Disparities in health: perspectives of a multi-ethnic, multi-racial America

This 2006 survey of 4,157 randomly selected U.S. adults compared perceptions of health care disparities among fourteen racial and ethnic groups to those of whites. Findings suggest that many ethnic minority groups view their health care situations differently and, often, more negatively than whites. A substantial proportion perceived discrimination in receiving health care, and many felt that they would not receive the best care if they were sick. Most differences remained when socioeconomic characteristics were controlled for. The variety of responses across racial groups demonstrates the importance of examining ethnic subgroups separately rather than combined into a single category.     

Evidence for an intensity-dependent interaction of NAT2 acetylation genotype and cigarette smoking in the Spanish Bladder Cancer Study

BACKGROUND: The N-acetyltransferase 2 (NAT2) enzyme detoxifies aromatic amines, an important class of carcinogens in tobacco smoke. Slow acetylation phenotype individuals have reduced detoxification capacity compared with those with a rapid/intermediate phenotype. Analysis of the Spanish Bladder Cancer Study found an odds ratio (OR) for slow acetylators relative to rapid/intermediate acetylators of 0.9 in never-smokers and 1.6 in ever-smokers, a 1.8-fold enhancement in smokers. Evidence indicates that acetylation is an exposure-dependent process, and thus the magnitude of the interaction may also depend on exposure level. METHODS: We extend a comprehensive three-parameter linear-exponential model for the excess odds ratio (EOR) for smoking to include effects of NAT2 status, and reanalyse smoking and NAT2 status for the bladder cancer data. RESULTS: We show that variations in smoking risk with NAT2 status result from interactions with smoking intensity (cigarettes per day) and not total pack-years of exposure. In addition, the relative increase in smoking risk in NAT2 slo acetylators increases with smoking intensity. CONCLUSIONS: Analyses reveal an enhanced effect for smoking intensity and bladder cancer in NAT2 slow acetylators which increases with intensity.     

The influence of calcium consumption on weight and fat following 9 months of exercise in men and women

BACKGROUND: There is some evidence that calcium consumption improves weight loss during energy restriction but the effects of calcium consumption in conjunction with chronic exercise are unknown. OBJECTIVE: The purpose of the study was to determine the degree to which calcium consumption influences weight and fat weight change as a result of 9 months of verified supervised exercise in the absence of energy restriction. METHODS: Participants were 50 previously sedentary, overweight and moderately obese men (n=20) and women (n=30). Exercise of moderate intensity was performed for 45 min/d, 5 d/wk, under supervision. Diet intake was ad libitum and was measured for energy, macronutrient and micronutrient composition at baseline, 4 and 9 months by use of observer recorded weighed plate waste and multiple-pass 24-h dietary recall procedures. RESULTS: Average calcium consumption was 987 +/- 389 mg/day for men and 786 +/- 276 mg/day for women. Weight change over the 9 months was -4.6 +/- 4.6 kg for men and 0.2 +/- 3.3 kg for women. Calcium consumption was associated with weight change (r =-0.47, p<0.05) in men. The calcium to protein ratio was associated with weight change (r=0.56) and fat weight change (r=-0.53) in men. There was no observed association between calcium and weight or fat weight change in women. CONCLUSION: Weight and fat weight loss as a result of nine months of moderate intensity exercise may be improved by increased calcium consumption in men but was not observed in women.     

Correlates of Positive Parenting Behaviors

The present study examined the influence of maternal and child characteristics on parenting behaviors in a genetically informative study. The participants were 976 twins and their mothers from the Colorado Longitudinal Twin Study and the Twin Infant Project. Indicators of positive parenting were coded during parent–child interactions when twins were 7–36 months old. Child cognitive abilities and affection were independent correlates of positive parenting. There were significant gender differences in the magnitude of genetic and environmental influences on positive parenting, with shared environmental influences on parenting of girls and additive genetic influences on parenting of boys. Girls received significantly more positive parenting than boys. Differences in etiology of positive parenting may be explained by developmental gender differences in child cognitive abilities and affection, such that girls may have more rewarding interactions with parents, evoking more positive parenting.     

Exploring patient-centeredness: The relationship between self-reported empathy and patient-centered communication in medical trainees

Objective

To explore the relationships between self-reported Empathy and the patient-centered communication patterns of physician trainees.

Informed and patient-centered decision-making in the primary care visits of African Americans with depression

Objective

We examined the prevalence and extent of informed decision-making (IDM) and patient-centered decision-making (PCDM) in primary care visits of African Americans with depression.

The impact of peer mentor communication with older adults on depressive symptoms and working alliance: A pilot study

Objective

The objective of this pilot study was to describe peer communication in meetings with depressed elders, associate their relationship with working alliance and depression and assess congruence of communication with training.

Patient-centered communication of community treatment assistants in Tanzania predicts coverage of future mass drug administration for trachoma

Objective

Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage.