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1.
Law Hum Behav ; 45(3): 215-228, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34351204

RESUMO

OBJECTIVE: The present study integrates several distinct lines of jury decision-making research by examining how the racial identities of the defendant and an informant witness interact in a federal drug conspiracy trial scenario and by assessing whether jurors' individual racial identity and jury group racial composition influence their judgments. HYPOTHESES: We predicted that jurors would be biased against the Black defendant and would be more likely to convict after exposure to a White informant, among other hypotheses. METHOD: We recruited 822 nonstudent jury-eligible participants assigned to 144 jury groups. Each group was assigned to one of four onditions where defendant race (Black or White) and informant race (Black or White) was manipulated. Each group watched a realistic audio-visual trial presentation, then deliberated as a group to render a verdict. RESULTS: Contrary to expectations, the conditions depicting a Black defendant yielded lower conviction rates compared to those with a White defendant-at both the predeliberation individual (odds ratio [OR] = 1.54) and postdeliberation group level (OR = 2.91)-while the informant race did not influence verdict outcomes. We also found that jurors rated the government witnesses as more credible when the defendant was White compared to when he was Black. Credibility ratings and verdict outcomes were also predicted by jurors' own race, although juror race did not interact with the race conditions when predicting verdicts. CONCLUSIONS: Jurors are sensitive to defendant race, and this sensitivity appears to strengthen after deliberation-but in a direction opposite to what was expected. One potential implication of our findings is that juries may operate as a check on system bias by applying greater scrutiny to law enforcement-derived evidence when the defendant is Black. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Tomada de Decisões , Tráfico de Drogas/legislação & jurisprudência , Julgamento , Função Jurisdicional , Fatores Raciais , Racismo/psicologia , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Idoso de 80 Anos ou mais , Direito Penal , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Aplicação da Lei , Masculino , Pessoa de Meia-Idade
2.
Law Hum Behav ; 45(3): 243-255, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34351206

RESUMO

OBJECTIVE: Although researchers, policymakers, and practitioners recognize the importance of the public's perceptions of police, few studies have examined developmental trends in adolescents and young adults' views of police. HYPOTHESES: Hypothesis 1: Perceptions of police legitimacy would exhibit a U-shaped curve, declining in adolescence before improving in young adulthood. Hypothesis 2: At all ages, Black youth would report more negative perceptions of police legitimacy than Latino youth, who would report more negative perceptions than White youth. Hypothesis 3: Perceptions of police bias would be consistently associated with worse perceptions of police legitimacy. METHOD: Utilizing longitudinal data from the Crossroads Study, this study examined within-person trends in males' perceptions of police legitimacy from ages 13 to 22, as well as whether perceptions of police bias were associated with perceptions of police legitimacy. RESULTS: Perceptions of police legitimacy followed a U-shaped curve that declined during adolescence, reached its lowest point around age 18, and improved during the transition to young adulthood. Compared with White youth, Latino and Black youth had shallower curves in perceptions of police legitimacy that exhibited less improvement during the transition to adulthood. Further, perceptions of police bias were consistently associated with more negative perceptions of police legitimacy across races and ages. CONCLUSIONS: While perceptions of police legitimacy may decline during adolescence before improving during the transition to adulthood, perceptions of police bias are consistently negatively related to youth and young adults' perceptions of police legitimacy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Atitude/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Hispano-Americanos/psicologia , Percepção , Polícia , Racismo/etnologia , Adolescente , Fatores Etários , Humanos , Aplicação da Lei , Estudos Longitudinais , Masculino , Estados Unidos/etnologia , Adulto Jovem
3.
Lancet Oncol ; 22(9): 1333-1340, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34399096

