Covid-19, Pregnancy, and Vaccinations.

Pregnancy in the presence of COVID-19 increases the risk for illness severity. Data suggest that pregnant women with COVID-19 are more likely to be hospitalized, to be admitted to the intensive care unit, and to require life support. Vaccination is currently considered the most effective preventive intervention against COVID-19 in the United States. However, the unsurprising exclusion of pregnant women as participants in initial COVID-19 vaccine clinical trials has led to a gap in the scientific data regarding the safety profile and subsequent use of COVID-19 vaccine for women who are pregnant. Experts believe current COVID-19 vaccines developed using either mRNA or viral vector vaccine technologies and authorized for emergency use by the United States Food and Drug Administration are unlikely to pose obstetrical or neonatal risks. Still, current vaccination recommendations for women who are pregnant have been both mixed and contradictory. The need to expeditiously identify, collate, and disseminate available vaccine-related safety data is critical to preventing severe illness while also advancing the health and wellness of an underserved high-risk population subgroup.

A Cohort Study Investigating the Psychological Correlates of Vigorous Physical Activity Among African-American Adolescent Females.

As a result of severe acute respiratory syndrome coronavirus 2, there has been a surge in the prevalence and severity of non-syndromic pediatric overweight (NSPO) in the United States. Prevention interventions such as engagement in regular moderate-to-vigorous physical activity have been consistently shown to mitigate the development and maintenance of NSPO. Yet, African-American adolescent females, a subgroup of the population disparately impacted by NSPO, are less likely to engage in regular physical activity. Although multidimensional global self-concept has been identified as a possible predictor of physical activity engagement, dimensional linkage with physical activity engagement among members of this subgroup has yet to be established. This secondary analysis of data from N = 312 urban dwelling African-American adolescent females sought to evaluate the contribution that selected dimensions of global self-concept had on engagement in vigorous physical activity. Findings from a 3-Model hierarchical regression analysis found that in addition to socioeconomic position, several social desirability and competence dimensions of global self-concept were significant predictive contributors to physical activity engagement among members of the study cohort. Specifically, these were the dimensions of physical appearance, romantic appeal, close friendship, social acceptance, and scholastic competence. Although more research is needed, results from this study have important implications for population health.

African-Americans Have a Higher Propensity for Death from COVID-19: Rationale and Causation.

The purpose of this article is to provide an understanding about the mechanisms that contribute to the proliferation of COVID-19 morbidity and mortality among high-risk populations, and especially African-Americans. African-Americans are succumbing to novel SARS-CoV-2 (COVID-19) at an alarming rate. Current data indicate that while African-Americans represent less than 13.4% of the United States' population, they account for one-third of more than 4.77 million persons with verified COVID-19 infections. Currently, more than 50,258 African-Americans have succumbed to the disease. African-Americans are disproportionately impacted by COVID-19 to an extent unobserved in other racial/ethnic subgroups. In addition, this article describes the physiological event inflammation-mediation storming (cytokine storming). Social determinants of health such as income, education, and employment are hypothesized to impact cogent health care delivery for African-Americans. Included in this article are data on clinical outcomes that highlight the role of pre-existing (health disparities) conditions like diabetes, hypertension, cardiovascular disease, obesity, and lung disease, as barriers to optimal outcomes among African-Americans who are hospitalized with COVID-19. Also explored in this article is causation for vascular complications. A further aim of this article is to provide insight into cause and effect rationales for COVID-19 and health disparities, from both biosocial and health inequality perspectives. Linkages between these selected health disparities and COVID-19 are examined to determine possible deteriorating effects of COVID-19. Finally, techniques are offered to render culturally competent care to African-Americans diagnosed with COVID-19 who present concomitantly with health disparities.

What Nurses Should Know About COVID-19.

