“African-American Literature”的辨析与翻译

“African-American Literature”在我国已经历了百余年研究历史,这个术语是应该被译为“非裔美国文学”还是“美国非裔文学”,一直是一个悬而未决的问题.美国非裔文学有多种说法,不能笼统而简单地归纳为一种定义或一种译文.美国非裔文学意义辨析和译文确定,与更大范畴的族裔文学的研究与进展、特别与美国非裔文学思想的发展流变及其内涵的变化不无相关.

Identification of speckle-type POZ protein somatic mutations in African American prostate cancer

The speckle-type POZ protein （SPOP） is a tumor suppressor in prostate cancer （PCa）. SPOP somatic mutations have been reported in up to 15% of PCa of those of European descent. However, the genetic roles of SPOP in African American （AA）-PCa are currently unknown. We sequenced the SPOP gene to identify somatic mutations in 49 AA prostate tumors and identified three missense mutations （p.Y87C, p.F102S, and p.G111E） in five AA prostate tumors （10%） and one synonymous variant （p.11061） in one tumor. Intriguingly, all of mutations and variants clustered in exon six, and all of the mutations altered conserved amino acids. Moreover, two mutations （p.F102S and p.G111E） have only been identified in AA-PCa to date. Quantitative real-time polymerase chain reaction analysis showed a lower level of SPOP expression in tumors carrying SPOP mutations than their matched normal prostate tissues. In addition, SPOP mutations and novel variants were detected in 5 of 27 aggressive PCa and one of 22 less aggressive PCa （P 〈 0.05）. Further studies with increased sample size are needed to validate the clinicopathological significance of these SPOP mutations in AA-PCa.

Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

AIM: To determine if efforts to improve antiretroviral therapy(ART) adherence minimizes the negative impact of depression on human immunodeficiency virus(HIV) outcomes. METHODS: A cross-sectional study of a clinic-based cohort of 158 HIV seropositive(HIV+) African Americans screened for major depressive disorder(MDD) in 2012. CD4 T lymphocyte(CD4+) counts were obtained from these individuals. Self-report on adherence to ART was determined from questionnaire administered during clinic visits. The primary outcome measure was conditional odds of having a poorer CD4+ count(< 350 cells/mm3). Association between CD4+ count and antidepressant-treated or untreated MDD subjects was examined controlling for self-reported adherence and other potential confounders. RESULTS: Out of 147 individuals with available CD4+ T lymphocyte data, 31% had CD4+ count < 350 cells/mm^3 and 28% reported poor ART adherence. As expected the group with > 350 cells/mm^3 CD4+ T lymphocyte endorsed significantly greater ART adherence compared to the group with < 350 cells/mm3 CD4+ T lymphocyte count(P < 0.004). Prevalence of MDD was 39.5% and 66% of individuals with MDD took antidepressants. Poor CD4+ T lymphocyte count was associated with poor ART adherence and MDD. Adjusting for ART adherence, age, sex and education, which were potential confounders, the association between MDD and poor CD4+ T lymphocyte remained significant only in the untreated MDD group.CONCLUSION: Therefore, CD4+ count could be a clinical marker of untreated depression in HIV+. Also, mental health care may be relevant to primary care of HIV+ patients.

Comparison of reflux esophagitis and its complications between African Americans and non-Hispanic whites

AIM: To determine the effect of ethnicity on the severity of reflux esophagitis (RE) and its complications. METHODS: A retrospective search of the endoscopy database at the University of Florida Health Science Center/Jacksonville for all cases of reflux esophagitis and its complications from January 1 to March 31, 2001 was performed. Inclusion criteria were endoscopic evidence of esophagitis using the LA classif ication, reflux related complications and self-reported ethnicity. The data obtained included esophagitis grade, presence of a hiatal hernia, esophageal ulcer, stricture and Barrett's esophagus, and endoscopy indication. RESULTS: The search identified 259 patients with RE or its complications, of which 171 were non-Hispanic whites and 88 were African Americans. The mean ages and male/female ratios were similar in the two groups. RE grade, esophageal ulcer, stricture and hiatal hernia frequency were likewise similar in the groups. Barrett's esophagus was present more often in non-Hispanic whites than in African Americans (15.8% vs 4.5%; P < 0.01). Heartburn was a more frequent indication for endoscopy in non-Hispanic whites with erosive esophagitis than in African Americans (28.1% vs 7.9%; P < 0.001). CONCLUSION: Distribution of RE grade and frequency of reflux-related esophageal ulcer, stricture andhiatal hernia are similar in non-Hispanic whites and African Americans. Heartburn was more frequently and nausea/vomiting less frequently reported as the primary endoscopic indication in non-Hispanic whites compared with African Americans with erosive esophagitis or its complications. African Americans have a decreased prevalence of Barrett's esophagus compared with non-Hispanic whites.