RESUMO

BACKGROUND: Kidney function assessment by estimated glomerular filtration rate (eGFR) equations, such as the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation, is important to determine dosing and eligibility for anticancer drugs. Inclusion of race in eGFR equations calculates a higher eGFR at a given serum creatinine concentration for Black patients versus non-Black patients. We aimed to characterise the effect of removing race from the CKD-EPI equation on dosing and eligibility of anticancer drugs with kidney function cutoffs. METHODS: We did a retrospective analysis of patients enrolled in phase 1 studies sponsored by the Cancer Therapy Evaluation Program between January, 1995, and October, 2010. eGFR based on creatinine (eGFRCr) was calculated by the CKD-EPI equation and a version of the CKD-EPI equation without the race term (CKD-EPIwithout race). Estimated creatinine clearance (eClCr) was calculated by the Cockcroft-Gault equation. Dosing simulations based on each assessment of kidney function were done for ten anticancer drugs with kidney function cutoffs for dosing (oxaliplatin, capecitabine, etoposide, topotecan, fludarabine, and bleomycin) or eligibility (cisplatin, pemetrexed, bendamustine, and mitomycin) based on labelling approved by the US Food and Drug Administration or consensus guidelines. The absolute proportion of patients eligible or in each renal dosing range was calculated for each drug. Eligibility and dosing discordance rates were also calculated. FINDINGS: Demographics and laboratory values from 340 Black patients (172 men and 168 women) were used. Median age was 57 years (IQR 47-64), median bodyweight was 78·1 kg (67·0-89·8), median body surface area was 1·91 m2 (1·77-2·09), and median serum creatinine concentration was 0·9 mg/dL (0·8-1·1). Median eGFRCr or eClCr was 103 mL/min (85-122) calculated by CKD-EPI, 89 mL/min (73-105) by CKD-EPIwithout race, and 90 mL/min (72-120) by Cockcroft-Gault. Black patients were recommended to receive dose reductions or were rendered ineligible to receive drug more frequently when using CKD-EPIwithout race than when using CKD-EPI, but at a similar rate as when using Cockcroft-Gault. The number of patients ineligible for therapy or recommended to receive any renal dose adjustment when CKD-EPIwithout race versus CKD-EPI was used increased by 72% (from 25 of 340 to 43 of 340 patients) for cisplatin, by 120% (from five to 11) for pemetrexed, by 67% (from three to five) for bendamustine, by 150% (from ten to 25) for capecitabine, by 150% (from ten to 25) for etoposide, by 67% (from three to five) for topotecan, by 61% (from 74 to 119) for fludarabine, and by 163% (from eight to 21) for bleomycin. Up to 18% of patients had discordant recommendations using CKD-EPIwithout race versus CKD-EPI. INTERPRETATION: Removing race from the CKD-EPI equation will calculate a lower eGFR for Black patients and exclude more patients from receiving anticancer therapy, which could lead to undertreatment of Black patients with cancer and adversely affect their outcomes. FUNDING: National Institutes of Health.


Assuntos
Antineoplásicos/uso terapêutico , Taxa de Filtração Glomerular/fisiologia , Neoplasias/tratamento farmacológico , Neoplasias/etnologia , Grupo com Ancestrais do Continente Africano , Ensaios Clínicos Fase I como Assunto , Creatinina/sangue , Cálculos da Dosagem de Medicamento , Definição da Elegibilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , National Cancer Institute (U.S.) , Neoplasias/fisiopatologia , Estudos Retrospectivos , Estados Unidos
4.
Afr J Prim Health Care Fam Med ; 13(1): e1-e6, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34342480

