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Rakhshan V, Ghorbanyjavadpour F. Anteroposterior and vertical soft tissue cephalometric norms of Iranians, interethnic comparisons, sex dimorphism, and the effect of age on cephalometric variables. Oral Maxillofac Surg 2019; 23:167-78. [PMID: 30941649 DOI: 10.1007/s10006-019-00755-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/21/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION This study established about 50 anteroposterior and vertical cephalometric norms of five tracing analyses in Iranians, using a large sample. METHODS Lateral cephalographs of 130 subjects (85 females, 45 males, with an average age of 22.77 ± 2.55 years (range 20-29)) were traced manually using the Ricketts, Holdaway, Z-Merrifield, Epker, and Legan-Burstone soft tissue analyses. The role of age and sex on measurements, as well as the comparisons between Iranian norms with Caucasians from European decent, was determined statistically (α = 0.001). RESULTS Age had no significant effect (all P values > 0.01). Sexual dimorphism existed in terms of numerous parameters. Compared to analysis standards, upper lip to E-plane, nose prominence, upper lip thickness, nasomental angle, Z angle, interlabial distance, subnasale perp to chin, subnasale-stomion:stomion-menton, subnasale-lower lip:lower lip-menton, interlabial gap, and vertical lip-chin ratio were smaller in Iranians. Superior sulcus depth, skeletal profile convexity, upper lip strain, upper lip curvature, H-angle, soft tissue chin thickness, nasofacial angle, subnasale perp to upper lip, subnasale perp to lower lip, maxillary prognathism, lower face throat angle, upper lip protrusion, lower lip protrusion, mentolabial sulcus, and lower vertical height-depth ratio were greater in Iranians compared to the norm (P ≤ 0.001). CONCLUSIONS A great degree of sex dimorphism might exist among Iranians. Many textbook norms might not be the best options for diagnosis or treatment of Iranians.
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Rønn PF, Jørgensen ME, Smith LS, Bjerregaard P, Dahl-Petersen IK, Larsen CVL, Grarup N, Andersen GS. Associations between birth weight and glucose intolerance in adulthood among Greenlandic Inuit. Diabetes Res Clin Pract 2019; 150:129-137. [PMID: 30851284 DOI: 10.1016/j.diabres.2019.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/15/2019] [Accepted: 03/01/2019] [Indexed: 01/09/2023]
Abstract
AIMS To examine the association between birth weight and glucose intolerance in adult Greenlandic Inuit. METHODS We examined 1429 participants aged 18-56 years from two population-based, cross-sectional studies in Greenland with information on birth weight. Oral glucose tolerance tests, anthropometric measures and ultrasound of abdominal tissue were performed. Associations of birth weight with glucose markers were analysed using linear or logistic regressions. Spline analyses were conducted to examine u-shaped associations. Adjustments were done for age, sex, birth place, family history of diabetes, genetic admixture, TBC1D4 p.Arg684Ter carrier status, BMI and visceral adipose tissue. RESULTS The median birthweight was 3300 g and 3.9% had type 2 diabetes, T2DM. Spline analyses indicated overall linear associations. In fully adjusted analyses, an increase in birth weight of 1 kg was associated with a change in fasting plasma glucose of -0.06 mmol/L (95%CI: -0.11, -0.01), 2-h plasma glucose of -0.16 mmol/L (95%CI: -0.35, 0.02), HOMA-IR of -5.45% (95%CI: -10.34, -0.29), insulin sensitivity index of 7.04% (95%CI: 1.88, 12.45) and a trend towards a reduced risk of hyperglycaemia and T2DM, although statistically insignificant. CONCLUSIONS Birth weight was inversely associated with hepatic and peripheral insulin resistance independently of adult adiposity. Thus, the findings support low birth weight as a contributing factor for glucose intolerance in adult Inuit in Greenland.
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Affiliation(s)
| | - Marit Eika Jørgensen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; University of Greenland, Greenland
| | | | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; University of Greenland, Greenland
| | - Inger Katrine Dahl-Petersen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; University of Greenland, Greenland
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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153
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Abstract
PURPOSE Puberty onset exhibits remarkable inter-individual and ethnic differences. 5% of Chileans are indigenous but puberty ethnic disparities have not been studied. We aim for evaluating precocious puberty prevalence in children with Mapuche ancestry vs non-indigenous Chilean children (according to their surnames). METHODS Longitudinal cohort study: 1003 children (50.2% girls) participating in the Growth and Obesity Chilean Cohort Study (GOCS) were studied. Annual anthropometry was measured since 4-7 years. Subsequently, Tanner staging and anthropometry were measured every 6 months. In girls, Tanner stage was assessed by breast palpation and in boys by testicular volume measurements. The cohort was stratified in three groups depending on Mapuche surname numbers as follows: (A) no indigenous surnames (n = 811), (B) one to two indigenous surnames (n = 147), and (C) three or more indigenous surnames (n = 45). We evaluated the prevalence of precocious thelarche, pubarche, menarche and gonadarche (testicular volume ≥ 4 ml-G2), using a cutoff age of 8 years in girls and 9 years in boys while controlling for socioeconomic status, body mass index, waist circumference, IGF-1 and DHEAS at 7 years. RESULTS In girls, no significant differences were observed. On the contrary, in boys, precocious gonadarche prevalence was higher in group C (29.2%) vs group A (6.0%) and vs group B (10.5%) (p =0.001, p = 0.004, respectively). Increased precocious gonadarche and pubarche risks in group C were observed even after adjustment [OR 7.31; 95% IC (2.32-23.51); p = 0.001] and [OR 6.17, 95% CI (1.62-23.49); p = 0.008], respectively. CONCLUSION Indigenous origin in Chile is an independent risk factor for precocious gonadarche and pubarche in boys but not in girls.
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Affiliation(s)
- M Fernández
- Institute of Maternal and Child Research (IDIMI), Faculty of Medicine, University of Chile, Santa Rosa 1234, 2a Piso, PO Box 226-3, Santiago, Chile
| | - A Pereira
- Institute of Nutrition and Food Technology (INTA), Faculty of Medicine, University of Chile, Santiago, Chile
| | - C Corvalán
- Institute of Nutrition and Food Technology (INTA), Faculty of Medicine, University of Chile, Santiago, Chile
| | - V Mericq
- Institute of Maternal and Child Research (IDIMI), Faculty of Medicine, University of Chile, Santa Rosa 1234, 2a Piso, PO Box 226-3, Santiago, Chile.
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154
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Smith LA, Melbourne A, Owen D, Cardoso MJ, Sudre CH, Tillin T, Sokolska M, Atkinson D, Chaturvedi N, Ourselin S, Hughes AD, Barkhof F, Jäger HR. Cortical cerebral blood flow in ageing: effects of haematocrit, sex, ethnicity and diabetes. Eur Radiol 2019; 29:5549-5558. [PMID: 30887200 PMCID: PMC6719435 DOI: 10.1007/s00330-019-06096-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/24/2018] [Accepted: 02/11/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Cerebral blood flow (CBF) estimates from arterial spin labelling (ASL) show unexplained variability in older populations. We studied the impact of variation of haematocrit (Hct) on CBF estimates in a tri-ethnic elderly population. MATERIALS AND METHODS Approval for the study was obtained from the Fulham Research Ethics Committee and participants gave written informed consent. Pseudo-continuous arterial spin labelling was performed on 493 subjects (age 55-90) from a tri-ethnic community-based cohort recruited in London. CBF was estimated using a simplified Buxton equation, with and without correction for Hct measured from blood samples. Differences in perfusion were compared, stratified by sex, ethnicity and diabetes. Results of Student's t tests were reported with effect size. RESULTS Hct adjustment decreased CBF estimates in all categories except white European men. The decrease for women was 2.7 (3.0, 2.4) mL/100 g/min) (mean (95% confidence interval (CI)), p < 0.001 d = 0.38. The effect size differed by ethnicity with estimated mean perfusion in South Asian and African Caribbean women found to be lower by 3.0 (3.6, 2.5) mL/100 g/min, p < 0.001 d = 0.56 and 3.1 (3.6, 2.5) mL/100 g/min), p < 0.001 d = 0.48, respectively. Estimates of perfusion in subjects with diabetes decreased by 1.8 (2.3, 1.4) mL/100 g/min, p < 0.001 d = 0.23) following Hct correction. Correction for individual Hct altered sample frequency distributions of CBF values, especially in women of non-European ethnicity. CONCLUSION ASL-derived CBF values in women, non-European ethnicities and individuals with diabetes are overestimated if calculations are not appropriately adjusted for individual Hct. KEY POINTS • CBF quantification from ASL using a fixed Hct of 43.5%, as recommended in the ISMRM white paper, may lead to erroneous CBF estimations particularly in non-European and female subjects. • Individually measured Hct values improve the accuracy of CBF estimation and, if these are not available, an adjusted value according to gender, ethnicity or diabetes status should be considered. • Hct-corrected ASL could be potentially important for CBF threshold decision making in the fields of neurodegenerative disease and neuro-oncology.
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Affiliation(s)
- Lorna A Smith
- MRC Unit for Lifelong Health and Ageing, Department of Population Science & Experimental Medicine, University College London, WC1E 6HX, London, UK. .,Centre for Medical Imaging, Division of Medicine, University College London, 2nd Floor, Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK.
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, SE1 7EH, UK.,Department of Medical Physics and Biomedical Engineering, University College London, London, NW1 2BU, UK
| | - David Owen
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, SE1 7EH, UK.,Department of Medical Physics and Biomedical Engineering, University College London, London, NW1 2BU, UK
| | - M Jorge Cardoso
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, SE1 7EH, UK.,Dementia Research Centre, UCL Institute of Neurology, London, Wc1N 3BG, UK
| | - Carole H Sudre
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, SE1 7EH, UK.,Department of Medical Physics and Biomedical Engineering, University College London, London, NW1 2BU, UK.,Dementia Research Centre, UCL Institute of Neurology, London, Wc1N 3BG, UK
| | - Therese Tillin
- MRC Unit for Lifelong Health and Ageing, Department of Population Science & Experimental Medicine, University College London, WC1E 6HX, London, UK
| | - Magdalena Sokolska
- Institute of Healthcare Engineering, University College London, London, UK
| | - David Atkinson
- Centre for Medical Imaging, Division of Medicine, University College London, 2nd Floor, Charles Bell House, 43-45 Foley Street, London, W1W 7TS, UK
| | - Nish Chaturvedi
- MRC Unit for Lifelong Health and Ageing, Department of Population Science & Experimental Medicine, University College London, WC1E 6HX, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, SE1 7EH, UK
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Ageing, Department of Population Science & Experimental Medicine, University College London, WC1E 6HX, London, UK
| | - Frederik Barkhof
- Department of Medical Physics and Biomedical Engineering, University College London, London, NW1 2BU, UK.,Dementia Research Centre, UCL Institute of Neurology, London, Wc1N 3BG, UK.,Department of Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, Netherlands
| | - H R Jäger
- Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, WC1N 3BG, UK.,Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London, London, WCN1 3BG, UK
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155
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Fossheim HJ. Past responsibility: History and the ethics of research on ethnic groups. Stud Hist Philos Biol Biomed Sci 2019; 73:35-43. [PMID: 30459017 DOI: 10.1016/j.shpsc.2018.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 10/03/2018] [Accepted: 11/03/2018] [Indexed: 06/09/2023]
Abstract
The article argues for the possibility of researchers' historical responsibility vis-à-vis ethnic groups. Such responsibility for a discipline's past transgressions is often attributed to anthropology, human genetics, parts of archaeology, and medicine, but without a clear conception of the nature of a responsibility supposedly going beyond the individual's own actions. Two concretizations are presented in order to show the fruitfulness and challenges of what I shall call a continuity approach: first, the case of the reburial of Sami human remains in Neiden, Norway; second, the use of the race concept in ethical and scientific contexts following the so-called New Synthesis in biology, which according to many marks a break with a racist past. Since no theory of researchers' historical responsibility towards ethnic groups exists, two partly relevant theories are brought in to provide a basis: Jenna Thompson's theory of nation states' responsibilities for past transgressions against peoples and a stance in political theory arguing that the beneficiary should pay even in cases where the beneficiary was not to blame for the original transgression. On this basis I sketch a continuity theory of historical responsibility, without which a notion of historical responsibility would be inapplicable in most actual cases.
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Biddle GJH, Edwardson CL, Rowlands AV, Davies MJ, Bodicoat DH, Hardeman W, Eborall H, Sutton S, Griffin S, Khunti K, Yates T. Differences in objectively measured physical activity and sedentary behaviour between white Europeans and south Asians recruited from primary care: cross-sectional analysis of the PROPELS trial. BMC Public Health 2019; 19:95. [PMID: 30665392 PMCID: PMC6341710 DOI: 10.1186/s12889-018-6341-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 12/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-reported data have consistently shown South Asians (SAs) to be less physically active than White Europeans (WEs) in developed countries, however objective data is lacking. Differences in sedentary time have not been elucidated in this population. This study aimed to quantify differences in objectively measured physical activity and sedentary behaviour between WEs and SAs recruited from primary care and to investigate differences in demographic and lifestyle correlates of these behaviours. METHODOLOGY Baseline data were utilised from a randomised control trial recruiting individuals identified at high risk of type 2 diabetes from primary care. Light intensity physical activity, moderate-to-vigorous intensity physical activity (MVPA) and steps were measured using the Actigraph GT3X+, while sitting, standing and stepping time were measured using the activPAL3™. Devices were worn concurrently for seven days. Demographic (employment, sex, age, education, postcode) and behavioural (fruit and vegetable consumption, alcohol consumption, smoking status) characteristics were measured via self and interview administered questionnaires. RESULTS A total of 963 WE (age = 62 ± 8, female 51%) and 289 SA (age = 55 ± 11, female 43%) were included. Compared to WEs, SAs did less MVPA (24 vs 33 min/day, p = 0.001) and fewer steps (6404 vs 7405 per day, p ≤ 0.001), but sat less (516 vs 552 min/day, p ≤ 0.001) and stood more (328 vs 283 min/day, p ≤ 0.001). Ethnicity also modified the extent to which demographic and behavioural factors act as correlates of physical activity and sedentary behaviour. Differences between sex in levels of MVPA and sitting time were greater in SAs compared to WEs, with SA women undertaking the least amount of MVPA (19 min/day), the least sitting time (475 min/day) and most standing time (377 min/day) than any other group. Smoking and alcohol status also acted as stronger correlates of sitting time in SAs compared to WEs. In contrast, education level acted as a stronger correlate of physical activity in WEs compared to SAs. CONCLUSION SAs were less active yet less sedentary than WEs, which demonstrates the need to tailor the behavioural targets of interventions in multi-ethnic communities. Common correlates of physical activity and sedentary behaviour also differed between ethnicities. TRIAL REGISTRATION ISRCTN83465245 Trial registration date: 14/06/2012.
