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2.
Pediatrics ; 144(3)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31405887

RESUMO

OBJECTIVES: To examine changes in care practices over time by race and ethnicity and whether the decrease in hospital mortality and severe morbidities has benefited infants of minority over infants of white mothers. METHODS: Infants 22 to 29 weeks' gestation born between January 2006 and December 2017 at a Vermont Oxford Network center in the United States were studied. We examined mortality and morbidity rate differences and 95% confidence intervals for African American and Hispanic versus white infants by birth year. We tested temporal differences in mortality and morbidity rates between white and African American or Hispanic infants using a likelihood ratio test on nested binomial regression models. RESULTS: Disparities for certain care practices such as antenatal corticosteroids and for some in-hospital outcomes have narrowed over time for minority infants. Compared with white infants, African American infants had a faster decline for mortality, hypothermia, necrotizing enterocolitis, and late-onset sepsis, whereas Hispanic infants had a faster decline for mortality, respiratory distress syndrome, and pneumothorax. Other morbidities showed a constant rate difference between African American and Hispanic versus white infants over time. Despite the improvements, outcomes including hypothermia, mortality, necrotizing enterocolitis, late-onset sepsis, and severe intraventricular hemorrhage remained elevated by the end of the study period, especially among African American infants. CONCLUSIONS: Racial and ethnic disparities in vital care practices and certain outcomes have decreased. That the quality deficit among minority infants occurred for several care practice measures and potentially modifiable outcomes suggests a critical role for quality improvement initiatives tailored for minority-serving hospitals.


Assuntos
Afro-Americanos/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos/estatística & dados numéricos , Mortalidade Infantil/etnologia , Lactente Extremamente Prematuro , Morbidade , Grupos Étnicos , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Disparidades em Assistência à Saúde/tendências , Humanos , Lactente , Mortalidade Infantil/tendências , Unidades de Terapia Intensiva Neonatal/tendências , Gravidez , Complicações na Gravidez/epidemiologia , Porto Rico/epidemiologia , Fatores Raciais , Estudos Retrospectivos , Fatores de Tempo , Estados Unidos/epidemiologia
3.
NeuroRehabilitation ; 44(3): 445-449, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31177245

RESUMO

BACKGROUND: While there is evidence of differences in the disease characteristics of multiple sclerosis (MS) across ethnic and racial groups, there has been limited research on cognitive functioning. OBJECTIVE: To explore potential differences among Caucasian (CA), African-American (AA), and Hispanic (HA) adults from a clinical sample on the Minimal Assessment of Cognitive Function in MS (MACFIMS). METHODS: A total of 245 age- and disease duration-matched individuals (194 CA, 23 AA, and 28 HA) were included in the analyses. Their rates of impairment, using the criterion of two standard deviations (SD) below the normative mean, on the MACFIMS were compared using chi-square analyses with post-hoc pairwise comparisons (Bonferroni adjusted). RESULTS: Compared to CA, AA had higher rates of impairment on measures of complex attention (p < 0.001) and executive functions (p < 0.001). CONCLUSIONS: These findings raise questions of whether the observed differences reflect the more aggressive disease course noted among AA or are due to discrepancies in performance on neuropsychological assessment that is associated with race/ethnicity in the general population. Future directions and implications are discussed.


Assuntos
Cognição/fisiologia , Grupos de Populações Continentais/psicologia , Grupos Étnicos/psicologia , Esclerose Múltipla/etnologia , Esclerose Múltipla/psicologia , Testes Neuropsicológicos , Adulto , Afro-Americanos/etnologia , Afro-Americanos/psicologia , Atenção/fisiologia , Estudos de Casos e Controles , Transtornos Cognitivos/complicações , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Hispano-Americanos/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/diagnóstico
4.
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
5.
Plast Reconstr Surg ; 143(6): 1179e-1188e, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31136477

RESUMO

As the United States continues to be more ethnically and racially diverse, it is important for the rhinoplasty surgeon to have an appreciation and understanding of nasal variations that exist to plan for and execute ethnically congruent results. The nasal analysis is a critical component of the patient evaluation, which has been used as a tool by surgeons to identify deviations from anatomical norms or canons. In this article, the authors describe common nasal anatomical variations that exist between ethnic groups as a guide for nasal analysis. Understanding these variations will facilitate and help define important cultural aesthetics, which can be used to plan for rhinoplasties in a diverse patient population.


