1
|
He X, Matsuki S, Li K, Sui Y, Matsuno K, Ren M, Sutter G, Hofmann BM. Pharmacokinetics, safety, and tolerability of the novel tetrameric gadolinium-based MRI contrast agent gadoquatrane in healthy Chinese and Japanese men: Two randomized dose-escalation studies including concentration-QTc modeling. Eur J Pharm Sci 2024; 196:106749. [PMID: 38499113 DOI: 10.1016/j.ejps.2024.106749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/23/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE To investigate the pharmacokinetics, safety, and tolerability of the novel tetrameric high-relaxivity gadolinium-based contrast agent gadoquatrane in Japanese (Study 1) and Chinese men (Study 2). PARTICIPANTS AND METHODS In two similarly designed single-center, randomized, single-blind, placebo-controlled, consecutive-cohort dose-escalation studies, healthy volunteers were randomly assigned to intravenous administration of gadoquatrane (0.01-0.1 mmol gadolinium/kg body weight) or placebo. Study procedures included blood sampling and collection of urine for pharmacokinetic analyses and safety assessments. RESULTS Twenty-five healthy Japanese men (mean age ± standard deviation: 26±5.9 years) and 23 healthy Chinese men (31±7.6 years old) were evaluated. In both studies, the pharmacokinetic profile of gadoquatrane was characterized by rapid distribution of the drug into the extracellular space and fast renal elimination. Postdose gadolinium concentrations rapidly declined with a geometric mean effective half-life of 1.3-1.4 h. The exposure increased approximately dose-proportionally with dose. The body weight-normalized volume of distribution was constant across dose levels (0.21-0.24 L/kg). Total recovery of gadolinium in urine amounted to 82-95 % (Study 1) and 96-99 % (Study 2) of the dose administered. Only a few mild, transient adverse events were reported, none of which gave rise to any safety concerns. Exploratory drug concentration-QTc modeling indicated no risk of a clinically relevant QT/QTc prolongation at the anticipated diagnostic dose. CONCLUSION Gadoquatrane was safe and well tolerated at all doses tested. The pharmacokinetic profile was essentially the same as that of other extracellular macrocyclic gadolinium-based contrast agents and was consequentially also similar for Japanese and Chinese participants.
Collapse
Affiliation(s)
- Xuemei He
- Clinical Trial Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing, PR China
| | | | - Kexin Li
- Clinical Trial Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing, PR China
| | - Yubin Sui
- Bayer Healthcare Co. Ltd., Research & Development Beijing, Pharmaceuticals, Clinical Pharmacology Asia, 6F, Tower B, Parkview Green, No.9, Dongdaqiao Road, Chaoyang District, Beijing, 100020, PR China.
| | - Kumi Matsuno
- Bayer Yakuhin, Ltd., Research & Development Japan, Translational Science, Clinical Pharmacology, 2-4-9 Umeda, Kita-ku Osaka, 530-0001, Japan.
| | - Mengyuan Ren
- Bayer Healthcare Co. Ltd., Research & Development Beijing, Pharmaceuticals, Clinical Pharmacology Asia, 6F, Tower B, Parkview Green, No.9, Dongdaqiao Road, Chaoyang District, Beijing, 100020, PR China
| | - Gabriele Sutter
- Bayer AG, Radiology, Pharmaceuticals, Muellerstr. 178, 13352, Berlin, Germany
| | - Birte Maria Hofmann
- Bayer AG, Radiology, Pharmaceuticals, Muellerstr. 178, 13352, Berlin, Germany
| |
Collapse
|
2
|
Hummel B, van Oortmerssen JA, Borst C, Harskamp RE, Galenkamp H, Postema PG, van Valkengoed IG. Sex and ethnic differences in unrecognized myocardial infarctions: Observations on recognition and preventive therapies from the multiethnic population-based HELIUS cohort. Int J Cardiol Cardiovasc Risk Prev 2024; 20:200237. [PMID: 38283611 PMCID: PMC10818071 DOI: 10.1016/j.ijcrp.2024.200237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/18/2023] [Accepted: 01/05/2024] [Indexed: 01/30/2024]
Abstract
Background Epidemiological studies suggest sex differences in the prevalence and characteristics of unrecognized and recognized myocardial infarction (uMI, rMI). Despite increasingly diverse populations, observations are limited in multiethnic contexts. Gaining better understanding may inform policy makers and healthcare professionals on populations at risk of uMI who could benefit from preventive measures. Methods We used baseline data from the multiethnic population-based HELIUS cohort (2011-2015; Amsterdam, the Netherlands). Using logistic regressions, we studied sex differences in the prevalence and proportion of uMIs across ethnic groups. Next, we studied whether symptoms, clinical parameters, and sociocultural factors were associated with uMIs. Finally, we compared secondary preventive therapies in women and men with a uMI or rMI. We relied on pathological Q-waves on a resting electrocardiogram as the electrocardiographic signature for (past) MI. Results Overall, and in Turkish and Moroccan subgroups, the prevalence of uMIs was higher in men than women. The proportion of uMIs was similar in women (21.0%) and men (18.4%), yet varied by ethnicity. In women and men, symptoms (chest pain, dyspnea) and clinical parameters (hypertension, hypercholesterolemia), and in women also lower educational level and diabetes were associated with lower odds of uMIs. Women (0.0%) and men (3.6%) with uMI were unlikely to receive secondary preventive therapies compared to those with rMI (28.1-40.9%). Conclusions The prevalence of uMIs was higher in men than women, and sex differences in the proportion of uMIs varied somewhat across ethnic groups. People with uMIs did not receive adequate preventative medications, posing a risk for recurrent events.
Collapse
Affiliation(s)
- Bryn Hummel
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | | | - CharlotteS.M. Borst
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Ralf E. Harskamp
- Department of General Practice, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
- Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands
| | - Pieter G. Postema
- Departments of Experimental and Clinical Cardiology, Heart Center, Amsterdam UMC Location AMC, Amsterdam, the Netherlands
| | - Irene G.M. van Valkengoed
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - IMPRESS consortium
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
- Department of General Practice, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
- Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands
- Departments of Experimental and Clinical Cardiology, Heart Center, Amsterdam UMC Location AMC, Amsterdam, the Netherlands
| |
Collapse
|
3
|
Parke KS, Brady EM, Alfuhied A, Motiwale RS, Razieh CS, Singh A, Arnold JR, Graham-Brown MPM, Bilak JM, Ayton SL, Dattani A, Yeo JL, McCann GP, Gulsin GS. Ethnic differences in cardiac structure and function assessed by MRI in healthy South Asian and White European people: A UK Biobank Study. J Cardiovasc Magn Reson 2024; 26:100001. [PMID: 38218434 DOI: 10.1016/j.jocmr.2023.100001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Echocardiographic studies indicate South Asian people have smaller ventricular volumes, lower mass and more concentric remodelling than White European people, but there are no data using cardiac MRI (CMR). We aimed to compare CMR quantified cardiac structure and function in White European and South Asian people. METHODS Healthy White European and South Asian participants in the UK Biobank Imaging CMR sub-study were identified by excluding those with a history of cardiovascular disease, hypertension, obesity or diabetes. Ethnic groups were matched by age and sex. Cardiac volumes, mass and feature tracking strain were compared. RESULTS 121 matched pairs (77 male/44 female, mean age 58 ± 8 years) of South Asian and White European participants were included. South Asian males and females had smaller absolute but not indexed left ventricular (LV) volumes, and smaller absolute and indexed right ventricular volumes, with lower absolute and indexed LV mass and lower LV mass:volume than White European participants. Although there were no differences in ventricular or atrial ejection fractions, LV global longitudinal strain was higher in South Asian females than White European females but not males, and global circumferential strain was higher in both male and South Asian females than White European females. Peak early diastolic strain rates were higher in South Asian versus White European males, but not different between South Asian and White European females. CONCLUSIONS Contrary to echocardiographic studies, South Asian participants in the UK Biobank study had less concentric remodelling and higher global circumferential strain than White European subjects. These findings emphasise the importance of sex- and ethnic- specific normal ranges for cardiac volumes and function.
Collapse
Affiliation(s)
- Kelly S Parke
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Emer M Brady
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Aseel Alfuhied
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Rishabh S Motiwale
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Cameron S Razieh
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Jayanth R Arnold
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Matthew P M Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Joanna M Bilak
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Sarah L Ayton
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Abhishek Dattani
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Jian L Yeo
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK.
| | - Gaurav S Gulsin
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| |
Collapse
|
4
|
Crouch T, Sturgeon J, Guck A, Hagiwara N, Smith W, Trost Z. Race, Ethnicity, and Belief in a Just World: Implications for Chronic Pain Acceptance Among Individuals with Chronic Low Back Pain. J Pain 2023; 24:2309-2318. [PMID: 37454884 PMCID: PMC10789909 DOI: 10.1016/j.jpain.2023.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/05/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
Chronic pain acceptance is a psychological process consistently linked with improved functional outcomes. However, existing research on this construct has not considered the role of racial or ethnic background, despite growing evidence of racialized disparities in pain experience and treatment. This study aimed to examine racial differences in chronic pain acceptance, as measured by the chronic pain acceptance questionnaires (CPAQ), in a multicultural sample of individuals with chronic low back pain (N = 137-37.2% White, 31.4% Hispanic, and 31.4% Black/African American). We further sought to examine moderating effects of discrimination, pain-related perceived injustice (PI), and just world belief (JWB). Analyses consisted of cross-sectional one-way analyses of variance with Bonferroni-corrected post hoc comparisons, followed by regression models with interaction terms, main effects, and relevant covariates. Results indicated higher scores on the CPAQ for White individuals compared to Black or Hispanic individuals. Significant interactions were noted between race/ethnicity and JWB in predicting pain acceptance, after controlling for demographic and pain-related variables, such that the positive association between JWB and pain acceptance was significant for White participants only. Race/ethnicity did not show significant interactions with PI or prior racial discrimination. Findings highlight racial differences in levels of chronic pain acceptance, an adaptive pain coping response, and a stronger JWB appears to have a positive impact on pain acceptance for White individuals only. Results further confirm that members of disadvantaged racial groups may be more susceptible to poorer pain adjustment, which is the result of complex, multi-level factors. PERSPECTIVE: This study identifies racial differences in levels of pain acceptance, an adaptive psychological response to chronic pain, such that White individuals with chronic low back pain demonstrate higher levels of pain acceptance. The article further explores the impacts of intrapersonal and sociocultural variables on racial differences in pain acceptance.
Collapse
Affiliation(s)
- Taylor Crouch
- Department of Psychiatry, Virginia Commonwealth University, VA, USA
| | - John Sturgeon
- Department of Anaesthesiology, Michigan State University, MI, USA
| | - Adam Guck
- Department of Family Medicine, John Peter Smith Health Network, Ft. Worth, TX, USA
| | - Nao Hagiwara
- Department of Psychology, Virginia Commonwealth University, VA, USA
| | - Wally Smith
- Department of Internal Medicine, Virginia Commonwealth University, VA, USA
| | - Zina Trost
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, VA, USA
| |
Collapse
|
5
|
Dasgupta K, Pacheco G, Plum A. State dependence in immunization and the role of discouragement. Econ Hum Biol 2023; 51:101313. [PMID: 37950998 DOI: 10.1016/j.ehb.2023.101313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/13/2023]
Abstract
We investigate whether having a child immunized at a prior schedule genuinely increases the likelihood of vaccinating the child at the subsequent schedule. We use longitudinal data from the Growing Up in New Zealand study and apply a dynamic random-effects model that also controls for the initial immunization status. Prior to any covariate-adjusted estimations, our data shows that almost 96% of the children immunized at the previous schedule are also immunized at the subsequent schedule. In comparison, only 29% of children who were not immunized at the prior schedule receive immunization at the next milestone, thereby indicating an unadjusted state dependence in immunization of 67 percentage points (p.p.). Upon controlling for relevant covariates and unobserved heterogeneities, the genuine state dependence in immunization is, on average, estimated to be 20 p.p. Importantly, the magnitude of the state dependence is greater for Māori (by 5 p.p.) and also greater for mothers that report being discouraged from having their child immunized during the antenatal period (by 10 p.p.).
Collapse
|
6
|
Zheng J, Frysz M, Faber BG, Lin H, Ebsim R, Ge J, Yong Y, Saunders FR, Gregory JS, Aspden RM, Harvey NC, Jiang BH, Cootes T, Lindner C, Gao X, Wang S, Tobias JH. Comparison between UK Biobank and Shanghai Changfeng suggests distinct hip morphology may contribute to ethnic differences in the prevalence of hip osteoarthritis. Osteoarthritis Cartilage 2023:S1063-4584(23)00958-5. [PMID: 37935324 DOI: 10.1016/j.joca.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/09/2023]
Abstract
OBJECTS Joint morphology is a risk factor for hip osteoarthritis (HOA) and could explain ethnic differences in HOA prevalence. Therefore, we aimed to compare the prevalence of radiographic HOA (rHOA) and hip morphology between the predominantly White UK Biobank (UKB) and exclusively Chinese Shanghai Changfeng (SC) cohorts. METHODS Left hip iDXA scans were used to quantify rHOA, from a combination of osteophytes (grade ≥1) and joint space narrowing (grade ≥1), and hip morphology. Using an 85-point Statistical Shape Model (SSM) we evaluated cam (alpha angle ≥60°) and pincer (lateral centre-edge angle (LCEA) ≥45°) morphology and acetabular dysplasia (LCEA <25°). Diameter of femoral head (DFH), femoral neck width (FNW), and hip axis length (HAL) were also obtained from these points. Results were adjusted for differences in age, height, and weight and stratified by sex. RESULTS Complete data were available for 5924 SC and 39,020 White UKB participants with mean ages of 63.4 and 63.7 years old. rHOA prevalence was considerably lower in female (2.2% versus 13.1%) and male (12.0% and 25.1%) SC compared to UKB participants. Cam morphology, rarely seen in females, was less common in SC compared with UKB males (6.3% versus 16.5%). Composite SSM modes, scaled to the same overall size, revealed SC participants to have a wider femoral head compared to UKB participants. FNW and HAL were smaller in SC compared to UKB, whereas DFH/FNW ratio was higher in SC. CONCLUSIONS rHOA prevalence is lower in Chinese compared with White individuals. Several differences in hip shape were observed, including frequency of cam morphology, FNW, and DFH/FNW ratio. These characteristics have previously been identified as risk factors for HOA and may contribute to observed ethnic differences in HOA prevalence.
