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1.
BMC Public Health ; 21(1): 1330, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34229621

RESUMO

BACKGROUND: Disparate racial/ethnic burdens of the Coronavirus Disease 2019 (COVID-19) pandemic may be attributable to higher susceptibility to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) or to factors such as differences in hospitalization and care provision. METHODS: In our cross-sectional analysis of lab-confirmed COVID-19 cases from a tertiary, eight-hospital healthcare system across greater Houston, multivariable logistic regression models were fitted to evaluate hospitalization and mortality odds for non-Hispanic Blacks (NHBs) vs. non-Hispanic Whites (NHWs) and Hispanics vs. non-Hispanics. RESULTS: Between March 3rd and July 18th, 2020, 70,496 individuals were tested for SARS-CoV-2; 12,084 (17.1%) tested positive, of whom 3536 (29.3%) were hospitalized. Among positive cases, NHBs and Hispanics were significantly younger than NHWs and Hispanics, respectively (mean age NHBs vs. NHWs: 46.0 vs. 51.7 years; p < 0.001 and Hispanic vs. non-Hispanic: 44.0 vs. 48.7 years; p < 0.001). Despite younger age, NHBs (vs. NHWs) had a higher prevalence of diabetes (25.2% vs. 17.6%; p < 0.001), hypertension (47.7% vs. 43.1%; p < 0.001), and chronic kidney disease (5.0% vs. 3.3%; p = 0.001). Both minority groups resided in lower median income (median income [USD]; NHBs vs. NHWs: 63,489 vs. 75,793; p < 0.001, Hispanic vs. non-Hispanic: 59,104 vs. 68,318; p < 0.001) and higher population density areas (median population density [per square mile]; NHBs vs. NHWs: 3257 vs. 2742; p < 0.001, Hispanic vs. non-Hispanic: 3381 vs. 2884; p < 0.001). In fully adjusted models, NHBs (vs. NHWs) and Hispanics (vs. non-Hispanic) had higher likelihoods of hospitalization, aOR (95% CI): 1.42 (1.24-1.63) and 1.61 (1.46-1.78), respectively. No differences were observed in intensive care unit (ICU) utilization or treatment parameters. Models adjusted for demographics, vital signs, laboratory parameters, hospital complications, and ICU admission vital signs demonstrated non-significantly lower likelihoods of in-hospital mortality among NHBs and Hispanic patients, aOR (95% CI): 0.65 (0.40-1.03) and 0.89 (0.59-1.31), respectively. CONCLUSIONS: Our data did not demonstrate racial and ethnic differences in care provision and hospital outcomes. Higher susceptibility of racial and ethnic minorities to SARS-CoV-2 and subsequent hospitalization may be driven primarily by social determinants.


Assuntos
Afro-Americanos , COVID-19 , Estudos Transversais , Grupos Étnicos , Hispano-Americanos , Hospitalização , Humanos , SARS-CoV-2
2.
Bioresour Technol ; 337: 125489, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34320768

RESUMO

Vanillin and vanillate are the major lignin-derived aromatic compounds produced through the alkaline oxidation of softwood lignin. Because the production of higher-value added chemicals from these compounds is essential for lignin valorization, the microbial production of ß-ketoadipate, a promising raw material for the synthesis of novel nylons, from lignin was considered. Pseudomonas putida KT2440 was engineered to convert vanillin and vanillate to ß-ketoadipate. By examining the culture conditions with an initial culture volume of 1 L, the engineered strain completely converted 25 g of vanillin and 25 g of vanillate and produced approximately 23 g of ß-ketoadipate from each of them with a yield of 93% or higher. Furthermore, this strain showed the ability to efficiently produce ß-ketoadipate from softwood lignin extracts in black liquor, a byproduct of pulp production. These results suggest that the production of ß-ketoadipate from industrial black liquor is highly feasible for substantial lignin valorization.


