Biomedical subjects

S A James

Publications and source records attributed to S A James.

At least 55 records · Page 3Linked to original sources

PubMed1994

The joint effects of race and age on the risk of end-stage renal disease attributed to hypertension.

To describe the joint effects of race and age on the risk of end-stage renal disease (ESRD) attributed to hypertension (ESRD-HT), we analyzed data for white and black adults, 20 to 84 years of age, reported by the United States Renal Data System during the period 1987 to 1990. The risk of ESRD-HT increased substantially with age for both blacks and whites; however, at each age, the risk was greater for blacks. A more in-depth description of the combination of effects involving race and age on ESRD-HT incidence was provided by two models of joint effects, one additive and the other multiplicative. Both models used the 20- to 24-year age group as the referent. Under the additive model the risk of ESRD-HT in blacks attributable to the joint effects between race and age increased continuously from younger to older groups. This indicates that although ESRD-HT risk increases with age for both blacks and whites, the increase for blacks is greater than expected if the effects of race were independent of the effects of age. However, the multiplicative model indicated that the proportional increase with age in ESRD-HT risk among blacks, as compared with whites, was more striking for younger ages (< or = 50 years among women and < or = 40 years among men), and especially so for men. This suggests a more accelerated course of hypertension toward ESRD for blacks (especially younger men) than for whites. A conceptual model to explain these patterns of race-age joint effects is proposed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1994

The genetic relationship of Lodderomyces elongisporus to other ascomycete yeast species as revealed by small-subunit rRNA gene sequences.

The 18S rRNA gene sequence of the ascomycete yeast Lodderomyces elongisporus was determined by PCR-direct sequencing. The phylogenetic inter-relationship of Lodderomyces elongisporus and other ascomycete yeast species was examined by comparative sequence analysis. Lodderomyces elongisporus was found to be most closely related to Candida parapsilosis, C. tropicalis and C. albicans, exhibiting sequence similarity values of greater than 97.5%. The relationship between L. elongisporus and Candida parapsilosis in particular is discussed with regard to the possibility that L. elongisporus is the teleomorph (sexual form) of C. parapsilosis.

Base Sequence↗

PubMed1993

Racial and ethnic differences in infant mortality and low birth weight. A psychosocial critique.

Recent studies on differences in infant mortality and low birth weight (LBW) among non-Hispanic whites, African Americans, and Mexican Americans were reviewed. Despite similar socioeconomic profiles, infant mortality among Mexican Americans (8/1000 live births) is less than half that of African Americans (18/1000 live births). In fact, the rate for Mexican Americans is identical to that of non-Hispanic whites. The data for LBW follow a similar pattern. What accounts for this unexpectedly low frequency of poor birth outcomes among Mexican Americans, especially given their economic disadvantages, reduced access to prenatal care, and exposure to discrimination based on ethnicity? Does adherence to a traditional Mexican cultural orientation protect otherwise high-risk Mexican Americans from poor pregnancy outcomes, as has been suggested? What is the "protective" social and psychological content of a traditional Mexican cultural orientation? And what are the implications of this line of reasoning for understanding the excess risk for poor birth outcomes among African Americans? This article explores these and related questions and concludes that new conceptual models are needed to guide research in this area.

Black or African American↗

PubMed1993

The excess risk of treated end-stage renal disease in blacks in the United States.

Analysis of national data from the United States Renal Data System for 1988 revealed an important joint effect of age and race in determining the higher risk of ESRD for blacks as compared with whites. For adults, both hypertension and diabetes made important contributions to the combined effect of age and race. In contrast, glomerulonephritis was not considered to be an important contributor to this joint effect. The combined effect of gender and race was weaker than that of age and race; however, among blacks, differences in the proportions of ESRD attributed to hypertension and diabetes across gender were observed. The age-race joint effect is consistent with the hypothesis that a combined effect of lack of treatment and aging on the process that leads to ESRD may play an important role in the excess risk for ESRD among blacks.

Adolescent↗

PubMed1993

The independent effects of obesity and body fat distribution on blood pressure in black adults: the Pitt County study.