Collapse
Affiliation(s)
- Jiayi Zheng
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Monika Frysz
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Benjamin G Faber
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Huandong Lin
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China; Fudan Institute for Metabolic Diseases, Shanghai, China
| | - Raja Ebsim
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
| | - Jieyu Ge
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Yanling Yong
- Academy of Medical Science, Zhengzhou University, Zhengzhou, China
| | - Fiona R Saunders
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK
| | - Jennifer S Gregory
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK
| | - Richard M Aspden
- Centre for Arthritis and Musculoskeletal Health, University of Aberdeen, Aberdeen, UK
| | - Nicholas C Harvey
- Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Bing-Hua Jiang
- Academy of Medical Science, Zhengzhou University, Zhengzhou, China
| | - Timothy Cootes
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
| | - Claudia Lindner
- Division of Informatics, Imaging and Data Sciences, The University of Manchester, Manchester, UK
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China; Fudan Institute for Metabolic Diseases, Shanghai, China.
| | - Sijia Wang
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China.
| | - Jonathan H Tobias
- Musculoskeletal Research Unit, University of Bristol, Bristol, UK; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
| |
Collapse
|
7
|
Chen C, Shi X, Lisabeth LD, Kwicklis M, Malvitz M, Case E, Morgenstern LB. Mexican Americans agree to participate in longitudinal clinical research more than non-Hispanic whites. BMC Public Health 2023; 23:2060. [PMID: 37864242 PMCID: PMC10589976 DOI: 10.1186/s12889-023-16998-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/16/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The National Institutes of Health has advocated for improved minority participation in clinical research, including clinical trials and observational epidemiologic studies since 1993. An understanding of Mexican Americans (MAs) participation in clinical research is important for tailoring recruitment strategies and enrollment techniques for MAs. However, contemporary data on MA participation in observational clinical stroke studies are rare. We examined differences between Mexican Americans (MAs) and non-Hispanic whites (NHWs) participation in a population-based stroke study. METHODS We included 3,594 first ever stroke patients (57.7% MAs, 48.7% women, median [IQR] age 68 [58-79]) from the Brain Attack Surveillance in Corpus Christi Project, 2009-2020 in Texas, USA, who were approached and invited to participate in a structured baseline interview. We defined participation as completing a baseline interview by patient or proxy. We used log-binomial models adjusting for prespecified potential confounders to estimate prevalence ratios (PR) of participation comparing MAs with NHWs. We tested interactions of ethnicity with age or sex to examine potential effect modification in the ethnic differences in participation. We also included an interaction between year and ethnicity to examine ethnic-specific temporal trends in participation. RESULTS Baseline participation was 77.0% in MAs and 64.2% in NHWs (Prevalence Ratio [PR] 1.20; 95% CI, 1.14-1.25). The ethnic difference remained after multivariable adjustment (1.17; 1.12-1.23), with no evidence of significant effect modification by age or sex (Pinteraction by age = 0.68, Pinteraction by sex = 0.83). Participation increased over time for both ethnic groups (Ptrend < 0.0001), but the differences in participation between MAs and NHWs remained significantly different throughout the 11-year time period. CONCLUSION MAs were persistently more likely to participate in a population-based stroke study in a predominantly MA community despite limited outreach efforts towards MAs during study enrollment. This finding holds hope for future research studies to be inclusive of the MA population.
Collapse
Affiliation(s)
- Chen Chen
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Xu Shi
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Lynda D Lisabeth
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Madeline Kwicklis
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Madelyn Malvitz
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Erin Case
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Lewis B Morgenstern
- Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
- Stroke Program, University of Michigan Medical School, Ann Arbor, MI, USA.
| |
Collapse
|
8
|
Hummel B, Yerkes MA, Harskamp RE, Galenkamp H, Kunst AE, Lok A, van Valkengoed IGM. The COVID-19 pandemic and temporal change in metabolic risk factors for cardiovascular disease: A natural experiment within the HELIUS study. SSM Popul Health 2023; 23:101432. [PMID: 37234865 PMCID: PMC10195766 DOI: 10.1016/j.ssmph.2023.101432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/18/2023] [Accepted: 05/14/2023] [Indexed: 05/28/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic, including the restrictive measures taken to reduce the spread of the virus, negatively affected people's health behavior. We explored whether the pandemic also had an effect on metabolic risk factors for cardiovascular disease (CVD) in women and men. We conducted a natural experiment, using data from 6962 participants without CVD at baseline (2011-2015) of six ethnic groups of the HELIUS study in Amsterdam, the Netherlands. We studied whether participants whose follow-up measurements were taken within the 11 months before the pandemic (control group) differed from those whose measurements were taken taken within 6 months after the first lockdown (exposed group). Using sex-stratified linear regressions with inverse probability weighting, we compared changes in baseline- and follow-up data between the control and exposed group in six metabolic risk factors: systolic and diastolic blood pressure (SBP, DBP), total cholesterol (TC), fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), and estimated glomerular filtration rate (eGFR). Next, we explored the mediating effect of changes in body-mass index (BMI), alcohol, smoking, depressive symptoms and negative life events at follow-up. We observed less favorable changes in SBP (+1.12mmHg for women, +1.38mmHg for men), DBP (+0.85mmHg, +0.80mmHg) and FPG (only in women, +0.12 mmol/L) over time in the exposed group relative to the control group. Conversely, changes in HbA1c (-0.65 mmol/mol, -0.84 mmol/mol) and eGFR (+1.06 mL/min, +1.04 mL/min) were more favorable in the exposed compared to the control group, respectively. Changes in SBP, DBP, and FPG were partially mediated by changes in behavioral factors, in particular BMI and alcohol consumption. Concluding, the COVID-19 pandemic, in particular behavioral changes associated with restrictive lockdown measures, may have negatively affected several CVD risk factors, in both women and men.
Collapse
Affiliation(s)
- Bryn Hummel
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Mara A Yerkes
- Department of Interdisciplinary Social Sciences, Utrecht University, Heidelberglaan 8, 3584, CS, Utrecht, the Netherlands
| | - Ralf E Harskamp
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Anton E Kunst
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Anja Lok
- Department of Psychiatry, Amsterdam University Medical Centre, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| | - Irene G M van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands
| |
Collapse
|
9
|
Romiti GF, Corica B, Proietti M, Mei DA, Frydenlund J, Bisson A, Boriani G, Olshansky B, Chan YH, Huisman MV, Chao TF, Lip GY. Patterns of oral anticoagulant use and outcomes in Asian patients with atrial fibrillation: a post-hoc analysis from the GLORIA-AF Registry. EClinicalMedicine 2023; 63:102039. [PMID: 37753446 PMCID: PMC10518516 DOI: 10.1016/j.eclinm.2023.102039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 09/28/2023] Open
Abstract
Background Previous studies suggested potential ethnic differences in the management and outcomes of atrial fibrillation (AF). We aim to analyse oral anticoagulant (OAC) prescription, discontinuation, and risk of adverse outcomes in Asian patients with AF, using data from a global prospective cohort study. Methods From the GLORIA-AF Registry Phase II-III (November 2011-December 2014 for Phase II, and January 2014-December 2016 for Phase III), we analysed patients according to their self-reported ethnicity (Asian vs. non-Asian), as well as according to Asian subgroups (Chinese, Japanese, Korean and other Asian). Logistic regression was used to analyse OAC prescription, while the risk of OAC discontinuation and adverse outcomes were analysed through Cox-regression model. Our primary outcome was the composite of all-cause death and major adverse cardiovascular events (MACE). The original studies were registered with ClinicalTrials.gov, NCT01468701, NCT01671007, and NCT01937377. Findings 34,421 patients were included (70.0 ± 10.5 years, 45.1% females, 6900 (20.0%) Asian: 3829 (55.5%) Chinese, 814 (11.8%) Japanese, 1964 (28.5%) Korean and 293 (4.2%) other Asian). Most of the Asian patients were recruited in Asia (n = 6701, 97.1%), while non-Asian patients were mainly recruited in Europe (n = 15,449, 56.1%) and North America (n = 8378, 30.4%). Compared to non-Asian individuals, prescription of OAC and non-vitamin K antagonist oral anticoagulant (NOAC) was lower in Asian patients (Odds Ratio [OR] and 95% Confidence Intervals (CI): 0.23 [0.22-0.25] and 0.66 [0.61-0.71], respectively), but higher in the Japanese subgroup. Asian ethnicity was also associated with higher risk of OAC discontinuation (Hazard Ratio [HR] and [95% CI]: 1.79 [1.67-1.92]), and lower risk of the primary composite outcome (HR [95% CI]: 0.86 [0.76-0.96]). Among the exploratory secondary outcomes, Asian ethnicity was associated with higher risks of thromboembolism and intracranial haemorrhage, and lower risk of major bleeding. Interpretation Our results showed that Asian patients with AF showed suboptimal thromboembolic risk management and a specific risk profile of adverse outcomes; these differences may also reflect differences in country-specific factors. Ensuring integrated and appropriate treatment of these patients is crucial to improve their prognosis. Funding The GLORIA-AF Registry was funded by Boehringer Ingelheim GmbH.
Collapse
Affiliation(s)
- Giulio Francesco Romiti
- Liverpool Centre for Cardiovascular Sciences at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Translational and Precision Medicine, Sapienza – University of Rome, Rome, Italy
| | - Bernadette Corica
- Liverpool Centre for Cardiovascular Sciences at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Translational and Precision Medicine, Sapienza – University of Rome, Rome, Italy
| | - Marco Proietti
- Liverpool Centre for Cardiovascular Sciences at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Davide Antonio Mei
- Liverpool Centre for Cardiovascular Sciences at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Juliane Frydenlund
- Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark
| | - Arnaud Bisson
- Liverpool Centre for Cardiovascular Sciences at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Service de Cardiologie, CHU Trousseau et Université François Rabelais, Tours, France
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
| | - Brian Olshansky
- Division of Cardiology, Department of Medicine, University of Iowa, Iowa City, USA
| | - Yi-Hsin Chan
- Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
- Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan City Taiwan
| | - Menno V. Huisman
- Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
| | - Tze-Fan Chao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Gregory Y.H. Lip
- Liverpool Centre for Cardiovascular Sciences at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| |
Collapse
|
10
|
Duarte Folle A, Flores M, Kusters C, Paul K, Del Rosario I, Zhang K, Ruiz C, Castro E, Bronstein J, Ritz B, Keener A. Ethnicity and Parkinson's Disease: Motor and Nonmotor Features and Disease Progression in Latino Patients Living in Rural California. J Gerontol A Biol Sci Med Sci 2023; 78:1258-1268. [PMID: 36645401 PMCID: PMC10329232 DOI: 10.1093/gerona/glad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is the second most common neurodegenerative disorder among older adults worldwide. Currently, studies of PD progression rely primarily on White non-Latino (WNL) patients. Here, we compare clinical profiles and PD progression in Latino and WNL patients enrolled in a community-based study in rural Central California. METHOD PD patients within 5 years of diagnosis were identified from 3 counties between 2001 and 2015. During up to 3 visits, participants were examined by movement disorders specialists and interviewed. We analyzed cross-sectional differences in PD clinical features severity at each study visit and used linear mixed models and Cox proportional hazards models to compare motor, nonmotor, and disability progression longitudinally and to assess time to death in Latinos compared to WNL patients. RESULTS Of 775 patients included, 138 (18%) self-identified as Latino and presented with earlier age at diagnosis (63.6 vs 68.9) and death (78.6 vs 81.5) than WNL. Motor (hazard ratio [HR] = 1.17 [0.71, 1.94]) and nonmotor symptoms did not progress faster in Latino versus WNL patients after accounting for differences in baseline symptom severity. However, Latino patients progressed to disability stages according to Hoehn and Yahr faster than WNL (HR = 1.81 [1.11, 2.96]). Motor and nonmotor symptoms in Latino patients were also medically managed less well than in WNL. CONCLUSIONS Our PD study with a large proportion of Latino enrollees and progression data reveals disparities in clinical features and progression by ethnicity that may reflect healthcare access and structural socioeconomic disadvantages in Latino patients with PD.
Collapse
Affiliation(s)
- Aline Duarte Folle
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Marie E S Flores
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Altamed, Pico Rivera, California, USA
| | - Cynthia Kusters
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Irish Del Rosario
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Keren Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Cristina Ruiz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Emily Castro
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Jeff Bronstein
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Adrienne M Keener
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Department of Neurology, Veterans Administration Greater Los Angeles Health Care System, Los Angeles, California, USA
| |
Collapse
|
11
|
Costello RE, Tazare J, Piehlmaier D, Herrett E, Parker EPK, Zheng B, Mansfield KE, Henderson AD, Carreira H, Bidulka P, Wong AYS, Warren-Gash C, Hayes JF, Quint JK, MacKenna B, Mehrkar A, Eggo RM, Katikireddi SV, Tomlinson L, Langan SM, Mathur R. Ethnic differences in the indirect effects of the COVID-19 pandemic on clinical monitoring and hospitalisations for non-COVID conditions in England: a population-based, observational cohort study using the OpenSAFELY platform. EClinicalMedicine 2023; 61:102077. [PMID: 37434746 PMCID: PMC10331810 DOI: 10.1016/j.eclinm.2023.102077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023] Open
Abstract
Background The COVID-19 pandemic disrupted healthcare and may have impacted ethnic inequalities in healthcare. We aimed to describe the impact of pandemic-related disruption on ethnic differences in clinical monitoring and hospital admissions for non-COVID conditions in England. Methods In this population-based, observational cohort study we used primary care electronic health record data with linkage to hospital episode statistics data and mortality data within OpenSAFELY, a data analytics platform created, with approval of NHS England, to address urgent COVID-19 research questions. We included adults aged 18 years and over registered with a TPP practice between March 1, 2018, and April 30, 2022. We excluded those with missing age, sex, geographic region, or Index of Multiple Deprivation. We grouped ethnicity (exposure), into five categories: White, Asian, Black, Other, and Mixed. We used interrupted time-series regression to estimate ethnic differences in clinical monitoring frequency (blood pressure and Hba1c measurements, chronic obstructive pulmonary disease and asthma annual reviews) before and after March 23, 2020. We used multivariable Cox regression to quantify ethnic differences in hospitalisations related to diabetes, cardiovascular disease, respiratory disease, and mental health before and after March 23, 2020. Findings Of 33,510,937 registered with a GP as of 1st January 2020, 19,064,019 were adults, alive and registered for at least 3 months, 3,010,751 met the exclusion criteria and 1,122,912 were missing ethnicity. This resulted in 14,930,356 adults with known ethnicity (92% of sample): 86.6% were White, 7.3% Asian, 2.6% Black, 1.4% Mixed ethnicity, and 2.2% Other ethnicities. Clinical monitoring did not return to pre-pandemic levels for any ethnic group. Ethnic differences were apparent pre-pandemic, except for diabetes monitoring, and remained unchanged, except for blood pressure monitoring in those with mental health conditions where differences narrowed during the pandemic. For those of Black ethnicity, there were seven additional admissions for diabetic ketoacidosis per month during the pandemic, and relative ethnic differences narrowed during the pandemic compared to the White ethnic group (Pre-pandemic hazard ratio (HR): 0.50, 95% confidence interval (CI) 0.41, 0.60, Pandemic HR: 0.75, 95% CI: 0.65, 0.87). There was increased admissions for heart failure during the pandemic for all ethnic groups, though highest in those of White ethnicity (heart failure risk difference: 5.4). Relatively, ethnic differences narrowed for heart failure admission in those of Asian (Pre-pandemic HR 1.56, 95% CI 1.49, 1.64, Pandemic HR 1.24, 95% CI 1.19, 1.29) and Black ethnicity (Pre-pandemic HR 1.41, 95% CI: 1.30, 1.53, Pandemic HR: 1.16, 95% CI 1.09, 1.25) compared with White ethnicity. For other outcomes the pandemic had minimal impact on ethnic differences. Interpretation Our study suggests that ethnic differences in clinical monitoring and hospitalisations remained largely unchanged during the pandemic for most conditions. Key exceptions were hospitalisations for diabetic ketoacidosis and heart failure, which warrant further investigation to understand the causes. Funding LSHTM COVID-19 Response Grant (DONAT15912).
