Steven S Coughlin, Deepak Nag Ayyala, Justin Xavier Moore, Ban A Majeed, Marlo M Vernon, Hayat Dergaga, John S Luque
Background: African Americans have poorer cardiovascular health and higher chronic disease mortality than non-Hispanic whites. The high burden of chronic diseases among African Americans is a primary cause of disparities in life expectancy between African Americans and whites.
Methods: We conducted a cross-sectional study via a postal survey among a sample of 65 male, African American patients aged ≥ 40 years. The overall objective was to examine the frequency of high blood pressure, high cholesterol, diabetes, myocardial infarction, congestive heart failure, stroke, asthma, emphysema, and cancer among patients treated at Augusta University Health.
Results: A high percentage of study participants (81.5 %) reported a history of high blood pressure; 50.8% had high cholesterol; 44.3% were overweight, 44.3% were obese, and 13.9% were current cigarette smokers. About 36.9% of the men had a reported history of diabetes; 10.8% of the men had a history of heart attack, 13.9% had a history of congestive heart failure, 9.2% had a history of stroke, and 15.4% had a history of prostate cancer. Men who reported a personal history of prostate cancer were significantly more likely to have a history of heart attack and stroke and to be overweight (p < 0.05 in each instance).
Discussion: Additional studies are needed of cardiovascular risk factors and adverse cardiovascular events among African American men, and interventional research aimed at controlling hypertension. Of particular concern is prostate cancer, and whether patients with hypertension, hypercholesterolemia, and diabetes are receiving appropriate therapy to reduce their cardiovascular risk and prevent morbidity and mortality from adverse cardiovascular events.
{"title":"A Health Survey of African American Men Seen at an Academic Medical Center in the Southern United States.","authors":"Steven S Coughlin, Deepak Nag Ayyala, Justin Xavier Moore, Ban A Majeed, Marlo M Vernon, Hayat Dergaga, John S Luque","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>African Americans have poorer cardiovascular health and higher chronic disease mortality than non-Hispanic whites. The high burden of chronic diseases among African Americans is a primary cause of disparities in life expectancy between African Americans and whites.</p><p><strong>Methods: </strong>We conducted a cross-sectional study via a postal survey among a sample of 65 male, African American patients aged ≥ 40 years. The overall objective was to examine the frequency of high blood pressure, high cholesterol, diabetes, myocardial infarction, congestive heart failure, stroke, asthma, emphysema, and cancer among patients treated at Augusta University Health.</p><p><strong>Results: </strong>A high percentage of study participants (81.5 %) reported a history of high blood pressure; 50.8% had high cholesterol; 44.3% were overweight, 44.3% were obese, and 13.9% were current cigarette smokers. About 36.9% of the men had a reported history of diabetes; 10.8% of the men had a history of heart attack, 13.9% had a history of congestive heart failure, 9.2% had a history of stroke, and 15.4% had a history of prostate cancer. Men who reported a personal history of prostate cancer were significantly more likely to have a history of heart attack and stroke and to be overweight (p < 0.05 in each instance).</p><p><strong>Discussion: </strong>Additional studies are needed of cardiovascular risk factors and adverse cardiovascular events among African American men, and interventional research aimed at controlling hypertension. Of particular concern is prostate cancer, and whether patients with hypertension, hypercholesterolemia, and diabetes are receiving appropriate therapy to reduce their cardiovascular risk and prevent morbidity and mortality from adverse cardiovascular events.</p>","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8478342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39472727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.21608/ejcm.2020.68616
S. Bahgat
Background: Hypertension diagnosis in children is difficult because of the multiple sex, age, and height-specific thresholds to define elevated blood pressure (BP). Blood pressureto-height ratio (BPHR) has been used to facilitate the identification of elevated BP in children. Methods: From January to June 2017, a cross-sectional study was conducted for 830 adolescents aged 12 to 15 years in Abu Kabir city, Sharkia governorate, Egypt. Blood pressure tables from the National High Blood Pressure Education Program (NHBPEP) Working Group on High Blood Pressure in Children and Adolescents were used as our standard of comparison. Sex-specific systolic and diastolic blood pressure-to-height ratios (SBPHR and DBPHR) were calculated. Receiver operating Characteristic (ROC) curve analyses were performed to assess the accuracy of BPHR for discriminating between hypertensive and non-hypertensive adolescents. Results: The prevalence of prehypertension and hypertension were 8.4% and 4.9% respectively. Optimal SBPHR and DBPHR thresholds for defining elevated BP were 0.741 and 0.475 in males, respectively, and 0.750 and 0.494 in females, respectively. The sensitivity of SBPHR and DBPHR in both sexes was all above 93%, and specificity in both sexes was above 94%. Positive predictive value for SBPHR and DBPHR was 76.4% for both in males; and 71.4% and 71.6% in females respectively; negative predictive values in both sexes were all above 98%. Conclusions: BPHR is a simple screening tool with high sensitivity and specificity for screening hypertension in adolescents.
