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1.
Psychol Trauma ; 12(5): 446-448, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32525371

RESUMEN

The mental health consequences of the COVID-19 pandemic are particularly relevant in African-American communities because African-Americans have been disproportionately impacted by the disease, yet they are traditionally less engaged in mental health treatment compared with other racial groups. Using the state of Michigan as an example, we describe the social and psychological consequences of the pandemic on African-American communities in the United States, highlighting community members' concerns about contracting the disease, fears of racial bias in testing and treatment, experiences of sustained grief and loss, and retraumatization of already-traumatized communities. Furthermore, we describe the multilevel, community-wide approaches that have been used thus far to mitigate adverse mental health outcomes within our local African-American communities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Afroamericanos/etnología , Servicios Comunitarios de Salud Mental , Infecciones por Coronavirus/etnología , Pesar , Disparidades en Atención de Salud/etnología , Servicios de Salud Mental , Neumonía Viral/etnología , Trauma Psicológico/etnología , Religión y Psicología , Adulto , Humanos , Michigan/etnología , Pandemias , Trauma Psicológico/terapia
2.
Psychol Trauma ; 12(5): 455-456, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32567874

RESUMEN

A series of 15-min videos were produced to provide resources to pastors in African-American communities to aid them in conveying accurate public and mental health information about COVID-19. Video presenters included trusted experts in public and mental health and pastors with considerable experience responding to the needs of the African-American community during the COVID-19 pandemic. Four culturally specific core themes to consider when providing care to African Americans who are at increased risk during the pandemic were identified: ritual disruption, negative reactions for not following public health guidelines, trauma, and culture and trust. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Asunto(s)
Afroamericanos , Clero , Información de Salud al Consumidor , Infecciones por Coronavirus , Control de Infecciones , Pandemias , Neumonía Viral , Trauma Psicológico , Espiritualidad , Adulto , Afroamericanos/etnología , Humanos , Internet , Trauma Psicológico/etnología , Confianza , Grabación en Video
3.
JAMA Netw Open ; 3(6): e2012270, 2020 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32543702

RESUMEN

Importance: In late December 2019, an outbreak caused by a novel severe acute respiratory syndrome coronavirus 2 emerged in Wuhan, China. Data on the clinical characteristics and outcomes of infected patients in urban communities in the US are limited. Objectives: To describe the clinical characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) and to perform a comparative analysis of hospitalized and ambulatory patient populations. Design, Setting, and Participants: This study is a case series of 463 consecutive patients with COVID-19 evaluated at Henry Ford Health System in metropolitan Detroit, Michigan, from March 9 to March 27, 2020. Data analysis was performed from March to April 2020. Exposure: Laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection. Main Outcomes and Measures: Demographic data, underlying comorbidities, clinical presentation, complications, treatment, and outcomes were collected. Results: Of 463 patients with COVID-19 (mean [SD] age, 57.5 [16.8] years), 259 (55.9%) were female, and 334 (72.1%) were African American. Most patients (435 [94.0%]) had at least 1 comorbidity, including hypertension (295 patients [63.7%]), chronic kidney disease (182 patients [39.3%]), and diabetes (178 patients [38.4%]). Common symptoms at presentation were cough (347 patients [74.9%]), fever (315 patients [68.0%]), and dyspnea (282 patients [60.9%]). Three hundred fifty-five patients (76.7%) were hospitalized; 141 (39.7%) required intensive care unit management and 114 (80.8%) of those patients required invasive mechanical ventilation. Male sex (odds ratio [OR], 2.0; 95% CI, 1.3-3.2; P = .001), severe obesity (OR, 2.0; 95% CI, 1.4-3.6; P = .02), and chronic kidney disease (OR, 2.0; 95% CI, 1.3-3.3; P = .006) were independently associated with intensive care unit admission. Patients admitted to the intensive care unit had longer length of stay and higher incidence of respiratory failure and acute respiratory distress syndrome requiring invasive mechanical ventilation, acute kidney injury requiring dialysis, shock, and mortality (57 patients [40.4%] vs 15 patients [7.0%]) compared with patients in the general practice unit. Twenty-nine (11.2%) of those discharged from the hospital were readmitted and, overall, 20.0% died within 30 days. Male sex (OR, 1.8; 95% CI, 1.1-3.1; P = .03) and age older than 60 years (OR, 5.3; 95% CI, 2.9-9.7; P < .001) were significantly associated with mortality, whereas African American race was not (OR, 0.98; 95% CI, 0.54-1.8; P = .86). Conclusions and Relevance: In this review of urban metropolitan patients with COVID-19, most were African American with a high prevalence of comorbid conditions and high rates of hospitalization, intensive care unit admission, complications, and mortality due to COVID-19.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Respiración Artificial/métodos , Insuficiencia Respiratoria/terapia , Lesión Renal Aguda/epidemiología , Adulto , Afroamericanos/etnología , Afroamericanos/estadística & datos numéricos , Anciano , Estudios de Casos y Controles , Comorbilidad , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/mortalidad , Tos/etiología , Disnea/etiología , Femenino , Fiebre/etiología , Hospitalización/estadística & datos numéricos , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Tiempo de Internación/tendencias , Masculino , Michigan/epidemiología , Persona de Mediana Edad , Obesidad/epidemiología , Pandemias , Neumonía Viral/sangre , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/mortalidad , Prevalencia , Respiración Artificial/efectos adversos , Insuficiencia Respiratoria/epidemiología , Insuficiencia Respiratoria/mortalidad , Estudios Retrospectivos
4.
Nutrients ; 12(4)2020 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-32252241