Body mass index versus percentage body fat in Chinese, African-American and Caucasian postmenopausal women

Objective: The aim of the study was to investigate in postmenopausal women whether the relationship between percentage body fat (PBF) and body mass index (BMI) differs between Asians living in Beijing (BA) and African-Americans (AA), and Caucasians (Ca) living in New York City. Methods: Healthy postmenopausal women (231 BA; 113 AA, 95 Ca), aged 50-80 years, were studied. Weight, height and PBF by dual energy X-ray absorptiometry (DXA) were measured. The relationship between PBF and BMI was assessed by multiple regression analysis. Results: Race, reciprocal of BMI (1/BMI) and the interaction between race and 1/BMI were all significantly (P<0.05) related to PBF in this sample. The slope of the line relating 1/BMI to PBF was different for BA compared to AA (P=0.01) and Ca (P=0.003) while the slopes for AA and Ca were not different (P>0.05). At lower levels of BMI, Asians tended to have higher PBF comparable to AA and Ca, while at BMI >30 BA tended to have less PBF than the other groups. Conclusion: The relation between PBF and BMI in BA postmenopausal women differs from that of AA and Ca women in this sample.

Light treatment for seasonal Winter depression in African-American vs Caucasian outpatients

AIM: To compare adherence, response, and remission with light treatment in African-American and Caucasian patients with Seasonal Affective Disorder.METHODS: Seventy-eight study participants, agerange 18-64(51 African-Americans and 27 Caucasians)recruited from the Greater Baltimore Metropolitan area, with diagnoses of recurrent mood disorder with seasonal pattern, and confirmed by a Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-Ⅳ, were enrolled in an open label study of daily bright light treatment. The trial lasted6 wk with flexible dosing of light starting with 10000 lux bright light for 60 min daily in the morning. At the end of six weeks there were 65 completers. Three patients had Bipolar Ⅱ disorder and the remainder had Major depressive disorder. Outcome measures were remission(score ≤ 8) and response(50% reduction)in symptoms on the Structured Interview Guide for the Hamilton Rating Scale for Depression(SIGH-SAD)as well as symptomatic improvement on SIGH-SAD and Beck Depression Inventory-Ⅱ. Adherence was measured using participant daily log. Participant groups were compared using t-tests, chi square, linear and logistic regressions. RESULTS: The study did not find any significant group difference between African-Americans and their Caucasian counterparts in adherence with light treatment as well as in symptomatic improvement.While symptomatic improvement and rate of treatment response were not different between the two groups,African-Americans, after adjustment for age, gender and adherence, achieved a significantly lower remission rate(African-Americans 46.3%; Caucasians 75%; P =0.02).CONCLUSION: This is the first study of light treatment in African-Americans, continuing our previous work reporting a similar frequency but a lower awareness of SAD and its treatment in African-Americans. Similar rates of adherence, symptomatic improvement and treatment response suggest that light treatment is a feasible, acceptable, and beneficial treatment for SAD in African-American patients. These results should lead to intensifying education initiatives to increase awareness of SAD and its treatment in African-American communities to increased SAD treatment engagement.In African-American vs Caucasian SAD patients a remission gap was identified, as reported before with antidepressant medications for non-seasonal depression, demanding sustained efforts to investigate and then address its causes.

