Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.007
Filtrar
1.
BMC Health Serv Res ; 19(1): 668, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533716

RESUMO

BACKGROUND: In England, people of Black Caribbean (BC) ethnicity are disproportionately affected by sexually transmitted infections (STI). We examined whether differences in sexual healthcare behaviours contribute to these inequalities. METHODS: We purposively selected 16 sexual health clinics across England with high proportions of attendees of BC ethnicity. During May-September 2016, attendees at these clinics (of all ethnicities) completed an online survey that collected data on health service use and sexual behaviour. We individually linked these data to routinely-collected surveillance data. We then used multivariable logistic regression to compare reported behaviours among BC and White British/Irish (WBI) attendees (n = 627, n = 1411 respectively) separately for women and men, and to make comparisons by gender within these ethnic groups. RESULTS: BC women's sexual health clinic attendances were more commonly related to recent bacterial STI diagnoses, compared to WBI women's attendances (adjusted odds ratio, AOR 3.54, 95% CI 1.45-8.64, p = 0.009; no gender difference among BC attendees), while BC men were more likely than WBI men (and BC women) to report attending because of a partner's symptoms or diagnosis (AOR 1.82, 95% CI 1.14-2.90; AOR BC men compared with BC women: 4.36, 95% CI 1.42-13.34, p = 0.014). Among symptomatic attendees, BC women were less likely than WBI women to report care-seeking elsewhere before attending the sexual health clinic (AOR 0.60, 95% CI 0.38-0.97, p = 0.039). No ethnic differences, or gender differences among BC attendees, were observed in symptom duration, or reporting sex whilst symptomatic. Among those reporting previous diagnoses with or treatment for bacterial STI, no differences were observed in partner notification. CONCLUSIONS: Differences in STI diagnosis rates observed between BC and WBI ethnic groups were not explained by the few ethnic differences which we identified in sexual healthcare-seeking and use. As changes take place in service delivery, prompt clinic access must be maintained - and indeed facilitated - for those at greatest risk of STI, regardless of ethnicity.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Saúde Sexual , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Idoso , Instituições de Assistência Ambulatorial/estatística & dados numéricos , Região do Caribe/etnologia , Estudos Transversais , Inglaterra/epidemiologia , Grupos Étnicos/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Utilização de Instalações e Serviços , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Assunção de Riscos , Fatores Sexuais , Comportamento Sexual/etnologia , Parceiros Sexuais , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/etnologia , Inquéritos e Questionários , Adulto Jovem
2.
AIDS Behav ; 23(9): 2514-2521, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31520239

RESUMO

To inform the development of interventions to increase uptake and adherence to antiretroviral therapy (ART), we explored perceptions of ART in semi-structured interviews with 52 men and women from UK black African and black Caribbean communities. Verbatim transcripts were analyzed using framework analysis. Perceptions of ART could be grouped into two categories: doubts about the personal necessity for ART and concerns about potential adverse effects. Doubts about necessity stemmed from feeling well, doubts about the efficacy of ART, religious beliefs and the belief that treatment was futile because it could not cure HIV. Concerns about adverse effects included the fear that attending HIV services and taking treatment would lead to disclosure of HIV, feeling overwhelmed at the prospect of starting treatment soon after diagnosis, fears about side effects and potential long-term effects, and physical repulsion. The findings will facilitate the development of interventions to increase uptake and adherence to ART.


Assuntos
Grupo com Ancestrais do Continente Africano/psicologia , Medo , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/psicologia , Adulto , África ao Sul do Saara/etnologia , Grupo com Ancestrais do Continente Africano/etnologia , Região do Caribe/etnologia , Estudos Transversais , Revelação , Feminino , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Masculino , Adesão à Medicação/etnologia , Pessoa de Meia-Idade , Percepção , Pesquisa Qualitativa , Religião , Estigma Social , Reino Unido/epidemiologia
3.
AIDS Behav ; 23(Suppl 3): 266-275, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31463712

RESUMO

Minority stress theory posits that homonegativity-whether experienced, anticipated, or internalized-adversely impacts health. We conducted qualitative interviews with 28 YB-GBMSM living with HIV to explore manifestations of homonegativity over the life course. Thematic analysis identified patterns in the ways that homonegativity was discussed at different points in participants' lives. Stifling, and sometimes traumatic, familial and religious environments led to experienced homonegativity early in life. These experiences led to anticipated and internalized homonegativity, which in turn shaped sexual identity formation processes in adolescence and into young adulthood. Ultimately, many participants distanced themselves from home environments, seeking and often finding extrafamilial support. Most participants eventually reached self-acceptance of both their sexuality and HIV status. In conclusion, experienced, anticipated and internalized homonegativity were pervasive as YB-GBMSM navigated family and religious environments over the life course. Future interventions should work with youth, families, and churches to prevent these harmful experiences.