RESUMEN

Sphingolipid metabolism plays a critical role in cell growth regulation, lipid regulation, neurodevelopment, type 2 diabetes, and cancer. Animal experiments suggest that vitamin D may be involved in sphingolipid metabolism regulation. In this study, we tested the hypothesis that vitamin D supplementation would alter circulating long-chain ceramides and related metabolites involved in sphingolipid metabolism in humans. We carried out a post-hoc analysis of a previously conducted randomized, placebo-controlled clinical trial in 70 overweight/obese African-Americans, who were randomly assigned into four groups of 600, 2000, 4000 IU/day of vitamin D3 supplements or placebo for 16 weeks. The metabolites were measured in 64 subjects (aged 26.0 ± 9.4 years, 17% male). Serum levels of N-stearoyl-sphingosine (d18:1/18:0) (C18Cer) and stearoyl sphingomyelin (d18:1/18:0) (C18SM) were significantly increased after vitamin D3 supplementation (ps < 0.05) in a dose-response fashion. The effects of 600, 2000, and 4000 IU/day vitamin D3 supplementation on C18Cer were 0.44 (p = 0.049), 0.52 (p = 0.016), and 0.58 (p = 0.008), respectively. The effects of three dosages on C18SM were 0.30 (p = 0.222), 0.61 (p = 0.009), and 0.68 (p = 0.004), respectively. This was accompanied by the significant correlations between serum 25-hydroxyvitamin D3 [25(OH)D] concentration and those two metabolites (ps < 0.05). Vitamin D3 supplementations increase serum levels of C18Cer and C18SM in a dose-response fashion among overweight/obese African Americans.


Asunto(s)
Afroamericanos , Calcifediol/sangre , Colecalciferol/administración & dosificación , Glicoesfingolípidos Neutros/metabolismo , Obesidad/metabolismo , Adulto , Afroamericanos/etnología , Colecalciferol/metabolismo , Suplementos Dietéticos , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Masculino , Obesidad/etnología , Sobrepeso/etnología , Sobrepeso/metabolismo
5.
Arthritis Care Res (Hoboken) ; 72(2): 225-232, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31507071

RESUMEN

OBJECTIVE: Lupus low disease activity state (LLDAS) is a potential treat-to-target goal in systemic lupus erythematosus (SLE). This study determined predictors of time to reach LLDAS in a longitudinal cohort. METHODS: Patients were grouped according to LLDAS status at cohort entry. Those who did not satisfy LLDAS at cohort entry were analyzed prospectively. The Kaplan-Meier approach was used to estimate the time to LLDAS. Cox regression was used to identify patient characteristics that were associated with time to LLDAS. RESULTS: The probability of LLDAS attainment within 1 year was 52% for Caucasians, 36% for African Americans, and 33% for SLE patients with renal involvement. The median time to LLDAS was 1.1 years. In multivariable models, African American ethnicity, baseline prednisone >10 mg daily, hypocomplementemia, baseline damage, and baseline renal activity remained significant predictors of longer time to attain LLDAS, while disease duration <1 year and cutaneous activity were associated with earlier attainment. CONCLUSION: LLDAS is potentially attainable in the majority of SLE patients. The time to LLDAS was found to be longer in African American patients with SLE. Characteristics of African American patients with SLE, such as renal activity and hypocomplementemia, were also independent predictors of slower attainment of LLDAS. These findings point to the need to include African American patients with SLE in both clinical and pharmaceutical research.


