African Americans and Whites Are Equally Appropriate to be Considered for Total Joint Arthroplasty

2009 ◽  
Vol 36 (9) ◽  
pp. 1971-1976 ◽  
Author(s):  
DENNIS C. ANG ◽  
NIGHAT TAHIR ◽  
HUFZA HANIF ◽  
YAN TONG ◽  
SAID A. IBRAHIM
Keyword(s):  
African Americans ◽  
Racial Differences ◽  
Total Joint Arthroplasty ◽  
Primary Care Clinic ◽  
Ethnic Disparities ◽  
Hip Osteoarthritis ◽  
Joint Arthroplasty ◽  
Care Clinic ◽  
Symptomatic Knee ◽  
The Mean

Objective.Ethnic disparities in the use of total joint arthroplasty (TJA) may be attributed to differences in the clinical appropriateness to undergo TJA. We sought to determine if racial differences in clinical appropriateness for surgery existed among a sample of primary care clinic patients with moderately to severely symptomatic knee or hip osteoarthritis (OA).Methods.We used the cross-sectional data of 684 patients who are potential candidates for TJA. Using a validated TJA appropriateness algorithm, an appropriateness factor was derived using the following variables: age (50–70 or > 70 yrs), Charlson comorbidity (≤ 1 or > 1), Western Ontario and McMaster Universities OA Index (WOMAC) pain and physical function, and adequacy of previous medical management. We used logistic regression to estimate the association of race with the dichotomous outcome of clinical appropriateness for TJA consideration.Results.Sample consisted of 425 (62%) whites and 260 (38%) African Americans; 532 (78%) had knee OA and 153 (22%) had hip OA. The mean age was 64 ± 9 years and the mean body mass index was 33.6 ± 8 kg/m2. The mean overall WOMAC score was 56 ± 14 (range 30–96), suggesting moderately severe OA. There were no significant racial group differences (p = 0.3) in the proportions of those deemed clinically appropriate for TJA. After controlling for potential confounders, race was not a predictor of clinical appropriateness for TJA (odds ratio 1.2, 95% confidence interval 0.8–1.8, p = 0.3).Conclusion.African Americans and whites were equally appropriate to be considered for TJA.

scholarly journals Cross-Cultural Comparisons of Subjective Cognitive Complaints in a Diverse Primary Care Population

2021 ◽  
pp. 1-11
Author(s):  
Danelly Rodríguez ◽  
Emmeline Ayers ◽  
Erica F. Weiss ◽  
Joe Verghese
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
African Americans ◽  
Primary Care Clinic ◽  
Depression Scale ◽  
Cognitive Complaints ◽  
Care Clinic ◽  
Primary Care Population ◽  
Subjective Cognitive Complaints

Background: Very few studies have explored the utility of subjective cognitive complaints (SCCs) in primary care settings. Objective: We aim to investigate associations between SCCs (item-level), objective cognitive function (across domains and global), and mood in a diverse primary care population, including subjects with mild cognitive impairment. Methods: We studied 199 (75.9%females; 57.8%Hispanics; 42.2%African Americans) older adults (mean age 72.5 years) with memory concerns at a primary care clinic. A five-item SCC questionnaire, and objective cognitive assessments, including the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale, were administered. Results: Logistic regression analyses showed associations between SCC score and depressive symptoms. A memory-specific (“memory worsening”) SCC predicted scores on the MoCA (p = 0.005) in Hispanics. Conclusion: SCCs are strongly linked to depressive symptoms in African Americans and Hispanics in a primary care setting; a specific type of SCC is related to global cognitive function in Hispanics.

scholarly journals FEASIBILITY OF A LOW-DOSE FRAILTY PREVENTION INTERVENTION AMONG OLDER AFRICAN AMERICANS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S293-S293
Author(s):  
Heather A Fritz ◽  
Wassim Tarraf ◽  
Pragnesh Patel
Keyword(s):  
African Americans ◽  
Low Dose ◽  
Healthy Lifestyle ◽  
Primary Care Clinic ◽  
Later Life ◽  
Community Dwelling ◽  
Feasibility Trial ◽  
Care Clinic ◽  
Prevention Intervention ◽  
Older African Americans