Assuntos
Nariz/anatomia & histologia , Afro-Americanos/etnologia , Árabes , Grupo com Ancestrais do Continente Asiático/etnologia , Estética , Grupo com Ancestrais do Continente Europeu/etnologia , Hispano-Americanos , Humanos , Índios Norte-Americanos/etnologia , Oriente Médio/etnologia
6.
Infant Behav Dev ; 55: 100-111, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31002987

RESUMO

Given the large numbers of families with more than one child, understanding similarities and differences in siblings' behaviors and in parents' interactions with their sibling infants is an important goal for advancing more representative developmental science. This study employed a within-family design to examine mean-level consistency and individual-order agreement in 5-month-old sibling behaviors and maternal parenting practices with their firstborns and secondborns (ns = 61 mothers and 122 infants). Each infant was seen independently with mother. Firstborn infants were more social with their mothers and engaged in more exploration with objects than secondborn infants; firstborn and secondborn infants' behaviors were correlated for smiling, distress communication, and efficiency of exploration. Mothers engaged in more physical encouragement, social exchange, didactic interaction, material provisioning, and language with their firstborns than with their secondborns. Notably, only maternal nurturing (e.g., feeding, holding) did not differ in mean level when mothers were with their two infants. However, mean differences in mothers' social exchange and material provisioning with their two children attenuated to nonsignificance when controlling for differences in siblings' behaviors. Individual-order agreement of mothers' behaviors with firstborn and secondborn infants (across an average of almost 3 years) was only moderate. These findings suggest that mother-firstborn interactions may differ from mother-secondborn interactions. Future research should move beyond studying mother-firstborn dyads to understand broader family and developmental processes.


Assuntos
Ordem de Nascimento/psicologia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Relações Familiares/etnologia , Relações Familiares/psicologia , Relações Mãe-Filho/etnologia , Relações Mãe-Filho/psicologia , Adulto , Criança , Educação Infantil/etnologia , Educação Infantil/psicologia , Pré-Escolar , Feminino , Humanos , Lactente , Comportamento do Lactente/etnologia , Comportamento do Lactente/psicologia , Masculino , Comportamento Materno/fisiologia , Comportamento Materno/psicologia , Irmãos/psicologia , Estados Unidos/etnologia
7.
Hum Genet ; 138(6): 681-689, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31025105

RESUMO

In human society, the facial surface is visible and recognizable based on the facial shape variation which represents a set of highly polygenic and correlated complex traits. Understanding the genetic basis underlying facial shape traits has important implications in population genetics, developmental biology, and forensic science. A number of single nucleotide polymorphisms (SNPs) are associated with human facial shape variation, mostly in European populations. To bridge the gap between European and Asian populations in term of the genetic basis of facial shape variation, we examined the effect of these SNPs in a European-Asian admixed Eurasian population which included a total of 612 individuals. The coordinates of 17 facial landmarks were derived from high resolution 3dMD facial images, and 136 Euclidean distances between all pairs of landmarks were quantitatively derived. DNA samples were genotyped using the Illumina Infinium Global Screening Array and imputed using the 1000 Genomes reference panel. Genetic association between 125 previously reported facial shape-associated SNPs and 136 facial shape phenotypes was tested using linear regression. As a result, a total of eight SNPs from different loci demonstrated significant association with one or more facial shape traits after adjusting for multiple testing (significance threshold p < 1.28 × 10-3), together explaining up to 6.47% of sex-, age-, and BMI-adjusted facial phenotype variance. These included EDAR rs3827760, LYPLAL1 rs5781117, PRDM16 rs4648379, PAX3 rs7559271, DKK1 rs1194708, TNFSF12 rs80067372, CACNA2D3 rs56063440, and SUPT3H rs227833. Notably, the EDAR rs3827760 and LYPLAL1 rs5781117 SNPs displayed significant association with eight and seven facial phenotypes, respectively (2.39 × 10-5 < p < 1.28 × 10-3). The majority of these SNPs showed a distinct allele frequency between European and East Asian reference panels from the 1000 Genomes Project. These results showed the details of above eight genes influence facial shape variation in a Eurasian population.