Asunto(s)
Afroamericanos/etnología , Progresión de la Enfermedad , Grupo de Ascendencia Continental Europea/etnología , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/etnología , Índice de Severidad de la Enfermedad , Adulto , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Tiempo
6.
Am J Clin Nutr ; 111(3): 515-525, 2020 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-31879755

RESUMEN

BACKGROUND: Race differences in body composition and fat distribution may in part explain the differences in insulin sensitivity and the disproportionate burden of type 2 diabetes in African Americans. OBJECTIVE: To determine if differences in body composition and fat distribution explain race differences in insulin sensitivity and identify obesity measures that were independently associated with insulin sensitivity. METHODS: Participants were 113 lean, overweight, and obese African-American and Caucasian-American adults without diabetes. Skeletal muscle insulin sensitivity was determined using a hyperinsulinemic-euglycemic clamp (SIClamp, insulin rate:120 mU/m2/min). Subcutaneous abdominal adipose tissue (SAAT), intra-abdominal adipose tissue (IAAT), and liver fat were measured by MRI; leg fat, total fat, and lean mass were measured by DXA. RESULTS: Race-by-adiposity interactions were significant in cross-sectional analyses utilizing multiple linear regression models for SIClamp (P < 0.05); higher BMI, fat mass, SAAT, leg fat, and liver fat were associated with lower SIClamp in Caucasian Americans but not African Americans. Race-by-IAAT interaction was not significant (P = 0.65). A central fat distribution (SAAT adjusted for leg fat) was associated with lower SIClamp in African Americans (ß = -0.45, SE = 0.11, P < 0.001) but not Caucasian Americans (ß = -0.42, SE = 0.30, P = 0.17). A peripheral fat distribution (leg fat adjusted for IAAT/SAAT) was associated with a higher SIClamp in African Americans (ß = 0.11, SE = 0.05, P = 0.02) but lower SIClamp in Caucasian Americans (ß = -0.28, SE = 0.14, P = 0.049). Lean mass was inversely associated with SIClamp in African Americans (ß = -0.05, SE = 0.03, P = 0.04) but not Caucasian Americans (ß = 0.08, SE = 0.05, P = 0.10) in the model for leg fat. CONCLUSIONS: Measures of overall adiposity were more strongly associated with SIClamp in Caucasian Americans, whereas body fat distribution and lean mass showed stronger correlations with SIClamp in African Americans. Insulin sensitivity may have a genetic basis in African Americans that is reflected in the pattern of body fat distribution. These findings suggest a race-specific pathophysiology of insulin resistance, which has implications for the prevention of diabetes and related cardiometabolic diseases.


Asunto(s)
Resistencia a la Insulina , Obesidad/etnología , Adiposidad , Adulto , Afroamericanos/etnología , Composición Corporal , Estudios Transversales , Grupo de Ascendencia Continental Europea/etnología , Femenino , Humanos , Insulina/metabolismo , Grasa Intraabdominal/metabolismo , Masculino , Persona de Mediana Edad , Obesidad/genética , Obesidad/metabolismo , Obesidad/fisiopatología , Adulto Joven
7.
Nutrients ; 11(11)2019 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-31683601

RESUMEN

Recent studies have assessed diet quality of low-income U.S. children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), but differences by race/ethnicity remain unknown. We assessed racial/ethnic disparities in nutrient intake from dietary sources (not supplements) among children participating in WIC, with a focus on priority nutrients and food groups for future WIC food package revisions, as described in a recent report by the National Academies of Sciences, Engineering, and Medicine (NASEM). We used data from the 2011-2014 National Health and Nutrition Examination Surveys (NHANES) and multivariable linear regression analysis to evaluate relationships between race/ethnicity and nutrient/food group intake of children participating in WIC. All data were analyzed using SAS 9.4 survey procedures, accounting for the complex survey design of the NHANES. Compared to non-Hispanic White children, Hispanic children had diets with better nutrient distribution and lower dietary energy density, while non-Hispanic Black children had diets with poorer nutrient intake. Hispanic children had higher potassium and fiber intake, and consumed more legumes, while non-Hispanic Black children had lower calcium and vitamin D intake, higher sodium intake, and lower total dairy intake, compared to non-Hispanic White children. These findings can inform WIC nutrition education messages and future food package revisions.


