RESUMO
BACKGROUND: The 5-year survival for Black women with breast cancer in the United States is lower than White women for stage-matched disease. Our past and ongoing work and that of others suggest that symptom incidence, cancer-related distress, and ineffective communication contribute to racial disparity in dose reduction and early therapy termination. Although race is perhaps the most studied social determinant of health, it is clear that race alone does not account for all disparities. OBJECTIVES: The aim of the study was to present a study protocol of Black and White women prescribed breast cancer chemotherapy. The aims are to (1) examine and compare chemotherapy received/prescribed over time and in total; (2a) examine and compare symptom incidence, distress, and management and clinical encounter, including patient-centeredness of care and management experience over time and (2b) correlate symptom incidence, distress, and management experience to Aim 1; and (3) explore the effects of social determinants of health, including age, income, education, zip code, and lifetime stress exposure, on Aims 1, 2a, and 2b. METHODS: A longitudinal, repeated-measures (up to 18 time points), comparative, mixed-methods design is employed with 179 White and 179 Black women from 10 sites in Western Pennsylvania and Northeast Ohio over the course of chemotherapy and for 2 years following completion of therapy. RESULTS: The study began in January 2018, with estimated complete data collection by late 2023. DISCUSSION: This study is among the first to explore the mechanistic process for racial disparity in dosage and delay across the breast cancer chemotherapy course. It will be an important contribution to the explanatory model for breast cancer treatment disparity and may advance potential mitigation strategies for racial survival disparity.
Assuntos
Negro ou Afro-Americano/psicologia , Neoplasias da Mama/tratamento farmacológico , Protocolos Clínicos , Tratamento Farmacológico/psicologia , Cooperação e Adesão ao Tratamento/psicologia , Adulto , Negro ou Afro-Americano/etnologia , Neoplasias da Mama/psicologia , Feminino , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Incidência , Pessoa de Meia-Idade , Ohio/epidemiologia , Ohio/etnologia , Pennsylvania/epidemiologia , Pennsylvania/etnologiaRESUMO
We employ data from the Adolescent Health and Development in Context Study-a representative sample of urban youth ages 11-17 in and around the Columbus, OH area-to investigate the feasibility and validity of smartphone-based geographically explicit ecological momentary assessment (GEMA). Age, race, household income, familiarity with smartphones, and self-control were associated with missing global positioning systems (GPS) coverage, whereas school day was associated with discordance between percent of time at home based on GPS-only versus recall-aided space-time budget data. Fatigue from protocol compliance increases missing GPS across the week, which results in more discordance. Although some systematic differences were observed, these findings offer evidence that smartphone-based GEMA is a viable method for the collection of activity space data on urban youth.
Assuntos
Orçamentos/estatística & dados numéricos , Avaliação Momentânea Ecológica/estatística & dados numéricos , Sistemas de Informação Geográfica/estatística & dados numéricos , Smartphone/instrumentação , Adolescente , Desenvolvimento do Adolescente/fisiologia , Saúde do Adolescente/economia , Criança , Complacência (Medida de Distensibilidade) , Estudos de Viabilidade , Feminino , Sistemas de Informação Geográfica/tendências , Humanos , Estudos Longitudinais , Masculino , Ohio/epidemiologia , Ohio/etnologiaRESUMO
To understand the behavioral lifestyle factors that may contribute to lower cancer incidence rates among the Amish population, this study evaluated differences in physical activity (PA) levels between Amish and non-Amish adults living in Ohio Appalachia. Amish (n = 134) and non-Amish (n = 154) adults completed face-to-face interviews as part of a cancer-related lifestyle study. Self-report of PA level was measured by the International Physical Activity Questionnaire (IPAQ) and by a diary of steps/day (pedometer: Digi-Walker SW-200). Total metabolic equivalent tasks (MET) minutes was calculated from the IPAQ and average number of steps/day from a pedometer diary. Amish males walked more steps/day (mean ± standard error (SE): 11,447 ± 611 vs. 7,605 ± 643; P < 0.001) and had a higher IPAQ score (MET min/week) (mean ± SE: 8,354 ± 701 vs. 5,547 ± 690; P < 0.01) than non-Amish males. In addition, Amish farmers walked significantly more steps/day than Amish non-farmers (mean ± SE: 15,278 ± 1,297 vs. 10,742 ± 671; P < 0.01). There was a trend for Amish females to walk more steps/day (mean ± SE: 7,750 ± 477 vs. 6,547 ± 437; P = 0.06) and to have higher IPAQ scores (mean ± SE: 4,966 ± 503 vs. 3,702 ± 450; P = 0.06) compared to non-Amish females. Two measures of PA demonstrated a higher PA level among Amish males, especially farmers, and a trend for higher PA level among Amish females. Higher levels of PA warrants further investigation as one factor potentially contributing to lower cancer incidence rates documented among the Amish.
