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Background: The paper examines the role of community-based participatory research (CBPR) within the context of social justice literature and practice. Methods: Two CBPR case studies addressing health inequities related to Type 2 Diabetes and Cardiovascular disease were selected from a national cross-site study assessing effective academic-community research partnerships. One CBPR partnership works with African Americans in rural Pemiscot County, Missouri and the other CBPR partnership works with African American and Latinos in urban South Bronx, New York City. Data collection included semi-structured key informant interviews and focus groups. Analysis focused on partnerships' context/ history and their use of multiple justice-oriented strategies to achieve systemic and policy changes in order to address social determinants of health in their communities. Results: Community context and history shaped each partnership's strategies to address social determinants. Four social justice approaches (identity/recognition, procedural, distributive, and structural justice) used by both partnerships were identified. These social justice approaches were employed to address underlying causes of inequitable distribution of resources and power structures, while remaining within a scientific research framework. Conclusion: CBPR can bridge the role of science with civic engagement and political participation, empowering community members to become political agents who integrate evidence into their social justice organizing strategies. [ABSTRACT FROM AUTHOR]

Aim: To provide a detailled analysis of the microvascular burden in patients with diabetes hopitalized for COVD‐19. Materials and Methods: We analysed data from the French CORONADO initiative and the UK Association of British Clinical Diabetologists (ABCD) COVID‐19 audit, two nationwide multicentre studies, and the AMERICADO, a multicentre study conducted in New York area. We assessed the association between risk of all‐cause death during hospital stay and the following microvascular complications in patients with diabetes hospitalized for COVID‐19: diabetic retinopathy and/or diabetic kidney disease and/or history of diabetic foot ulcer. Results: Among 2951 CORONADO, 3387 ABCD COVID‐19 audit and 9327 AMERICADO participants, microvascular diabetic complications status was ascertained for 1314 (44.5%), 1809 (53.4%) and 7367 (79.0%) patients, respectively: 1010, 1059 and 1800, respectively, had ≥1 severe microvascular complication(s) and 304, 750 and 5567, respectively, were free of any complications. The patients with isolated diabetic kidney disease had an increased risk of all‐cause death during hospital stay: odds ratio [OR] 2.53 (95% confidence interval [CI] 1.66‐3.83), OR 1.24 (95% CI 1.00‐1.56) and OR 1.66 (95% CI 1.40‐1.95) in the CORONADO, the ABCD COVID‐19 national audit and the AMERICADO studies, respectively. After adjustment for age, sex, hypertension and cardiovascular disease (CVD), compared to those without microvascular complications, patients with microvascular complications had an increased risk of all‐cause death during hospital stay in the CORONADO, the ABCD COVID‐19 diabetes national audit and the AMERICADO studies: adjusted OR (adjOR) 2.57 (95% CI 1.69‐3.92), adjOR 1.22 (95% CI 1.00‐1.52) and adjOR 1.33 (95% CI 1.15‐1.53), respectively. In meta‐analysis of the three studies, compared to patients free of complications, those with microvascular complications had an unadjusted OR for all‐cause death during hospital stay of 2.05 (95% CI 1.42‐2.97), which decreased to 1.62 (95% CI 1.19‐2.119) after adjustment for age and sex, and to 1.50 (1.12‐2.02) after hypertension and CVD were further added to the model. Conclusion: Microvascular burden is associated with an increased risk of death in patients hospitalized for COVID‐19. [ABSTRACT FROM AUTHOR]

