Lancet Regional Health-Americas最新文献

{"title":"“The end TB strategy” pathway in South America: out of track for 2025 milestones and 2035 eradication","authors":"Miguel Angel Garcia-Bereguiain , Angel Sebastian Rodriguez-Pazmiño , Greta Franco-Sotomayor , Solon Alberto Orlando , Manuel González , Cesar Ugarte-Gil","doi":"10.1016/j.lana.2025.101045","DOIUrl":"10.1016/j.lana.2025.101045","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101045"},"PeriodicalIF":7.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing biobanking in Latin America: success stories and challenges ahead","authors":"Gustavo Sevlever , Lucía Crivelli , Claudia Kimie Suemoto , Ezequiel Surace , Analía Taratuto","doi":"10.1016/j.lana.2025.101047","DOIUrl":"10.1016/j.lana.2025.101047","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101047"},"PeriodicalIF":7.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder-driven multi-stage adaptive real-world theme-oriented (SMART) telehealth evaluation framework: a scoping review","authors":"Yunxi Zhang ,&nbsp;Yueh-Yun Lin ,&nbsp;Lincy S. Lal ,&nbsp;Jennifer C. Reneker ,&nbsp;Elizabeth G. Hinton ,&nbsp;Saurabh Chandra ,&nbsp;J. Michael Swint","doi":"10.1016/j.lana.2025.101041","DOIUrl":"10.1016/j.lana.2025.101041","url":null,"abstract":"<div><div>Telehealth has revolutionized healthcare delivery by integrating cutting-edge technologies, yet evaluations of its services and programs often lack comprehensive frameworks, resulting in unclear standards for quality assurance. To address this gap, we conducted a scoping review of telehealth evaluation frameworks applicable to the United States healthcare system, following the Joanna Briggs Institute methodology and a published protocol. Twelve telehealth evaluation frameworks published between 2019 and 2023 were identified, focusing on four key themes: program implementation, clinical impact, economic impact, and equity. Guided through two auxiliary frameworks, we further developed a stakeholder-driven multi-stage adaptive real-world theme-oriented (SMART) conceptual framework for telehealth evaluation. We illustrated this framework through a use case on a remote patient monitoring program. This comprehensive telehealth evaluation framework not only facilitates stakeholders in developing tailored evaluation plans but also contributes to the standardization and enhancement of telehealth services, ultimately improving health outcomes and promoting greater equity across society.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101041"},"PeriodicalIF":7.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific racism as a public health emergency of global concern","authors":"Francisco Jiménez-Trejo ,&nbsp;Katia L. Jiménez-García ,&nbsp;Telma Lisboa-Nascimento ,&nbsp;Santiago Rodríguez-Vega ,&nbsp;José L. Cervantes-Escárcega ,&nbsp;Gustavo Canul-Medina","doi":"10.1016/j.lana.2025.101049","DOIUrl":"10.1016/j.lana.2025.101049","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101049"},"PeriodicalIF":7.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The erosion of the US health-care workforce: silence is not an answer","authors":"The Lancet Regional Health – Americas","doi":"10.1016/j.lana.2025.101054","DOIUrl":"10.1016/j.lana.2025.101054","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"43 ","pages":"Article 101054"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The silent trauma: U.S. immigration policies and mental health","authors":"Omid Dadras ,&nbsp;Mohammad Sediq Hazratzai","doi":"10.1016/j.lana.2025.101048","DOIUrl":"10.1016/j.lana.2025.101048","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"44 ","pages":"Article 101048"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaching pediatric mental health screening and care in immigration detention","authors":"Shela Sridhar ,&nbsp;Leah Ratner ,&nbsp;Matthew G. Gartland ,&nbsp;Dennis Kunichoff ,&nbsp;Margaret M. Sullivan ,&nbsp;Vasileia Digidiki","doi":"10.1016/j.lana.2025.100999","DOIUrl":"10.1016/j.lana.2025.100999","url":null,"abstract":"<div><div>Children held in US immigration detention facilities often arrive with significant mental health conditions requiring prompt attention. Despite the abundance of literature highlighting the need for adequate mental health care in migrant