Asunto(s)
Afroamericanos , Dieta , Hispanoamericanos/estadística & datos numéricos , Factores Socioeconómicos , Afroamericanos/etnología , Afroamericanos/estadística & datos numéricos , Preescolar , Estudios Transversales , Dieta/etnología , Dieta/estadística & datos numéricos , Femenino , Asistencia Alimentaria , Disparidades en el Estado de Salud , Humanos , Lactante , Masculino , Encuestas Nutricionales , Estados Unidos
8.
Dev Psychol ; 55(11): 2440-2450, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31535895

RESUMEN

This study investigated children's and adolescents' predictions of inclusion and evaluations of exclusion in interracial and same-race peer contexts. The sample (N = 246) consisted of African American (n = 115) and European American (n = 131) children and adolescents who judged the likelihood of including a new peer, evaluated the group's decision to exclude the new peer, and provided reasons for their judgments. European American participants, particularly adolescents, viewed same-race inclusion as more likely than interracial inclusion. In contrast, African American participants viewed interracial and same-race inclusion to be just as likely, and evaluated all forms of exclusion to be more wrong than did their European American counterparts. The findings are discussed with respect to peer messages about interracial peer encounters and the conditions that are necessary for prejudice reduction. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Afroamericanos , Grupo de Ascendencia Continental Europea , Procesos de Grupo , Relaciones Interpersonales , Principios Morales , Grupo Paritario , Racismo , Distancia Social , Percepción Social , Adolescente , Afroamericanos/etnología , Niño , Grupo de Ascendencia Continental Europea/etnología , Femenino , Humanos , Masculino , Racismo/etnología
9.
BMJ Case Rep ; 12(9)2019 Sep 18.
Artículo en Inglés | MEDLINE | ID: mdl-31537586

RESUMEN

Postural orthostatic tachycardia syndrome (POTS) is a heterogeneous autonomic disorder characterised by orthostatic intolerance and a rise in heart rate by at least 30 bpm or an absolute heart rate value of at least 120 bpm within 10 min of standing or during a tilt table test. Overwhelmingly, POTS affects young Caucasian women, which can lead physicians to miss the diagnosis in men or non-white patients. We describe a case of 29-year-old African-American man who developed lightheadedness, generalised weakness, tachycardia and palpitations and was subsequently diagnosed with POTS. We review its clinical features, differential diagnosis, pathophysiology and treatment options. We also emphasise that POTS should be considered as a differential diagnosis in any patient presenting with typical clinical features, who may not be in the usual demographics of the disorder.


Asunto(s)
Mareo/etiología , Síndrome de Taquicardia Postural Ortostática/diagnóstico , Síndrome de Taquicardia Postural Ortostática/terapia , Taquicardia/etiología , Adulto , Afroamericanos/etnología , Diagnóstico Diferencial , Humanos , Masculino , Síndrome de Taquicardia Postural Ortostática/fisiopatología , Atención Primaria de Salud , Sodio/administración & dosificación , Pruebas de Mesa Inclinada/métodos , Resultado del Tratamiento
10.
Diabetes Res Clin Pract ; 156: 107866, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31542318

RESUMEN

AIMS: We aimed to assess ethnic differences in visceral adipose tissue (VAT), intrahepatic (IHL), intrapancreatic (IPL) and intramyocellular lipids (IMCL) between healthy white European (WE) and black west African (BWA) men. METHODS: 23 WE and 20 BWA men underwent Dixon-magnetic resonance imaging to quantify VAT, IHL and IPL; and proton-magnetic resonance spectroscopy to quantify IMCL. Insulin sensitivity and beta-cell function were determined using homeostasis model assessment (HOMA-2). RESULTS: BWA men exhibited significantly lower VAT (P = 0.021) and IHL (P = 0.044) than WE men, but comparable IPL (P = 0.92) and IMCL (P = 0.87). VAT was associated with IPL in both ethnicities (WE: P < 0.001; BWA: P = 0.001) but the relationship with IHL differed by ethnicity (Pinteraction = 0.018) and was only significant in WE men (WE: P < 0.001; BWA: P = 0.36). All ectopic fat depots inversely associated with insulin sensitivity and positively associated with beta-cell function in WE but not BWA men. CONCLUSIONS: Lower VAT and IHL, and their lack of interrelation, in BWA men suggests ethnic differences exist in the mechanisms of ectopic fat deposition. The lack of association between ectopic fat with insulin sensitivity and beta-cell function in BWA men may indicate a lesser role for ectopic fat in the development of type 2 diabetes mellitus in black populations.