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Affiliation(s)
- Gregory J H Biddle
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK. .,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK. .,Department of Health Sciences, University of Leicester, Leicester, UK.
| | - Charlotte L Edwardson
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Alex V Rowlands
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Danielle H Bodicoat
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK
| | - Wendy Hardeman
- Behavioural Science Group, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK.,School of Health Sciences, University of East Anglia, Research Park, Norwich, NR4 7TJ, UK
| | - Helen Eborall
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Stephen Sutton
- Behavioural Science Group, Institute of Public Health, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Simon Griffin
- Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.,Primary Care Unit, University of Cambridge School of Clinical Medicine, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.,NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, UK.,NIHR Leicester Biomedical Research Centre, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, UK
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Ogundipe F, Kodadhala V, Ogundipe T, Mehari A, Gillum R. Disparities in Sepsis Mortality by Region, Urbanization, and Race in the USA: a Multiple Cause of Death Analysis. J Racial Ethn Health Disparities 2019; 6:546-551. [PMID: 30607577 DOI: 10.1007/s40615-018-00553-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE To assess gender, race/ethnicity, and geographic disparities in sepsis-associated mortality. MATERIALS AND METHODS The US data for multiple causes of death (MCOD) for years 2013-2016 were used to determine numbers of deaths and age-adjusted rates for sepsis as underlying or contributing cause of death using the International Classification of Diseases-10 (ICD-10) codes for non-Hispanic blacks (NHB) and whites (NHW) aged 15 years and older. RESULTS There were a total of 746,725 sepsis-associated deaths. Among females, age-adjusted death rate for NHB was 88.6 (95% CI 87.8-89.3) and for NHW, 55.4 (95% CI 55.1-55.6). Among males, age-adjusted death rate for NHB was 115.2 (95% CI 114.1-116.3) and for NHW, 69.5 (95% CI 69.2-69.8). Rates were generally higher in divisions of the south region (West South Central in NHB). Within the South, NHW and NHB who resided in non-metropolitan areas had the highest rates, while the lowest were in suburban metropolitan areas. CONCLUSIONS Sepsis-related MCOD mortality rates were highest in males, in NHB, in the South region, and, within the South, non-metropolitan areas.
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Affiliation(s)
| | | | | | - Alem Mehari
- Howard University Hospital, Washington, DC, USA.,Howard University College of Medicine, Washington, DC, USA
| | - Richard Gillum
- Howard University College of Medicine, Washington, DC, USA
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158
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Assari S, Bazargan M. Marital Status and Physical Health: Racial Differences. Int J Epidemiol Res 2019; 6:108-113. [PMID: 31572801 PMCID: PMC6768071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES As suggested by the Minorities' Diminished Return theory, the association between socioeconomic status and health is weaker for racial and ethnic minorities compared to Whites. The current study compared Blacks and Whites in terms of the association between marital status and physical health. METHODS The State of the State Survey (2017) included 881 adults (92 Blacks and 782 Whites) generalizable to the state of Michigan, the United States. The marital status and self-rated physical health (SRPH), which was measured using a single item, were considered as independent and dependent variables, respectively. In addition, age, gender, education, and employment were covariates. Race/ethnicity was regarded as the moderating factor. Logistic regression was used for data analysis. RESULTS Based on the results, being married was associated with better SRPH, the net of all confounders. A significant interaction was found between race and marital status on SRPH, suggesting a larger association for Blacks compared to Whites. In race stratified models, marital status was related to better SRPH for Whites and Blacks, but the magnitude of this link was larger for Blacks compared to Whites. CONCLUSION Overall, marital status was differently linked to SRPM for Whites and Blacks. Accordingly, policymakers should be cautious while not assuming that diverse racial and ethnic groups with similar economic resources have similar health status.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA
- Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
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159
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Shakeel N, Sletner L, Falk RS, Slinning K, Martinsen EW, Jenum AK, Eberhard-Gran M. Prevalence of postpartum depressive symptoms in a multiethnic population and the role of ethnicity and integration. J Affect Disord 2018; 241:49-58. [PMID: 30096592 DOI: 10.1016/j.jad.2018.07.056] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 06/11/2018] [Accepted: 07/22/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Postpartum depression (PPD) may have adverse effects on both mother and child. The aims were to determine the prevalence of postpartum depressive symptoms, PPDS, identify associations with ethnicity and with the level of social integration. METHOD Population-based, prospective cohort study of 643 pregnant women (58% ethnic minorities) attending primary antenatal care in Oslo. Questionnaires regarding demographics and health issues were collected through interviews. PPDS was defined as a sum score ≥ 10 by the Edinburgh Postnatal Depression Scale, used as the main outcome in logistic regression analyses, first with ethnicity, second with level of integration as main explanatory factors. RESULTS The prevalence of PPDS was higher in ethnic minorities 12.7% (95% CI: 9.31-16.09) than in Western Europeans 4.8% (2.26-7.34). Adverse life events, lack of social support and depressive symptoms during the index pregnancy were other significant risk factors. Western European with PPDS were more likely to have had depressive symptoms also during pregnancy than women from ethnic minorities (72.2% versus 33.3%, p = 0.041). When replacing ethnicity with integration, a low level of integration was independently associated with PPDS (2.1 (1.11-3.95)). LIMITATIONS Cases with PPDS were limited. Heterogeneity in the ethnic groups is a concern. CONCLUSION Both point prevalence and new onset of PPDS was higher among ethnic minorities than among Western Europeans. Low level of integration was associated with PPDS. Our findings suggest that clinicians should be aware of the increased risk of new cases of PPDS among ethnic minorities compared to Western European women and offer evidence-based care accordingly.
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Affiliation(s)
- Nilam Shakeel
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway.
| | - Line Sletner
- Department of Pediatrics and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway.
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Norway.
| | - Kari Slinning
- Center for Child and Adolescent Mental Health Eastern and Southern Norway (R.BUP Oslo), Norway.
| | - Egil W Martinsen
- Division of Mental Health and Addiction, Oslo University Hospital, Institute of Clinical Medicine, University of Oslo, Norway.
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Norway.
| | - Malin Eberhard-Gran
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway; Health Services Research Centre, Akershus University Hospital, Lørenskog; Institute of Clinical Medicine, Campus Ahus, University of Oslo, Norway.
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160
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He N, Wu LL, Qi M, Lin S, Xin W. [Differences in anterior segment structure between Chinese Han people and American Caucasians]. Zhonghua Yan Ke Za Zhi 2018; 54:820-826. [PMID: 30440152 DOI: 10.3760/cma.j.issn.0412-4081.2018.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Objective: To compare the difference of anterior segment structure between Chinese Han people and American Caucasians, and to explore the confounding factors of anterior chamber angle. Methods: Cross-sectional study. The study was designed to include two healthy groups of Chinese Han people (enrolled from Department of Ophthalmology, Peking University Third Hospital) and American Caucasians (enrolled from Department of Ophthalmology, University of California, San Francisco) from May 2008 to December 2010, each with approximately 120 participants, including 15 persons of each gender in each decade between 40 and 80 years of age. The parameters of the anterior segment were measured by the automatic refractive test, A-ultrasound and ultrasound biomicroscopy. Differences between the two groups were compared with the independent-sample t test or Wilcoxon two-sample test for continuous variable data and the χ(2) test for classified variable data. Multiple linear regression models were performed to analyze the associated factors of anterior chamber angle. Results: There were 118 subjects (118 eyes) and 117 subjects (117 eyes) enrolled in the Chinese and American Caucasians groups, respectively. Compared to Caucasians, Chinese had smaller A-ultrasound measured anterior chamber depth [(3.03±0.34) mm vs. (3.38±0.36) mm, t=-5.791, P<0.001], smaller relative lens position [0.227 (0.198, 0.256) vs. 0.235 (0.191, 0.262), Z=-3.063, P=0.002], smaller axial length [23.3 (20.9,28.3) mm vs. 24.2 (20.8,28.5) mm, Z=-5.510, P<0.001], smaller iris root distance [0.111 (0.000, 0.401) mm vs. 0.142 (0.000, 0.451) mm, Z=-3.188, P=0.001], smaller ciliary body thickness at 1 mm posterior to the scleral spur [0.661 (0.424, 0.892) mm vs. 0.716 (0.467, 0.942) mm, Z=-3.456, P=0.001], smaller trabecular ciliary process distance [0.780 (0.410, 1.400) mm vs. 0.930 (0.420, 1.470) mm, Z=-3.191, P=0.001], smaller trabecular ciliary process angle [73.4° (36.3°, 115.3°) vs. 81.1° (47.9°, 147.9°), Z=-3.407, P=0.001], smaller angle opening distance at 500 μm (AOD500) [0.181 (0.000, 0.703) mm vs. 0.264 (0.000, 0.806) mm, Z=-3.444, P=0.001], smaller angle recess area (ARA) [0.118 (0.011, 0.457) mm(2) vs. 0.179 (0.000, 0.626) mm(2), Z=-3.814, P<0.001], larger spherical equivalent [0.40 (-5.80, 4.00) D vs. -0.70 (-8.00, 4.00) D, Z=-5.454, P<0.001], larger lens thickness [(4.62±0.40) mm vs. (4.52±0.40) mm, t=2.077, P=0.039] and larger iris thickness [0.430 (0.280, 0.600) mm vs. 0.410 (0.240, 0.580) mm, Z=-2.263, P=0.024]. On average, with each decade of the increased age, Chinese had a greater decrease in the AOD500 than Caucasians (0.040 mm in Chinese vs. 0.030 mm in Caucasians), while the angle recess area decreased at the same rate (0.020 mm(2) in both groups). After adjusted for age, gender, spherical equivalent, axial length and other parameters of the anterior segment, the trabecular ciliary process angle [for AOD500, standardized regression coefficient (SRC)=0.487, R(2)=0.549, P<0.001; for ARA, SRC=0.372, R(2)=0.502, P<0.001] and anterior chamber depth (for AOD500, SRC=0.413, R(2)=0.476, P<0.001; for ARA, SRC=0.331, R(2)=0.403, P<0.001) were the main factors of anterior chamber angle parameters for Chinese and Caucasians, respectively. Conclusions: Compared with age and gender matched American Caucasians, Chinese Han people have more crowded anterior chambers and narrower anterior chamber angles. The more anteriorly positioned ciliary processes and shallower anterior chambers are the main factors that contributed to more crowded anterior chambers in Chinese Han people and American Caucasians, respectively. (Chin J Ophthalmol, 2018, 54: 820-826).
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Affiliation(s)
- N He
- Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China
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Power M, Small N, Doherty B, Pickett KE. Hidden hunger? Experiences of food insecurity amongst Pakistani and white British women. Br Food J 2018; 120:2716-2732. [PMID: 30581196 PMCID: PMC6290894 DOI: 10.1108/bfj-06-2018-0342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/21/2018] [Accepted: 07/28/2018] [Indexed: 05/30/2023]
Abstract
PURPOSE Foodbank use in the UK is rising but, despite high levels of poverty, Pakistani women are less likely to use food banks than white British women. The purpose of this paper is to understand the lived experience of food in the context of poverty amongst Pakistani and white British women in Bradford, including perspectives on food aid. DESIGN/METHODOLOGY/APPROACH A total of 16 Pakistani and white British women, recruited through community initiatives, participated in three focus groups (one interview was also held as a consequence of recruitment difficulties). Each group met for two hours aided by a moderator and professional interpreter. The transcripts were analysed thematically using a three-stage process. FINDINGS Women in low-income households employed dual strategies to reconcile caring responsibilities and financial obligations: the first sought to make ends meet within household income; the second looked to outside sources of support. There was a reported near absence of food insecurity amongst Pakistani women which could be attributed to support from social/familial networks, resource management within the household, and cultural and religious frameworks. A minority of participants and no Pakistani respondents accessed charitable food aid. There were three reasons for the non-use of food aid: it was not required because of resource management strategies within the household and assistance from familial/social networks; it was avoided out of shame; and knowledge about its existence was poor. ORIGINALITY/VALUE This case study is the first examination of varying experiences of food insecurity amongst UK white British and Pakistani women. Whilst the sample size is small, it presents new evidence on perceptions of food insecurity amongst Pakistani households and on why households of varying ethnicities do not use food aid.
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Vable AM, Cohen AK, Leonard SA, Glymour MM, Duarte CDP, Yen IH. Do the health benefits of education vary by sociodemographic subgroup? Differential returns to education and implications for health inequities. Ann Epidemiol 2018; 28:759-766.e5. [PMID: 30309690 PMCID: PMC6215723 DOI: 10.1016/j.annepidem.2018.08.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/26/2018] [Accepted: 08/30/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Evidence suggests education is an important life course determinant of health, but few studies examine differential returns to education by sociodemographic subgroup. METHODS Using National Longitudinal Survey of Youth 1979 (n = 6158) cohort data, we evaluate education attained by age 25 years and physical health (PCS) and mental health component summary scores (MCS) at age 50 years. Race / ethnicity, sex, geography, immigration status, and childhood socioeconomic status (cSES) were evaluated as effect modifiers in birth year adjusted linear regression models. RESULTS The association between education and PCS was large among high cSES respondents (β = 0.81 per year of education, 95% CI: 0.67, 0.94), and larger among low cSES respondents (interaction β = 0.39, 95% CI: 0.06, 0.72). The association between education and MCS was imprecisely estimated among White men (β = 0.44; 95% CI: -0.03, 0.90), while, Black women benefited more from each year of education (interaction β = 0.91; 95% CI: 0.19, 1.64). Similarly, compared to socially advantaged groups, low cSES Blacks, and low and high cSES women benefited more from each year of education, while immigrants benefited less from each year of education. CONCLUSIONS If causal, increases in educational attainment may reduce some social inequities in health.