{"title":"Determining the Accuracy of Blood Pressure to Height Ratio as a Screening Tool for Hypertension among Egyptian Children","authors":"S. Bahgat","doi":"10.21608/ejcm.2020.68616","DOIUrl":"https://doi.org/10.21608/ejcm.2020.68616","url":null,"abstract":"Background: Hypertension diagnosis in children is difficult because of the multiple sex, age, and height-specific thresholds to define elevated blood pressure (BP). Blood pressureto-height ratio (BPHR) has been used to facilitate the identification of elevated BP in children. Methods: From January to June 2017, a cross-sectional study was conducted for 830 adolescents aged 12 to 15 years in Abu Kabir city, Sharkia governorate, Egypt. Blood pressure tables from the National High Blood Pressure Education Program (NHBPEP) Working Group on High Blood Pressure in Children and Adolescents were used as our standard of comparison. Sex-specific systolic and diastolic blood pressure-to-height ratios (SBPHR and DBPHR) were calculated. Receiver operating Characteristic (ROC) curve analyses were performed to assess the accuracy of BPHR for discriminating between hypertensive and non-hypertensive adolescents. Results: The prevalence of prehypertension and hypertension were 8.4% and 4.9% respectively. Optimal SBPHR and DBPHR thresholds for defining elevated BP were 0.741 and 0.475 in males, respectively, and 0.750 and 0.494 in females, respectively. The sensitivity of SBPHR and DBPHR in both sexes was all above 93%, and specificity in both sexes was above 94%. Positive predictive value for SBPHR and DBPHR was 76.4% for both in males; and 71.4% and 71.6% in females respectively; negative predictive values in both sexes were all above 98%. Conclusions: BPHR is a simple screening tool with high sensitivity and specificity for screening hypertension in adolescents.","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68474690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Graziella B Alves, T. C. Oliveira, Nicole Alessandra Nodari, Larianne Maria Belloto de Francisco, W. Nagata, J. Gomes, K. Bresciani
Leishmaniasis is an important worldwide disease with a zoonotic potential that presenting visceral and cutaneous clinical forms. The domestic dog is seen as the main reservoir of Leishmania spp. and for this reason, it is the target of the control program in some countries. The health professionals’ knowledge about prevention and control of leishmaniasis was investigated. Through interviews with health professionals from endemic regions, it was observed that there are several conceptuais gaps about leishmaniasis. Therefore, it is essential to put into practice the concepts of single health, bringing human, animal and environmental health, next to population. Journal of Community Medicine
{"title":"Health professionals’ knowledge about prevention and control of leishmaniosis","authors":"Graziella B Alves, T. C. Oliveira, Nicole Alessandra Nodari, Larianne Maria Belloto de Francisco, W. Nagata, J. Gomes, K. Bresciani","doi":"10.33582/2637-4900/1011","DOIUrl":"https://doi.org/10.33582/2637-4900/1011","url":null,"abstract":"Leishmaniasis is an important worldwide disease with a zoonotic potential that presenting visceral and cutaneous clinical forms. The domestic dog is seen as the main reservoir of Leishmania spp. and for this reason, it is the target of the control program in some countries. The health professionals’ knowledge about prevention and control of leishmaniasis was investigated. Through interviews with health professionals from endemic regions, it was observed that there are several conceptuais gaps about leishmaniasis. Therefore, it is essential to put into practice the concepts of single health, bringing human, animal and environmental health, next to population. Journal of Community Medicine","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41938187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Entrenched deterrents to obesity prevention necessitate radical measures","authors":"James L DeBoy","doi":"10.33582/2637-4900/1009","DOIUrl":"https://doi.org/10.33582/2637-4900/1009","url":null,"abstract":"","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69455353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Sub Saharan Africa (SSA) continues to exhibit inequalities in HIV epidemic. As of 2017, about 69.5% of people living with HIV, 64% of new infections and 73% HIV-related deaths were in SSA. Most HIV research conducted in the continent has focused on individual-level factors. Objectives: This research identifies social and structural factors that increase vulnerability to HIV; and estimates the effect of community-level factors in increasing vulnerability to HIV infection. Methods: Multilevel binary logistic regression is applied to 39,766 individual cases with HIV test results obtained in 887 clusters of Uganda HIV/AIDS Indicators Survey conducted in 2004-2005 and 2011. Findings: After controlling for individual-level factors, living in a community with a higher proportion of wealthy households (Average Odds Ratio=1.07, CI [1.03–1.11], with more former