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At least 487 records · Page 27Linked to original sources
PubMed1999

Limitations in the use of race in the study of disease causation.

Tremendous variation exists in the rates of many chronic diseases across racial groups. However, serious technical and conceptual limitations hamper the ability of racial comparisons to illuminate the causative pathways. First, race is confounded by social class, which is complex, and like other confounders of race, may not be measured with equal validity across racial groups. Second, statistical "adjustments" for race effects can be misleading since residual confounding may be misconstrued as a genetic effect. Third, the biologic concept of race tempts us to ignore the context dependency of genetic expression. When trying to detect genetic effects, both the environmental and genetic contributions must be measured and potential gene-environment interactions accounted for. Unfortunately, this process is beyond our current technical capabilities. To move forward on the problem of prostate cancer and other diseases distinguished by marked ethnic differentials, investigators need a more comprehensive understanding of the factors that mediate the apparent effect of race combined with valid measures of those factors, as well as novel strategies that can help overcome the technical and interpretive limitations of statistical adjustment. Finally, the "grand" theories of race-based genetic susceptibility must be replaced with rigorous criteria to determine when a trait can be ascribed to some genetic origin.

Causality↗
PubMed2002

Categorizing race and ethnicity in the HMO Cancer Research Network.

BACKGROUND: The Cancer Research Network (CRN) was formed in 1999 with funding from the National Cancer Institute. The CRN represents a collaboration of 10 health plans across the United States, with a combined total of approximately 9 million enrollees. The goal of the CRN is to promote collaborative research, which will ultimately increase the effectiveness of preventive, curative, and supportive interventions for major cancers. Special emphasis is placed upon diverse populations, and racial and ethnic differences in outcomes, costs, and cost effectiveness. PURPOSE: There is increasing awareness in the research literature of the relationship between race and ethnicity and health outcomes. However, the majority of the health maintenance organizations represented in the CRN, similar to other health plans and organizations, do not routinely collect race and ethnicity data on their members. In order to compare data and outcomes across the CRN sites, consensus is needed in the measurement of race and ethnicity. METHODS: This review discusses terminology used in the research literature to describe race and ethnicity and the manner in which these constructs have been measured in previous studies. CONCLUSIONS: This review concludes with suggestions for standardized measures of race and ethnicity. IMPLICATIONS: It is hoped that shared conceptualizations of race and ethnicity will lead to improved data quality and precision in measurement.

Cooperative Behavior↗
PubMed2004

[Rapid construction of full-length MnSOD cDNA of chickens by one-step 3'RACE].

RACE (rapid amplification of cDNA ends) is a popular technique to rapidly obtain the full-length cDNA. After obtaining the 3' cDNA and 5' cDNA fragments with a overlapped region by 3' RACE and 5' RACE, the full-length cDNA could be generated by end-to-end PCR or subcloning. In this study, 3' RACE combined with touch-down PCR was successfully used for the rapid construction of full-length MnSOD cDNA of chickens. Compared with the conventional end-to-end PCR or subcloning, this method, called one-step 3' RACE, is fast, economical and highly specific. It especially fits the rapid construction of full-length cDNA by RACE method.

Animals↗
PubMed2005

Collecting information on race, Hispanic ethnicity, and birthplace of cancer patients: policies and practices in Connecticut hospitals.

OBJECTIVE: Cancer incidence, treatment, and prognosis show important disparities by race, Hispanic ethnicity, and birthplace, but hospital policies and procedures in obtaining this information are poorly documented. This study documented policies and procedures in a state (Connecticut) with a high-quality population-based cancer registry. METHODS: Directors of medical records and/or admissions at all 30 hospitals were surveyed, and hospital records were abstracted for a sample of 220 minority (African-American/Black, Asian, and Hispanic) cancer patients diagnosed in 2000-2001 at three hospitals of various sizes. RESULTS: At least one staff member at 86% of the 28 responding hospitals reported a hospital policy to ask patients about their race, vs 25% for ethnicity and 57% for birthplace, and patient self-reports were reportedly used to obtain race in 100% of hospitals vs 54% for ethnicity. Race was regarded as "very important" or "important" by staff at 89% of hospitals, vs only 46% for ethnicity and 61% for birthplace, and 68% of hospitals reported using a single item for both race and ethnicity. Results of record abstraction for the 220 minority patients at the three selected hospitals were generally consistent with data from surveys of hospital staff. Ethnicity was rarely recorded on any specific type of document, although preferred language was usually recorded. Disagreement in recorded race or ethnicity on different documents was rare (2%-3%). CONCLUSIONS: Efforts are needed to educate hospital staff on the importance of collecting information on Hispanic ethnicity and birthplace. Similar studies are needed in other states.