Asunto(s)
Afroamericanos/etnología , Grasa Intraabdominal/fisiopatología , Adolescente , Adulto , Anciano , Grupos Étnicos , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
11.
Bull Menninger Clin ; 83(4): 399-431, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31380699

RESUMEN

Trichotillomania (TTM) involves the chronic pulling out of hair to the point of hair loss or thinning, which continues despite repeated attempts to stop. Behavior therapy is a promising treatment for the condition, but studies have been limited by the lack of a credible control condition, small sample sizes, follow-up periods of short duration, and low participation by underrepresented populations. In the current article, the authors describe the theoretical rationale for an acceptance-enhanced form of behavior therapy for TTM in adults and describe the methodology used to test the efficacy of this intervention against a psychoeducation and supportive control condition. In addition, the authors discuss the importance of and difficulties encountered with enrolling minority participants into TTM research, as well as strategies used to enhance minority recruitment. Finally, the authors discuss the instruments, procedures, and related outcomes of the fidelity measures used in the randomized controlled trial.


Asunto(s)
Afroamericanos/etnología , Terapia Conductista/métodos , Evaluación de Procesos y Resultados en Atención de Salud , Selección de Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Tricotilomanía/etnología , Tricotilomanía/terapia , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Garantía de la Calidad de Atención de Salud , Wisconsin/etnología , Adulto Joven
12.
Fam Process ; 58(3): 595-609, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31381844

RESUMEN

The complexity of the African American community in the United States continues to evolve. The growing number of professional African Americans who grew up in the postcivil rights era combined with the persistent reminders of inequity paints a complex backdrop for understanding African American relationships. The majority of our knowledge about African American couples disproportionately comes from nonclinical social science fields such as sociology and demography. Unfortunately, the scholarly literature on how to work with African American couples is relatively scant. This paper seeks to add to this limited literature by providing clinicians and scholars with a proposed set of issues to consider when conceptualizing and treating African American couples. In particular, the complexity and nuance needed to work with African American couples are best done by using an integrative model. Thus, this paper will discuss how the Integrative Systemic Therapy (IST) model is particularly well suited for working with African American couples. This paper will summarize the science on African American marriages with a focus on salient factors such as gender, SES, and trust, which will then be translated into clinical practice by utilizing a case example. The case example will be of a middle-class couple in order to delineate the challenges and the growing heterogeneity of African Americans. The article will conclude with a commentary on the evolving heterogeneity of African Americans, which sheds light on how an integrative perspective is important for disentangling and embracing the growing complexity of African American couples.


Asunto(s)
Afroamericanos/psicología , Terapia de Parejas , Afroamericanos/etnología , Terapia de Parejas/métodos , Cultura , Femenino , Financiación Personal , Humanos , Relaciones Interpersonales , Masculino , Factores Sexuales
13.
AIDS Behav ; 23(10): 2803-2815, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31407211

RESUMEN

Although young Black men who have sex with men (YBMSM) are disproportionately affected by HIV, they may be more heterogeneous as a group than is typically appreciated. Thus, the present study used a person-centered data-analytic approach to determine profiles of HIV-related risk among YBMSM and whether these profiles could be distinguished by age, HIV status, and socioeconomic risk (i.e., socioeconomic distress). YBMSM (N = 1808) aged 18 to 29 years completed a survey of sociodemographic characteristics, HIV status, and HIV-related behavioral and attitudinal factors (i.e., safer-sex self-efficacy, negative condom attitudes, being in difficult sexual situations, being in difficult sexual relationships, HIV treatment optimism, perceived HIV stigma). Latent profile analysis was used to identify HIV risk profiles and whether age, HIV status, and socioeconomic distress were associated with these profiles. Four profiles emerged: low-, medium-, and high-risk profiles, respectively, and a mixed profile characterized by a tendency to be in difficult sexual situations and relationships while also reporting high safer-sex self-efficacy and low negative attitudes toward condom use. Difficult sexual situations emerged as the key defining indicator of whether a profile reflected higher or lower risk. Younger age, being HIV-positive, and socioeconomic distress were associated with having a higher-risk profile. Given that unique risk profiles emerged that were differentially predicted by sociodemographic characteristics and HIV status, these findings have implications for tailoring interventions to the needs of different subgroups of YBMSM. Also, disempowering or risky sexual situations and relationships among YBMSM must be addressed.


