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Background: Minoritized communities including refugees are at an increased risk of poorly controlled hypertension. Evidence indicates that self-measured blood pressure monitoring (SMBP) is an effective method to improve blood pressure control in patients with hypertension. However, it has not been studied among refugee populations. The objective of this study is to examine barriers and facilitators to SMBP among Arab refugees resettled in the United States (US) with diagnosed hypertension. Methods: A total of 109 participants were recruited through a Federally Qualified Health Center system that is a major provider of healthcare to refugees in San Diego, California. Participants completed a questionnaire and were interviewed using in-depth, semi-structured interviews. Interviews were transcribed and translated, and data were coded using inductive thematic analysis and organized based on the theory of care-seeking behavior. Results: Several barriers to engaging in effective SMBP monitoring were identified. Clinical and sociodemographic barriers included reliance on public monitors and poor hypertension literacy. Psychosocial barriers of affect, norms, and habits included fear and anxiety from hypertension, cultural stigma of illness, and conditional SMBP with symptoms, respectively. Utility psychosocial barriers included lack of SMBP prioritization in treatment and perceived inaccuracy of home monitors. Family members' support with home monitoring served as an important facilitator to SMBP. Conclusions: There are several barriers to effective SMBP among the US-resettled Arab refugee population that may reflect unique cultural and care-seeking behaviors. Tailored public health and clinical interventions are needed to support refugee patients and providers to improve hypertension self-management behaviors for this unique population. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a global leading cause of death which disproportionately affects refugees. This chronic disease increases the risk of heart disease, stroke, brain, and other end-organ disease, if left uncontrolled. The 2017 United States travel or "Muslim" ban prevented immigrants and refugees from seven Muslim-majority countries from entering the United States, including Syria and Iraq; two major contributors to the global refugee population. As of 2020, the United States has admitted more than 133,000 and 22,000 Iraqi and Syrian refugees, respectively. Studies on the health effects of this policy on refugees are lacking. This study qualitatively explores the impact of the refugee ban on United States resettled Syrian and Iraqi refugees with hypertension. Methods: Participants were recruited through a federally qualified health center system that is the largest healthcare provider for refugees in San Diego, CA. All participants were Arabic-speaking refugees diagnosed with hypertension from Syria and Iraq. In-depth interviews took place between April 2021 and April 2022. Inductive thematic analysis was used to analyze data from semi-structured interviews. Results: Participants (N = 109) include 53 women and 56 men (23 Syrian, 86 Iraqi). The average age was 61.3 years (SD: 9.7) and stay in the United States was 9.5 years (SD 5.92). Four themes emerged linking the travel ban's impact on health, in line with the society to cells framework: (1) family factors: the refugee ban resulted in family separation; (2) physiological factors: the refugee ban worsened participants' mental health, exacerbating hypertension and perceived health outcomes; (3) community factors: perpetuation of Islamophobia, xenophobia, and perceived discrimination were structural barriers with links to poorer health; and (4) individual factors: trickle down consequences led to worsened participant self-image and self-perception within their host community. Discussion: The refugee ban negatively impacted the mental and physical health of United States resettled Arabic-speaking refugees through perceived discrimination, stress, and poor social integration. It continues to have long-lasting effects years after the ban was instated. Centering family reunification within the United States Refugee Admissions Program and tailoring interventions through the healthcare and public health systems are warranted to reduce hypertension disparities in this growing and overlooked population. [ABSTRACT FROM AUTHOR]

Objectives. To determine age-associated changes in cardiorespiratory fitness (CRF) among firefighters. Methods. Male firefighters (n = 1169) underwent annual evaluations from 2005 to 2015 in San Diego, California. We assessed CRF, the ability to deliver and use oxygen, during a maximal graded exercise test and recorded it in metabolic equivalents (METs; 1 MET = 3.5 ml/kg/min). We investigated differences in baseline CRF among 10-year age groups and patterns of change over follow-up using cross-sectional and longitudinal analyses, respectively. Results. Both analyses support an inverse relationship between CRF and age. Mean baseline CRF decreased from 15.7 61.7 to 11.7 61.9 METs in the younger than 30 years and 50 years and older age groups, respectively. There was no interaction between body fat and age in predicting CRF (Page x body fat = .09). Longitudinally, there was a nonlinear decrease in CRF, which differed across age groups: the youngest age group demonstrated the greatest decrease in CRF. Conclusions. Results support a negative, nonlinear association between age and CRF without modification by body fatness. Public Health Implications. Fire departments should recognize the health and safety risks of declining CRF and institutionalize programs to promote firefighter fitness. [ABSTRACT FROM AUTHOR]