RESUMO

BACKGROUND: Diabetes is an enormous, growing clinical and public health problem, which together with hypertension contributes significantly to the high risk of cardiovascular diseases (CVDs) globally. AIM: To examine the indirect and direct effects of risk factors simultaneously as a network of multiple pathways leading to diabetes in the rurally based adult population (aged 15+) using a household survey. METHODS: This investigation was based on a predictive model using a cross-sectional community-based study to identify the direct and indirect effects of diabetes risk factors in the Dikgale Health and Demographic Surveillance System (HDSS) consisting of 15 villages, with 7200 households and a total population of approximately 36 000. Fasting blood glucose and total cholesterol were measured using ILAB 300 with the following cut-off values: high fasting blood glucose 7 mmol/L and triglycerides 1.70 mmol/L. RESULTS: A total of 1407 individuals were interviewed, of whom 1281 had their blood pressure (BP) measured. The conceptual model was validated by the goodness-of-fit indexes (comparative fit index [CFI] = 1.00, Tucker Lewis index [TLI] = 1.041, root mean square error of approximation [RMSEA] = 0.001). Hypertension had the strongest direct effect of 0.0918 on diabetes, followed by age (0.0039) and high waist circumference (-0.0023). Hypertension also mediates the effects that high waist circumference (0.0005) and triglycerides (0.0060) have on diabetes status. CONCLUSION: The results in this study confirm the conceptual model considered in the risk factors for diabetes and suggest that hypertension, age and high waist circumference are the key variables directly affecting the diabetes status in the South African rural black population. The direct effect of triglycerides on diabetes suggests mediation by some measured factor(s).


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , África do Sul/epidemiologia , Adulto Jovem
6.
Nutrients ; 13(7)2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34371950

RESUMO

Long-chain omega-3 PUFAs, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are of increasing interest because of their favorable effect on cardiometabolic risk. This study explores the association between omega 6 and 3 fatty acids intake and cardiometabolic risk in four African-origin populations spanning the epidemiological transition. Data are obtained from a cohort of 2500 adults aged 25-45 enrolled in the Modeling the Epidemiologic Transition Study (METS), from the US, Ghana, Jamaica, and the Seychelles. Dietary intake was measured using two 24 h recalls from the Nutrient Data System for Research (NDSR). The prevalence of cardiometabolic risk was analyzed by comparing the lowest and highest quartile of omega-3 (EPA+ DHA) consumption and by comparing participants who consumed a ratio of arachidonic acid (AA)/EPA + DHA ≤4:1 and >4:1. Data were analyzed using multiple variable logistic regression adjusted for age, gender, activity, calorie intake, alcohol intake, and smoking status. The lowest quartile of EPA + DHA intake is associated with cardiometabolic risk 2.16 (1.45, 3.2), inflammation 1.59 (1.17, 2.16), and obesity 2.06 (1.50, 2.82). Additionally, consuming an AA/EPA + DHA ratio of >4:1 is also associated with cardiometabolic risk 1.80 (1.24, 2.60), inflammation 1.47 (1.06, 2.03), and obesity 1.72 (1.25, 2.39). Our findings corroborate previous research supporting a beneficial role for monounsaturated fatty acids in reducing cardiometabolic risk.


Assuntos
Grupo com Ancestrais do Continente Africano , Fatores de Risco Cardiometabólico , Gorduras na Dieta/administração & dosagem , Ácidos Graxos Monoinsaturados/administração & dosagem , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-6/administração & dosagem , Adulto , Fibras na Dieta/administração & dosagem , Ácidos Docosa-Hexaenoicos/administração & dosagem , Ácido Eicosapentaenoico/administração & dosagem , Ácido Eicosapentaenoico/análogos & derivados , Feminino , Gana/epidemiologia , Humanos , Inflamação/epidemiologia , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Estudos Prospectivos , Seicheles/epidemiologia , Estados Unidos/epidemiologia
7.
Malawi Med J ; 33(1): 15-20, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-34422229

