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1.
Patient Educ Couns ; 115: 107888, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37463555

RESUMO

BACKGROUND: Advancing health equity requires innovative patient education approaches for adapting English-language evidence-based interventions (EBIs) to resonate with multicultural, multilingual audiences. OBJECTIVE: Examine the benefit, functionality, and practical considerations of transcreation (translation + cultural adaptation) as a critical and salient learner-centric process for developing a Spanish-language intervention (photonovella + video): Un examen sencillo para un colon saludable (A simple test for a healthy colon). PATIENT/COMMUNITY INVOLVEMENT: We involved patients/community members in a participatory reflective process, from problem identification to intervention design, development, delivery, and impact measurement. METHODS: A community-based participatory research (CBPR) approach involving formative research plus systematic iterative pretesting and learner verification checks augmented by a community advisory board guided the transcreation processes. RESULTS: Data collected using a learner-centric approach effectively produced a new Spanish-language EBI and substantiated the value of co-learner/co-design methods. Learner-centric methods identified cultural nuances that were treated as knowledge and integrated into the intervention materials and study design. Pilot testing of the intervention among Latinos receiving care at community clinics demonstrated improved initial colorectal cancer screening uptake, awareness, and perceived susceptibility. DISCUSSION: Inherent in the transcreation process was learner involvement that informed essential modification and adaptation of the materials. The transcreation methods led to the development of a culturally salient intervention that maintained theoretical integrity and message intent as well as behavioral activation. Findings have broad implications for the creation and transfer of EBIs to new audiences for greater adoption, engagement, and 'reach' of interventions. PRACTICAL VALUE: Transcreation aligns with a growing paradigm shift in health communication science that brings to light the beneficial effect that construction and application of cultural knowledge has on patient education toward health equity.


Assuntos
Neoplasias Colorretais , Pesquisa Participativa Baseada na Comunidade , Idioma , Participação do Paciente , Humanos , Hispânico ou Latino , Projetos de Pesquisa , Assistência à Saúde Culturalmente Competente , Determinantes Sociais da Saúde , Equidade em Saúde
2.
Sci Total Environ ; 881: 163292, 2023 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-37030387

RESUMO

Wastewater-based surveillance has become an effective tool around the globe for indirect monitoring of COVID-19 in communities. Variants of Concern (VOCs) have been detected in wastewater by use of reverse transcription polymerase chain reaction (RT-PCR) or whole genome sequencing (WGS). Rapid, reliable RT-PCR assays continue to be needed to determine the relative frequencies of VOCs and sub-lineages in wastewater-based surveillance programs. The presence of multiple mutations in a single region of the N-gene allowed for the design of a single amplicon, multiple probe assay, that can distinguish among several VOCs in wastewater RNA extracts. This approach which multiplexes probes designed to target mutations associated with specific VOC's along with an intra-amplicon universal probe (non-mutated region) was validated in singleplex and multiplex. The prevalence of each mutation (i.e. VOC) is estimated by comparing the abundance of the targeted mutation with a non-mutated and highly conserved region within the same amplicon. This is advantageous for the accurate and rapid estimation of variant frequencies in wastewater. The N200 assay was applied to monitor frequencies of VOCs in wastewater extracts from several communities in Ontario, Canada in near real time from November 28, 2021 to January 4, 2022. This includes the period of the rapid replacement of the Delta variant with the introduction of the Omicron variant in these Ontario communities in early December 2021. The frequency estimates using this assay were highly reflective of clinical WGS estimates for the same communities. This style of qPCR assay, which simultaneously measures signal from a non-mutated comparator probe and multiple mutation-specific probes contained within a single qPCR amplicon, can be applied to future assay development for rapid and accurate estimations of variant frequencies.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , SARS-CoV-2/genética , Águas Residuárias , Ontário
3.
Cancer Med ; 12(2): 1869-1877, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35796421

RESUMO

Participation in cancer research trials by minority populations is imperative in reducing disparities in clinical outcomes. Even with increased awareness of the importance of minority patient inclusion in clinical research to improve cancer care and survival, significant barriers persist in accruing and retaining minority patients into clinical trials. This study sought to identify and address barriers to minority accrual to a minimal risk clinical research study in real-time.