Assuntos
Amish/psicologia , Estilo de Vida/etnologia , Atividade Motora , Adulto , Idoso , Idoso de 80 Anos ou mais , Agricultura/estatística & dados numéricos , Amish/estatística & dados numéricos , Região dos Apalaches/epidemiologia , Região dos Apalaches/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/etnologia , Ohio/epidemiologia , Ohio/etnologia , Fatores Sexuais , Caminhada/psicologia , Caminhada/estatística & dados numéricos , Adulto JovemRESUMO
Geographers play important roles in public health research, particularly in understanding healthcare accessibility, utilisation, and individual healthcare experiences. Most accessibility studies have benefited from the increased sophistication of geographic information systems (GIS). Some studies have been enhanced with semi-structured in-depth interviews to understand individual experiences of people as they access healthcare. However, few accessibility studies have explicitly utilised individual in-depth interview data in the construction of new GIS accessibility measures. Using mixed methods including GIS analysis and individual data from semi-structured in-depth interviews, we offer satisfaction-adjusted distance as a new way of conceptualising accessibility in GIS. Based on fieldwork in a predominantly lower-income community in Columbus, Ohio (USA), we find many residents felt neighbourhood healthcare facilities offered low-quality care, which suggested an added perceived distance as they attempt to access high-quality healthcare facilities. The satisfaction-adjusted distance measure accounts for the perceived distance some residents feel as they search for high-quality healthcare in lower-income urban neighbourhoods. In moving beyond conventional GIS and re-conceptualising accessibility in this way, we offer a more realistic portrayal of the issues lower-income urban residents face as they attempt to access high-quality healthcare facilities. The work has theoretical implications for conceptualising healthcare accessibility, advances the mixed-methodologies literature, and argues for a more equitable distribution of high-quality healthcare in urban neighbourhoods.
Assuntos
Atenção à Saúde , Sistemas de Informação Geográfica , Acessibilidade aos Serviços de Saúde , Garantia da Qualidade dos Cuidados de Saúde , Características de Residência , Classe Social , População Urbana , Comportamento do Consumidor/economia , Comportamento do Consumidor/legislação & jurisprudência , Atenção à Saúde/economia , Atenção à Saúde/etnologia , Atenção à Saúde/história , Atenção à Saúde/legislação & jurisprudência , Sistemas de Informação Geográfica/economia , Sistemas de Informação Geográfica/história , Sistemas de Informação Geográfica/legislação & jurisprudência , Acessibilidade aos Serviços de Saúde/economia , Acessibilidade aos Serviços de Saúde/história , Acessibilidade aos Serviços de Saúde/legislação & jurisprudência , História do Século XX , História do Século XXI , Ohio/etnologia , Saúde Pública/economia , Saúde Pública/educação , Saúde Pública/história , Saúde Pública/legislação & jurisprudência , Garantia da Qualidade dos Cuidados de Saúde/economia , Garantia da Qualidade dos Cuidados de Saúde/história , Garantia da Qualidade dos Cuidados de Saúde/legislação & jurisprudência , Características de Residência/história , Classe Social/história , População Urbana/históriaRESUMO
The world is currently in a pandemic of COVID-19 (Coronavirus disease-2019) caused by a novel positive-sense, single-stranded RNA ß-coronavirus referred to as SARS-CoV-2. Here we investigated rates of SARS-CoV-2 infection in the greater Cincinnati, Ohio, USA metropolitan area from August 13 to December 8, 2020, just prior to initiation of the national vaccination program. Examination of 9,550 adult blood donor volunteers for serum IgG antibody positivity against the SARS-CoV-2 Spike protein showed an overall prevalence of 8.40%, measured as 7.56% in the first 58 days and 9.24% in the last 58 days, and 12.86% in December 2020, which we extrapolated to ~20% as of March, 2021. Males and females showed similar rates of past infection, and rates among Hispanic or Latinos, African Americans and Whites were also investigated. Donors under 30 years of age had the highest rates of past infection, while those over 60 had the lowest. Geographic analysis showed higher rates of infectivity on the West side of Cincinnati compared with the East side (split by I-75) and the lowest rates in the adjoining region of Kentucky (across the Ohio river). These results in regional seroprevalence will help inform efforts to best achieve herd immunity in conjunction with the national vaccination campaign.