Assuntos
Afro-Americanos/psicologia , Grupo com Ancestrais do Continente Africano/psicologia , Bissexualidade/etnologia , Infecções por HIV/diagnóstico , Homossexualidade Masculina/etnologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Bissexualidade/psicologia , Georgia/epidemiologia , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Homossexualidade Masculina/psicologia , Humanos , Entrevistas como Assunto , Masculino , Grupos Minoritários , Pesquisa Qualitativa , Comportamento Sexual , Minorias Sexuais e de Gênero/psicologia , Adulto Jovem
4.
Cancer Causes Control ; 30(11): 1259-1268, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31468279

RESUMO

PURPOSE: African Americans, especially men, have a higher incidence of lung cancer compared with all other racial and ethnic groups in the US. Self-reported race is frequently used in genomic research studies to capture an individual's race or ethnicity. However, it is clear from studies of genetic admixture that human genetic variation does not segregate into the same biologically discrete categories as socially defined categories of race. Previous studies have suggested that the degree of West African ancestry among African Americans can contribute to cancer risk in this population, though few studies have addressed this question in lung cancer. METHODS: Using a genetic ancestry panel of 100 SNPs, we estimated West African, European, and Native American ancestry in 1,407 self-described African Americans and 2,413 European Americans. RESULTS: We found that increasing West African ancestry was associated with increased risk of lung cancer among African American men (ORQ5 vs Q1 = 2.55 (1.45-4.48), p = 0.001), while no association was observed in African American women (ORQ5 vs Q1 = 0.90 (0.51-1.59), p = 0.56). This relationship diminished following adjustment for income and education. CONCLUSIONS: Genetic ancestry is not a major contributor to lung cancer risk or survival disparities.


Assuntos
Grupo com Ancestrais do Continente Africano , Neoplasias Pulmonares , África Ocidental , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/genética , Idoso , Feminino , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etnologia , Neoplasias Pulmonares/genética , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Risco
5.
Health Qual Life Outcomes ; 17(1): 85, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101052

RESUMO

BACKGROUND: Ethnic inequalities in oral health among British adults remain largely unexplored. This study explored the role of socioeconomic position (SEP) in explaining ethnic inequalities in oral health; and the consistency of socioeconomic inequalities in oral health across ethnic groups. METHODS: Data from 45,599 adults, aged 16 years and over, who participated in the Health Survey for England were pooled across 5 years. The seven ethnic groups included were White British, Irish, Black Caribbean, Indian, Pakistani, Bangladeshi and Chinese. Edentulousness and toothache were the outcome measures. A composite measure of SEP was developed based on education, social class, income and economic activity using confirmatory factor analysis. Ethnic inequalities in oral health were assessed in logistic regression adjusting for sex, age, survey year and SEP. RESULTS: Indian (OR: 0.55, 95%CI: 0.40-0.76), Pakistani (0.56, 0.38-0.83), Bangladeshi (0.35, 0.23-0.52) and Chinese (0.41, 0.25-0.66) were less likely to be edentulous than White British after controlling for SEP. Irish (1.22, 1.06-1.39) and Caribbean (1.37, 1.19-1.58) were more likely and Bangladeshi (0.83, 0.69-0.99) were less likely to have toothache than White British after controlling for SEP. Socioeconomic inequalities in edentulousness were consistently found across almost all ethnic groups while socioeconomic inequalities in toothache were found among White British and Irish only. CONCLUSION: This study shows that the role of SEP in explaining ethnic inequalities in oral health depended on the outcome being investigated. Socioeconomic inequalities in oral health among minority ethnic groups did not consistently reflect the patterns found in White British.


