Severe Mpox Among People With Advanced Human Immunodeficiency Virus Receiving Prolonged Tecovirimat in New York City.

Severe mpox has been observed in people with advanced human immunodeficiency virus (HIV). We describe clinical outcomes of 13 patients with advanced HIV (CD4 <200 cells/µL), severe mpox, and multiorgan involvement. Despite extended tecovirimat courses and additional agents, including vaccinia immune globulin, cidofovir, and brincidofovir, this group experienced prolonged hospitalizations and high mortality.

Lessons learned from building an infrastructure for community-engaged research.

Before community-based participatory research (CBPR) can commence an infrastructure needs to be established whereby both academic researchers and community members can participate in CBPR as equitable partners throughout the research process. OBJECTIVES: We describe the key principles of the Brooklyn Health Disparities Center (BHDC), a community-academic-government partnership, to guide the development for an infrastructure to support, increase, and sustain the capacity of academics and community members to engage in CBPR to address cardiovascular health disparities in Brooklyn, New York. METHODS: The guiding principles of the BHDC consist of 1) promoting equitable and collaborative partnerships 2) enhancing research capacity and 3) building/sustaining trust. Delphi survey, youth summer internship programs, and workshops were among the tools utilized in enhancing community capacity. RESULTS: Several lessons were gleaned: design programs that are capable of building trust, skills, capacity, and interest of community members concomitantly; be flexible in terms of the priorities and objectives that the partners seek to focus on as these may change over time; and build a groundswell of local advocates to embrace the research and policy agenda of the BHDC.

Functional capacity is a better predictor of coronary heart disease than depression or abnormal sleep duration in Black and White Americans.

OBJECTIVE: To assess whether functional capacity is a better predictor of coronary heart disease (CHD) than depression or abnormal sleep duration. METHODS: Adult civilians in the USA (n=29,818, mean age 48 ± 18 years, range 18-85 years) were recruited by a cross-sectional household interview survey using multistage area probability sampling. Data on chronic conditions, estimated habitual sleep duration, functional capacity, depressed moods, and sociodemographic characteristics were obtained. RESULTS: Thirty-five percent of participants reported reduced functional capacity. The CHD rates among White and Black Americans were 5.2% and 4%, respectively. Individuals with CHD were more likely to report extreme sleep durations (short sleep [≤ 5h] or long sleep [≥ 9 h]; odds ratio [OR] 1.65, 95% confidence interval [CI] 1.38-1.97; P<0.0001), less likely to be functionally active (anchored by the ability to walk one-quarter of a mile without assistance [OR 6.27, 95% CI 5.64-6.98; P<0.0001]) and more likely to be depressed (OR 1.78, 95% CI 1.60-1.99; P<0.0001) than their counterparts. On multivariate regression analysis adjusting for sociodemographic factors and health characteristics, only functional capacity remained an independent predictor of CHD (OR 1.81, 95% CI 1.42-2.31; P<0.0001). CONCLUSION: Functional capacity was an independent predictor of CHD in the study population, whereas depression and sleep duration were not independent predictors.

Engaging minority high school students as health disparities interns: findings and policy implications of a summer youth pipeline program.

PURPOSE: The purpose of this paper was to describe the development and implementation of a health disparities summer internship program for minority high school students that was created to increase their knowledge of health disparities, provide hands-on training in community-engaged research, support their efforts to advocate for policy change, and further encourage youth to pursue careers in the health professions. PROCEDURES: Fifty-one high school students who were enrolled in a well-established, science-enrichment after-school program in Brooklyn, New York, participated in a 4-week summer internship program. Students conducted a literature review, focus groups/interviews, geographic mapping or survey development that focused on reducing health disparities at 1 of 15 partnering CBOs. FINDINGS: Overall, student interns gained an increase in knowledge of racial/ethnic health disparities. There was a 36.2% increase in students expressing an interest in pursuing careers in minority health post program. The majority of the participating CBOs were able to utilize the results of the student-led research projects for their programs. In addition, research conclusions and policy recommendations based on the students' projects were given to local elected officials. CONCLUSIONS: As demonstrated by our program, community-academic partnerships can provide educational opportunities to strengthen the academic pipeline for students of color interested in health careers and health disparities research.

Beliefs and attitudes toward obstructive sleep apnea evaluation and treatment among blacks.

OBJECTIVE: Although blacks are at higher risk for obstructive sleep apnea (OSA), they are not as likely as their white counterparts to receive OSA evaluation and treatment. This study assessed knowledge, beliefs, and attitudes towards OSA evaluation and treatment among blacks residing in Brooklyn, New York. METHODS: Five focus groups involving 39 black men and women (aged > or =18 years) were conducted at State University of New York (SUNY) Downstate Medical Center in Brooklyn to ascertain barriers preventing or delaying OSA evaluation and treatment. RESULTS: Misconceptions about sleep apnea were a common theme that emerged from participants' responses. Obstructive sleep apnea was often viewed as a type of insomnia, an age-related phenomenon, and as being caused by certain bedtime activities. The major theme that emerged about barriers to OSA evaluation was unfamiliarity with the study environment. Barriers were categorized as: problems sleeping in a strange and unfamiliar environment, unfamiliarity with the study protocol, and fear of being watched while sleeping. Barriers to continuous positive airway pressure (CPAP) treatment adoption were related to the confining nature of the device, discomfort of wearing a mask while they slept, and concerns about their partner's perceptions of treatment. CONCLUSION: Results of this study suggest potential avenues for interventions to increase adherence to recommended evaluation and treatment of OSA. Potential strategies include reducing misconceptions about OSA, increasing awareness of OSA in vulnerable communities, familiarizing patients and their partners with laboratory procedures used to diagnose and treat OSA. We propose that these strategies should be used to inform the development of culturally and linguistically tailored sleep apnea interventions to increase awareness of OSA among blacks who are at risk for OSA and associated comorbidities.