The portrayal of depression in the three most popular English-language Black-American magazines in the USA: Ebony,Essence, and Jet

Objective. To examine how depression is portrayed within a specific racialized group.

Design. Manifest and latent content analysis of the three highest circulating magazines directed toward Black-American readers, Essence, Ebony, and Jet, from 2000 to 2007.

Results. The findings demonstrate ambiguity and contradictions about depression's meaning and incidence, as well as the availability, accessibility, and suitability of medical treatment. All of these are linked to racialized identities among Black Americans.

Conclusion. Magazine portrayal of depression in these magazines can only be understood in the context of experienced racism, oppression, and ethnic identity among Blacks.     

Gender and ethnic differences in the co-occurrence of adolescent risk behaviors

Design

Results

Conclusion

We consider gender and ethnic differences in the co-occurrence of adolescent behaviors related to health and well-being.

Using a nationally representative sample of adolescents in the National Longitudinal Survey of Youth (1997–2000), we examine behavior among students as well as school drop-outs. We use latent class models (LCMs) to identify subpopulations of adolescents with similar patterns of co-occurring behaviors. The generalizability of the findings for African American adolescents in the 1970s is considered using a sample of inner-city youth from the Pathways to Adulthood Survey.

For all ethnic groups, we find a subpopulation with ‘problem behavior’ characteristics (in which early sexual initiation, alcohol use, smoking, marijuana use, and truancy are all highly prevalent). This cluster is most common among European American adolescents and among young men. A subpopulation characterized by behaviors often leading to poor social outcomes (e.g. truancy, early sexual initiation and fighting) is most common for African American adolescents, especially young African American men.

Our findings suggest that multi-factorial interventions which address the interrelationships between all of the behaviors are relevant regardless of gender or ethnicity. However, the ethnic and gender differences in the likelihood of specific patterns of interrelationships highlight the importance of considering the ethnic and gender composition of a population when developing future research and interventions.     

Ethnicity, genetics, and breast cancer: media portrayal of disease identities

Design

Results

Conclusions

To describe, compare, and analyze how the risk of breast cancer is framed in newspapers directed towards an ethnic minority population (Jewish) with higher risk of inherited breast cancer compared with newspaper coverage for the general population (Anglo-Canadian) without this risk.

This investigation utilized a mixed methods (quantitative and qualitative) approach. The design emphasized a content analysis conducted on ethnically specific and non-ethnic newspaper articles.

It is noteworthy that the ‘Jewish’ newspapers devote a substantially larger proportion of articles on breast cancer to genetic risk as the key risk factor for this disease. Articles in the Jewish newspapers tend to link being a Jewish woman with being at risk for a diagnosis of breast cancer. This ethnic ‘identity’ is reinforced through the repeated association of Jewish heritage and genetic breast cancer risk at the exclusion of other known risk factors. This isolated genetic link to breast cancer is not a message that is replicated within the provincial newsprint articles.

These findings assist in the facilitation of prevention and treatment of those with or at risk of breast cancer. The health policy implications of this portrayal as well as suggestions for change are considered.     

Patient ethnicity: a key predictor of cancer care satisfaction

Introduction. Research in cancer care satisfaction itself is scarce; investigation of the role of ethnicity in care satisfaction is even rarer.

Objective. The present study examined relationships between ethnicity and satisfaction with care in a sample of 759 patients diagnosed with three different types of cancer (lung, head and neck, or gynecologic) from a large tertiary cancer hospital.

Method. Respondents filled out an assessment package that consisted of demographics, the Ware Patient Satisfaction Questionnaire-III (PSQ-III), 17 additional items constructed by the research team to examine other specific areas of satisfaction, and the Psychological Screen for Cancer (PSSCAN) Part C, to measure anxiety and depression.

Results. In a multivariate analysis, being non-White emerged as the primary predictor variable (beyond patient age, gender, marital status, education, cancer site, duration of illness, and presence or absence of metastases) of several of the PSQ-III satisfaction subscales.

Conclusion. Health care systems must consider how to become more responsive to the needs of all individuals, regardless of their ethnic background and levels of acculturation.     

