Ethical Dimensions of Disparities in Depression Research and Treatment in the Pharmacogenomic Era

2012 ◽  
Vol 40 (4) ◽  
pp. 886-903 ◽  
Author(s):  
Lisa S. Parker ◽  
Valerie B. Satkoske
Keyword(s):  
African American ◽  
Personalized Medicine ◽  
Cultural Beliefs ◽  
Behavioral Problem ◽  
Response To Treatment ◽  
Depression Treatment ◽  
Elderly Adults ◽  
Related Response ◽  
Health Need ◽  
Her Genes

Personalized medicine with its promise of developing interventions tailored to an individual's health need and genetically related response to treatment might seem a promising antidote to the documented underutilization of standard depression treatments by African Americans. In addition, understanding depression not merely in biochemical terms but also in genetic terms might seem to counter cultural beliefs and stigma that attach to depression when conceived as a mood or behavioral problem under an individual's control. After all, if there is one thing for which a person is not responsible and cannot be blamed, it is her genes. Nevertheless, for multiple reasons, a personalized medical approach to depression treatment, and its attendant conceptualization of depression and treatment response as genetically influenced, present the risk of exacerbating well-documented disparities in access to, and utilization of, treatment for depression among African-American and Caucasian elderly adults.

scholarly journals Implementing Personalized Medicine in COVID-19 in Andalusia: An Opportunity to Transform the Healthcare System

2021 ◽  
Vol 11 (6) ◽  
pp. 475
Author(s):  
Joaquín Dopazo ◽  
Douglas Maya-Miles ◽  
Federico García ◽  
Nicola Lorusso ◽  
Miguel Ángel Calleja ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Clinical Practice ◽  
Personalized Medicine ◽  
Local Level ◽  
Individual Variability ◽  
Response To Therapy ◽  
Control Measures ◽  
Response To Treatment ◽  
Specific Patient

The COVID-19 pandemic represents an unprecedented opportunity to exploit the advantages of personalized medicine for the prevention, diagnosis, treatment, surveillance and management of a new challenge in public health. COVID-19 infection is highly variable, ranging from asymptomatic infections to severe, life-threatening manifestations. Personalized medicine can play a key role in elucidating individual susceptibility to the infection as well as inter-individual variability in clinical course, prognosis and response to treatment. Integrating personalized medicine into clinical practice can also transform health care by enabling the design of preventive and therapeutic strategies tailored to individual profiles, improving the detection of outbreaks or defining transmission patterns at an increasingly local level. SARS-CoV2 genome sequencing, together with the assessment of specific patient genetic variants, will support clinical decision-makers and ultimately better ways to fight this disease. Additionally, it would facilitate a better stratification and selection of patients for clinical trials, thus increasing the likelihood of obtaining positive results. Lastly, defining a national strategy to implement in clinical practice all available tools of personalized medicine in COVID-19 could be challenging but linked to a positive transformation of the health care system. In this review, we provide an update of the achievements, promises, and challenges of personalized medicine in the fight against COVID-19 from susceptibility to natural history and response to therapy, as well as from surveillance to control measures and vaccination. We also discuss strategies to facilitate the adoption of this new paradigm for medical and public health measures during and after the pandemic in health care systems.

scholarly journals Acculturative status, age, and hypertension among African American women

2021 ◽  
Vol 8 (5) ◽  
pp. 2083
Author(s):  
Fern J. Webb ◽  
Christina Jones ◽  
Ross Jones ◽  
Kristen Morga ◽  
Lori Bilello ◽  
...  
Keyword(s):  
African American ◽  
African American Women ◽  
Cultural Beliefs ◽  
The United States ◽  
Population Based ◽  
Health Interventions ◽  
Traditional Values ◽  
American Women ◽  
Using Data ◽  
Research Assistants

Background: Understanding culture’s impact on hypertension (HTN) is important since its prevalence in African American women (AAW) in the United States is among the highest. It is therefore important to know if younger AAW have similar acculturation status as older AAW when developing culturally relevant interventions.  The objective of this study was to examine the association between acculturation status and age, determining whether acculturation status and age are significantly associated with hypertension among AAW.Methods: Acculturation status, age, and HTN were analyzed using data from the listening to our voices study (LOVS), a population-based observational study of 294 AAW conducted throughout Florida. LOVS was promoted via African American women research assistants trained to inform and recruit AAW living in Ft. Lauderdale, Jacksonville, Miami, and Tampa.Results: Findings demonstrate that AAW held traditional values regardless of age. Moreover, AAW of younger ages had higher average acculturation scores compared with older AAW indicating stronger agreement with traditional values, practices and beliefs. Acculturation subscale scores were not associated with HTN. AAW with HTN scored higher on the traditional food subscale compared to AAW without HTN.Conclusions: These findings indicate the significance of considering the beliefs, values, and practices of AAW when developing health interventions. Health interventions developed should be tailored toward AAW of varying ages to incorporate activities relevant to their cultural beliefs, values and practices.

