 to 2020 National Cancer Database.gg METHODS: We used multivariate logistic regression to assess the association of predisposing, enabling, and need factors with PC use. We also investigated the association of these factors with interventional PC type (chemotherapy, radiotherapy, surgery) and refusal of curative treatment in the last 6 months of life. Five percent of patients received PC. "Predisposing factors" associated with less PC use include Hispanic ethnicity (adjusted odds ratio [aOR], 086; 95% confidence interval [CI], 0.76-0.97) and white and black race (vs white: aOR, 1.14; 95% CI, 1.07-1.22). "Enabling factors" associated with lower PC include private insurance (vs uninsured: aOR, 064; 95% CI, 0.53-0.77) and high-income (aOR, 078; 95% CI, 0.71-0.85). "Need factors" associated with higher PC use include stage IV (vs stage III cancer: aOR, 2.25; 95% CI, 2.11-2.40) and higher comorbidity index (vs Index 1: aOR, 1.58; 95% CI, 1.42-1.75). High-income (aOR, 0.78; 95% CI, 0.71-0.85) and private insurance (aOR, 0.6; 95% CI, 0.53, 0.77) were associated with higher interventional PC use and lower curative treatment refusal (insurance: aOR, 0.82; 95% CI, 0.55, 0.67; income aOR, 0.48; 95% CI, 0.44, 0.52). Low PC uptake is attributed to patients' race/culture, financial capabilities, and disease severity. Culturally informed counseling, clear guidelines on PC indication, and increasing financial accessibility of PC may increase timely and appropriate use of this service.

Comorbidities and Treatment Options for Acne Keloidalis Nuchae

Acne keloidalis nuchae (AKN) is a condition that involves chronic inflammation of the hair follicles on the occipital scalp and posterior neck that often progresses to keloid-like plaques. AKN has most commonly been reported to affect postpubertal males of African descent. The cause of AKN has not been definitively described; however, it is likely an inflammatory response to trauma or infection of the scalp. AKN is associated with chronic scalp folliculitis, hidradenitis suppurativa, folliculitis decalvans, acne mechanica, keratosis follicularis spinulosa decalvans, cutis verticis gyrata, metabolic syndrome, acanthosis nigricans, and hypothyroidism. Treatment for AKN begins with topicals, antibiotics, and intralesional steroid injections. Refractory cases are treated with laser and surgery. Isotretinoin, cryotherapy, phototherapy, electrosection, and radiotherapy have also been effective in treating AKN but are less commonly used. In this review, we describe the existing understanding of AKN with a focus on comorbid conditions and available treatment options.

Knowledge and Attitudes of Female Adolescents on the Causes, Effects and Prevention of Vaginal Candidiasis in the Adenta Municipality of the Greater Accra Region of Ghana