Assuntos
Lignina , Pseudomonas putida , Adipatos , Afro-Americanos , Humanos
3.
Nutrients ; 13(6)2021 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-34204927

RESUMO

This study examined the effects of parental feeding practices and adolescent emotional eating (EE) on dietary outcomes among overweight African American adolescents. Based on Family Systems Theory, it was hypothesized that parental feeding practices, such as parental monitoring and responsibility, would buffer the effects of EE on poor dietary quality, whereas practices such as concern about a child's weight, restriction, and pressure-to-eat would exacerbate this relationship. Adolescents (N = 127; Mage = 12.83 ± 1.74; MBMI% = 96.61 ± 4.14) provided baseline data from the Families Improving Together (FIT) for Weight Loss trial and an ancillary study. Dietary outcomes (fruit and vegetables (F&Vs), energy intake, sweetened beverage, total fat, and saturated fat) were assessed using random 24-h dietary recalls. Validated surveys were used to assess adolescent-reported EE and parental feeding practices. Results demonstrated a significant interaction between EE and parental monitoring (adjusted analyses; B = 0.524, SE = 0.176, p = 0.004), restriction (B = -0.331, SE = 0.162, p = 0.043), and concern (B = -0.602, SE = 0.171, p = 0.001) on F&V intake; under high monitoring, low restriction, and low concern, EE was positively associated with F&V intake. There were no significant effects for the other dietary outcomes. These findings indicate that parental feeding practices and EE may be important factors to consider for dietary interventions, specifically for F&V intake, among overweight African American adolescents.


Assuntos
Afro-Americanos/estatística & dados numéricos , Ingestão de Alimentos , Comportamento Alimentar , Pais/psicologia , Obesidade Pediátrica/etiologia , Adolescente , Afro-Americanos/psicologia , Bebidas Gaseificadas , Criança , Ingestão de Alimentos/etnologia , Ingestão de Alimentos/psicologia , Emoções , Ingestão de Energia , Comportamento Alimentar/etnologia , Comportamento Alimentar/psicologia , Feminino , Frutas , Humanos , Masculino , Obesidade Pediátrica/etnologia , Obesidade Pediátrica/psicologia , Inquéritos e Questionários , Verduras
4.
AMA J Ethics ; 23(6): E480-486, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34212849

RESUMO

Transgenerational trauma is a potential barrier to achieving a healthy and holistic patient-physician relationship, particularly for Black Americans. Examination of deeply rooted historical injustices that Black patients suffer in health care and how they undermine trust can help clarify connections between historical trauma, distrust, and health outcomes. Furthering clinicians' understanding of how daily practice can respond to Black patients' experiences can help restore trust and mitigate racial and ethnic health inequity.


Assuntos
Trauma Histórico , Afro-Americanos , Grupos de Populações Continentais , Humanos , Relações Médico-Paciente , Confiança
5.
J Anal Psychol ; 66(3): 678-694, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34231891

RESUMO

These extraordinary months due to COVID-19 and the Black Lives Matter protests, set as they are against a backdrop of the increasingly worrying climate emergency, have brought fear, anxiety and discord across the globe. But we have also experienced a deepening of our understanding of our connectedness, protests against injustice, expressions of social concern and a demand for change. The concept of the cultural complex as developed by Singer & Kimbles (2004) offers a helpful means of connecting the psychology of the individual psyche and the political phenomena of power relations. Using a small example to illustrate how it might operate at a local level, I suggest that a fundamental shift is taking place raising profound levels of anxiety as we move from the known to the unknown. The bipolar nature of these complexes means the extremes are surfacing bringing fears of the very real possibility of more entrenched attacks on democracy from the far right and the hunkering down behind armed borders. But there is also hope that different ways of living together may be developing from the ground up, ways that are rooted in our sense of interdependence - with each other and our planetary home.


Assuntos
Afro-Americanos , COVID-19 , Ativismo Político , Racismo , Inconsciente Psicológico , Adulto , Inglaterra , Humanos
6.
J Anal Psychol ; 66(3): 378, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34231904
7.
JAMA Netw Open ; 4(7): e2117115, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34259846