Connecticut↗
PubMedDate not supplied

[Biventricular functional adaptation during a prolonged race. An analysis of global and regional ventricular function].

To determine the effects of a six-hour competitive race on left and right ventricular performance, 99mTc gated blood pool scans were performed to 6 long distance runners before the race (rest), each hour during the race and one hour after concluding the exercise (recovery). Heart rate increased during the race, peaking at 4th hour of competition (55 +/- 3 to 110 +/- 9 lpm; p = 0.001). Evolution of right ventricular ejection fraction showed a similar behavior with the evolution of left ventricular ejection fraction during the competition (r = 0.39; p = 0.006). Blood volume in the lungs increased at the end of the race (index 1.13 +/- 0.14) normalizing at recovery (index 1.03 +/- 0.03). Left and right ventricular peak filling rate had an inverse correlation with pulmonary blood volume (r = -0.31; p = 0.041 and r = -0.47; p = 0.001 respectively). Both left and right ventricular ejection fraction had an inverse correlation with pulmonary blood volume (r = -0.38; p = 0.006 and r = -0.34; p = 0.01 respectively). The anteroseptal regional ejection fraction showed an inverse correlation with end-systolic and end-diastolic volume (r = -0.32; p = 0.03 and r = -0.4; p less than 0.01 respectively). The posterolateral region showed a parallel evolution with the global ejection fraction for both left and right ventricles (r = 0.57; p less than 0.0001 and r = 0.38; p = 0.009 respectively). In conclusion, a transient biventricular functional adaptation during a prolonged race is related to pulmonary blood volume redistribution and to a higher preload for both ventricles and a greater afterload for the right ventricle. The posterolateral and inferoapical regions show a similar behavior as both left and right ventricular ejection fraction, response that does not occur with the anteroseptal regional ejection fraction.

Adaptation, Physiological↗
PubMed2006

[The analysis of HLA-A, B and DRB1 allelic polymorphism in Han race population in Lanzhou region of China].

OBJECTIVE: To investigate the HLA-A, B and DRB1 allele polymorphism of the Han race population in Lanzhou area. METHODS: Polymerase chain reaction-sequence specific primer was used to detect HLA-A, B and DRB1 alleles in 200 unrelated healthy Han individuals from Lanzhou region, Northwest China, and the results were compared with those of Han populations in North, South and Northwest China, and Hui, Uigur and Tibetan population in China. RESULTS: Fourteen of alleles were detected and identified for HLA-A; 32 for HLA-B; and 13 for HLA-DRB1. HLA- A*01, A*02,A*11,A*24, A*30, A*31, A*33; HLA- B*13, B*15, B*40, B*44, B*46, B*51, B*58, B*60; HLA- DRB1*04,. DRB1*07, DRB1*08, DRB1*09, DRB1*11, DRB1*12, DRB1*14 and DRB1*15 were the most common alleles. The frequencies of HLA-A, B and DRB1 genes of Lanzhou Han race were close to that of North China Hans and Hui population in Northwest China, and a little different to that of South China Hans. The HLA-DRB1 alleles were significantly different to those of Uigur and Tibetan race population of China. CONCLUSION: The allelic polymorphism of HLA-A,B and DRB1 loci of Han race population in Lanzhou area was between North and South Han race of China, close to Northwest China Hui, and markedly different to Northwest China Uigur and Tibetan race populations.

Adult↗
PubMed1990

Simulating the effects of poverty on the race disparity in postneonatal mortality.

The U.S. postneonatal mortality rate has declined from over 60 postneonatal deaths per 1,000 live births at the turn of the century to below 4 deaths in 1987. It is generally accepted that this impressive decline is due to improvements in the general standard of living throughout the twentieth century. However, efforts to reduce the race differential in postneonatal mortality have been less successful. Black postneonatal mortality rates have been roughly double the white rate since race-specific data has been collected. This paper examines the degree to which the substantial race disparities in postneonatal mortality are a function of race disparities in the prevalence of poverty. The analysis specifies a race-specific model of postneonatal mortality. The model is then manipulated to allow for a simulation of the impact of reducing black poverty on the postneonatal mortality race disparity. It is concluded that racial postneonatal mortality differentials may be addressed by remedies which need not be explicitly medical intervention (e.g. effective policy that reduces disparities in socioeconomic status).