Coronavirus disease 19 (COVID-19) is a highly infectious illness caused by novel SARS-CoV-2 coronavirus. The World Health Organization recently designated SARS-CoV-2 associated COVID-19 to be a global pandemic. The fear or spread of COVID-19 has touched every continent. The importance of understanding the drivers of COVID-19 on community health is amplified by the ability of SARS-CoV-2 to rapidly change genetic structure, our restricted knowledge about the disease, and limited or non-existent vaccines and treatment options. An understanding of basic COVID-19 epidemiology is a prerequisite for curtailing transmission, preventing morbidity and mortality, developing efficacious vaccines, implementing effective infection control protocols, and applying treatment algorithms.

Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: Review and Appraisal of Current Evidence.

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated coronavirus disease 19 (COVID-19) began ravaging most of the globe in November 2019. In the United States more than 25 million people have been infected with SARS-CoV-2. To date, COVID-19 has killed close to 400,000 U.S. citizens. In the face of limited pharmacotherapies, the current burden of SARS-CoV-2 and COVID-19 signals overwhelming sickness and trillions in healthcare costs ahead. The need to expeditiously identify safe and efficacious prophylaxis and treatment options is critical. Drug repositioning may be a promising strategy toward mitigating the impact of SARS-CoV-2 and COVID-19. This rapid review appraises available evidence on the viability of vintage antimalarial drugs chloroquine (CHQ) and its analog hydroxychloroquine (HCQ) repositioned for SARS-CoV-2 prophylaxis and COVID-19 treatment. Findings suggest neither the use of CHQ nor HCQ singularly, or concomitantly, with azithromycin and/or zinc provide definitive benefits for use against SARS-CoV-2 infection or COVID-19 illness. Moreover, administration of these medications was linked to significant and sometimes fatal complications.

Pregnancy and Postpartum Challenges During COVID-19 for African-African Women.

The purpose of this article is to discern and examine causative factors that are likely to influence the higher consequences of health disparities experienced by pregnant and postpartum African-American women with COVID-19. Although understudied, pregnancy in the presence of COVID-19 increases the risk for illness severity. Data suggest that pregnant women with COVID-19 are more likely to be hospitalized, to be admitted to the intensive care unit, and to require life support. Similarly, COVID-19 poses significant challenges to maternal and obstetric care during the postpartum recovery period. African- American women bear a disproportionately higher morbidity and mortality burden for diseases such as diabetes, obesity, and hypertension. Pre-existing chronic health conditions may place pregnant and postpartum women at a higher risk for developing severe health consequences from COVID-19 before, during, and after delivery. In addition, social determinants of health are hypothesized to modulate the deleterious impact of COVID-19 among pregnant and postpartum African-American women.

Exploration of African-American Nurses' Perceptions Toward Seeking and Utilizing Genetic Information.

Advances in genetics and genomics have revolutionized the treatment possibilities for common diseases. Many treatment prospects demonstrate promise for addressing population health disparities. African-American nurses have a crucial role in facilitating the translation of scientific discovery into real-world practice among at-risk populations. The primary aims of this pilot study were to gain insight into the contextual perspectives of African-American nurses' views about factors that impede, support, and/or promote genetics and genomics knowledge in practice and participation in research. Data were obtained from a focused discussion of N = 6 registered nurses who attended the 2011 National Black Nurses Association (NBNA) annual conference. Utilizing a grounded theory approach, themes extrapolated from the focused discussion included the need for genetic and genomic education, distrust, cultural competency in care interactions, and the role of the NBNA in providing education. Suggestions for explanatory relationships are also presented.

The Community Compass Project: A Community Engagement Model Targeting African-Americans in the Low Country of South Carolina.

Despite cutting edge progress in early detection, risk reduction, and prevention, unique contextual and sociocultural factors contribute to higher mortality rates for selected cancers in African-American men and women. Collaborative community engagement and outreach programming strategies that focus on sustainability and grass-roots organizing can inform health risk disparities, build trust, and allow communities to take ownership of their own health needs. This paper describes a successful evidence-based community engagement intervention woven into the social and interpersonal fabric of the African-American community in Charleston, South Carolina. Through the creation of a coalition of community partners that included the state's only National Cancer Institute designated cancer center, collaboratively developed platforms devoted to population-specific preventive interventions for cancer and obesity education, awareness, and research initiatives were implemented within the identified community.