Objectives: Smoking is a major risk factor for both cardiovascular disease (CVD) and lung cancer. Aortic valve calcification (AVC) and coronary artery calcification (CAC) are both due to atherosclerotic disease. We aim to investigate whether AVC on low-dose CT (LDCT) predicts death from CVD in smokers beyond that provided by CAC. Methods: We reviewed a prospective cohort of 8618 smokers enrolled in LDCT screening for lung cancer in New York State between June 2000 and December 2005. As of December 2009, 169 of the 643 deaths were due to CVD; median follow-up time was 96.4 months. Visual AVC was assessed as being absent (AVC = 0) or present (AVC > 0). CAC ordinal scores of 0–12 were categorized into three validated prognostic categories (0, 1–3, and 4–12). Cox proportional hazards regression analysis was used to assess whether AVC > 0 increased the risk of CVD death, after adjustment for CAC categories and other risk factors. Results: The prevalence of AVC significantly increased (p < 0.0001) with the increasing severity of the CAC categories; Pearson, Spearman, and Kendall's correlation coefficients showed a significant correlation between AVC and CAC with r = 0.29, ρ = 0.32, and τB = 0.28 (all p values < 0.0001), respectively. CAC and AVC were significant predictors of CVD death when considered alone using multivariable Cox regression analysis (adjusted HR of CAC = 1.57, p = 0.04; adjusted HR of AVC = 1.39, p = 0.045). When AVC > 0 and CAC ≥ 4, the hazard ratio was 2.35 (95%CI 1.57–3.50) compared with the reference group of AVC = 0 and CAC < 4, when adjusted for other risk factors. Conclusions: The presence of AVC identified on LDCT is a significant predictor of future CVD death, particularly for those with ordinal CAC score ≥ 4. Key Points: • Aortic valve calcification (AVC) and coronary artery calcification (CAC) are both due to atherosclerotic disease. The prevalence of AVC in lung cancer screening cohort significantly increased with the increasing severity of CAC. • CAC and AVC were significant predictors of cardiovascular disease (CVD) death when considered alone. Participants who underwent lung cancer screening with AVC > 0 and CAC ≥ 4 had more than a 2-fold increased risk of CVD death than the group with AVC = 0 and CAC < 4, when adjusted for other risk factors. [ABSTRACT FROM AUTHOR]

South Asians (SA) develop cardiometabolic disease at elevated rates. We investigate whether reproductive-aged SA women are at higher risk for a precursor condition, polycystic ovary syndrome (PCOS), as compared to Caucasian controls. 52 SA and 52 Caucasian infertility patients from a single institution were included in a cross-sectional analysis. Outcomes were compared using Student's t, Mann-Whitney U, Pearson's Chi-squared and Fisher's exact tests. SA women were younger, with six-fold greater odds of PCOS. SA women were not obese, with similar body mass indices to controls. However, when screened, they demonstrated abundant metabolic disease, including insulin resistance, diabetes and dyslipidemia, and endometrial disease, including hyperplasia and polyps. The SA population was younger with more PCOS and high rates of metabolic and endometrial pathology. These findings, in the context of ethnicity-specific elevations in cardiometabolic risk, highlight the need for comprehensive screening and counseling in this patient population. [ABSTRACT FROM AUTHOR]

There have been few epidemiological studies exploring the link between PTSD and inflammation using population-based samples. This study examined the relation between posttraumatic stress disorder (PTSD) and inflammation-related medical conditions using data from the 2013-2014 New York City Health and Nutrition Examination Survey. Using a representative sample of 1,527 residents in New York City, the association between PTSD and 17 inflammation-related medical conditions were examined. Bivariate and multivariable analyses were conducted, adjusting for demographic characteristics and lifetime depression. PTSD was strongly associated with increased odds for hypercholesterolemia, insulin resistance, angina, heart attack, and emphysema with the greatest odds observed for heart attack (OR= 3.94) and emphysema (OR= 4.06). But PTSD was also associated with lower odds for hypertension, type 1 diabetes, asthma, coronary heart disease, stroke, osteoporosis, and a failing kidney with the lowest odds observed for type 1 diabetes (OR= 0.43). These findings suggest a complex link between PTSD and inflammation-related medical conditions. [ABSTRACT FROM AUTHOR]