Assuntos
Face/anatomia & histologia , Genética Populacional , Estudo de Associação Genômica Ampla/métodos , Polimorfismo de Nucleotídeo Único , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/etnologia , China , Grupo com Ancestrais do Continente Europeu/etnologia , Feminino , Frequência do Gene , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Adulto Jovem
8.
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
9.
Artigo em Inglês | MEDLINE | ID: mdl-30817862

RESUMO

Objective: To compare prevalence rates of alcohol, nicotine, and other drug use and major psychiatric disorders (major depressive disorder, persistent depression, bipolar I disorder, agoraphobia, social and specific phobias, and antisocial, schizotypal, and borderline personality disorders) between US-born and foreign-born Mexican Americans and non-Hispanic whites and between early entry versus later-entry foreign-born Mexican Americans and non-Hispanic whites. Methods: Data were derived from face-to-face interviews in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (N = 36,309). Results: US-born Mexican Americans and US-born non-Hispanic whites were at greater risk (P < .05) of alcohol, nicotine, and any drug use and their associated disorders and other DSM-5 psychiatric disorders relative to their foreign-born counterparts. US-born non-Hispanic whites were more likely (P < .05) to use substances and develop many psychiatric disorders relative to US-born Mexican Americans. Foreign-born Mexican Americans < 18 years old at immigration were at greater risk of drug use, drug use disorders, and nicotine use disorder compared with foreign-born Mexican Americans ≥ 18 years old at immigration. Foreign-born non-Hispanic whites < 18 years old at immigration were more likely to use substances and to develop many psychiatric disorders relative to foreign-born non-Hispanic whites ≥ 18 years old at immigration. Conclusions: Taken together, the findings of this study support the healthy immigrant hypothesis and adverse role of acculturation for US-born and foreign-born Mexican Americans and non-Hispanic whites. Further research is warranted on immigration status and age at arrival into the United States and those processes underlying differential exposure to substances and development of psychiatric conditions. An understanding of these processes can be invaluable to clinicians in guiding culturally sensitive and informed prevention and intervention efforts.


Assuntos
Aculturação , Transtornos de Ansiedade/etnologia , Transtorno Bipolar/etnologia , Transtorno Depressivo Maior/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Grupo com Ancestrais do Continente Europeu/etnologia , Americanos Mexicanos/estatística & dados numéricos , Transtornos da Personalidade/etnologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Adolescente , Adulto , Fatores Etários , Transtornos Relacionados ao Uso de Álcool/etnologia , Europa (Continente)/etnologia , Feminino , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Tabagismo/etnologia , Estados Unidos/etnologia , Adulto Jovem
10.
Psychiatry Res ; 275: 1-9, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30878850

RESUMO

The current study tested a new interpersonal model of disordered eating behaviours, whereby maladaptive schemas and theory of mind decoding (ToM-decoding) were related with disordered eating attitudes (body dissatisfaction) and behaviours (binging/purging and food restriction) through the mediating variable appearance-based rejection-sensitivity. A secondary aim was to test whether this model differed between two cultural groups: Caucasian Australian women (N = 197, ages ranging 17-43, M = 19.25, SD = 3.10), and Asian women living in East-Asia (N = 195, ages ranging 18-40, M = 28.60, SD = 5.15). Participants completed an online survey assessing the variables of interest. While the model showed acceptable fit for both groups, invariance testing demonstrated that the model worked differently in each group. Appearance-based rejection-sensitivity mediated the effect of maladaptive schemas on body dissatisfaction and disordered eating in both groups, but only mediated the effect of ToM-decoding on body dissatisfaction in the East-Asian group. Overall, the significant indirect pathways were greater in strength and number for the Caucasian-Australian group. These findings indicate that while the relationships between maladaptive schemas, appearance-based rejection-sensitivity, and disordered eating attitudes and behaviours are present in both cultures, ToM-decoding may only play a role for East-Asian participants.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Imagem Corporal/psicologia , Grupo com Ancestrais do Continente Europeu/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Teoria da Mente , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático/etnologia , Atitude/etnologia , Austrália/etnologia , Comparação Transcultural , Grupo com Ancestrais do Continente Europeu/etnologia , Transtornos da Alimentação e da Ingestão de Alimentos/etnologia , Feminino , Humanos , Inquéritos e Questionários , Teoria da Mente/fisiologia , Adulto Jovem
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.
Skin Res Technol ; 25(4): 517-525, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30758871

