Community-Based Recruitment Strategies for Young Adult Pacific Islanders into a Randomized Community Smoking Cessation Trial.

BACKGROUND: Lung cancer represents the leading cause of cancer death for Pacific Islanders in the United States, but they remain underrepresented in studies leading to the lack of evidence-based cessation programs tailored to their culture and lifestyle. OBJECTIVES: This paper aims to describe the development of culturally tailored and community informed recruitment materials, and provide lessons learned regarding implementation and adaptation of strategies to recruit Pacific Islander young adult smokers into a randomized cessation study. METHODS: Development of recruitment materials involved a series of focus groups to determine the cessation program logo and recruitment video. The initial recruitment strategy relied on community-based participatory research partnerships with Pacific Islander community-based organizations, leaders and health coaches with strong ties to the community.Results/Lessons Learned: While the recruitment materials were well received, initial strategies tapered off after the first 3 months of recruitment resulting in the need to revise outreach plans. Revised plans included the creation of a list with more than 200 community locations frequented by Pacific Islander young adult smokers, along with the hiring of part-time recruitment assistants who reflected the age and ethnicities of the desired cessation study participants. These materials and strategies ultimately yielded 316 participants, 66% of whom were recruited by the revised strategies. CONCLUSIONS: Community-based participatory research approaches not only inform the design of culturally tailored intervention recruitment material and strategies, but also result in innovative solutions to recruitment challenges to address the National Cancer Institute's gaps in science regarding small populations.

Association Between Stress and Social Support Among Young Adult Pacific Islander Smokers.

Recent studies have found high levels of stress among Americans, particularly amongst young adults and ethnic minority groups. The purpose of this secondary data analysis was to explore the association between stress and social support among a sample of 276 young adult smokers of Pacific Islander ancestry, specifically Samoans and Tongans with an average age of 25.3 years. Previous research had documented the protective role of social support on stress, and thus it is hypothesized that young adult Pacific Islander smokers who perceived higher levels of social support will have less perceived stress. Social support was assessed using a 12-item scale which measured participant's perceived social support from family, friends, and significant others. Perceived stress was measured using a 10-item scale with 2 subscales - self efficacy and helplessness. Standardized parameter estimates from structural equation modeling indicated a statistically significant inverse relationship between perceived social support from family and perceived stress related to helplessness. More specifically, young adult Samoans and Tongans who report higher levels of social support from family do not feel as much stress stemming from being helpless. The results highlight the importance of family social support on stress management among this population. Most importantly, these findings add to the limited research around mental health within Pacific Islander (Samoan and Tongan) communities in the US.

On not 'being there': Making sense of the potent urge for physical proximity in transnational families at the outbreak of the COVID-19 pandemic.

This paper investigates transnational families' experiences of the COVID-19 pandemic outbreak and the accompanying sudden and unexpected travel restrictions. Our data consist of written stories collected in April-June 2020 from migrants with ageing kin living in another country. For many respondents, the situation provoked an acutely felt urge for physical proximity with their families. By analysing their experiences of 'not being there', we seek to understand what exactly made the urge to 'be there' so forceful. Bringing into dialogue literature on transnational families with Jennifer Mason's recent theoretical work on affinities, we move the focus from families' transnational caregiving practices to the potent connections between family members. We argue that this approach can open important avenues for future research on families-transnational or otherwise-because it sheds light on the multisensory and often ineffable charges between family members that serve to connect them.

Delirium in Cardiac Intensive Care Unit.

Delirium is a multifactorial syndrome and is described as an acute brain dysfunction seen commonly in post-cardiac surgery patients. The prevalence of post-operative Delirium (POD) ranges from 11.4% to 55%, depending on the diagnostic tool and type of study. Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) are the two most used and recommended tools by the Society of Intensive Care Medicine. Annual delirium-related healthcare costs in the United States (US) range from 6.6 to 20.4 billion USD in ICU patients. However, delirium in cardiac ICU (CICU) is underdiagnosed and warrants vigorous workup. The risk factors for delirium in CICU can be classified as modifiable, non-modifiable, and cardiac surgical causes. After cardiac procedures, delirium is associated with increased mortality, increased length of hospital stay, loss of functional independence, increased hospital costs, and an independent predictor of death 10 years postoperatively. Non-pharmacological measures such as avoiding delirium-risk medications, early physical rehabilitation, occupational therapy, and sleep improvement strategies have shown significant benefits in decreasing delirium. Pharmacological options are limited for use in CICU, and a need for future studies in this topic is in demand.