Asunto(s)
Afroamericanos/etnología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Homosexualidad Masculina/etnología , Atención Dirigida al Paciente , Profilaxis Pre-Exposición , Autoeficacia , Conducta Sexual/estadística & datos numéricos , Estigma Social , Adolescente , Adulto , Afroamericanos/psicología , Condones/estadística & datos numéricos , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Homosexualidad Masculina/psicología , Humanos , Masculino , Factores de Riesgo , Sexo Seguro , Encuestas y Cuestionarios , Texas , Adulto Joven
14.
Perspect Psychol Sci ; 14(5): 797-815, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31412219

RESUMEN

Empirical evidence demonstrates that racism is a source of traumatic stress for racial/ethnic minorities, particularly African Americans. Like race and racism, skin tone and experiences of colorism-an often overlooked form of discrimination that privileges lighter skinned over darker skinned individuals, although not uniformly, may also result in traumatic stress. This article proposes a new conceptual model of skin-tone trauma. The model depicts how historical and contemporary underpinnings of colorism lead to colorist incidents that may directly and indirectly, by eliciting traumatic stress reactions, lead to negative effects on the health and interpersonal relationships of African Americans. Key tenets of critical race and intersectionality theories are used to highlight the complexities of skin-tone trauma as a result of intersectional identities on the basis of existing social hierarchies. Last, we present suggestions for researchers, as well as recommendations and strategies for practitioners, to unmask "skin-tone wounds" and promote healing for individuals, families, and communities that suffer from skin-tone trauma. Skin-tone trauma should be acknowledged by researchers, scholars, and practitioners to better understand and assess the widespread scope of trauma in the African American community.


Asunto(s)
Afroamericanos/psicología , Relaciones Interpersonales , Racismo/etnología , Pigmentación de la Piel , Trastornos de Estrés Traumático/etnología , Afroamericanos/etnología , Derechos Civiles , Cortejo/etnología , Cortejo/psicología , Esclavización/etnología , Esclavización/psicología , Relaciones Familiares , Femenino , Humanos , Masculino , Salud Mental , Racismo/psicología , Trastornos de Estrés Traumático/psicología , Estrés Psicológico/etnología , Estrés Psicológico/psicología , Estados Unidos/etnología
15.
Respir Med ; 155: 58-60, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31302579

RESUMEN

BACKGROUND: Black patients with asthma have a higher disease burden and greater morbidity compared with other racial/ethnic groups. Tiotropium Respimat®, as add-on to at least inhaled corticosteroids (ICS), improves lung function and asthma control and reduces asthma exacerbation risk in patients, with a safety profile comparable with placebo. This study aimed to assess the safety of tiotropium Respimat®, compared with placebo, in black or African-American patients. METHODS: Data were pooled from 12 randomized, placebo-controlled, parallel-group, Phase II or III trials from the global Boehringer Ingelheim program with once-daily tiotropium Respimat® (5 µg or 2.5 µg). Trial participants had symptomatic persistent asthma with a broad range of severities and were aged 1-75 years. The safety results of black or African-American patients were compared with the overall trial population. RESULTS: Of the 5165 patients treated with tiotropium or placebo, 3.2% were black or African American. For both doses of tiotropium, the proportion of patients reporting adverse events (AEs) was approximately 10% lower compared with placebo and was generally comparable with the proportion of patients reporting AEs in all groups of the overall population. The number of investigator-assessed drug-related AEs, AEs leading to trial drug discontinuation or serious AEs reported by patients was low and comparable between treatment groups and with the overall population. CONCLUSION: Tiotropium Respimat® appears to be a generally safe add-on bronchodilator treatment option to ICS with or without other controllers in pediatric and adult black or African-American patients with asthma. CLINICAL TRIAL IDENTIFIERS: NCT01634113, NCT01634139, NCT01634152, NCT01257230, NCT01277523, NCT01316380, NCT00350207, NCT01172808, NCT01172821, NCT01340209, NCT00772538, NCT00776984.