children, there is a chasm between the care offered to detained migrant children in the US and the minimum standards of healthcare in the US. This discrepancy is fueled by the mandate of Immigration and Customs Enforcement (ICE), which prioritizes immigration enforcement rather than the health and well-being of detained children. The tension between the existing ICE's enforcement mandate and the internationally recognized right to health care for children results in inadequate mental health care, causing long-term harm. We highlight current pediatric mental health screening and treatment practices in immigration detention facilities, exploring the role of ICE and child protection frameworks. We conclude by providing policy recommendations to improve mental health care in US-based detention facilities.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"43 ","pages":"Article 100999"},"PeriodicalIF":7.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances and challenges for gene therapies in Brazil","authors":"Antonio Carlos Campos de Carvalho ,&nbsp;Adriana Bastos Carvalho","doi":"10.1016/j.lana.2025.101035","DOIUrl":"10.1016/j.lana.2025.101035","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"43 ","pages":"Article 101035"},"PeriodicalIF":7.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic correlates of hypertension prevalence, awareness, and control in the Eastern Caribbean","authors":"Carol R. Oladele ,&nbsp;Mary I. Miller ,&nbsp;Oswald P. Adams ,&nbsp;Rohan G. Maharaj ,&nbsp;Cruz M. Nazario ,&nbsp;Maxine Nunez ,&nbsp;Marcella Nunez-Smith ,&nbsp;Mayur Desai","doi":"10.1016/j.lana.2025.101012","DOIUrl":"10.1016/j.lana.2025.101012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;This study aimed to quantify prevalence, awareness, and control of hypertension in the Eastern Caribbean and identify sociodemographic correlates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Baseline data (2013–2018) from the Eastern Caribbean Health Outcomes Research Network Cohort Study (ECS) was used (n = 2961). The ECS is an ongoing longitudinal study of community-dwelling persons 40 years and older conducted in Barbados, Puerto Rico, Trinidad and Tobago, and U.S. Virgin Islands. Participants completed a self-administered health survey, clinical examination, and laboratory testing. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) guidelines defined hypertension prevalence and control. Self-reported hypertension and clinical blood pressure values defined awareness. Binomial proportions, including 95% confidence intervals and logistic regression, were used for analyses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Analyses included 2932 participants with complete data. The mean age of participants was 57 (SD = 10.3) years, and 65.3% (n = 1916/2932) were women. Prevalence of hypertension was 57.9% (n = 1698/2932), among whom 36.8% (n = 591/1698) were unaware, and 56.4 percent (n = 624/1107) of aware persons lacked control. Persons who were 70 and older (82.9%, n = 325/392, 95% CI:79.2%–86.6%), had low educational attainment (63.4%, n = 642/1012, 95% CI:60.5%–66.4%), obese (67.2%, n = 753/1121, 95% CI:64.4%–69.9%), and low physical activity (63.3%, n = 766/1210, 95% CI:60.6%–66.0%) had the highest prevalences of hypertension. Awareness was highest among persons 70 and older (76.6%, n = 249/325, 95% CI:72.0%–81.2%), women (70.7%, n = 781/1104, 95% CI:68.1%–73.4%), and those with a usual source of healthcare (70.4%, n = 1042/1480, 95% CI:68.1%–72.7%). Persons with lower educational attainment had lowest control across sociodemographic groups (36.1%, n = 154/427, 95% CI:31.5%–40.6%). Multivariable results showed ages 70 and older (OR = 10.6, 95% CI:7.4–15.2) and obesity (OR = 4.0, 95% CI:3.1–5.1) were the strongest predictors of hypertension. Usual source of care (OR = 5.66, 95% CI:3.8–8.4) and ages 70 and older (OR = 4.2, 95% CI:2.7–6.5) were most strongly associated with awareness. Results for control were not statistically significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Findings highlight challenges across the hypertension care cascade in the Eastern Caribbean, particularly with control. These findings have implications for public health and healthcare system solutions to improve screening and blood pressure control.