Collapse
Affiliation(s)
| | - John Tazare
- London School of Hygiene and Tropical Medicine, London, UK
| | - Dominik Piehlmaier
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- University of Sussex Business School, Jubilee Building, Brighton, UK
| | - Emily Herrett
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Bang Zheng
- London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | - Angel Y S Wong
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Joseph F Hayes
- Division of Psychiatry, University College London, London, UK
| | - Jennifer K Quint
- Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, UK
| | - Brian MacKenna
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amir Mehrkar
- Bennett Institute for Applied Data Science, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | | | | | | | - Rohini Mathur
- London School of Hygiene and Tropical Medicine, London, UK
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary, University of London, London, UK
| |
Collapse
|
12
|
Treister-Goltzman Y, Peleg R, Sagy I, Menashe I. Medication use and factors associated with opiate use among patients with diagnosed fibromyalgia from two ethnic sectors in southern Israel. J Pharm Policy Pract 2023; 16:78. [PMID: 37365657 DOI: 10.1186/s40545-023-00586-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Our aims were to compare fibromyalgia (FM) rate, drug treatment and factors associated with the use of opiates in two ethnic sectors. METHODS A retrospective cross-sectional study in southern district of Israel was performed on diagnosed FM patients in 2019-2020 [7686 members (1.50%)]. Descriptive analyses were conducted and multivariable models for the use of opiates were developed. RESULTS There were significant differences between the two ethnic groups in FM prevalence at 1.63% and 0.91% in the Jewish and Arab groups, respectively. Only 32% of the patients used recommended medications and about 44% purchased opiates. Age, BMI, psychiatric co-morbidity, and treatment with a recommended drug were similarly associated with an increased risk for opiate use in both ethnic groups. However, male gender was associated with × 2 times reduced risk to use opiates only among the Bedouins (aOR = 0.552, 95%CI = 0.333-0.911). In addition, while in both of ethnic groups the existence of another localized pain syndrome was associated with an increased risk for opiates use, this risk was 4 times higher in the Bedouin group (aOR = 8.500, 95%CI = 2.023-59.293 and aOR = 2.079, 95%CI = 1.556-2.814). CONCLUSIONS The study showed underdiagnosis of FM in the minority Arab ethnicity. Female Arab FM patients in low or high, compared to middle socio-economic status, were a risk group for excess opiate use. Increased use of opiates and very low rate of purchase of recommended drugs point to a lack of effectiveness of these drugs. Future research should assess whether the treatment of treatable factors can reduce the dangerous use of opiates.
Collapse
Affiliation(s)
- Yulia Treister-Goltzman
- Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105, Beer-Sheva, Israel.
- Clalit Health Services, Southern District, Israel.
| | - Roni Peleg
- Department of Family Medicine and Siaal Research Center for Family Practice and Primary Care, The Haim Doron Division of Community Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105, Beer-Sheva, Israel
- Clalit Health Services, Southern District, Israel
| | - Iftach Sagy
- Rheumatology Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel
- Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Idan Menashe
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| |
Collapse
|
13
|
Hummel B, Harskamp RE, Bolijn R, Moll van Charante EP, Galenkamp H, Mommersteeg PMC, van Valkengoed IGM. Psychosocial factors may serve as additional eligibility criteria for cardiovascular risk screening in women and men in a multi-ethnic population: The HELIUS study. Prev Med 2023; 172:107515. [PMID: 37062519 DOI: 10.1016/j.ypmed.2023.107515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/23/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023]
Abstract
Cardiovascular disease (CVD) prevention strategies include identifying and managing high risk individuals. Identification primarily occurs through screening or case finding. Guidelines indicate that psychosocial factors increase CVD risk, but their use for screening is not yet recommended. We studied whether psychosocial factors may serve as additional eligibility criteria in a multi-ethnic population without prior CVD. We performed a cross-sectional analysis using baseline data of 10,226 participants of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin aged 40-70 years, living in Amsterdam, the Netherlands. Using logistic regressions and Akaike Information Criteria, we analyzed whether psychosocial factors (educational level, employment status, occupational level, financial stress, primary earner status, mental health, stress, depression, and social isolation) improved prediction of high CVD risk (SCORE-estimated fatal and non-fatal CVD risk ≥5%) beyond eligibility criteria from history taking (smoking, obesity, family history of CVD). Next, we compared the additional predictive value of psychosocial eligibility criteria in women and men across ethnic groups, using the area under the curve (AUC). Of our sample, 32.7% had a high CVD risk. Only socioeconomic eligibility criteria (employment status and educational level) improved high CVD risk prediction (p < .001 for likelihood-ratio tests). These increased AUCs in women (from 0.563 to 0.682) and men (from 0.610 to 0.664), particularly in Dutch, South-Asian Surinamese, African Surinamese and Moroccan women, and Dutch and Moroccan men. Concluding, socioeconomic eligibility criteria may be considered as additional eligibility criteria for CVD risk screening, as they improve detection of women and men at high CVD risk.
Collapse
Affiliation(s)
- Bryn Hummel
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands.
| | - Ralf E Harskamp
- Department of General Practice, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Renee Bolijn
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Eric P Moll van Charante
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands; Department of General Practice, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviours and Chronic Diseases, Amsterdam, the Netherlands
| | - Paula M C Mommersteeg
- Center of Research on Psychological Disorders and Somatic diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Irene G M van Valkengoed
- Department of Public and Occupational Health, Amsterdam UMC, Location AMC, Amsterdam, the Netherlands
| |
Collapse
|
14
|
Kawaguchi T. Ethnic differences in lung cancer: "we can differ and still unite around common goals.". Respir Investig 2023; 61:355-356. [PMID: 36963275 DOI: 10.1016/j.resinv.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/26/2023] [Accepted: 02/05/2023] [Indexed: 03/26/2023]
Affiliation(s)
- Tomoya Kawaguchi
- Department of Respiratory Medicine, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahi-cho, Abeno-ku, Osaka, Osaka 545-8585, Japan.
| |
Collapse
|
15
|
Appiah L, John D, Owoade DR, Mendenhall J, Appiah D. Factors Influencing Racial and Ethnic Differences in Prescription Opioid Misuse Among Young Adolescents in the USA, 2009-2019. J Racial Ethn Health Disparities 2023; 10:32-42. [PMID: 34845676 DOI: 10.1007/s40615-021-01194-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/15/2021] [Accepted: 11/22/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Prescription opioid misuse (POM) is an important public health concern. Not many studies have evaluated factors influencing racial and ethnic differences in POM exclusively in young adolescents. We evaluated factors influencing the racial and ethnic differences in POM in a nationally representative sample of 8th- and 10th-grade (12-15 years old) US adolescents. METHODS Data were from 107,786 adolescents who participated in the 2009-2019 Monitoring the Future survey. Logistic regression and mediation analysis were used to identify risk factors for POM and evaluate mediators of the association of race and ethnicity on the frequency of POM in the past year. RESULTS From 2009 to 2019, the prevalence of POM in the past year decreased from 3.2% to 1.8% (p = 0.032), with significant differences in POM trends by race and ethnicity. Overall, the prevalence was higher among non-Hispanic White adolescents (3.2%) than Hispanic (2.5%) and non-Hispanic Black adolescents (1.6%), p < 0.001. After adjustment for demographic, substance use, lifestyle, and family-related factors, the odds of POM were lower among Black (odds ratio (OR) = 0.81, 95% confidence interval (CI): 0.66-0.98) and Hispanic adolescents (OR = 0.64, CI: 0.55-0.74) compared to White adolescents. Illicit drug use and misuse of other prescription drugs together explained 77.2% and 47.3% of the racial and ethnic disparities in POM among Black and Hispanic adolescents, respectively. CONCLUSION In this study, significant racial and ethnic differences in the trends of POM were observed. Illicit drug use and misuse of other prescription drugs substantially explained the racial and ethnic disparities in POM among young adolescents.
Collapse
|
16
|
Eastwood SV, Hughes AD, Tomlinson L, Mathur R, Smeeth L, Bhaskaran K, Chaturvedi N. Ethnic differences in hypertension management, medication use and blood pressure control in UK primary care, 2006-2019: a retrospective cohort study. Lancet Reg Health Eur 2023; 25:100557. [PMID: 36818236 PMCID: PMC9929586 DOI: 10.1016/j.lanepe.2022.100557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/10/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022]
Abstract
Background In the UK, previous work suggests ethnic inequalities in hypertension management. We studied ethnic differences in hypertension management and their contribution to blood pressure (BP) control. Methods We conducted a cohort study of antihypertensive-naïve individuals of European, South Asian and African/African Caribbean ethnicity with a new raised BP reading in UK primary care from 2006 to 2019, using the Clinical Practice Research Datalink (CPRD). We studied differences in: BP re-measurement after an initial hypertensive BP, antihypertensive initiation, BP monitoring, antihypertensive intensification, antihypertensive persistence/adherence and BP control one year after antihypertensive initiation. Models adjusted for socio-demographics, BP, comorbidity, healthcare usage and polypharmacy (plus antihypertensive class, BP monitoring, intensification, persistence and adherence for BP control models). Findings A total of 731,506 (93.5%), 30,379 (3.9%) and 20,256 (2.6%) people of European, South Asian and African/African Caribbean ethnicity were studied. Hypertension management indicators were similar or more favourable for South Asian than European groups (OR/HR [95% CI] in fully-adjusted models of BP re-measurement: 1.16 [1.09, 1.24]), antihypertensive initiation: 1.49 [1.37, 1.62], BP monitoring: 0.97 [0.94, 1.00] and antihypertensive intensification: 1.10 [1.04, 1.16]). For people of African/African Caribbean ethnicity, BP re-measurement rates were similar to those of European ethnicity (0.98 [0.91, 1.05]), and antihypertensive initiation rates greater (1.48 [1.32, 1.66]), but BP monitoring (0.91 [0.87, 0.95]) and intensification rates lower (0.93 [0.87, 1.00]). Persistence and adherence were lower in South Asian (0.48 [0.45, 0.51] and 0.51 [0.47, 0.56]) and African/African Caribbean (0.38 [0.35, 0.42] and 0.39 [0.36, 0.43]) than European groups. BP control was similar in South Asian and less likely in African/African Caribbean than European groups (0.98 [0.90, 1.06] and 0.81 [0.74, 0.89] in age, gender and BP adjusted models). The latter difference attenuated after adjustment for persistence (0.91 [0.82, 0.99]) or adherence (0.92 [0.83, 1.01]), and was absent for antihypertensive-adherent people (0.99 [0.88, 1.10]). Interpretation We demonstrate that antihypertensive initiation does not vary by ethnicity, but subsequent BP control was notably lower among people of African/African Caribbean ethnicity, potentially associated with being less likely to remain on regular treatment. A nationwide strategy to understand and address differences in ongoing management of people on antihypertensives is imperative. Funding Diabetes UK.
Collapse
Affiliation(s)
- Sophie V Eastwood
- MRC Unit for Lifelong Health and Aging at UCL, 1-19 Torrington Place, Floor 5, London, WC1E 7HB, UK
| | - Alun D Hughes
- MRC Unit for Lifelong Health and Aging at UCL, 1-19 Torrington Place, Floor 5, London, WC1E 7HB, UK
| | - Laurie Tomlinson
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, 2nd floor, Keppel Street, London, WC1E 7HT, UK
| | - Rohini Mathur
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, 2nd floor, Keppel Street, London, WC1E 7HT, UK
| | - Liam Smeeth
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, 2nd floor, Keppel Street, London, WC1E 7HT, UK
| | - Krishnan Bhaskaran
- Electronic Health Records Group, London School of Hygiene and Tropical Medicine, 2nd floor, Keppel Street, London, WC1E 7HT, UK
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Aging at UCL, 1-19 Torrington Place, Floor 5, London, WC1E 7HB, UK
| |
Collapse
|
17
|
Razieh C, Zaccardi F, Miksza J, Davies MJ, Hansell AL, Khunti K, Yates T. Differences in the risk of cardiovascular disease across ethnic groups: UK Biobank observational study. Nutr Metab Cardiovasc Dis 2022; 32:2594-2602. [PMID: 36064688 DOI: 10.1016/j.numecd.2022.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS To describe sociodemographic, lifestyle, environmental and traditional clinical risk factor differences between ethnic groups and to investigate the extent to which such differences confound the association between ethnic groups and the risk of cardiovascular disease (CVD) METHODS AND RESULTS: A total of 440,693 white European (55.9% women), 7305 South Asian (48.6%) and 7628 black African or Caribbean (57.7%) people were included from UK Biobank. Associations between ethnicity and cardiovascular outcomes (composite of non-fatal stroke, non-fatal myocardial infarction and CVD death) were explored using Cox-proportional hazard models. Models were adjusted for sociodemographic, lifestyle, environmental and clinical risk factors. Over a median (IQR) of 12.6 (11.8, 13.3) follow-up years, there were 22,711 (5.15%) cardiovascular events in white European, 463 (6.34%) in South Asian and 302 (3.96%) in black African or Caribbean individuals. For South Asian people, the cardiovascular hazard ratio (HR) compared to white European people was 1.28 (99% CI [1.16, 1.43]). For black African or Caribbean people, the HR was 0.80 (0.66, 0.97). The elevated risk of CVD in South Asians remained after adjusting for differences in sociodemographic, lifestyle, environmental and clinical factors, whereas the lower risk in black African or Caribbean was largely attenuated. CONCLUSIONS South Asian, but not black African or Caribbean individuals, have a higher risk of CVD compared to white European individuals. This higher risk in South Asians was independent of sociodemographic, lifestyle, environmental and clinical factors.