Asunto(s)
Afroamericanos/etnología , Asma/tratamiento farmacológico , Antagonistas Colinérgicos/administración & dosificación , Bromuro de Tiotropio/administración & dosificación , Administración por Inhalación , Adolescente , Corticoesteroides/administración & dosificación , Corticoesteroides/uso terapéutico , Adulto , Anciano , Asma/diagnóstico , Asma/etnología , Asma/mortalidad , Niño , Preescolar , Antagonistas Colinérgicos/efectos adversos , Antagonistas Colinérgicos/uso terapéutico , Quimioterapia Combinada , Humanos , Lactante , Persona de Mediana Edad , Placebos/administración & dosificación , Seguridad , Bromuro de Tiotropio/efectos adversos , Bromuro de Tiotropio/uso terapéutico , Resultado del Tratamiento , Adulto Joven
16.
Neuropsychology ; 33(8): 1089-1100, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31343234

RESUMEN

OBJECTIVE: Although researchers have documented the influence of cultural factors on neuropsychological test performance, few studies have examined the distribution of test scores among neurologically healthy older adults from different ethnic groups. The objective of this study was to determine whether there are group differences in neuropsychological test score distributions with ethnicity-specific norms for non-Hispanic White and Black/African American older adults. METHOD: Participants from the National Alzheimer's Coordinating Center were selected if they were not diagnosed with dementia within 5 years (Mage = 75.26, SDage = 6.98; Meducation = 15.70, SDeducation = 2.91). Groups were formed based on self-identified ethnicity of White (n = 5,311) or Black/African American (n = 1,098). All participants completed neuropsychological testing, including the Mini Mental State Exam, Logical Memory Immediate and Delayed, Digit Span Forward and Backward, Trail Making Test A & B, Animal Naming, Vegetable Naming, Digit Symbol, and Boston Naming Test. RESULTS: Based on combined ethnicity norms, the scores of Black participants were overrepresented in the below-average and low-average clinical ranges, and the scores of White participants were overrepresented in the high-average and superior clinical ranges for all 11 neuropsychological measures. When group specific norms were used, the unbalanced pattern of score categorization was no longer present for any of the neuropsychological measures. CONCLUSIONS: These findings emphasize the importance of developing and using ethnically and culturally appropriate neuropsychological test norms as well as the risk of interpreting some Black individual's scores as below average when they likely are not. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Asunto(s)
Afroamericanos/estadística & datos numéricos , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Pruebas Neuropsicológicas/estadística & datos numéricos , Afroamericanos/etnología , Anciano , Anciano de 80 o más Años , Grupo de Ascendencia Continental Europea/etnología , Femenino , Humanos , Masculino , Valores de Referencia
17.
Adv Child Dev Behav ; 57: 169-194, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31296315

RESUMEN

Positioning our analyses within two theoretical frameworks, system justification (SJ) theory and critical consciousness (CC), we examine relationships between social class and endorsement of SJ and CC beliefs and behaviors within a sample of low-income, Latinx and Black youth living in Chicago. We operationalize social class using five indicators: income-to-needs ratio (INR), subjective social status (SSS), financial strain, violence exposure, and neighborhood income. We find that for Black youth, higher INR is related to a greater likelihood of rejecting the status quo. Comparatively, living in a higher income neighborhood is negatively related to and being exposed to violence is positively related to the likelihood of engaging in social change behaviors. A different pattern emerged for Latinx youth where, higher perceived status was positively associated with accepting the status quo and greater exposure to violence was negatively related to youths' perceived ability to make a difference in the world around them.


Asunto(s)
Afroamericanos/etnología , Exposición a la Violencia/etnología , Hispanoamericanos , Política , Pobreza/etnología , Características de la Residencia , Conducta Social , Clase Social , Percepción Social , Adolescente , Chicago/etnología , Femenino , Humanos , Estudios Longitudinales , Masculino
18.
Adv Child Dev Behav ; 57: 195-233, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31296316