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Affiliation(s)
- Anusha M Vable
- Department of Epidemiology and Biostatistics, University of California, San Francisco; Department of Family and Community Medicine, University of California, San Francisco.
| | - Alison K Cohen
- Department of Public and Nonprofit Administration, School of Management, University of San Francisco
| | - Stephanie A Leonard
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine; Center for Population Health Sciences, Stanford University School of Medicine
| | - M Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health
| | - Catherine D P Duarte
- Division of Epidemiology, School of Public Health, University of California, Berkeley
| | - Irene H Yen
- Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced
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Aggarwal NK, Lam P, Jiménez-Solomon O, Desilva R, Margolies PJ, Cleary K, Cain B, Dixon L, Lewis-Fernández R. An Online Training Module on the Cultural Formulation Interview: The Case of New York State. Psychiatr Serv 2018; 69:1135-1137. [PMID: 30041589 PMCID: PMC6347550 DOI: 10.1176/appi.ps.201800119] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Professional organizations and government guidelines recommend cultural competence training for providers, but the lack of a standardized cultural assessment has hindered research. Studies with the DSM-5 Cultural Formulation Interview (CFI) suggest that active learning during training improves perceptions of the CFI's usefulness as a cultural competence tool. This column reports demographic characteristics and evaluation scores among 423 providers who completed an online CFI training module developed through the New York State Office of Mental Health. Both the module, which uses the principle of active learning, and the CFI were associated with strong favorability ratings.
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Affiliation(s)
- Neil Krishan Aggarwal
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
| | - Peter Lam
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
| | - Oscar Jiménez-Solomon
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
| | - Ravi Desilva
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
| | - Paul J Margolies
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
| | - Katherine Cleary
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
| | - Bernadette Cain
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
| | - Lisa Dixon
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
| | - Roberto Lewis-Fernández
- Dr. Aggarwal, Mr. Lam, Mr. Jiménez-Solomon, Dr. Desilva, Dr. Margolies, Ms. Cleary, and Ms. Cain are with the New York State Psychiatric Institute, New York. Dr. Aggarwal, Dr. Desilva, and Dr. Margolies are also with Columbia University College of Physicians and Surgeons, New York. Dr. Dixon and Dr. Lewis-Fernández are with the Department of Psychiatry, Columbia University Medical Center, New York. Dr. Lewis-Fernández is editor of this column
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Maskarinec G, Shvetsov YB, Conroy SM, Haiman CA, Setiawan VW, Le Marchand L. Type 2 diabetes as a predictor of survival among breast cancer patients: the multiethnic cohort. Breast Cancer Res Treat 2018; 173:637-645. [PMID: 30367331 DOI: 10.1007/s10549-018-5025-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/20/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE The purpose of the study was to investigate the association of type 2 diabetes (T2D) with survival of breast cancer (BC) patients across five ethnic groups within the Multiethnic Cohort study. METHODS Between recruitment in 1993-1996 and 2013, 7570 incident BC cases were identified through SEER cancer registries in Hawaii and California. T2D diagnosed before BC was ascertained in 1013 women from self-reports and confirmed by administrative data sources. Covariate information was collected by questionnaire. Cox regression analysis with age as the time metric and BMI as time-varying exposure was applied to estimate hazard ratios (HR) and 95% confidence intervals (CI) for BC-specific and all-cause survival while adjusting for known prognostic factors. RESULTS In total, 2119 all-cause and 730 BC-specific deaths were recorded with corresponding 5-year survival rates of 86 and 93%. T2D was not a significant predictor of BC-specific survival (HR 0.84; 95% CI 0.65-1.09), but mortality was 36% lower for those with < 7 years of T2D than a longer history of T2D. On the other hand, all-cause mortality was higher in women with T2D (HR 1.23; 95% CI 1.08-1.40), especially in women with T2D of ≥ 7 years duration (HR 1.27; 95% CI 1.07-1.49). In women receiving none or either chemotherapy or radiation but not both, T2D predicted higher all-cause mortality (Pinteraction = 0.004). Variations in the association of T2D with mortality across ethnic groups were small. CONCLUSIONS T2D was associated with higher all-cause but not BC-specific mortality among women with BC in the Multiethnic Cohort study. However, T2D affected survival in cases who did not receive both radiation and chemotherapy.
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Affiliation(s)
- Gertraud Maskarinec
- Cancer Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, Hi, 96813, USA.
| | - Yurii B Shvetsov
- Cancer Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, Hi, 96813, USA
| | - Shannon M Conroy
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA, USA
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Veronica W Setiawan
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Loïc Le Marchand
- Cancer Epidemiology, University of Hawaii Cancer Center, 701 Ilalo Street, Honolulu, Hi, 96813, USA
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Blagoeva Atanasova V, Arevalo-Serrano J, Antolin Alvarado E, García-Tizón Larroca S. Maternal mortality in Spain and its association with country of origin: cross-sectional study during the period 1999-2015. BMC Public Health 2018; 18:1171. [PMID: 30314490 PMCID: PMC6186083 DOI: 10.1186/s12889-018-6091-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 10/04/2018] [Indexed: 12/22/2022] Open
Abstract
Background The available literature suggests that there are significant differences in maternal mortality according to maternal origin in high income countries. The objective of this study was to quantify the risk of maternal death by maternal origin and region of Spain where the birth occurred and to identify the most important causes of maternal death in our country. Methods An ecological cross-sectional study was conducted that included all deliveries that resulted in maternal survival and cases of maternal death during 1999–2015 in Spain. A descriptive analysis of the maternal mortality rate by maternal origin, region and year of birth was performed. The risk of maternal death was calculated using univariate and multivariate logistic regression analysis, with adjustment for the variables included in the descriptive analysis. Results There were 272 maternal deaths during this period, most of which were due to haemorrhage (63 cases, 23.16%).Women whose continent of origin was South America had the highest adjusted risk of maternal death, with an OR of 3.92 (95% CI 2.75–5.58). The region of Spain with the highest risk of maternal death was Ceuta, with an OR of 12.11 (95% CI 2.02–72.68). Conclusions This study shows that there are inequalities in maternal mortality according to maternal origin and region where labour occurred. These findings highlight the need to establish strategies at the national and European levels to analyse the most relevant causes and risk factors associated with maternal mortality in order to reduce it and pay closer attention in identifying and carefully managing pregnant women from this at risk groups.
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Affiliation(s)
- V Blagoeva Atanasova
- Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - J Arevalo-Serrano
- Department of Internal Medicine, Hospital Universitario, Principe de Asturias de Alcalá de Henares, Madrid, Spain
| | | | - Santiago García-Tizón Larroca
- Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain. .,Obstetrics and Gynecology Unit, Department of Obstetrics and Gynaecology, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, 28029, Madrid, ES, Spain.
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166
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Mozooni M, Preen DB, Pennell CE. Stillbirth in Western Australia, 2005-2013: the influence of maternal migration and ethnic origin. Med J Aust 2018; 209:394-400. [PMID: 30282563 DOI: 10.5694/mja18.00362] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/20/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate prevalence rates and the risk of ante- and intrapartum stillbirth in Western Australia with respect to maternal country of birth and ethnic origin. DESIGN, SETTING AND PARTICIPANTS Whole population retrospective cohort analysis of de-identified, linked routinely collected birth, perinatal and mortality data for all births to non-Indigenous women in WA during 2005-2013. MAIN OUTCOME MEASURES Crude and adjusted odds ratios (aORs) with 95% confidence intervals were estimated by logistic regression and adjusted for confounding factors, for all stillbirths, antepartum stillbirths and intrapartum stillbirths, stratified by migrant status and ethnic background (white, Asian, Indian, African, Māori, other). RESULTS Women born overseas were more likely to have a stillbirth than Australian-born women (aOR, 1.26; 95% CI, 1.09-1.37). There was no significant difference for any type of stillbirth between Australian-born women of white and non-white backgrounds, but non-white migrant women were more likely than white migrants to have a stillbirth (OR, 1.42; 95% CI, 1.19-1.70). Compared with Australian-born women, migrants of Indian (aOR, 1.71; 95% CI, 1.17-2.47), African (aOR, 2.12; 95% CI, 1.46-3.08), and "other" ethnic origins (aOR, 1.43; 95% CI, 1.06-1.93) were more likely to have antepartum stillbirths; women of African (aOR, 5.08; 95% CI, 3.14-8.22) and "other" (aOR, 1.86; 95% CI, 1.15-3.00) background were more likely to have an intrapartum stillbirth. CONCLUSIONS Immigrants of African or Indian background appear to be at greater risk of ante- and intrapartum stillbirth in WA. Specific strategies are needed reduce the prevalence of stillbirth in these communities.
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167
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Assari S, Lankarani MM, Piette JD, Aikens JE. Self-Rated Health and Glycemic Control in Type 2 Diabetes: Race by Gender Differences. J Racial Ethn Health Disparities 2018; 5:721-727. [PMID: 28779480 PMCID: PMC6378221 DOI: 10.1007/s40615-017-0416-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/17/2017] [Accepted: 07/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Although some studies have shown a link between self-rated health (SRH) and glycemic control in type 2 diabetes (DM), other studies have failed to support this association. The purpose of this study was to determine whether these equivocal findings can be explained by specific interactions between gender, race, and SRH, as suggested by the intersectionality literature. METHODS This cross-sectional study included 287 patients with DM (85 Black men, 78 Black women, 64 White men, and 60 White women). After adjusting for demographic and medical factors, we regressed HbA1c on SRH with and without interactions between gender, race, and SRH. We conducted additional subgroup analyses to further characterize gender by race group differences. RESULTS Although there was no main effect of SRH upon HbA1c (b = .16, 95% CI: .08-.39), we found a significant interaction between gender and SRH on HbA1c (b = -.50, 95% CI: -.97 to -.03). In race by gender-stratified models, SRH (b = .53, 95% CI: .00-1.07) was associated with HbA1c in Black men. SRH was not associated with HbA1c in White men, White women, or Black women. CONCLUSION Combined race and gender differences may exist in the link between SRH and glycemic control in DM. Specifically, Black men with DM may be more attuned to the relationship between their overall health and their glycemic control.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Maryam Moghani Lankarani
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA
| | - John D Piette
- VA Center for Clinical Management Research, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA
| | - James E Aikens
- Department of Family Medicine, Michigan Medicine, Ann Arbor, MI, USA
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Gruer LD, Millard AD, Williams LJ, Bhopal RS, Katikireddi SV, Cézard GI, Buchanan D, Douglas AF, Steiner MFC, Sheikh A. Differences in all-cause hospitalisation by ethnic group: a data linkage cohort study of 4.62 million people in Scotland, 2001-2013. Public Health 2018; 161:5-11. [PMID: 29852341 PMCID: PMC6085114 DOI: 10.1016/j.puhe.2018.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/14/2018] [Accepted: 04/17/2018] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Immigration into Europe has raised contrasting concerns about increased pressure on health services and equitable provision of health care to immigrants or ethnic minorities. Our objective was to find out if there were important differences in hospital use between the main ethnic groups in Scotland. STUDY DESIGN A census-based data linkage cohort study. METHODS We anonymously linked Scotland's Census 2001 records for 4.62 million people, including their ethnic group, to National Health Service general hospitalisation records for 2001-2013. We used Poisson regression to calculate hospitalisation rate ratios (RRs) in 14 ethnic groups, presented as percentages of the White Scottish reference group (RR = 100), for males and females separately. We adjusted for age and socio-economic status and compared those born in the United Kingdom or the Republic of Ireland (UK/RoI) with elsewhere. We calculated mean lengths of hospital stay. RESULTS 9.79 million hospital admissions were analysed. Compared with the White Scottish, unadjusted RRs for both males and females in most groups were about 50-90, e.g. Chinese males 49 (95% confidence interval [CI] = 45-53) and Indian females 76 (95% CI 71-81). The exceptions were White Irish, males 120 (95% CI 117-124) and females 115 (95% CI 112-119) and Caribbean females, 103 (95% CI 85-126). Adjusting for age increased the RRs for most groups towards or above the reference. Socio-economic status had little effect. In many groups, those born outside the UK/RoI had lower admission rates. Unadjusted mean lengths of stay were substantially lower in most ethnic minorities. CONCLUSIONS Use of hospital beds in Scotland by most ethnic minorities was lower than by the White Scottish majority, largely explained by their younger average age. Other countries should use similar methods to assess their own experience.