A comprehensive cardiovascular disease lifestyle treatment controlled trial among high-risk African Americans

Background: The purpose of this study was to assess the effects of a comprehensive lifestyle intervention on modifiable cardiovascular risk factors among high-risk African Americans. Methods: The study included a randomized treatment/controlled intervention trial among 136 African Americans residing in Atlanta, GA who were overweight and had elevated blood pressure. The treatment group was exposed to 3-months of a multi-component intervention and the control to an abbreviated 6-week intervention after the completion of the treatment group’s intervention. The main outcomes included mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), mean waist circumference, mean body mass index (BMI), mean number of times exercise per week, mean number of servings of fruits and vegetables per day, and mean level of daily stress. Data were collected at baseline and at 6-month follow-up. Separate linear regressions were used with an established significance level of P P P = 0.002). Conclusion: These results show that a comprehensive lifestyle intervention can improve cardiovascular risk factor profile among high risk African Americans. Caregivers should encourage patients to participate in such programs and public health policymakers should allocate resources to community based health oriented organizations to implement comprehensive lifestyle program.

Effect of Medical Advice for Diet on Diabetes Self-Management and Glycemic Control for Haitian and African Americans with Type 2 Diabetes

Adequate care of type 2 diabetes is reflected by the individual’s adherence to dietary guidance;yet, few patients are engaged in diabetes self-care at the recommended level, regardless of race/ethnicity. Few studies on the effect of dietary medical advice on diabetes self-management (DSM) and glycemic control have been conducted on Haitian and African American adults with type 2 diabetes. These relationships were assessed in total of 254 Blacks with type 2 diabetes (Haitian Americans = 129;African Americans = 125) recruited from Miami-Dade and Broward Counties, Florida by community outreach methods. Although dietary advice received was not significantly different between the two Black ethnicities, given advice “to follow a diet” as a predictor of “using food groups” was significant for Haitian Americans, but not for African Americans. Haitian Americans who were advised to follow a diet were approximately 3 times more likely to sometimes or often use food groups (or exchange lists) in planning meals. Less than optimal glycemic control (A1C > 7.2) was inversely related to DSM for African Americans;but the relationship was not significant for Haitian Americans. A one unit increase in DSM score decreased the odds ratio point estimate of having less than optimal glycemic control (A1C > 7.2%) by a factor of 0.94 in African Americans. These results suggest that medical advice for diet plans may not be communicated effectively for DSM for some races/ethnicities. Research aimed at uncovering the enablers and barriers of diet management specific to Black ethnicities with type 2 diabetes is recommended.

The Benefits and Barriers Related to Regular Participation in Physical Activity by African-American Women: Implications for Intervention Development

A common strategy for improving health behaviors is to emphasize the benefits and reduce the barriers to behavior change. This study investigated potential differences in perceived benefits and barriers related to participation in physical activity (PA) between women in pre-maintenance versus the maintenance phase of PA behavior to determine if perceived benefits were greater and perceived barriers lower in women with more extensive and successful PA participation experience. Data were collected from a community-based sample (N = 113) of middle-aged African-American women. The sample was stratified into two groups according to how long they had been regularly engaging in PA (6 months or longer versus less than 6 months). Chi-square analyses were conducted to investigate possible differences between the two groups of women in regard to perceived benefits and barriers associated with PA. Descriptive data showed that nearly all of the benefits and barriers to PA were perceived as being important for a majority of the participants and chi-square and t-test results indicated few significant between-group differences (p < .05) in regard to these perceptions. Additional analyses indicated there was no significant between-group difference (p < .05) for Body Mass Index. The results suggest the benefits and barriers related to PA behavior are already valued and understood by many African-American women. Further, the results do not support the commonly held belief that effective health behavior improvement programming should emphasize the benefits and reduce the barriers related to the behavior. Practitioners should consider focusing on other evidenced based factors proven to promote PA behavior such as counseling regarding social support (e.g., buddy system) and increasing self-efficacy (e.g., goal setting) to initiate and sustain a physically active lifestyle.