RESUMEN

The present study seeks to explore the intersectionality of ethnicity/race and socioeconomic status (SES) among ethnic/racial minority adolescents in their developmental contexts, examining its implications for sleep disparities and the roles of discrimination and ethnic/racial identity (ERI; i.e., adolescents' understanding and feelings about who they are in relation to their ethnic/racial group). With 350 adolescents (Asian 41.4%, Black, 21.7%, and Latinx 36.9%, female=69.1%, Mage=14.27), we conducted a latent class analysis (LCA) to identify latent classes of adolescents' ethnicity/race, ethnic/racial diversity in their schools and neighborhoods along with SES of their families, schools, and neighborhoods. Next, with hierarchical regression, we tested the association between class membership and subjective and objective sleep duration and quality, followed by the moderating effect of discrimination and ERI. We expected to find adolescents living in low diversity and low SES across various developmental contexts to experience lower levels of subjective and objective sleep duration and quality compared to their counterparts. We also expected to find exacerbating effects of discrimination and ERI exploration, and protective effects of ERI commitment in these associations. Three latent groups were identified (C1: "Black/Latinx adolescents in low/moderate SES families in varying diversity and low SES schools and neighborhoods," C2: "Predominantly Latinx adolescents in low SES families and moderate diversity and SES schools and neighborhoods," and C3: "Predominantly Asian adolescents in low/moderate SES families in moderate/high diversity and SES schools and neighborhoods"). The class memberships to C1 and C2 were associated with compromised sleep duration and quality compared to C3. An interaction effect of discrimination was found for C1 in subjective sleep duration and for C2 in objective sleep duration. While no interactions were found for ERI, ERI commitment had a direct association with objective sleep duration and quality. Interpretations and implications for intersectionality approach in studies on sleep disparities and the roles of discrimination and ERI are discussed.


Asunto(s)
Afroamericanos/etnología , Americanos Asiáticos , Hispanoamericanos , Sueño , Clase Social , Discriminación Social , Identificación Social , Actigrafía , Adolescente , Femenino , Humanos , Masculino
19.
Adv Child Dev Behav ; 57: 235-279, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31296317

RESUMEN

The intersection of SES and race-ethnicity impact youth development at the family and neighborhood levels. The confluence of neighborhood structural and social characteristics intersects to impact parenting multiple ways. Within lower-income neighborhoods, there is variability in economic and racial-ethnic demographics and social characteristics and a multitude of different lived experiences. We use a person-centered approach to understand how a plurality of neighborhood social characteristics shape parents' ethnic-racial socialization and monitoring strategies, normative parenting practices for diverse families. With 144 African American and Latino families in a new destination context-areas lacking an enduring historical and economic presence of same-ethnic populations-we examined whether we could replicate neighborhood profiles found in other neighborhood contexts using four neighborhood social process indicators (i.e., connectedness, cohesion and trust, informal social control, and problems), identified family- and neighborhood-level predictors of profiles, and explored differences in ethnic-racial socialization and parental monitoring knowledge by profile. We replicated three neighborhood profiles-integral (high on all positive social dynamics and low problems), anomic (low on all positive social dynamics and high problems), and high problems/positive relationships. Caregivers in these profiles differed in family SES and neighborhood disadvantage such that those in anomic neighborhoods had the lowest income-to-needs ratio whereas those in integral neighborhoods experienced the highest neighborhood disadvantage and lowest proportion of Hispanic residents. Egalitarianism, an ethnic-racial socialization message, and parental monitoring levels differed by neighborhood. Findings suggest African American and Latino families' unique experiences in a new destination context, signaling a complex interplay between race-ethnicity, SES, and place.


Asunto(s)
Afroamericanos/etnología , Hispanoamericanos , Responsabilidad Parental/etnología , Características de la Residencia , Socialización , Factores Socioeconómicos , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , New England/etnología
20.
Adv Child Dev Behav ; 57: 27-63, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31296318

RESUMEN

Researchers in developmental science often examine parenting and child development by ethnic, racial, and socioeconomic groups, frequently highlighting group differences in parent and infant behaviors. A sole focus on differences, however, obscures notable variability that exists within each community. Moreover, categories such as ethnicity and race are often assumed to encompass shared cultural backgrounds, which risks conflating race, ethnicity, and culture in psychological research. In this chapter, we examine cultural specificity and within-group heterogeneity that characterizes parenting and child development across socio-economic, ethnic, and racial groups. Drawing upon our work on ethnically and socioeconomically diverse parents and infants, we document the between-group differences, within-group variation, and universal processes in the form and content of parent-infant interactions. Most centrally, we highlight the role of family economic, human, and social capital in explaining the variability in parent-infant interactions across racial, ethnic, and cultural groups.


Asunto(s)
Afroamericanos/etnología , Desarrollo Infantil , Grupo de Ascendencia Continental Europea/etnología , Hispanoamericanos , Conducta Materna/etnología , Relaciones Padres-Hijo/etnología , Adulto , Femenino , Humanos , Lactante , Estados Unidos/etnología
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