Assuntos
Disparidades nos Níveis de Saúde , Saúde Bucal/etnologia , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Idoso , Grupo com Ancestrais do Continente Asiático/etnologia , Estudos Transversais , Inglaterra/epidemiologia , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Classe Social , Adulto Jovem
7.
Eur J Clin Invest ; 49(7): e13116, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30932178

RESUMO

BACKGROUND: Brain-derived neurotrophic factor (BDNF) modulates brain health and cognition, which can interfere with executive cognitive function. BDNF was implicated with microcirculatory ischaemia and may reflect cardiomyocyte injury. We aimed to determine whether prospective changes (%Δ) in BDNF and cardiac troponin T (cTnT) will be associated with executive cognitive function in a bi-ethnic cohort. DESIGN: A prospective investigation was conducted over a three-year period in a bi-ethnic sex cohort (N = 338; aged 20-65 years) from South Africa. Fasting serum samples for BDNF and cTnT were obtained. The STROOP-color-word conflict test (CWT) was applied to assess executive cognitive function at baseline. RESULTS: In Blacks, BDNF (P < 0.001) increased over the three-year period while cTnT did not change. In contrast, in Whites, BDNF and cTnT decreased over three years. In Black men, no change in cTnT was associated with increased ΔBDNF (ß = 0.25; 95% CI 0.05-0.45; P = 0.02). In the Black men, constant cTnT levels were inversely associated with executive cognitive function (ß = -0.33; 95% CI -0.53 to -0.12; P = 0.003). Three-year increases in BDNF increased the likelihood for chronic lower cTnT levels at a pre-established cut-point of <4.2 ng/L [OR = 2.35 (1.12-4.94), P = 0.02]. The above associations were not found in the White sex groups. CONCLUSIONS: Central neural control mechanisms may have upregulated BDNF in Black men as a way to protect against myocardial stress progression and to possibly improve processes related to cognitive interference control. High-sensitive cTnT levels may act as an early predictor of disturbed neural control mechanisms.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/metabolismo , Função Executiva/fisiologia , Troponina T/metabolismo , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Idoso , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , África do Sul/etnologia , Teste de Stroop , Adulto Jovem
8.
Acad Med ; 94(8): 1071-1073, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30998580

RESUMO

In this Invited Commentary, the author probes current events overlapping with his early medical education for unwritten lessons. Today's generation of trainees studies the careful application of science to suffering in the roiling context of resurgent white supremacy, anti-immigrant hatred, climate disasters, contentious public health epidemics, and attacks on the structures undergirding access to health care for millions. The author reflects on the connections between sociopolitical events and his own experiences, as well as those of his classmates, friends, and family members. These experiences, he argues, have galvanized his and his fellow medical students' commitment to decency, truth, diversity, and equity. He concludes that, in the current climate, the practice of healing is inextricably tied to the social and political context, such that advocacy and activism have become essential to a career in medicine.


Assuntos
Defesa do Consumidor/psicologia , Educação de Pós-Graduação em Medicina/tendências , Meios de Comunicação de Massa/normas , Racismo/psicologia , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/psicologia , California/etnologia , Defesa do Consumidor/normas , Educação de Pós-Graduação em Medicina/métodos , Educação de Pós-Graduação em Medicina/normas , Humanos , Meios de Comunicação de Massa/tendências , Racismo/etnologia
9.
Hum Nat ; 30(2): 217-241, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30888612

RESUMO

There has been a long-standing debate about the roles of San in the militaries of southern Africa and the prevalence of violence among the Ju/'hoansi and other San people. The evolutionary anthropology and social anthropological debates over the contexts in which violence and warfare occurs among hunters and gatherers are considered, as is the "tribal zone theory" of warfare between states and indigenous people. This paper assesses the issues that arise from these discussions, drawing on data from San in Angola, Namibia, Botswana, and Zimbabwe. Utilizing cases of how San have been affected by military forces and wildlife conservation agencies in what became protected areas in southern Africa, this article shows that indigenous peoples have been treated differentially by state and nongovernmental organizations involved in anti-poaching, shoot-to-kill, and forced resettlement policies. Particular emphasis is placed on the !Xun and Khwe San of southern Angola and northern Namibia and the Tshwa San of western Zimbabwe and northern Botswana, who have been impacted by militarization and coercive conservation efforts since the late nineteenth century. Principal conclusions are that conservation and militarization efforts have led to a reduction in land and resources available to indigenous people, higher levels of poverty, increased socioeconomic stratification, and lower levels of physical well-being. San have responded to these trends by engaging in social activism, forming community-based institutions, and pursuing legal actions aimed at obtaining human rights and equitable treatment.