RESUMO

Importance: Social distancing is critical to the control of COVID-19, which has disproportionately affected the Black community. Physician-delivered messages may increase adherence to these behaviors. Objectives: To determine whether messages delivered by physicians improve COVID-19 knowledge and preventive behaviors and to assess the differential effectiveness of messages tailored to the Black community. Design, Setting, and Participants: This randomized clinical trial of self-identified White and Black adults with less than a college education was conducted from August 7 to September 6, 2020. Of 44 743 volunteers screened, 30 174 were eligible, 5534 did not consent or failed attention checks, and 4163 left the survey before randomization. The final sample had 20 460 individuals (participation rate, 68%). Participants were randomly assigned to receive video messages on COVID-19 or other health topics. Interventions: Participants saw video messages delivered either by a Black or a White study physician. In the control groups, participants saw 3 placebo videos with generic health topics. In the treatment group, they saw 3 videos on COVID-19, recorded by several physicians of varied age, gender, and race. Video 1 discussed common symptoms. Video 2 highlighted case numbers; in one group, the unequal burden of the disease by race was discussed. Video 3 described US Centers for Disease Control and Prevention social distancing guidelines. Participants in both the control and intervention groups were also randomly assigned to see 1 of 2 American Medical Association statements, one on structural racism and the other on drug price transparency. Main Outcomes and Measures: Knowledge, beliefs, and practices related to COVID-19, demand for information, willingness to pay for masks, and self-reported behavior. Results: Overall, 18 223 participants (9168 Black; 9055 White) completed the survey (9980 [55.9%] women, mean [SD] age, 40.2 [17.8] years). Overall, 6303 Black participants (34.6%) and 7842 White participants (43.0%) were assigned to the intervention group, and 1576 Black participants (8.6%) and 1968 White participants (10.8%) were assigned to the control group. Compared with the control group, the intervention group had smaller gaps in COVID-19 knowledge (incidence rate ratio [IRR], 0.89 [95% CI, 0.87-0.91]) and greater demand for COVID-19 information (IRR, 1.05 [95% CI, 1.01-1.11]), willingness to pay for a mask (difference, $0.50 [95% CI, $0.15-$0.85]). Self-reported safety behavior improved, although the difference was not statistically significant (IRR, 0.96 [95% CI, 0.92-1.01]; P = .08). Effects did not differ by race (F = 0.0112; P > .99) or in different intervention groups (F = 0.324; P > .99). Conclusions and Relevance: In this study, a physician messaging campaign was effective in increasing COVID-19 knowledge, information-seeking, and self-reported protective behaviors among diverse groups. Studies implemented at scale are needed to confirm clinical importance. Trial Registration: ClinicalTrials.gov Identifier: NCT04502056.


Assuntos
Afro-Americanos , COVID-19/prevenção & controle , Grupo com Ancestrais do Continente Europeu , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Médicos , Racismo , Adulto , Comunicação , Competência Cultural , Escolaridade , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Distanciamento Físico , Saúde Pública , SARS-CoV-2 , Marketing Social , Inquéritos e Questionários , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-34207968

RESUMO

Sexual health communication warrants greater attention as it may help to reduce the rates of HIV incidence among youth. A growing body of literature suggests that conversations about sexual health among Black and Latino youth may serve as a potential strategy for HIV prevention. The current study investigates whether sexual health communication-in particular, conversations about sexual health and HIV-influences Black and Latino youth's personal agency regarding their role in achieving an HIV-free generation. For this secondary data analysis, we used the National Survey of Teens and Young Adults on attitudes towards HIV/AIDS (n = 701). Participants included youth between the ages 15 and 24, and the average was 20 years. We used a multiple regression analysis to examine whether sexual health communication contributed to youth knowledge and awareness of (1) the national plan for EHE, and (2) their role in ending the epidemic". (1) knowledge and awareness of the national plan for EHE, and (2) role in ending the epidemic. The final multiple regression model was statistically significant [R2 = 0.16 F (12, 701) = 001, p < 0.001] for both outcomes. Study results found that sexual health communication was positively related to Black and Latino youth's awareness of efforts to end the HIV epidemic (EHE) and their belief that they could play a role in achieving EHE. In addition, HIV stigma influenced personal agency and whether youth were aware of efforts to achieve EHE. Our results demonstrated that openly communicating about sexual health and HIV may contribute to a sense of personal agency among Black and Latino youth. In addition, understanding whether sexual health communication contributes to a sense of personal agency among youth may inform HIV prevention efforts to achieve the goals set forth by the national EHE plan for the U.S.