Poverty Status and Clustering of Cardiometabolic Risk Factors and Metabolic Syndrome among African Americans: Results from the National Health and Nutritional Examination Survey 2001-2006

Background: African Americans (AA) are disproportionally affected by cardiovascular disease as compared to other racial-ethnic groups. Exposure to adverse socioeconomic conditions may partially explain disparities in risk factors and prevalence and cardiovascular diseases for AA. We aim to study the impact of poverty status on metabolic syndrome (MetS) and its components among African Americans. Methods: We used data from the National Health and Nutritional Examination Survey (NHANES) cycles 2001-2006. We defined MetS using the Joint Scientific Definition as the presence of any 3/5 components: elevated blood pressure (BP), elevated triglycerides (TGL), lower high-density lipoprotein cholesterol (LDL), elevated fasting plasma glucose (FPG), and elevated waist circumference (WC). Poverty to income ratio (PIR) was categorized as below poverty (<1), above poverty (1 - 3) and high income (>3) groups. We used multivariable survey-weighted logistic regression models to study the impact of poverty status of prevalence of MetS and its components among AA men and women. Results: Overall, the average aggregate prevalence of MetS among AA sample was 22% in our study with prevalence being 25% for women and 18% among men (p < 0.001). In regression models, among women, living below poverty (PIR < 1) was associated with a higher prevalence/odds of having metabolic syndrome compared to those living in the high-income group (PIR > 3) (OR = 1.57, 95%CI = 1.00 - 2.46, p = 0.05) with no association observed among men (OR (PIR < 1 vs PIR >= 1) = 0.70, 95%CI = 0.43 - 1.19, p = 0.13). Further, similar associations were observed for individual components among women including: elevated waist circumference (OR = 2.04, 95%CI = 1.37, 3.01, p < 0.001), elevated triglycerides (OR = 1.85, 95%CI = 1.02 - 3.36, p = 0.04), reduced HDL (OR = 2.04, 95%CI = 1.15, 3.60, p = 0.02) and elevated blood pressure (OR = 2.16, 95%CI = 1.34 - 3.49, p = 0.002) as compared to women in high income group (PIR > 3). No association of poverty status with MetS and its components were observed among AA men. Clustering of factors identified key groups that define MetS among women included WC. Conclusion: African American women living below poverty have a higher likelihood of having MetS and 4 of 5 individual components. Clustering of these factors differ across men and women and should be further explored as tools for clinical management. Main Points: 1) Metabolic syndrome remains an important public health burden among African Americans and shows disparities by socioeconomic status;2) Women living below poverty were more likely to have MetS and associated components as compared to women living above poverty;3) Clustering of components gave us snapshot of factors that should be considered to develop gender specific targeted health interventions for MetS among African Americans.

Elderly African Americans Insights on the COVID-19 Pandemic: An Exploratory Study of Risk Perception and Personal, Social, and Cultural Factors

This exploratory study examined elderly African Americans attitudes on the COVID-19 pandemic by identifying their perceptions of risk based personal, social, and cultural factors. It seeks to understand their insights toward public health pandemic response initiatives and other efforts to mitigate COVID-19 outbreak response measures impacting elderly African Americans, including policies, interventions, and public information/communication. The effectiveness of pandemic response measures and community caregiving support for the elderly African Americans was examined as well. Respondents in this study were a convenient sample of 60 residents predominantly in a Midwestern metropolitan area. Respondents were eligible for study participation if 1) there were 60 years and over and, 2) African American or people of African descent. A mixed research method design comprising focus groups and online survey was used to collect the data for the study. The respondents characterized the impact of the coronavirus as a personal, family, and community loss (e.g., less socially engaged and burdensome). An overwhelming majority (98.3%) expressed no worries about getting health care if they or their family members needed it. A sizable number of respondents expressed the need for all to be tested to help prevent the spread of the virus.

The Power of Partners: A Qualitative Study of the Dissonance between African-American Females’ Interest in Practicing Secondary Abstinence and Continued Sexual Activity

Reducing disparities in STI/HIV rates for young heterosexual African-American women in the US is a public health priority. Although several strategies can reduce risk, some sexually experienced young women are choosing to abstain from sex for various reasons and periods of time following sexual debut, a practice known as secondary abstinence. However, others who desire to practice secondary abstinence find it difficult to do so. This qualitative study explored barriers that explained the dissonance between interest in secondary abstinence and continued sexual activity. In-depth interviews were conducted with 20 sexually-experienced African-American adolescent females, ages 18 - 23, who expressed interest in secondary abstinence. Partner-related barriers that created power imbalances presented the greatest challenges to becoming or remaining abstinent. Findings suggest that teaching young women how to recognize characteristics of healthy and unhealthy relationships, identify power imbalances, communicate assertively and develop positive coping skills can empower young women to build healthier relationships with their partners.