married individuals (AOR=1.21, CI [1.09–1.33]), with a higher proportion of people drunk with alcohol before unsafe sex (AOR=1.11, CI [1.05–1.18]), and living in a community where a higher proportion of people believe it is okay for a woman to ask her sexual partner to use a condom (AOR=1.08, CI [1.02–1.15]) was significantly associated with being HIV positive. However, living in a community where a higher proportion of men practiced polygamy was associated with reduced vulnerability to the risk of HIV infection (AOR=0.91, CI [0.85–0.98]). Conclusion: Community factors influence vulnerability to the risk of HIV infection in Uganda. Immediate efforts to prevent HIV infection need to focus on community awareness about the influence of these factors, and long-term efforts need to address the broader determinants of these practices.
{"title":"Social and structural vulnerability to HIV infection in Uganda: A multilevel modelling of AIDS indicators survey data, 2004-2005 and 2011","authors":"P. Igulot, M. Magadi","doi":"10.33582/2637-4900/1008","DOIUrl":"https://doi.org/10.33582/2637-4900/1008","url":null,"abstract":"Introduction: Sub Saharan Africa (SSA) continues to exhibit inequalities in HIV epidemic. As of 2017, about 69.5% of people living with HIV, 64% of new infections and 73% HIV-related deaths were in SSA. Most HIV research conducted in the continent has focused on individual-level factors. \u0000 \u0000Objectives: This research identifies social and structural factors that increase vulnerability to HIV; and estimates the effect of community-level factors in increasing vulnerability to HIV infection. \u0000 \u0000Methods: Multilevel binary logistic regression is applied to 39,766 individual cases with HIV test results obtained in 887 clusters of Uganda HIV/AIDS Indicators Survey conducted in 2004-2005 and 2011. \u0000 \u0000Findings: After controlling for individual-level factors, living in a community with a higher proportion of wealthy households (Average Odds Ratio=1.07, CI [1.03–1.11], with more former married individuals (AOR=1.21, CI [1.09–1.33]), with a higher proportion of people drunk with alcohol before unsafe sex (AOR=1.11, CI [1.05–1.18]), and living in a community where a higher proportion of people believe it is okay for a woman to ask her sexual partner to use a condom (AOR=1.08, CI [1.02–1.15]) was significantly associated with being HIV positive. However, living in a community where a higher proportion of men practiced polygamy was associated with reduced vulnerability to the risk of HIV infection (AOR=0.91, CI [0.85–0.98]). \u0000 \u0000Conclusion: Community factors influence vulnerability to the risk of HIV infection in Uganda. Immediate efforts to prevent HIV infection need to focus on community awareness about the influence of these factors, and long-term efforts need to address the broader determinants of these practices.","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45516529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Law has always been the rulebook by which most healthcare professionals guide their medical practice. However and despite healthcare’s founding fathers being esteemed philosophers and ethicists, we rarely use moral or ethical principals to guide the care we provide to patients. In this article, a review of Charity Scott’s essay entitled Why Law Pervades Medicine: An Essay on Ethics in Health Care shows the continued divide between healthcare and legal practitioners and suggests a movement to a higher standard, namely ethics. Journal of Community Medicine
{"title":"Healthcare ethics and the law- Why law pervades medicine","authors":"Al Giwa","doi":"10.33582/2637-4900/1007","DOIUrl":"https://doi.org/10.33582/2637-4900/1007","url":null,"abstract":"Law has always been the rulebook by which most healthcare professionals guide their medical practice. However and despite healthcare’s founding fathers being esteemed philosophers and ethicists, we rarely use moral or ethical principals to guide the care we provide to patients. In this article, a review of Charity Scott’s essay entitled Why Law Pervades Medicine: An Essay on Ethics in Health Care shows the continued divide between healthcare and legal practitioners and suggests a movement to a higher standard, namely ethics. Journal of Community Medicine","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43022970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Result: Smoke pollution is linked to lower-respiratory diseases, heart disease, damage to the brain, liver and kidney, bronchitis and pneumonia. Toxic gases in air due to smoke pollution increases the burden of diseases, including plants getting stunted, water scarcity and water drying up, which could exacerbate domestic poverty and lead to the inability to cover community medicine expenses in many countries. The risks partly arise from inadequately ventilated stoves, burning biomass fuels, such as wood fuel, dung or coal, which impact phenomena that influence the accumulation of greenhouse gases, particularly carbon dioxide, and the accompanying weather changes.