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Affiliation(s)
- L D Gruer
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK.
| | - A D Millard
- Public Health Science Directorate, NHS Health Scotland, Glasgow, UK
| | - L J Williams
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
| | - R S Bhopal
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
| | - S V Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK
| | - G I Cézard
- Population and Health Research Group, University of St Andrews, UK
| | - D Buchanan
- Information Services Division, NHS National Services Scotland, UK
| | - A F Douglas
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
| | - M F C Steiner
- Department of Child Health, University of Aberdeen, UK
| | - A Sheikh
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK
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169
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Assari S. Ethnic Groups Differ in How Poor Self-Rated Mental Health Reflects Psychiatric Disorders. J Racial Ethn Health Disparities 2018; 5:728-736. [PMID: 28913713 PMCID: PMC6378222 DOI: 10.1007/s40615-017-0417-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 07/23/2017] [Accepted: 07/25/2017] [Indexed: 01/07/2023]
Abstract
AIM This study aimed to explore cross-ethnic variation in the pattern of the associations between psychiatric disorders and self-rated mental health (SRMH) in the USA. METHODS This cross-sectional study used data from the Collaborative Psychiatric Epidemiology Surveys (CPES), 2001-2003, a national household probability sample. The study enrolled 18,237 individuals who were either Non-Hispanic White (n = 7587), African American (n = 4746), Mexican (n = 1442), Cuban (n = 577), Puerto Rican (n = 495), Other Hispanic (n = 1106), Vietnamese (n = 520), Filipino (n = 508), Chinese (n = 600) or Other Asian (n = 656). SRMH was the outcome. Independent variables were psychiatric disorders including major depressive disorder [MDD], general anxiety disorder [GAD], social phobia, alcohol abuse, binge eating disorders, panic disorder, and post-traumatic stress disorder [PTSD], measured by the Composite International Diagnostic Interview (CIDI). Demographic (age and gender) and socioeconomic (education and income) factors were covariates. RESULTS The only psychiatric disorder which was universally associated with SRMH across all ethnic groups was MDD. More psychiatric disorders were associated with poor SRMH in Non-Hispanic Whites than any other ethnic groups. Among African Americans, demographic and socioeconomic factors could fully explain the associations between psychiatric disorders and SRMH. Among Mexican and Other Hispanics, demographic and socioeconomic factors could only explain the association between some but not all psychiatric disorders and SRMH. In all other ethnic groups, demographic and socioeconomic factors did not explain the link between psychiatric disorders and SRMH. CONCLUSION Although SRMH is a useful tool for estimation of mental health needs of populations, poor SRMH may not have universal meanings across ethnically diverse populations. Ethnic groups differ in how their poor SRMH reflects psychiatric conditions and the role of demographic and socioeconomic factors in explaining such links. These ethnic differences may be a source of measurement bias in cross-ethnic health comparisons.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
- Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
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170
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Assari S, Caldwell CH. High Risk of Depression in High-Income African American Boys. J Racial Ethn Health Disparities 2018; 5:808-819. [PMID: 28842841 PMCID: PMC6556394 DOI: 10.1007/s40615-017-0426-1] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/17/2017] [Accepted: 08/10/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Despite the well-established literature on the protective effect of socioeconomic status (SES) on physical and mental health, there are a few reports on poor mental health of blacks with high SES. Using a national sample, this study investigated the association between household income and risk of major depressive disorder (MDD) in black youth based on ethnicity, gender, and their intersection. METHODS One thousand one hundred seventeen black adolescents (810 African Americans and 360 Caribbean blacks) were included in the current study. Household income was the main predictor. MDD (lifetime, 12-month, and 30-day) was the main outcome. Age was the covariate. Ethnicity and gender were the focal moderators. Logistic regressions were used for data analysis. RESULTS In the pooled sample, household income was not associated with risk of MDD (lifetime, 12-month, or 30-day). We found significant interactions between income and gender on lifetime and 12-month MDD, suggesting a stronger protective effect of income on MDD for females than males. We also found significant interaction between income and ethnicity on 30-day MDD, suggesting stronger protective effect of income against MDD for Caribbean blacks than African Americans. In African American males, high household income was associated with higher risk of lifetime, 12-month, and 30-day MDD. For Caribbean black males and females, high household income was associated with lower odds of 30-day MDD. CONCLUSION Findings suggest that ethnicity and gender influence how socioeconomic resources such as income are associated with MDD risk among black youth. Higher household income may be associated with higher risk of MDD for African American males.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
| | - Cleopatra H Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education (HBHE), School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Jones AM, Finkelstein R, Koehoorn M. Disability and workplace harassment and discrimination among Canadian federal public service employees. Can J Public Health 2018; 109:79-88. [PMID: 29981058 DOI: 10.17269/s41997-018-0022-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/18/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Policy and legislation that prohibits workplace harassment and discrimination, including that which is disability related, has been in place in Canada for many years. The study objective was to examine associations between disability and workplace harassment and discrimination in the current Canadian context, as well as the intersection of disability with age, gender, and ethnicity. METHODS Cross-sectional data from the 2014 Canadian Public Service Employee Survey was analyzed (n = 175,742) using logistic regression to investigate the relationship between self-reported disability and workplace harassment and discrimination in the last 2 years. Age, gender, and ethnicity were included as potential confounders and effect modifiers. Additive and multiplicative effect modifications were examined using linear binomial and logistic regression, respectively. RESULTS Overall, 18 and 8% of the sample of Canadian public service employees reported workplace harassment and discrimination, respectively. The prevalence was higher for workers with disability (37 and 26%). Disability was significantly associated with an increased odds of harassment (odds ratio (OR) = 2.80; 95% confidence interval (CI), 2.68-2.92) and discrimination (OR = 4.97; 95% CI, 4.72-5.23) in models adjusted for confounders. Significant positive additive effect modification was observed for (1) age in the harassment and discrimination models and (2) ethnicity in the discrimination model. CONCLUSION Findings from a 2014 census of the Canadian federal public service suggest that additional efforts are needed to address workplace harassment and discrimination beyond those already in place. Consideration should be given to workers with disability, as well as the intersectional impacts for older workers, visible minorities, and Aboriginal peoples.
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Affiliation(s)
- Andrea Marie Jones
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z9, Canada.
| | | | - Mieke Koehoorn
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z9, Canada
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Kim JM, Ryu JM, Kim I, Choi HJ, Nam SJ, Kim SW, Yu J, Lee SK, Lee JE. Verification of a Western Nomogram for Predicting Oncotype DX™ Recurrence Scores in Korean Patients with Breast Cancer. J Breast Cancer 2018; 21:222-226. [PMID: 29963119 PMCID: PMC6015974 DOI: 10.4048/jbc.2018.21.2.222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 05/30/2018] [Indexed: 11/30/2022] Open
Abstract
A recent study conducted at the University of Tennessee Medical Center using a large dataset from the National Cancer Database (NCDB) reported the use of nomograms for predicting Oncotype DX™ (ODX) scores with clinicopathologic data. We reviewed the data of 218 patients who underwent the ODX test at a single institution in Korea to confirm that nomograms can accurately predict ODX score groups using our data, which differ from those of the NCDB in terms of ethnicity. The concordance index (c-index) of nomograms was much lower than that of the University of Tennessee Medical Center for high- and low-risk groups of commercial ODX and Trial Assigning Individualized Options for Treatment values. Although the nomogram for predicting ODX scores was based on a large dataset, it could not be generalized to patients in Asia. Further studies using large datasets of patients from different ethnicities should be performed to develop a nomogram applicable to patients worldwide.
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Affiliation(s)
- Jae-Myung Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jai Min Ryu
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Isaac Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Jun Choi
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Won Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jonghan Yu
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Se Kyung Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Carr BL, Copnell B, McIntyre M. Differences in meconium stained amniotic fluid in an Australian population: A retrospective study. Women Birth 2018; 32:e259-e263. [PMID: 29954687 DOI: 10.1016/j.wombi.2018.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 05/25/2018] [Accepted: 06/05/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Meconium stained amniotic fluid commonly occurs postdates ( >40 weeks gestation) indicating fetal maturity. Previous literature indicates that different ethnicities mature at different rates. AIM To compare the rate of meconium stained amniotic fluid of Australian-born and non-Australian born women. METHODS A retrospective correlation study design was implemented, using data collected in the birth outcomes system at one tertiary hospital. Data was collected from all women who gave birth to a term (>/=37 weeks gestation), singleton, liveborn baby between January 1st to December 31st, 2014. Maternal country of birth was used for comparison. Categorical data was analyzed using Chi-Square test for Independence. Continuous variables were assessed for normality, and differences were compared using an Independent t-test or a Mann-Whitney U test. All tests were two-tailed and p<0.05 was considered statistically significant. RESULTS 3,041 women were included; 1131 Australian-born and 1910 non-Australian born. Meconium stained amniotic fluid occurred more frequently in non-Australian born women compared to Australian-born women (23.5% vs. 19.8 p=0.02). Their babies were significantly smaller (Mean=3265g, Standard Deviation 463.8 vs Mean=3442g, Standard Deviation 499.2, p<0.001), with no difference in gestational length (Mean=39.4, Standard Deviation 1.28 vs Mean=39.5, Standard Deviation 1.18, p=0.06). Increasing gestational age had the strongest association with meconium stained amniotic fluid; >/=42 weeks gestation occurring 3.52 (95% Confidence Interval: 2.00, 6.22, p=<0.001) more than <40 weeks gestation. CONCLUSION Maternity health services should record ethnicity and region of birth to provide individualised care as women born overseas often have poorer perinatal outcomes when compared to Australian-born women.
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Affiliation(s)
- Bethany L Carr
- Monash University, School of Nursing and Midwifery, McMahons Rd, Frankston 3199, VIC, Australia; Monash Medical Centre, Women's & Children's Program, 246 Clayton Rd, Clayton 3168, VIC, Australia.
| | - Beverley Copnell
- La Trobe University, School of Nursing and Midwifery Centre, Plenty Rd & Kingsbury Dve, Bundoora 3086, VIC, Australia
| | - Meredith McIntyre
- Monash University, School of Nursing and Midwifery, McMahons Rd, Frankston 3199, VIC, Australia
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Yamashita Y, Morimoto T, Toyota T, Shiomi H, Makiyama T, Ono K, Kimura T. Asian patients versus non-Asian patients in the efficacy and safety of direct oral anticoagulants relative to vitamin K antagonist for venous thromboembolism: A systemic review and meta-analysis. Thromb Res 2018; 166:37-42. [PMID: 29655001 DOI: 10.1016/j.thromres.2018.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 03/26/2018] [Accepted: 04/09/2018] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The standard for treatment and secondary prevention of venous thromboembolism (VTE) has been vitamin K antagonist (VKA), which might be associated with a higher risk of bleeding particularly in Asian patients. Direct oral anticoagulants (DOAC) have been shown to be safer alternatives for VTE. It remains unclear whether this is the case in Asian ethnicity. MATERIALS AND METHODS We performed a meta-analysis of randomized controlled trials to evaluate the efficacy and safety of DOACs in Asian and non-Asian patients with acute VTE. We searched MEDLINE, CENTRAL, and ClinicalTrials.gov. The efficacy endpoint was recurrent VTE or VTE-related death. The safety endpoint was major bleedings or clinically relevant non-major bleedings. The pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated. RESULTS We identified 6 studies that comprised 3542 Asian and 23,481 non-Asian patients. The efficacy of DOACs was comparable with VKA in both Asian and non-Asian patients (OR, 0.90; 95% CI, 0.55-1.49; P = 0.69 for Asian patients; OR, 0.92; 95% CI, 0.78-1.08; P = 0.32 for non-Asian patients; P interaction = 0.94). DOACs significantly reduced the safety endpoint compared with VKA in Asian patients (OR, 0.64; 95% CI, 0.51-0.80; P < 0.001), while DOACs were associated with non-significant reduction in non-Asian patients (OR, 0.73; 95% CI, 0.53-1.01; P = 0.06), indicating that the reduction seemed numerically more prominent in Asian patients, although there was no statistically significant interaction (P interaction = 0.49). CONCLUSIONS The efficacy of DOACs was comparable with VKA irrespective of ethnicity, and DOACs could be safer alternatives in Asian patients.
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Affiliation(s)
- Yugo Yamashita
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Toshiaki Toyota
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeru Makiyama
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koh Ono
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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175
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Briones-Vozmediano E, La Parra-Casado D, Vives-Cases C. Health Providers' Narratives on Intimate Partner Violence Against Roma Women in Spain. Am J Community Psychol 2018; 61:411-420. [PMID: 29493794 DOI: 10.1002/ajcp.12235] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This qualitative study identifies health professionals' dominant, adaptive, and liberating narratives regarding inter-ethnic relations when talking about intimate partner violence (IPV) and the health system responses to the way it affects Roma women. Dominant narratives are oppressive internalized stories that shape social perceptions of members of both dominant and minority groups, adaptive narratives refer to those that acknowledge asymmetry and inequality, and liberating narratives directly challenge oppression with resistant views of stereotypes and negative interpretations. A total of 25 in-depth interviews were carried out with healthcare professionals in Spain in 2015. A discourse analysis of the interview transcriptions was conducted, showing the way in which different narratives about Roma people and IPV are combined among health providers. Dominant narratives were more salient: they were used by health providers to reflect prejudicial social perceptions in Spain that depict the Roma as a marginalized and traditional group, to construct Roma women in negative and prejudicial terms as patients, and to explain the existence of the cultural normalization of IPV among Roma women. Adaptive and liberating narratives showed a prevailing ideology in terms of the tendency to socially discriminate against Roma people. Using liberating narratives to train and raise awareness among health professionals about IPV among Roma women could facilitate a positive change in their treatment of Roma women who could be affected by IPV, helping to ameliorate the maintenance of existing prejudices.
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Affiliation(s)
- Erica Briones-Vozmediano
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Public Health Research Group, University of Alicante, Alicante, Spain
- Interuniversity Institute for Social Development and Peace, WHO Collaborating Centre for Health and Social Inclusion, Alicante, Spain
| | - Daniel La Parra-Casado
- Interuniversity Institute for Social Development and Peace, WHO Collaborating Centre for Health and Social Inclusion, Alicante, Spain
- Department of Sociology II, University of Alicante, Alicante, Spain
| | - Carmen Vives-Cases
- Public Health Research Group, University of Alicante, Alicante, Spain
- Interuniversity Institute for Social Development and Peace, WHO Collaborating Centre for Health and Social Inclusion, Alicante, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Dong Y, Zou Z, Yang Z, Wang Z, Yang Y, Ma J, Dong B, Ma Y, Arnold L. Prevalence of excess body weight and underweight among 26 Chinese ethnic minority children and adolescents in 2014: a cross-sectional observational study. BMC Public Health 2018; 18:562. [PMID: 29703183 PMCID: PMC5923026 DOI: 10.1186/s12889-018-5352-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 03/21/2018] [Indexed: 01/21/2023] Open
Abstract
Background Little is known regarding the nutritional burden in Chinese ethnic minority children. This study aimed to investigate the epidemiological characteristics of excess body weight and underweight for 26 ethnic groups. Methods Data on 80,821 participants aged 7–18 years across 26 minorities, with completed records from a large national cross-sectional survey, were obtained from Chinese National Survey on Students’ Constitution and Health (CNSSCH) in 2014. Excess body weight, underweight and their components were classified according to Chinese national BMI references. Results The overall prevalence of excess body weight and underweight among ethnic groups were 12.0% and 14.5%, in which 4.4% and 4.1% of the participants were classified as obese and severe wasting, respectively. Compared with girls, boys showed a higher prevalence of underweight, severe wasting and obesity, but a lower prevalence of excess body weight (P < 0.05). Among 26 ethnic groups, Koreans had the highest prevalence of excess body weight (30.4%), while Bouyeis showed the highest prevalence of underweight (25.7%). The ethnic minority groups with high prevalence of excess body weight and underweight were more likely to show high burden of obesity and severe wasting, respectively. However, it is not the case for some groups, such as Miaos and Shuis. Conclusions A worrying dual burden of excess body weight and underweight was recognized in Chinese ethnic minority children. Since various characteristics were found among different minorities, the ethnic-specific effort is warranted to improve their nutritional status. Electronic supplementary material The online version of this article (10.1186/s12889-018-5352-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yanhui Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Zhiyong Zou
- Institute of Child and Adolescent Health & School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Zhaogeng Yang
- Institute of Child and Adolescent Health & School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Zhenghe Wang
- Institute of Child and Adolescent Health & School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yide Yang
- Institute of Child and Adolescent Health & School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jun Ma
- Institute of Child and Adolescent Health & School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Bin Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Yinghua Ma
- Institute of Child and Adolescent Health & School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China.
| | - Luke Arnold
- South Western Sydney Primary Health Network, Sydney, Australia
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Marin B, Fontana A, Arcuti S, Copetti M, Boumédiene F, Couratier P, Beghi E, Preux PM, Logroscino G. Age-specific ALS incidence: a dose-response meta-analysis. Eur J Epidemiol 2018; 33:621-34. [PMID: 29687175 DOI: 10.1007/s10654-018-0392-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 04/02/2018] [Indexed: 12/12/2022]
Abstract
To evaluate the association between worldwide ALS incidence rates and age, using a dose-response meta-analysis. We reviewed Medline and Embase up to July 2016 and included all population-based studies of newly-diagnosed cases, using multiple sources for case ascertainment. A dose-response meta-analysis was performed. A meta-regression investigated potential sources of heterogeneity. Of 3254 articles identified in the literature, we included 41 incidence studies covering 42 geographical areas. Overall, the fit between observed and predicted age-specific rates was very good. The expected variation of ALS incidence with age was characterized, in each study, by a progressive increase in the incidence from the 40s leading to a peak in the 60s or 70s, followed by a sharp decrease. Cochran's Q test suggested a significant heterogeneity between studies. Overall, estimated patterns of ALS age-specific incidence (at which the peak was reached) were similar among subcontinents of Europe and North America: peak of ALS incidence ranged in these areas between 6.98 and 8.17/100,000 PYFU, which referred to age in the range 71.6-77.4 years. The relationship between age and ALS incidence appeared different for Eastern Asia which was characterized by a peak of ALS incidence at 2.20/100,000 PYFU around 75 years of age. This study confirms the consistency of the age-specific ALS incidence pattern within different subcontinents. Age-specific incidence appears lower in Eastern Asia as compared to Europe and North America.
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Perini W, Snijder MB, Peters RJG, Kunst AE. Ethnic disparities in estimated cardiovascular disease risk in Amsterdam, the Netherlands : The HELIUS study. Neth Heart J 2018; 26:252-62. [PMID: 29644501 DOI: 10.1007/s12471-018-1107-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Ethnic differences have been reported in cardiovascular disease (CVD) risk factors. It is still unclear which ethnic groups are most at risk for CVD when all traditional CVD risk factors are considered together as overall risk. Objectives To examine ethnic differences in overall estimated CVD risk and the risk factors that contribute to these differences. Design Using data of the multi-ethnic HELIUS study (HEalthy LIfe in an Urban Setting) from Amsterdam, we examined whether estimated CVD risk and risk factors among those eligible for CVD risk estimation differed between participants of Dutch, South Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin. Using the Systematic COronary Risk Evaluation (SCORE) algorithm, we estimated risk of fatal CVD and risk of fatal plus non-fatal CVD. These risks were compared between ethnic groups via age-adjusted linear regression analyses. Results The SCORE algorithm was applicable to 9,128 participants. Relative to the fatal CVD risk of participants of Dutch origin, South Asian Surinamese participants showed a higher fatal CVD risk, Ghanaian males a lower fatal CVD risk, and participants of other ethnic origins a similar fatal CVD risk. For fatal plus non-fatal CVD risk, African Surinamese and Turkish men also showed a higher risk. When diabetes was incorporated in the CVD risk algorithm, all but Ghanaian men showed a higher CVD risk relative to the participants of Dutch origin (betas ranging from 0.98–3.10%). The CVD risk factors that contribute the most to these ethnic differences varied between ethnic groups. Conclusion Ethnic minority groups are at a greater estimated risk of fatal plus non-fatal CVD relative to the group of native Dutch. Further research is necessary to determine whether this will translate to ethnic differences in CVD incidence and, if so, whether ethnic-specific CVD prevention strategies are warranted. Electronic supplementary material The online version of this article (10.1007/s12471-018-1107-3) contains supplementary material, which is available to authorized users.
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Escobar-Ballesta M, García-Ramírez M, Albar-Marín MªJ, Paloma V. [Sexual and reproductive health in Roma women: the family planning programme of Polígono Sur in Seville (Spain)]. Gac Sanit 2018; 33:222-228. [PMID: 29628121 DOI: 10.1016/j.gaceta.2017.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 12/17/2017] [Accepted: 12/18/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the challenges, resources and strategies of the staff of the family planning programme of the Polígono Sur Healthcare Centre in Seville (Spain) in their care of Roma women. METHOD This is a descriptive study in which in-depth interviews and discussion groups were held with all programme professionals, including a documentary review of the programme. The information was analyzed based on the Roma Health Integration Policy Index, a tool that evaluates the entitlement, accessibility, sensitivity and capacity for change of health programmes for the Roma population. RESULTS The professionals encountered multiple challenges to implement the family planning programme with Roma women due to the characteristics of the users and the low sensitivity of the programme towards them. The absence of specific actions for Roma women within the family planning programme, agreed to by the healthcare district, obliges professionals to develop adaptations and strategies to ensure quality sexual and reproductive health services for their users. CONCLUSIONS It is necessary to adapt sexual and reproductive health programmes targeted at Roma women by (a) detecting, evaluating, systematizing and disseminating good practices, (b) developing actions that address the multiple vulnerabilities of Roma women, (c) acknowledging professionals who advocate for the health of these women within their organizations, and (d) promoting reproductive justice as the goal of these programmes.
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Affiliation(s)
- Marta Escobar-Ballesta
- Coalición para el Estudio de la Salud, el Poder y la Diversidad (CESPYD), Universidad de Sevilla, Sevilla, España.
| | - Manuel García-Ramírez
- Coalición para el Estudio de la Salud, el Poder y la Diversidad (CESPYD), Universidad de Sevilla, Sevilla, España
| | - M ª Jesús Albar-Marín
- Coalición para el Estudio de la Salud, el Poder y la Diversidad (CESPYD), Universidad de Sevilla, Sevilla, España
| | - Virginia Paloma
- Coalición para el Estudio de la Salud, el Poder y la Diversidad (CESPYD), Universidad de Sevilla, Sevilla, España
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Phumthum M, Srithi K, Inta A, Junsongduang A, Tangjitman K, Pongamornkul W, Trisonthi C, Balslev H. Ethnomedicinal plant diversity in Thailand. J Ethnopharmacol 2018; 214:90-98. [PMID: 29241674 DOI: 10.1016/j.jep.2017.12.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 12/05/2017] [Accepted: 12/05/2017] [Indexed: 05/20/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Plants have provided medicine to humans for thousands of years, and in most parts of the world people still use traditional plant-derived medicine. Knowledge related to traditional use provides an important alternative to unavailable or expensive western medicine in many rural communities. At the same time, ethnomedicinal discoveries are valuable for the development of modern medicine. Unfortunately, globalization and urbanization causes the disappearance of much traditional medicinal plant knowledge. AIM OF THE STUDY To review available ethnobotanical knowledge about medicinal plants in Thailand and to estimate its diversity. METHODS Information about ethnomedicinal uses of plants in Thailand was extracted from 64 scientific reports, books, and theses produced between 1990 and 2014. Plant identifications in the primary sources were updated to currently accepted names following The Plant List website and the species were assigned to family following the Angiosperm Phylogeny Website. Use Values (UV) were calculated to estimate the importance of medicinal plant species (UVs) and families (UVf). Medicinal use categories, plant parts used, preparations of the medicine, and their applications were noted for each use report. RESULTS We found 16,789 use reports for 2187 plant species in 206 families. These data came from 19 ethnic groups living in 121 villages throughout Thailand. The health conditions most commonly treated with medicinal plants were in the categories digestive system disorders, infections/infestations, nutritional disorders, muscular-skeletal system disorders, and genitourinary system disorders. Plant families with very high use values were Fabaceae, Asteraceae, Acanthaceae, Lamiaceae, and Zingiberaceae and species with very high use values were Chromolaena odorata (L.) R.M.King & H.Rob., Blumea balsamifera (L.) DC., and Cheilocostus speciosus (J.Koenig) C.D.Specht. Stems and leaves were the most used plant parts, but also other parts of the plants were used in medicinal recipes. The most common way of using the medicinal plants was as a decoction in water. CONCLUSION We found 2187 plant species that were used in traditional medicine in Thailand. Of these a few hundred had high use values, suggesting that they may produce bioactive compounds with strong physiological effects.
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Affiliation(s)
- Methee Phumthum
- Department of Bioscience, Aarhus University, Building 1540, Ny Munkegade 116, DK-8000 Aarhus C, Denmark
| | - Kamonnate Srithi
- Program in Plant Protection, Faculty of Agricultural Production, Maejo University, Sansai, Chiang Mai 50290, Thailand; Department of Biology, Faculty of Science, Chiang Mai University, Thailand
| | - Angkhana Inta
- Department of Biology, Faculty of Science, Chiang Mai University, Thailand
| | - Auemporn Junsongduang
- Science and Technology Department, Liberal Art and Science Faculty, Roi Et Rajabhat University, Thailand
| | - Kornkanok Tangjitman
- Faculty of Science and Technology, Muban Chom Bueng Rajabhat University, Chom Bueng, Ratchaburi 70150, Thailand
| | | | - Chusie Trisonthi
- Department of Biology, Faculty of Science, Chiang Mai University, Thailand
| | - Henrik Balslev
- Department of Bioscience, Aarhus University, Building 1540, Ny Munkegade 116, DK-8000 Aarhus C, Denmark.
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Khosravanifard B, Raeisi E, Kadkhodaei Oliadarani F, Rakhshan V. Soft-Tissue Anthropometric Norms of Iranians with Proper Occlusion and Inter-Ethnic Norm Comparisons. J Maxillofac Oral Surg 2018; 17:588-96. [PMID: 30344405 DOI: 10.1007/s12663-018-1101-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 03/05/2018] [Indexed: 10/17/2022] Open
Abstract
Background Photographic soft-tissue norms of Iranian race are not reported previously, nor are they compared with other ethnicities. Besides, sex dimorphism is assessed in only very few studies on soft-tissue profile. The aim of this study was to assess the soft-tissue measurements of Iranians with good occlusion and the existing sex dimorphism and to compare the Iranian norms with other ethnicities. Materials and Methods Twelve anthropometric variables were measured by a dentist in 100 Iranian subjects with good occlusions. The subjects included 50 males and 50 females. The differences between the two genders, as well as the differences between Iranian norms and the norms in all other ethnicities available in the literature were statistically analyzed using a t test (α = 0.05). Results There were significant differences between males and females regarding frontonasal angle (P = 0.0000), mentolabial sulcus (P = 0.0000), vertical height ratio (P = 0.0000), vertical lip-chin ratio (P = 0.0013), nasolabial angle (P = 0.0019), lower vertical height-depth ratio (P = 0.0029), maxillary prognathism (P = 0.0045), and mandibular prognathism (P = 0.0118). The difference in facial convexity was marginally significant (P = 0.0543). Protrusions of both lips and horizontal distance between the lips were not significantly different between sexes (P > 0.2). Conclusions Unlike Americans and Brazilians but similar to Koreans, there was considerable sex dimorphism in Iranians. Compared to Iranian men, women might have more convex profiles, more advanced mandibles (unlike all other races studied), more protruded maxillae, lips closer to the middle of nose-chin vertical distance, deeper mentolabial sulci, less protruded noses with higher nose tips, and smaller lower faces.