Assuntos
Ensaios Clínicos como Assunto , Grupos Minoritários , Humanos , Seleção de Pacientes , Determinantes Sociais da Saúde
4.
Emerg Infect Dis ; 28(9): 1770-1776, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35867051

RESUMO

Wastewater monitoring of SARS-CoV-2 enables early detection and monitoring of the COVID-19 disease burden in communities and can track specific variants of concern. We determined proportions of the Omicron and Delta variants across 30 municipalities covering >75% of the province of Alberta (population 4.5 million), Canada, during November 2021-January 2022. Larger cities Calgary and Edmonton exhibited more rapid emergence of Omicron than did smaller and more remote municipalities. Notable exceptions were Banff, a small international resort town, and Fort McMurray, a medium-sized northern community that has many workers who fly in and out regularly. The integrated wastewater signal revealed that the Omicron variant represented close to 100% of SARS-CoV-2 burden by late December, before the peak in newly diagnosed clinical cases throughout Alberta in mid-January. These findings demonstrate that wastewater monitoring offers early and reliable population-level results for establishing the extent and spread of SARS-CoV-2 variants.


Assuntos
COVID-19 , SARS-CoV-2 , Alberta/epidemiologia , COVID-19/epidemiologia , Humanos , SARS-CoV-2/genética , Águas Residuárias
5.
BMJ Open ; 12(4): e059260, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35365543

RESUMO

OBJECTIVE: Diabetes mellitus (DM) and tuberculosis (TB) comorbidity is evolving into an emerging epidemic globally. In Nigeria, a high burden of both diseases, respectively, exists with limited information on tuberculosis-diabetes mellitus (TB-DM) comorbidity. We determined the fasting blood glucose (FBG) level among patients with TB and factors associated with TB-DM comorbidity in Oyo State, South-west Nigeria. METHODS: A cross-sectional study was conducted among patients with TB aged 15 years and above, who were selected using multistage sampling. Data were collected on patients' biodata, anthropometric measurements and FBG levels using a pretested semistructured questionnaire. The FBG test was conducted on patients with confirmed pulmonary TB (old and newly diagnosed patients with TB) at any stage of anti-TB treatment. Background characteristics and FBG level were summarised using descriptive statistics and factors associated with TB-DM comorbidity were examined at bivariate and multivariable analyses. RESULTS: Of the 404 patients with TB, 30 (7.4%) had impaired fasting glucose and 32 (7.9%) were diagnosed with diabetes. The mean age of the male and female respondents was 41 (±14.2) and 36.8 (±15.0), respectively. Females were more likely than males to have diabetes (10.6% vs 6.3%). Median FBG level for the patients was 88 (IQR: Q1: 99, Q3: 79) mg/dL. Age, marital status and educational level were not associated with TB-DM comorbidity. In the multivariable model, only normal body mass index was independently and significantly associated with diabetes. CONCLUSION: TB-DM was prevalent among the studied population in South-west Nigeria. We recommend the integration of DM screening within the continuum of care for TB management.


Assuntos
Diabetes Mellitus , Tuberculose , Adolescente , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Tuberculose/complicações , Tuberculose/tratamento farmacológico , Tuberculose/epidemiologia
7.
J Psychosoc Oncol ; 37(4): 526-540, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30916616

RESUMO

PURPOSE/OBJECTIVES: Young adult cancer patients undergo stress at a time when their primary source of psychosocial support may be changing. Our goal was to provide insight into the expectations young adult patients and their family caregivers for types of psychosocial support. RESEARCH APPROACH: Semi-structured interviews. PARTICIPANTS: Fifteen patients, 9 caregivers recruited from an AYA clinic. Methodological Approach: Thematic content analysis using the constant comparison method. FINDINGS: Two themes were identified. First, families described coordinating support around strengths to determine who would take on caregiving roles/tasks. Second, families described the importance of patient-caregiver relationship status/history in determining trust and expectations. INTERPRETATION: Family strengths and existing relationships can impact caregiving roles and expectations for families of young adult cancer patients. Implications for Psychosocial Providers: Cancer clinics may need to involve members of the psychosocial provider team to better understand the family dynamics of their patients and how these relate to support.


Assuntos
Cuidadores/psicologia , Relações Familiares/psicologia , Neoplasias/terapia , Adulto , Cuidadores/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Adulto Jovem
8.
J Cancer Educ ; 34(6): 1097-1102, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30083846

RESUMO

The shift from adolescence to adulthood is marked by increased independence from parents. The purpose of this research is to describe types of beneficial support and concordance between young adult cancer patients/survivors and their parents. One-on-one phone interviews were conducted. Data were analyzed with constant comparison and linguistic methods. Fifteen patients and eight mothers participated. Support types most cited included informational, tangible, and emotional. The greatest difference between patients and mothers was in mention of emotional or tangible support. Continued attention to the role of parental support for young adult cancer patients is important for care.