Assuntos
Conservação dos Recursos Naturais , Direitos Humanos , Violência/etnologia , Guerra/etnologia , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Angola/etnologia , Botsuana/etnologia , Humanos , Namíbia/etnologia , Zimbábue/etnologia
10.
AIDS Care ; 31(7): 897-907, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30709323

RESUMO

Migrants from sub-Saharan Africa (SSA) are often diagnosed at an advanced stage of HIV, and many of them have harsh living conditions. We aimed to evaluate the entry into care after HIV diagnosis and examine the related social determinants. The ANRS PARCOURS study is a life-event survey conducted in 2012-2013 in the Paris region among. Time between HIV diagnosis of SSA migrants living diagnosed HIV positive in France and HIV care and the determinants was assessed yearly by using mixed-effects logistic regression models. Among a total of 792 participants, 94.2% engaged in HIV care within the year of HIV diagnosis, 4.3% in the following year and 2.5% beyond the second year after diagnosis. The participants were more likely to engage in HIV care during years when they were effectively covered by health insurance and if the HIV test was carried out at the initiative of the doctor. Immigration for economic reasons or owing to threats in his/her country of origin was associated with delayed engagement in HIV care. Additionally, 4.3% of treated participants discontinued HIV care at least once at the time of the survey and more often if diagnosed at an advanced HIV disease stage and financially dependent.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Infecções por HIV/diagnóstico , Acesso aos Serviços de Saúde , Seguro Saúde , Qualidade da Assistência à Saúde , Migrantes/estatística & dados numéricos , Adulto , África ao Sul do Saara/etnologia , Grupo com Ancestrais do Continente Africano/etnologia , Emigração e Imigração , Feminino , França/epidemiologia , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários
11.
Eur J Cancer Care (Engl) ; 28(2): e12997, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30748056

RESUMO

INTRODUCTION: A shift in focus towards risk stratification and survivorship in early stage endometrial cancer (EC) has led to the replacement of hospital follow-up (HFU) with patient-initiated follow-up (PIFU) schemes. METHODS: A mixed methods study was undertaken prospectively to investigate utility and patient satisfaction with a newly introduced PIFU scheme. RESULTS: Two hundred and twenty-eight women were enrolled onto PIFU in the first 18 months, median age 65 years (range 42-90 years). Twenty-four (10.5%) women were non-British White ethnicity. Forty-five women contacted the Clinical Nurse Specialist (CNS) at least once (19.7%), the primary reason being vaginal bleeding/discharge (42%). Contact was greater in first six months on the scheme compared to the second 6 months, and women who made contact were significantly younger than those who did not (57 years vs. 65 years, p < 0.001). CONCLUSIONS: PIFU appears to be well received by the majority of women. Although many of the CNS contacts were due to physical symptoms, a number were for psychological support or reassurance. Younger women had greater CNS contact indicating that they may benefit from a greater level support. Patient feedback of the PIFU scheme was positive, with many women reporting that it enabled them to have more control over their own health.


Assuntos
Neoplasias do Endométrio/terapia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Assistência ao Convalescente , Idoso , Idoso de 80 Anos ou mais , Ásia Ocidental/etnologia , Neoplasias do Endométrio/etnologia , Neoplasias do Endométrio/psicologia , Inglaterra/epidemiologia , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Humanos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Satisfação do Paciente , Estudos Prospectivos , Qualidade de Vida , Classe Social , Hemorragia Uterina/etnologia , Hemorragia Uterina/etiologia , Descarga Vaginal/etnologia , Descarga Vaginal/etiologia , Índias Ocidentais/etnologia
12.
West J Nurs Res ; 41(2): 217-237, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29606085