Assuntos
Anticorpos Antivirais/sangue , Doadores de Sangue/estatística & dados numéricos , COVID-19/epidemiologia , SARS-CoV-2/imunologia , Glicoproteína da Espícula de Coronavírus/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/imunologia , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Ohio/etnologia , Pandemias , Estudos Soroepidemiológicos , Adulto JovemRESUMO
BACKGROUND AND PURPOSE: Although other studies (in largely white populations) have found that stroke incidence declined during the 1990s, we previously reported that stroke incidence in our population (18% of which was black) did not change during that decade and that incidence rates in blacks were significantly higher than in whites. We sought to update temporal trends in stroke incidence by adding new data obtained from our large, biracial population in 2005. The objective of this study was to examine temporal trends in stroke incidence and case-fatality within a large biracial population over time by comparing stroke incidence rates from 1993 to 1994, 1999, and 2005. METHODS: Within the Greater Cincinnati/Northern Kentucky population of 1.3 million, all strokes among area residents were ascertained at all local hospitals during July 1993 to June 19/94 and calendar years 1999 and 2005. A sampling scheme was used to ascertain cases in the out-of-hospital setting. Only first-ever strokes were included in this analysis. Race-specific incidence rates, standardized to the 2000 US Census population, and case-fatality rates were calculated. RESULTS: The number of physician-confirmed first-ever strokes in patients >or=20 years of age was 1942 in 1993 to 1994, 2041 in 1999, and 1921 in 2005. In all study periods, blacks had higher stroke incidence than whites, and case-fatality rates were similar between races. In contrast to previous study periods, we found a significant decrease in overall stroke incidence in 2005. When stratified by race and stroke subtype, this change was driven by a decrease in ischemic stroke incidence among whites, whereas ischemic stroke incidence in blacks was unchanged. Hemorrhagic stroke incidence was unchanged in both races. CONCLUSIONS: For the first time, we report a significant decrease in stroke incidence within our population, which is consistent with other reports in the literature. This decrease was found only among whites, which suggests a worsening of the racial disparity in stroke incidence.
Assuntos
População Negra/etnologia , População Negra/estatística & dados numéricos , Vigilância da População , Acidente Vascular Cerebral/etnologia , Acidente Vascular Cerebral/epidemiologia , População Branca/etnologia , População Branca/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Incidência , Kentucky/epidemiologia , Kentucky/etnologia , Masculino , Pessoa de Meia-Idade , Ohio/epidemiologia , Ohio/etnologia , Vigilância da População/métodos , Acidente Vascular Cerebral/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
African-American women have disproportionate rates of hypertension that can be further complicated as they transition through menopause. Stress, coupled with depression and hypertension in perimenopausal African-American women has not been fully explored. This study examines the associations of stress, depression, and social support on systolic blood pressure (SBP) among a sample of 184 perimenopausal African-American women. We used descriptive statistics, Pearson's correlation, and logistic regression to analyze data stratified by menopausal status (perimenopausal or menopausal) and SBP status (<130 mmHg vs. >130 mmHg). Women classified as menopausal reported higher levels of stress and depressive symptoms, and lower levels of social support. Age, body mass index (BMI), health insurance, and perceived health status were significant predictors of SBP in menopausal women. Stress, depression, and social support did not play a role in SBP. It is necessary that future research focus on reducing cardiovascular risk include addressing menopausal health.
