Assuntos
Tomada de Decisão Clínica , Nefropatias , Medicina de Precisão , Fatores Raciais , Determinantes Sociais da Saúde/etnologia , Tomada de Decisão Clínica/ética , Tomada de Decisão Clínica/métodos , Disparidades nos Níveis de Saúde , Humanos , Nefropatias/etnologia , Nefropatias/genética , Nefropatias/terapia , Nefrologia/ética , Nefrologia/métodos , Nefrologia/normas , Seleção de Pacientes , Medicina de Precisão/ética , Medicina de Precisão/métodos , Medicina de Precisão/normas , Fatores Raciais/ética , Fatores Raciais/métodosAssuntos
Concussão Encefálica/diagnóstico , Concussão Encefálica/psicologia , Futebol Americano/psicologia , Testes de Estado Mental e Demência/normas , Fatores Raciais/normas , Determinantes Sociais da Saúde/normas , Concussão Encefálica/etnologia , Futebol Americano/lesões , Humanos , Masculino , Fatores Raciais/métodos , Análise de RegressãoRESUMO
BACKGROUND: Overweight/obesity and dense breasts are strong breast cancer risk factors whose prevalences vary by race/ethnicity. The breast cancer population attributable risk proportions (PARP) explained by these factors across racial/ethnic groups are unknown. METHODS: We analyzed data collected from 3,786,802 mammography examinations (1,071,653 women) in the Breast Cancer Surveillance Consortium, associated with 21,253 invasive breast cancers during a median of 5.2 years follow-up. HRs for body mass index (BMI) and breast density, adjusted for age and registry were estimated using separate Cox regression models by race/ethnicity (White, Black, Hispanic, Asian) and menopausal status. HRs were combined with observed risk-factor proportions to calculate PARPs for shifting overweight/obese to normal BMI and shifting heterogeneously/extremely dense to scattered fibroglandular densities. RESULTS: The prevalences and HRs for overweight/obesity and heterogeneously/extremely dense breasts varied across races/ethnicities and menopausal status. BMI PARPs were larger for postmenopausal versus premenopausal women (12.0%-28.3% vs. 1.0%-9.9%) and nearly double among postmenopausal Black women (28.3%) than other races/ethnicities (12.0%-15.4%). Breast density PARPs were larger for premenopausal versus postmenopausal women (23.9%-35.0% vs. 13.0%-16.7%) and lower among premenopausal Black women (23.9%) than other races/ethnicities (30.4%-35.0%). Postmenopausal density PARPs were similar across races/ethnicities (13.0%-16.7%). CONCLUSIONS: Overweight/obesity and dense breasts account for large proportions of breast cancers in White, Black, Hispanic, and Asian women despite large differences in risk-factor distributions. IMPACT: Risk prediction models should consider how race/ethnicity interacts with BMI and breast density. Efforts to reduce BMI could have a large impact on breast cancer risk reduction, particularly among postmenopausal Black women.
Assuntos
Densidade da Mama/fisiologia , Neoplasias da Mama/epidemiologia , Etnicidade/estatística & dados numéricos , Menopausa/fisiologia , Fatores Raciais/métodos , Adulto , Índice de Massa Corporal , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
Prior work has demonstrated that greater community violence concerns are associated with poor sleep quality among adolescents. However, these effects may not be uniform across all youth. The present study examined the role of individual difference variables, physiological regulation and race, as moderators of risk in the relation between adolescents' community violence concerns and their sleep. Adolescents (N = 219; 55.3% female; 69.9% White/European American, 30.1% Black/African American) participated in the study when they were 18 years old (M = 17.7 years, SD = 1.0). Physiological regulation was assessed via respiratory sinus arrhythmia, a measure of parasympathetic regulation, at rest and in response to a stressor. Adolescents wore actigraphs for 7 nights to assess their sleep duration and quality, and reported on their community violence concerns via a well-validated questionnaire. Results demonstrated a consistent pattern of interactions, such that African American adolescents who showed less adaptive patterns of regulating physiological arousal experienced shorter sleep duration and poorer sleep quality in the context of greater community violence concerns. Community violence concerns were not associated with sleep for White adolescents. The findings may suggest that race-related stressors exacerbate risk for poor sleep among African American adolescents who experience more community violence concerns and have more difficulty regulating physiological arousal. Coping strategies for managing stress and arousal may be helpful for improving sleep for some youth.
Assuntos
Comportamento do Adolescente/psicologia , Psicofisiologia/métodos , Saúde Pública/métodos , Fatores Raciais/métodos , Distúrbios do Início e da Manutenção do Sono/etiologia , Violência/psicologia , Adolescente , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Breastfeeding is an active area in public health advocacy. Despite documented benefits for infants and mothers, exclusive breastfeeding is not universal. Ethnicity, among other variables, has been shown to influence breastfeeding practice. Research aim: Our study aimed to determine which variables are associated with infant feeding patterns at the postpartum visit; compare the sociodemographic variables associated with infant feeding patterns between Hispanic and non-Hispanic mothers; and determine the odds of exclusive breastfeeding, mixed feeding, and exclusive formula feeding associated with sociodemographic characteristics. METHODS: A retrospective, cross-sectional two-group comparison design was used. Hispanic and non-Hispanic women's ( N = 666) infant feeding patterns at 6-week postpartum were analyzed. Group comparisons were made of the demographic characteristics and infant feeding practice. RESULTS: Thirty-four percent of Hispanic participants reported exclusive breastfeeding compared with 59% of non-Hispanic White participants. Language and body mass index were significantly associated with infant feeding patterns among Hispanic participants. Compared with non-Hispanic White participants, Hispanic participants had increased odds of reporting mixed feeding and exclusive formula feeding. CONCLUSION: Breastfeeding initiatives should target English-speaking Hispanic mothers and obese Hispanic mothers to align breastfeeding rates with medical recommendations. Healthcare providers may benefit from additional training to address barriers to breastfeeding among obese women and to provide culturally sensitive support that encourages continued breastfeeding in this population.