ABSTRACT
Post-traumatic headache (PTH) is a common problem in military personnel due to their high rate of traumatic brain injury (TBI). From a prior study in migraine we demonstrated that a high Omega-3/low Omega-6 (H3-L6) diet intervention reduced headache pain, altered circulating anti- and pro-nociceptive lipid mediators and their precursor fatty acids, reduced psychological distress and improved quality-of- life in a chronic headache population. We propose to carry out a 2-arm, parallel group, randomized, controlled 12-week dietary intervention trial to evaluate the biochemical effects and therapeutic efficacy of two dietary interventions (one high in Omega-3 and the other high in Omega-6, reflecting the usual US diet) in patients with PTH that are migrainous. We hypothesize that compared to the Control Diet (high Omega-6, low Omega-3), the H3-L6 intervention will produce significant increases in anti-nociceptive n-3 metabolites including 17- hydroxy DHA (Primary Biochemical Aim), and reductions in pro-nociceptive n-6 metabolites. Further, we hypothesize that compared to the Control Diet, the H3-L6 intervention will produce significant improvement in the Headache Impact Test(a headache-specific quality of life measure-Primary Clinical Outcome), mean total Headache Hours per day, and mean Severe Headache Hours per day.
ABSTRACT
Women from racial and ethnic minority groups face a disproportionate burden of cervical and breast cancers in the United States. The Coronavirus Disease 2019 (COVID-19) pandemic might exacerbate these disparities as supply and demand for screening services are reduced. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides cancer screening services to women with low income and inadequate health insurance. We examined COVID-19's impact on NBCCEDP screening services during January-June 2020. We found the total number of NBCCEDP-funded breast and cervical cancer screening tests declined by 87% and 84%, respectively, during April 2020 compared with the previous 5-year averages for that month. The extent of declines varied by geography, race/ethnicity, and rurality. In April 2020, screening test volume declined most severely in Health and Human Services Region 2 - New York (96% for breast, 95% for cervical cancer screening) compared to the previous 5-year averages. The greatest declines were among American Indian/Alaskan Native women for breast cancer screening (98%) and Asian Pacific Islander women for cervical cancer screening (92%). Test volume began to recover in May and, by June 2020, NBCCEDP breast and cervical cancer screening test volume was 39% and 40% below the 5-year average for that month, respectively. However, breast cancer screening remained over 50% below the 5-year average among women in rural areas. NBCCEDP programs reported assisting health care providers resume screening.