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;&lt;span&gt;National Heart, Lung, and Blood Institute&lt;/span&gt; Award--&lt;span&gt;&lt;span&gt;1K01HL145347-01A1&lt;/span&gt;&lt;/span&gt;, &lt;span&gt;National Institute on Minority Health and Health Disparities&lt;/span&gt; (Yale-TCC)--&lt;span&gt;&lt;span&gt;U54MD010711&lt;/span&gt;&lt;/span&gt;, and &lt;span&gt;National Institute on Minority Health and Health ","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"43 ","pages":"Article 101012"},"PeriodicalIF":7.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural racism and breast cancer stage at presentation in a South Florida majority-minority population: a retrospective study","authors":"Alexandra E. Hernandez ,&nbsp;Maya Lubarsky ,&nbsp;Ashly C. Westrick ,&nbsp;Brianna L. Cohen ,&nbsp;Cheyenne Thompson ,&nbsp;Susan B. Kesmodel ,&nbsp;Neha Goel","doi":"10.1016/j.lana.2024.100962","DOIUrl":"10.1016/j.lana.2024.100962","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Residential segregation, both economic, racial and ethnic, is a social determinant of health that contributes to disparities in breast cancer outcomes. The objective of this study was to examine the association of economic and racial and ethnic residential segregation, as measured by the Index of Concentration at the Extremes (ICE), with breast cancer stage at presentation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this retrospective two-institution study, we included patients with stage I-IV breast cancer from 2005 to 2017. Using five-year estimates from the American Community Survey (2009–2013), five ICE variables were computed to create five models, controlling for economic segregation, Non-Hispanic Black (NHB) segregation, NHB/economic segregation, Hispanic segregation, and Hispanic/economic segregation. Multi-level logistic regression models determined the association between economic and racial segregation on breast cancer stage at presentation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;4898 patients were included: 56% Hispanic, 27% Non-Hispanic White, 17% NHB. Those living in the most economically marginalised neighbourhoods [by quartiles (Q)] [OR&lt;sub&gt;Q1&lt;/sub&gt; 1.38 (95% CI: 1.14–1.68), &lt;em&gt;p&lt;/em&gt; &lt; 0.05, majority NHB neighbourhoods [OR&lt;sub&gt;Q1&lt;/sub&gt;1.51 (95% CI: 1.01–2.27)], majority Hispanic neighbourhoods [OR&lt;sub&gt;Q1&lt;/sub&gt; 1.29 (95% CI: 1.06–1.56)], the most NHB and economically segregated neighbourhoods [NHB and economic: OR&lt;sub&gt;Q1&lt;/sub&gt; 1.64 (95% CI: 1.28–2.09), and the most Hispanic and economically segregated neighbourhoods [Hispanic and economic: OR&lt;sub&gt;Q1&lt;/sub&gt; 1.60 (95% CI: 1.24–1.68)] had significantly increased odds of presenting with later stage disease compared to the reference group in each category.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;This study, to our knowledge, is the first to evaluate stage at presentation by ICE, which allows us to evaluate the association between racial and economic residential segregation and breast cancer disparities. Our findings suggest that structural racism influences stage at presentation. To address these disparities, effective interventions are needed to account for the social and environmental contexts in which cancer patients live and can access care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;Research reported in this publication was supported by the &lt;span&gt;National Cancer Institute&lt;/span&gt; of the &lt;span&gt;National Institutes of Health&lt;/span&gt; under Award Number R37CA288502. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The research was also supported by a &lt;span&gt;University of Miami School of Medicine DREAM Scholar Award&lt;/span&gt;, a NIH/NCI T32CA211034, an &lt;span&gt;American Surgical Association Fellowship Award&lt;/span&gt;, a &lt;span&gt;Breast Cancer Research Foundation&lt;/span&gt;, an &lt;span&gt;ASCO Career Development Award&lt;/span&gt;, a &lt;span&gt;Florida Department of Health Bankhead Cole Cancer Resea","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"43 ","pages":"Article 100962"},"PeriodicalIF":7.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143487691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}