This study examined the ways in which depression affects immigrant Latina women residing in an emerging Latino immigrant community in the United States. Three Spanish-language focus groups were conducted within a community-based participatory research framework. Latina women expressed concerns about their immigration status, separation from family in their native countries, and about finances and inabilities to meet family obligations. They expressed fears for their children in the United States. Their sociopolitical, economic, and familial explanations for depression differ from the individual, biological explanations of depression common today. Implications for policymakers, community organizers, health care providers, public health educators, and school counselors are presented.Este estudio examinó las formas en las que la depresión afecta a mujeres inmigrantes Latinas, que residen en una comunidad de Latinos emergente en los EEUU. Tres grupos focoles en español fueron realizados utilizando el modelo conceptual de investigación comunitaria participativa. Las mujeres Latinas en este estudio expresaron preocupacion por sus estatus de inmigración, la separación de sus familias en sus países, las finanzas, el no poder cumplir con sus obligaciones familiares, y el terror por sus hijos en los EEUU. Sus explicaciones sobre depresión en las areas sociopolíticas, económicas y familiares difieren de las explicaciones individuales y biológicas comunes hoy en día. Las implicancias para quienes diseñan políticas, organizan la comunidad, proveen asistencia médica, proveen educación en salud publica, y son consejeros de escuela son presentados.

Dyspnea is a common chief complaint in the emergency department, with over 4 million visits annually in the US. Establishing the correct diagnosis can be challenging, because the subjective sensation of dyspnea can result from a wide array of underlying pathology, including pulmonary, cardiac, neurologic, psychiatric, toxic, and metabolic disorders. Further, the presence of dyspnea is linked with increased mortality in a variety of conditions, and misdiagnosis of the cause of dyspnea leads to poor patient-level outcomes. In combination with the history and physical, efficient, and focused use of laboratory studies, the various cardiopulmonary biomarkers can be useful in establishing the correct diagnosis and guiding treatment decisions in a timely manner. Use and interpretation of such tests must be guided by the clinical context, as well as an understanding of the current evidence supporting their use. This review discusses current standards and research regarding the use of established and emerging cardiopulmonary laboratory markers in the evaluation of acute dyspnea, focusing on recent evidence assessing the diagnostic and prognostic utility of various tests. These markers include brain natriuretic peptide (BNP) and N-terminal prohormone (NT-proBNP), mid-regional peptides proatrial NP and proadrenomedullin, cardiac troponins, D-dimer, soluble ST2, and galectin 3, and included is a discussion on the use of arterial and venous blood gases.

Background Educational attainment is protective for cardiovascular health (CVH), but the benefits of education may not persist across racial and ethnic groups. Our objective was to determine whether the association between educational attainment and ideal CVH differs by race and ethnicity in a nationally representative sample. Methods and Results Using the National Health and Nutrition Examination Survey, we determined the distribution of ideal CVH, measured by Life’s Simple 7, across levels of educational attainment. We used multivariable ordinal logistic regression to assess the association between educational attainment (less than high school, high school graduate, some college, college graduate) and Life’s Simple 7 category (ideal, intermediate, poor), by race and ethnicity (Asian, Black, Hispanic, White). Covariates were age, sex, history of cardiovascular disease, health insurance, access to health care, and income–poverty ratio. Of 7771 National Health and Nutrition Examination Survey participants with complete data, as level of educational attainment increased, the criteria for ideal health were more often met for most metrics. After adjustment for covariates, effect of education was attenuated but remained significant ( P <0.01). Those with at least a college degree had 4.12 times the odds of having an ideal Life’s Simple 7 compared with less than high school (95% CI, 2.70–5.08). Among all racial and ethnic groups, as level of educational attainment increased, so did Life’s Simple 7. The magnitude of the association between education and CVH varied by race and ethnicity (interaction P <0.01). Conclusions Our findings demonstrate that educational attainment has distinct associations with ideal CVH that differs by race and ethnicity. This work demonstrates the need to elucidate barriers preventing individuals from racial and ethnic minority groups from achieving equitable CVH.

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Study objective: Single parenthood is associated with adverse health outcomes. How cardiovascular risk differs by parenthood status has had limited study. We hypothesized that single parents would have worse cardiovascular risk profiles compared to those in partnered-parent households. Design: We compared associations of parenthood status and the American Heart Association’s Life Simple 7 (LS7), an established metric measuring modifiable components of cardiovascular health (smoking status, body mass index, physical activity, diet, cholesterol, glycohemoglobin, and blood pressure) in multivariable-adjusted models. Participants: We selected adults (age ≥ 25) from the National Health and Nutrition Examination Survey (NHANES) 2015–16 cycle. We defined single parenthood as reporting a child <18 years residing in the home and marital status other than married or living with partner. Main outcome measures: LS7, continuous (range 0–14) and categorized as poor (0–4), intermediate (5–9), or ideal (10–14). Results: In total, 2180 NHANES participants identified as parents and 1782 (82%) had complete LS7 scores. Of these, 462 identified as single parents, of whom 356 (74.9%) were women. Single parents were more likely to smoke, have poor physical activity, and have high blood pressure ( p < 0.01) than partnered parents. Single parents had 1.3-fold greater likelihood of poor cardiovascular health compared with partnered parents, adjusting for age, sex, race/ethnicity, health insurance, healthcare access, poverty index, educational attainment and number of children (95% confidence interval [CI] 1.01–1.71). Conclusions: We identified an association between single parenthood and adverse cardiovascular health. Our results demonstrate the importance of considering household composition in risk assessment and cardiovascular disease prevention.

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There is limited data on maternal cardiac arrest. Case reports are providing some insight into safety and efficacy of certain mechanisms of treatment, including use of extracorporeal membranous oxygenation and thrombolysis, for example. Data increasingly supports the preventability of a significant portion of maternal cardiac arrest, which remains the most important target for intervention. maternal cardiac arrest has increased in incidence over the past several decades but remains a rare event. In recent years, guidelines have emerged in attempt to standardize treatment, although research on best practice is scarce. Ultimately, future progress in targeting the rise in rate of cardiac arrest will come from large scale collaboration in data sharing and development of mechanisms to identify at risk patients to prevent arrest.