Collapse
Affiliation(s)
- Cameron Razieh
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK; Office for National Statistics, Newport, NP10 8XG, UK.
| | - Francesco Zaccardi
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Joanne Miksza
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, LE5 4PW, UK; Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK
| | - Anna L Hansell
- Centre for Environmental Health and Sustainability, University of Leicester, Leicester, LE1 7RH, UK; NIHR Health Protection Research Unit (HPRU) in Environmental Exposures and Health at the University of Leicester, Leicester, LE1 7RH, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK; Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK; Leicester Diabetes Centre, University Hospitals of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK; NIHR Applied Research Collaboration - East Midlands (ARC-EM), Leicester General Hospital, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, LE5 4PW, UK; National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, LE5 4PW, UK
| |
Collapse
|
18
|
Barreiro A, Wolter-Warmerdam K, Friedman S, Hickey F, Johnson S, Marmolejo J. Child feeding practices in children with Down syndrome in relationship to ethnicity and BMI. Appetite 2022; 170:105888. [PMID: 34953969 DOI: 10.1016/j.appet.2021.105888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 12/03/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022]
Abstract
Children with Down syndrome (DS) exhibit higher overweight and obesity rates than their typically developing peers, although it is unknown whether parent feeding practices for children with DS are associated with child weight status or parental and demographic factors, especially in the Hispanic and Latino populations. A prospective study of 68 children with DS from 2 to 7 years of age, who received care at a single, large, pediatric academic hospital was conducted to evaluate parent child feeding practices. Parents completed the Child Feeding Questionnaire+ (CFQ+) assessing seven primary factors of feeding practices and comparisons to children without DS were conducted. Data for body mass index (BMI) and BMI-for-sex/age z score (BMIz scores) were collected in clinic at the time of CFQ+ completion for both parent and child. Parents of children with DS endorsed higher perceived responsibility but lower concern about child weight and restriction compared to previously reported feeding practices in typically developing children. Hispanic/Latino parents of children with DS reported higher perceived responsibility and monitoring than non-Hispanic/Latino parents of children with DS. Higher BMIz scores in children with DS correlated with greater perceived child weight (p = 0.001) and concern about child weight (p = 0.008). Differences in BMIz scores were observed when comparing sex/ethnicity groups as determined by one-way ANOVA (F(3,64) = 4.170, p = 0.009); with Hispanic/Latino boys with DS more likely to have obesity. Our results suggest a need for specific DS Guidelines to educate providers and parents of children with DS on recommended feeding practices prior to parental concern about their child's weight, especially in the Hispanic/Latino population.
Collapse
Affiliation(s)
- Alessandra Barreiro
- Department of Pediatrics, Section of Developmental Pediatrics, University of Colorado School of Medicine, USA
| | | | - Sandra Friedman
- Department of Pediatrics, Section of Developmental Pediatrics, University of Colorado School of Medicine, USA
| | - Francis Hickey
- Department of Pediatrics, Section of Developmental Pediatrics, University of Colorado School of Medicine, USA
| | - Susan Johnson
- Department of Pediatrics, Section of Nutrition, University of Colorado School of Medicine, USA
| | - Juana Marmolejo
- Department of Exercise Physiology, University of Northern Colorado, Greeley, CO, USA
| |
Collapse
|
19
|
Trief PM, Kalichman SC, Wang D, Drews KL, Anderson BJ, Bulger JD, Weinstock RS. Medication adherence in young adults with youth-onset type 2 diabetes: iCount, an observational study. Diabetes Res Clin Pract 2022; 184:109216. [PMID: 35085644 DOI: 10.1016/j.diabres.2022.109216] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 01/10/2022] [Accepted: 01/21/2022] [Indexed: 11/21/2022]
Abstract
AIMS To assess prevalence of, and factors associated with, medication adherence of young adults with youth-onset type 2 diabetes. METHODS Oral hypoglycaemia agent (OHA) adherence was measured with unannounced telephone pill counts, insulin adherence was self-reported. Those taking ≥ 80% of pills/insulin were classified "high-adherent," <80% of pills/insulin "low-adherent." Analyses included unadjusted, and adjusted linear and logistic regressions assessing associations of participant factors with adherence. RESULTS For people taking OHAs (N = 212, mean age 26 yrs, 67% women, 18% non-Hispanic White, 35% non-Hispanic Black, 41% Hispanic), 69.8% were low-adherent. HbA1c was lower in the high-adherent group (9.2%/77 mmol/mol vs. 10.0%/86 mmol/mol, p < 0.04). More non-Hispanic Blacks were low-adherent (85.7%) than Hispanics (60.2%) and non-Hispanic whites (55.3%, p < 0.002); 91.4% of participants without healthcare coverage were low-adherent vs. 65.5% of those with coverage (p < 0.004). After adjustment, gender (p = 0.024), race/ethnicity (p < 0.001) and healthcare coverage (p = 0.001) remained related to OHA adherence. For insulin (N = 192), 37% were low-adherent. HbA1c was associated with insulin adherence (low = 11.2%/99 mmol/mol vs. high = 10.0%/86 mmol/mol, p < 0.001) with and without adjustment. CONCLUSIONS Young adults with youth-onset type 2 diabetes, especially females, non-Hispanic Blacks and those without healthcare coverage, commonly had low-OHA adherence. Glycaemic control was also poor. Interventions to improve medication adherence are needed for this vulnerable group.
Collapse
Affiliation(s)
- Paula M Trief
- State University of New York (SUNY) Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210, USA.
| | - Seth C Kalichman
- University of Connecticut, 2006 Hillside Road, Storrs, CT 06269-1020, USA.
| | - Dongliang Wang
- State University of New York (SUNY) Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210, USA.
| | - Kimberly L Drews
- George Washington University, 6110 Executive Blvd., Rockville, MD 20852, USA.
| | | | - Jane D Bulger
- State University of New York (SUNY) Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210, USA.
| | - Ruth S Weinstock
- State University of New York (SUNY) Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210, USA.
| |
Collapse
|
20
|
Chew NWS, Phua K, Ngiam JN, Cheong C, Kong G, Ng JLM, Sia CH, Loh PH, Lee CH, Wong RCC, Poh KK, Yeo TC, Kong WKF. Inter- Ethnic Differences in Valvular Dysfunction, Aortopathy, and Progression of Disease of an Asian Bicuspid Aortic Valve Population. Heart Lung Circ 2021; 31:469-479. [PMID: 34844903 DOI: 10.1016/j.hlc.2021.10.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 10/02/2021] [Accepted: 10/30/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND There are differences in bicuspid aortic valve (BAV) characteristics between Asian and European populations, but little is known about the inter-ethnic differences in bicuspid valve function and aortic root dimensions within the diverse Asian population. METHODS From 1992-2017, 562 patients with index echocardiographic diagnosis of BAV in a tertiary health care institution in Singapore were analysed according to their ethnic groups: Chinese, Malay, Indian, and Eurasian. Study outcomes included BAV complications (infective endocarditis, aortic dissection) and clinical outcomes (aortic valve surgery, aortic root surgery, all-cause mortality). Total events were defined as composite outcome of all BAV complications and outcomes. Aortic dimensions and aortic dilatation rates were also studied. RESULTS There were 379 (67.5%) Chinese, 79 (14.0%) Malay, 73 (13.0%) Indian, and 31 (5.5%) Eurasian patients. Type 1 BAV (58.5%) was the most prevalent BAV morphology, with moderate-to-severe aortic stenosis (AS) (36.8%) being the most common complication in the overall population. There was a higher prevalence of type 0 BAV in Chinese and Indian groups, and type 1 BAV with fusion of left-right coronary cusp in Eurasian and Malay groups (p=0.082). There was no difference in significant AS among groups. The highest prevalence of moderate-to-severe aortic regurgitation was observed amongst the Eurasian group, followed by Chinese, Indian, and Malay groups (p=0.033). The Chinese group had the largest mean indexed diameters of the aortic root. Multivariable linear regression demonstrated that only the Chinese had significantly larger indexed diameters in the aortic annulus, sinotubular junction (STJ), and ascending aorta (AA), relative to the Eurasian group, after adjusting for age, sex, smoking, hypertension, hyperlipidaemia, diabetes, and aortic regurgitation. On follow-up echocardiography, there was a trend towards the highest dilatation rates of sinus of Valsalva and STJ amongst Indian, and AA amongst Malay groups. Kaplan-Meier curves showed the highest incidence of total events amongst Chinese, followed by Malay, Indian and Eurasian (log-rank=9.691; p=0.021) patients. CONCLUSION There were differences in BAV morphology, valve dysfunction, aortopathy, and prognosis within the Asian population. Chinese patients had one of the highest prevalence of significant aortic regurgitation, with the largest aortic dimensions and worst outcomes compared with other Asian ethnicities. Closer surveillance is warranted in BAV patients within the Asian population.
Collapse
Affiliation(s)
- Nicholas W S Chew
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore. https://twitter.com/elisabettasabet
| | - Kailun Phua
- Department of Medicine, National University Health System, Singapore
| | | | - Clare Cheong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Gwyneth Kong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Julia L M Ng
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Poay-Huan Loh
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chi-Hang Lee
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Raymond C C Wong
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kian-Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Tiong-Cheng Yeo
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - William K F Kong
- Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| |
Collapse
|
21
|
Bains S, Gutman LM. Mental Health in Ethnic Minority Populations in the UK: Developmental Trajectories from Early Childhood to Mid Adolescence. J Youth Adolesc 2021; 50:2151-2165. [PMID: 34436736 PMCID: PMC8505297 DOI: 10.1007/s10964-021-01481-5#sec18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/12/2021] [Indexed: 11/25/2023]
Abstract
A large body of literature has demonstrated that there are developmental differences in mental health problems. However, less is known about the development of mental health problems in ethnic minority children, particularly at the population level. Using a detailed ethnic classification and nationally representative data from the UK Millennium Cohort Study (n = 18, 521, 49% female, 18% ethnic minority), this study examines ethnic differences in children's mental health problems and trajectories of mental health from ages 3 to 14 years. Growth curve modeling revealed that ethnic minority children followed different developmental trajectories of internalizing and externalizing problems than white children, either in terms of the mean-level and/or rate of change across age. These differences were not explained by child sex, socioeconomic status, maternal depressive symptoms, and maternal immigrant status, highlighting the need for further research exploring the factors that underpin ethnic inequalities in child mental health.
Collapse
Affiliation(s)
- Simran Bains
- University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | | |
Collapse
|
22
|
Buunk AP, Van Brummen-Girigori OJ, Leckie GL. Ethnic Culture as Related to Sexual and Reproductive Behavior in the Republic of Suriname: The Pervasiveness of Culture. Arch Sex Behav 2021; 50:3695-3702. [PMID: 34427844 PMCID: PMC8604846 DOI: 10.1007/s10508-021-02013-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 08/27/2020] [Accepted: 04/15/2021] [Indexed: 06/13/2023]
Abstract
We examined the effects of culture and ethnicity on life history strategies in terms of sexual and reproductive behaviors. The sample included 500 adults, aged 25-50 years, from the five major ethnic groups in Suriname, i.e., the Maroons, Creoles, Hindustani, Javanese, and Mixed. First, there were strong gender differences: men reported to have had more sex partners and to have had their first sexual experience earlier than women, whereas women had their first child earlier and had more children than men. Second, in general, ethnicity affected life history substantially. The Maroons stood out by a relatively fast life history: they reported to have had more sexual partners, to have had their first sex and first child at an earlier age, and to have more children than all other groups. The Creoles were in general similar to the Maroons, whereas the Hindustani and the Javanese were characterized by a relatively slow life history: they reported to have had the lowest number of sexual partners, to have had their first sex and first child at the latest age, and to have had the lowest number of children. The differences between the ethnic groups were upheld when controlling for income, educational level, and father absence during childhood. A lower education was associated with reporting to have had one's first sex as well as one's first child at a younger age and children who grew up without a father reported to have had their first sex at a younger age.
Collapse
Affiliation(s)
- Abraham P Buunk
- Department of Psychology, University of Groningen, Grote Kruisstraat 2/1, 9712 TS, Groningen, The Netherlands.
- Netherlands Interdisciplinary Demographic Institute, The Hague, The Netherlands.
| | | | - Glenn L Leckie
- Department of Psychology, Anton de Kom University, Paramaribo, Suriname
| |
Collapse
|
23
|
Bains S, Gutman LM. Mental Health in Ethnic Minority Populations in the UK: Developmental Trajectories from Early Childhood to Mid Adolescence. J Youth Adolesc 2021; 50:2151-65. [PMID: 34436736 DOI: 10.1007/s10964-021-01481-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/12/2021] [Indexed: 11/25/2022]
Abstract
A large body of literature has demonstrated that there are developmental differences in mental health problems. However, less is known about the development of mental health problems in ethnic minority children, particularly at the population level. Using a detailed ethnic classification and nationally representative data from the UK Millennium Cohort Study (n = 18, 521, 49% female, 18% ethnic minority), this study examines ethnic differences in children’s mental health problems and trajectories of mental health from ages 3 to 14 years. Growth curve modeling revealed that ethnic minority children followed different developmental trajectories of internalizing and externalizing problems than white children, either in terms of the mean-level and/or rate of change across age. These differences were not explained by child sex, socioeconomic status, maternal depressive symptoms, and maternal immigrant status, highlighting the need for further research exploring the factors that underpin ethnic inequalities in child mental health.