RESUMO

BACKGROUND: The main objective of this study was to determine the lipid profile of brown and white Caucasian hair fibres and the effects of lipids on the properties of fibres. MATERIALS AND METHODS: To determine the structures of white and brown hair lipid bilayers, cross sections of fibres of both hair types were examined using synchrotron-based µ-FTIR mapping. Dynamic vapour sorption (DVS) analyses were also performed to determine the differences in the barrier function of both fibres. RESULTS: Spatial identification of lipids showed that a great amount of lipids was present in the medulla of fibres of both hair types, but important differences were also observed between cuticles of the different fibres. The cuticle of a white hair fibre showed a significant decrease in its lipid content, but did not show differences in the lateral packing order with respect to the cuticle of a brown hair fibre. The cortex and medulla of the white hair fibre also exhibited a significant decrease in its lipid content but with a higher lateral packing order than brown hair. Using DVS analysis, it was found that the water dynamics of white hair fibres differed from those of brown hair fibres, showing a decrease in their total capacity to absorb water and an increase in the velocity of the exchange of water with the environment. CONCLUSION: The results of both techniques demonstrated a high correlation between the characteristics of the lipids located in the cuticle and the water dynamics of the fibres.


Assuntos
Cor de Cabelo/fisiologia , Cabelo/química , Espectroscopia de Infravermelho com Transformada de Fourier/instrumentação , Água/metabolismo , Grupo com Ancestrais do Continente Europeu/etnologia , Cabelo/fisiologia , Cabelo/ultraestrutura , Humanos , Hidrodinâmica , Metabolismo dos Lipídeos , Lipídeos/sangue , Síncrotrons
13.
J Abnorm Psychol ; 128(3): 263-271, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30762376

RESUMO

There is evidence that African Americans are 2.4 times more likely to be diagnosed with a schizophrenia-spectrum diagnosis compared with White individuals, who are more likely to receive an affective diagnosis. The reason for these diagnostic discrepancies is unclear, however, 2 explanations have garnered attention: epigenetic differences and systematic error or bias in the diagnostic process. The latter is the focus of the present study and it is hypothesized that the bias involves cultural insensitivity on the part of the clinician. The present study has investigated bias-driven diagnostic disparities between African Americans and White individuals, by using traditional symptom rating scales, clinical diagnoses, and objective, behaviorally based measures. Data was aggregated from 3 separate studies conducted on outpatients (N = 251) with schizophrenia-spectrum or affective disorders. The present study used computationally derived acoustic markers of speech to tap hallmark negative symptoms (e.g., blunted affect or alogia) and behavioral-based markers of language failures to tap disorganization. Clinician symptom ratings were made using the Brief Psychiatric Rating Scale. Our findings confirmed the diagnostic bias between African Americans and White individuals though there were no differences on clinician symptom ratings. On the other hand, the computerized and behavioral measures revealed more speech disorder and less blunted affect in African Americans versus White individuals. Moderation analysis suggests that behaviorally based measures impact the relationship between race and diagnosis; however, this was largely unsupported for race and clinical symptom ratings. Further research is needed to disentangle normative variations from psychopathology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Afro-Americanos/psicologia , Esquizofrenia/diagnóstico , Adulto , Afro-Americanos/etnologia , Transtorno Depressivo Maior/etnologia , Transtorno Depressivo Maior/psicologia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Feminino , Humanos , Linguagem , Masculino , Transtornos do Humor/diagnóstico , Transtornos do Humor/etnologia , Transtornos do Humor/psicologia , Esquizofrenia/etnologia , Fala
14.
Dev Psychol ; 55(3): 562-573, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30802107