Abstract Older African Americans (OAA) are at high risk for becoming frail in later life. Interventions can reverse or delay frailty, yet OAA have largely been excluded from frailty intervention research. Many interventions are also time and resource intensive, making them inaccessible to socially disadvantaged OAA. We present results of a feasibility trial of a low dose frailty prevention intervention among 60 community-dwelling, pre-frail OAA aged 55+ recruited from a primary care clinic between June 1st and October 31st 2018. Using a 2-arm RCT, participants were assigned to the intervention, which was delivered by an occupational therapist (OT) and comprised of four sessions over four months (an OT evaluation, and sessions on healthy dietary practices, increasing physical activity, and maintaining a healthy lifestyle), or enhanced usual care (publicly available information about healthy lifestyle, home safety, and local elder services). Feasibility criteria were set a priori at 75% for participant retention (including attrition due to death/hospitalization), 80% for session engagement, 2 participants/week for mean participant accrual, and 90% for program satisfaction. Participants were 65% female with an average age of 76.58 years, 51.67% of which lived alone and 51.67% lived off of less than 15K per year. Feasibility metrics were met. The study recruited 2.5 participants per week and retained 75% of participants who attended 95% of scheduled sessions. Mean satisfaction scores were 93%. The intervention was feasible to deliver. Qualitative findings from exit interviews suggested changes to the program dose, structure, and content that could improve it for future use.

Analysis of Outcomes of Total Cementless Hip Joint Arthroplasty in the Treatment of Advanced Hip Osteoarthritis Following Childhood Perthes’ Disease

2020 ◽  
Vol 22 (5) ◽  
pp. 333-342
Author(s):  
Marek Drobniewski ◽  
Magdalena Krasińska ◽  
Andrzej Grzegorzewski ◽  
Marek Synder ◽  
Andrzej Borowski
Keyword(s):  
Hip Joint ◽  
Hip Osteoarthritis ◽  
Joint Arthroplasty ◽  
Perthes Disease ◽  
Acetabular Cup ◽  
Kaplan Meier ◽  
Long Term Follow Up ◽  
The Mean ◽  
Joint Arthroplasties

Background. The aim of this study is to analyse the outcomes of total cementless hip joint arthroplasty in the treatment of advanced hip osteoarthritis following Perthes’ disease in childhood. Material and methods. The study enrolled 56 patients (15 women and 41 men) who underwent a total of 61 hip joint arthroplasties for coxarthrosis following Perthes’ disease. The mean age of the patients at surgery was 46.7 years (range 21-67 years). The mean follow-up period was 13.7 years. Results. Pre-operative Merle d’Aubigne-Postel scores (modified by Charnley) of the study group were poor in all patients. Mean post-operative improvement was 6.7 points. The outcomes were classified as excellent in 25 cases, good in 16, satisfactory in 16 and poor in 9 cases. Poor results were always related to loosening of the acetabular cup. Heterotopic ossification was noted in 7 cases. According to the Kaplan-Meier estimator, 10 years’ survival probability was 85.24% for the whole implant and 100% for the stem. Conclusions. 1. Total cementless hip joint arthroplasty is an effective method in the treatment of advanced hip osteoarthritis following Perthes’ disease in childhood. 2. With good surgical technique and in the absence of complications, the risk of aseptic loosening is minimal. 3. Due to the patients’ young age, there may be more cases of loosening over time, requiring regular long-term follow-up.