RESUMO

Purpose: To evaluate the clinical and socio-demographic profile of patients living with glaucoma and receiving care in a tertiary eye center in Zimbabwe. Method: A hospital-based retrospective study of clinical records of glaucoma patients from January 2014 to December 2018. The study involved collating demographic information of patients, visual acuities, (VA) intraocular pressure, (IOP), cup-to-disc ratios, (CDRs), average retinal nerve fibers thickness, (RNFL), cup volume, cup-to-disc area, vertical cup-to-disc ratio, (VCDR), rim area, disc area, glaucoma hemifield test, visual field indices and the management of glaucoma. Results: Nine thousand one hundred and eighty-five (9,185) folders were retrieved. Out of these, 432 (4.7%) qualified for the study and were analyzed. There were 267 (61.8%) males and 165 (38.2%) females. The mean age (± Standard deviation, SD) of the patients was 62.66 ± 15.94 years, (range 10 - 110 years). The means visual acuity (VA): OD =1.30 ± 1.06 Logarithm of the Minimum Angle of Resolution, (logMAR), OS = 1.33 ± 1.06 logMAR; IOP: OD = 29.51 ± 12.89 mmHg, OS: 29.17 ± 12.59 mmHg; CDRs: OD = 0.91 ± 0.14 D, OS = 0.92 ± 0.14 D; and the average RNFL thickness was 72.76 ± 18.26 µm and 71.24 ± 23.17 µm in the right and left eye respectively. The mainstay of treatment was medication only. Conclusion: There were more males than females receiving glaucoma care at the tertiary level. Glaucoma cases included juveniles but the mean age was mostly the elderly. It was characterized by high IOPs, large CDRs, and thin RNFL suggestive of late presentation.


Assuntos
Glaucoma/diagnóstico , Glaucoma/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Glaucoma/terapia , Glaucoma de Ângulo Aberto/epidemiologia , Humanos , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/patologia , Retina/anatomia & histologia , Estudos Retrospectivos , Fatores Socioeconômicos , Campos Visuais/fisiologia , Adulto Jovem , Zimbábue/epidemiologia
8.
Sports Med Arthrosc Rev ; 29(3): e24-e33, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34398119

RESUMO

Meniscus surgery is one of the most commonly performed orthopedic procedures worldwide. Modifiable risk factors for meniscus injury include body mass index, participation in athletics and occupation. Nonmodifiable risk factors include age, sex, lower extremity alignment, discoid meniscus, ligamentous laxity, and biconcave tibial plateau. Conditions commonly associated with meniscal injury are osteoarthritis, anterior cruciate ligament injury, and tibial plateau fractures. Tear type and location vary by patient age and functional status. Surgical management of meniscus injury is typically cost-effective in terms of quality-adjusted life years. The purpose of this review is to provide an overview of meniscal injury epidemiology by summarizing tear types and locations, associated conditions, and factors that increase the risk for meniscal injury. The economic burden of meniscus injury and strategies to prevent injury to the meniscus are also reviewed.


Assuntos
Lesões do Menisco Tibial/epidemiologia , Grupo com Ancestrais do Continente Africano , Fatores Etários , Lesões do Ligamento Cruzado Anterior/complicações , Traumatismos em Atletas/etiologia , Índice de Massa Corporal , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Masculino , Traumatismos Ocupacionais/etiologia , Osteoartrite do Joelho/complicações , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Ruptura/epidemiologia , Ruptura/etiologia , Fatores Sexuais , Fumar/efeitos adversos , Fraturas da Tíbia/complicações , Lesões do Menisco Tibial/economia , Lesões do Menisco Tibial/etiologia , Lesões do Menisco Tibial/terapia
10.
Nutrients ; 13(8)2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34444895