RESUMO

An intersectional approach to human development emphasizes the multiple social categories individuals occupy, some of which confer privilege (e.g., being White) and some of which confer marginalization (e.g., being poor). This approach is needed especially in critical consciousness scholarship, and particularly in regard to understanding whether and how it may manifest among youth who simultaneously experience privileges due to some aspects of their identities and marginalization due to other aspects of their identities. We explored critical reflection (CR) about socioeconomic inequalities through interviews with 31 White young men from low-income and working-class backgrounds who were attending trade colleges in Pennsylvania. Participants were asked about their understandings of the causes of poverty in the United States and potential solutions. Multiple rounds of qualitative analysis were conducted to understand the potential manifestation of CR in responses. Inductive across-case thematic analysis yielded 11 themes describing participants' understandings of poverty. We then conducted case-based analyses to identify the specific attributions about poverty that each participant made (structural, fatalistic, and/or individual), the ways in which these attributions arose in responses, and how the pattern identified related to CR. Eight participants were identified as having some CR or the potential to develop CR, and their responses were explored for references to experiences that may have been related to CR as well as their membership in a privileged racial and gender group, and more marginalized socioeconomic group. Implications for examining and promoting CR in different groups of youth are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Grupo com Ancestrais do Continente Europeu , Pobreza , Classe Social , Pensamento , Adulto , Grupo com Ancestrais do Continente Europeu/etnologia , Humanos , Masculino , Pennsylvania/etnologia , Pobreza/etnologia , Pesquisa Qualitativa , Adulto Jovem
15.
Psychopharmacology (Berl) ; 236(10): 2923-2936, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30721322

RESUMO

RATIONALE: As a species, humans are vulnerable to numerous mental disorders, including depression and schizophrenia. This susceptibility may be due to the evolution of our large, complex brains, or perhaps because these illnesses counterintuitively confer some adaptive advantage. Additionally, cultural and biological factors may contribute to susceptibility and variation in mental illness experience and expression. Taking a holistic perspective could strengthen our understanding of these illnesses in diverse cultural contexts. OBJECTIVES: This paper reviews some of these potential factors and contextualizes mental disorders within a biocultural framework. RESULTS: There is growing evidence that suggests cultural norms may influence inflammation, neurotransmitters, and neurobiology, as well as the illness experience. Specific examples include variation in schizophrenia delusions between countries, differences in links between inflammation and emotion between the United States and Japan, and differences in brain activity between Caucasian and Asian participants indicating that cultural values may moderate cognitive processes related to social cognition and interoception. CONCLUSIONS: Research agendas that are grounded in an appreciation of biocultural diversity as it relates to psychiatric illness represent key areas for truly interdisciplinary research that can result in culturally sensitive treatments and highlight possible biological variation affecting medical treatment.


Assuntos
Comparação Transcultural , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Transtorno Depressivo/etnologia , Transtorno Depressivo/psicologia , Transtorno Depressivo/terapia , Grupo com Ancestrais do Continente Europeu/etnologia , Grupo com Ancestrais do Continente Europeu/psicologia , Humanos , Japão/etnologia , Transtornos Mentais/psicologia , Esquizofrenia/etnologia , Esquizofrenia/terapia , Psicologia do Esquizofrênico , Estados Unidos/etnologia
16.
Genet Test Mol Biomarkers ; 23(2): 75-83, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30676117

RESUMO

AIMS: This study compared facilitators and barriers to genetic testing and determined awareness about the Genetic Information Nondiscrimination Act (GINA) across young Hispanic and non-Hispanic white (NHW) breast cancer (BC) survivors. MATERIALS AND METHODS: Women diagnosed with BC of age ≤50 years in 2009-2012 were recruited through the Florida State Cancer Registry to complete a questionnaire. RESULTS: There were 1182 participants of which 61% (174/285) of Hispanic patients, and 65% (580/897) of NHW patients had BC testing. Among untested participants, the most common barriers were lack of testing recommendation (44% Hispanics, 32% NHW; p = 0.02) and cost-related concerns (41% Hispanics, 40% NHW; p = 0.83). Among tested participants, the top facilitators were as follows: (1) "To benefit my family's future" (70% Hispanic, 68% NHW), (2) "My doctor recommended testing" (60% Hispanic, 54% NHW), and (3) "Minimal cost to me" (59% Hispanic, 72% NHW). Only 27% of tested and 15% of untested women were aware of GINA; misuse of test results was reported as a barrier for only 6.5%. CONCLUSIONS: Rates of genetic testing recommendation are lower among Hispanics, but both groups reported additional barriers. Most are unaware of GINA, yet misuse is not a highly cited barrier. Findings suggest the need to educate providers on the importance of recommending testing to all who meet criteria; increase awareness of newer options for more affordable testing; and bolster facilitators that may increase testing uptake.