Assuntos
Sobreviventes de Câncer/psicologia , Emoções/fisiologia , Mães/psicologia , Neoplasias/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Apoio Social , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-28959743

RESUMO

INTRODUCTION: Approximately 70,000 adolescent and young adults (AYA) are diagnosed with cancer each year. While advancements in treatment have led to improved prognosis and survival for patients, these same treatments can adversely affect AYA reproductive capacity. Localized treatments such as surgery and radiation therapy may affect fertility by removing or damaging reproductive organs, and systemic therapies such as chemotherapy can be toxic to gonads, (ovaries and testicles), thus affecting fertility and/or endocrine function. This can be traumatic for AYA with cancer as survivors often express desire to have genetic children and report feelings of regret or depression as a result of infertility caused by cancer treatments. AREAS COVERED: Emerging technologies in the field of assisted reproductive technology offer new promise for preserving the reproductive capacity of AYA cancer patients prior to treatment as well as providing alternatives for survivors. The following review revisits contemporary approaches to fertility preservation as well newly developing technologies. EXPERT COMMENTARY: There are several advances in ART that hold promise for patients and survivors. However there are challenges that inhibit uptake including poor communication between providers and patients about risks and fertility preservation options; high costs; and lack of insurance coverage for fertility preservation services.

10.
Afr J Reprod Health ; 17(1): 85-93, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24069737

RESUMO

Delivery of health services to people with hearing impairment is poorly understood in Nigeria and limited research has been done to throw more light on the process involved. This study described experiences of 167 girls with hearing impairment in accessing reproductive health services in Ibadan using a validated questionnaire. Descriptive statistics and binary logistic regression were used to analyze the data. Almost 95.0% of respondents had ever visited health facility for reproductive health issues. Of these 6.2% and 4.6% went for treatment of STIs and pregnancy termination respectively; 36.7% were embarrassed to ask questions in the presence of an interpreter, communication (40.5%) and cost (10.8%) were key barriers to access and 85.6% would use facility if hearing impairment-friendly services are provided. Respondents who were currently working were 20 times more likely to receive services they wanted (OR = 20.29, CI = 1.05-392.16). Availability of certified interpreters and ensuring confidentiality are key to effective service delivery for the hearing impaired.


Assuntos
Acessibilidade aos Serviços de Saúde , Pessoas com Deficiência Auditiva , Serviços de Saúde Reprodutiva , Adolescente , Adulto , Criança , Confidencialidade , Feminino , Humanos , Modelos Logísticos , Gravidez , Inquéritos e Questionários
11.
Vet Hum Toxicol ; 35(5): 406-9, 1993 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-8249261

RESUMO

A rapid and sensitive HPLC method for the determination of chloramphenicol (CAP) residues in albumin and yolk of eggs is described. Conditions of isolation and identification are presented in detail. The detection limit is 10 ppb and the linearity is very good up to 2500 ppb CAP. The recovery of the method is 82 and 77%, and the precision is 6.6 and 11.1% for the albumin and yolk determinations respectively. The method was tested to quantitate CAP residues in eggs of 5 laying hens to which CAP had been administered in feed at a concentration of 800 mg/kg. CAP was detected in albumin and yolk of eggs laid 3 and 8 days after the CAP administration, respectively.


Assuntos
Galinhas , Cloranfenicol/análise , Cromatografia Líquida de Alta Pressão/métodos , Ovos/análise , Contaminação de Alimentos/análise , Animais , Cloranfenicol/administração & dosagem , Cloranfenicol/farmacocinética , Feminino , Reprodutibilidade dos Testes
13.
J Chromatogr ; 295(2): 405-11, 1984 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-6432830

RESUMO

The assay of the complexed (ferrioxamine) and uncomplexed forms of deferoxamine, a strong iron(III) chelating agent, by reversed-phase high-performance liquid chromatography was investigated. Complex formation with trace amounts of iron in the chromatographic system hinders the assay of deferoxamine by causing appearance of unexpected peaks, reaction zones and variations in retention time. By purging the column with deferoxamine and using EDTA in the mobile phase, these adverse effects in the determination of deferoxamine were eliminated. No interference by iron contamination of the chromatographic system was found in the assay of ferrioxamine, which is facilitated by the strong absorption of the analyte at 430 nm.


Assuntos
Desferroxamina/análise , Compostos Férricos/análise , Ferro/análise , Cromatografia Líquida de Alta Pressão/métodos , Ácido Edético , Espectrofotometria/métodos
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