RESUMO

The purpose of this study was to explore racial/ethnic differences in midlife women's cognitive symptoms among four major racial/ethnic groups in the United States and to determine multiple factors that influenced the women's cognitive symptoms. This was a secondary analysis of the data from two larger studies among 1,054 midlife women. The instruments included multiple questions on background characteristics and health and menopausal status, and the Cognitive Symptom Index for Midlife Women. The data were analyzed using multiple logistic and Poisson regression analyses. There existed significant racial/ethnic differences in the total numbers and total severity scores of cognitive symptoms ( p < .01); non-Hispanic Asians had significantly lower total numbers and total severity scores compared with other racial/ethnic groups. Socioeconomic status and health and menopausal status were significant factors that influenced cognitive symptoms across racial/ethnic groups ( p < .05). Further studies on racial/ethnic differences in cognitive symptoms are needed with diverse groups of midlife women.


Assuntos
Disfunção Cognitiva/etiologia , Grupos de Populações Continentais/estatística & dados numéricos , Menopausa/psicologia , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Análise de Variância , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , Distribuição de Qui-Quadrado , Disfunção Cognitiva/etnologia , Grupos de Populações Continentais/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Hispano-Americanos/estatística & dados numéricos , Humanos , Internet , Menopausa/etnologia , Pessoa de Meia-Idade , Distribuição de Poisson , Psicometria/instrumentação , Psicometria/métodos , Índice de Gravidade de Doença , Inquéritos e Questionários , Estados Unidos/etnologia
13.
Eur J Clin Invest ; 49(1): e13039, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30347447

RESUMO

BACKGROUND AND AIM: Information regarding the effect of leptin on the vasculature in young healthy adults at risk for cardiovascular disease development is limited. We therefore examined the associations between measures of subclinical atherosclerosis (carotid intima-media thickness, carotid cross-sectional wall area), large artery stiffness (pulse wave velocity) and a measure of endothelial dysfunction (von Willebrand factor [vWF]) with leptin in young healthy men and women. METHODS: In a cross-sectional study in South Africa involving 820 normotensive individuals (337 men and 483 women) aged 20-30 years, we measured carotid intima-media thickness, carotid cross-sectional wall area, pulse wave velocity, vWF from citrated plasma and leptin from serum. RESULTS: Despite sevenfold higher leptin in women than men (P < 0.001), only in young healthy men, we observed negative, independent associations between measures of carotid wall thickness (carotid intima-media thickness: R2  = 0.05; ß = -0.20; P = 0.036; carotid cross-sectional wall area: R2  = 0.05; ß = -0.20; P = 0.035) with leptin in multivariable-adjusted regression analyses. When reviewing these associations across body mass index categories, we found an association to be evident only in overweight men (carotid intima-media thickness: R2  = 0.15; ß = -0.41; P = 0.007; carotid cross-sectional wall area: R2  = 0.21; ß = -0.47; P = 0.002). No association was observed in the women or between pulse wave velocity and vWF with leptin. CONCLUSION: In young healthy men, we found a beneficial inverse association between measures of carotid wall thickness and circulating leptin, thereby supporting a potential vascular protective role of leptin.


Assuntos
Artérias Carótidas/anatomia & histologia , Leptina/fisiologia , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Composição Corporal/fisiologia , Artérias Carótidas/diagnóstico por imagem , Artérias Carótidas/fisiologia , Doenças das Artérias Carótidas/fisiopatologia , Espessura Intima-Media Carotídea , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/etnologia , Exercício/fisiologia , Humanos , Masculino , Estudos Prospectivos , Análise de Onda de Pulso , Análise de Regressão , África do Sul/etnologia , Rigidez Vascular/fisiologia , Adulto Jovem
14.
AIDS Behav ; 23(8): 1985-1997, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30334233

RESUMO

Black people living with HIV (BPLWH) are less likely to adhere to antiretroviral treatment than are members of other racial/ethnic groups. Data were combined from two studies of BPLWH (n = 239) to estimate adherence trajectories using a semiparametric, group-based modeling strategy over three time-points (spanning 6 months). Analyses identified three groups of individuals (high-stable, moderately low-stable, low-decreasing). Multinomial logistic regressions were used to predict trajectory membership with multiple levels of socio-ecological factors (structural, institutional/health system, community, interpersonal/network, individual). Older age was associated with being in the high-stable group, whereas substance use, lower perceived treatment effectiveness, and lower quality healthcare ratings were related to being in the moderately low-stable group. In sum, multiple socio-ecological factors contribute to adherence among BPLWH and thus could be targeted in future intervention efforts.