Black or African American↗
PubMed1988

Immunoassay detection of drugs in racing horses. IV. Detection of fentanyl and its congeners in equine blood and urine by a one step ELISA assay.

We have developed and evaluated a one step enzyme-linked immunosorbent assay (ELISA) test for fentanyl as part of a panel of pre- and post-race tests for narcotic analgesics in racing horses. This ELISA test detects fentanyl with an I-50 of about 100 pg/ml. The test is economical in that it can be read with an inexpensive spectrophotometer, or even by eye. The test is rapid, and ten samples, a normal pre-race complement, can be analyzed in about twenty minutes. The test readily detects the presence of fentanyl or its metabolites in equine blood and urine from two and twenty-four hours respectively after administration of sub-therapeutic doses. The two antibodies evaluated also cross-react with the methylated analogs of fentanyl, sufetanil and carfentanil and the test detected these drugs shortly after their administration to horses. When introduced into routine screening, this test, in combination with another immunoassay test previously described, yielded 10 sufentanil positives. As such this test is capable of both improving the quality and reducing the cost of pre-race and post-race testing for fentanyl and a number of its congeners in racing horses.

Analgesics↗
PubMed1995

Motion sickness incidence during a round-the-world yacht race.

Motion sickness experiences were obtained from participants in a 9 month, round the world yacht race. Race participants completed questionnaires on their motion sickness experience 1 week prior to the start of the race, during the race, and following the race. Yacht headings, sea states, and wind directions were recorded throughout the race. Illness and the occurrence of vomiting were related to the duration at sea and yacht encounter directions relative to the prevailing wind. Individual crewmember characteristics, the use of anti-motion sickness drugs, activity while at sea, and after-effects of yacht motion were also examined with respect to sickness occurrence. Sickness was greatest among females and younger crewmembers, and among crewmembers who used anti-motion sickness drugs. Sickness varied as a function of drug type and activity while at sea. Crewmembers who reported after-effects of yacht motion also reported greater sickness while at sea. The primary determinants of motion sickness were the duration of time spent at sea and yacht encounter direction to the prevailing wind.

Adult↗
PubMed1995

The roles of race and socioeconomic factors in health services research.

For decades data have been collected comparing health care in racial and ethnic groups. The use of such groups in health services research assumes that standard, reliable, and valid definitions of race and ethnicity exist and that these definitions are used consistently. In fact, race is a term often used, but ill defined. It can incorporate biological, social, and cultural characteristics of patients and can refer to both genetic and behavioral traits. Various investigators have reported differences between racial and ethnic groups in health status, disease manifestation and outcome, resource utilization, and health care access, often specifying neither a definition of race nor the measurement they used to classify their study populations. The role of race as an explanatory variable in health services research requires greater scrutiny than many researchers currently provide. Many studies use race as a proxy for other socioeconomic factors not collected in the research effort. This article explores the ambiguities about race as an explanatory variable that render such research difficult to interpret. We suggest that health services researchers focus on nonracial socioeconomic characteristics that might be both more informative and more useful in guiding policy formation.

Ethnicity↗
PubMed1993

[Hematologic changes induced by exertion during a long-distance race].

PURPOSE: To evaluate the haematological changes induced by a long-distance race in well trained runners. PATIENTS AND METHODS: The haematological changes presented by 17 runners (15 men and 2 women) were assessed in a 6-hour race. For this purpose samples were examined before the race, 2 hours later, 4 hours later, at the end of the race, and 4 days after the trial. RESULTS: Haemoglobin rates, as well as leucocyte, neutrophil, monocyte and platelet counts were increased, probably due to decreased plasma volume. Haemolytic traits were seen as well, namely, increased reticulocyte count and decreased haptoglobin. High transferrin-transport capability and serum B12 levels were also present. Mild haematuria was found without any haemosiderinuria, siderinuria or haemoglobinuria. All these changes recovered in the post-race study. CONCLUSION: Changes in the major haematologic values are present during long-distance races, some of them due to haemoconcentration. Leucocytosis, haemolysis and haematuria are noteworthy, and these findings must be borne in mind when evaluating the health of runners.

Adult↗
PubMed1993

Serum biochemical changes in dogs competing in a long-distance sled race.