Assuntos
Grupo com Ancestrais do Continente Europeu/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Hispano-Americanos/psicologia , Adulto , Neoplasias da Mama/diagnóstico , Sobreviventes de Câncer , Barreiras de Comunicação , Grupos Étnicos/genética , Grupo com Ancestrais do Continente Europeu/genética , Feminino , Florida , Testes Genéticos/métodos , Hispano-Americanos/genética , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Fatores Socioeconômicos , Sobreviventes
17.
Invest Ophthalmol Vis Sci ; 60(1): 134-146, 2019 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-30629727

RESUMO

Purpose: Glaucoma, a leading cause of blindness worldwide, often remains undetected until irreversible vision loss has occurred. Treatments focus on lowering intraocular pressure (IOP), the only modifiable and readily measurable risk factor. However, IOP can vary and does not always predict disease progression. MicroRNAs (miRNAs) are promising biomarkers. They are abundant and stable in biological fluids, including plasma and aqueous humor (AqH). We aimed to identify differentially expressed miRNAs in AqH and plasma from glaucoma, exfoliation syndrome (XFS), and control subjects. Methods: Plasma and AqH from two ethnic cohorts were harvested from glaucoma or XFS (often associated with glaucoma, n = 33) and control (n = 31) patients undergoing elective surgery. A custom miRNA array measured 372 miRNAs. Molecular target prediction and pathway analysis were performed with Ingenuity Pathway Analysis (IPA) and DIANA bioinformatical tools. Results: Levels of miRNAs in plasma, a readily accessible biomarker source, correlated with miRNA levels in AqH. Twenty circulating miRNAs were at least 1.5-fold higher in glaucoma or XFS patients than in controls across two ethnic cohorts: miR-4667-5p (P = 4.1 × 10-5), miR-99b-3p (P = 4.8 × 10-5), miR-637 (P = 5.1 × 10-5), miR-4490 (P = 5.7 × 10-5), miR-1253 (P = 6.0 × 10-5), miR-3190-3p (P = 3.1 × 10-4), miR-3173-3p (P = 0.001), miR-608 (P = 0.001), miR-4725-3p (P = 0.002), miR-4448 (P = 0.002), and miR-323b-5p (P = 0.002), miR-4538 (P = 0.003), miR-3913-3p (P = 0.003), miR-3159 (P = 0.003), miR-4663 (P = 0.003), miR-4767 (P = 0.003), miR-4724-5p (P = 0.003), miR-1306-5p (P = 0.003), miR-181b-3p (P = 0.004), and miR-433-3p (P = 0.004). miR-637, miR-1306-5p, and miR-3159, in combination, allowed discrimination between glaucoma patients and control subjects (AUC = 0.91 ± 0.008, sensitivity 85.0%, specificity 87.5%). Conclusions: These results identify specific miRNAs as potential biomarkers and provide insight into the molecular processes underlying glaucoma.


Assuntos
Humor Aquoso/metabolismo , Biomarcadores/sangue , Síndrome de Exfoliação/sangue , Glaucoma de Ângulo Aberto/sangue , MicroRNAs/sangue , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Síndrome de Exfoliação/etnologia , Síndrome de Exfoliação/cirurgia , Feminino , Perfilação da Expressão Gênica , Glaucoma de Ângulo Aberto/etnologia , Glaucoma de Ângulo Aberto/cirurgia , Humanos , Pressão Intraocular , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Sensibilidade e Especificidade , Estados Unidos/epidemiologia
18.
Int J Neurosci ; 129(8): 746-753, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30616495