Assuntos
Afro-Americanos/psicologia , Grupo com Ancestrais do Continente Africano/psicologia , Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/psicologia , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Feminino , Infecções por HIV/psicologia , Humanos , Modelos Logísticos , Masculino , Adesão à Medicação/etnologia , Pessoa de Meia-Idade , Modelos Estatísticos , Qualidade da Assistência à Saúde , Apoio Social , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/complicações , Estados Unidos
15.
J Matern Fetal Neonatal Med ; 32(6): 947-953, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29057692

RESUMO

BACKGROUND: Short birth-to-pregnancy intervals have been associated with adverse perinatal outcomes. Racial disparities in short birth-to-pregnancy intervals and adverse perinatal outcomes are also well known. However, little is known about birth-to-pregnancy intervals among African-born black women in the US and risk factors that contribute to short birth-to-pregnancy intervals in this population. OBJECTIVES: To investigate the risk and associated risk factors of short birth-to-pregnancy intervals among African-born black women in Washington State. STUDY DESIGN: A retrospective cohort study using data from linked birth certificate and hospital discharge records for 18,984 consecutive, singleton birth pairs (1992-2013) to African-born black (n = 3312), US-born white (n = 7839), and US-born black women (n = 7833) in Washington State. Logistic regression models were used to determine adjusted odds ratios (aOR) and 95% confidence intervals (CI). RESULTS: Women with short birth-to-pregnancy intervals (<6 months) comprised 10.0% of African-born women, 4.3% of US-born white women, and 6.8% of US-born black women. African-born black women had 3-fold (aOR 3.44; 95%CI: 2.53-4.68) and 1.5-fold (aOR 1.49; 95%CI: 1.28-1.74) higher risk of short birth-to-pregnancy intervals compared with US-born white women and US-born black women, respectively. Among African-born black women, those born in East Africa (aOR 3.17; 95%CI: 1.92, 5.24) had higher odds of short birth-to-pregnancy intervals compared with those born in other regions of Africa. Maternal age ≥35 years old (aOR 0.59; 95%CI: 0.35, 0.98), multiparity (aOR 0.73; 95%CI: 0.54-0.98), > 12 years education (aOR 0.52; 95%CI: 0.38-0.71), and cesarean delivery in prior births (aOR 0.61; 95%CI: 0.44-0.84) were associated with lower odds of short birth-to-pregnancy intervals among African-born black women. CONCLUSIONS: African-born black women have higher risk for short birth-to-pregnancy intervals compared with US-born white and black women. Several risk factors (age, parity, education, and prior delivery type) contribute to short birth-to-pregnancy intervals among African-born black women. Future studies may inform our understanding of factors affecting pregnancy spacing and family planning strategies among African-born black women.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Intervalo entre Nascimentos/etnologia , Adulto , Feminino , Humanos , Gravidez , Estudos Retrospectivos , Washington/epidemiologia , Adulto Jovem
16.
Ethn Health ; 24(4): 365-377, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-28669199

RESUMO

OBJECTIVE: The role of different physical activity (PA) characteristics, i.e. domain, duration and intensity in obesity prevention still requires investigation. Furthermore, ethnicity can modify the effect of PA on body composition. Therefore, we aim to describe the association between obesity and PA characteristics across the Asian- and African-Surinamese population, living in the capital of Suriname. DESIGN: Between February 2013 and July 2015, we included 1157 healthy subjects, 18-70 years, from the Healthy Life in Suriname (HELISUR) study. We measured height, weight, hip and waist circumference and defined general and central obesity according to World Health Organization (WHO) recommendations. The International Physical Activity Questionnaire was used to assess PA and to calculate the duration (minutes/week) and the total volume (METs-minutes/week) of activity. Ethnicity was self-reported. RESULTS: Out of 1157 participants we included 1079 (42.6% Asian-Surinamese, 40.1% African-Surinamese and 17.3% of other ethnicity), mean age 42.6 ± 13.6 years for analysis. Obesity prevalence ratio (PR) was significantly lower in participants meeting WHO PA recommendations [PR= 0.81 (0.68-0.97)], especially within the commuting [PR= 0.66 (0.47-0.91)] and leisure time domains [PR= 0.67 (0.47-0.94)], compared to participants that did not meet the recommendations. Active minutes/week and total volume of activity were inversely associated with obesity and waist circumference, in the overall (p < 0.05) and in the African-Surinamese population (p < 0.05), but not in the Asian-Surinamese population. CONCLUSION: Meeting PA recommendations, particularly within the commuting and leisure time domains, is associated with lower obesity prevalence in the total population. Among the African-Surinamese population, PA within the leisure time domain, more active minutes/week and higher levels of total volume are associated with a lower obesity prevalence. This is not found in the Asian-Surinamese population.