Introduction: Among every four women, at least, three of them experience vaginal candidiasis caused by Candida albicans. People with dysfunctional immune system such as the aged, very young children, altered pH and sugar content in vaginal secretions as a result of pregnancy, HIV/AIDS, diabetes, hormonal fluctuations, smoking, black race, oral-contraceptives, obesity and use of broad-spectrum antibiotics increases the frequency to acquiring infection and are therefore vulnerable to fungal infections. Poor hygiene, chemical irritants and the presence of foreign body in the vagina can also cause vaginal candidiasis Objective: This study sought to access the knowledge and attitudes regarding causes, effects and prevention of vaginal candidiasis among female adolescent in the Adenta Municipality. Methods: A cross-sectional design and a multi-stage sampling technique was used to obtain a sample of 403 female adolescents within the Adenta Municipality using a structured questionnaire. The data collected from respondents were collected and entered into Epi Data Entry Client v4.0.2.4.9 and was exported into Stata 14.0 for analysis. All numerical data was analyzed using descriptive statistics. Chi-square, p-values were used to establish the associations between variables. Logistic regression of less than 0.05 were considered statistically significant at 95% confidence interval. Results were presented in tables and graphs. Result: The study revealed that the overall knowledge of respondents was good (54.7%). Majority (57.7%) of the respondents knew poor hygiene to be the major cause of vaginal candidiasis and it can easily be transmitted through sexual intercourse (67.8%). About 97% of the respondents most agreed that sugar intake was a major risk factor of vaginal candidiasis with (39.9%) of them knowing infertility as a major effect of vaginal candidiasis if not treated. Friends (47.5%) and school (41.1%) were seen to be the major source of information regarding vaginal candidiasis. The attitude towards the prevention of candidiasis among female adolescents was good (58.9%). Though, more than 50% of the respondents agreed that candidiasis infection was dangerous, majority (82.7%) of them were unsure of symptoms and therefore (87.6%) agreed that people infected with candidiasis must seek for treatment from the hospital. Having a good knowledge on vaginal candidiasis [AOR=2.56 (95% Cl: 1.57– 4.15), p&lt;0.001] and a good attitude towards it prevention [AOR=1.83 (95% Cl: 1.12–2.99), p&lt;0.015] were positively associated with the effects of vaginal candidiasis. These participants were 3 and 2 times respectively more likely to have good attitudes towards the effects of vaginal candidiasis respectively. Also, the participants who were in a relationship with the opposite sex was statistically significant such that those who were in a relationship were 3 times more likely to be knowledgeable about candidiasis [AOR=2.96 (95% Cl: 1.14 – 7.84), p&lt;0.025] as compared with those who were not in a relationship. In conclusion, female adolescents in the Adenta Municipality had good knowledge on the causes and effects of vaginal candidiasis. Those aged 10-15 years exhibited poor knowledge and attitudes regarding the causes, effects and prevention of vaginal candidiasis. Programs aimed at increasing the knowledge, attitudes of female adolescents on vaginal candidiasis should be implemented and more attention should be given to the adolescents between the ages of 10 and 15 years. The responses given by respondents was seen to be influenced by the socio-demographic characteristics such as age, level of education, religion and ethnic group.

Oral cavity disorders in traditional, ethnic and original people communities

This chapter describes a worrying scenario and the territory of multidisciplinary health work in Brazil, a diverse country: the knowledge on the part of the dentist and the multidisciplinary team about the health of the black population corresponds to a demand in health, since this group has a predisposition to certain diseases, which if diagnosed early, will be possible to contribute to better therapeutic planning, predictability, and a favorable prognosis in certain clinical manifestations. However, such semiological methodological research may also contribute to the investigation and better understanding of oral cavity disorders that occur in members of traditional communities, in addition to displaced people (indigenous and gypsies), in an urban presence in Rio de Janeiro/Brazil. , envisioning better health outcomes for these vulnerable populations. Periodontal disease can be defined as a multifactorial chronic inflammatory process that affects the protective and supporting tissues of the teeth. Several factors related to this process are currently recognized, such as environmental, genetic, socioeconomic, systemic, ethnic factors and individual susceptibility of the host (very well covered technically by Semiology and repertorization). The manifestations of periodontal disease in people of African descent and the possible causal relationships that make them more susceptible (as described for sickle cell anemia) were presented, thus indicating the need for an individualized preventive approach to this population. Habits that are harmful to the health of the oral cavity were also listed. Finally, we emphasize the culminating point that was the meeting in the health space of the 7th ward of the Homeopathy Service of the Hospital Geral Santa Casa da Misericórdia in Rio de Janeiro, when it was possible to talk about the importance of interventions on habits that compromise the style of life and quality of life also contribute to the emergence of oral cavity neoplasms. The path of health promotion via multidisciplinary health education carried out jointly by professionals who are members of Homeopathy institutions in Rio de Janeiro stood out in relevance.

Men of Color, Linked Fate, and Support for Women of Color Candidates

Abstract Scholars are increasingly interested in “of color” identities. Yet, studies of “of color” identities have neglected attention to the gendered identities of men who could be categorized as “of color.” Meanwhile, women of color are playing a growing role in US politics as candidates and elected officials but are underrepresented in comparison with their presence in the population. We investigate whether Black and Latino men express a “men of color” linked fate and whether it has implications for support for women candidates of color. We seek to understand how Black and Latino men’s gender, race, and “of color” identities impact their evaluations of women candidates who are Black, Latina, and “of color” to better understand coalitional possibilities across gender and race lines. We find that Black and Latino men subscribe to “men of color” linked fate, with political consequences.