Assuntos
Negro ou Afro-Americano/etnologia , Hipertensão/complicações , Menopausa/psicologia , Psicologia/estatística & dados numéricos , Adulto , Negro ou Afro-Americano/psicologia , Índice de Massa Corporal , Feminino , Florida/epidemiologia , Florida/etnologia , Humanos , Hipertensão/etnologia , Hipertensão/psicologia , Modelos Logísticos , Menopausa/fisiologia , Pessoa de Meia-Idade , Ohio/epidemiologia , Ohio/etnologia , Prevalência , Psicologia/classificação , Psicometria/instrumentação , Psicometria/métodos , Inquéritos e Questionários , Ilhas Virgens Americanas/epidemiologia , Ilhas Virgens Americanas/etnologiaRESUMO
Increasingly, respondent-driven sampling (RDS) is being applied to study not-in-treatment users of illicit drugs. Although RDS has been successfully applied in recruiting active users in densely-populated, metropolitan areas, its utility with hidden populations in rural areas has yet to be determined. This study critically evaluates the sample of not-in-treatment, illicit stimulant drug users (n=249) recruited from the application of RDS in three rural counties in west-central Ohio. The findings of this study largely support the results of earlier studies in urban areas and suggest that RDS is a useful method of sampling hidden drug using populations in less densely populated rural areas. Some limitations of RDS are also discussed.
Assuntos
Drogas Ilícitas , Seleção de Pacientes , Detecção do Abuso de Substâncias/métodos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Distribuição por Idade , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Transtornos Relacionados ao Uso de Cocaína/etnologia , Transtornos Relacionados ao Uso de Cocaína/psicologia , Projetos de Pesquisa Epidemiológica , Feminino , Humanos , Relações Interpessoais , Masculino , Ohio/epidemiologia , Ohio/etnologia , Saúde da População Rural , Estudos de Amostragem , Distribuição por Sexo , Meio Social , Transtornos Relacionados ao Uso de Substâncias/etnologia , Transtornos Relacionados ao Uso de Substâncias/psicologiaRESUMO
Diagnosing Autism Spectrum Disorders (ASD) is important throughout the lifespan. The objective was to investigate the transcultural diagnostic validity of the Social Communication Questionnaire (SCQ) in a clinical sample of 451 adults with Intellectual Developmental Disorder (IDD) with and without ASD in Germany, the U.S.A. and Great Britain. Variables associated with higher SCQ sum-scores were higher levels of IDD, male gender, a diagnosis of ASD and the study site (Germany > U.S.A > G.B.). An ROC analysis revealed a cut-score of 13, which resulted in a sensitivity of 0.87 and a specificity of 0.58. It is recommended to adjust the cut-score according to level of IDD and gender. Further research is needed to align diagnostic assignment of ASD across different sites and countries.
Assuntos
Transtorno do Espectro Autista/etnologia , Comunicação , Comparação Transcultural , Deficiência Intelectual/etnologia , Relações Interpessoais , Inquéritos e Questionários/normas , Adulto , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/psicologia , Berlim/etnologia , Feminino , Humanos , Deficiência Intelectual/diagnóstico , Deficiência Intelectual/psicologia , Londres/etnologia , Masculino , Ohio/etnologia , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
BACKGROUND: Married couples often share similar health-related characteristics and behaviors, including cigarette smoking status. Despite their rising popularity in the U.S., little research has examined the patterns of spousal concordance (SC) for alternative tobacco products (ATPs), such as e-cigarettes, cigars, and hookah. METHODS: The purpose of this project was to examine the roles of age, gender, and culture in the strength of SC for these ATPs. Analyses focused on a diverse community sample of married individuals in Ohio, U.S. (N=278), but also examined patterns in Austria, Greece, Israel, the Netherlands, and Slovakia. All participants completed a survey in which they indicated both their own, and their spouse's ever-use of various tobacco products. RESULTS: For the U.S. sample, SC was highest for e-cigarettes, flavored e-cigarettes, flavored cigarettes, and hookah (Ïs=0.48- 0.61); SC appeared to be stronger among younger couples, and when there was only a small female vs. male differences in use. Similar patterns were found in the other countries, with a few key exceptions. In particular, there was low SC for e-cigarettes and flavored e-cigarettes in the other countries, where e-cigarettes had been federally regulated by the time of data collection. CONCLUSION: Overall, these findings have implications for the continued spreading popularity of these tobacco use behaviors.
Assuntos
Comparação Transcultural , Sistemas Eletrônicos de Liberação de Nicotina/estatística & dados numéricos , Fumar/etnologia , Cônjuges/etnologia , Produtos do Tabaco/estatística & dados numéricos , Adulto , Áustria/etnologia , Sistemas Eletrônicos de Liberação de Nicotina/psicologia , Sistemas Eletrônicos de Liberação de Nicotina/tendências , Feminino , Grécia/etnologia , Humanos , Israel/etnologia , Masculino , Países Baixos/etnologia , Ohio/etnologia , Eslováquia/etnologia , Fumar/psicologia , Fumar/tendências , Cônjuges/psicologia , Inquéritos e Questionários , Uso de Tabaco/etnologia , Uso de Tabaco/psicologia , Uso de Tabaco/tendências , Tabagismo/diagnóstico , Tabagismo/etnologia , Tabagismo/psicologia , Tabaco sem FumaçaRESUMO
BACKGROUND: Population heterogeneity may be a significant confounding factor hampering detection and verification of late onset Alzheimer's disease (LOAD) susceptibility genes. The Amish communities located in Indiana and Ohio are relatively isolated populations that may have increased power to detect disease susceptibility genes. METHODS: We recently performed a genome scan of dementia in this population that detected several potential loci. However, analyses of these data are complicated by the highly consanguineous nature of these Amish pedigrees. Therefore we applied the Combinatorial Mismatch Scanning (CMS) method that compares identity by state (IBS) (under the presumption of identity by descent (IBD)) sharing in distantly related individuals from such populations where standard linkage and association analyses are difficult to implement. CMS compares allele sharing between individuals in affected and unaffected groups from founder populations. Comparisons between cases and controls were done using two Fisher's exact tests, one testing for excess in IBS allele frequency and the other testing for excess in IBS genotype frequency for 407 microsatellite markers. RESULTS: In all, 13 dementia cases and 14 normal controls were identified who were not related at least through the grandparental generation. The examination of allele frequencies identified 24 markers (6%) nominally (p < or = 0.05) associated with dementia; the most interesting (empiric p < or = 0.005) markers were D3S1262, D5S211, and D19S1165. The examination of genotype frequencies identified 21 markers (5%) nominally (p < or = 0.05) associated with dementia; the most significant markers were both located on chromosome 5 (D5S1480 and D5S211). Notably, one of these markers (D5S211) demonstrated differences (empiric p < or = 0.005) under both tests. CONCLUSION: Our results provide the initial groundwork for identifying genes involved in late-onset Alzheimer's disease within the Amish community. Genes identified within this isolated population will likely play a role in a subset of late-onset AD cases across more general populations. Regions highlighted by markers demonstrating suggestive allelic and/or genotypic differences will be the focus of more detailed examination to characterize their involvement in dementia.
Assuntos
Demência/genética , Ligação Genética , Predisposição Genética para Doença , Genômica/métodos , Estudos de Casos e Controles , Demência/etnologia , Frequência do Gene , Genótipo , Humanos , Indiana/etnologia , Repetições de Microssatélites , Ohio/etnologia , LinhagemRESUMO
OBJECTIVES: To identify reasons for lower organ donation rates by African Americans, we examined knowledge and attitudes about brain death, donation, and transplantation and trust in the health care system. METHODS: Data were collected from 1,283 subjects in Ohio using a random digit dial telephone survey. Items were developed based on focus group results. Willingness-to-donate indicators included a signed donor card and willingness to donate one's own and a loved one's organs. RESULTS: Compared with whites, African-Americans had lower rates of signing a donor card (39.1% vs 64.9%, P < .001), and willingness to donate their own organs (72.6% vs 88.3%, P < .001) or a loved one's organs (53.0% vs 66.2%, P < .001). African Americans had lower scores on the Trust in the Health Care System scale (mean scores +/- SD, 9.43 +/- 3.05 vs 9.93 +/- 2.88, P < .01) and were more likely to agree that "if doctors know I am an organ donor, they won't try to save my life" (38.6% vs 25.9%, P < .001), the rich or famous are more likely to get a transplant (81.9% vs 75.7%, P < .05), and less likely to agree that doctors can be trusted to pronounce death (68.2% vs 82.9, P < .001). African Americans were also more likely to agree that families should receive money for donating organs (45.6% vs 28.0%, P < .001) and funeral expenses (63.1% vs 46.6%, P < .001). CONCLUSIONS: African Americans reported greater mistrust in the equity of the donation system and were more favorable about providing tangible benefits to donor families than white respondents.
Assuntos
Atitude/etnologia , Negro ou Afro-Americano/psicologia , Doadores de Tecidos/psicologia , Obtenção de Tecidos e Órgãos , Adulto , Feminino , Grupos Focais , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Ohio/etnologia , Religião , Fatores Socioeconômicos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , População Branca/psicologiaRESUMO
We sought to examine the association of insulin, insulin sensitivity, and blood pressure using ambulatory blood pressure monitor in three ethnically distinct populations. The study population comprised the following. Group 1 (n = 31): African-Americans; Group 2 (n = 27): recent African immigrants; and Group 3 (n = 31): white Americans who were residing in Franklin County, Ohio. Quantitative insulin sensitivity index (Si) was obtained using the minimal model method in both groups of African ancestry and white Americans. The mean insulin sensitivity index (Si) was similar in the African-Americans (3.23 +/- 0.47 x (10)-4 x [min-l x microU/mL (-1)])(-l) and African immigrants (2.53 +/- 0.27). However, these Si values were significantly (P < .01) lower in people of African ancestry than in white Americans (6.56 +/- 1.07). The mean systolic (SBP) and diastolic blood pressure (DBP) and heart rates (HR) during 24-h and daytime periods were not significantly different in the African-Americans and African immigrants. During the night, whereas the mean SBP was not different in the three groups, DBP and HR were significantly (P < .05) higher in both groups of African ancestry than in white Americans. However, we found no significant relationships among serum insulin levels, insulin sensitivity, and ambulatory blood pressure (systolic and diastolic and mean arterial pressure) and heart rates in any of the groups. In summary, our present study demonstrates that people of African ancestry manifest 1) significantly lower insulin sensitivity indices and 2) blunted physiologic reduction in nocturnal DBP and HR when compared to white Americans who reside in the same environment. We speculate that these chronobiological alterations in BP and HR in blacks appear to be genetically determined.
Assuntos
População Negra , Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Resistência à Insulina/fisiologia , Insulina/farmacologia , População Branca , Adulto , Glicemia/metabolismo , Monitorização Ambulatorial da Pressão Arterial/métodos , Emigração e Imigração , Etnicidade , Feminino , Gana/etnologia , Teste de Tolerância a Glucose , Humanos , Insulina/sangue , Resistência à Insulina/genética , Masculino , Ohio/etnologia , Fatores SexuaisRESUMO
OBJECTIVE: Chronic hepatitis B virus (HBV) infection and liver cancer mortality represent a neglected health disparity among Asian Americans. The purposes of this study were to compare the prevalence of hepatitis B among a diverse group of 1311 Ohioans in Franklin County, OH (85% Asians, 7.5% African Americans, and 6.5% whites) and to improve access to care for high-risk Asian adults through advocacy and policy changes. RESEARCH DESIGN AND METHODS: The Asian subgroups comprised of Chinese, Filipino, Asian Indian, Pakistani, Vietnamese, Korean, Laotian, Indonesian, Japanese, Cambodian, Thai, and Malaysian nationalities. The HBV screening was completed at health fairs, restaurants, churches, and temples from 2006 to 2011. RESULTS: The prevalence of HBV infection (9.5% vs 5%) and family history of liver cancer was significantly higher among Asians than other racial ethnic groups (P = 0.001). Cambodian, Vietnamese, and Chinese participants were disproportionately infected with the virus compared with other Asian subgroups (P < 0.001). Advocacy and policy changes for resources allowed vaccine-eligible Asians included as "high risk" group to receive free vaccinations at the health department. However, although vouchers were provided to vaccine-eligible Asian adults, compliance in getting vaccinated was very low (11%). Common barriers for compliance were lack of time and knowledge of completing the 3 shot series, low English proficiency, and fear of adverse effects. CONCLUSIONS: Outreach education may use community liaisons to improve screenings, education, and vaccination/treatment. A hepatitis free clinic was established in 2009 to provide culturally and linguistically appropriate treatment for low-income Asian Americans in Franklin County, OH.