{"title":"Smoke exposure following domestic pollution: Prevention and community medicine improvement","authors":"David Baguma","doi":"10.33582/2637-4900/1006","DOIUrl":"https://doi.org/10.33582/2637-4900/1006","url":null,"abstract":"Result: Smoke pollution is linked to lower-respiratory diseases, heart disease, damage to the brain, liver and kidney, bronchitis and pneumonia. Toxic gases in air due to smoke pollution increases the burden of diseases, including plants getting stunted, water scarcity and water drying up, which could exacerbate domestic poverty and lead to the inability to cover community medicine expenses in many countries. The risks partly arise from inadequately ventilated stoves, burning biomass fuels, such as wood fuel, dung or coal, which impact phenomena that influence the accumulation of greenhouse gases, particularly carbon dioxide, and the accompanying weather changes.","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43829719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The research advancement of fibroblast on diabetic non-healing skin wound","authors":"Juan Du","doi":"10.33582/2637-4900/1005","DOIUrl":"https://doi.org/10.33582/2637-4900/1005","url":null,"abstract":"","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42424758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: African Americans are at the highest risk of having hypertension compared to all other races and ethnicities in the United States. This disparity is compounded by lower rates of medication adherence and blood pressure control among African Americans. Divergence in African American patients’ views of their hypertension from the biomedical model may be an important driver in shaping adherence behaviors and outcomes. Our study sought to identify African American explanatory models (EMs) of hypertension with a focus on disease etiology, in order to increase provider understanding of how African American patients conceptualize their hypertension and how this information can be used to foster provider-patient trust and engagement.
{"title":"Neighborhood and social influences on blood pressure: An exploration of causation in the explanatory models of hypertension among African Americans","authors":"K. Koehler, L. Lewis, P. Cronholm","doi":"10.33582/2637-4900/1002","DOIUrl":"https://doi.org/10.33582/2637-4900/1002","url":null,"abstract":"Objective: African Americans are at the highest risk of having hypertension compared to all other races and ethnicities in the United States. This disparity is compounded by lower rates of medication adherence and blood pressure control among African Americans. Divergence in African American patients’ views of their hypertension from the biomedical model may be an important driver in shaping adherence behaviors and outcomes. Our study sought to identify African American explanatory models (EMs) of hypertension with a focus on disease etiology, in order to increase provider understanding of how African American patients conceptualize their hypertension and how this information can be used to foster provider-patient trust and engagement.","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42209474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although it is commonly thought that patients who LWBS have non urgent medical problems, some studies have shown that they may actually require important medical attention on further consultation, such as hospitalization or surgery [3,4,12] and also, many patients who LWBS seek further medical care elsewhere [13]. As these patients may have important clinical outcomes and therefore require a critical treatment, the health system missed an opportunity of contact with these patients. The rate of patients who LWBS has been considered one of the most important performance indicators for EDs [6,14,15].
{"title":"Emergency department patients who leave without being seen (LWBS): A population-based study in Veneto region, Italy","authors":"M. Saia, M. Fonzo","doi":"10.33582/2637-4900/1001","DOIUrl":"https://doi.org/10.33582/2637-4900/1001","url":null,"abstract":"Although it is commonly thought that patients who LWBS have non urgent medical problems, some studies have shown that they may actually require important medical attention on further consultation, such as hospitalization or surgery [3,4,12] and also, many patients who LWBS seek further medical care elsewhere [13]. As these patients may have important clinical outcomes and therefore require a critical treatment, the health system missed an opportunity of contact with these patients. The rate of patients who LWBS has been considered one of the most important performance indicators for EDs [6,14,15].","PeriodicalId":92921,"journal":{"name":"Journal of community medicine (Reno, Nev.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45038218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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