Association of Psychosocial Symptoms, Blood Pressure, and Menopausal Status in African-American Women.

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.

The "Last Child": Lone Family Caregivers in St. Croix, US Virgin Islands.

I investigate local explanations for a common family configuration of care for older relatives on the island of St. Croix, U.S. Virgin Islands: the "lone family caregiver." Through the examination of a paradigm case emerging from these explanations, I argue that local logics can divest some children of obligations to care for their older parents. I suggest that this case is an important addition to recent discussions within the anthropology of care that emphasize how families practice "care across distance," as it offers an alternative example of how families manage care in the context of migration.

Factors associated with increased risk for lethal violence in intimate partner relationships among ethnically diverse black women.

The purpose of this study was to identify factors associated with increased risk for lethal violence among ethnically diverse Black women in Baltimore, Maryland (MD), and the U.S. Virgin Islands (USVI). Women with abuse experiences (N = 456) were recruited from primary care, prenatal, or family planning clinics in Baltimore, MD, and St. Thomas and St. Croix. Logistic regression was used to examine factors associated with the risk for lethal violence among abused women. Factors independently related to increased risk of lethal violence included fear of abusive partners, posttraumatic stress disorder (PTSD), symptoms, and use of legal resources. These factors must be considered in assessing safety needs of Black women in abusive relationships.

Assessing the association of nativity and acculturation to fast food restaurant use and its relationship to metabolic risk factors among US blacks with Afro-Caribbean ethnicity.

OBJECTIVES: This investigation among Afro-Caribbean adults in the United States Virgin Islands (USVI) examined whether acculturation and preference for dining out accounted for variation by nativity in the frequency of fast food restaurant use, and assessed the relationship of fast food restaurant use to body weight and insulin resistance. METHODS: A randomly selected sample of 679 Afro-Caribbean adults (aged ≥ 20 years), including 436 who were foreign-born and 243 who were native-born, were recruited on the island of St. Croix, USVI. Information on demographic characteristics, level of acculturation and dietary practices were obtained from participants by questionnaire. Fasting blood samples, which were measured for glucose and insulin, and anthropometric measurements were also collected from participants. Insulin resistance was estimated by the homeostasis model assessment (HOMA). Relationships between variables were assessed with analysis of variance and logistic regression analyses. RESULTS: In bivariate analyses, birth in the USVI, younger age, being single, greater preference for dining out and higher levels of education and acculturation were significantly (P < .05) associated with fast food restaurant use. In multivariate logistic regression analyses, birth in the USVI, younger age and preference for dining out were independently associated with frequent (≥ 2 days/week) fast food restaurant use. The mean level of HOMA insulin resistance among participants increased significantly with more frequent use of fast food restaurants. CONCLUSIONS: Among Afro-Caribbean adults in the USVI, fast food restaurant use is positively associated with insulin resistance and varies by nativity, but acculturation does not account for this variation.

Victimization experiences, substance misuse, and mental health problems in relation to risk for lethality among African American and African Caribbean women.

The purpose of this study was to investigate the association of intimate partner victimization experiences, mental health (MH), and substance misuse problems with the risk for lethality among women of African descent. Data for this cross-sectional study were derived from a large case-control study examining the relationship between abuse status and health consequences. Women were recruited from primary care, prenatal, or family planning clinics in Baltimore and the U.S. Virgin Islands. Logistic regression was used to generate the study findings. Among 543 abused women, physical and psychological abuse by intimate partners, comorbid posttraumatic stress disorder (PTSD) and depression symptoms, and PTSD-only problems significantly increased the likelihood of lethality risk. However, victims' substance misuse and depression-only problems were not associated with the risk for lethality. In addition, PTSD symptoms mediated the relationship between severe victimization experiences and risk for lethality. Practitioners should pay attention to victimization experiences and MH issues when developing treatment and safety plans. Policies to fund integrated services for African American and African Caribbean women with victimization and related MH issues, and training of providers to identify at-risk women may help reduce the risk for lethality in intimate partner relationships.

Intimate partner violence, depression, PTSD, and use of mental health resources among ethnically diverse black women.

