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PubMed2002

Racing Alaskan sled dogs as a model of "ski asthma".

Athletes who play sports in cold weather, particularly skaters and cross-country skiers, have an increased prevalence of lower airway disease that is hypothesized to result from repeated penetration of incompletely conditioned air into the lung periphery. In this study, we investigated the hypothesis that canine winter athletes also suffer from increased prevalence of lung disease secondary to hyperpnea with cold air. Bronchoscopy and bronchoalveolar lavage was conducted in elite racing sled dogs 24 to 48 hours after completion of a 1,100-mile endurance race. Bronchoscopic abnormalities were classified as none, mild, moderate, or severe, based on the quantity and distribution of intralumenal debris. Eighty-one percent of the dogs (48 of 59) examined had abnormal accumulations of intralumenal debris, with 46% (27 of 59) classified as moderate or severe, indicating significant accumulation of exudate. Bronchoalveolar lavage obtained from dogs after the race had significantly higher nucleated macrophage and eosinophil counts compared with sedentary control dogs. Our findings support the hypothesis that strenuous exercise in cold environments can lead to lower airway disease and suggest that racing sled dogs may be a useful naturally occurring animal model of the analogous human disease.

Alaska↗
PubMed2006

Variations in primary open-angle glaucoma prevalence by age, gender, and race: a Bayesian meta-analysis.

PURPOSE: To quantify the variation in primary open-angle glaucoma (OAG) prevalence with age, gender, race, year of publication, and survey methodology. METHODS: Medline, EMBASE, and PubMed were searched for studies of OAG prevalence. Studies with defined population samplings were sought. Forty-six published observational studies of OAG prevalence (103,567 participants with 2509 cases of OAG) were identified for inclusion in the systematic review and meta-analysis. Data on the number of people and the number of cases of OAG by age, race, and gender were sought for each study. Additional information was obtained regarding whether the definition of glaucoma relied on raised intraocular pressure (IOP) and whether visual field examination was performed routinely on all individuals. Bayesian meta-analysis was used to model the associations between the log odds of OAG and age, race, gender, year of publication, method of visual field testing, and effect of reliance on IOP in the definition of OAG. RESULTS: Black populations had the highest OAG prevalence at all ages, but the proportional increase in prevalence of OAG with age was highest in white populations. The odds ratio per decade increase in age was 2.05 in white populations (95% credible interval, 1.91 to 2.18), 1.61 (95% credible interval, 1.53 to 1.70) in black populations, and 1.57 (95% credible interval, 1.46 to 1.68) in Asian populations. The average estimated prevalence in those older than 70 years of age was 6% in white populations, 16% in black populations, and 3% in Asian populations. After adjusting for age, race, year of publication, and survey methods, men were 1.37 (95% credible interval, 1.22 to 1.53) times more likely than women to have OAG. The prevalence of OAG was one third lower in studies in which routine visual fields were not assessed and that used an IOP criterion in the definition of glaucoma; this effect was reduced to the null after adjustment for age, racial group, and year of publication. CONCLUSIONS: Although black populations had the highest prevalence of OAG at all ages, white populations showed the steepest increase in OAG prevalence with age. Men were more likely than women to have OAG.

Adult↗
PubMed2006

Early-life origins of the race gap in men's mortality.

Using a life course framework, we examine the early life origins of the race gap in men's all-cause mortality. Using the National Longitudinal Survey of Older Men (1966-1990), we evaluate major social pathways by which early life conditions differentiate the mortality experiences of blacks and whites. Our findings indicate that early life socioeconomic conditions, particularly parental occupation and family structure, explain part of the race gap in mortality. Black men's higher rates of death are associated with lower socioeconomic standing in early life and living in homes lacking both biological parents. However these effects operate indirectly through adult socioeconomic achievement processes, as education, family income, wealth, and occupational complexity statistically account for the race gap in men's mortality. Our findings suggest that policy interventions to eliminate race disparities in mortality and health should address both childhood and adult socioeconomic conditions.

Black or African American↗
PubMed2004

A threat in the computer: the race implicit association test as a stereotype threat experience.