Duchenne's Muscular Dystrophy: The Role of Induced Pluripotent Stem Cells and Genomic Editing on Muscle Regeneration.

There are two types of well-known muscular dystrophies: Duchenne's muscular dystrophy (DMD) and Becker's muscular dystrophy. This article focuses on the X-linked recessive disorder of Duchenne's muscular dystrophy, which primarily affects children at age four, with a shortened life span of up to 40 years. A defective dystrophin protein lacking the gene dystrophin is the primary cause of the disease pathophysiology. This defect causes cardiac and skeletal muscle down-regulation of dystrophin, leading to weak and fibrotic muscles. The disease is currently untreatable, so most kids die due to cardiac failure in their late 30's. This review presents current treatment options, based on previous studies conducted over the last five years. We used the PubMed database to analyze and review the most important investigations. We also included an analysis of induced pluripotent stem cell therapy vs. genetic therapy using the mdx mouse model. We have discovered promising results on mdx mouse models to date and excited about the potential for where further clinical human trials can go.

The Critical Role of Cardiac Magnetic Resonance Imaging in Evaluating Patients With Eosinophilic Granulomatosis With Polyangiitis.

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare autoimmune systemic necrotizing vasculitis of blood vessels that often presents with hypereosinophilia. Cardiac involvement in EGPA directly correlates with the mortality of patients with the disease and is a central part of the disease process. The evaluation and treatment of cardiac anomalies are vital in patients with EGPA. The frequency with which cardiac involvement is seen in the disease process makes early diagnosis crucial in all patients with EGPA. Early treatment has been proven to reverse or cause the disease to go into remission. Several studies have shown that cardiac magnetic resonance (CMR) imaging is the most sensitive and best early indicator of cardiovascular involvement in EGPA. CMR routinely outperforms other diagnostic techniques such as ECG (echocardiography) and CTA (computed tomography angiography) in the detection of cardiac anomalies and should be a part of the standardized assessment of all patients with EGPA. CMR is also a non-invasive diagnostic tool that can also outperform biopsy in the detection of EGPA cardiac involvement. CMR is also a valuable technique that can be used to monitor disease progression while treatment is being performed. Although long-term research studies have yet to show these benefits, the studies that are available today provide ample evidence that shows CMR imaging could ultimately help bring down mortality rates currently seen in EGPA patients if it is used as an evaluation tool from initial diagnosis and throughout the entire course of disease management.

The Gut-Brain Axis and Its Role in Depression.

The gut microbiota in humans communicates to the central nervous system through the gut-brain axis, and this communication functions in a bidirectional manner. The backbone of this axis is via the vagus nerve allowing the communication. Research on the functionality of the gut-brain axis is present; however, analysis of the diversity and stratification of the gut microbiota is in its infancy. Through the exploration of various studies focusing on the role of the gut microbiota and its effects on the efficacy of selective serotonin receptor inhibitors (SSRIs) in depression management, many promising alterations in constructive changes have emerged. It has become evident that a set of quantifiable microbial markers have been identified as consistent in the stools of depressive subjects that can be further used to determine the severity of disease progression - the presence of certain bacterial species being a common thread amongst the therapeutic bacteria for depression management. The vagus nerve's role in the gut-brain axis, which is vital to carry out any constructive alterations in the gut microbiota, has been strengthened through evidence of SSRIs depending on the vagus to execute therapeutic effects. This review will focus on the interaction between the diversity of the gut microbiota and investigate its link with depression.

Role of Bicarbonates and Mannitol in Rhabdomyolysis: A Comprehensive Review.

Rhabdomyolysis is characterized by rapid muscle breakdown and release of intracellular muscle components into the circulation. Acute renal injury is the most common and fatal complication of rhabdomyolysis. The current literature emphasizes the importance of preventing rhabdomyolysis and finding the benefits of sodium bicarbonates and mannitol in its prevention. A PubMed database search for the keywords "Rhabdomyolysis," "Sodium bicarbonate use in rhabdomyolysis," "Mannitol use in rhabdomyolysis," and a Medical Subject Headings (MeSH) search using the keyword "Rhabdomyolysis; Acute Kidney Injury (Subheading-Prevention and control)" generated 10,005 articles overall. After a thorough application of inclusion/exclusion criteria, 37 relevant studies were selected for this literature study. This analysis demonstrates that aggressive early volume resuscitation with normal saline should continue being the principal focus of therapy, and the use of sodium bicarbonate and mannitol in practical situations is not entirely justified. This article also emphasizes the need for future research on this topic and provides recommendations for future research.

Reversal of Hartmann's Procedure: Evaluating Outcomes of Single-Port Laparoscopic Approach Versus Conventional Approach.

Bowel restoration following Hartmann's procedure (HP) remains a topic of discussion and innovation. This article seeks to highlight and analyze the outcomes of conventional reversal approaches such as open surgery (OS) and conventional laparoscopic (CL) to single-port laparoscopic reversal (SPLR) approach to evaluate whether SPLR is a feasible alternative to the OS or CL approach. A PubMed search using keywords yielded 5,750 articles. After applying the inclusion/exclusion criteria, 40 articles of relevance were reviewed, and endpoints considered. These included 13 systematic reviews and 27 observational reviews, three of which identified themselves as retrospective or comparative studies. The analysis showed overwhelming support for CL over OS as a choice for HP reversal. Studies comparing SPLR to CL showed SPLR to be a safe and feasible alternative, given its significantly shorter operating times, hospitalization times, and complication rates.

Psychosocial characteristics of smoking patterns among young adult Samoans and Tongans in California.

INTRODUCTION: Despite the high burden of tobacco-related diseases experienced by Samoans and Tongans, there is relatively little understanding of the factors that influence their smoking behaviors which could inform effective smoking cessation strategies. This study examined several psychosocial characteristics that intertwine to predict smoking patterns in these Pacific Islander subgroups. METHODS: Samoans and Tongans between the ages of 18 and 33, who consumed at least 100 cigarettes in their lifetime and were current smokers, were categorized as light, moderate, or heavy smokers. Baseline data from a randomized controlled smoking cessation trial were analyzed. Participants (n = 278) were measured on self-efficacy, perceived stress, sensation seeking, hostility, depression, and impulsivity. Least square means estimated from General Linear Models were used to compare psychosocial characteristics across smoking groups, as well as by gender and ethnicity. RESULTS: Samoan male heavy smokers reported higher levels of self-efficacy compared to light smokers, and greater stress, hostility, depression, and urgency over moderate smokers. Samoan female heavy smokers demonstrated greater stress and hostility than moderate and light smokers. Tongan female heavy and light smokers had significantly elevated levels of sensation seeking compared to moderate smokers. Tongan male smokers did not display any meaningful associations with these psychosocial constructs. CONCLUSIONS: This study underscores the important distinctions between smoking patterns, gender, and ethnic subgroups. Interventions that rely on aggregated smoking profiles or general Pacific Islander data may not adequately address the complex array of mental health factors that contribute to tobacco use.

Design and Outcomes of a Community Trial to Increase Pap Testing in Pacific Islander Women.

BACKGROUND: Pap tests remain an essential cervical cancer detection method in the United States, yet they are underutilized among Pacific Islanders (PI) who experience elevated cervical cancer incidence and mortality. This study describes the design, methods, participants, and outcomes of a multiyear (2010-2016), community-based randomized intervention trial in southern California. Based upon strong collectivistic norms, the trial tested the efficacy of a unique social support intervention targeting Chamorro, Samoan, and Tongan women and their male husbands/partners. METHODS: A single-session educational intervention was designed and tailored for ethnic- and gender-specific groups to increase men's social support for their female wives/partners to receive a Pap test, and for women to receive a Pap test. The comparison group received preexisting brochures on Pap testing (for women) or general men's health (for men). Pretest and 6-month follow-up data were analyzed. RESULTS: Intervention and comparison groups were mostly equivalent on pretest demographics and outcome variables. Intervention women who were not compliant with Pap screening recommendations at pretest were significantly more likely to have scheduled and received a Pap test at 6-month follow-up. However, 6-month follow-up results indicated no intervention effect on changes in women's Pap testing knowledge, fatalistic attitudes, or perceived social support from their male partner. CONCLUSIONS: Ethnic- and gender-tailored community interventions can successfully increase Pap test behaviors for PI women, although more research is needed on the specific pathways leading to behavior change. IMPACT: Collaborative community-based interventions lead to increases in women's cancer prevention and early detection for Pacific Islander and other collectivistic communities.