Collapse
|
24
|
Shadlow JO, Kell PA, Toledo TA, Huber FA, Kuhn BL, Lannon EW, Hellman N, Sturycz CA, Ross EN, Rhudy JL. Sleep Buffers the Effect of Discrimination on Cardiometabolic Allostatic Load in Native Americans: Results from the Oklahoma Study of Native American Pain Risk. J Racial Ethn Health Disparities 2021; 9:1632-1647. [PMID: 34319571 DOI: 10.1007/s40615-021-01103-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/18/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Compared to other racial/ethnic groups, Native Americans (NAs) are more likely to develop health conditions associated with allostatic load (stress-related wear-and-tear). Psychosocial factors (i.e., adverse life events, discrimination, psychological distress) often promote stress and may help explain greater allostatic load in NAs. Moreover, previous research suggests sleep may either mediate or moderate the effects of some psychosocial stressors, like discrimination, on allostatic load. The current study investigated the relationship between adverse life events, discrimination, psychological stress, sleep, and cardiometabolic load. METHODS Using a sample of 302 healthy, chronic pain-free NAs and non-Hispanic White (NHW) participants, bootstrapped mediation analyses were conducted to determine whether the relationship between NA race/ethnicity and cardiometabolic allostatic load (composite score of body mass index, mean arterial pressure, and heart rate variability) was mediated by psychosocial stressors. Models also assessed whether sleep disturbance served as an additional mediator or a moderator to the effects. RESULTS Consistent with prior research, we found that NAs experienced greater discrimination, adverse life events (potentially traumatic events), and cardiometabolic allostatic load than NHWs. Further, discrimination was associated with increased psychological stress for NAs, but this did not explain why NAs experience higher cardiometabolic allostatic load. A moderating effect of sleep on discrimination was found, such that discrimination partially contributed to the relationship between NA race/ethnicity and cardiometabolic allostatic load, but only for participants reporting greater sleep disturbance. Implications These findings highlight that good sleep can buffer the effect of psychosocial stress on cardiometabolic allostatic load in Native Americans.
Collapse
Affiliation(s)
- Joanna O Shadlow
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA.
| | - Parker A Kell
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Tyler A Toledo
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Felicitas A Huber
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Bethany L Kuhn
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Edward W Lannon
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Natalie Hellman
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Cassandra A Sturycz
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Erin N Ross
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| | - Jamie L Rhudy
- Department of Psychology, The University of Tulsa, 800 South Tucker Drive, Tulsa, OK, 74104, USA
| |
Collapse
|
25
|
Bhat AK, Jindal R, Acharya AM. The influence of ethnic differences based on upper limb anthropometry on grip and pinch strength. J Clin Orthop Trauma 2021; 21:101504. [PMID: 34367910 PMCID: PMC8321953 DOI: 10.1016/j.jcot.2021.101504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/27/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Ethnic differences in upper limb anthropometry have significant variations which can influence surgical outcomes and rehabilitation. We hypothesize that there would be a significant difference in the anthropometry based on ethnicity and gender which will reflect on objective measurements. METHODS We performed 13 anthropometric measurements of the upper limb, grip and three types of pinch strength in 210 volunteers across seven ethnicities in young adults at our university campus. We compared them statistically based on ethnic and gender differences. RESULTS There was a significant correlation noted between grip, palmar and tip to tip pinch strength in 12 of the 13 anthropometric measurements. Key pinch correlated with eight parameters. Mean grip and pinch strength are noted to be more in males and from developed nations across all ethnicities. CONCLUSIONS This study shows that there is significant variation between the anthropometric measurements based on gender and ethnicity which correlates with differences in grip and pinch strength.
Collapse
|
26
|
Turner EA, Plitt C, Gamez Y, Godfrey C. Therapy Fears and Help-Seeking Behaviors among Mothers: Examining Racial Differences in Mental Health Services. Community Ment Health J 2021; 57:808-813. [PMID: 32951113 DOI: 10.1007/s10597-020-00711-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 09/12/2020] [Indexed: 11/24/2022]
Abstract
In the United States, approximately 20% of children and adolescents meet diagnostic criteria for a mental health diagnosis, but few receive treatment. The purpose of the current study was to explore the factors that contribute to help-seeking among mothers from diverse ethnic groups (52.5% European American/White, 23% African American/Black, and 24.6% Latinx). Participants were 122 mothers recruited from 2014 to 2017 through a convenience sample in Central Texas. Using MANOVA, results indicated that mother with no history of therapy use reported more fears about seeking therapy for children. Additionally, there was a trend towards African American mothers reporting more fears about therapists' responsiveness and image concerns. Finally, therapy fears significantly predicted mother's intentions to delay seeking therapy in the future. Implications for research and practice are discussed.
Collapse
Affiliation(s)
- Erlanger A Turner
- Graduate School of Education and Psychology, Pepperdine University, 6100 Center Drive, 5th Floor, Los Angeles, CA, 90045, USA.
| | - Corina Plitt
- University of Houston-Downtown, Houston, Texas, USA
| | - Yadira Gamez
- University of Houston-Downtown, Houston, Texas, USA
| | | |
Collapse
|
27
|
Poelman MP, Nicolaou M, Dijkstra SC, Mackenbach JD, Lu M, Karssenberg D, Snijder MB, Vaartjes I, Stronks K. Does the neighbourhood food environment contribute to ethnic differences in diet quality? Results from the HELIUS study in Amsterdam, the Netherlands. Public Health Nutr 2021;:1-12. [PMID: 33947481 DOI: 10.1017/S1368980021001919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of the current study was to establish whether the neighbourhood food environment, characterised by the healthiness of food outlets, the diversity of food outlets and fast-food outlet density within a 500 m or 1000 m street network buffer around the home address, contributed to ethnic differences in diet quality. DESIGN Cross-sectional cohort study. SETTING Amsterdam, the Netherlands. PARTICIPANTS Data on adult participants of Dutch, South-Asian Surinamese, African Surinamese, Turkish and Moroccan descent (n total 4728) in the HELIUS study were analysed. RESULTS The neighbourhood food environment of ethnic minority groups living in Amsterdam is less supportive of a healthy diet and of less diversity than that of participants of Dutch origin. For example, participants of Turkish, Moroccan and South-Asian Surinamese descent reside in a neighbourhood with a significantly higher fast-food outlet density (≤1000 m) than participants of Dutch descent. However, we found no evidence that neighbourhood food environment characteristics directly contributed to ethnic differences in diet quality. CONCLUSION Although ethnic minority groups lived in less healthy food environments than participants of ethnic Dutch origin, this did not contribute to ethnic differences in diet quality. Future research should investigate other direct or indirect consequences of residing in less supportive food environments and gain a better understanding of how different ethnic groups make use of their neighbourhood food environment.
Collapse
|
28
|
Divia Aricatt P, Ashraf SM, Subramanyam K, Avadhani R, Ezhilan J, Subba SH, Ajith Mullasari S, Narasimhan C. Pitfalls in comparison of coronary artery measurements of Indian population with different geographical area studies. Indian Heart J 2021; 73:347-352. [PMID: 34154754 PMCID: PMC8322926 DOI: 10.1016/j.ihj.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/23/2021] [Accepted: 04/08/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Coronary artery disease (CAD) is the most common cause of morbidity and mortality especially in the developing countries. Coronary artery measurements (CAM) are the most important factor affecting the procedure and outcome of coronary angioplasty (PCI) as well as coronary by-pass operations (CABG). In this study, we aimed to establish a database for the normal CAM as well as for gender difference among the Indian population using quantitative coronary angiography (QCA) with an objective of assessing normal coronary vessel morphology of patients with normal coronaries. Materials and methods Four thousand angiograms from patients of Indian origin were studied prospectively after procuring the sanction for the same from the ethical committee of the pre-selected hospitals of four states in India. Informed consents were obtained. Post CABG, post PCI patients and patient being diabetic for ≥5 years were also excluded from the study. Results Ten segments from right and left coronary arteries were taken for diameter measurements. These coronary diameters were indexed to body surface area (BSA) (mean diameter mm/m2 BSA). Among, 4000 patients, 933(23.3%) [M:F-521:412] had normal coronaries and 3067 (76.7%) were diseased. Discussion and conclusion The dimensions of the coronary artery segments of Indians were smaller (in BSA indexed and non-indexed data), compared to studies from other continents which can be due to their smaller BSA.
Collapse
Affiliation(s)
- Paul Divia Aricatt
- Department of Anatomy, Yenepoya Medical College, Yenepoya (Deemed to be) University, Deralakatte, Mangalore, 575018, Karnataka, India.
| | - S M Ashraf
- Department of Cardio Vascular Sciences, Sahakarana Hrudayalaya, Government Medical College, Pariyaram, Kannur, Kerala, 670503, India.
| | - K Subramanyam
- Department of Interventional Cardiology, K.S Hegde Medical Academy and Hospital, Deralakatte, Mangalore, 575018, Karnataka, India.
| | - Ramakrishna Avadhani
- Department of Anatomy, Yenepoya Medical College, Yenepoya (Deemed to be) University, Deralakatte, Mangalore, 575018, Karnataka, India.
| | - J Ezhilan
- Department of Cardiology, Madras Medical Mission, Chennai, Tamilnadu, 670503, India.
| | - Sonu H Subba
- Department of Community Medicine & Family Medicine, AIIMS, Bhubaneswar, Odhisa, 751019, India.
| | - S Ajith Mullasari
- Department of Cardiology, Madras Medical Mission, Chennai, Tamilnadu, 670503, India.
| | - C Narasimhan
- Department of Cardiology Care Hospital, Banjara Hills, Hyderabad, 500034, India.
| |
Collapse
|
29
|
Cheong WF, Ji S, Cazenave-Gassiot A, Thu WPP, Logan S, Cauley J, Kramer MS, Yong EL. Predictors of circulating vitamin D levels in healthy mid-life Singaporean women. Arch Osteoporos 2021; 16:26. [PMID: 33559771 DOI: 10.1007/s11657-021-00880-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/04/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Vitamin D levels were lowest in Indian and Malay compared to Chinese women, and in younger and employed women. The main reason for hypovitaminosis D in study women was deficient cutaneous production. Supplementation in regions with abundant sunshine should consider ethnicity and opportunities for exposure to sunlight. INTRODUCTION Little is known about variations in circulating vitamin D levels in multiethnic mid-life women living in communities with year-round sunlight. Our study describes the circulating vitamin D levels and their sociodemographic predictors in mid-life Singaporean women. METHODS Prospective cross-sectional study of healthy Singaporean women, age 45-69 years, who were not consuming vitamin D supplements. Total 25-hydroxyvitaminD [25(OH)D], the sum of 25(OH)D2 and 25(OH)D3, was measured by liquid chromatography-tandem mass spectrometry. RESULTS The analytic cohort of 721 women, mean age 55.2±6.0 (±SD) years, was of Chinese (82%), Indian (11%), and Malay (7%) ethnicity. Their mean 25(OH)D level was 24.8±7.8ng/mL. One-third (32.6%) of the women had deficient 25(OH)D (≤20ng/mL) and 3.5% were severely deficient (<12ng/mL). 25(OH)D3 comprised 98% of the total circulating 25(OH)D level. Adjusted mean total 25(OH)D levels were significantly lower for women of Indian and Malay (vs Chinese) ethnicity, who were premenopausal or working outside the home. Indian and Malay women had higher odds (adjusted OR 5.58 (95% CI 3.22, 9.87) and 3.83 (95% CI 1.97, 7.57), respectively) of low 25(OH)D compared to Chinese women. Obesity was not an independent predictor of low 25(OH)D, as its strong crude association was confounded by ethnicity. The adjusted odds of low 25(OH)D was reduced in women ≥65 years (adjusted OR 0.37 (95% CI 0.14, 0.87)) compared to those aged 45-55 years. CONCLUSION One-third of mid-life Singaporean women were 25(OH)D deficient, and the major independent predictors of deficiency were Indian or Malay ethnicity and younger age. Vitamin D supplementation in mid-life women should be targeted to those with documented deficiency or limited cutaneous production.
Collapse
Affiliation(s)
- Wei Fun Cheong
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 12, Singapore, 119228, Republic of Singapore
| | - Shanshan Ji
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore, 117456, Republic of Singapore
| | - Amaury Cazenave-Gassiot
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore, 117456, Republic of Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117596, Republic of Singapore
| | - Win Pa Pa Thu
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 12, Singapore, 119228, Republic of Singapore
| | - Susan Logan
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 12, Singapore, 119228, Republic of Singapore
| | - Jane Cauley
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA
| | - Michael S Kramer
- Departments of Epidemiology, Biostatistics & Occupational Health and of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, H3G 1Y6, Canada
| | - Eu-Leong Yong
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 12, Singapore, 119228, Republic of Singapore.
| |
Collapse
|
30
|
Holdaway M, Wiles J, Kerse N, Wu Z, Moyes S, Connolly MJ, Menzies O, Teh R, Muru-Lanning M, Gott M, Broad JB. Predictive factors for entry to long-term residential care in octogenarian Māori and non-Māori in New Zealand, LiLACS NZ cohort. BMC Public Health 2021; 21:34. [PMID: 33407278 PMCID: PMC7788817 DOI: 10.1186/s12889-020-09786-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-term residential care (LTC) supports the most vulnerable and is increasingly relevant with demographic ageing. This study aims to describe entry to LTC and identify predictive factors for older Māori (indigenous people of New Zealand) and non-Māori. METHODS LiLACS-NZ cohort project recruited Māori and non-Māori octogenarians resident in a defined geographical area in 2010. This study used multivariable log-binomial regressions to assess factors associated with subsequent entry to LTC including: self-identified ethnicity, demographic characteristics, self-rated health, depressive symptoms and activities of daily living [ADL] as recorded at baseline. LTC entry was identified from: place of residence at LiLACS-NZ interviews, LTC subsidy, needs assessment conducted in LTC, hospital discharge to LTC, and place of death. RESULTS Of 937 surveyed at baseline (421 Māori, 516 non-Māori), 77 already in LTC were excluded, leaving 860 participants (mean age 82.6 +/- 2.71 years Māori, 84.6 +/- 0.52 years non-Māori). Over a mean follow-up of 4.9 years, 278 (41% of non-Māori, 22% of Māori) entered LTC; of the 582 who did not, 323 (55%) were still living and may yet enter LTC. In a model including both Māori and non-Māori, independent risks factors for LTC entry were: living alone (RR = 1.52, 95%CI:1.15-2.02), self-rated health poor/fair compared to very good/excellent (RR = 1.40, 95%CI:1.12-1.77), depressive symptoms (RR = 1.28, 95%CI:1.05-1.56) and more dependent ADLs (RR = 1.09, 95%CI:1.05-1.13). For non-Māori compared to Māori the RR was 1.77 (95%CI:1.39-2.23). In a Māori-only model, predictive factors were older age and living alone. For non-Māori, factors were dependence in more ADLs and poor/fair self-rated health. CONCLUSIONS Non-Māori participants (predominantly European) entered LTC at almost twice the rate of Māori. Factors differed between Māori and non-Māori. Potentially, the needs, preferences, expectations and/or values may differ correspondingly. Research with different cultural/ethnic groups is required to determine how these differences should inform service development.