Assuntos
Epidemias , Infecções por HIV , Comunicação em Saúde , Saúde Sexual , Adolescente , Adulto , Afro-Americanos , Infecções por HIV/epidemiologia , Hispano-Americanos , Humanos , Adulto Jovem
9.
JAMA Netw Open ; 4(7): e2117074, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34264327

RESUMO

Importance: Black and Latinx communities have been disproportionately affected by the COVID-19 pandemic, yet little work has sought to understand their perspectives. Objective: To explore the experiences of Black and Latinx communities during the pandemic to better understand their perspectives on COVID-19 mitigation behaviors (eg, mask wearing), testing, and vaccines. Design, Setting, and Participants: In this community-engaged qualitative study conducted with 18 community-based organizations and 4 health care organizations between November 19, 2020, and February 5, 2021, in New Jersey counties severely affected by the pandemic, group and individual interviews were used to purposively sample 111 Black and Latinx individuals. A total of 13 group interviews were organized by race/ethnicity and language: 4 English-speaking groups with Black participants (n = 34), 3 Spanish-speaking groups with Latinx participants (n = 24), and 4 English-speaking groups with Black and Latinx participants (n = 36). To understand the views of health care workers from these communities, 2 additional groups (n = 9) were convened and supplemented with individual interviews. Main Outcomes and Measures: Description of Black and Latinx participants' experiences during the COVID-19 pandemic and their perspectives on mitigation behaviors, testing, and vaccines. Results: The study included 111 participants (87 women [78.4%]; median age, 43 years [range, 18-93 years]). Participants described the devastating effects of the pandemic on themselves, loved ones, and their community. Their experiences were marked by fear, illness, loss, and separation. These experiences motivated intense information seeking, mitigation behaviors, and testing. Nevertheless, vaccine skepticism was high across all groups. Participants did not trust the vaccine development process and wanted clearer information. Black participants expressed that they did not want to be subjects of experiments. Conclusions and Relevance: The remaining unknowns about new vaccines need to be acknowledged and described for Black and Latinx communities to make informed decisions. Ultimately, scientists and public officials need to work transparently to address unanswered questions and work collaboratively with trusted community leaders and health professionals to foster partnered approaches, rather than focusing on marketing campaigns, to eliminate vaccine skepticism.


Assuntos
Afro-Americanos , Atitude/etnologia , Vacinas contra COVID-19 , COVID-19 , Hispano-Americanos , Pandemias , Confiança , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/diagnóstico , COVID-19/etnologia , COVID-19/prevenção & controle , COVID-19/psicologia , Teste para COVID-19 , Feminino , Humanos , Comportamento de Busca de Informação , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , New Jersey , Pesquisa , SARS-CoV-2 , Adulto Jovem
10.
Braz J Med Biol Res ; 54(10): e10380, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34287573

RESUMO

Depression is a common disorder in the population, but some people are more vulnerable to this condition. Groups at higher risk of developing psychic suffering include black children and adolescents living in vulnerable socioeconomic conditions. This study aimed to analyze race and life conditions as determinants of depression in children and adolescents. This was a systematic review with meta-analysis. The study sources were MEDLINE Ovid, Web of Science, Latin American and Caribbean Health Science Information database, Science Citation Index-Expanded, PubMed, EMBASE, and Scopus. The following keywords were used: Child, Adolescent, Stress, Psychological, Depression, and African Continental Ancestry Group, using the logical operators AND and OR. The general criteria were observational studies published in the last 20 years. Language was not restricted to avoid possible bias in the selection of articles. Studies with a high risk of bias were excluded. General analysis was conducted with RStudio 3.0 software using odds ratio analysis with a 95% confidence interval and 0.05 significance level. We firstly found 654 studies, of which 18 met the criteria and were included in this review. Race and life conditions were determinants of depression in children and adolescents, with a negative impact for the black population.


Assuntos
Afro-Americanos , Depressão , Adolescente , Ansiedade , Criança , Depressão/epidemiologia , Humanos
11.
PLoS One ; 16(7): e0254127, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34242275

RESUMO

Pundits and academics across disciplines note that the human toll brought forth by the novel coronavirus (COVID-19) pandemic in the United States (U.S.) is fundamentally unequal for communities of color. Standing literature on public health posits that one of the chief predictors of racial disparity in health outcomes is a lack of institutional trust among minority communities. Furthermore, in our own county-level analysis from the U.S., we find that counties with higher percentages of Black and Hispanic residents have had vastly higher cumulative deaths from COVID-19. In light of this standing literature and our own analysis, it is critical to better understand how to mitigate or prevent these unequal outcomes for any future pandemic or public health emergency. Therefore, we assess the claim that raising institutional trust, primarily scientific trust, is key to mitigating these racial inequities. Leveraging a new, pre-pandemic measure of scientific trust, we find that trust in science, unlike trust in politicians or the media, significantly raises support for COVID-19 social distancing policies across racial lines. Our findings suggest that increasing scientific trust is essential to garnering support for public health policies that lessen the severity of the current, and potentially a future, pandemic.