Fifty-five blood samples were collected from 28 dogs competing in the 1991 Yukon Quest International Sled-Dog Race to examine race-induced changes in serum biochemical values. Blood was collected after a 36-hour mandatory rest at the midpoint of the race, and again at 2 subsequent checkpoints. The mean speed of dogs between checkpoints was approximately 4.5 mph. There were no significant increases in PCV, or in serum total protein, sodium, or creatinine concentrations during the race. Mean serum potassium concentration decreased significantly (P < 0.05) from 4.8 +/- 0.4 to 4.4 +/- 0.3 to 3.9 +/- 0.3 mEq/L, as did the serum triglyceride concentration (138 +/- 52, 88 +/- 25, 81 +/- 16 mg/dl). Plasma cortisol concentration did not change significantly. Increases in the mean serum activity of creatine kinase (167, 420, 344 U/L), and aspartate aminotransferase (55, 79, 62 U/L) during the race were significant (P < 0.05). Participation in a long-distance sled race was associated with mild changes in routinely measured serum biochemical values in dogs.

Animals↗
PubMed1996

Prognosis for return to racing after recovery from infectious pleuropneumonia in thoroughbred racehorses: 70 cases (1984-1989).

OBJECTIVE: To determine the percentage of Thoroughbred racehorses that would be capable of racing performance after recovery from infectious pleuropneumonia. DESIGN: Retrospective case series. ANIMALS: 70 Thoroughbred horses that had recovered from pleuropneumonia. Only horses < or = 5 years old and horses > 5 years old known to be in race training at the time of illness were included in the study. RESULTS: Forty-three of the 70 (61%) horses raced after recovery, and 24 of the 43 (56%) won at least 1 race. Horses that required placement of an indwelling thoracic drain apparently did not have a worse prognosis than did horses that did not require placement of a drain. The prognosis for racing for horses that developed pleuropneumonia-associated complications (pulmonary abscess, cranial thoracic mass, bronchopleural fistula) was worse than the prognosis for horses that did not develop these complications. Duration of hospitalization was not considered indicative of outcome. CLINICAL IMPLICATIONS: In Thoroughbreds, the prognosis for return to racing after recovery from uncomplicated pleuropneumonia appears to be good.

Animals↗
PubMed1996

Spirometry of healthy adult South African men. Part II. Interrelationship between socio-environmental factors and 'race' as determinants of spirometry.

AIM: To examine the interaction of socio-environmental background, 'race' and anthropometry on spirometry. METHODS: A study population of white and black bank workers with broadly comparable current socio-economic circumstances was identified. Detailed questionnaires regarding a number of indicators of socio-environmental status (SES) were administered in addition to anthropometric and spirometric measurements. Multiple linear regression analyses were performed. The Kappa statistic was used to determine the best predictors of SES. RESULTS: 'Race' was found to be the best predictor of SES. Within the black group a sub-classification of high and low SES was possible. In all respects the white SES indicators were higher than those of the black high SES group. Multiple regression analysis showed that sitting height was a better anthropometric predictor of spirometry than standing height. Replacing 'race' with other indicators of SES gave similar measures of prediction (by Mallow's CP statistic) of spirometry in the over-30-year age group. CONCLUSION: The impact of 'race' on spirometry can be reduced substantially by incorporating sitting height and indicators of SES in the regression equations. This observation lends support to the hypothesis that 'race' is not a direct genetic predictor of lung size, but may have an influence because of SES and anthropometric features associated with 'race'.

Adult↗
PubMed1997

Comparison of racing performance before and after treatment of incomplete, midsagittal fractures of the proximal phalanx in standardbreds: 49 cases (1986-1992)

OBJECTIVE: To assess the effect of incomplete, midsagittal fractures of the proximal phalanx (P1) on racing performance in Standardbreds. DESIGN: Retrospective cohort study. ANIMALS: 49 Standardbred horses admitted to the George D. Widener Hospital for Large Animals between July 1986 and December 1992 with a definitive radiographic diagnosis of an incomplete, midsagittal fracture of P1 and a known method of treatment. PROCEDURE: Performance index and racing time were compared before and after diagnosis and treatment of fracture, using ANOVA that controlled for the effects of horse, gender, age, track length, and track condition. RESULTS: Expected racing time increased by 0.7 seconds and performance index decreased by 0.7 points, although controlling for factors known to affect racing performance had a substantial impact on these results. CLINICAL IMPLICATIONS: Standardbreds with incomplete, midsagittal fractures of P1 have a favorable prognosis for return to racing; recovered horses will likely have slower racing times and decreased performance indices.

