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Muslim American Families: A Social Worker’s Reflections
No full textMuslim families are diverse culturally, in their practice of Islam, and in the challenges they face. They often experience spiritual, social, mental health, and behavioral health concerns. Among them are those whose members are impacted by the problems of childhood traumas, intergenerational communication problems, and marital problems; caring for children and adults with special needs and aging members; and those confronted by mental illness, suicide, domestic abuse, substance use disorder, incarceration, poverty, racism, and Islamophobia. Even as families strive to be healthy in terms of functioning, their struggles are real. Being Muslim does not totally shield one from these and other trials and tests.
As a Muslim, social worker, and active community member, I have had a front row seat to the successes and challenges facing these families. I have observed aspects of the community’s growth and development over the past 45 years. In this article, I share my reflections
The Muslim Marriage Crisis: How Re-Establishing Islamic Principles Can Help Muslims Find Love and Marriage
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Electronic Health Record-based Surveillance of Hypertension Prevalence
Get PDFBackground:Public health officials require timely, accurate data to guide decision-making. The Behavioral Risk Factor Surveillance System (BRFSS), a nationwide telephone survey of U.S. adults conducted by the CDC, serves as a primary source for chronic disease prevalence data. However, limitations like small sample sizes and publication delays exist. A promising alternative is Electronic Health Record-based (EHR) surveillance. Under the CDC-funded Multi-state Electronic Health Record-based Network for Disease Surveillance (MENDS) project, the Regenstrief Institute utilizes EHR data from the Indiana Network for Patient Care database to detect hypertension using algorithms based on a combination of blood pressure measurements, diagnostic codes, and antihypertensive prescriptions.
Methods:We compared hypertension prevalence estimates between BRFSS and MENDS using 2015 data from Indiana residents. BRFSS included individuals who positively reported a diagnosis of hypertension or antihypertensive medication use. MENDS included individuals based on clinical diagnosis, abnormal blood pressure readings, and medication history. Gestational hypertension and end-stage renal disease cases were excluded. Equivalence was empirically tested using the two one-sided t-tests (TOST) statistical method.
Results:TOST analysis revealed the two methods were not equivalent overall (p < 0.0001) or in any strata measured. The EHR-based model produced a lower estimate of 18.7% (95% CI ± 7.1 x 10-6, n=10,800,076), while BRFSS produced a higher estimate of 28.4% (95% CI ± 3.8, n=934).
Conclusion:BRFSS might overestimate (i.e., too sensitive) hypertension prevalence due to survey methodology, while the EHR-based model might underestimate (i.e., too specific) due to its more complex hypertension-detection algorithm. Nevertheless, the EHR-based model provides a reliable and more timely method for estimating hypertension prevalence.
Implications:MENDS provides estimates for other chronic disease risk measures such as diabetes, smoking, and obesity. Participating health departments receive updated data each month and can monitor trends. By providing reliable and timely data, public health officials can make well-informed decisions to serve their communities
Neuromuscular dysfunction precedes muscle atrophy in C26 tumor-bearing mice
Get PDFBackground: Cancer patients frequently develop skeletal muscle wasting and weakness, which are hallmarks of cachexia, a wasting disease which worsens quality of life and is directly responsible for up to 30% of all cancer-related deaths. While advancements in detection and treatment have increased the population of cancer survivors, skeletal muscle dysfunction can persist for years following cancer remission. We previously demonstrated that late-stage cachexia is associated with impaired skeletal muscle innervation, linking loss of motor unit (MU) connectivity to cancer-induced wasting and weakness. In the present study, we investigated the onset of neuromuscular dysfunction in a preclinical model of cancer cachexia.
Methods: CD2F1 male mice (8-week-old) were subcutaneously injected with C26 colorectal cancer cells (1.0x106) or saline and randomized into one the following timepoint groups: day 6, day 8, or day 10 (n=8-10). Animals were assessed for indices of MU connectivity and muscle function at each timepoint. Following functional assessment, skeletal muscles were harvested, weighed, and processed for molecular analyses.
Results: 6 days post tumor injection, C26 hosts displayed reductions in neuromuscular junction (NMJ) transmission and motor unit connectivity, while muscle torque and mass were preserved. Specific torque was reduced in C26 hosts at day 8, while reductions in muscle mass or cross-sectional area did not occur until day 10. Molecular analysis revealed alterations of NMJ components as early as day 6 in C26 hosts, further suggesting that neuromuscular dysfunction precedes muscle atrophy.
Conclusions: Altogether our data demonstrate that cancer-induced neuromuscular dysfunction precedes cancer-induced muscle atrophy, identifying impaired innervation as an early prognosticator of cachexia progression. Our work supports strategies to counteract impaired neuromuscular function in the treatment of cancer cachexia, in hopes of sustaining quality of life in cancer patients and the growing population of cancer survivors