Epidemiology, Comorbidity, and Burden of OCD

2017 ◽  
Author(s):  
Albina R. Torres ◽  
Leonardo F. Fontenelle ◽  
Roseli G. Shavitt ◽  
Marcelo Q. Hoexter ◽  
Christopher Pittenger ◽  
...  
Keyword(s):  
Disease Burden ◽  
Negative Impact ◽  
Public Awareness ◽  
Response To Treatment ◽  
Obsessive Compulsive ◽  
Access To Treatment ◽  
Compulsive Disorder ◽  
Professional Recognition ◽  
Epidemiological Surveys ◽  
Health Need

This chapter addresses the interrelated topics of OCD epidemiology, comorbidity, and disease burden. Obsessive-compulsive disorder (OCD) is a frequent condition, especially if subthreshold manifestations are considered. Epidemiological surveys describe current and lifetime prevalence rates of full-blown OCD around 1% and 2.5%, respectively. Subthreshold symptoms occur in up to a third of the general population. Comorbidity is the rule in OCD, which increases the complexity, severity, distress, chronicity, and negative impact of the disorder. Comorbidity may influence the search for, adherence with, and response to treatment. OCD entails significant costs to society, both illness related and care/treatment related. Epidemiological surveys show that only a minority of individuals with OCD are receiving treatment. Recognition and treatment of OCD is often delayed for many years, increasing the morbidity and the burden of sufferers, family members, and society. Increasing public awareness, professional recognition, and access to treatment is an urgent clinical and public health need.

scholarly journals LATINOS’ PERCEPTIONS AND CONCERNS ABOUT ALZHEIMER’S DISEASE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S543-S543
Author(s):  
Laura Y Cabrera
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
African American ◽  
Alzheimer Disease ◽  
Focus Groups ◽  
Puerto Ricans ◽  
A Priori ◽  
Cultural Beliefs ◽  
Single Group ◽  
Health Aging

Abstract Several studies indicate that Latinos are at higher risk of developing Alzheimer Disease (AD). While research has centered on African-American/White or Latino/non-Latino differences, there exists heterogeneity within those groups. Clustering Latinos under a single group in AD resources, neglects cultural, biological and environmental differences. To address this complexity we examine perceptions and concerns about AD symptoms, diagnosis, and care among Mexicans and Puerto Ricans via six focus groups. A priori variables for thematic exploration include familiarity, cultural beliefs, trust, privacy, notions of identity and personhood. We use a pragmatic neuroethics framework as a lens to discuss and assess our findings and related implications. This will help address the multidimensional and multidirectional nature of knowledge and communication about diagnosis, treatments and nature of AD. These findings will help to identify differences and similarities among two distinct Latino groups, thereby contributing to scholarship in the fields of Latino’s health, aging, and neuroethics.

Differences in Cultural Beliefs and Values among African American and European American Men with Prostate Cancer

2007 ◽  
Vol 14 (3) ◽  
pp. 277-284 ◽  
Author(s):  
Chanita Hughes Halbert ◽  
Frances K. Barg ◽  
Benita Weathers ◽  
Ernestine Delmoor ◽  
James Coyne ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Cultural Beliefs ◽  
European American ◽  
Beliefs And Values

Intracranial Complications of Pediatric Frontal Rhinosinusitis

2006 ◽  
Vol 20 (3) ◽  
pp. 320-324 ◽  
Author(s):  
Brian W. Herrmann ◽  
James C. Chung ◽  
John F. Eisenbeis ◽  
James W. Forsen
Keyword(s):  
African American ◽  
Advanced Disease ◽  
Nasal Congestion ◽  
Tertiary Care ◽  
Case Series ◽  
Response To Treatment ◽  
Intracranial Complication ◽  
Early Symptoms ◽  
Neurological Findings ◽  
Intracranial Complications

Background The aim of this study was to review the presentation and management of children admitted for intracranial complications arising from frontal rhinosinusitis. We performed a retrospective case series review at two academic tertiary care children's hospitals. Methods This study consisted of children <18 years old who presented with intracranial complications from frontal rhinosinusitis between January 1, 1990 and December 31, 2002. Relevant literature was reviewed with the assistance of Medline. Presentation, type of intracranial complication, radiographic evaluations, response to treatment, and prognosis were evaluated. Results Sixteen patients were identified with intracranial complications due to frontal rhinosinusitis. Patients were usually older (mean age, 14 years and 3 months), of male gender (M/F, 4.3:1.0), and African American (AA/W, 3.0:1.0). Headache, nasal congestion, and visual changes were the most common early symptoms and neurological findings indicated advanced disease. Subdural (56%), epidural (44%), and cerebral abscesses (19%) were the most common complications. Meningitis alone was identified in 13% and was associated with another intracranial complication in 6%. Multiple intracranial complications were noted in 31%. Polymicrobial cultures were obtained in 50% of patients. Although CT was excellent in identifying orbital pathology, MRI was superior for characterization of intracranial disease. Conclusion Intracranial complications of frontal rhinosinusitis are rare in children. Early symptoms often are nonspecific, with neurological findings more commonly seen in advanced disease. Adolescent African American male patients were found to be at highest risk for intracranial complications from frontal rhinosinusitis. Headache and orbital complaints associated with rhinosinusitis in older children failing to respond to initial therapy should prompt an aggressive evaluation including MRI.

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