Animals↗
PubMed1997

The National Cancer Data Base report on race, age, and region variations in prostate cancer treatment.

BACKGROUND: Patterns of care for prostate cancer patients in the United States have changed as early detection has improved. The National Cancer Data Base of the American College of Surgeons Commission on Cancer provides information about the treatment of patients in all age, race, and regional groups from institutions that represent cancer care at the community level as well as in medical centers. METHODS: Data on 251,416 prostate cancer patients diagnosed between 1992 and 1994 were studied. Patient and disease characteristics, including age, race, the geographic region from which a case was reported, American Joint Committee on Cancer stage, and tumor grade were related to the primary pattern of treatment. Stage-standardized comparisons were made among different age groups, race groups, and regional groups. RESULTS: Stage and tumor grade varied little across age, race, and regional classifications. African American patients were more likely than white patients to have Stage IV prostate cancer at the time of diagnosis. Men older than 75 years had greater proportions than younger men of both the earliest and the most advanced stages of cancer. Overall, 24.6% of patients received no cancer-directed therapy, 11.6% were treated with hormones or endocrine surgery, 28.6% received radiation therapy, 28.3% underwent radical prostatectomy, and 6.9% were treated by other modalities or combinations of modalities. Treatment patterns varied markedly by age. The selection of radical prostatectomy relative to no treatment and radiation therapy varied by race and region. CONCLUSIONS: The results of this study showed that prostate cancer treatment varies by patient age, race, and geographic region. The reasons for some of these variations are not well understood and deserve further investigation.

Age Factors↗
PubMed2000

The effect of patient race and socio-economic status on physicians' perceptions of patients.

Despite its potential influence on quality of care, there has been little research on the way physicians perceptions of and beliefs about patients are affected by patient race or socio-economic status. The lack of research in this area creates a critical gap in our understanding of how patients' demographic characteristics influence encounter characteristics, diagnoses, treatment recommendations, and outcomes. This study uses survey data to examine the degree to which patient race and socio-economic status affected physicians' perceptions of patients during a post-angiogram encounter. A total of 842 patient encounters were sampled, out of which 193 physicians provided data on 618 (73%) of the encounters sampled. The results of analyses of the effect of patient race and SES on physician perceptions of and attitude towards patients, controlling for patient age, sex, race, frailty/sickness, depression, mastery, social assertiveness and physician characteristics, are presented. These results supported the hypothesis that physicians' perceptions of patients were influenced by patients' socio-demographic characteristics. Physicians tended to perceive African-Americans and members of low and middle SES groups more negatively on a number of dimensions than they did Whites and upper SES patients. Patient race was associated with physicians' assessment of patient intelligence, feelings of affiliation toward the patient, and beliefs about patient's likelihood of risk behavior and adherence with medical advice; patient SES was associated with physicians' perceptions of patients' personality, abilities, behavioral tendencies and role demands. Implications are discussed in terms of further studies and potential interventions.

Attitude of Health Personnel↗
PubMedDate not supplied

Does race or socioeconomic status predict adverse outcome after out of hospital cardiac arrest: a multi-center study.

OBJECTIVE: To assess whether socioeconomic status (SES) or race is associated with adverse outcome after an out-of-hospital cardiac arrest (OHCA). METHODS: A convenience sample of OHCA of presumed cardiac origin from seven suburban cities in Michigan, 1991-1996. Median household income (HHI), utilizing patient home address and 1990 census tract data, was dichotomized above and below 1990 state median income. Patient race was dichotomized as black or white. Outcome was defined as survival to hospital discharge (DC). Multiple logistic regression and Pearson's chi2 values were used for analysis. RESULTS: Of 1317 cases with complete data for analysis, the average age was 67.3 +/- 16.0, 939 (71.1%) were white, 587 (44.4%) arrests were witnessed (WIT), and 65 (4.9%) were DC alive. There was no significant difference between races with respect to WIT arrests, V(T)/V(F) arrest rhythms, and a small difference in EMS response interval. Whites were more likely to be above median HHI (57.1 vs. 26.2%, P < 0.001). Adjusted odds ratios for predictors of survival were WIT arrest (OR = 3.76, 95% CI (1.7, 8.2)), V(T)/V(F) (OR = 8.74, 95% CI (3.7, 10.8), but not race (OR = 0.68, 95% CI (0.3, 1.4)) or SES (OR = 1.51, 95% C1 0.8, 2.8). CONCLUSION: In this population, neither race nor SES was independently associated with a worse outcome after OHCA.

Black or African American↗