RESUMO

Objectives: Although there have been numerous studies conducted to better understand Parkinson's disease (PD), the epidemiology of its debilitating non-motor symptoms across different ethnicities remains understudied. Herein we explore the relationship between depression, anxiety and pain in PD patients of Caucasian or Indian ethnicity (PD Caucasians and PD Indians). Patients and Methods: All patients and healthy age and gender matched controls were assessed via semi-structured interviews for anxiety, pain and depression using structured questionnaires. Results: PD Indians did not differ from PD Caucasians on anxiety or depression. However, PD Caucasians were more likely to report aching pain by 80 times and dull pain by 108 times compared to PD Indians. PD Indians were 82% less likely to have pain interfering with social activities, and 90% less likely to have pain interfering with relations with others compared to PD Caucasians. Conclusion: Although an Indo-Caucasian difference may not be detected from mood dysfunction, important differences may exist from the influence of pain interfering with several dimensions of life.


Assuntos
Ansiedade/etnologia , Depressão/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Dor/etnologia , Doença de Parkinson/etnologia , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Depressão/etiologia , Feminino , Humanos , Índia/etnologia , Masculino , Pessoa de Meia-Idade , Ontário/etnologia , Dor/etiologia , Doença de Parkinson/complicações
19.
Arthritis Care Res (Hoboken) ; 71(1): 95-103, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29669194

RESUMO

OBJECTIVE: Relative to studies of systemic lupus erythematosus (SLE), epidemiologic studies of chronic cutaneous lupus erythematosus (CCLE) are rare and are limited to populations with no racial diversity. We sought to provide minimum estimates of the incidence of primary CCLE (CCLE in the absence of SLE) in a population comprised predominantly of white individuals and black individuals in the southeastern region of the US. METHODS: The Georgia Lupus Registry allowed for the use of multiple sources for case-finding, including dermatology and rheumatology practices, multispecialty health care facilities, and dermatopathology reports. Cases with a clinical or clinical/histologic diagnosis of CCLE were classified as definite. Cases ascertained exclusively from dermatopathology reports were categorized as probable. Age-standardized incidence rates stratified by sex and race were calculated for discoid lupus erythematosus (DLE) in particular and for CCLE in general. RESULTS: The overall age-adjusted estimates for combined (definite and probable) CCLE were 3.9 per 100,000 person-years (95% confidence interval [95% CI] 3.4-4.5). The overall age-adjusted incidences of definite and combined DLE were 2.9 (95% CI 2.4-3.4) and 3.7 (95% CI 3.2-4.3) per 100,000 person-years, respectively. When capture-recapture methods were used, the age-adjusted incidence of definite DLE increased to 4.0 (95% CI 3.2-4.3). The black:white and female:male incidence ratios for definite DLE were 5.4 and 3.1, respectively. CONCLUSION: Our findings underscore the striking racial disparities in susceptibility to primary CCLE, with black individuals having a 3-fold to 5-fold increased incidence of CCLE in general, and DLE in particular, compared with white individuals. The observed sex differences were consistent with those reported previously, with a 3 times higher risk of DLE in women compared with men.


Assuntos
Afro-Americanos/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Disparidades em Assistência à Saúde/etnologia , Lúpus Eritematoso Discoide/etnologia , Lúpus Eritematoso Sistêmico/etnologia , Sistema de Registros , Adulto , Feminino , Georgia/etnologia , Humanos , Incidência , Lúpus Eritematoso Discoide/diagnóstico , Lúpus Eritematoso Discoide/terapia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/terapia , Masculino , Pessoa de Meia-Idade , Sudeste dos Estados Unidos/etnologia
20.
J Marital Fam Ther ; 45(1): 61-75, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29682765

RESUMO

Privilege is the freedom to ignore things that other people are forced to confront; dramatic things like being gunned down by a vigilante on the way home from a convenience store or less urban and visible things like having to live on secluded parcels of land that no one else wants. Most family therapists enjoy the freedom not to experience such events. Many of the people who come to us for help don't have that freedom. My intent here is to increase felt awareness of the injustice of institutional racism and to suggest some actions that White family therapists can take to bring forth a more just society in terms of education, housing, access to wealth, and basic safety.


Assuntos
Afro-Americanos/etnologia , Grupo com Ancestrais do Continente Europeu/etnologia , Terapia Familiar , Violações dos Direitos Humanos/etnologia , Médicos/psicologia , Racismo/etnologia , Comportamento Social , Humanos , Estados Unidos/etnologia
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