The relationship of obesity measures to blood pressure and hypertension prevalence was assessed in a community probability sample of 25-50-year-old black adults (1101 women and 655 men) who were examined in 1988 in Pitt County, North Carolina. Among black women, both body mass index and waist-to-hip ratio had independent relationships with systolic and diastolic blood pressures and hypertension prevalence after controlling for the effects of age, socio-economic status, physical activity, alcohol, and the other obesity measure (P < 0.05). Body mass index also had independent relationships with blood pressure levels and hypertension prevalence in black men (P < 0.05), while waist-to-hip ratio was associated with hypertension prevalence (P = 0.05) and diastolic blood pressure (P < 0.05), but not with systolic blood pressure. The relationships of waist-to-hip ratio with blood pressure and hypertension prevalence were considerably reduced in both sex groups after controlling for body mass index. This study presents new evidence that waist-to-hip ratio is related to hypertension and blood pressure level independent of body mass index, in young to middle-aged black adult women and men.

Abdomen↗

PubMed1992

Distribution and correlates of waist-to-hip ratio in black adults: the Pitt County Study.

A 1988 community-based survey of 1,784 black adults aged 25-50 years in Pitt County, North Carolina, found mean waist-to-hip ratios of 0.890 for men and 0.852 for women. Based on guidelines from the US Department of Agriculture, 20% of the men and 76% of the women had an elevated waist-to-hip ratio. Sedentary behavior was associated with elevated waist-to-hip ratio in men, while a similar excess was associated with alcohol consumption in women. Weak, nonsignificant associations with waist-to-hip ratio were observed for smoking. Socioeconomic status was unrelated to waist-to-hip ratio in men, but it had a strong inverse relation for women.

Adipose Tissue↗

PubMed1992

Socioeconomic status, John Henryism, and blood pressure in black adults. The Pitt County Study.

The joint influence of socioeconomic status and John Henryism on blood pressure was examined in a probability sample of 1,784 black adults aged 25-50 years in Pitt County, North Carolina, in 1988. John Henryism was measured by means of the John Henryism Active Coping Scale. Socioeconomic status (low, medium, and high) was based on respondents' education and occupation. Prior research indicated that, for blacks, the inverse association between socioeconomic status and hypertension may be stronger for individuals who score high in John Henryism. In this more urban sample of blacks, the hypothesized interaction achieved modest statistical support (p less than 0.08) only for hypertension prevalence. For individuals with high levels of John Henryism, adjusted prevalences declined with increasing socioeconomic status (29.4%, 26.2%, and 20.5% for low, medium, and high socioeconomic status, respectively); for individuals with low levels of John Henryism, hypertension prevalence was similar in the low (22.6%) and medium (22.8%) socioeconomic categories but higher in the high socioeconomic category (25.9%). Elevated psychological stress in white-collar workers was probably responsible for the nonsignificant inverse gradients between socioeconomic status and mean blood pressures and for the weak interaction between socioeconomic status and John Henryism with regard to hypertension prevalence.

Adaptation, Psychological↗

PubMed1992

Socioeconomic and behavioral correlates of body mass index in black adults: the Pitt County Study.

BACKGROUND: Obesity is more prevalent among Black women than Black men, but there is little information on the correlates of obesity in Blacks. This study describes the relations of sociodemographic factors and health behaviors to body mass index in a southern, Black population. METHODS: In 1988, a community probability sample of 1784 Black adults, aged 25 to 50, was examined in Pitt County, NC. RESULTS: More women than men were at least 20% overweight (57% vs 36%). The relation of socioeconomic status (a composite of education and occupation) to age-adjusted body mass index level was inverse in women but not in men. Body mass index did not differ with either current energy intake or energy expenditure. Smokers and drinkers had lower age-adjusted levels than non-smokers and abstainers. CONCLUSIONS: Since the excess body mass index levels associated with low socioeconomic status in women could not be explained after controlling for adverse health behaviors, further epidemiologic study of risk factors for obesity in Black women is recommended.

Adult↗

PubMed1992

Psychosocial stressors and low birth weight: development of a questionnaire.

Low birth weight is a major public health problem because it is a major contributor to infant mortality as well as to various types of morbidity among young children. Of particular concern is that black women have an increased risk of low birth weight babies compared with white women. Many etiologic factors for low birth weight have been identified, but even within homogeneous strata of risk, black women have a greater risk of low birth weight babies than do white women. The reasons for this excess risk are not well understood. Available evidence suggests that exposure to psychosocial stressors is associated with adverse pregnancy outcomes. However, prior work in this area has been limited by the lack of a valid and reliable tool to assess exposure to stressors among pregnant women. We report on the development and testing of such a questionnaire, the Prenatal Social Environment Inventory. In this questionnaire, exposure to stressors is conceptualized and measured in the context of chronic stressful conditions. The questionnaire is self-administered and can be used in clinical settings with pregnant women. Findings of psychometric evaluations showed that the questionnaire has acceptable levels of 30-day temporal stability (reliability), internal consistency, and construct validity.

Black or African American↗

PubMed1991

Alcohol consumption and blood pressure in black adults: the Pitt County Study.

While there is a clear consensus in the epidemiologic literature on the direct association between alcohol consumption and blood pressure, the shape of this relation and its strength in blacks are uncertain. Therefore, the association between alcohol and blood pressure was examined in a community-based random sample of 1,784 black adults aged 25 to 50 years living in eastern North Carolina. These individuals were interviewed in 1988 for a study of psychosocial and dietary risk factors for elevated blood pressure. Alcohol consumption was estimated from responses to a food frequency questionnaire and was divided into four categories, which ranged from abstention (52% of the sample) to greater than or equal to seven drinks/week (12%). After adjustment for age and body mass, the systolic blood pressure of adults reporting greater than or equal to seven drinks/week exceeded that of nondrinkers by 6.8 mmHg for men and women (p less than 0.001). There was no evidence of a threshold effect, and similar patterns were observed for diastolic blood pressure. Being in the highest category of alcohol consumption was related to low socioeconomic status, lower social integration, and higher levels of socioeconomic stressors. These data are consistent with a graded association between alcohol and blood pressure in black adults and suggest the importance of social factors underlying this association.

Adult↗

PubMed1991

Physical activity and hypertension in black adults: the Pitt County Study.

The relation of physical activity to hypertension was examined in 1751 Black adults in Pitt County, NC. More women (65%) than men (44%) were classified as sedentary. Sedentary behavior was not associated with the prevalence of hypertension in men, but was associated with a 31% increase in prevalence for women (sedentary-26.2%; active-20.0%; P less than .01). The association in women was independent of other risk factors for hypertension.

Adult↗

PubMed1991

Socioeconomic status and electrolyte intake in black adults: the Pitt County Study.

BACKGROUND: Although the inverse association between socioeconomic status (SES) and blood pressure has often been observed, little is known about the relationship between SES and dietary risk factors for elevated blood pressure. Therefore, this study described the distribution of dietary intakes of sodium, potassium, and calcium and examined the association between electrolyte intake and SES among 1784 Black men and women aged 25 to 50 residing in eastern North Carolina. METHODS: Household interviews were conducted in 1988 to obtain information on psychosocial and dietary correlates of blood pressure. Electrolyte intake (mg/day) was assessed using a food frequency questionnaire adapted to reflect regional and ethnic food preferences. SES was categorized into three levels defined by the participant's educational level and occupation. RESULTS: After adjustment for age and energy intake, potassium and calcium intake increased with increasing SES for both sexes. Sodium intake was high for all groups and did not vary markedly with SES, but sodium to potassium and sodium to calcium ratios decreased with increasing SES. In addition, high SES individuals were more likely to believe that diet affects risk for disease and to report less salt use at the table and less current sodium consumption than in the past. CONCLUSION: These data indicate that nutritional beliefs as well as the consumption of electrolytes are associated with SES in Black adults.

Adult↗

PubMed1991

Predictors of relapse in sexual practices among homosexual men.

Selected sociodemographic, psychosocial, and behavioral variables were used to predict maintenance or relapse in sexual practices over a 1-year interval in a cohort of homosexual men in Chicago. Univariate analyses and multivariate logistic regression were used to define predictive models for safer practices separately for insertive and receptive and sex. Demographic and psychosocial variables were not associated with subsequent relapse. Neither was HIV serostatus. Using more rigorous multiple logistic regression, only monogamous relationships, less peer support, and less assertiveness in negotiating safer sex appeared to predict relapse to less safe practices. The importance of interpersonal variables and social norms for future interventions among homosexual men is discussed.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Hypertension in Brazil: a review of the epidemiological evidence.

