Duchenne muscular dystrophy: comparison among different racial groups

We have compared 232 patients with Duchenne muscular dystrophy belonging to three racial groups: caucasoids, negroids, and mongoloids. Clinical evolution, serum creatine-kinase, and pyruvate-kinase levels were analysed in the three groups. The results of this investigation show that the clinical evolution did not differ significantly among these three racial groups. For serum enzyme activities a statistically significant difference was found only for CK between negroids and mongoloids.     

Conspiracy beliefs about the origin of HIV/AIDS in four racial/ethnic groups

We examined beliefs about the origin of HIV as a genocidal conspiracy in men and women of four racial/ethnic groups in a street intercept sample in Houston, Texas. Groups sampled were African American, Latino, non-Hispanic white, and Asian. Highest levels of conspiracy theories were found in women, and in African American and Latino populations (over a quarter of African Americans and over a fifth of Latinos) with slightly lower rates in whites (a fifth) and Asians (less than one in ten). Reductions in condom use associated with such beliefs were however only apparent in African American men. Conspiracy beliefs were an independent predictor of reported condom use along with race/ethnicity, gender, education, and age group. Data suggest that genocidal conspiracy beliefs are relatively widespread in several racial/ethnic groups and that an understanding of the sources of these beliefs is important to determine their possible impact on HIV prevention and treatment behaviors.     

Attitudes toward menopause and aging across ethnic/racial groups

OBJECTIVE: Attitudes have a potential role to play in the experience of menopause. The objective of this study was to examine the degree to which attitudes toward menopause and aging vary across ethnic groups and menopausal status (ie, premenopausal through postmenopausal). METHODS: More than 16,000 women were interviewed by telephone as part of the Study of Women's Health Across the Nation. They represented five ethnic/racial groups (African American, white, Chinese American, Japanese American, and Hispanic) from seven geographical sites (Boston, MA; Pittsburgh, PA; Chicago, IL; Michigan; New Jersey; and northern and southern California). RESULTS: African American women were significantly more positive in attitude. The least positive groups were the less acculturated Chinese American and Japanese American women. Menopausal status was not a consistent predictor of attitude across ethnic groups. CONCLUSIONS: In general, women's attitudes toward menopause range from neutral to positive. Ethnic groups within the United States vary slightly, but reliably, in their attitudes toward menopause and aging. Factors other than those directly associated with menopausal status seem to play a role in attitude.     

Communication prompts donation: Exploring the beliefs underlying registration and discussion of the organ donation decision

Objectives . To use a theory of planned behaviour (TPB) framework to explore the beliefs underlying communication of the donation decision for people who had not previously registered their consent on a donor register or discussed their decision with significant others. Design . Initially, a focus group study elicited the common TPB (behavioural, normative, and control) beliefs about registering and discussing the organ donation decision. The main study assessed the important TPB belief predictors of intentions to register and discuss the donation decision. Method . University students and community members from Queensland, Australia (N = 123) completed items assessing their intentions and the TPB behavioural, normative, and control beliefs for registering and discussing their donation decision. Results . Structural equation modelling (SEM) analyses revealed significant paths between people's intentions to register their donation decisions and underlying behavioural (e.g. enabling efficient donation procedures), normative (e.g. friends, doctors/medical professionals), and control (e.g. lack of motivation, knowing details about transplant recipients) beliefs (R²=.30). There were also significant paths between people's intentions to discuss their donation decision and underlying behavioural (e.g. feeling uncomfortable talking about death related topics) and normative (e.g. partner/spouse, family members) beliefs, but not control beliefs (R²=.33). There was a significant path between intentions to register and intentions to discuss one's donation decision. Conclusions . Results highlight the importance of focusing on behavioural and normative beliefs about communicating the donation decision, specifically for people who have not previously communicated their decision, and suggest potential targets for interventions designed to promote decision communication.     

Attitudes towards gamete donation among Swedish gynaecologists and obstetricians

BACKGROUND: Assisted reproductive technology (ART) legislation in Swedenhas undergone a gradual transformation from being fairly restrictivewhen first introduced to becoming more permissive in recentyears. Regarding gamete donation, Sweden became the first countryto pass legislation about disclosure by establishing a child’sright to find out the identity of the gamete donor once thechild has reached maturity. Our aim was to investigate attitudestowards gamete donation among Swedish gynaecologists and obstetricians. METHODS: A questionnaire was mailed to all gynaecologists and obstetricianslisted from a commercial register of all working in Sweden.Among 1230 eligible gynaecologists/obstetricians, 854 (69%)answered the questionnaire. RESULTS: In general, the majority of Swedish gynaecologists/obstetricianshad positive attitudes towards gamete donation. Although a majorityadvocated openness regarding informing the child that he orshe was conceived by making use of gamete donation, 40% opposedallowing the child to receive any information about the donorwhen the child has reached maturity. Even though Swedish legislationhas allowed sperm donation to lesbian couples since July 2005,one-third of the gynaecologists/obstetricians opposed donationto lesbians. CONCLUSIONS: The results indicate that the gynaecologists’/obstetricians’negative attitudes towards disclosure may influence patients’ability to discuss their thoughts and feelings about donation.This may also have a negative impact on donor recruitment aswell as on the extent of methods made accessible within ART.     

Assessing racial and ethnic differences in medical student knowledge, attitudes and behaviors regarding organ donation

OBJECTIVES: Previous studies have demonstrated that informed healthcare providers could increase patient willingness to donate. We assessed medical students' knowledge and attitudes to determine their preparedness to encourage organ donation. METHODS: 500 first- and second-year students attending one of three Ohio medical schools completed the 41-item questionnaire (93% cooperation rate). The questions evaluated students' donation knowledge, training, exposure and perceived barriers as well as their willingness to donate. RESULTS: On univariate analysis, Asians (OR: 0.5, 95% CI: 0.2-0.9) and blacks (OR: 0.1, 95% CI: 0.1-0.2) were less willing than whites to donate. On multivariate analysis, race was no longer significantly associated with willingness to donate,Three factors were associated with a decreased donation willingness: wanting burial with organs intact (OR: 0.1, 95%CI: 0.1-0.2), having personal conflicts with donation (OR: 0.2, 95%Cl: 0.1-0.6), and concern that carrying a donor card will lead to insufficient medical care (OR: 0.2, 95% Cl: 0.1-0.4). Of note, knowledge was not associated with willingness to donate. CONCLUSION: In this medical student cohort, minorities were less willing to donate. Three factors were associated with a decreased willingness to donate regardless of student race. Addressing these barriers may increase student donation willingness, and physicians should encourage donation discussions with their patients.     

Religious altruism and organ donation

Clinicians performing psychiatric assessments of potential organ donors must consider the motivations behind an act that is--strictly in terms of its physiological implications--entirely altruistic. The authors present two case reports in which proposed kidney donors conceptualized their offers exclusively in terms of their religious beliefs and not in terms of kinship or emotional intimacy with the intended recipients. The negative reactions of some clinicians to the offers reveal the readiness with which religious beliefs can be pathologized and the way in which biological relationships can unduly restrict the clinical understanding of healthy altruism.     

Attitudes, beliefs, and practices regarding smoking and smoking cessation among African-American physicians and dentists.

African-American physicians and dentists in metropolitan Atlanta were surveyed to assess smoking cessation practices and perceptions. Questionnaires were mailed to 373 physicians and 90 dentists. A total of 154 questionnaires were returned, for an overall response rate of 33.3%. More physicians than dentists considered smoking a "very serious" threat to patients'' health, and physicians were more likely to document smoking status in charts and to counsel smokers to quit. Physicians also were approached more frequently by patients seeking cessation advice. Both types of practitioners considered the nicotine patch, formal cessation programs, and behavior modification/psychotherapy to be among the most effective cessation methods, and nicotine gum and acupuncture to be among the least effective. These results indicate African-American physicians are much more involved than dentists in promoting smoking cessation among patients. Advice of health professionals generally is viewed as a powerful influence for African-American patients. Further work is needed to utilize fully the power of health care providers, especially dentists, in the fight against tobacco-related morbidity and mortality.     

Lay theories of psychotherapy. I: Attitudes toward, and beliefs about, psychotherapy and therapists

Two hundred people completed two questionnaires that concerned their beliefs about what psychotherapy clients experience and their attitudes toward psychotherapy. Both questionnaires were shown to have an interpretable factor structure, and these beliefs and attitudal factors were shown to be clearly related. There were no sex, a few age, but a number of educational and "psychological experience" correlates of the belief and attitudinal factors. A canonical correlation produced one factor that seemed readily interpretable, with psychological experience the most powerful correlate of both beliefs and attitudes. The results were discussed in terms of the work on lay beliefs and expectations about therapy and counseling.     

Differences in attitudes toward organ donation among African Americans and whites in the United States.

The availability of organs within the African-American population has been an on-going issue. Historically, African Americans donate organs at a much lower rate than whites. Thus, this study was designed to compare general attitudes between African Americans, whites, and other minorities concerning the issue of organ donation and to identify the factors that hamper African Americans from becoming organ donors. We conducted a 12-question survey of 249 African Americans, 492 whites, and a category of others defining themselves as 71 Asians, 23 Hispanics, 22 Native Americans, and 35 unknowns for a total sample of 892. Samples were taken from six United States cities. Thirty-eight percent of African Americans stated they would not donate organs, compared to 10% of whites. When asked why not, African Americans stated "personal reasons" followed by "if I am an organ donor I won't get the necessary medical attention" as their top choices. Whites chose "religious reasons" followed by "organs may be taken before I am dead" as their top choices. African Americans were more concerned with getting proper medical treatment as opposed to whites, who worried their organs might be taken before their death. Regarding family discussion pertaining to organ donation, 66% of African Americans stated no discussion. Whites had a 46% rate for no family discussion. Regarding trust of doctors, 46% of African Americans expressed lack of trust for doctors, with 23% of whites expressing lack of trust for doctors. The results of this study point to the areas that must be given more focus by African-American health care providers and educators.     

A trend analysis of organ transplantation among ethnic groups

PURPOSE: This research provides public policy implications regarding organ resource allocation and increases public awareness of the current status of transplant use in various ethnic populations. PROCEDURES: Healthcare Cost and Utilization Project (HCUP), National Inpatient Sample (NIS) data were used to obtain a yearly estimate of the number of organ transplants by organ and by ethnic origin for 1988-1997. ICD-9-CM codes identified lung, heart, liver, and kidney organ-transplantation procedures. Each record in the sample was weighted by its respective discharge weight in order to extrapolate a national estimate. To assess whether there are significant differences among ethnic groups in organ transplantation rates over time, regression models were estimated for heart, liver, and kidney transplants. Transplantation rates were modeled as a function of time, ethnic origin, and interaction variables. FINDINGS: Examination of time trend graphs and regression analyses indicates that transplantation rates have not varied substantially across ethnic groups between 1988 and 1997. Rates for all groups, with the exception of Asians, exhibited similar time trends with little systematic variation. CONCLUSIONS: Further research is needed to determine whether variations exist due to organ availability versus prevalence of the disease.     

Communicating with providers about racial healthcare disparities: The role of providers’ prior beliefs on their receptivity to different narrative frames

Objective

Evaluate narratives aimed at motivating providers with different pre-existing beliefs to address racial healthcare disparities.

Relative rates of AIDS among racial/ethnic groups by exposure categories

The relative rates of acquired immunodeficiency syndrome (AIDS) were calculated among racial/ethnic populations using Centers for Disease Control and Prevention HIV (human immunodeficiency virus)/Surveillance reports assuming that racial/ethnic distributions reflect that of the US Census Data from 1990. For comparison, a rate of 1 was assigned to whites in each calculation. The overall relative rates were whites--1, African Americans--4.7, Hispanics--3, Asian/Pacific Islanders--0.4, and Native Americans--0.5. Acquired immunodeficiency syndrome surveillance data show higher rates of AIDS for African Americans and Hispanics compared with whites, Asians/Pacific Islanders, and Native Americans. The relative rates for African Americans and Hispanics compared with whites were highest for injecting drug users, heterosexual contact, and pediatric patients. These results led us to explore possible explanations for increased AIDS reporting in African Americans and Hispanics. We then explored available national datasets regarding those variables. The analyses indicate that variables such as access and receptivity to HIV prevention and treatment efforts, race/ethnicity, sexual behaviors, sexually transmitted diseases, socioeconomic status, and substance abuse interact in a complex fashion to influence HIV transmission and progression to AIDS in affected communities.     

Heterogeneity of serum creatine kinase activity among racial and gender groups of the population

To develop reference ranges for creatine kinase (CK) appropriate for the patient population served by this hospital, levels of serum CK were measured in 1,537 individuals in our employee population. There was substantial heterogeneity in mean, median, and range of CK levels among the several race/gender subgroups in the population studied. The race/gender subgroups could be placed into three broad groups: a high CK group, composed solely of black men; an intermediate CK group, consisting of nonblack men plus black women; and a low CK group, comprised of nonblack women. Mean CK level of the high CK group was twice that of the intermediate CK group, which, in turn, was twice that of the low CK group. Differences in mean CK values among the subgroups placed into either the intermediate CK group or the low CK group were not significant when tested with analysis of variance. Therefore, practical reference ranges for these groups are as follows: 52-520 U/L for the high CK group; 35-345 U/L for the intermediate CK group; and 25-145 U/L for the low CK group.