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Assari S, Thomas A, Caldwell CH, Mincy RB. Blacks' Diminished Health Return of Family Structure and Socioeconomic Status; 15 Years of Follow-up of a National Urban Sample of Youth. J Urban Health 2018; 95:21-35. [PMID: 29230628 PMCID: PMC5862702 DOI: 10.1007/s11524-017-0217-3] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The protective effect of family structure and socioeconomic status (SES) on physical and mental health is well established. There are reports, however, documenting a smaller return of SES among Blacks compared to Whites, also known as Blacks' diminished return. Using a national sample, this study investigated race by gender differences in the effects of family structure and family SES on subsequent body mass index (BMI) over a 15-year period. This 15-year longitudinal study used data from the Fragile Families and Child Wellbeing Study (FFCWS), in-home survey. This study followed 1781 youth from birth to age 15. The sample was composed of White males (n = 241, 13.5%), White females (n = 224, 12.6%), Black males (n = 667, 37.5%), and Black females (n = 649, 36.4%). Family structure and family SES (maternal education and income to need ratio) at birth were the independent variables. BMI at age 15 was the outcome. Race and gender were the moderators. Linear regression models were run in the pooled sample, in addition to race by gender groups. In the pooled sample, married parents, more maternal education, and income to need ratio were all protective against high BMI of youth at 15 years of age. Race interacted with family structure, maternal education, and income to need ratio on BMI, indicating smaller effects for Blacks compared to Whites. Gender did not interact with SES indicators on BMI. Race by gender stratified regressions showed the most consistent associations between family SES and future BMI for White females followed by White males. Family structure, maternal education, and income to need ratio were not associated with lower BMI in Black males or females. The health gain received from family economic resources over time is smaller for male and female Black youth than for male and female White youth. Equalizing access to economic resources may not be enough to eliminate health disparities in obesity. Policies should address qualitative differences in the lives of Whites and Blacks which result in diminished health returns with similar SES resources. Policies should address structural and societal barriers that hold Blacks against translation of their SES resources to health outcomes.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA.
| | - Alvin Thomas
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Palo Alto University, Palo Alto, CA, USA
| | - Cleopatra H Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Ronald B Mincy
- Center for Research on Fathers, Children, and Family Well-Being, New York, NY, USA
- Columbia Population Research Center (CPRC), New York, NY, USA
- Columbia School of Social Work, New York, NY, USA
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Abstract
Background To evaluate macular pigment optical density (MPOD) and to identify its determinants in a sample of Brazilian individuals. Methods This was a cross-sectional study. One hundred three healthy individuals had both eyes photographed using a Visucam 500 digital fundus camera (Carl Zeiss Meditec, Jena, Germany) in combination with the MPOD module. Four variables were obtained: maximum MPOD, mean MPOD, MPOD volume, and MPOD area. Demographic data and information on lifestyle habits were also collected.
Results Mean MPOD was 0.14 density unit ± 0.05. MPOD was not influenced by gender, smoking history, or refractive error. MPOD was significantly higher among black individuals than among white and biracial individuals. There was a positive but low correlation between MPOD and age. Conclusion This study found MPOD values to be similar to those found in European samples but lower than other studies performed on Asian and Australian samples. This is the first data regarding MPOD in a South American Population.
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Affiliation(s)
| | | | - Eduardo Jorge
- Instituto Panamericano da Visão, Street T 8 No. 171 Setor Marista, 74150-060 Goiânia, GO Brazil
| | - Marcos Pereira de Ávila
- 2Universidade Federal de Goiás, Av 1 No. 355 Setor Universitário, 74605-020 Goiânia, GO Brazil
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184
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Tin Tin S, Elwood JM, Brown C, Sarfati D, Campbell I, Scott N, Ramsaroop R, Seneviratne S, Harvey V, Lawrenson R. Ethnic disparities in breast cancer survival in New Zealand: which factors contribute? BMC Cancer 2018; 18:58. [PMID: 29310606 PMCID: PMC5759270 DOI: 10.1186/s12885-017-3797-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 11/17/2017] [Indexed: 11/24/2022] Open
Abstract
Background New Zealand has major ethnic disparities in breast cancer survival with Māori (indigenous people) and Pacific women (immigrants or descended from immigrants from Pacific Islands) faring much worse than other ethnic groups. This paper identified underlying factors and assessed their relative contribution to this risk differential. Methods This study involved all women who were diagnosed with primary invasive breast cancer in two health regions, covering about 40% of the national population, between January 2000 and June 2014. Māori and Pacific patients were compared with other ethnic groups in terms of demographics, mode of diagnosis, disease factors and treatment factors. Cox regression modelling was performed with stepwise adjustments, and hazards of excess mortality from breast cancer for Māori and Pacific patients were assessed. Results Of the 13,657 patients who were included in this analysis, 1281 (9.4%) were Māori, and 897 (6.6%) were Pacific women. Compared to other ethnic groups, they were younger, more likely to reside in deprived neighbourhoods and to have co-morbidities, and less likely to be diagnosed through screening and with early stage cancer, to be treated in a private care facility, to receive timely cancer treatment, and to receive breast conserving surgery. They had a higher risk of excess mortality from breast cancer (age and year of diagnosis adjusted hazard ratio: 1.76; 95% CI: 1.51–2.04 for Māori and 1.97; 95% CI: 1.67–2.32 for Pacific women), of which 75% and 99% respectively were explained by baseline differences. The most important contributor was late stage at diagnosis. Other contributors included neighbourhood deprivation, mode of diagnosis, type of health care facility where primary cancer treatment was undertaken and type of loco-regional therapy. Conclusions Late diagnosis, deprivation and differential access to and quality of cancer care services were the key contributors to ethnic disparities in breast cancer survival in New Zealand. Our findings underscore the need for a greater equity focus along the breast cancer care pathway, with an emphasis on improving access to early diagnosis for Māori and Pacific women. Electronic supplementary material The online version of this article (10.1186/s12885-017-3797-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sandar Tin Tin
- Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand.
| | - J Mark Elwood
- Section of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Charis Brown
- SMART Marketing and Research, Hamilton, New Zealand
| | - Diana Sarfati
- Department of Public Health, The University of Otago, Wellington, New Zealand
| | - Ian Campbell
- Waikato Clinical Campus, The University of Auckland, Hamilton, New Zealand.,Waikato District Health Board, Hamilton, New Zealand
| | - Nina Scott
- Waikato District Health Board, Hamilton, New Zealand
| | - Reena Ramsaroop
- Surgical Pathology Department, Waitemata District Health Board, Auckland, New Zealand
| | | | - Vernon Harvey
- Auckland District Health Board, Auckland, New Zealand
| | - Ross Lawrenson
- National Institute of Demographic and Economic Analysis, The University of Waikato, Hamilton, New Zealand.,Waikato District Health Board, Hamilton, New Zealand
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185
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Li J, Liu XQ, Jiang SW, Li X, Yu F, Wang Y, Peng Y, Gu XM, Sun YN, Zhang H, Wang LX. Improving tuberculosis case detection in underdeveloped multi-ethnic regions with high disease burden: a case study of integrated control program in China. Infect Dis Poverty 2017; 6:151. [PMID: 29183369 PMCID: PMC5706405 DOI: 10.1186/s40249-017-0365-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 10/03/2017] [Indexed: 11/26/2022] Open
Abstract
Background In the underdeveloped multi-ethnic regions of China, high tuberculosis (TB) burden and regional inequity in access to healthcare service increase the challenge of achieving the End TB goals. Among all the provinces, the highest TB burden is reported in Xinjiang, where ethnic minorities and older people have suffered most. However, current case-finding strategy is inadequate given the complex social determinants and suboptimal case detection rates. Thus, we developed an integrated TB control program to improve case detection and conducted a pilot in Xinjiang from 2014 to 2015. In this case study, we summarized the activities and key findings. We also shared the experiences and challenges of implementing interventions and provided recommendations to inform the TB control program in the future. Case presentation The pilot interventions were implemented in one selected town in Yining based on local TB control programs. By applying tailor-made educational materials, outreach TB educational activities were conducted in diverse ways. In 22 Masjids, the trained imams promoted TB education to the Muslims, covering 20,440 person-times in 88 delivered preaching sessions. In seven schools, 1944 students were educated by the teachers and contributed to educating 6929 family members. In the village communities, 13,073 residents participated in household education and screening. Among them, 12,292 people aged under 65 years were investigated for suspicious pulmonary TB symptoms, where six TB patients were diagnosed out of 89 TB suspects; 781 older people were mobilized for screening directly by chest X-ray, where 10 patients were diagnosed out of 692 participants. Supportive healthcare system, multi-sectoral cooperation and multi-channel financing mechanism were the successful experiences of implementation. The interventions were proved to be more effective than the previous performance: the number of TB suspects consulting doctors and patients detected increased by 50% and 26%, respectively. The potential challenges, implications and recommendations should been taken into account for further program improvement. Conclusions In underdeveloped multi-ethnic regions with high TB burden, improving case detection is necessary and the interventions can be feasible and effective within a supportive system. More intensive educational and training approaches, a high index of TB suspicion and prioritization of older people in screening are recommended. To sustain and scale up the program, the impacts, cost-effectiveness, feasibility and acceptability of interventions warrant further research and evaluation in each specific context. Electronic supplementary material The online version of this article (10.1186/s40249-017-0365-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jun Li
- Jockey School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong, China
| | - Xiao-Qiu Liu
- National Center for TB Control and Prevention, China CDC, 0515, 155 Changbai Road, Changping District, Beijing, 102206, China.
| | - Shi-Wen Jiang
- National Center for TB Control and Prevention, China CDC, 0515, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Xue Li
- National Center for TB Control and Prevention, China CDC, 0515, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Fei Yu
- Yining Center for Disease Control and Prevention, Yili, China
| | - Yan Wang
- Yining Center for Disease Control and Prevention, Yili, China
| | - Yong Peng
- Yili Center for Disease Control and Prevention, Yili, China
| | - Xiao-Ming Gu
- Xinjiang Center for Disease Control and Prevention, Urumqi, China
| | - Yan-Ni Sun
- World Health Organization Beijing Office, Beijing, China
| | - Hui Zhang
- National Center for TB Control and Prevention, China CDC, 0515, 155 Changbai Road, Changping District, Beijing, 102206, China
| | - Li-Xia Wang
- National Center for TB Control and Prevention, China CDC, 0515, 155 Changbai Road, Changping District, Beijing, 102206, China
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Peled A, Gordon B, Twig G, Mendlovic J, Derazne E, Lisnyansky M, Raz I, Afek A. Immigration to Israel during childhood is associated with diabetes at adolescence: a study of 2.7 million adolescents. Diabetologia 2017; 60:2226-2230. [PMID: 28821907 DOI: 10.1007/s00125-017-4399-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
Abstract
AIMS/HYPOTHESIS Immigration studies can shed light on diabetes pathogenesis and risk factors. To this end, we investigated the association between age at immigration and diabetes occurrence at adolescence among immigrants to Israel. METHODS We analysed cross-sectional data on 2,721,767 Jewish adolescents assessed for mandatory military service at approximately 17 years of age between 1967 and 2014. The study population comprised 430,176 immigrants with origins in Ethiopia, former USSR, Middle East and North Africa (ME/NA) and western countries. ORs for diabetes were calculated for men and women, grouped according to age at immigration, with Israel-born participants as controls. Unadjusted and fully adjusted models were made to account for possible confounders. Additionally, the study population was stratified by origin and each immigrant group was referenced to Israel-born participants of the same origin. RESULTS There was a graded decrease in OR for diabetes across the study groups in the fully adjusted model. Immigrants arriving at age 0-5 years had comparable OR for diabetes to the Israeli-born reference group; those arriving at age 6-11 years had an OR of 0.82 (95% CI 0.70, 0.97; p = 0.017) and recent immigrants, arriving at age 12-19 years, had the lowest OR of 0.65 (95% CI 0.54, 0.77; p < 0.0001). When age at immigration was treated as a continuous variable, there was an adjusted risk for occurrence of diabetes of 0.97 (95% CI 0.96, 0.99; p = 0.001) for every year increment. The lower risk for diabetes among recent immigrants persisted in the unadjusted model and persisted when the study sample was stratified by sex and origin, except for immigrants arriving from ME/NA. Notably, Ethiopians born in Israel had a sixfold higher diabetes crude prevalence than Ethiopian immigrants arriving after the age of 5 years. CONCLUSIONS/INTERPRETATION Immigrants of different ethnic groups arriving earlier in childhood lose their protection against diabetes at adolescence, relative to children born in Israel. This is perhaps due to environmental and lifestyle changes, especially those beginning at an early age.
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Affiliation(s)
- Alon Peled
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- , Leshem 37, Rishon Lezion, Israel.
| | - Barak Gordon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical Corps, Israeli Defense Forces, Tel Hashomer Base, Tel Hashomer, Israel
| | - Gilad Twig
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical Corps, Israeli Defense Forces, Tel Hashomer Base, Tel Hashomer, Israel
- Department of Medicine, Sheba Medical Center, Tel Hashomer, Israel
- Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Sheba Medical Center, Tel Hashomer, Israel
- Institute of Endocrinology, Sheba Medical Center, Tel Hashomer, Israel
| | - Joseph Mendlovic
- Ministry of Health, Jerusalem, Israel
- Shaare Zedek Medical Center, Jerusalem, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Medical Corps, Israeli Defense Forces, Tel Hashomer Base, Tel Hashomer, Israel
| | | | - Itamar Raz
- Diabetes Research Center, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Arnon Afek
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Ministry of Health, Jerusalem, Israel
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McKinn S, Duong LT, Foster K, McCaffery K. 'I do want to ask, but I can't speak': a qualitative study of ethnic minority women's experiences of communicating with primary health care professionals in remote, rural Vietnam. Int J Equity Health 2017; 16:190. [PMID: 29084545 PMCID: PMC5663077 DOI: 10.1186/s12939-017-0687-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 10/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ethnic minority groups in Vietnam experience economic, social and health inequalities. There are significant disparities in health service utilisation, and cultural, interpersonal and communication barriers impact on quality of care. Eighty per cent of the population of Dien Bien Province belongs to an ethnic minority group, and poor communication between health professionals and ethnic minority women in the maternal health context is a concern for health officials and community leaders. This study explores how ethnic minority women experience communication with primary care health professionals in the maternal and child health setting, with an overall aim to develop strategies to improve health professionals' communication with ethnic minority communities. METHODS We used a qualitative focused ethnographic approach and conducted focus group discussions with 37 Thai and Hmong ethnic minority women (currently pregnant or mothers of children under five) in Dien Bien Province. We conducted a thematic analysis. RESULTS Ethnic minority women generally reported that health professionals delivered health information in a didactic, one-way style, and there was a reliance on written information (Maternal and Child Health handbook) in place of interpersonal communication. The health information they receive (both verbal and written) was often non-specific, and not context-adjusted for their personal circumstances. Women were therefore required to take a more active role in interpersonal interactions in order to meet their own specific information needs, but they are then faced with other challenges including language and gender differences with health professionals, time constraints, and a reluctance to ask questions. These factors resulted in women interpreting health information in diverse ways, which in turn appeared to impact their health behaviours. CONCLUSIONS Fostering two-way communication and patient-centred attitudes among health professionals could help to improve their communication with ethnic minority women. Communication training for health professionals could be included along with the nationwide implementation of written information to improve communication.