This study examined the relation between misperception of healthy weight and obesity, as well as moderators of this relation, in a sample of middle-aged black men. Survey data from 404 mostly immigrant, black males living in greater New York City were collected as part of a larger randomized controlled trial. Data included measures of health status, BMI, perceived healthy weight, and misperception of healthy weight. Misperception of healthy weight was more frequent among obese men (90.2%) than nonobese men (48.7%) (P < 0.001). Mean level of misperception was also significantly higher in obese men than nonobese men (P < 0.001). Health status moderated the relation between misperception of healthy weight and obesity: obese men who felt healthy or who had fewer comorbid conditions had greater misperception of healthy weight than obese men who felt unhealthy or had relatively more comorbid conditions (P < 0.01). Our findings demonstrate that misperception of healthy weight discriminates between obese and nonobese black men, and the magnitude of this relation is exacerbated in obese men who are relatively healthy. Future studies should determine the prevalence of misperception of healthy weight in more diverse populations and identify potential mediators of the relation between misperception of healthy weight and obesity. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the efficacy and safety of unrestricted everolimus-eluting stent (EES) implantation in a contemporary cohort of real-world patients. Background: The randomized SPIRIT (A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System in the Treatment of Patients With de Novo Native Coronary Artery Lesions) trials have evaluated the performance of EES, resulting in their approval by the Food and Drug Administration, but data regarding unselected usage, including off-label indications are lacking. Methods: Consecutive patients treated with EES (either PROMUS, Boston Scientific Corp., Natick, Massachusetts, or XIENCE-V, Abbott Vascular Devices, Santa Clara, California) between October 2006 and February 2008 were analyzed. End points were cardiac death, myocardial infarction (MI), ischemic-driven target lesion revascularization (TLR), stent thrombosis (ST), and major adverse cardiac events (MACE) (a composite of cardiac death, MI, TLR) during follow-up. Results: We identified 345 patients (573 lesions) treated with EES. The majority of patients (71.9%) were treated for ≥1 off-label or untested indication. Clinical follow-up was completed in 99%. At a median follow-up of 378 days (interquartile range 334 to 473), MACE occurred in 36 (10.6%) patients, TLR in 27 (7.9%), MI in 7 (2.1%), and cardiac death in 7 (2.1%). Definite and probable ST was observed in 3 (0.9%) cases. Off-label EES implantation was not associated with a statistically significant increased risk of MACE (12.2% vs. 6.3%, p = 0.17), TLR (9.3% vs. 4.2%, p = 0.18), or ST (0.8% vs. 1.1%, p = 1.0). On multivariable analysis, previous bypass surgery (p = 0.002) and diabetes (p = 0.03) were associated with MACE. Conclusions: In unrestricted daily practice, EES were implanted predominantly for off-label indications and associated with a relative low rate of MACE and TLR. [Copyright &y& Elsevier]

Since the early 1970's legislative efforts in the United States, such as Title IX of the Education Amendments Act, have been implemented to increase opportunities for women through a process of assimilation. Our research discusses the debate between assimilationist and separatist strategies for gender equality and empirically examines the relationship between opening legal-structural opportunities for women and successful negotiation of identity in a traditionally male-dominated context. Using qualitative methods, we examine female intramural sports officials attempting to negotiate a legitimate identity in games involving male participants. Our analysis indicates that legal access to structures does not mean ideological legitimation. Even worse, it appears that in order to gain any form of acceptance, women are forced to exhibit male-like qualities thereby perpetuating a deep-seeded sexism that can not be abolished through legislation. The paper concludes by suggesting that compromise between assimilationist and separatist positions should be sought whereby social arenas, such as sport activity, accept expression of non-paternalistic qualities. [ABSTRACT FROM AUTHOR]