Rural Health and the Nonemergency Use of Emergency Medical Services.

The use of emergency department (ED) services for nonemergent conditions is common and seems to be growing. At a time when health care reform efforts are focused on delivering the right care, at the right time, and in the right place, understanding access barriers to health care and the impact of these barriers on the achievement of health equity for everyone is critical to achieving identified Healthy People 2020 national objectives. This article describes motivations for nonemergent use of ED services by individuals living in rural southeastern United States.

Non-Biological (Fictive Kin and Othermothers): Embracing the Need for a Culturally Appropriate Pedigree Nomenclature in African-American Families.

Although the Family Health History (FHH) is the most cost-effective tool in the staratification of disense risk, it is not designed to collect information from non-biological family members (NBFM). Significant NBFM, defined as "fictive kin and othermothers," tend to play a major role in the transmission of culture, health promotion, and decision-making; yet, their influence cannot be captured using the standard FHH. Participants attending the National Black Nurses Association (NBNA) 2012 genetic workshop were divided into groups to role-play FHH. All participants (N = 50) indicated difficulties with the standard FHH, ranking collection of sensitive data as the number 1 challenge. Consequently, a new symbol was developed with support from NBNA genetics workshop participants. Having such a symbol afforts an apportunity for inclusion of all NBFM to help guide risk-specific recommendations for disense management, prevention, and health promotion of common chronic diseases. This report will describe the process, presentation, and adoption of the symbol.

A cohort study evaluating the implications of biology, weight status and socioeconomic level on global self-esteem competence among female African-American adolescents.

The link between obesity and self-esteem among minority youth has received minimal empirical evaluation. This study aims to describe the magnitude of risk that body mass index, household income, and transitional age have on global self-esteem levels among African-American adolescents. These analyses were conducted on cross-sectional data obtained from 264 urban-dwelling African-American females between 14 and 18 years of age. Survey data on global self-esteem levels, transitory age, and socioeconomic levels were collected using self-administered questionnaires. Measured height and weight values were used to calculate and categorize weight status according to body mass index. Logistic regression models examined the probability of reporting less than average levels of global self-esteem. Adolescent African-American females residing in low-income households were 10 times more likely to report lower global self-esteem scores than those individuals from more affluent households (95% CI: 1.94, 60.19, p < .001). Neither weight status (95% CI: 0.81, 2.55; p = .26) nor age (95% CI: 0.05, 1.87; p = .82) were significant risk indicators for lower than average levels of global self-esteem among participants in this study. Household income appears to be the greatest predictor of global self-esteem levels. Further research in this area is needed to fully elucidate precursors for psychological health vulnerability and facilitate intervention development.

Views of Black nurses toward genetic research and testing.

PURPOSE: To describe views and beliefs that Black nurses hold regarding several conceptual areas of genetic research and testing. DESIGN: Data were generated using a descriptive, cross-sectional design. The sample consisted of 384 Black nurses attending the 2009 annual conference of the National Black Nurses Association in Las Vegas, Nevada. METHODS: The chi-squared test was used to evaluate group differences by education level, functional area, age, and gender. FINDINGS: One half of the Black nurses surveyed believed the potential for the discriminative misuse of genetic information against minority populations exists. However, 84% of these nurses believed the possibility of information misuse should not be used as a barrier to participation in genetic research and testing by the Black populace. CONCLUSIONS: Black nurses expressed concerns about the potential for discriminatory use of genetic information gleaned from research and testing. Yet, Black nurses recognize the importance of racial-ethnic minority participation in genetic research and testing. CLINICAL RELEVANCE: Participation in genetic research and testing by diverse populations will provide opportunities to improve the healthcare delivery system and aid the eradication of health disparities. More research is needed to clarify factors that contribute to the bifurcation of importance for participation, reluctance to participate, and what interventions might reduce reluctance.