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Affiliation(s)
- Shannon McKinn
- Sydney School of Public Health, Edward Ford Building (A27), The University of Sydney, Sydney, NSW 2008 Australia
| | - Linh Thuy Duong
- Faculty of Nursing and Midwifery, Hanoi Medical University, 1 Ton That Tung, Dong Da, Hanoi, Vietnam
| | - Kirsty Foster
- Office for Global Health, Sydney Medical School, Edward Ford Building (A27), The University of Sydney, Sydney, NSW 2008 Australia
- Kolling Institute at Northern Clinical School, Sydney Medical School, Royal North Shore Hospital, St Leonard, NSW 2065 Australia
| | - Kirsten McCaffery
- Sydney School of Public Health, Edward Ford Building (A27), The University of Sydney, Sydney, NSW 2008 Australia
- Centre for Medical Psychology & Evidence-based Decision-making (CeMPED), The University of Sydney, Sydney, NSW Australia
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Abstract
Understanding the epidemiology of food allergy is complicated by the difficulty of identifying it on a large scale. The prevalence of food allergy is higher in younger age groups and decreases with age. Allergy to peanut and egg seems to be more common in Northern Europe, the United States, Canada and Australia compared with Southern Europe, Eastern Europe and Asia, whereas shellfish and fish allergies may be more common in Asia. The rate of transient unrecognized food allergy may be high and variable recognition of food allergy may explain some of the differences seen in food allergy prevalence.
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Affiliation(s)
- Joan H Dunlop
- Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, CMSC 1102, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Corinne A Keet
- Division of Pediatric Allergy and Immunology, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, CMSC 1102, 600 North Wolfe Street, Baltimore, MD 21287, USA.
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189
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Cheng CH, Lin CC, Chen HL, Lin IT, Wu CH, Lee YK, Wong MW, Bair MJ. High frequencies of a favorable IL-28B rs8099917 polymorphism and the clinical implications in patients with HCV in one multiracial area of Taiwan. Kaohsiung J Med Sci 2017; 33:510-515. [PMID: 28962822 DOI: 10.1016/j.kjms.2017.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 05/14/2017] [Accepted: 06/02/2017] [Indexed: 12/25/2022] Open
Abstract
There is a strong association between hepatitis C virus (HCV) treatment efficacy and the interleukin (IL)-28B gene. However, the IL-28B variant's distribution and potential role in the therapeutic response are not well established in Taitung, a racially diverse county in Taiwan. Here, we investigated the distribution pattern of IL-28B rs8099917 and its influence on treatment efficacy. In this retrospective study, we enrolled 180 patients who had been treated with pegylated-interferon plus ribavirin. Patients' general information, virological characteristics, IL-28B status, laboratory results, treatment course, and outcome were analyzed. Of the patients enrolled, 56.7% were male, with a mean age of 54.11 years. A total of 24.4% of the population were indigenous people. The majority of patients had the favorable IL-28B polymorphism (rs8099917 TT/TG/GG: 94.4%/5.6%/0%). The proportion of patients with the TT genotype seemed to be higher in indigenous patients. The rate of sustained virological response (SVR) among included patients was 73.0%. Univariate analysis showed that genotype non-1, patients achieved rapid virological response (RVR), lower body mass index (BMI), and lower baseline HCV viral load were significantly associated with SVR. Multivariate analysis revealed that BMI <25 and RVR are the independent predictor of success treatment. In conclusion, the favorable IL-28B rs8099917 polymorphism occurs in high frequency in this multiracial area, which might be important to help guide physicians and patients in their future clinical decisions.
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Affiliation(s)
- Chun-Han Cheng
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan
| | - Ching-Chung Lin
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan
| | - Huan-Lin Chen
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan
| | - I-Tsung Lin
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan
| | - Chia-Hsien Wu
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan
| | - Yuan-Kai Lee
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan
| | - Ming-Wun Wong
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan
| | - Ming-Jong Bair
- Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung, Taiwan; Mackay Medical College, New Taipei, Taiwan.
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190
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Fernandes KG, Souza RT, Leal MC, Moura EC, Santos LM, Cecatti JG. Ethnic differences in maternal near miss. Arch Gynecol Obstet 2017; 296:1063-1070. [PMID: 28918461 DOI: 10.1007/s00404-017-4530-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 09/12/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the association between ethnic differences and the occurrence of maternal near miss (MNM) in the Amazon and Northeast regions of Brazil. METHODS This is a secondary analysis of a national cross-sectional study focused on the assessment of care to pregnancy, childbirth, and infants under 1 year of age. Ethnicity was classified as white, black or indigenous. Ethnic distribution by state and region, the proportion of severe maternal complications and related procedures, and the prevalence of MNM and its criteria were calculated for the ethnic groups. Risks for MNM were estimated per sociodemographic characteristics and healthcare received by ethnic group, using prevalence ratios adjusted by all predictors and by the sampling method. RESULTS 76% of the 16.783 women were black, 20% white and 3.5% indigenous. Around 36% reported any complication related to pregnancy and the most frequent were hemorrhage (27-31%), and infection (7.1-9.0%). The MNM ratio was higher among indigenous (53.1) and black (28.4) than in white women (25.7). For black women, the risks of MNM were lower for private prenatal care and hospital admission for conditions other than hypertension, while higher for cesarean section and peregrination. For indigenous, the risks of MNM were lower for private prenatal care, and higher for a longer time to reach the hospital. For white women, only the low number of prenatal visits increased the risk of MNM. CONCLUSIONS The occurrence of MNM was higher for indigenous and black than for white women.
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Affiliation(s)
- Karayna Gil Fernandes
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, R. Alexander Fleming, 101, Campinas, SP, 13083-891, Brazil
| | - Renato Teixeira Souza
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, R. Alexander Fleming, 101, Campinas, SP, 13083-891, Brazil
| | - Maria Carmo Leal
- National School of Public Health, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Erly C Moura
- National School of Public Health, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Leonor M Santos
- Department of Public Health, School of Health Sciences, University of Brasília, Brasília, DF, Brazil
| | - Jose Guilherme Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas, R. Alexander Fleming, 101, Campinas, SP, 13083-891, Brazil.
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191
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Ning G, Bandgar T, Hehnke U, Lee J, Chan JCN. Efficacy and Safety of Linagliptin in 2681 Asian Patients Stratified by Age, Obesity, and Renal Function: A Pooled Analysis of Randomized Clinical Trials. Adv Ther 2017; 34:2150-2162. [PMID: 28819835 PMCID: PMC5599450 DOI: 10.1007/s12325-017-0595-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Indexed: 12/21/2022]
Abstract
Introduction Asian patients with type 2 diabetes (T2D) are younger, leaner, and more likely to develop renal dysfunction than White populations. In this multiethnic analysis of data from phase 3 trials, we investigated the efficacy and safety of the dipeptidyl peptidase-4 inhibitor linagliptin in Asians stratified by these subphenotypes. Methods Data from randomized, double-blind, placebo-controlled trials evaluating linagliptin (as monotherapy, add-on therapy to metformin ± sulfonylurea, combined with pioglitazone or added to insulin) were pooled with efficacy data from 11 randomized trials of at least 24 weeks and safety data from 15 trials of various durations. Results In the efficacy set, 1404 Asian patients received linagliptin [mean (standard deviation) age 54.5 (10.1) years; body mass index (BMI) 26.0 (3.9) kg/m2] and 661 received placebo [age 55.0 (9.7) years; BMI 26.1 (3.9) kg/m2] with the same glycated hemoglobin (HbA1c): 8.2 (0.9)% in both groups. At 24 weeks, the placebo-corrected adjusted mean ± standard error change from baseline in HbA1c with linagliptin was −0.73 ± 0.04% (95% confidence interval −0.81, −0.65; P < 0.0001). Reductions in HbA1c were similar upon stratification by age [<65 years, −0.71 ± 0.05% (−0.80, −0.62; P < 0.0001); ≥65 years, −0.81 ± 0.10% (−1.01, −0.60; P < 0.0001)], BMI (<25 kg/m2, −0.82 ± 0.06% [−0.94, −0.70; P < 0.0001]; ≥25 kg/m2, −0.65 ± 0.06% [−0.76, −0.54; P < 0.0001]) and estimated glomerular filtration rate [<90 mL/min/1.73 m2, −0.71 ± 0.06% (−0.82, −0.60; P < 0.0001); ≥90 mL/min/1.73 m2, −0.75 ± 0.06% (−0.87, −0.64; P < 0.0001)]. In the safety set (linagliptin, n = 1842; placebo, n = 839), 52.2% and 54.6% of patients, respectively, experienced adverse events. The rates of drug-related adverse events were 10.9% in the linagliptin group and 10.4% in the placebo group. The respective rates of hypoglycemia were 8.3% and 9.5%, mainly among patients treated with sulfonylurea or insulin. Severe hypoglycemia was rare (<1.0% in either group). Conclusion Linagliptin effectively reduced hyperglycemia in Asian patients with uncontrolled T2D, irrespective of age, BMI, renal function, or ethnic subgroups, and was well tolerated. Funding Boehringer Ingelheim, Eli Lilly and Company, and the Diabetes Alliance. Electronic supplementary material The online version of this article (doi:10.1007/s12325-017-0595-7) contains supplementary material, which is available to authorized users.
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192
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Assari S, Lankarani MM. Demographic and Socioeconomic Determinants of Physical and Mental Self-rated Health Across 10 Ethnic Groups in the United States. Int J Epidemiol Res 2017; 3:185-193. [PMID: 31435528 DOI: 10.15171/ijer.2017.02] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background and aims The aim of this study was to explore ethnic differences in demographic and socioeconomic determinants of poor physical and mental self-rated health (SRH) in the United States. Methods We used data from the Collaborative Psychiatric Epidemiology Surveys (CPES) 2001-2003, which included a national household probability sample of 18237 individuals including 520 Vietnamese, 508 Filipino, 600 Chinese, 656 other Asian, 577 Cuban, 495 Puerto Rican, 1442 Mexican, 1106 other Hispanic, 4746 African American, and 7587 non-Latino Whites. Demographic factors (age and gender), socioeconomic factors (education and income), body mass index (BMI), and physical and mental SRH were measured. Pearson correlation was used to explore correlates of physical and mental SRH across ethnic groups. Results While age was positively associated with poor physical SRH, ethnic groups differed in the effect of age on mental SRH. Age was positively associated with mental SRH among Vietnamese, Filipino, Chinese, Cuban, Puerto Rican, and African American individuals, but this was not so for other Asians, Mexicans, other Hispanics, and non-Hispanic Whites. Chinese and Cubans were the only groups where female gender was associated with poor physical and mental SRH. With other Asians being an exception, education and income were protective against poor physical and mental SRH in all ethnic groups. Ethnic groups also differed in how their mental and physical SRH reflect BMI. Conclusion Demographic and socioeconomic determinants of physical and mental SRH vary across ethnic groups. Poor physical and mental SRH are differently shaped by social determinants across ethnic groups. These ethnic differences may cause bias in health measurement in ethnically diverse populations.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, School of Public Health, University of Michigan, USA
| | - Maryam Moghani Lankarani
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA. Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Andrea SB, Hooker ER, Messer LC, Tandy T, Boone-Heinonen J. Does the association between early life growth and later obesity differ by race/ethnicity or socioeconomic status? A systematic review. Ann Epidemiol 2017; 27:583-592.e5. [PMID: 28911983 DOI: 10.1016/j.annepidem.2017.08.019] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 06/16/2017] [Accepted: 08/15/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE Rapid growth during infancy predicts higher risk of obesity later in childhood. The association between patterns of early life growth and later obesity may differ by race/ethnicity or socioeconomic status (SES), but prior evidence syntheses do not consider vulnerable subpopulations. METHODS We systemically reviewed published studies that explored patterns of early life growth (0-24 months of age) as predictors of later obesity (>24 months) that were either conducted in racial/ethnic minority or low-SES study populations or assessed effect modification of this association by race/ethnicity or SES. Literature searches were conducted in PubMed and SocINDEX. RESULTS Ten studies met the inclusion criteria. Faster growth during the first 2 years of life was consistently associated with later obesity irrespective of definition and timing of exposure and outcome measures. Associations were strongest in populations composed of greater proportions of racial/ethnic minority and/or low-SES children. For example, ORs ranged from 1.17 (95% CI: 1.11, 1.24) in a heterogeneous population to 9.24 (95% CI: 3.73, 22.9) in an entirely low-SES nonwhite population. CONCLUSIONS The impact of rapid growth in infancy on later obesity may differ by social stratification factors such as race/ethnicity and family income. More robust and inclusive studies examining these associations are needed.