Accessibility and use of touchscreens by black and ethnic minority groups in the three cities project

Design

Results

Conclusion

The public are being encouraged by Government, at a national level, to take a greater role in the management of their health and healthcare but information to support this is not always accessible to black and ethnic minority group members who do not speak or read English. This study looks at the feasibility of providing health-related information in a multilanguage format through a touchscreen kiosk.

Three touchscreen kiosks were programmed with information on 10 health topics translated into five languages: Chinese, Bengali, Gujarati, Urdu and Mirpuri Punjabi. Information was provided orally and in written format. Over an 18-month period the touchscreens were rotated between settings including health centres and libraries, located in deprived areas of Leicester, Sheffield and Nottingham. Information was logged on each individual user with respect to language used, topic selected, age group and gender of user. A number of users were invited to complete a short questionnaire about their use and ease of use of the touchscreen.

Touchscreens were accessed by 2,456 people across all ages, 53% of whom were male. Urdu and Gujarati were the most frequently accessed languages (37 and 38%, respectively) and Bengali used least (9%). There was some variation in use by setting. Most of the 508 people questioned who had used the touchscreen found it easy to use. Ease of use was related to home computer use and to being younger in age. The five most popular topics accessed by 12% or more users were stress, diabetes, blood pressure, healthy eating and exercise. Topic choice varied by language used by males but not by females.

Touchscreens providing health information in ethnic minority languages can be successfully accessed by black and ethnic minority groups, particularly those living in deprived areas. Touchscreens proved acceptable to, and were used by, the targeted audience.     

Rodent control in urban communities in Johannesburg,South Africa: from research to action

Introduction:

Rodents are troublesome urban pests, with potentially serious health implications. Preventive efforts require greater understanding of social contexts in which they are prevalent. This study aimed to determine rodent prevalence and identify factors associated with rodent infestations in urban residential settings.

Methods:

The Health, Environment and Development study is a longitudinal panel study conducted in five settlements across Johannesburg. Data on socio-economic status, domestic behaviour and housing quality are collected annually. Logistic regression revealed risk factors for rodent prevalence at household level.

Results:

Rodents are a major household problem in all study areas (prevalence 54%). Factors associated with increased prevalence of rats included lower income, living in informal areas, overcrowding, cracks in dwelling walls and internal damp.

Conclusion:

Socio-economic status, housing quality, domestic behaviour and environmental health services are associated with exposure to rodents in urban Johannesburg communities. This information served as a platform to launch rodent awareness campaigns at study sites.     

Perceived racial/ethnic discrimination,problem behaviors,and mental health among minority urban youth

Objectives. We examined perceived frequency and intensity of racial/ethnic discrimination and associations with high-risk behaviors/conditions among adolescents.

Design. With surveys from 2490 racial/ethnic minority adolescents primarily with low socioeconomic status, we used regression analysis to examine associations between racial/ethnic discrimination and behavioral health outcomes (alcohol use, marijuana use, physical aggression, delinquency, victimization, depression, suicidal ideation, and sexual behaviors).

Results. Most adolescents (73%) experienced racial/ethnic discrimination and 42% of experiences were ‘somewhat-’ or ‘very disturbing.’ Adolescents reporting frequent and disturbing racial/ethnic discrimination were at increased risk of all measured behaviors, except alcohol and marijuana use. Adolescents who experienced any racial/ethnic discrimination were at increased risk for victimization and depression. Regardless of intensity, adolescents who experienced racial/ethnic discrimination at least occasionally were more likely to report greater physical aggression, delinquency, suicidal ideation, younger age at first oral sex, unprotected sex during last intercourse, and more lifetime sexual partners.

Conclusion. Most adolescents had experienced racial/ethnic discrimination due to their race/ethnicity. Even occasional experiences of racial/ethnic discrimination likely contribute to maladaptive behavioral and mental health outcomes among adolescents. Prevention and coping strategies are important targets for intervention.     

Racial discrimination,racial/ethnic segregation,and health behaviors in the CARDIA study

Objective

Racial discrimination has been associated with unhealthy behaviors, but the mechanisms responsible for these associations are not understood and may be related to residential racial segregation. We investigated associations between self-reported racial discrimination and health behaviors before and after controlling for individual- and neighborhood-level characteristics; and potential effect modification of these associations by segregation.