RESUMO

(1) Background: Early childhood malnutrition may result in increased fat mass (FM) among school-aged children in low- and middle-income countries (LMICs). We explored whether South African children with shorter stature have greater overall and abdominal FM compared to normal stature children. (2) Methods: Baseline assessments of body composition and weight were determined among school-aged children enrolled in a randomized controlled trial in Port Elizabeth, South Africa, using bioelectrical impedance analysis. Multiple linear regression models tested associations of children's height and degree of stunting with FM, fat free mass (FFM), truncal fat mass (TrFM), and truncal fat free mass (TrFFM) overall and by sex. (3) Results: A total of 1287 children (619 girls, 668 boys) were assessed at baseline. Reduced child height was associated with higher FM and lower FFM and TrFFM, but these associations were reversed with increases in height. Girls classified as mildly or moderately/severely stunted had higher FM and TrFM but lower FFM and TrFFM, while no association was found for boys. (4) Conclusions: Our study suggests that efforts to reduce the non-communicable disease burden in LMICs should target growth-impaired children who may have greater overall FM and greater abdominal FM.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Composição Corporal , Estatura , Transtornos do Crescimento/fisiopatologia , Tecido Adiposo , Criança , Impedância Elétrica , Feminino , Transtornos do Crescimento/epidemiologia , Humanos , Modelos Lineares , Masculino , Estado Nutricional , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores Sexuais , África do Sul/epidemiologia
11.
Mol Ther ; 29(9): 2794-2805, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34365034

RESUMO

The numbers of cases and deaths from coronavirus disease 2019 (COVID-19) are continuously increasing. Many people are concerned about the efficacy and safety of the COVID-19 vaccines. We performed a comprehensive analysis of the published trials of COVID-19 vaccines and the real-world data from the Vaccine Adverse Event Reporting System. Globally, our research found that the efficacy of all vaccines exceeded 70%, and RNA-based vaccines had the highest efficacy of 94.29%; moreover, Black or African American people, young people, and males may experience greater vaccine efficacy. The spectrum of vaccine-related adverse drug reactions (ADRs) is extremely broad, and the most frequent ADRs are pain, fatigue, and headache. Most ADRs are tolerable and are mainly grade 1 or 2 in severity. Some severe ADRs have been identified (thromboembolic events, 21-75 cases per million doses; myocarditis/pericarditis, 2-3 cases per million doses). In summary, vaccines are a powerful tool that can be used to control the COVID-19 pandemic, with high efficacy and tolerable ADRs. In addition, the spectrum of ADRs associated with the vaccines is broad, and most of the reactions appear within a week, although some may be delayed. Therefore, ADRs after vaccination need to be identified and addressed in a timely manner.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , SARS-CoV-2/imunologia , Vacinação/métodos , Vacinas Sintéticas/efeitos adversos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano , Idoso , Idoso de 80 Anos ou mais , COVID-19/etnologia , COVID-19/virologia , Ensaios Clínicos Fase III como Assunto , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Imunogenicidade da Vacina , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
15.
J Steroid Biochem Mol Biol ; 212: 105949, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34242778

RESUMO

BACKGROUND: Vitamin D deficiency (VDD) has been associated with adverse maternal and foetal outcomes and is determined by measuring 25 hydroxyvitamin D (25(OH)D). The 25(OH)D is catabolized to 24, 25-(OH) 2D and the ratio of 25(OH) D to 24, 25-(OH)2D, the vitamin D metabolite ratio (VMR), is thought to be a superior marker of VDD, being elevated in such states. The aims of this study were to assess the longitudinal vitamin D status of pregnant women by measuring cholecalciferol, 25(OH)D, 24, 25-(OH)2D and VMR at two time points and also to determine any association of vitamin D and metabolites with gestational age at birth, birth length and weight. METHODS: We recruited 400 pregnant black African women in their first trimester (V1) and measured weights and heights. Ultrasound scans were performed for gestational age. Blood was drawn at V1 and at about 26 weeks (V2) of gestation for cholecalciferol, 25(OH)D, 24, 25-(OH)2D, VMR and parathyroid hormone (PTH). An OGTT was performed at V2 where fasting glucose, insulin and 30-minute glucose were measured. At birth, we measured birth weight, length and gestational age. Maternal insulin, PTH and vitamin D binding protein (VDBP) were measured by immunoassay. Maternal albumin was measured colorimetrically. Maternal cholecalciferol, 25(OH)D and 24, 25-(OH)2D, were measured by mass spectrometry and free and bioavailable vitamin D were calculated. Initial gestation was determined by ultrasound. We compared analytes by visit as well as by 25(OH)D status. Vitamin D deficiency (<30 nmol/L) was defined according to the National Academy of Medicine guidelines. Linear regression analysis was used to determine associations of vitamin D molecules with maternal blood pressure, fasting and 30-minute insulin and blood glucose and neonatal parameters. RESULTS: Results are presented for participants for whom we had complete data (n = 330-346 depending on variable). The prevalence of vitamin D deficiency (VDD) was 35.8 % at V1 and 32.4 % at V2. Levels of 25(OH)D did not change significantly between visits. Levels of 24, 25(OH)2D dropped from the first to the second visit (17.64 ± 12.64 to 9.39 ± 9.07 nmol/L; p < 0.0001) while VMR increased ((3.15 (1.31; 7.67) to 7.90 (2.44; 25.98); p < 0.0001). The proportion of women with the lowest cholecalciferol concentrations increased at V2 compared to the V1 (36.1-42.8 %; p = 0.02). In multivariable regression models 25(OH)D was negatively associated with 30-minute glucose concentrations (p = 0.038) whilst 24, 25-(OH)2D was positively associated with fasting insulin (p = 0.017) and HOM A-I R (p = 0.023). There was no correlation of 25(OH)D or metabolites with infant birth weight, birth length or gestational age. CONCLUSIONS: Maternal VDD is common in pregnant black South African women. Decreased VMR suggest that catabolism of 25(OH)D is reduced in pregnancy to maintain adequate free vitamin D levels.