Assuntos
Exercício/fisiologia , Obesidade/etnologia , Obesidade/epidemiologia , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Asiático/etnologia , Peso Corporal , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Suriname/epidemiologia
17.
Eur J Cancer Care (Engl) ; 28(2): e12977, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30548713

RESUMO

Access and recruitment barriers may have contributed to the underrepresentation of Black African/Caribbean men and their partners in current psychosocial research related to prostate cancer survivors. Whilst some studies have explored recruitment barriers and facilitators from participants' perspectives, little is known from researchers' point of view. This paper aimed to address this gap in the literature. Recruitment strategies included the following: cancer support groups, researchers' networks, media advertisement, religious organisations, National Health Service hospitals and snowball sampling. Thirty-six eligible participants (men = 25, partners = 11) were recruited into the study. Recruitment barriers comprised of gate-keeping and advertisement issues and the stigma associated with prostate cancer disclosure. Facilitators which aided recruitment included collaborating with National Health Service hospitals, snowball sampling, flexible data collection, building rapport with participants to gain their trust and researcher's attributes. Findings highlight that "hard to reach" Black African/Caribbean populations may be more accessible if researchers adopt flexible but strategic and culturally sensitive recruitment approaches. Such approaches should consider perceptions of stigma associated with prostate cancer within these communities and the influence gatekeepers can have in controlling access to potential participants. Increased engagement with healthcare professionals and gatekeepers could facilitate better access to Black African/Caribbean populations so that their voices can be heard and their specific needs addressed within the healthcare agenda.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Seleção de Pacientes , Neoplasias da Próstata/etnologia , Adolescente , Adulto , Afro-Americanos/etnologia , Afro-Americanos/psicologia , Grupo com Ancestrais do Continente Africano/psicologia , Idoso , Revelação , Feminino , Controle de Acesso , Acesso aos Serviços de Saúde , Humanos , Relações Interinstitucionais , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Neoplasias da Próstata/psicologia , Pesquisa Qualitativa , Parceiros Sexuais , Estereotipagem , Índias Ocidentais/etnologia , Adulto Jovem
18.
Interface (Botucatu, Online) ; 23: e180314, 2019.
Artigo em Português | LILACS | ID: biblio-984545

RESUMO

Em uma perspectiva sócio-histórica, o artigo discute a problematização da questão racial realizada pelo saber psiquiátrico pela análise da produção científica do Hospício do Juquery, e de sua forma de operação cotidiana pelo registro de suas práticas asilares. O período estudado, de 1898 a 1920, compreende a criação da instituição e gestão de Franco da Rocha, seu fundador, momento em que ganha corpo o debate sobre o homem livre e sua significação na formação nacional. As fontes do texto são os prontuários médicos da população internada, os registros e a produção científica da instituição no período enfocado.(AU)


Based on a socio-historical perspective, the present article discusses the problematization of the race issue in psychiatric knowledge by analyzing the scientific production developed by the Hospice of Juquery and its daily operations, through access to records of its asylum practices. The studied period, 1898 to 1920, includes the creation of the institution and its management under Franco da Rocha, its founder, a time when the debate about the free man and its significance to the nation's formation began to take shape. The source text was extracted from the clinical medical histories of inpatients, as well as the records and scientific production developed by the institution during the studied period.(AU)


En una perspectiva sociohistórica, el artículo discute la problematización de la cuestión racial realizada por el saber psiquiátrico por el análisis de la producción científica del manicomio de Juquery y de su forma de operación cotidiana por el registro de sus prácticas de asilo. El período estudiado, de 1898 a 1920, incluye la creación de la institución y gestión de Franco da Rocha, su fundador, momento en el que adquiere cuerpo el debate sobre el hombre libre y su significación en la formación nacional. Las fuentes de texto son las fichas médicas de la población internada, los registros y la producción científica de la institución en el período de estudio.(AU)