Marital Status and Sexually Transmitted Infections Among African Americans

2010 ◽  
Vol 31 (9) ◽  
pp. 1147-1165 ◽  
Author(s):  
Eboni M. Taylor ◽  
Adaora A. Adimora ◽  
Victor J. Schoenbach
Keyword(s):  
African Americans ◽  
Marital Status ◽  
Racial Disparities ◽  
Racial Differences ◽  
Risk Behaviors ◽  
Ethnic Disparities ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Marriage Rates ◽  
Racial Ethnic

This article assesses the relationship between low marriage rates and racial disparities in sexually transmitted infection (STI) rates. Data from the 2002 National Survey of Family Growth was used to examine the prevalence of sexual risk behaviors by marital status. Logistic regression was used to examine whether racial differences in marriage patterns help account for racial disparities in STI rates. Results indicate that the 12-month prevalence of multiple partners and high-risk partnerships was lowest among currently married, intermediate among cohabiting, and highest among formerly and never-married respondents. Of all racial/ethnic groups, African Americans were least likely to be married. In multiple logistic analyses adjustment for marriage attenuated the association between race and STI risk behaviors for African Americans. Low marriage rates may be an important contributing factor to racial/ethnic disparities in STI rates, particularly for African Americans.

scholarly journals Prehypertensive State, Mild Hypertension, Metabolic Syndrome and Cardiovascular Risk Factors among Young Adults in Rural Malaysia

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Abdullah Aszrin ◽  
Shah M Azarisman ◽  
Rahman A Jamaluddin ◽  
Razak A Tariq ◽  
Noor M Noriah
Keyword(s):  
Metabolic Syndrome ◽  
Young Adults ◽  
Cardiovascular Risk ◽  
Mild Hypertension ◽  
Primary Care Clinic ◽  
Population Based ◽  
Care Clinic ◽  
Mean Values ◽  
Biochemical Profiles ◽  
The Mean

Introduction: Prehypertension precedes overt hypertension and has been acknowledged by many guidelines. Hypertension is an important risk factor for cardiovascular disease in Malaysia. Hypertension prevalence is at 42.6% and population-based control is poor at 26.8%. The objective of the study is to ascertain the cardiovascular risk profile of prehypertensive and mildly hypertensive young adults against age-matched controls in rural Malaysia. Methods: 484 (four hundred and eighty four) subjects attending primary care clinic were screened. 91 (Ninety one) young adults with pre/mild hypertension and normotensive, agematched controls were enrolled. The blood pressure and biochemical profiles for both groups were assessed and compared. Results: Fifty-four subjects and 37 controls were enrolled. Amongst subjects, 46.3% had prehypertension and 53.7% had mild hypertension. Mean values compared to age-matched controls for MAP were 102.68 ± 7.48 vs 83.25 ± 6.08 mmHg (p< 0.001), LDL 3.75 ± 0.95 vs 3.32 ± 0.93 mmol/L (p=0.03), FBG 4.65 ± 0.54 vs 4.33 ± 0.42 mmol/L (p=0.03), BMI 28.81 ± 5.16 vs 24.12 ± 4.91 (p< 0.001). The mean BP was significantly associated with BMI, FBG, triglycerides, HDL and the TC/HDL ratio. Conclusions: Greater BMI, FBG, HDL, triglyceride levels and TC/HDL ratio characterised the young adults with pre/mild hypertension. The data suggests that hypertension in young adults is secondary to metabolic syndrome.

Reductions in Race and Ethnic Disparities in Hospital Readmissions Following Total Joint Arthroplasty from 2005 to 2015

2019 ◽  
Vol 101 (22) ◽  
pp. 2044-2050 ◽  
Author(s):  
Robert H. Aseltine ◽  
Wenjie Wang ◽  
Ross A. Benthien ◽  
Matthew Katz ◽  
Catherine Wagner ◽  
...  
Keyword(s):  
Total Joint Arthroplasty ◽  
Hospital Readmissions ◽  
Ethnic Disparities ◽  
Joint Arthroplasty

scholarly journals Racial/Ethnic Variability in Diabetes Mellitus among United States Residents Is Unexplained by Lifestyle, Sociodemographics and Prognostic Factors

2012 ◽  
Vol 2012 ◽  
pp. 1-8
Author(s):  
Laurens Holmes ◽  
Jobayer Hossain ◽  
Doriel Ward ◽  
Franklin Opara
Keyword(s):  
Diabetes Mellitus ◽  
African Americans ◽  
Marital Status ◽  
Racial Differences ◽  
Ethnic Disparities ◽  
Physical Activities ◽  
Prevalence Odds Ratio ◽  
Ethnic Variability ◽  
Race Ethnicity ◽  
Racial Ethnic