Assuntos
Gravidez/metabolismo , Deficiência de Vitamina D/metabolismo , Vitamina D/metabolismo , Vitaminas/metabolismo , Adulto , Grupo com Ancestrais do Continente Africano , Tamanho Corporal , Feminino , Idade Gestacional , Humanos , Gravidez/sangue , África do Sul/epidemiologia , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Vitaminas/sangue , Adulto Jovem
16.
Nat Commun ; 12(1): 4198, 2021 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-34234117

RESUMO

Our study describes breast cancer risk loci using a cross-ancestry GWAS approach. We first identify variants that are associated with breast cancer at P < 0.05 from African ancestry GWAS meta-analysis (9241 cases and 10193 controls), then meta-analyze with European ancestry GWAS data (122977 cases and 105974 controls) from the Breast Cancer Association Consortium. The approach identifies four loci for overall breast cancer risk [1p13.3, 5q31.1, 15q24 (two independent signals), and 15q26.3] and two loci for estrogen receptor-negative disease (1q41 and 7q11.23) at genome-wide significance. Four of the index single nucleotide polymorphisms (SNPs) lie within introns of genes (KCNK2, C5orf56, SCAMP2, and SIN3A) and the other index SNPs are located close to GSTM4, AMPD2, CASTOR2, and RP11-168G16.2. Here we present risk loci with consistent direction of associations in African and European descendants. The study suggests that replication across multiple ancestry populations can help improve the understanding of breast cancer genetics and identify causal variants.


Assuntos
Grupo com Ancestrais do Continente Africano/genética , Neoplasias da Mama/genética , Grupo com Ancestrais do Continente Europeu/genética , Predisposição Genética para Doença , Locos de Características Quantitativas , Feminino , Estudo de Associação Genômica Ampla , Humanos , Íntrons , Polimorfismo de Nucleotídeo Único
18.
Res Nurs Health ; 44(5): 767-775, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34227136