Three experiments test whether the threat of appearing racist leads White participants to perform worse on the race Implicit Association Test (IAT) and whether self-affirmation can protect from this threat. Experiments 1 and 2 suggest that White participants show a stereotype threat effect when completing the race IAT, leading to stronger pro-White scores when the test is believed to be diagnostic of racism. This effect increases for domain-identified (highly motivated to control prejudice) participants (Experiment 2). In Experiment 3, self-affirmation inoculates participants against stereotype threat while taking the race IAT. These findings have methodological implications for use of the race IAT and theoretical implications concerning the malleability of automatic prejudice and the potential interpersonal effects of the fear of appearing racist.

Adult↗
PubMed2000

Illness intrusiveness explains race-related quality-of-life differences among women with systemic lupus erythematosus.

Our objective was to investigate whether quality of life in systemic lupus erythematosus (SLE) differs across ethnoracial groups and to identify factors that may explain race-related differences. Self-administered questionnaire data from 335 White, 40 Black, and 30 Asian women with SLE were obtained from a multi-center database. Measures assessed illness intrusiveness, psychological well-being, depressive symptoms, musculoskeletal pain, and learned helplessness. Extent of SLE disease activity was indexed by self-reported functional-system involvement. Educational attainment was indicated by number of years in school. Principal-components analysis reduced the four psychosocial measures to a single factor score. This represented psychosocial well-being In path analysis. Psychosocial well-being differed significantly across the three groups, with Whites reporting the highest, and Blacks the lowest, levels. Path analysis indicated that illness intrusiveness accounted for this race-related difference. Although disease activity was significantly associated with psychosocial well-being, it did not differ across ethnoracial groups. Illness intrusiveness and educational attainment emerged as independent mediators of the race-related difference in psychosocial well-being. We conclude that race-related quality-of-life differences exist among women with SLE and are mediated independently by illness intrusiveness and educational attainment.

Asia↗
PubMed2000

The effect of race on the referral process for invasive cardiac procedures.

Coronary artery disease is the leading cause of death in the United States. Blacks are more likely than whites to experience premature disease, and they have poorer prognosis after acute myocardial infarction. Multiple studies have demonstrated that blacks are less likely to be referred for certain invasive cardiac procedures. Few studies have examined the effect of race on physician and patient decision making in referrals for cardiac procedures. The authors present a framework for the complex series of steps involved in obtaining invasive cardiac care. Patient race can affect each of these steps, and differences in physician and patient race may be a particular impediment to effective communication about symptoms and preferences and to the establishment of a therapeutic partnership. The potential role of communication in race-discordant physician-patient relationships suggests a need for more research in physician decision making and for efforts to promote cultural competency as a core component of medical education.

Adult↗
PubMed2005

Race differences in the relationship between role experiences and well-being.

Theory and research generally support the notion that social roles benefit subjective well-being. These conclusions, however, are largely based on studies examining Whites. Studies that have included Blacks have found race differences in the influence of social roles on well-being, yet most of these studies focus on role occupancy. With few exceptions, little attention has been paid to whether there are race differences in how individuals experience their roles, and the extent to which race differences in role experiences relate to differences in well-being. In this article we examine racial variation in the experience of work and family roles. We find that Blacks and Whites are similar in their experiences of role conflict and perceptions of role success and balance, but the association between these experiences and well-being varies, to some extent, by race and gender. The implications of these findings as well as suggestions for future research are discussed.

Adult↗
PubMed2003

Reexamining age, race, site, and thermometer type as variables affecting temperature measurement in adults - A comparison study.

BACKGROUND: As a result of the recent international vigilance regarding disease assessment, accurate measurement of body temperature has become increasingly important. Yet, trusted low-tech, portable mercury glass thermometers are no longer available. Thus, comparing accuracy of mercury-free thermometers with mercury devices is essential. Study purposes were 1) to examine age, race, site as variables affecting temperature measurement in adults, and 2) to compare clinical accuracy of low-tech Galinstan-in-glass device to mercury-in-glass at oral, axillary, groin, and rectal sites in adults. METHODS: Setting 176 bed accredited healthcare facility, rural northwest USParticipants Convenience sample (N = 120) of hospitalized persons GreaterEqual; 18 years old.Instruments Temperatures ( degrees F) measured at oral, skin (simultaneous), immediately followed by rectal sites with four each mercury-glass (BD) and Galinstan-glass (Geratherm) thermometers; 10 minute dwell times. RESULTS: Participants averaged 61.6 years (SD 17.9), 188 pounds (SD 55.3); 61% female; race: 85% White, 8.3% Native Am., 4.2% Hispanic, 1.7 % Asian, 0.8% Black. For both mercury and Galinstan-glass thermometers, within-subject temperature readings were highest rectally; followed by oral, then skin sites. Galinstan assessments demonstrated rectal sites 0.91 degrees F > oral and FullEqual; 1.3 degrees F > skin sites. Devices strongly correlated between and across sites. Site difference scores between devices showed greatest variability at skin sites; least at rectal site. 95% confidence intervals of difference scores by site ( degrees F): oral (0.142 - 0.265), axilla (0.167 - 0.339), groin (0.037 - 0.321), and rectal (-0.111 - 0.111). Race correlated with age, temperature readings each site and device. CONCLUSION: Temperature readings varied by age, race. Mercury readings correlated with Galinstan thermometer readings at all sites. Site mean differences between devices were considered clinically insignificant. Still considered the gold standard, mercury-glass thermometers may no longer be available worldwide. Therefore, mercury-free, environmentally safe low-tech Galinstan-in-glass may be an appropriate replacement. This is especially important as we face new, internationally transmitted diseases.

Journal Article↗
PubMed2006

Race-specific geography of prostate cancer incidence.

BACKGROUND: This study evaluated geographic distribution of race-specific prostate cancer incidence in Connecticut and Massachusetts. This cross-sectional analysis of census and cancer registry data included records of 29,040 Whites and 1,647 African Americans diagnosed with incident prostate cancer between 1994 and 1998. A spatial scan statistic was used to detect and test significance of the geographic variation in race-specific incidence rates within the two-state area. RESULTS: Significant geographic variation in age-adjusted incidence rates among both White and African American men was observed, with little overlap noted between distributions. Identified locations reflected patterns of residential segregation and socio-economic conditions. Among Whites, places with higher than expected incidence had higher socioeconomic status than places with lower than expected incidence. No discernable relationship between social indicators and rate variation among African Americans was evident. CONCLUSION: Differences in race-specific geographic distribution of prostate cancer incidence do not suggest a shared environmental etiology. Further study of genetic, behavioral and health care factors affecting the occurrence and/or reporting of the disease is warranted. This study highlights the need for race- and geographic-specific interventions to better control disease within at-risk communities and for on-going analysis into social and contextual factors that contribute to observed disparities between African Americans and Whites in the occurrence of cancer.

Black or African American↗
PubMed1995

Assessment of transcript polyadenylation by 3' RACE: the response of epidermal growth factor messenger ribonucleic acid to thyroid hormone in the thyroid and submaxillary glands.

The complementary DNA (cDNA) sequence of epidermal growth factor (EGF) indicates that its 3' untranslated region (3' UTR) is 745 bases long, with polyadenylation occurring at residue 4749. However, when we used reverse transcriptase-polymerase chain reaction (RT-PCR) with an anchored 3' primer [3'rapid amplification of cDNA ends (RACE)] to amplify the 3' ends of cDNA, we actually detected two major products [800 and 600 base pairs (bp)] and a minor product (400 bp) in the thyroid or submaxillary glands (SMGs) of male mice. Analysis of genomic DNA with a battery of primer pairs gave only the predicted PCR products from the 3' UTR, demonstrating the lack of introns in this region of genomic DNA and eliminating alternate splicing as the explanation of the transcript diversity we detected. We confirmed that two potential polyadenylation sites proximal to residue 4749 are used in vivo by hybridizing the same 3' RACE products with probes specific for the 5' end of the 3' UTR, and also for poly-A tails. To assess the distribution of poly-A tail lengths on transcripts using the terminal polyadenylation site (4749), we used several different approaches to analyze 3' RACE products. Solution hybridization with 3' UTR probes revealed a striking difference between transcripts in SMG and thyroid: SMG contained two large 3' RACE populations (approximately 770 and 870 bp), whereas thyroid only contained one (approximately 770 bp). EGF transcript heterogeneity due to different poly-A tail lengths was confirmed using an upstream primer 400 bases closer to the 3' end of the 3' UTR, and TaqI digestion. Again we found two major populations in SMG (approximately 380 and 480 bp), but only one (380 bp) in thyroid, which upon TaqI digestion showed tissue-specific heterogeneity only in the 3' fragment. T4 treatment of male mice (0.25 microgram T4/gm ip) increased the intensity of both populations in SMG and the smaller population in thyroid within 24 h. However, after a week of T4 injections, only the intensity of the population with the longer poly-A tails in the SMG remained elevated, a finding consistent with tissue-specific enhanced stability of transcripts due to polyadenylation. Finally, to resolve poly-A tail lengths more precisely, we used an upstream primer that was specific for the 3' end of murine 3' UTR. This approach revealed that the thyroid contains three major populations of EGF transcripts, with poly-A tail lengths of approximately 20, 50, and 70 A's. After T3 treatment for 24 h, the intensity of transcripts containing 20 A's increased 52% (P < 0.02) and those with 50 A's increased 130% (P < 0.01), whereas there was no change in transcripts with tails > or = 70 A's. On the other hand, there were no distinct bands in SMG samples, but rather a heterogeneous distribution of poly-A tail lengths from approximately 20-120 A's that showed an overall increase of approximately 60% in response to T3.

Alternative Splicing↗
PubMed2006

Does multiple sclerosis-associated disability differ between races?

OBJECTIVE: To investigate differences in disability between African American and Caucasian patients with multiple sclerosis (MS) by comparing the relationship between current age and disability between races and by assessing the effect of adjustment for socioeconomic status (SES) on the associations. METHODS: The authors selected US participants from the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry with an age at symptom onset of 10 to 60 years, who reported their race as Caucasian or African American (n = 21,557). They classified participants as having mild, moderate, or severe disability in the domains of mobility, hand function, cognition, and vision using Patient Determined Disease Steps and Performance Scales and assessed the association of disability with race using polytomous logistic regression. RESULTS: Disability increased more rapidly with increasing disease duration in older patients, but there was no interaction between race and age. African Americans had increased odds of severe vs mild disability in all four domains (odds ratio [OR] [95% CI]: hand 1.35 [1.10 to 1.64]; vision 1.75 [1.37 to 2.27]; cognition 1.32 [1.04 to 1.67]; mobility 1.32 [1.11 to 1.56]). Adjustment for all covariates, including SES, attenuated these associations (OR [95% CI]: hand 1.27 [1.00 to 1.61]; vision 1.59 [1.19 to 2.08]; cognition 0.98 [0.74 to 1.30]; mobility 1.37 [1.11 to 1.67]). Lack of adjustment for SES produced stronger associations. After enrollment in NARCOMS, disability progression did not differ between the groups. CONCLUSIONS: African Americans experience greater multiple sclerosis-associated disability than Caucasians. Failure to account for socioeconomic status leads to overestimation of these differences. Disease progression is similar in African Americans and Caucasians after diagnosis.

Adolescent↗
PubMed1994

Access to long-term care: race as a barrier.

Race continues to impede access to health services, for acute as well as long-term care. Whites, for example, use disproportionately more days of nursing home care than nonwhites, not simply because they are more likely to be private payers and, therefore, are preferred over nonwhites: the difference in utilization persists even among those whose nursing home stays are covered by Medicare. Using data from a study of patients awaiting alternative placement in North Carolina acute care general hospitals in 1991, this article examines racial differences in discharge delay, that is, in the time between when a patient is medically ready for discharge to another form of care and when he or she actually is discharged. Logistic regression and ordinary least squares are used heuristically to identify patient characteristics associated with delay, and two-way analyses of variance are used to document the independent effect of race. The results indicate that race has substantial independent explanatory power. This finding is reinforced by the analysis of variance with controls for the patient's payment source for long-term care, chronic condition or special care requirements, demographic attributes, family cooperativeness, whether the patient had a behavior problem that impeded the discharge planning process, and whether there was a financial problem in arranging for the patient's discharge. The inescapable conclusion is that nursing homes discriminate on the basis of race in admitting patients. This practice is patently objectionable; it also is costly to hospitals, thus to society, since hospitals bear the direct costs of delayed discharges and hospitals do not keep costs to themselves. While research is needed to determine whether the North Carolina findings are replicable in other states, past research suggests that the problem is not confined to this state.

Black or African American↗
PubMed2003

Impact of a competitive marathon race on systemic cytokine and neutrophil responses.

PURPOSE: To investigate whether cytokines and neutrophils mediate exercise-related pathogenesis, we examined their responses and possible association after exhaustive exercise. METHODS: Plasma and urine samples were obtained from 10 male runners before and after a 42.195-km marathon race. Major cytokines and neutrophil activation markers [myeloperoxidase (MPO) and lactoferrin (LTF)] were measured by enzyme-linked immunosorbent assays. Functional modulation of standard neutrophils and monocytes by plasma was determined on their luminol-dependent chemiluminescence responses. RESULTS: The race induced peripheral neutrophilia accompanied by an increase in band neutrophils and monocytosis. Plasma MPO and LTF concentrations increased significantly by 1.8 and 1.4 times after the race. There was a greater increase in urine concentrations of MPO and LTF, 12.3 and 3.5 times after exercise, respectively, suggesting that neutrophil activation occurred and that renal clearance exceeded the increase in plasma concentrations. Plasma interleukin (IL)-6, IL-8, IL-10, granulocyte colony-stimulating factor (G-CSF), macrophage CSF (M-CSF), and monocyte chemotactic protein 1 (MCP-1) increased significantly after the race, and urine IL-1beta, IL-6, G-CSF, M-CSF, and MCP-1 increased significantly. The plasma IL-6 responses correlated with the increases of band neutrophil count (r = 0.860, P < 0.01), suggesting IL-6-mediated bone marrow release of neutrophils. Furthermore, the increases in urine MPO concentration were correlated with increases in urine IL-6 (r = 0.868, P < 0.01) and G-CSF (r = 0.875, P < 0.01), suggesting that these cytokines promoted neutrophil activation. However, preincubation of neutrophils and monocytes with postexercise plasma could not cause priming responses, possibly because of the exercise-induced enhancement of plasma antioxidant activity. CONCLUSION: Although many cytokines recruiting and priming neutrophils and monocytes were secreted and functional after exhaustive exercise, overwhelming antioxidant and antiinflammatory defenses were induced, preventing exercise-induced oxidative stress.

Adult↗
PubMed2005

Effect of training and rest on respiratory mechanical properties in racing sled dogs.

INTRODUCTION: Racing Alaskan sled dogs develop exercise-induced airway inflammation, similar to that reported for elite human athletes participating in cold-weather sports. These human athletes also have airway hyperresponsiveness, but airway function in sled dogs has not been measured. PURPOSE: To compare respiratory mechanical properties in trained, rested Alaskan sled dogs with typical laboratory hounds, and to determine whether subsequent training alters respiratory mechanical properties. METHODS: Nineteen healthy adult Alaskan sled dogs were compared with five healthy adult mixed-breed laboratory hounds. All dogs were rested for at least 4 months before examination. Respiratory mechanical properties were measured while the dogs were anesthetized and ventilated with a piston ventilator. The mean respiratory resistance and compliance measurements for 20 consecutive breaths were used as baseline values immediately before measurement of respiratory reactivity. Respiratory reactivity was the mean of 20 consecutive breaths immediately after the administration of aerosol histamine, expressed as the percentage change in prehistamine measurements. After the initial examinations, the sled dogs were divided into exercised and controls. Exercised dogs were trained for competitive endurance racing. Both groups were examined after 2 and 4 months of training. RESULTS: Alaskan sled dogs had greater respiratory compliance reactivity to histamine (77.47 +/- 8.58% baseline) compared with laboratory dogs (87.60 +/- 9.22% baseline). There was no effect of training on respiratory mechanical properties detected in racing sled dogs. CONCLUSIONS: Racing Alaskan sled dogs have airway dysfunction similar to "ski asthma" that persists despite having 4 months of rest. These findings suggest that repeated exercise in cold conditions can lead to airway disease that does not readily resolve with cessation of exercise.