Background. The mortality and prevalence of diabetes mellitus (DM) vary across racial/ethnic groups with African Americans/blacks being disproportionately affected. However, it is unclear to what extent such disparities persist after the adjustment for covariates related to race/ethnicity and/or DM in the population. We aimed to assess racial/ethnic disparities in DM and to determine which covariates account for the observed racial/ethnic variabilities. Materials and Methods. We utilized a large cross-sectional survey of the US noninstitutionalized residents (n=30,852) to investigate the racial/ethnic disparities in diabetes mellitus, and the degree in which the disparities are explained by the relevant covariates. Pearson’s chi-square was used to examine study variables by race/ethnicity, while logistic regression was used to assess the effect of race/ethnicity and other covariates on DM prevalence. Results. There were statistically significant ethnic/racial differences with respect to income, education, marital status, smoking, alcohol, physical activities, body mass index, and age, P<0.05, but not insurance coverage, P>0.05. Race/ethnicity was a single independent predictor of DM, with African Americans (non-Hispanic blacks) more likely to be diagnosed for DM compared with non-Hispanic whites, prevalence odds ratio (POR) 1.45, 95% confidence interval (CI) 1.30–1.62, while Hispanics were less likely to be diagnosed, POR = 0.98, 95% CI 0.87–1.09. Similarly, after controlling for potential confounders, the racial/ethnic variability in DM between AA/blacks and non-Hispanic whites persisted, adjusted POR = 1.30, 95% CI 1.15–1.47. Conclusions. Racial/ethnic variability exists in DM prevalence and is unexplained by racial/ethnic variance in education, income, marital status, smoking, alcohol, physical activities, age, and sex.

Abstract TP308: Fatalism or Realism? Racial Differences in the Beliefs of Stroke Survivors

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Charles Ellis ◽  
Gayenell S Magwood
Keyword(s):  
African Americans ◽  
Health Outcomes ◽  
Racial Differences ◽  
General Health ◽  
Stroke Recovery ◽  
Stroke Survivors ◽  
The Mean ◽  
Serious Disease ◽  
Strongly Agree ◽  
College Educated

Introduction: Fatalistic beliefs which contribute to worse health outcomes are believed to be more common in African Americans (AA). Hypothesis: AA stroke survivors exhibit more fatalistic beliefs about stroke and stroke recovery than White stroke survivors. Methods: A 20-item fatalism scale was administered to 63 AA and 22 white stroke survivors within 30 days of their stroke. The fatalism scale measured predetermination, luck and pessimism. Responses to the 20 questions included: strongly disagree, disagree, neutral, agree and strongly agree. Results: The mean age for the sample was 58 years and 58% were female and there were no racial differences in either age or sex. More Whites (77 vs 35%) reported being college educated than AAs (p=.006). There were no racial differences in the mean total fatalism score or the predetermination, luck and pessimism subtest scores. When the responses were examined in categorical fashion utilizing their combined responses of: strongly disagree/ disagree, neutral and agree/strongly agree racial differences were present on select questions. Predetermination: AAs were more likely to agree or strongly agree (52% vs 40%) that if someone is meant to get a serious disease they will (p=.04). In contrast, AAs were more likely to strongly disagree or disagree (43% vs 22%) that how long you live is predetermined (p=.03). Luck: AAs were more likely to strongly disagree or disagree (86% vs 77%) or to be neutral (0% vs 14%) that they will get diseases if they are unlucky (p=.011). Pessimism: AAs were more likely strongly disagree or disagree (77% vs 50%) and less likely to agree or strongly agree (16% vs 41%) that they often feel helpless dealing with the problems of life (p=.043). AAs were also more likely to strongly disagree or disagree (81% vs 64%) and were less likely to be neutral (2% vs 18%) that there is really no way they can solve the problems they have (p=.017). Conclusions: The general health literature suggests AAs exhibit more fatalistic beliefs. AAs in this stroke sample were less fatalistic on select questions and did not differ on others. Fatalism is a complex construct and questions designed to examine fatalism should be carefully examined particularly when race comparisons are being considered.

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