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Affiliation(s)
- Sarah B Andrea
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland
| | - Elizabeth R Hooker
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland
| | - Lynne C Messer
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland
| | - Thomas Tandy
- OHSU-PSU School of Public Health, Oregon Health & Science University, Portland
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Laverty M, McDermott DR, Calma T. Embedding cultural safety in Australia's main health care standards. Med J Aust 2017; 207:15-16. [PMID: 28659104 DOI: 10.5694/mja17.00328] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 05/02/2017] [Indexed: 11/17/2022]
Affiliation(s)
| | - Dennis R McDermott
- Poche Centre for Indigenous Health and Wellbeing, Flinders University, Adelaide, SA
| | - Tom Calma
- Poche Indigenous Health Network, University of Sydney, Sydney, NSW
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195
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Li G, Guo G, Wang W, Wang K, Wang H, Dong F, Qian Y, Gong H, Xu G, Li Y, Pan L, Zhang B, Shan G. Association of prehypertension and cardiovascular risk factor clustering in Inner Mongolia: a cross-sectional study. BMJ Open 2017; 7:e015340. [PMID: 28667215 PMCID: PMC5734362 DOI: 10.1136/bmjopen-2016-015340] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To assess the clustering of cardiovascular disease (CVD) risk factors in Han and Mongolian adults with prehypertension or hypertension in Northern China. METHODS We selected 3227 Han and Mongolian participants (20-80 years old) using a multistage cluster sampling method in 2014. The participants were interviewed by standard questionnaires and underwent anthropometric measurement and biochemical testing. Han and Mongolian participants were divided into optimal, prehypertension, and hypertension groups based on blood pressure. A multinomial logit analysis was performed to explore relationships between CVD risk factor clustering and prehypertension or hypertension, and the heterogeneity between Han and Mongolian was evaluated by the Cochran Q test. The differences between the ethnic groups in the proportions of risk factors was tested with the χ2 test. RESULTS The clustering of two or three CVD risk factors in the prehypertension or hypertension groups was consistently higher than in the optimal group (Bonferroni, p<0.0167). The odds ratios (ORs) of prehypertension and hypertension increased with the number of CVD risk factors (ptrend <0.0001). In multivariate modelling, the adjusted ORs of one, two, and ≥3 CVD risk factors versus no risk factors was, respectively, 1.95, 2.25, and 2.28 in Han prehypertensive participants, and 1.73, 2.83, and 3.69 in Mongolian prehypertensive participants. In addition, the adjusted ORs were 3.15, 4.75, and 6.49 in Han hypertensive participants, and 1.90, 5.29, and 8.13 in Mongolian hypertensive participants (all p<0.05). There was no significant heterogeneity between Han and Mongolian participants in the prehypertension or hypertension groups. The age-standardised prevalence of ≥3 risk factors was 38.30% in Han men and 39.79% in Mongolian men. The rate was significantly lower in Han women than Mongolian women (9.18% vs 14.55%, p=0.002). CONCLUSIONS These findings showed clustering of CVD risk factors in prehypertensive Han and Mongolian adults, and showed prehypertension may be a useful target for intervention.
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Affiliation(s)
- Guoju Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Guanghong Guo
- Department of Clinical Biochemistry, Chinese PLA General Hospital, Beijing, China
| | - Wenrui Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Ke Wang
- Department of Obstetrics, Key Laboratory of 9 Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China 10 Second University Hospital, Sichuan University, Chengdu, China
| | - Hailing Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Fen Dong
- China-Japan Friendship Hospital, Beijing, China
| | - Yonggang Qian
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Haiying Gong
- Fangshan District Center for Disease Control and Prevention, Beijing, China
| | - Guodong Xu
- China-Japan Friendship Hospital, Beijing, China
| | - Yanlong Li
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Biao Zhang
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
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196
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Brown DM, Barbara A, Cohen AK, Rehkopf DH. Motherhood, Fatherhood and Midlife Weight Gain in a US Cohort: Associations differ by race/ethnicity and socioeconomic position. SSM Popul Health 2017; 3:558-565. [PMID: 29204513 PMCID: PMC5711467 DOI: 10.1016/j.ssmph.2017.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
While there is an association of greater short-term weight gain with childbearing among women, less is known about longer-term weight gain, whether men have similar gains, and how this varies by race/ethnicity and socioeconomic position. Our cohort consisted of a nationally representative sample of 7356 Americans with oversampling of Black and Hispanic populations. We estimated the associations between number of biological children and parental weight, measured as both change in self-reported body mass index (BMI) from age 18 and overweight/obese status (BMI ≥ 25) at age 40. We performed multivariate linear and logistic regression analysis and tested for effect modification by gender. For change in BMI, men gained on average 0.28 BMI (95% CI: (0.01, 0.55)) units per child, while women gained 0.13 units per child (95% CI: (-0.22, 0.48)). The adjusted odds ratios for overweight/obesity associated with each child were 1.32 (95% CI: (1.11, 1.58)) for men and 1.15 (95% CI: (1.01, 1.31)) for women. Stratified analyses by race/ethnicity and socioeconomic position suggested that the observed full-cohort differences were driven primarily by gendered differences in low-income Hispanics and Whites – with the greatest associations among Hispanic men. For example, among low-income Hispanic men we observed a positive relationship between the number of children and weight change by age 40, with average weight change of 0.47 units per child (95%CI: (-0.65, 1.59 For low-income Hispanic women, however, the average weight change was -0.59 units per child (95%CI: (-1.70, 0.47), and the P-value for the test of interaction between gender and number of children was P < 0.001. Our findings suggest that the shared social and economic aspects of raising children play an important role in determining parental weight at mid-life. Researchers have seen associations between having a child and short term weight gain. We examined the relationship of having children with long term weight gain by gender. We did not observe any evidence that women tended to gain more weight than men. In some subcohorts, we observed stronger associations among men than women. Hispanics of lower socioeconomic position had the strongest gendered difference.
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Affiliation(s)
- Daniel M Brown
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, United States of America
| | - Abrams Barbara
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, United States of America
| | - Alison K Cohen
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, United States of America
| | - David H Rehkopf
- Division of General Medical Disciplines, Stanford University School of Medicine, Stanford, CA, United States of America
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197
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Xin WR, Kwok LL, Yong WF. Screening Uptake Differences Are Not Implicated in Poorer Breast Cancer Outcomes among Singaporean Malay Women. J Breast Cancer 2017; 20:183-191. [PMID: 28690655 PMCID: PMC5500402 DOI: 10.4048/jbc.2017.20.2.183] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 03/01/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose This study was undertaken to examine the impact of screening and race on breast cancer outcomes in Singapore. Methods An institutional database was reviewed, and invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) data were analyzed separately. Overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were assessed. Results The study included 6,180 IDC and 1,031 DCIS patients. The median follow-up time was 4.1 years. Among IDC patients, Malay women were the youngest when first diagnosed, and were more likely to present with advanced stage disease. Malay women also had the highest proportion of T3 and T4 tumors at 14.2%, compared with Chinese women at 8.7% and Indian women at 9.6% (p<0.001). Malay women had a higher incidence of node-positive disease at 58.3% compared with Chinese women at 46.4% and Indian women at 54.9% (p<0.001). Malay subjects also had higher-grade tumors; 61.8% had grade 3 tumors compared with 45.8% of Chinese women and 52% of Indian women (p<0.001). Furthermore, tumors in Malay subjects were less endocrine-sensitive and more human epidermal growth factor receptor 2 enriched. Malay women had the lowest 5- and 10-year OS, DFS, and CSS rates (p<0.001). After separating clinically and screen-detected tumors, multivariate analysis showed that race was still significant for outcomes. For screen-detected tumors, the OS hazard ratio (HR) for Malay women compared to Chinese women was 5.78 (95% confidence interval [CI], 2.64–12.64), the DFS HR was 2.18 (95% CI, 1.19–3.99), and the CSS HR was 5.93 (95% CI, 2.15–16.39). For DCIS, there were no statistically significant differences in the tumor size, grade, histology subtypes, or hormone sensitivity. Conclusion Malay race is a poor prognostic factor in both clinically and screen-detected IDC. Special attention should be given to the detection and follow-up of breast cancer in this group.
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Affiliation(s)
- Wong Ru Xin
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Li-Lian Kwok
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
| | - Wong Fuh Yong
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore
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198
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Abstract
PURPOSE Despite the well-established health effects of socioeconomic status (SES), SES resources such as employment may differently influence health outcomes across sub-populations. This study used a national sample of US adults to test if the effect of baseline employment (in 1986) on all-cause mortality over a 25-year period depends on race, gender, education level, and their intersections. METHODS Data came from the Americans' Changing Lives (ACL) study, which followed 2025 Whites and 1156 Blacks for 25 years from 1986 to 2011. The focal predictor of interest was baseline employment (1986), operationalized as a dichotomous variable. The main outcome of interest was time to all-cause mortality from 1986 to 2011. Covariates included baseline age, health behaviors (smoking, drinking, and exercise), physical health (obesity, chronic disease, function, and self-rated health), and mental health (depressive symptoms). A series of Cox proportional hazard models were used to test the association between employment and mortality risk in the pooled sample and based on race, gender, education, and their intersections. RESULTS Baseline employment in 1986 was associated with a lower risk of mortality over a 25-year period, net of covariates. In the pooled sample, baseline employment interacted with race (HR = .69, 95% CI = .49-.96), gender (HR = .73, 95% CI = .53-1.01), and education (HR = .64, 95% CI = .46-.88) on mortality, suggesting diminished protective effects for Blacks, women, and individuals with lower education, compared to Whites, men, and those with higher education. In stratified models, the association was significant for Whites (HR = .71, 95%CI = .59-.90), men (HR = .60, 95%CI = .43-.83), and individuals with high education (HR = .66, 95%CI = .50-.86) but not for Blacks (HR = .77, 95%CI = .56-1.01), women (HR = .88, 95%CI = .69-1.12), and those with low education (HR = .92, 95%CI = .67-1.26). The largest effects of employment on life expectancy were seen for highly educated men (HR = .50, 95%CI = .32-.78), White men (HR = .55, 95%CI = .38-.79), and highly educated Whites (HR = .63, 95%CI = .46-.84). The effects were non-significant for Black men (HR = 1.10, 95%CI = .68-1.78), Whites with low education (HR = 1.01, 95%CI = .67-1.51), and women with low education (HR = 1.06, 95%CI = .71-1.57). CONCLUSION In the USA, the health gain associated with employment is conditional on one's race, gender, and education level, along with their intersections. Blacks, women, and individuals with lower education gain less from employment than do Whites, men, and highly educated people. More research is needed to understand how the intersections of race, gender, and education alter health gains associated with socioeconomic resources.
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199
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Smolnikova MV, Freidin MB, Tereshchenko SY. The prevalence of the variants of the L-ficolin gene (FCN2) in the arctic populations of East Siberia. Immunogenetics 2017; 69:409-413. [PMID: 28391359 DOI: 10.1007/s00251-017-0984-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/03/2017] [Indexed: 01/09/2023]
Abstract
L-ficolin encoded by FCN2 gene is a crucial factor of defence against infection in humans. We studied the prevalence of the two common variants (rs17549193 and rs7851696) in aboriginal and alien populations of the Taymyr-Dolgan-Nenets region of Krasnoyarskiy Kray, East Siberia, Russia (Nenets, Dolgans, Nganasans, Russians). We found a decreased prevalence of the rs17549193*T allele in all aboriginal populations as compared to Russians. Also, its frequency was the lowest in the Nenets among the studied populations, while frequency of the rs7851696*T allele was increased in this population. The results suggest that the Arctic populations of East Siberia are characterised by specificity of genetic make-up responsible for the activity of L-ficolin. Clinical and epidemiological studies are required to discover if these genetic features correlate with the infant infectious morbidity in East Siberian populations.
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Affiliation(s)
- Marina V Smolnikova
- Federal Research Center "Krasnoyarsk Science Center" of the Siberian Branch of the Russian Academy of Sciences, Scientific Research Institute of medical problems of the North, Partizana Zheleznyaka street, 3G, Krasnoyarsk, Russia, 660022
| | - Maxim B Freidin
- Research Institute of Medical Genetics, Tomsk NRMC, 10 Nab. Ushaiki, Tomsk, Russia, 634050
| | - Sergey Yu Tereshchenko
- Federal Research Center "Krasnoyarsk Science Center" of the Siberian Branch of the Russian Academy of Sciences, Scientific Research Institute of medical problems of the North, Partizana Zheleznyaka street, 3G, Krasnoyarsk, Russia, 660022.
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200
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Ryan JM, Potier T, Sherwin A, Cassidy E. Identifying factors that predict attrition among first year physiotherapy students: a retrospective analysis. Physiotherapy 2017; 110:26-33. [PMID: 33563371 DOI: 10.1016/j.physio.2017.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 04/12/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND A number of first year students leave physiotherapy programmes every year. A high attrition rate has implications for the student and the academic institution. OBJECTIVES To report the rate of attrition among first year physiotherapy students, and to identify contributing factor. DESIGN Retrospective analysis. SETTING University. PARTICIPANTS Electronic student records for enrolled students 2010 to 2013. MEASURES Independent variables; gender, age at entry, mode of admission, place of residence, ethnicity, fee status, level of education, disability, whether a student obtained a B in A level Biology, and whether a student repeated A level examinations. Logistic regression analysis was conducted to identify the relationship between independent variables and drop-out (failure to continue to the second year). RESULTS Data from 338 students were included in the analysis. The percentage drop-out was 17%; 38 students (11%) failed, and 20 students (6%) withdrew voluntarily. Black and Asian students had greater odds of drop-out for any reason (Odds Ratio (OR): 6.23; 95% Confidence Interval (CI) 1.79 to 21.63, and OR: 6.43; 95% CI: 3.03 to 13.68 respectively), and due to failure (OR: 5.50, 95% CI: 1.27 to 23.70, and OR: 7.19; 95% CI: 3.02 to 17.08, respectively) compared to white British students. Students who lived off-campus were more likely to withdraw from the programme irrespective of ethnicity (OR: 4.65; 95% CI: 1.41 to 15.34). CONCLUSION A significant number of students from ethnic minority backgrounds failed to progress. Specific strategies to retain students from ethnic minority backgrounds should be implemented. Students who live off-campus may be at high risk of drop-out; reasons for this should be investigated.
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Affiliation(s)
- Jennifer M Ryan
- Department of Clinical Sciences, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK.
| | - Tara Potier
- Department of Clinical Sciences, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK.
| | - Alison Sherwin
- Department of Clinical Sciences, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK.
| | - Elizabeth Cassidy
- Department of Clinical Sciences, Brunel University London, Kingston Lane, Uxbridge UB8 3PH, UK.
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