Assuntos
Afro-Americanos/psicologia , COVID-19 , Disparidades nos Níveis de Saúde , Hispano-Americanos/psicologia , Pandemias , Distanciamento Físico , SARS-CoV-2 , Confiança , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
12.
Artigo em Inglês | MEDLINE | ID: mdl-34202168

RESUMO

Investigating the spatial distribution patterns of disease and suspected determinants could help one to understand health risks. This study investigated the potential risk factors associated with COVID-19 mortality in the continental United States. We collected death cases of COVID-19 from 3108 counties from 23 January 2020 to 31 May 2020. Twelve variables, including demographic (the population density, percentage of 65 years and over, percentage of non-Hispanic White, percentage of Hispanic, percentage of non-Hispanic Black, and percentage of Asian individuals), air toxins (PM2.5), climate (precipitation, humidity, temperature), behavior and comorbidity (smoking rate, cardiovascular death rate) were gathered and considered as potential risk factors. Based on four geographical detectors (risk detector, factor detector, ecological detector, and interaction detector) provided by the novel Geographical Detector technique, we assessed the spatial risk patterns of COVID-19 mortality and identified the effects of these factors. This study found that population density and percentage of non-Hispanic Black individuals were the two most important factors responsible for the COVID-19 mortality rate. Additionally, the interactive effects between any pairs of factors were even more significant than their individual effects. Most existing research examined the roles of risk factors independently, as traditional models are usually unable to account for the interaction effects between different factors. Based on the Geographical Detector technique, this study's findings showed that causes of COVID-19 mortality were complex. The joint influence of two factors was more substantial than the effects of two separate factors. As the COVID-19 epidemic status is still severe, the results of this study are supposed to be beneficial for providing instructions and recommendations for the government on epidemic risk responses to COVID-19.


Assuntos
COVID-19 , Afro-Americanos , Grupo com Ancestrais do Continente Europeu , Disparidades nos Níveis de Saúde , Humanos , SARS-CoV-2 , Estados Unidos/epidemiologia
13.
Nutrients ; 13(6)2021 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-34205293

RESUMO

We examined the associations of dietary cholesterol and egg intakes with cardiometabolic and all-cause mortality among Chinese and low-income Black and White Americans. Included were 47,789 Blacks, 20,360 Whites, and 134,280 Chinese aged 40-79 years at enrollment. Multivariable Cox models with restricted cubic splines were applied to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality outcomes using intakes of 150 mg cholesterol/day and 1 egg/week as the references. Cholesterol intake showed a nonlinear association with increased all-cause mortality and a linear association with increased cardiometabolic mortality among Black Americans: HRs (95% CIs) associated with 300 and 600 mg/day vs. 150 mg/day were 1.07 (1.03-1.11) and 1.13 (1.05-1.21) for all-cause mortality (P-linearity = 0.04, P-nonlinearity = 0.002, and P-overall < 0.001) and 1.10 (1.03-1.16) and 1.21 (1.08-1.36) for cardiometabolic mortality (P-linearity = 0.007, P-nonlinearity = 0.07, and P-overall = 0.005). Null associations with all-cause or cardiometabolic mortality were noted for White Americans (P-linearity ≥ 0.13, P-nonlinearity ≥ 0.06, and P-overall ≥ 0.05 for both). Nonlinear inverse associations were observed among Chinese: HR (95% CI) for 300 vs. 150 mg/day was 0.94 (0.92-0.97) for all-cause mortality and 0.91 (0.87-0.95) for cardiometabolic mortality, but the inverse associations disappeared with cholesterol intake > 500 mg/day (P-linearity ≥ 0.12; P-nonlinearity ≤ 0.001; P-overall < 0.001 for both). Similarly, we observed a positive association of egg intake with all-cause mortality in Black Americans, but a null association in White Americans and a nonlinear inverse association in Chinese. In conclusion, the associations of cholesterol and egg intakes with cardiometabolic and all-cause mortality may differ across ethnicities who have different dietary patterns and cardiometabolic risk profiles. However, residual confounding remains possible.