Collapse
Affiliation(s)
- Marycarol Holdaway
- Department of Geriatric Medicine, University of Auckland, C/- Waitematā District Health Board, Takapuna, PO Box 93 503, Auckland, New Zealand
| | - Janine Wiles
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Ngaire Kerse
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Zhenqiang Wu
- Department of Geriatric Medicine, University of Auckland, C/- Waitematā District Health Board, Takapuna, PO Box 93 503, Auckland, New Zealand
| | - Simon Moyes
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Martin J Connolly
- Department of Geriatric Medicine, University of Auckland, C/- Waitematā District Health Board, Takapuna, PO Box 93 503, Auckland, New Zealand.,Waitematā District Health Board, Auckland, New Zealand
| | | | - Ruth Teh
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Marama Muru-Lanning
- James Henare Māori Research Centre, University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Joanna B Broad
- Department of Geriatric Medicine, University of Auckland, C/- Waitematā District Health Board, Takapuna, PO Box 93 503, Auckland, New Zealand.
| |
Collapse
|
31
|
Mukherjee A, Halder SK, Nandi S, Mandal M, Khanra D, Biswas K. A study on normal reference values of echocardiographic chamber dimensions in young eastern Indian adults. Indian Heart J 2020; 73:77-84. [PMID: 33714414 PMCID: PMC7961241 DOI: 10.1016/j.ihj.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/21/2020] [Accepted: 12/17/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Various studies have shown racial differences in adult cardiac chamber measurements by echocardiography. There is lack of any large scale data from India regarding the echocardiographic chamber measurements in cardiologically healthy individuals. In this study we present the normal reference values of echocardiographic chamber dimensions in young eastern Indian adults and compare it with the data in present guidelines and recent studies involving Indian subjects. METHODS This study was performed on 1377 healthy adults aged 18-35 years. Standard transthoracic echocardiographies were performed to obtain basic measurements. All measurements were indexed to body surface area. RESULTS The mean maximal aortic valve cusp separation (ACS) and indexed ACS were significantly more in females (p = 0.002, p = 0.03). Mean left ventricular (LV) ejection fraction (LVEF) and LV fractional shortening were marginally higher in females. Upper normal reference limit of LV end diastolic dimension (LVEdD) is slightly more for males. Comparing to ASE data, LVEdD, LV end systolic dimension, LV end diastolic volume, indexed LV end systolic volume, left atrial anteroposterior dimension, aortic root dimension and right ventricle outflow diameter were significantly lower in study population while LVEF was significantly higher (p < 0.0001). CONCLUSION The study reconfirms that Indian subjects have smaller cardiac chamber measurements compared to western population where as LVEF is higher in the Indian population and also demonstrates the wide variation of normal echocardiographic measurements within Indian subcontinent. No previous data from eastern India makes this research a singular experience.
Collapse
Affiliation(s)
| | | | - Saumen Nandi
- Department of Chest Medicine, NRS Medical College, Kolkata, India.
| | | | - Dibbendhu Khanra
- Fellow of Electrophysiology and Devices, Royal Wolverhampton NHS Trust, UK.
| | - Kaushik Biswas
- Department of Cardiology, NRS Medical College, Kolkata, India.
| |
Collapse
|
32
|
Rassu FS, Luedke JC, Nanavaty N, Mathur VA, Meagher MW. Greater mechanical temporal summation of pain in Latinx-Americans and the role of adverse life experiences. Pain Rep 2020; 5:e842. [PMID: 33134748 DOI: 10.1097/PR9.0000000000000842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 11/26/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. Latinx-Americans showed greater temporal summation, adversity, and adversity correlates relative to non-Hispanic Whites. Discrimination and lifespan social status change inversely related to summation for Latinx-Americans. Introduction: Adverse life experiences disproportionately impact Latinx-Americans and are related to greater chronic pain rates. However, little is known about how adversities interact with central pain mechanisms for the development of later pain among Latinx-Americans. Objectives: The current study examined the relationship between adverse life experiences (eg, trauma and ethnic discrimination) and correlates (eg, social status) with mechanical temporal summation of pain (a proxy measure of central sensitization) between pain-free U.S. native Latinx (n = 65) and non-Hispanic White (NHW) (n = 51) adults. Methods: Participants completed self-report adverse life experience and correlational measures regarding childhood and adulthood and a mechanical temporal summation protocol. Results: Relative to NHWs, Latinx-Americans reported experiencing significantly greater trauma, discrimination, and lower social status during childhood and adulthood, along with greater temporal summation. Contrary to hypotheses, recent and lifetime experiences of ethnic discrimination significantly correlated with less temporal summation among Latinx-Americans. Decreases in objective and subjective social status across the lifespan (childhood to present day) correlated with greater temporal summation for Latinx-Americans. However, r-to-z transformation analyses confirmed that significant adversity and social status correlations observed among the Latinx group did not significantly differ from NHW participants. Conclusions: The present findings highlight the complex association between adverse experiences, adverse experience risk factors, and pain for Latinx-Americans. Given the disproportion of experienced pain and adversity among Latinx-Americans, the current findings suggest that a better understanding of the unique adversities for this sample may help elucidate the mechanisms underlying the relationship between adversities, adversity correlates, and pain risk for Latinx-Americans.
Collapse
|
33
|
Ing CT, Ahn HJ, Kawakami R, Grandinetti A, Seto TB, Kaholokula JK. Ethnic and Gender Differences in 10-Year Coronary Heart Disease Risk: a Cross-Sectional Study in Hawai'i. J Racial Ethn Health Disparities 2020; 8:943-952. [PMID: 32869210 PMCID: PMC8285323 DOI: 10.1007/s40615-020-00851-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/07/2020] [Accepted: 08/17/2020] [Indexed: 01/14/2023]
Abstract
Background Cardiovascular disease (CVD) is the leading cause of death in the US. In Hawai‘i, Filipinos and Native Hawaiians have the highest rates of CVD-related risk factors. CVD risk across these ethnic groups has not been examined. This cross-sectional study examines 10-year CVD risk as determined by the Framingham Risk Score (FRS) across ethnic groups in Hawai‘i, controlling for clinical, demographic, and psychosocial factors. Methods This study includes secondary data analysis of the Kohala Health Research Project dataset. All non-pregnant adults (≥ 18 years of age) who resided in the community of interest during the study period were eligible to participate with 1462 participants completing the clinical examination and surveys. This analysis included clinical, demographic, and psychosocial variables. Ethnic differences were examined using the chi-squared test and one-way ANOVA. Multiple linear regression on FRS was conducted and least square means of FRS were calculated. Results Data from 1146 individuals were analyzed. Participants were 44.4% Native Hawaiian, 15.4% Filipino, 15.3% Japanese, and 25% non-Hispanic White; 55.4% were female and had a mean age of 48.8 years. For males, the unadjusted Japanese mean FRS was significantly higher compared with the other ethnic groups. For females, Filipino and Japanese mean FRS were significantly higher compared with Native Hawaiians and non-Hispanic Whites. In the fully adjusted model, there were no ethnic group differences in FRS among males and Filipinos had significantly higher FRS compared with non-Hispanic White among females. Conclusions This cross-sectional community-based epidemiological study examined ethnic differences in CVD risk after adjusting for age, depression, social support, and acculturation. The results suggest that some ethnic differences in CVD risk persist even after controlling for confounders but that recalibration of risk assessment is necessary.
Collapse
Affiliation(s)
- Claire Townsend Ing
- Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI, USA.
| | - Hyeong Jun Ahn
- Department of Quantitative Health Sciences, University of Hawai'i, Honolulu, HI, USA
| | | | - Andrew Grandinetti
- Office of Public Health Studies, University of Hawai'i, Honolulu, HI, USA
| | - Todd B Seto
- Department of Medicine, University of Hawai'i and Queen's Medical Center, Honolulu, HI, USA
| | | |
Collapse
|
34
|
Barrington DS, James SA, Williams DR. Socioeconomic Correlates of Obesity in African-American and Caribbean-Black Men and Women. J Racial Ethn Health Disparities 2021; 8:422-32. [PMID: 32623661 DOI: 10.1007/s40615-020-00798-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/29/2020] [Accepted: 06/05/2020] [Indexed: 12/15/2022]
Abstract
The high prevalence of obesity among Black Americans warrants additional investigation into its relationship with socioeconomic position (SEP), sex, and ethnicity. This cross-sectional study utilizes 2001–2003 data from the National Survey of American Life, a nationally representative sample of 3570 African-Americans and 1621 Caribbean-Blacks aged 18 years and older. Multivariate logistic regression models stratified by ethnicity and sex describe the independent associations between obesity and multilevel socioeconomic factors after adjustment for age, other SEP measures at the individual, family and neighborhood levels, and health behaviors such as physical activity, alcohol intake, and smoking. A positive relationship was observed between obesity and family income among African-American and Caribbean-Black men. Receipt of public assistance was a strongly associated factor for obesity in Caribbean-Black men and women. Among African-American women, inverse relationships were observed between obesity and education, occupation, and family income; residence within a neighborhood with a supermarket also decreased their odds of obesity. Residence in a neighborhood with a park decreased the odds of obesity only among African-American men, whereas residence in a neighborhood with a supermarket decreased the odds of obesity among Caribbean-Black men. The social patterning of obesity by individual, household, and neighborhood socioeconomic resources differs for African-American and Caribbean-Black men and women within these cross-sectional analyses; an appreciation of these differences may be a prerequisite for developing effective weight control interventions and policies for these two populations.
Collapse
|
35
|
Al Ayoubi A, Khandan Dezfully A, Madléna M. Dentoskeletal and tooth-size differences between Syrian and Hungarian adolescents with Class II division 1 malocclusion: a retrospective study. BMC Res Notes 2020; 13:270. [PMID: 32493458 DOI: 10.1186/s13104-020-05115-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 05/26/2020] [Indexed: 11/10/2022] Open
Abstract
Objectives Malocclusion features differ across various populations and ethnicities. At this time, no data are available regarding the dentofacial differences between Syrian and European adolescents with Class II division 1 malocclusion, which is one of the most frequently treated pathologies in orthodontic practice. The present combined cephalometric and tooth-size study aimed to compare the dentoskeletal and tooth-size characteristics of Syrian and Hungarian adolescents with Class II division 1 malocclusion. Results Class II division 1 malocclusion in Hungarian adolescents was a sagittal discrepancy, while in Syrian adolescents, it was a result of excessive vertical development. Syrian adolescents had a significantly excessive vertical development when compared with Hungarian adolescents, regardless of sex (p < 0.01). Hungarian boys had significantly more protruded maxillae (p < 0.001) and less retruded mandibles (p < 0.01) when compared with Syrian boys, while Hungarian girls had significantly shorter mandibles relative to those of Syrian girls (p < 0.01). Syrian girls had significantly more protrusive lower incisors (p < 0.001), accompanied by significantly larger anterior tooth-size ratios when compared to Hungarian girls (p < 0.001). In conclusion, these findings underscore the importance of considering ethnic differences during orthodontic diagnosis and may have implications for optimizing orthodontic treatments in Syrian and Hungarian adolescents with Class II division 1 malocclusion.
Collapse
|
36
|
Flores Sanchez P, Muilwijk M, Nicolaou M, Snijder MB, Peters R, van Valkengoed I. Serum carotenoid concentrations and their association with ethnic differences in type 2 diabetes within the Healthy Life in an Urban Setting (HELIUS) study. Public Health Nutr 2021; 24:1362-71. [PMID: 32366346 DOI: 10.1017/S1368980019004968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Studies have reported an inverse association between a diet rich in fruits and vegetables and type 2 diabetes (T2D), but data on high-risk ethnic minority groups is limited. We investigated whether serum carotenoids, as biomarkers for fruit and vegetable intake, mediate ethnic differences in the prevalence of T2D. DESIGN Age-adjusted serum carotenoid concentrations were compared using ANCOVA. A cross-sectional analysis was performed using Cox regression to estimate prevalence ratios (PR) and their 95 % CI of the association between serum carotenoid concentrations and T2D. To study whether serum carotenoids potentially mediate the differences in the prevalence of T2D across ethnic groups, we compared PR of the model including known risk factors and the model additionally adjusted for serum carotenoid concentrations using the Dutch group as reference. SETTING A study among six ethnic groups living in Amsterdam, the Netherlands. PARTICIPANTS Data on 204 Dutch, 203 South Asian Surinamese, 204 African Surinamese, 203 Turkish and 200 Moroccan-origin participants from the Healthy Life in an Urban Setting (HELIUS) study were used. RESULTS Serum carotenoid concentrations differed across ethnic groups. After adjusting for confounders, the serum concentrations of total carotenoids (PR 0·67, 95 % CI 0·54, 0·84), α-carotene (PR 0·57, 95 % CI 0·42, 0·77), β-carotene (PR 0·45, 95 % CI 0·32, 0·63) and β-cryptoxanthin (PR 0·73, 95 % CI 0·58, 0·92) were inversely associated with T2D. Despite the associations, serum carotenoids did not mediate the ethnic differences in the prevalence of T2D. CONCLUSIONS The limited contribution of serum carotenoids to ethnic differences in T2D suggests that a focus on increasing fruit and vegetable intake alone will not likely eliminate ethnic differences in T2D prevalence.
Collapse
|
37
|
Abstract
A caring and compassionate attitude toward the self (i.e., self-compassion) has been linked to various mental and physical health benefits. The Self-Compassion Scale (SCS) is widely used in psychology literature in order to assess global self-compassion. However, recent evidence suggests that the single factor model comprising positive and negative items of the SCS in fact measures two distinct constructs (i.e., self-criticism/self-coldness and self-compassion) with different psychological correlates. Given these recent findings, in addition to other research that highlights cultural differences in self-conceptualizations and self-evaluations, the present study examined potential ethnic differences in the relationships between self-criticism, self-compassion, and perceived health. Participants included 728 college students (141 Asian American, 449 European American, and 138 Hispanic/Latinx individuals) attending a university in the northeast United States. Results indicated that the relationship between self-criticism and self-compassion was significantly different across ethnicity. In addition, the relationships between these two constructs (i.e., self-criticism and self-compassion) and perceived health were moderated by ethnicity. Our findings suggest that focusing on global self-compassion scores (i.e., total SCS scores) may miss some of the important cultural or ethnic differences in the relationships between self-criticism, self-compassion, and perceived health.
Collapse
|
38
|
Hayek S, Derhy S, Smith ML, Towne SD, Zelber-Sagi S. Patient satisfaction with primary care physician performance in a multicultural population. Isr J Health Policy Res 2020; 9:13. [PMID: 32213194 PMCID: PMC7098152 DOI: 10.1186/s13584-020-00372-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 03/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A key component of the quality of health care is patient satisfaction, particularly in regard to Primary Care Physician (PCP), which represents the first contact with health care services. Patient satisfaction is associated with ethnic, regional and socio-demographic differences, due to differences in service quality, patient-doctor communication, and the patient's perceptions. The aim of this study was to evaluate patients' satisfaction related to primary care physicians' (PCP) performance and to explore potential differences by ethnicity in a multicultural population. METHODS A national cross-sectional telephone survey was conducted, among a random sample of the Israeli population aged ≥25 years. Satisfaction level from performance of PCP was assessed using a validated questionnaire (30 items; 6 different domains). RESULTS The final sample included (n = 827 Jews; n = 605 Arabs, mean age 54.7(±14.9). In the adjusted logistic regression models, Arabs reported lower general satisfaction related to PCPs' performance as compared to Jews (adjusted odds ratio (AOR), 0.63; (95% CI: 0.40-0.98). Arabs reported lower satisfaction related to PCPs' performance across the following domains: communication skills (AOR, 0.42; 95% CI, 0.22-0.82); interpersonal manners (AOR, 0.37; 95% CI, 0.24-0.58); and time spent with the patients (AOR, 0.60; 95% CI, 0.43-0.85). CONCLUSIONS Jews and Arabs were very satisfied with PCPs' performance. However, there are ethnic differences in the extent of satisfaction level related to the performance of PCP. Satisfaction from PCPs' performance may be achieved by improving the communication skills of the PCP, encouraging interpersonal interaction between the PCP and the patient, and devoting more time to the patient during the visits.
Collapse
Affiliation(s)
- Samah Hayek
- School of Public Health, University of Haifa, Haifa, Israel. .,, Memphis, USA.
| | - Shany Derhy
- School of Public Health, University of Haifa, Haifa, Israel
| | - Mathew Lee Smith
- Center for Population Health and Aging, Texas A&M University, College Station, TX, 77843, USA.,Department of Environmental and Occupational Health, School of Public Health, Texas A &M University, College Station, TX, 77843, USA.,Department of Health Promotion and Behavior, College of Public Health, The University of Georgia, Athens, GA, 30602, USA
| | - Samuel D Towne
- Center for Population Health and Aging, Texas A&M University, College Station, TX, 77843, USA.,Department of Health Management and Informatics, University of Central Florida, Orlando, FL, 32816, USA.,Disability, Aging and Technology Faculty Cluster Initiative, University of Central Florida, Orlando, FL, 32816, USA
| | | |
Collapse
|
39
|
Grgic O, Shevroja E, Dhamo B, Uitterlinden AG, Wolvius EB, Rivadeneira F, Medina-Gomez C. Skeletal maturation in relation to ethnic background in children of school age: The Generation R Study. Bone 2020; 132:115180. [PMID: 31786375 DOI: 10.1016/j.bone.2019.115180] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/13/2019] [Accepted: 11/27/2019] [Indexed: 12/11/2022]
Abstract
Ethnicity is a well-established determinant of pediatric maturity, but the underlying genetic and environmental contributions to these ethnic differences are poorly comprehended. We aimed to evaluate the influence of ethnicity on skeletal age (SA), an assessment of pediatric maturation widely used in clinical settings. We included children from the Generation R Study, a multiethnic population-based pregnancy cohort, assessed at a mean age of 9.78 (±0.33) years. SA was evaluated by a trained observer on hand DXA scans using the Greulich and Pyle method. Ethnic background was defined as geographic ancestry (questionnaire-based assessment) (N = 5325) and genetic ancestry (based on admixture analysis) (N = 3413). Associations between the ethnic background and SA were investigated separately in boys and girls, using linear regression models adjusted for age, height and BMI. Based on geographic ancestry, 84% of the children were classified as European, 6% as Asian and 10% as African. Children of European background had on average younger SA than those of Asian or African descent. Asian boys had 0.46 (95% CI 0.26-0.66, p-value < 0.0001) and African boys 0.36 years (95% CI 0.20-0.53, p-value < 0.0001) older SA as compared to European boys. Similarly, Asian girls showed 0.64 (95% CI 0.51-0.77, p-value < 0.0001) and African girls 0.38 years (95% CI 0.27-0.48, p-value < 0.0001) older SA as compared to European girls. A similar pattern was observed in the analysis with genetically-defined ancestry. Furthermore, an increase in the proportion of Asian or African component was associated with older SA in both boys (log[Non-European/European]proportion = 0.10, 95% CI 0.06-0.13, p-value < 0.0001) and girls (log[Non-European/European]proportion = 0.06, 95% CI 0.04-0.08, p-value < 0.0001). In summary, children of Asian and African backgrounds have on average older SA as compared to children of European descent, partially explained by a genetic component.
Collapse
Affiliation(s)
- Olja Grgic
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; The Generation R Study, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands
| | - Enisa Shevroja
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands
| | - Brunilda Dhamo
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; The Generation R Study, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands
| | - Andre G Uitterlinden
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; The Generation R Study, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands
| | - Eppo B Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; The Generation R Study, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; The Generation R Study, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands
| | - Carolina Medina-Gomez
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; The Generation R Study, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands; Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD, the Netherlands.
| |
Collapse
|
40
|
Seet V, Abdin E, Vaingankar JA, Shahwan S, Chang S, Lee B, Chong SA, Subramaniam M. The use of complementary and alternative medicine in a multi-ethnic Asian population: results from the 2016 Singapore Mental Health Study. BMC Complement Med Ther 2020; 20:52. [PMID: 32054477 PMCID: PMC7076843 DOI: 10.1186/s12906-020-2843-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 02/04/2020] [Indexed: 01/12/2023] Open
Abstract
Background This study seeks to investigate factors associated with using complementary and alternative medicine (CAM) for a mental illness among the three major ethnic groups (Chinese, Indians and Malays) in the general population of Singapore. Methods Data from the 2016 Singapore Mental Health Study was used; responses from the “Services” section of the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) administered during face-to-face household interviews with participants were analyzed to establish prevalence of CAM use among Singaporeans. Additionally, sociodemographic variables of interest were selected for sub-group regression analyses to yield correlates of CAM use among the three ethnic groups. Results 6.4% of Singaporeans used at least one form of CAM in the past 12 months for their mental illness. Malays reported using CAM the most, followed by Indians and Chinese. Sociodemographic variables such as education and employment were differently associated with CAM use among the ethnicities. Across all three ethnic groups, CAM users were more likely to report poorer mental health-related quality of life. Conclusion Despite the significant differences in CAM use among Chinese, Malays and Indians, those who had a mental illness were significantly more likely to use CAM regardless of ethnicity. This highlights the need for communication between CAM practitioners and conventional mental healthcare providers for early referral when appropriate which would lead to improved healthcare delivery and better clinical outcomes.
Collapse
Affiliation(s)
- Vanessa Seet
- Research Division, Institute of Mental Health, Singapore, Singapore.
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Sherilyn Chang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore
| |
Collapse
|
41
|
Rhudy JL, Huber F, Kuhn BL, Lannon EW, Palit S, Payne MF, Hellman N, Sturycz CA, Güereca YM, Toledo TA, Demuth MJ, Hahn BJ, Shadlow JO. Pain-related anxiety promotes pronociceptive processes in Native Americans: bootstrapped mediation analyses from the Oklahoma Study of Native American Pain Risk. Pain Rep 2020; 5:e808. [PMID: 32072102 PMCID: PMC7004502 DOI: 10.1097/pr9.0000000000000808] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 12/11/2019] [Accepted: 12/14/2019] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Evidence suggests Native Americans (NAs) experience higher rates of chronic pain than the general US population, but the mechanisms contributing to this disparity are poorly understood. Recently, we conducted a study of healthy, pain-free NAs (n = 155), and non-Hispanic whites (NHWs, n = 150) to address this issue and found little evidence that NAs and NHWs differ in pain processing (assessed from multiple quantitative sensory tests). However, NAs reported higher levels of pain-related anxiety during many of the tasks. OBJECTIVE The current study is a secondary analysis of those data to examine whether pain-related anxiety could promote pronociceptive processes in NAs to put them at chronic pain risk. METHODS Bootstrapped indirect effect tests were conducted to examine whether pain-related anxiety mediated the relationships between race (NHW vs NA) and measures of pain tolerance (electric, heat, ischemia, and cold pressor), temporal summation of pain and the nociceptive flexion reflex (NFR), and conditioned pain modulation of pain/NFR. RESULTS Pain-related anxiety mediated the relationships between NA race and pain tolerance and conditioned pain modulation of NFR. Exploratory analyses failed to show that race moderated relationships between pain-related anxiety and pain outcomes. CONCLUSION These findings imply that pain-related anxiety is not a unique mechanism of pain risk for NAs, but that the greater tendency to experience pain-related anxiety by NAs impairs their ability to engage descending inhibition of spinal nociception and decreases their pain tolerance (more so than NHWs). Thus, pain-related anxiety may promote pronociceptive processes in NAs to place them at risk for future chronic pain.
Collapse
Affiliation(s)
- Jamie L. Rhudy
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Felicitas Huber
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Bethany L. Kuhn
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Edward W. Lannon
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Shreela Palit
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
- Department of Community Dentistry & Behavioral Science, University of Florida, Pain Research and Intervention Center of Excellence, Gainesville, FL, USA
| | - Michael F. Payne
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Natalie Hellman
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | | | | | - Tyler A. Toledo
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Mara J. Demuth
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | - Burkhart J. Hahn
- Department of Psychology, The University of Tulsa, Tulsa, OK, USA
| | | |
Collapse
|
42
|
Wan CS, Teede H, Nankervis A, Aroni R. Ethnic Differences in Dietary Management of Gestational Diabetes Mellitus: A Mixed Methods Study Comparing Ethnic Chinese Immigrants and Australian Women. J Acad Nutr Diet 2019; 120:86-102. [PMID: 31718911 DOI: 10.1016/j.jand.2019.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/14/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dietary modification is the primary intervention strategy for management of gestational diabetes mellitus (GDM), which usually occurs in the third trimester of pregnancy when women have extra nutritional needs. There is a high migration rate of ethnic Chinese people to Western countries, and those women present a high-risk group for GDM. Little is known about diet, dietary self-management, and nutritional supplementation use among ethnic Chinese migrant women with GDM compared with members of the host population with GDM. OBJECTIVE This study aimed to compare the perceptions and experiences of dietary self-management and nutritional needs of ethnic Chinese migrants with those of Australian-born white women with GDM in Australia. DESIGN A predominantly qualitative mixed methods approach with a quantitative component was used. Data collection involved in-depth, semistructured interviews, and 3-day 24-hour recall diaries collected concurrently. Data analysis and management relied on NVivo (QSR International Pty Ltd), FoodWorks (FoodWorks Professional 2017, Xyris Software), and SPSS (SPSS Inc). Pearson χ2 test, independent-samples t test, and Mann-Whitney U test were used to compare nutrient intakes between groups. The Pearson correlation was used to determine the relationship between dietary patterns and nutrient intake. PARTICIPANTS A total of 44 ethnic Chinese and 39 Australian-born white participants with GDM were recruited from two large Australian maternity services located in tertiary hospitals. RESULTS Ethnic differences in satisfaction with GDM education influenced GDM self-management. Ethnic Chinese women with GDM perceived dietary advice received from health professionals to be lacking in cultural relevance and detail and responded by restricting their dietary intake and relying on nutritional supplementation. The perceived benefits of specific supplements produced ethnic differences in the patterns of supplement use. Cultural dietary patterns influenced dietary adequacy in pregnancy. CONCLUSIONS This study suggests the need for provision of more concrete, prescriptive, and culturally relevant dietary and supplementation advice for ethnic Chinese women with GDM.
Collapse
|
43
|
Eastwood SV, Chaturvedi N, Sattar N, Welsh PI, Hughes AD, Tillin T. Impact of Kidney Function on Cardiovascular Risk and Mortality: A Comparison of South Asian and European Cohorts. Am J Nephrol 2019; 50:425-433. [PMID: 31665726 DOI: 10.1159/000503873] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 09/30/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Evidence is limited on ethnic differences in associations between kidney function markers and mortality or cardiovascular disease (CVD). METHODS Baseline cross-sectional analysis and longitudinal follow-up study of a UK population-based cohort of 1,116 Europeans and 1,104 South Asians of predominantly Indian descent, age 52 ± 7 years at baseline (1988-1991). Kidney function was estimated using Cystatin C and creatinine-based chronic kidney disease (CKD) Epidemiology Collaboration estimated glomerular filtration rate (eGFR) equations, and urinary albumin-creatinine ratio (ACR). Mortality was captured at 27 years, and incident CVD at 22 years, from death certification, medical records and participant report. Longitudinal associations between eGFR/ACR and mortality/incident CVD were examined using Cox models. RESULTS eGFRcys was lower and ACR higher in South Asians than Europeans. eGFRcys and -eGFRcreat were more strongly associated with outcomes in Europeans than South Asians. Conversely, associations between ACR and outcomes were greater in South Asians than Europeans, for example, for CVD mortality: HRs (95% CI) adjusted for CVD risk factors and ACR/eGFRcys as appropriate, p for ethnicity interaction: eGFRcys: Europeans: 0.76 (0.62-0.92), South Asians: 0.92 (0.78-1.07), p = 0.05, eGFRcreat: Europeans 0.81 (0.67-0.99), South Asians 1.18 (0.97-1.41), p = 0.002, ACR: -Europeans: 1.24 (1.08-1.42), South Asians: 1.39 (1.25-1.57), p= 0.23. Addition of all CKD measures to a standard CVD risk factor model modestly improved prediction capability in -Europeans; in South Asians only ACR contributed to improvement. CONCLUSIONS Strong associations between ACR and outcomes in South Asians of predominantly Indian origin, and null associations for eGFRcys and eGFRcreat, suggest that ACR may have greater utility in CVD risk prediction in South Asians. Further work is needed to validate these -findings.