Design

We used data from the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) study for 1169 African-Americans and 1322 whites. To assess racial discrimination, we used a four category variable to capture the extent and persistence of self-reported discrimination between examination at years 7 (1992–1993) and 15 (2000–2001). We assessed smoking status, alcohol consumption, and physical activity at year 20 (2005–2006). Segregation was examined as the racial/ethnic composition at the Census tract level.

Results

Discrimination was more common in African-Americans (89.1%) than in whites (40.0%). Living in areas with high percentage of blacks was associated with less reports of discrimination in African-Americans but more reports in whites. After adjustment for selected characteristics including individual- and neighborhood-level socioeconomic conditions and segregation, we found significant positive associations of discrimination with smoking and alcohol consumption in African-Americans and with smoking in whites. African-Americans experiencing moderate or high discrimination were more physically active than those reporting no discrimination. Whites reporting some discrimination were also more physically active than those reporting no discrimination. We observed no interactions between discrimination and segregation measures in African-Americans or whites for any of the three health behaviors.

Conclusions

Racial discrimination may impact individuals' adoption of healthy and unhealthy behaviors independent of racial/ethnic segregation. These behaviors may help individuals buffer or reduce the stress of discrimination.     

Incidence of mental disorders in second-generation immigrants in sweden: a four-year cohort study

Methods

Results

Conclusions

Few studies have investigated mental health among second-generation immigrants who have reached adulthood. The aim of this study was to examine whether second-generation adult immigrants have a higher risk of being hospitalised for mental disorders than the Swedish majority population after adjustment for socio-economic status.

In total 1.9 million Swedish-born women and men aged 16–34 were followed from 1 January 1995 to 31 December 1998 for first hospital admissions for mental disorders, categorised in four main diagnosis groups. Second-generation immigrants comprised four groups and the Swedish majority population was used as reference group. Cox proportional hazard models were used to analyse the data.

Second-generation immigrants with one parent born in Sweden and second-generation Finns had higher risks of being hospitalised for psychotic disorders, affective disorders, neurotic disorders, and personality disorders than the Swedish majority population. For second-generation Finns the age- and sex-adjusted hazard ratio for psychotic disorders was 2.42 (CI?=?2.09–2.80). No significant hazard ratios were found for second-generation labour immigrants. For second-generation refugees the risk of being hospitalised was higher than for the Swedish majority population but only for psychotic disorders. All results remained significant and decreased only slightly after adjustment for income and education.

Many groups of second-generation immigrants have a higher risk of being hospitalised for mental disorder than the majority population. With increasing global migration it is crucial for all industrialised countries to take measures to improve mental health among second-generation immigrants.     

‘I didn't feel like any of those things were me’: results of a qualitative pilot study of race/ethnicity survey items with minority ethnic adolescents in the USA

Objective. The present study is a qualitative exploration of the thought processes of minority ethnic adolescents in responding to standard epidemiologic survey questions about racial/ethnic group membership in the USA.

Design. Fifteen minority ethnic adolescents (ages 15–21) were enrolled in a pilot qualitative study using a cognitive processing interview technique to elicit their understanding and interpretation of race/ethnicity survey items.

Results. Findings from this pilot study indicated that racial/ethnic classification survey items commonly used in the USA were susceptible to a number of item performance problems, including participant confusion, and misreported or insufficient responses. Additionally, item wording elicited intense affective reactions among participants. Results suggest the need for careful review of current US race/ethnic classifications systems, as standard survey measures are likely to provide an incomplete demographic characterization of minority ethnic adolescents.

Conclusions. Recommendations are provided for improving procedures for collecting race and ethnicity data from youth in the USA.     

Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles

Objectives. This study is designed to provide an empirical conceptualization of daily hassles among unaccompanied refugees, and whether they might affect mental health of young refugees after resettlement. First, we examined the underlying structure of daily hassles conceptualized as measuring general and acculturation-specific hassles. Second, we examined whether these two distinct categories of daily hassles significantly contribute to depression above and beyond the impact of premigration trauma.

Design. The study was based on self-report questionnaire data collected from 895 unaccompanied refugees who had been granted residence in Norway.

Results. Using structural equation modeling, the results confirmed the grouping of hassles in two general categories, which explained 43% of the variance in depression.

Conclusion. The findings underscore the importance of current life conditions for unaccompanied refugees' mental health.     

Usual Intake Distribution of Vitamins and Prevalence of Inadequacy in a Large Sample of Iranian At-Risk Population: Application of NCI Method

Objective: This study provides an assessment of usual intake distribution of vitamins and estimating prevalence of inadequacy and excess among a large representative sample of middle-aged and elderly people in central regions of Iran.

Design: A cross-sectional study that is a second follow-up to the Isfahan Cohort Study (ICS).

Setting: The study setting included urban and rural areas from 3 cities (Isfahan, Najafabad, and Arak) in central regions of Iran.

Subjects: Subjects included 1922 people aged 40 years and older, with a mean age of 55.9 ± 10.6; 50.4% were male and the majority (79.3%) were urban.

Measures and Analysis: Dietary intakes were collected using a 24-hour recall and 2 food records. Distribution of vitamins intake was estimated using traditional and national cancer institute (NCI) methods. The proportion of subjects at risk of vitamin intake inadequacy or excess was estimated using the estimated average requirement (EAR) cut-point method and the tolerable upper intake levels (UL) index.

Results: There were differences between values obtained from traditional and NCI methods, particularly in the lower and upper percentiles of the intake distribution. High prevalence of inadequacies for vitamins A, D, E, B₂, B₃ (especially among females), and B₉ was observed. Significant gender differences were found in terms of inadequate intakes for vitamins A, B₁, B₂, B₃, B₆, B₉, B₁₂, and C (p < 0.05).

Conclusion: Imbalanced vitamin intake was observed in the middle-aged and elderly Iranian population. Nutritional interventions particularly through population-based educational programs in order to improve diet variety and consume nutrient supplements may be necessary.     

Latvian family physicians’ experience diagnosing depression in somatically presenting depression patients: A qualitative study

Background: Depression continues to be under-diagnosed in primary care settings. One factor that influences physicians’ likelihood of diagnosing depression is patients’ presentation style. Patients who initially present with somatic symptoms are diagnosed at a lower rate and with greater delay than patients who present with psychosocial complaints.

Objectives: To identify the barriers preventing depression diagnosis in somatically presenting patients in an Eastern European primary care setting.

Methods: Thematic analysis of semi-structured interviews with 16 family physicians (FPs) in Latvia. FPs were sampled using a maximum variation strategy, varying on patient load, urban/rural setting, FP gender, presence/absence of on-site mental health specialists, and FP years of practice.

Results: FPs observed that a large subgroup of depression patients presented with solely somatic complaints. FPs often did not recognize depression in somatically presenting patients until several consultations had passed without resolution of the somatic complaint. When FPs had psychosocial information about the somatically presenting patient, they recognized depression more quickly. Use of depression screening questionnaires was rare. Barriers to diagnosis continued beyond recognition. Faced with equivocal symptoms that undermined clinical certainty, FPs postponed investigating their clinical suspicion that the patient had depression and pursued physical examinations that delayed depression diagnosis. FPs also used negative physical examination results to convince reluctant patients of a depression diagnosis.

Conclusion: Delayed recognition, the need to rule out physical illness, and the use of negative physical examination results to discuss depression with patients all slowed the path to depression diagnosis for somatically presenting patients in Latvian primary care.     

Methodological challenges when doing research that includes ethnic minorities: a scoping review

Background: There are challenging methodological issues in obtaining valid and reliable results on which to base occupational therapy interventions for ethnic minorities. The aim of this scoping review is to describe the methodological problems within occupational therapy research, when ethnic minorities are included.

Method: A thorough literature search yielded 21 articles obtained from the scientific databases PubMed, Cinahl, Web of Science and PsychInfo. Analysis followed Arksey and O’Malley’s framework for scoping reviews, applying content analysis.

Results: The results showed methodological issues concerning the entire research process from defining and recruiting samples, the conceptual understanding, lack of appropriate instruments, data collection using interpreters to analyzing data.

Conclusion: In order to avoid excluding the ethnic minorities from adequate occupational therapy research and interventions, development of methods for the entire research process is needed. It is a costly and time-consuming process, but the results will be valid and reliable, and therefore more applicable in clinical practice.     

Promoting exercise in patients with depression: lessons learned from a brief educational intervention

Introduction: Depression is a leading cause of disability worldwide. It is recommended that exercise is incorporated into the management of patients with depression, but it is not clear how best to implement this recommendation in clinical practice.

Objective: The objective of this study was to evaluate a pragmatic educational intervention promoting exercise to a group of patients diagnosed with depression, in a community setting.

Methods: Participants were convenience sampled from community based psychiatry clinics. WHO 5 Wellbeing and International Physical Activity Questionnaire scores were measured for each participant at baseline, and again three months after receiving the educational intervention on exercise. Open ended questions were used to elicit participants’ beliefs and barriers to exercise and responses were thematically analysed.

Results: Thirty-five patients with depression were enrolled. Three months after the educational intervention, there were no significant changes in patients’ activity levels or well-being scores (P > 0.05). Participants’ responses to open ended questions revealed their varied, and often contradictory, beliefs on physical activity and exercise. Following from this, their suggestions on ways to improve the uptake of exercise advice highlighted the need for an individualized approach, with persistent patient encouragement and positive reinforcement.

Conclusion: This study has generated valuable information on how to improve the promotion of exercise to patients with depression. Advice framed in a positive light, with persistent encouragement and tailoring to individual circumstances, is desired by patients to support their behavioural change.     

Book Review

Changing the public health

Rcswch Unit in Health .ad Behaviourd Chutge. University of Edinburgh, John Wdey and Son, London, 1989, ISBN 0 471 91976 4.

The new public health

John Ashtw and RowYd Seymour. Open University Press, 1988. ISBN 0 335 15550 2, £6.95.

Infertility services-a desperate case

N d Pfeilu cmd Allison Qukk. Greater London Association of Community Health Councils, 1988.

A new kind of Doctor

Julian Tudor Hart. Merlin Press, 1988. ISBN 085036 299 7, £11.95 (hardback).     

Alexithymia is associated with low level of vitamin D in young healthy adults

Objective

Vitamin D plays an important role in brain development and functioning. Low levels of vitamin D have been described in several psychiatric and neurologic conditions including autism spectrum disorder. Alexithymia that shows high comorbidity with autism is also present in the general population as well as hypovitaminosis D.

Methods

Here we assessed the relation between alexithymia as measured by the Toronto Alexithymia Scale-20 and vitamin D level in healthy young adults.

Results

We found an inverse correlation between the levels of alexithymia and vitamin D.

Discussion

These data suggest the association between disturbed emotional processing and low levels of vitamin D to be present in young healthy subjects.     

Health-related quality of life among Mexican-origin Latinos: the role of immigration legal status

Objective: To assess the relationship between immigration legal status and related vulnerabilities and health-related quality of life (HRQoL) among Mexican-origin Latinos living in a U.S.-Mexico border region.

Methods: Data were obtained using multistage sampling from 393 Latino adults who took part in the 2009 San Diego Prevention Research Center community survey.

Results: Significant differences in HRQoL were found across immigration legal status subgroups. Vulnerabilities associated with HRQoL varied across immigration legal status subgroups, and only depression was associated with HRQoL regardless of immigration legal status.

Conclusion: Results from this study emphasize the need for policies and programs to facilitate access to preventive services, including mental health services, in order to maintain the health of at-risk Latino immigrants.     

Acceleration of reflex maturation and physical development in suckling rats: effects of a maternal diet containing lipids from goat milk

Objective

To investigate the effects of lipids from goat milk containing conjugated linoleic acids on body weight and reflex ontogeny of neonatal rats treated during the prenatal and suckling periods.

Methods

Three groups were studied: soybean oil (S), coconut oil (C), and goat milk lipids (GM). Reflex maturation (palm grasp, righting reflex, cliff avoidance, vibrissae placing, negative geotaxis, auditory startle, and free-fall righting) as well as body weight evolution were recorded during lactation.

Results

Data demonstrated that the lipids from goat milk accelerated body weight evolution as well as all the reflex maturation investigated (P < 0.05).

Discussion

The supply of goat's milk offered to Wistar rats during pregnancy and lactation provided a variety of fatty acids necessary to accelerate the development of offspring.