Biospecimen Education Among Pacific Islanders in Southern California.

Despite increasing rates of cancer, biospecimen donations for cancer research remains low among Pacific Islanders (PIs). To address this disparity, researchers partnered with PI community organizations to develop and test a theory-based culturally tailored educational intervention designed to raise awareness about the issues surrounding biospecimen research. A total of 219 self-identified PI adults in Southern California were recruited to participate in a one-group pre-post design study. Participants completed questionnaires that assessed their knowledge and attitude regarding biospecimen research before and after viewing an educational video and receiving print materials. Results showed that participants' overall knowledge and attitude increased significantly from pre-test to post-test (p < .0001). Over 98% of participants also reported that they would be willing to donate at least one type of biospecimen sample. Efforts such as these that utilize culturally tailored education interventions may be instrumental in improving biospecimen donation rates in the PI community as well as other minority populations.

Linking Formal Child Care Characteristics to Children's Socioemotional Well-Being: A Comparative Perspective.

Most research on formal child care and children's outcomes has focused on single countries. We, however, contend that policy context may moderate the association between formal child care characteristics and children's socioemotional well-being. We examined this by comparing the Netherlands, Finland and the UK; three countries that differ regarding family policies. Of these three countries, Finland was recently ranked highest (ranked 1st) with regards to quality of child care in a recent analysis by the Economist, followed by the UK (ranked 3rd) and then the Netherlands (ranked 7th). We hypothesized that children who attend child-care settings in countries with higher-quality formal child-care provision would generally show better socioemotional outcomes. Data from the comparative 'Families 24/7' survey were used, including 990 parents with children aged 0-12. We distinguished between two age groups in our analysis. Results indicated that, compared to the UK, longer hours in formal care were less beneficial in the Netherlands. Furthermore, spending time in formal care during nonstandard hours was more harmful for children in Finland compared to the UK. Lastly, receiving care from multiple caregivers was more disruptive for British children than for Dutch children. No differences were found between Finland and the Netherlands.

Belonging across the lifetime: Time and self in Mass Observation accounts.

Our sense of belonging rarely stands still, yet the research literature has hitherto paid little attention to the temporal nature of belonging. Based on an analysis of 62 Mass Observation Project (MOP) accounts written by people living in the UK aged from their 20s to their 90s, this paper argues that as people age, how they locate belonging in time shifts. This has to do with changing concerns related to belonging, but also to metaphysical issues of temporality and mortality, namely how people experience their own finite lifetime. The paper thus offers an illustrative example of how time can be empirically researched in sociology, with a particular focus on the important role that the future plays in how people construct their 'functional present' (Mead ). The central argument put forward is that time itself can be an important source of belonging, but one that is unequally accessible to people of different ages because of contemporary cultural scripts that present life as a linear progression into the future and construct the future as a more meaningful temporal horizon than the past.

Development of an Online Smoking Cessation Curriculum for Pacific Islanders: A Community-Based Participatory Research Approach.

BACKGROUND: Pacific Islanders (PIs) have one of the highest rates of cigarette use, but evidence-based smoking cessation programs designed specifically for PIs are practically nonexistent. OBJECTIVES: This paper reports on the development of a culturally tailored smoking cessation curriculum designed specifically for young adult PIs using a community-based participatory research (CBPR) approach. This paper demonstrates the shared leadership and equal contribution of community and academic partnerships. METHODS: Together community and academic partners conceptualized and developed a smoking cessation curriculum. Data from formative studies shaped the various components of the educational modules. RESULTS: Eight educational modules were developed through CBPR. Information on the dangers of cigarettes, benefits to cessation, and ways to cope with cravings and stress through cognitive behavioral therapy were offered in both narrative and non-narrative formats. CONCLUSIONS: Use of CBPR is critical in the development of the curriculum because it allowed for the sharing of ideas and knowledge between academics and community members.

Developing an Internet- and Mobile-Based System to Measure Cigarette Use Among Pacific Islanders: An Ecological Momentary Assessment Study.