Aerosols↗
PubMed2001

Is variation in quality of mammographic services race linked?

The purpose of this investigation was to (1) determine whether there was variability in the quality of services offered in mammography facilities across Connecticut and (2) determine whether African American women were more likely than white women to receive mammograms in facilities that offered substandard services. Since most facilities do not routinely record information on race, this investigation represents a unique opportunity to address the question of race-linked variation in the quality of screening mammography. Information on equipment, personnel, and record keeping in mammography facilities was used to construct indices that represented separate domains of quality: technical attributes, educational practices, and tracking of clients. While some variation in the quality of mammography services was found, there were no significant differences between the two race categories in the mean scores for each of three quality indices. Thus, variation in quality of screening mammographic services does not appear to be race linked.

Accreditation↗
PubMedDate not supplied

Health disparities by race and class: why both matter.

In this essay we examine three competing causal interpretations of racial disparities in health. The first approach views race as a biologically meaningful category and racial disparities in health as reflecting inherited susceptibility to disease. The second approach treats race as a proxy for class and views socioeconomic stratification as the real culprit behind racial disparities. The third approach treats race as neither a biological category nor a proxy for class, but as a distinct construct, akin to caste. We point to historical, political, and ideological obstacles that have hindered the analysis of race and class as codeterminants of disparities in health.

Health Status Indicators↗
PubMed2001

Impact of race in lung cancer: analysis of temporal trends from a surveillance, epidemiology, and end results database.

STUDY OBJECTIVES: We analyzed data from a community-based cancer database over a 26-year period in order to characterize clinicopathologic differences between black and white patients with lung cancer, and to identify relevant temporal trends in incidence and survival. DESIGN, SETTING, AND PATIENTS: Data on demographics, stage, histology, and survival were obtained on all black and white patients with primary bronchogenic carcinoma registered in the community-based metropolitan Detroit Surveillance, Epidemiology, and End Results database from 1973 to 1998. RESULTS: Of 48,318 eligible patients, 23% were black. Lung cancer incidence rates decreased for men of both races from 1985 to 1998, with a greater decline occurring in black men (p < 0.0001). Although incidence rates declined over time for men of both races < 50 years of age, this decrease was greater in white men, resulting in an increase in the racial differential in younger men. Temporal trends in incidence rates were similar for women of both races. The incidence of distant-stage disease was higher among blacks throughout the study period. The incidence of local-stage disease decreased for both races, though this decline was greater in blacks. A significant racial difference in 2-year and 5-year survival rates developed during the study period, due to a distinct lack of improvement in black patients. In a multivariate model, the relative risks of death for black patients, relative to white patients, were 1.24 (p < 0.0001) for local stage, 1.14 (p < 0.0001) for regional stage, and 1.03 (p = 0.045) for distant stage. CONCLUSION: Significant racial differences exist in the incidence and survival rates for lung cancer in metropolitan Detroit. Since 1973, several disturbing trends have developed, particularly with regard to the lack of improvement in overall survival in black patients. Further study is required to determine the factors responsible for these temporal trends.

Adenocarcinoma↗
PubMed2005

A new 5' terminal murine GAPDH exon identified using 5'RACE LaNe.

In this work, a ligation-independent, fully gene-specific, nested polymerase chain reaction (PCR) method for the elucidation of 5' cDNA sequence is described and demonstrated for the first time. Two manifestations of the method, rapid amplification of cDNA ends (RACE) by lariat-dependent nested PCR 5' (RACE LaNe), at least as simple to perform as conventional RACE, were successfully applied to the murine housekeeping genes phosphoglycerate kinase 1 (PGK1), beta-actin (beta-ACT), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) and the alpha thalassemia mental retardation Y homolog (ATRY) gene of the marsupial, Macropus eugenii. Significantly, a new murine GAPDH 5' exon, separated by 365 kb of intronic sequence from previously annotated GAPDH sequence, was discovered using 5'RACE LaNe.

5' Untranslated Regions↗