Assuntos
Humanos , Saúde Mental , Grupo com Ancestrais do Continente Africano/etnologia , Racismo/etnologia , Hospitais Psiquiátricos
19.
Psychiatr Rehabil J ; 41(4): 277-289, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30507242

RESUMO

OBJECTIVE: Race and gender differences in help seeking are well-established; however, reasons for these differences are less clear. This study examined race and gender differences in two potential contributors-perceptions of illness and attitudes toward treatment-in a sample of marginalized young adults. METHOD: Interviews were conducted with young adults (age 18-25) with prior involvement in public systems of care and mood disorder diagnoses (n = 60). A quantitative interview assessed illness perceptions and attitudes followed by a qualitative interview focused on perceptions of mental illness and treatment. Analyses examined quantitative differences across four race/gender subgroups-White women (n = 13), White men (n = 6), women of color (n = 27), and men of color (n = 14), then qualitative results were reviewed for a subset of cases (n = 30) to understand differences revealed in the quantitative analyses. RESULTS: Women of color had lower scores on illness understanding compared to other groups and men of color had lower scores on chronicity. Attitudes including propensity toward help seeking and stigma resistance were lowest in men of color, followed by women of color. Qualitative findings supported that men of color viewed their symptoms as less chronic and managed symptoms by changing their mindset rather than formal treatments. White participants talked more about their illnesses as chronic conditions and spoke more positively of treatment. CONCLUSION AND IMPLICATIONS FOR PRACTICE: Race/gender differences were identified, particularly in relation to views of mental illness and stigma. Messaging that highlights independence and strength in relation to managing symptoms may be particularly important for young people of color. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Grupos Minoritários , Transtornos do Humor/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Estigma Social , Adolescente , Adulto , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Fatores Sexuais , Adulto Jovem
20.
J Am Coll Cardiol ; 72(20): 2431-2439, 2018 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-30442286

RESUMO

BACKGROUND: Prior studies have consistently demonstrated that blacks have an approximate 2-fold higher incidence of sudden cardiac death (SCD) than whites; however, these analyses have lacked individual-level sociodemographic, medical comorbidity, and behavioral health data. OBJECTIVES: The purpose of this study was to evaluate whether racial differences in SCD incidence are attributable to differences in the prevalence of risk factors or rather to underlying susceptibility to fatal arrhythmias. METHODS: The Reasons for Geographic and Racial Differences in Stroke study is a prospective, population-based cohort of adults from across the United States. Associations between race and SCD defined per National Heart, Lung, and Blood Institute criteria were assessed. RESULTS: Among 22,507 participants (9,416 blacks and 13,091 whites) without a history of clinical cardiovascular disease, there were 174 SCD events (67 whites and 107 blacks) over a median follow-up of 6.1 years (interquartile range: 4.6 to 7.3 years). The age-adjusted SCD incidence rate (per 1,000 person-years) was higher in blacks (1.8; 95% confidence interval [CI]: 1.4 to 2.2) compared with whites (0.7; 95% CI: 0.6 to 0.9), with an unadjusted hazard ratio of 2.35; 95% CI: 1.74 to 3.20. The association of black race with SCD risk remained significant after adjustment for sociodemographics, comorbidities, behavioral measures of health, intervening cardiovascular events, and competing risks of non-SCD mortality (hazard ratio: 1.97; 95% CI: 1.39 to 2.77). CONCLUSIONS: In a large biracial population of adults without a history of cardiovascular disease, SCD rates were significantly higher in blacks as compared with whites. These racial differences were not fully explained by demographics, adverse socioeconomic measures, cardiovascular risk factors, and behavioral measures of health.


Assuntos
Grupo com Ancestrais do Continente Africano/etnologia , Morte Súbita Cardíaca/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Africano/genética , Idoso , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/genética , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/etnologia , Arritmias Cardíacas/genética , Estudos de Coortes , Morte Súbita Cardíaca/prevenção & controle , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Fumar/efeitos adversos , Fumar/etnologia , Fumar/genética , Estados Unidos/etnologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA