Which Mexican-Americans underutilize health services?

Data collected from the Los Angeles site of the National Institute of Mental Health Epidemiologic Catchment Area Program were used to examine the utilization of health services in a community population. Mexican-Americans, especially the less acculturated, had significantly lower rates of use of outpatient, but not inpatient, care than non-Hispanic whites. Differences were greater for mental than physical health care. Less acculturated Mexican-Americans made very little use of either mental health specialists or the human services sector (e.g., religious leaders). Among those with a recent psychiatric disorder, non-Hispanic whites were seven times more likely to use outpatient mental health services than the less acculturated Mexican-Americans.     

A middle ear implantable hearing device for controlled amplification of sound in the human: a preliminary report

Millions of people in the United States suffer from hearing impairment that is not benefited or poorly benefited by surgery or conventional hearing aids. Recently, we introduced an implantable Temporal Bone Stimulator (TBS) designed for those patients having a hearing loss due to external canal conditions; such as, external canal atresia or disease, inoperable ossicular problems, atelectasis or eustachian tube malfunction, and chronic open-cavity mastoid disease. This device requires relatively good cochlear function. However, the electromagnetic application of this device has led to the development of a new device we call the Implantable Hearing Device (IHD). This device stimulates, by an electromagnetic field, an independent electromagnetic sensitive prosthesis attached to the ossicular chain. This direct energy transfer to the ossicular chain provides a high degree of sound amplification and fidelity, thus providing benefit for those with various degrees of sensorineural hearing impairment. Preliminary disclosure of the device design, the animal experimental results, and the data from human testing will be given.     

From the Editor of Sexuality and Disability: The Year 2021…A Pause for Reflection

Sexuality and Disability -     

Prolonged breastfeeding in Bangladesh: indicators of inadequate feeding practices or mothers'' response to children''s poor health?

The association between breastfeeding and diarrhoeal morbidity was examined in a prevalence study of 5502 children aged 6-71 months from rural and urban Bangladesh. Breastfeeding was found to be associated with reduced prevalence of diarrhoea. This association was most pronounced at the age of six months and declined linearly to zero at approximately 30 months of age; thereafter, breastfeeding was increasingly associated with diarrhoeal illness. The linear association was found only among those children who have no access to modern health services and information, when controlling for urban and rural differences. The literature provides two opposing explanations for the positive association of prolonged breastfeeding with diarrhoeal illness. The first explanation suggests that breastfeeding can be seen as mothers' response to children's poor health. The second explanation incriminates sub-optimal child feeding practices, characterised by prolonged breastfeeding and inadequate quality and quantity of complementary foods, as the cause of malnutrition and diarrhoea. Further studies are needed to identify which explanation is correct, given the public health implications in terms of children's survival, growth and development.     

β-Endorphin modulates T-cell intracellular calcium flux and c-myc expression via a potassium channel

To characterize the effect of β-endorphin on T-lymphocyte activation, we examined its influence on membrane currents, intracellular calcium flux, and c-myc mRNA levels during mitogenic stimulation of Jurkat cells. While β-endorphin weakly enhanced voltage-activated K⁺ currents of Jurkat cells by itself, it suppressed these currents in the presence of mitogen. Naloxone, by itself, also enhanced K⁺ current amplitude, but in the presence of mitogen partially reversed the suppressive effect of β-endorphin. A 5–30 min exposure to β-endorphin resulted in an increase in the rate of mitogen-stimulated intracellular calcium release and an increase in c-myc mRNA levels relative to controls. Longer exposure (1–2 h) to β-endorphin retarded intracellular calcium release, and suppressed c-myc expression. The suppressive effects were reversed by naloxone and mimicked by the K⁺ channel blocker, tetraethylammonium ion. These data suggest that opiate receptors and K⁺ channels of Jurkat cells are functionally coupled in a way that modulates intracellular calcium release and c-myc expression — two key processes in T-cell mitogenesis.     

Six-month prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic whites in Los Angeles

The current prevalence of DSM-III psychiatric disorders was assessed using the Diagnostic Interview Schedule (DIS) as part of a Los Angeles household population survey. The Los Angeles prevalence estimates were compared with sex- and age-adjusted estimates from four other US field sites, all of which were part of the Epidemiologic Catchment Area (ECA) program. Overall, few significant differences in household population rates were found between Los Angeles and the other ECA sites. Within the Los Angeles household sample, the current prevalence of disorder among Mexican Americans was compared with that among non-Hispanic whites. Non-Hispanic whites had higher rates of drug abuse/dependence than Mexican Americans; the rates among non-Hispanic whites in Los Angeles were also higher than those found at other ECA sites. Mexican Americans displayed higher rates of severe cognitive impairment, a finding that likely reflects ethnic and educational bias in the measurement of cognitive impairment. Another ethnic difference was found only for one specific age and sex group: Mexican-American women 40 years of age or older had strikingly high rates of phobia.