Collapse
Affiliation(s)
- Sophie V Eastwood
- Institute of Cardiovascular Science, University College London, London, United Kingdom,
| | - Nishi Chaturvedi
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Paul I Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Therese Tillin
- Institute of Cardiovascular Science, University College London, London, United Kingdom
| |
Collapse
|
44
|
Abstract
Behçet syndrome (BS) is a multi-systemic complex disorder with unknown etiology and a unique geographic distribution. It could not be possible to include it into specific classification schemes and it is certainly not a uniform disease. Several cluster and association studies revealed that it has been composed of multiple phenotypes ascribing the principal problem such as skin-mucosa, joint, eye, vascular, neurological and gastrointestinal involvement. Each phenotype has its own characteristic demographic and clinical features as such their management strategies and prognosis differ substantially. Actually, the concept of phenotyping has been well known for some time and is considered one of the basic elements of the still continuing debate whether to call this entity 'disease' or 'syndrome'. Further supporting evidence comes from the observation of the geographical differences of disease expression. In this setting, BS resembles rather a construction made of several dynamic and interactive LEGO pieces of different shapes and colors. These pieces presenting phenotypes with their own disease mechanism have presumably different genetic determinants. The analysis of phenotyping could help us to identify this disorder and hence could contribute to find better ways of treatment.
Collapse
Affiliation(s)
- Emire Seyahi
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, University of Istanbul, 81310, Istanbul, Turkey.
| |
Collapse
|
45
|
Prasertcharoensuk S, Wongkonkitsin N, Pavarangkul T, Ahooja A. High risk to have type 2 endoleak in Asian population. Asian J Surg 2019; 42:1019-1020. [PMID: 31362855 DOI: 10.1016/j.asjsur.2019.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 11/18/2022] Open
Affiliation(s)
| | | | - Tanut Pavarangkul
- Vascular Unit, Department of Surgery, Khon Kaen University, Khon Kaen, Thailand
| | - Anucha Ahooja
- Department of Radiology, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
46
|
Timasheva YR, Balkhiyarova ZR, Nasibullin TR, Avzaletdinova DS, Morugova TV, Mustafina OE, Prokopenko I. Multilocus associations of inflammatory genes with the risk of type 1 diabetes. Gene 2019; 707:1-8. [PMID: 31054364 DOI: 10.1016/j.gene.2019.04.085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/10/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Genome-wide association studies have captured a large proportion of genetic variation related to type 1 diabetes mellitus (T1D). However, most of these studies are performed in populations of European ancestry and therefore the disease risk estimations can be inaccurate when extrapolated to other world populations. METHODS We conducted a case-control study in 1866 individuals from the three major populations of the Republic of Bashkortostan (Russians, Tatars, and Bashkirs) in Russian Federation, using single-locus and multilocus approach to identify genetic predictors of T1D. RESULTS We found that LTA rs909253 and TNF rs1800629 polymorphisms were associated with T1D in the group of Tatars. Meta-analysis of the association study results in the three ethnic groups has confirmed the association between the T1D risk and LTA rs909253 genetic variant. LTA rs909253 and TNF rs1800629 loci were also featured in combinations most significantly associated with T1D. CONCLUSION Our findings suggest that LTA rs909253 and TNF rs1800629 polymorphisms are associated with the risk of T1D both independently and in combination with polymorphic markers in other inflammatory genes, and the analysis of multi-allelic combinations provides valuable insight in the study of polygenic traits.
Collapse
Affiliation(s)
- Yanina R Timasheva
- Institute of Biochemistry and Genetics of Ufa Federal Research Centre of Russian Academy of Sciences, 71 October Avenue, 450054 Ufa, Russian Federation; Section of Genomics of Common Disease, Department of Medicine, Imperial College London, Hammersmith Hospital Campus, Burlington Danes Building, Du Cane Road, London W12 0NN, United Kingdom; Bashkir State Medical University, 3 Lenin street, 450000 Ufa, Russian Federation.
| | - Zhanna R Balkhiyarova
- Section of Genomics of Common Disease, Department of Medicine, Imperial College London, Hammersmith Hospital Campus, Burlington Danes Building, Du Cane Road, London W12 0NN, United Kingdom; Bashkir State Medical University, 3 Lenin street, 450000 Ufa, Russian Federation
| | - Timur R Nasibullin
- Institute of Biochemistry and Genetics of Ufa Federal Research Centre of Russian Academy of Sciences, 71 October Avenue, 450054 Ufa, Russian Federation
| | | | - Tatiana V Morugova
- Bashkir State Medical University, 3 Lenin street, 450000 Ufa, Russian Federation
| | - Olga E Mustafina
- Institute of Biochemistry and Genetics of Ufa Federal Research Centre of Russian Academy of Sciences, 71 October Avenue, 450054 Ufa, Russian Federation
| | - Inga Prokopenko
- Section of Genomics of Common Disease, Department of Medicine, Imperial College London, Hammersmith Hospital Campus, Burlington Danes Building, Du Cane Road, London W12 0NN, United Kingdom
| |
Collapse
|
47
|
Thu WPP, Logan SJS, Cauley JA, Kramer MS, Yong EL. Ethnic differences in bone mineral density among midlife women in a multi-ethnic Southeast Asian cohort. Arch Osteoporos 2019; 14:80. [PMID: 31324992 DOI: 10.1007/s11657-019-0631-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/07/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED Chinese Singaporean middle-aged women have significantly lower femoral neck bone mineral density and higher lumbar spine bone mineral density than Malays and Indians, after adjustment for age, body mass index, and height. PURPOSE Information regarding mediators of differences in bone mineral density (BMD) among Asian ethnicities are limited. Since the majority of hip fractures are predicted to be from Asia, differences in BMD in Asian ethnicities require further exploration. We compared BMD among the Chinese, Malay, or Indian ethnicities in Singapore, aiming to identify potential mediators for the observed differences. METHODS BMD of 1201 women aged 45-69 years was measured by dual-energy X-ray absorptiometry. We examined the associations between ethnicity and BMD at both sites, before and after adjusting for potential mediators measured using standardized questionnaires and validated performance tests. RESULTS Chinese women had significantly lower femoral neck BMD than Malay and Indian women. Of the more than 20 variables examined, age, body mass index, and height accounted for almost all the observed ethnic differences in femoral neck BMD between Chinese and Malays. However, Indian women still retained 0.047 g/cm2 (95% CI, 0.024, 0.071) higher femoral neck BMD after adjustment, suggesting that additional factors may contribute to the increased BMD in Indians. Although no crude ethnic differences in lumbar spine BMD were observed, adjusted regression model unmasked ethnic differences, wherein Chinese women had 0.061(95% CI, - 0.095, 0.026) and 0.065 (95% CI, - 0.091, 0.038) g/cm2 higher lumbar spine BMD compared to Malay and Indian women, respectively. CONCLUSION BMD in middle-aged Asian women differ by ethnicity and site. Particular attention should be paid to underweight women of Chinese ethnic origin, who may be at highest risk of osteoporosis at the femoral neck and hence hip fractures.
Collapse
|
48
|
McKenzie N, Killaspy H, Jakobowitz S, Faranak H, Bebbington P. Assessing needs for psychiatric treatment in prisoners: 3. Comparison of care received by black and minority ethnic prisoners and by white prisoners. Soc Psychiatry Psychiatr Epidemiol 2019; 54:883-886. [PMID: 30989256 DOI: 10.1007/s00127-019-01663-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/21/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate to what extent mental health treatment needs are met in white and black and minority ethnic (BME) prisoners. METHODS Treatment needs of a random sample of male (n = 197) and female (n = 171) prisoners were assessed with standardised instruments. Interventions provided were confirmed through face-to-face interviews and case note review. RESULTS BME prisoners comprised 44% of participants. Treatment for depression, personality disorder and alcohol abuse was more often needed by White than BME prisoners. Needs were more frequently met in White than BME prisoners (48.5% vs 38.2%; p < 0.05), largely due to the delivery of psychological treatments. CONCLUSIONS BME prisoners had fewer of their mental health needs met.
Collapse
Affiliation(s)
- Nigel McKenzie
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Helen Killaspy
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
| | - Sharon Jakobowitz
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Hamidi Faranak
- School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King's College London, Guy's Campus, London, SE1 1UL, UK
| | - Paul Bebbington
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| |
Collapse
|
49
|
Yong EL, Ganesan G, Kramer MS, Logan S, Lau TC, Cauley JA, Tan KB. Hip fractures in Singapore: ethnic differences and temporal trends in the new millennium. Osteoporos Int 2019; 30:879-886. [PMID: 30671610 DOI: 10.1007/s00198-019-04839-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 01/03/2019] [Indexed: 12/17/2022]
Abstract
UNLABELLED Despite an increase in absolute numbers, the age-standardized incidence of hip fractures in Singapore declined in the period 2000 to 2017. Among the three major ethnic groups, Chinese women had the highest fracture rates but were the only group to show a temporal decline. INTRODUCTION A study published in 2001 predicted a 30-50% increase in Singapore hip fracture incidence rates over the ensuing 30 years. To test that prediction, we examined the incidence of hip fracture in Singapore from 2000 to 2017. METHODS We carried out a population-based study of hip fractures among Singapore residents aged ≥ 50 years. National medical insurance claims data were used to identify admissions with a primary discharge diagnosis of hip fracture. Age-adjusted rates, based on the age distribution of the Singapore population of 2000, were analyzed separately by sex and ethnicity (Chinese, Malay, or Indian). RESULTS Over the 18-year study period, 36,082 first hip fractures were recorded. Total hip fracture admissions increased from 1487 to 2729 fractures/year in the years 2000 to 2017. Despite this absolute increase, age-adjusted fracture rates declined, with an average annual change of - 4.3 (95% CI - 5.0, - 3.5) and - 1.1 (95% CI - 1.7, - 0.5) fractures/100,000/year for women and men respectively. Chinese women had 1.4- and 1.9-fold higher age-adjusted rates than Malay and Indian women: 264 (95% CI 260, 267) versus 185 (95% CI 176, 193) and 141 (95% CI 132, 150) fractures/100,000/year, respectively. Despite their higher fracture rates, Chinese women were the only ethnic group exhibiting a decline, most evident in those ≥ 85 years, in age-adjusted fracture rate of - 5.3 (95% CI - 6.0, - 4.5) fractures/100,000/year. CONCLUSION Although the absolute number of fractures increased, steep drops in elderly Chinese women drove a reduction in overall age-adjusted hip fracture rates. Increases in the older population will lead to a rise in total number of hip fractures, requiring budgetary planning and new preventive strategies.
Collapse
Affiliation(s)
- E L Yong
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore, Singapore.
| | - G Ganesan
- Division of Policy, Research and Evaluation, Ministry of Health, Singapore, Singapore
| | - M S Kramer
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore, Singapore
- Departments of Epidemiology, Biostatistics & Occupational Health and of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, H3G 1Y6, Canada
| | - S Logan
- Department of Obstetrics and Gynecology, National University of Singapore, Singapore, Singapore
| | - T C Lau
- Department of Medicine, National University Hospital, National University of Singapore, Singapore, 119228, Singapore
| | - J A Cauley
- Graduate School of Public Health, Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - K B Tan
- Division of Policy, Research and Evaluation, Ministry of Health, Singapore, Singapore.
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| |
Collapse
|
50
|
Grgic O, Chung K, Shevroja E, Trajanoska K, Uitterlinden AG, Wolvius EB, Rivadeneira F, Medina-Gomez C. Fractures in school age children in relation to sex and ethnic background: The Generation R Study. Bone 2019; 121:227-231. [PMID: 30677542 DOI: 10.1016/j.bone.2019.01.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/07/2019] [Accepted: 01/16/2019] [Indexed: 11/30/2022]
Abstract
Fracture rate in childhood is increasing and its consequences may affect health and developmental processes and cause school absence and restricted activity days. There are scarce epidemiologic studies regarding fractures in children. The aim of this study was to evaluate if pediatric fractures show disparities across sexes and ethnic groups. This study was conducted based on data from 3632 participants of the Generation R Study. Prevalent fractures were assessed using a questionnaire at a mean age of 9.7 years. Child's ethnicity was determined based on country of birth of the parents using questionnaires (geographic ancestry) or admixture analysis (genetic ancestry). Associations between fracture occurrence and sex or ethnicity were evaluated using logistic regression models adjusted for age, weight, lean mass fraction, bone mineral density (BMD) and sex/ethnicity. Fracture was reported for 525 (14.5%) children. The great majority of these children were classified as European (N = 3164), followed by African (N = 283) and Asian (N = 185) based on geographic ancestry. Similarly, the highest proportion of Europeans was observed based on genetic ancestry. Prevalence of fractures was not different between boys and girls, even after adjustment for possible confounders (OR: 1.03, 95% CI 0.84-1.27, p-value = 0.8). However, odds of prevalent fractures were two times higher in European when compared to Asian children (OR: 2.01, 95% CI 1.17-3.45, p-value = 0.01), and 1.5 times higher when compared to African children (OR: 1.50, 95% CI 1.00-2.26, p-value = 0.05). Overall, in this study, European children showed a highest risk of prevalent fractures independently of factors such as body composition and BMD, while no difference in the prevalence of fractures between boys and girls was observed.
Collapse
Affiliation(s)
- Olja Grgic
- Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Internal Medicine, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Maxillo-Facial Surgery, Special Dental Care and Orthodontics, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, The Generation R Study, the Netherlands
| | - Kuan Chung
- Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, The Generation R Study, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Epidemiology, the Netherlands.
| | - Enisa Shevroja
- Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Internal Medicine, the Netherlands.
| | - Katerina Trajanoska
- Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Internal Medicine, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Epidemiology, the Netherlands.
| | - Andre G Uitterlinden
- Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Internal Medicine, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, The Generation R Study, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Epidemiology, the Netherlands.
| | - Eppo B Wolvius
- Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Maxillo-Facial Surgery, Special Dental Care and Orthodontics, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, The Generation R Study, the Netherlands.
| | - Fernando Rivadeneira
- Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Internal Medicine, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, The Generation R Study, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Epidemiology, the Netherlands.
| | - Carolina Medina-Gomez
- Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Internal Medicine, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, The Generation R Study, the Netherlands; Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Department of Epidemiology, the Netherlands.
| |
Collapse
|