Assuntos
Colesterol na Dieta/administração & dosagem , Dieta/estatística & dados numéricos , Ovos , Síndrome Metabólica/mortalidade , Mortalidade/etnologia , Pobreza/estatística & dados numéricos , Adulto , Afro-Americanos , Idoso , Grupo com Ancestrais do Continente Asiático , China/epidemiologia , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Saúde do Homem , Síndrome Metabólica/etnologia , Pessoa de Meia-Idade , Estudos Prospectivos , Estados Unidos/epidemiologia , Saúde da Mulher
14.
Curr Psychiatry Rep ; 23(9): 61, 2021 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-34297202

RESUMO

PURPOSE OF REVIEW: Disparities in health outcomes are a well documented and worrisome part of our health care system. These disparities persist in spite of, and are occasionally exacerbated by, new technologies that are intended to improve health care. This results in a "digital divide" in which populations that have poorer health outcomes continue to have poorer health outcomes despite technological improvements. RECENT FINDINGS: In many ways, the digitical divide is already shrinking via improved access to internet and technology/process improvements. For example, people with schizophrenia, PTSD, and bipolar disorder have had their care successfully augmented by new technology. However, problems persist- being impoverished, female, and black all correlate with decreased probability of completing a telehealth visit, and millions of americans have insufficient internet access to complete telehealth visits. We must continue to utilize new technology in health care to improve outcomes, but we must also be wary to ensure those outcomes are equitable across different populations.


Assuntos
Exclusão Digital , Telemedicina , Afro-Americanos , Feminino , Disparidades em Assistência à Saúde , Humanos , Internet
15.
N Engl J Med ; 385(4): 342-351, 2021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34289277

RESUMO

BACKGROUND: Historically, the receipt of prescription opioids has differed among racial groups in the United States. Research has not sufficiently explored the contribution of individual health systems to these differences by examining within-system prescription opioid receipt according to race. METHODS: We used 2016 and 2017 Medicare claims data from a random 40% national sample of fee-for-service, Black and White beneficiaries 18 to 64 years of age who were attributed to health systems. We identified 310 racially diverse systems (defined as systems with ≥200 person-years each for Black and White patients). To test representativeness, we compared patient characteristics and opioid receipt among the patients in these 310 systems with those in the national sample. Within the 310 systems, regression models were used to explore the difference between Black and White patients in the following annual opioid measures: any prescription filled, short-term receipt of opioids, long-term receipt of opioids (one or more filled opioid prescriptions in all four calendar quarters of a year), and the opioid dose in morphine milligram equivalents (MME); models controlled for patient characteristics, state, and system. RESULTS: The national sample included 2,197,153 person-years, and the sample served by 310 racially diverse systems included 896,807 person-years (representing 47.4% of all patients and 56.1% of Black patients in the national sample). The national sample and 310-systems sample differed meaningfully only in the percent of person-years contributed by Black patients (21.3% vs. 25.9%). In the 310-systems sample, the crude annual prevalence of any opioid receipt differed slightly between Black and White patients (50.2% vs. 52.2%), whereas the mean annual dose was 36% lower among Black patients than among White patients (5190 MME vs. 8082 MME). Within systems, the adjusted race differences in measures paralleled the population trends: the annual prevalence of opioid receipt differed little, but the mean annual dose was higher among White patients than among Black patients in 91% of the systems, and at least 15% higher in 75% of the systems. CONCLUSIONS: Within individual health systems, Black and White patients received markedly different opioid doses. These system-specific findings could facilitate exploration of the causes and consequences of these differences. (Funded by the National Institute on Aging and the Agency for Healthcare Research and Quality.).


Assuntos
Analgésicos Opioides/uso terapêutico , Disparidades em Assistência à Saúde/etnologia , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Adulto , Afro-Americanos , Pessoas com Deficiência , Grupo com Ancestrais do Continente Europeu , Feminino , Serviços de Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Masculino , Medicare , Pessoa de Meia-Idade , Manejo da Dor , Medicamentos sob Prescrição/uso terapêutico , Estados Unidos , Adulto Jovem
16.
Nutrients ; 13(7)2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34210069