RESUMO

The COVID-19 pandemic has had devastating effects on Black and rural populations with a mortality rate among Blacks three times that of Whites and both rural and Black populations experiencing limited access to COVID-19 resources. The primary purpose of this study was to explore the health, financial, and psychological impact of COVID-19 among rural White Appalachian and Black nonrural central Kentucky church congregants. Secondarily we sought to examine the association between sociodemographics and behaviors, attitudes, and beliefs regarding COVID-19 and intent to vaccinate. We used a cross sectional survey design developed with the constructs of the Health Belief and Theory of Planned Behavior models. The majority of the 942 respondents were ≥36 years. A total of 54% were from central Kentucky, while 47.5% were from Appalachia. Among all participants, the pandemic worsened anxiety and depression and delayed access to medical care. There were no associations between sociodemographics and practicing COVID-19 prevention behaviors. Appalachian region was associated with financial burden and delay in medical care (p = 0.03). Appalachian respondents had lower perceived benefit and attitude for COVID-19 prevention behaviors (p = 0.004 and <0.001, respectively). Among all respondents, the perceived risk of contracting COVID was high (54%), yet 33.2% indicated unlikeliness to receive the COVID-19 vaccine if offered. The COVID-19 pandemic had a differential impact on White rural and Black nonrural populations. Nurses and public health officials should assess knowledge and explore patient's attitudes regarding COVID-19 prevention behaviors, as well as advocate for public health resources to reduce the differential impact of COVID-19 on these at-risk populations.


Assuntos
COVID-19/prevenção & controle , Protestantismo/psicologia , População Rural/estatística & dados numéricos , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/psicologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , COVID-19/etnologia , COVID-19/psicologia , Estudos Transversais , Feminino , Humanos , Kentucky , Masculino , Pessoa de Meia-Idade , População Rural/tendências , Inquéritos e Questionários
19.
Child Adolesc Ment Health ; 26(3): 265-266, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34240554

RESUMO

We explore racial inequality in relation to Black children and young people (CYP) and Child and Adolescent Mental Health Services (CAMHS). We argue that the experience of racism should be universally considered an Adverse Childhood Experience (ACE). We argue that racism and the vicarious trauma arising from exposure to frequent media reports of racially motivated violence against persons of Black ethnicity can all predispose Black CYP to increased risk of mental health problems. We make recommendations to improve Black CYP's early access to CAMHS, and to reduce their overrepresentation in psychiatric in-patient settings in the UK. This would require making CAMHS more welcoming to Black CYP and consideration of the impact of racism and trauma in the diagnostic and treatment formulation for Black CYP. This should include: the impact of racism in staff training, improving the cultural competence of CAMHS staff, and supporting Black CYP to articulate their experiences of racism and related traumas whilst facilitating their development of coping strategies to manage these experiences.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Saúde Mental , Racismo/psicologia , Adolescente , Experiências Adversas da Infância , Grupo com Ancestrais do Continente Africano , COVID-19 , Criança , Grupos Étnicos , Humanos , Pandemias , Reino Unido
20.
Artigo em Inglês | MEDLINE | ID: mdl-34199708

RESUMO

Type 2 diabetes (T2DM) prevalence is three times higher among West African Immigrants compared to the general population in the UK. The challenges of managing T2DM among this group have resulted in complications. Reports have highlighted the impact of migration on the health of the immigrant population, and this has contributed to the need to understand the influence of living in West Africa, and getting diagnosed with T2DM, in the management of their condition in the UK. Using a qualitative constructivist grounded theory approach, thirty-four West African immigrants living in the UK were recruited for this study. All participants were interviewed using Semi-structured interviews. After coding transcripts, concepts emerged including noticing symptoms, delayed diagnosis, affordability of health services, beliefs about health, feelings at diagnosis, and emotions experienced at diagnosis all contribute to finding out about diagnosis T2DM. These factors were linked to living in West Africa, among participants, and played significant roles in managing T2DM in the UK. These concepts were discussed under finding out as the overarching concept. Findings from this study highlight important aspects of T2DM diagnosis and how lived experiences, of living in West Africa and the UK, contribute to managing T2DM among West African immigrants. The findings of this study can be valuable for healthcare services supporting West African immigrants living in the UK.


Assuntos
Diabetes Mellitus Tipo 2 , Emigrantes e Imigrantes , África Ocidental/epidemiologia , Grupo com Ancestrais do Continente Africano , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Reino Unido/epidemiologia
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