In order to effectively address cardiovascular disease among African Americans, evidence-based health information must be disseminated within a context aligned with the values and beliefs of the population. Faith-based organizations play a critical role in meeting the religious and spiritual needs of many African Americans. Additionally, faith-based organizations can be effective in health promotion. A manual was created by incorporating biblical scriptures relating to health messages drawn from existing health manuals oriented toward African Americans. Lay health educators active in their churches participated in a 12-week training to learn the basics of cardiovascular disease and methods for delivering the program to their congregations' members. After the completion of the training, these lay health educators recruited participants from their respective churches and administered their own 12-week HeartSmarts program. Measurements of participants' systolic and diastolic blood pressure (mmHg), height (in.), weight (lbs.), and waist circumference (in.) were taken, and cardiovascular disease knowledge assessments (based on 20 open-ended questions) were administered at the start and end of the 12-week programs. Fourteen predominantly African American churches in NYC participated. Of the 221 participants, 199 completed the program. There were significant reductions in pretest and posttest total participant averages for systolic BP (4.48 mmHg, p < 0.001), diastolic BP (3.38 mmHg, p < 0.001), weight (3lbs., p = 0.001), and BMI (0.46, p = 0.001). Cardiovascular disease health assessment scores had an average increase of 12.74 correct responses ( p < 0.001). The HeartSmarts program may be an effective ecumenical and cultural model for disseminating health messages and reducing cardiovascular risk among African Americans. [ABSTRACT FROM AUTHOR]

Objectives To examine the association between diet and executive function, episodic memory and global verbal cognition in the Einstein Aging Study ( EAS) cohort and determine whether race modifies this relationship. Design Cross-sectional. Setting Community. Participants EAS participants without dementia who completed the Rapid Eating and Activity Assessment for Patients ( REAP) (N = 492). Measurements The previously validated REAP is based on the 2000 U.S. dietary guidelines. REAP scores were dichotomized as less-healthy (

This study demonstrates that patients who are taking 81 mg of aspirin and are nonresponsive benefit from a dose of 162 mg or greater vs a different antiplatelet therapy. We identified 100 patients who were nonresponsive to aspirin 81 mg via whole blood aggregometry and observed how many patients became responsive at a dose of 162 mg or greater. Platelet nonresponsiveness was defined as >10 Ω of resistance to collagen 1 µg/mL and/or an ohms ratio of collagen 1 µg/mL to collagen 5 µg/mL >0.5 and/or >6 Ω to arachidonate. Borderline response was defined as an improvement in 1 but not both of the above criteria. Of the initial 100 patients who were nonresponsive to an aspirin dose of 81 mg, 79% became responsive at a dose of 162 mg or >162 mg. Only 6% did not respond to any increase in dose. We believe that patients treated with low-dose aspirin who have significant risk for secondary vascular events should be individually assessed to determine their antiplatelet response. Those found to have persistent platelet aggregation despite treatment with 81 mg of aspirin have a higher likelihood of obtaining an adequate antiplatelet response at a higher aspirin dose. [ABSTRACT FROM AUTHOR]

Background: Hypertension (HTN) constitutes a risk factor for the development of atrial fibrillation (AF), as well as for thromboembolic and bleeding events. We analysed the outcome after catheter ablation of AF in HTN in a cohort from the prospective multicenter German Ablation Registry. Methods: Between 03/2008 and 01/2010, 626 patients undergoing AF-ablation were analysed. Patients diagnosed with HTN (n = 386) were compared with patients without HTN (n = 240) with respect to baseline, procedural and long-term outcome parameters. Results: Patients with HTN were older and more often presented with persistent forms of AF and cardiac comorbidities. Major and moderate in-hospital complications were low. At long-term follow-up, major cardiovascular events were rare in both groups. Rates of AF-recurrence, freedom from antiarrhythmic medication and repeat ablation were not statistically different between groups. Most patients reported improvement of symptoms and satisfaction with the treatment. However, patients with HTN more frequently complained of dyspnea of New York Heart Association (NYHA) class ≥ II and angina. They were more often rehospitalized, particularly when persistent AF had been diagnosed. Conclusion: Catheter ablation of AF is associated with low complication rates and favorable arrhythmia-related results in patients with HTN. Residual clinical symptoms may be due to cardiac comorbidities and require additional attention in this important subgroup of AF-patients. [ABSTRACT FROM AUTHOR]