RESUMO

The purpose of this study was to conduct in-depth individual interviews with 30 African American adolescents with overweight and obesity and their families (caregiver/adolescent dyads) to gain a better understanding of how to integrate stress and coping essential elements into an existing family-based health promotion program for weight loss. Interview data from 30 African American adolescents with overweight and obesity (Mage = 15.30 ± 2.18; MBMI%-ile = 96.7 ± 3.90) were transcribed and coded for themes using inductive and deductive approaches by two independent coders. Inter-rater reliability was acceptable (r = 0.70-0.80) and discrepancies were resolved to 100% agreement. The themes were guided by the Relapse Prevention Model, which focuses on assessing barriers of overall coping capacity in high stress situations that may undermine health behavior change (physical activity, diet, weight loss). Prominent themes included feeling stressed primarily in response to relationship conflicts within the family and among peers, school responsibilities, and negative emotions (anxiety, depression, anger). A mix of themes emerged related to coping strategies ranging from cognitive reframing and distraction to avoidant coping. Recommendations for future programs include addressing sources of stress and providing supportive resources, as well as embracing broader systems such as neighborhoods and communities. Implications for future intervention studies are discussed.


Assuntos
Adaptação Psicológica , Comportamento do Adolescente/psicologia , Afro-Americanos/psicologia , Obesidade Pediátrica/psicologia , Estresse Psicológico/psicologia , Adolescente , Terapia Comportamental , Criança , Dieta/psicologia , Família/psicologia , Relações Familiares/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Humanos , Masculino , Obesidade Pediátrica/terapia , Pesquisa Qualitativa , Ensaios Clínicos Controlados Aleatórios como Assunto , Programas de Redução de Peso
17.
Front Public Health ; 9: 676784, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34249843

RESUMO

Declaring racism a public health crisis has the potential to shepherd meaningful anti-racism policy forward and bridge long standing divisions between policy-makers, community organizers, healers, and public health practitioners. At their best, the declarations are a first step to address long standing inaction in the face of need. At their worst, the declarations poison or sedate grassroots momentum toward anti-racism structural change by delivering politicians unearned publicity and slowing progress on health equity. Declaring racism as a public health crisis is a tool that must be used with clarity and caution in order to maximize impact. Key to holding public institutions accountable for creating declarations is the direct involvement of Black and Indigenous People of Color (BIPOC) led groups and organizers. Sharing power, centering their voices and working in tandem, these collaborations ensure that declarations push for change from the lens of those most impacted and authentically engage with the demands of communities and their legacies. Superficial diversity and inclusion efforts that bring BIPOC people and organizers into the conversation and then fail to implement their ideas repeat historical patterns of harm, stall momentum for structural change at best, and poison the strategy at worst. In this paper we will examine three declarations in the United States and analyze them utilizing evaluative criteria aligned with health equity and anti-racism practices. Finally, we offer recommendations to inform anti-racist public health work for meaningful systematic change toward decentralization and empowerment of communities in their health futures.


Assuntos
Equidade em Saúde , Venenos , Racismo , Afro-Americanos , Humanos , Saúde Pública , Estados Unidos
18.
Trop Anim Health Prod ; 53(3): 399, 2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34254207

RESUMO

Diets have an important effect on the fatty acid (FA) content in milk from dairy cows so that feeding strategies may modify the FA profile. There is little information on the fatty acid contents of whole-crop barley (BLY) and black oat (BKO) silages and on milk from cows fed these silages that are an alternative forage for small-scale dairy systems (SSDS). Given the growing interest in foods with favourable health attributes, the objective was to identify the FA content of milk from dairy cows fed whole-crop BLY and BKO silages in small-scale systems. Three inclusion levels of BLY and BKO silage were assessed in nine lactating cows at pasture for 8 h/day and supplemented with 4.6 kg/DM/cow/day commercial concentrate. Treatments were BLY: 10 kg DM/cow/day BLY silage; BKO: 10 kg DM/cow/d BKO silage; and BLY/BKO: 5 kg BLY and 5 kg DM/cow/d BKO silages (50:50). A 3 × 3 Latin square design repeated three times with nine cows and 14-day periods was utilised. Variables evaluated were the content of fatty acids present in feeds and milk. Contents of linoleic (C18:2n-6) and linolenic (C18:3n-3) acids, as precursors of polyunsaturated fatty acids, were 46 in BLY and 50 BKO g/100 g, lower than for multispecies pasture (61 g/100 g). There were statistical differences in the content of short-chain fatty acids in milk (P < 0.05), being lower for BLY (18.9 g/100 g) compared with BKO (20.4 g/100 g) and BLY/BKO (20.6 g/100 g), the saturated fatty acids and linoleic acid (C18:2n-6c) were higher in BLY/BKO in relation to BLY and BKO. Content of health-promoting polyunsaturated fatty acids in milk was higher in BLY/BKO (P < 0.05). There were no differences (P < 0.05) in the atherogenic index, with values within reports. Small-grain cereal forages may produce milk with a favourable fatty acid content for human health.