Population-based studies of hypertension in Brazil were reviewed. Nineteen studies were identified, all employing cross-sectional study designs. The majority of these studies were conducted in the south and southeast regions of the country, although increasing mortality from cardiovascular diseases is now a nationwide problem in Brazil. Except for Amazonian Indians, age and blood pressure were positively correlated in the studies reviewed. Men generally had higher blood pressures than women up to age 50; studies consistently reported that blacks, or groups combining blacks and mulattoes, had higher blood pressures than whites. Methodological problems that characterize many of these studies were noted, and some suggestions for future research were offered.

Adolescent↗

PubMed1990

Work-related physical exertion and risk of preterm, low birthweight delivery.

Although many women work during pregnancy, the effect of maternal job experience on pregnancy outcome is controversial. We investigated whether work-related physical exertion increases a woman's risk of delivering a preterm, low birthweight infant. We studied 773 employed, pregnant women included in the National Longitudinal Survey of Labor Market Experience, Youth Cohort (NLSY), a nationally representative sample of young adults. Data concerning work status, job title during pregnancy, and other factors affecting the outcome of pregnancy were obtained from the NLSY. Assessment of physical exertion was based on job title, using an established catalogue of occupational characteristics. Women in jobs characterised by high physical exertion experienced a higher rate of preterm, low birthweight delivery, defined as maternal report of delivery more than 3 weeks early and birthweight under 2,500 g (adjusted RR = 5.1, 95% CI = 1.5, 17.7). These findings support a policy of limiting work-related physical exertion during pregnancy.

Adolescent↗

PubMed1990

Work-related psychosocial stress and risk of preterm, low birthweight delivery.

We investigated whether work-related psychologic stress--defined as work characterized by both high psychologic demands and limited control over the response to these demands--increases a woman's risk of delivering a preterm, low birthweight infant. We studied 786 employed pregnant women included in the National Longitudinal Survey of Labor Market Experience, Youth Cohort (NLSY), a nationally representative sample of 12,686 young adults. Data concerning work status, job title, and other factors affecting pregnancy outcome were obtained from the NLSY. Assessment of job experience was based on job title, using an established catalogue of occupation characteristics. After accounting for the physical exertion entailed in a job, occupational psychologic stress as measured by job title was not associated with preterm, low birthweight delivery for the sample as a whole (Relative risk = 1.16, 95% confidence interval .45, 2.95). For those women who did not want to remain in the work force, work-related stress increased their risk of experiencing this outcome (RR = 8.1, 95% CI 1.5, 50.2). Personal motivation toward work, as well as the physical effort of work, should be considered in evaluating the impact of a job's psychologic characteristics on pregnancy outcome.

Adult↗

PubMed1989

The association between depressive symptoms and mortality among older participants in the Epidemiologic Catchment Area-Piedmont Health Survey.

The association between depression and two-year mortality risk was assessed in 1,606 elderly community participants in the 1982-83 Epidemiologic Catchment Area-Piedmont Health Survey. Two depression measures were formed from the Diagnostic Interview Schedule (DIS) depressive symptom items. Neither measure was associated with mortality in univariate or multiple logistic regression analyses. The adjusted relative risk of mortality comparing the lowest to highest levels of a three-level depression variable was 0.9 (95% confidence interval = 0.5-1.4). Similar results were obtained with other versions of the depression variables, with each depressive symptom category, and within sex, chronic disease, widowhood status, and age groups. These results indicate that depression does not increase mortality in elderly adults, but the short follow-up, sample characteristics, and operationalization of depression may have affected this association.

Age Factors↗

PubMed1989

Chronic stressors and maternal depression: implications for prevention.

We report on the use of an instrument to measure exposure to stressors among 149 women presenting with their children for pediatric care at an urban primary care center. Overall, 38.3 percent of the women had significant levels of depressive symptoms; 71.4 percent of those in the "high stress" group had an adjusted prevalence odds ratio of 5.00 [95% CI = 2.12, 11.82]. We conclude that screening in the pediatric office is feasible for identifying women at high risk of becoming depressed.

Depression↗