Assuntos
Asiático/etnologia , Negro ou Afro-Americano/etnologia , Disparidades em Assistência à Saúde/etnologia , Vacinas contra Hepatite B/uso terapêutico , Hepatite B/etnologia , População Branca/etnologia , Adulto , Idoso , Estudos Transversais , Gerenciamento Clínico , Feminino , Seguimentos , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Humanos , Imunização/métodos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Ohio/etnologia , Grupos Raciais/etnologia , Fatores de TempoRESUMO
The body adiposity index (BAI; hip circumference (cm)/height (m)(1.5) - 18) has recently been shown to demonstrate a stronger correlation with percentage body fat (%fat) than that between the BMI and %fat in Mexican-American adults. Here, we compare the concordance between %fat from dual-energy X-ray absorptiometry (DXA) and BAI, and between %fat and BMI, in European-American adults (n = 623). Agreement between BAI, BMI, and %fat was assessed using Lin's concordance coefficients (ρ(c)), where values <0.90 are considered poor. In the sample as a whole, the agreement between BAI and %fat (ρ(c) = 0.752) was far better than that between BMI and %fat (ρ(c) = 0.445) but was nonetheless relatively poor. There were large mean differences in %fat between the BAI and DXA %fat, particularly at lower levels of adiposity (<20%), and further the BAI overestimated %fat in males and underestimated %fat in females. Optimizing the BAI formula for our sample only marginally improved performance. Results of the present study show that BAI provides a better indicator of adiposity in European-American adults than does BMI, but does not provide valid estimates of %fat, particularly at lower levels of body fatness. Further research is warranted to investigate the predictive ability of BAI for various health outcomes.
Assuntos
Adiposidade , Obesidade/etnologia , População Branca/estatística & dados numéricos , Absorciometria de Fóton , Adiposidade/etnologia , Adulto , Índice de Massa Corporal , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/patologia , Ohio/epidemiologia , Ohio/etnologia , Adulto JovemRESUMO
Perhaps the world's first peace garden, the Cleveland Cultural Gardens embody the history of twentieth-century America and reveal the complex interrelations between art and place. This essay uses the Cleveland Cultural Gardens as a lens through which to explore how art and place have intersected over time. It explores how communities have negotiated questions of national, ethnic, and American identity and embedded those identities into the vernacular landscape. It considers how the particulars of place were embedded into a public garden and asks whether it is possible for public art to transcend its placeboth in terms of geography and history. In some sense, the Gardens have transcended their place, but in others respects, their fortunes were bound inextricably to that place, to the economic, demographic, and cultural contours that shaped and reshaped Northern Ohio. As works of art, the Cleveland Cultural Gardens both have reflected the history of Cleveland and American industrial cities during the 20th century and revealed something of the dynamics that underscored the changing character of public art and gardens in American cities.
Assuntos
Arte , Características Culturais , Jardinagem , Logradouros Públicos , Saúde da População Urbana , Reforma Urbana , Arte/história , Cidades/economia , Cidades/etnologia , Cidades/história , Cidades/legislação & jurisprudência , Características Culturais/história , Saúde Ambiental/economia , Saúde Ambiental/educação , Saúde Ambiental/história , Saúde Ambiental/legislação & jurisprudência , Flores , Jardinagem/economia , Jardinagem/educação , Jardinagem/história , Jardinagem/legislação & jurisprudência , História do Século XX , História do Século XXI , Ohio/etnologia , Plantas , Logradouros Públicos/economia , Logradouros Públicos/história , Logradouros Públicos/legislação & jurisprudência , Características de Residência/história , Mudança Social/história , Árvores , Saúde da População Urbana/história , População Urbana/história , Reforma Urbana/economia , Reforma Urbana/educação , Reforma Urbana/história , Reforma Urbana/legislação & jurisprudênciaRESUMO
Despite the benefits of substance abuse treatment, only a small proportion of drug users enter treatment. Understanding "readiness" is critical for engaging drug users in treatment and for involving them in the recovery process. This paper reports on ethnographic interviews conducted with 35 active drug users as they were entering treatment services, to describe how they perceive readiness for treatment. Drug users expressed readiness for treatment in terms reflective of twelve step programs, a folk model of treatment. A better understanding of drug users' perceptions can help to inform interventions designed to improve readiness for treatment.