BACKGROUND: Recent prevalence data indicates that Pacific Islanders living in the United States have disproportionately high smoking rates when compared to the general populace. However, little is known about the factors contributing to tobacco use in this at-risk population. Moreover, few studies have attempted to determine these factors utilizing technology-based assessment techniques. OBJECTIVE: The objective was to develop a customized Internet-based Ecological Momentary Assessment (EMA) system capable of measuring cigarette use among Pacific Islanders in Southern California. This system integrated the ubiquity of text messaging, the ease of use associated with mobile phone apps, the enhanced functionality offered by Internet-based Cell phone-optimized Assessment Techniques (ICAT), and the high survey completion rates exhibited by EMA studies that used electronic diaries. These features were tested in a feasibility study designed to assess whether Pacific Islanders would respond to this method of measurement and whether the data gathered would lead to novel insights regarding the intrapersonal, social, and ecological factors associated with cigarette use. METHODS: 20 young adult smokers in Southern California who self-identified as Pacific Islanders were recruited by 5 community-based organizations to take part in a 7-day EMA study. Participants selected six consecutive two-hour time blocks per day during which they would be willing to receive a text message linking them to an online survey formatted for Web-enabled mobile phones. Both automated reminders and community coaches were used to facilitate survey completion. RESULTS: 720 surveys were completed from 840 survey time blocks, representing a completion rate of 86%. After adjusting for gender, age, and nicotine dependence, feeling happy (P=<.001) or wanting a cigarette while drinking alcohol (P=<.001) were positively associated with cigarette use. Being at home (P=.02) or being around people who are not smoking (P=.01) were negatively associated with cigarette use. CONCLUSIONS: The results of the feasibility study indicate that customized systems can be used to conduct technology-based assessments of tobacco use among Pacific Islanders. Such systems can foster high levels of survey completion and may lead to novel insights for future research and interventions.

Associations Between Women's Perception of Their Husbands'/Partners' Social Support and Pap Screening in Pacific Islander Communities.

Pacific Islanders experience high rates of cervical cancer incidence and mortality. This cross-sectional study examined the extent to which Samoan, Chamorro, and Tongan women's perceived receipt of social support from their husbands or male partners was associated with rates of routine cancer screening- specifically Pap testing. A total of 585 Pacific Islander women who live in the United States completed a self-report survey. Women who reported having a Pap test within the past 3 years had significantly higher scores on support from their husbands/male partners. Furthermore, the relationship of emotional support and informational support with increased Pap testing was significantly stronger for Tongan women. The findings suggest that men play an important role in promoting women's cancer prevention behaviors in Pacific Islander and potentially other collectivistic populations. Incorporating social support messages into interventions may be a simple yet effective strategy to increase women's Pap testing.

Let's Move for Pacific Islander Communities: an Evidence-Based Intervention to Increase Physical Activity.

Pacific Islander (PI) populations of Southern California experience high obesity and low physical activity levels. Given PI's rich cultural ties, efforts to increase physical activity using a community-tailored strategy may motivate members in a more sustainable manner. In this paper, we (1) detail the program adaptation methodology that was utilized to develop the Weaving an Islander Network for Cancer Awareness, Research and Training (WINCART) Center's PI Let's Move Program, a culturally tailored program aimed to increase physical activity levels among members of PI organizations in Southern California, and (2) share the program's pilot evaluation results on individual and organizational changes. The WINCART Center applied the National Cancer Institute's program adaptation guidelines to tailor the evidence-based Instant Recess program to fit the needs of PIs. The end product, the PI Let's Move Program, was piloted in 2012 with eight PI organizations, reaching 106 PI adults. At baseline, 52 % of participants reported that they were not physically active, with the average number of days engaged in medium-intensity physical activity at 2.09 days/week. After the 2-month program, participants increased the number of days that they engaged in medium-intensity physical activity from 2.09 to 2.90 days/week. Post-pilot results found that 82 % of participants reported intentions to engage in physical activity for at least the next 6 months. At baseline, only one organization was currently implementing a physical activity program, and none had implemented an evidence-based physical activity program tailored for PIs. After the 2-month timeframe, despite varying levels of capacity, all eight organizations were able to successfully implement the program. In conclusion, results from our program provide evidence that disparity populations, such as PIs, can be successfully reached through programs that are culturally tailored to both individuals and their community organizations.