Assuntos
Hordeum , Silagem , Afro-Americanos , Animais , Avena , Bovinos , Dieta/veterinária , Ácidos Graxos , Feminino , Humanos , Lactação , México , Leite , Silagem/análise , Zea mays
19.
Transl Psychiatry ; 11(1): 363, 2021 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-34226506

RESUMO

Stimulant dependence is heritable, but specific genetic factors underlying the trait have not been identified. A genome-wide association study for stimulant dependence was performed in a discovery cohort of African- (AA) and European-ancestry (EA) subjects ascertained for genetic studies of alcohol, opioid, and cocaine use disorders. The sample comprised individuals with DSM-IV stimulant dependence (393 EA cases, 5288 EA controls; 155 AA cases, 5603 AA controls). An independent cohort from the family-based Collaborative Study on the Genetics of Alcoholism (532 EA cases, 7635 EA controls; 53 AA cases, AA 3352 controls) was used for replication. One variant in SLC25A16 (rs2394476, p = 3.42 × 10-10, odds ratio [OR] = 3.70) was GWS in AAs. Four other loci showed suggestive evidence, including KCNA4 in AAs (rs11500237, p = 2.99 × 10-7, OR = 2.31) which encodes one of the potassium voltage-gated channel protein that has been linked to several other substance use disorders, and CPVL in the combined population groups (rs1176440, p = 3.05 × 10-7, OR = 1.35), whose expression was previously shown to be upregulated in the prefrontal cortex from users of cocaine, cannabis, and phencyclidine. Analysis of the top GWAS signals revealed a significant enrichment with nicotinic acetylcholine receptor genes (adjusted p = 0.04) and significant pleiotropy between stimulant dependence and alcohol dependence in EAs (padj = 3.6 × 10-3), an anxiety disorder in EAs (padj = 2.1 × 10-4), and ADHD in both AAs (padj = 3.0 × 10-33) and EAs (padj = 6.7 × 10-35). Our results implicate novel genes and pathways as having roles in the etiology of stimulant dependence.


Assuntos
Estudo de Associação Genômica Ampla , Transtornos Relacionados ao Uso de Substâncias , Afro-Americanos , Autoantígenos , Grupo com Ancestrais do Continente Europeu , Predisposição Genética para Doença , Humanos , Proteínas de Membrana Transportadoras , Polimorfismo de Nucleotídeo Único , Transtornos Relacionados ao Uso de Substâncias/genética
20.
Appl Microbiol Biotechnol ; 105(13): 5577-5587, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34226961

RESUMO

The black carpet beetle (BCB) is a household pest unique in its ability to digest complex proteins such as keratin that makes up the majority of feather structure. Despite voluminous yield and high protein content ( > 85%), feathers are poorly digested by most known organisms and are thereby rendered an environmental hazard. Furthermore, keratinolytic microbial strains are typically thermophilic and therefore economically and environmentally unsustainable. Given the BCB's ability to digest wool, feathers, and other keratin-rich materials, we assembled a de novo transcriptome of larvae fed on either feathers or standard chow. All proteolytic enzymes were identified via homology to the MEROPS database and subsequently annotated for a complete overview of enzymatic activity and distribution of peptidase clans in the transcriptome. Both differential expression and sequence homology screening were then used to identify potentially keratinolytic candidates from the assembly to be used in future expression experiments. The BCB transcriptome showed a high proportion of serine (22.6%) and cysteine (18.9%) proteases as well as metallopeptidases (25.5%) compared with other insect species. Regarding differential expression, serine and metalloproteases represented a large proportion of upregulated genes in the feather-fed group, constituting 42.9% and 57.1% of upregulated proteases, respectively. Additionally, several candidate transcripts identified through homology screening showed significant sequence overlap to seven existing keratinases, indicating a strong likelihood of keratinolytic function in this organism. KEY POINTS: • A de novo transcriptome of black carpet beetle larvae was assembled. • The transcriptome consisted of 67% of serine, cysteine, and metalloproteases. • Differential transcriptomes of beetles fed feather and chow were compared.


Assuntos
Besouros , Plumas , Afro-Americanos , Animais , Besouros/genética , Humanos , Aves Domésticas , Transcriptoma
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