This study examined exposure to violence and risk for lethality in intimate partner relationships as factors related to co-occurring MH problems and use of mental health (MH) resources among women of African descent. Black women with intimate partner violence (IPV) experiences (n = 431) were recruited from primary care, prenatal or family planning clinics in the United States and the U.S. Virgin Islands. Severity of IPV was significantly associated with co-occurring MH problems, but was not associated with the use of MH resources among African-American women. Risk for lethality and co-occurring problems were also not significantly related to the use of resources. African Caribbean women with severe physical abuse experiences were significantly less likely to use resources. In contrast, severity of physical abuse was positively associated with the use of resources among Black women with mixed ethnicity. Severe IPV experiences are risk factors for co-occurring MH problems, which in turn, increases the need for MH services. However, Black women may not seek help for MH problems. Thus, social work practitioners in health care settings must thoroughly assess women for their IPV experiences and develop tailored treatment plans that address their abuse histories and MH needs.

Assessment of the ability of the triglyceride to high density lipoprotein cholesterol ratio to discriminate insulin resistance among Caribbean-born black persons with and without Hispanic ethnicity / Evaluación de la capacidad de la proporción de los triglicéridos en relación con el colesterol de las lipoproteínas de alta densidad para identificar la resistencia a la insulina entre personas negras nacidad en el Caribe con o sin etnicidad Hispánica

OBJECTIVE: The objective of this research was to determine if the triglyceride (TG) to high density lipoprotein (HDL) cholesterol (TG/HDL) ratio has similar utility for discriminating insulin resistance in Caribbean-born black persons with and without Hispanic ethnicity. METHODS: Serum lipids, glucose and insulin were determined and compared for 144 Hispanic blacks and 655 non-Hispanic blacks living in the US Virgin Islands. Area under the receiver operating characteristics (AUROC) curve statistics were used to evaluate the ability of the TG/HDL ratio to discriminate insulin resistance in the two ethnic groups. RESULTS: Hispanic blacks had significantly higher levels of triglycerides and insulin resistance and a lower level of HDL cholesterol than non-Hispanic blacks. The AUROC curve for the ability of the TG/HDL to discriminate insulin resistance was 0.71 (95% CI = 0.62, 0.79) for Hispanic blacks and 0.64 (95% CI = 0.59, 0.69) for non-Hispanic blacks. CONCLUSIONS: Among Caribbean-born black persons living in the US Virgin Islands, the TG/HDL ratio is a useful screening measure for discriminating insulin resistance in those with Hispanic ethnicity but not in those without Hispanic ethnicity.

OBJETIVO: El objetivo de esta investigación fue determinar si la proporción (TG/HDL) de los triglicéridos (TG) con respecto al colesterol de las lipoproteínas de alta densidad (HDL) tiene una utilidad similar a la hora de identificar la resistencia a la insulina en personas negras nacidas en el Caribe, con o sin etnicidad hispánica. MÉTODOS: Se determinaron y compararon la insulina, la glucosa y los lípidos séricos de 144 negros hispánicos y 655 negros no hispánicos residentes en Islas Vírgenes, USA. Las estadísticas del área bajo la curva de las características operativas del receptor (AUROC) se utilizaron para evaluar la capacidad de la proporción TG/HDL para establecer la resistencia a la insulina en los dos grupos étnicos. RESULTADOS: Los negros hispánicos tenían niveles significativamente más altos de triglicéridos y resistencia a la insulina y un menor nivel de colesterol HDL que los negros no hispánicos. La curva AUROC para la capacidad del TG/HDL para establecer la resistencia a la insulina fue 0.71 (95% CI = 0.62, 0.79) para los negros hispánicos y 0.64 (95% CI = 0.59, 0.69) para los negros no hispánicos. CONCLUSIONES: Entre las personas negras que viven en las Islas Vírgenes, la proporción de TG/HDL es una medida útil de tamizaje pata establecer la resistencia a la insulina en las personas de etnia hispana, pero no en las personas de etnicidad no hispánica.

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) and extranodal involvement of the orbit.

We present the case of a 5-year-old boy who was referred to the Neurosurgical Service of the San Jorge Children's Hospital for evaluation of right eye proptosis. At the age of one year the diagnosis of sinus histiocytosis with massive lymphadenopathy (SHML) had been rendered on a cervical lymph node biopsy. The right orbit mass causing the proptosis was the result of extranodal involvement of the orbital tissue by SHML. The clinical and pathologic features of this entity are discussed.

Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) and extranodal involvement of the orbit

We present the case of a 5-year-old boy who was referred to the Neurosurgical Service of the San Jorge Children's Hospital for evaluation of right eye proptosis. At the age of one year the diagnosis of sinus histiocytosis with massive lymphadenopathy (SHML) had been rendered on a cervical lymph node biopsy. The right orbit mass causing the proptosis was the result of extranodal involvement of the orbital tissue by SHML. The clinical and pathologic features of this entity are discussed