Neighborhood deprivation and availability of culturally specific African-American and Latino fruits and vegetables in five small central Illinois cities

Introduction: Although individual-level dietary behavior among racial/ethnic minority groups in the US is influenced by cultural food preferences and socioeconomic position, few studies of the food store environment have simultaneously examined both factors. The objective of this cross-sectional study was to investigate the availability of culturally specific fruits and vegetables for African Americans and Latinos by levels of neighborhood deprivation. The 5 small central Illinois cities selected for the study have exhibited increasing numbers of both racial/ ethnic groups in the last decade. Methods: A validated audit tool was used to survey 118 food stores in 2008. Census 2000 block group data was used to create a neighborhood deprivation index (categorized as low, medium, and high) based on socioeconomic characteristics using principal component analysis. Statistical analyses were performed in SPSS version 17.0 to determine whether the availability of culturally specific fruits and vegetables (n = 31) varied by neighborhood levels of deprivation and store type. Results: Fewer than 50% of neighborhoods carried culturally specific fruits and vegetables, with the lowest availability found in low deprivation neighborhoods (p < 0.05). Culturally specific fruits and vegetables were most often found in neighborhoods with medium levels of deprivation, and in grocery stores (p < 0.05). Latino fruits and vegetables were less likely to be found across neighborhoods or in stores, compared to African-American fruits and vegetables. Conclusions: The limited availability of culturally specific fruits and vegetables for African Americans and Latinos highlights potential environmental challenges with adherence to daily dietary guidelines for fruit and vegetable consumption in these groups.

Refining a Church-Based Lifestyle Intervention Targeting African-American Adults at Risk for Cardiometabolic Diseases: A Pilot Study

Objective: The pilot study was intended to test the feasibility of a multiple-component lifestyle intervention targeting African American adults in a weight control and cardiometabolic risk reduction program on diet, activity, and stress, using community-engagement principles. Methods: Applying mixed qualitative and quantitative measures, the intervention had a two-part sequential study design consisting of 12 weekly small group sessions that provided individual and group counseling in nutrition, exercise, and mindfulness, while incorporating focus group and interactive techniques to learn about barriers and acceptable practices for this population. The program was implemented at an African-American church in Nashville, Tennessee. Results: Thirty-four participants (aged 56.1 ± 11 years, body mass index (BMI) 36.7 ± 6.6 kg/m2) completed the intervention. Lifestyle changes after the 12 weekly sessions showed some positive trends including reduced sodium intake (from 2725.3 ± 326.5 to 2132 ± 330, mg/day, P = 0.008), increased walking steps (from 4392.1 ± 497.2 to 4895.3 ± 497.9, steps/day, not significant), and slightly decreased Perceived Stress Scale (PSS) scores (from 13.7 ± 1.4 to 12.4 ± 1.5, not significant). Body fat % among male participants decreased significantly (from 33.8 ± 2.6 to 28 ± 2.6, %, P = 0.043). Among cardiometabolic risk biomarkers, hemoglobin A1c (HbA1c) decreased significantly (from 6.6 ± 0.2 to 6.1 ± 0.2, %, P β = 2.4, P = 0.006). Twenty-one participants took part in focus groups during the program to identify barriers to healthy lifestyle changes. Primary barriers reported were price, time for preparing healthy meals, unfamiliarity with mindfulness activities, their health condition, and daily schedule available for physical activities. Conclusions: This church-based pilot intervention was proven feasible by showing modest progress in reducing adiposity and decreasing HbA1c levels. The focus group and interactive methods facilitated program direction. Future full-scale studies are warranted to identify key strategies that provide more personalized approaches and supportive environments to sustain a healthy lifestyle among these at risk minorities with limited resources.

Sexually Transmitted Infections among African-American Population of the Midwest United States

Background: Sexually transmitted infections (STIs) such as chlamydia and gonorrhea are commonly reported infections in the United States. Greater Omaha has had continually higher reported rates of chlamydia and gonorrhea for more than a decade compared to the rest of the state rates. Minority and young adults have been disproportionately affected. Purpose: The objectives of our study were to estimate the prevalence and to identify risk factors for chlamydia and gonorrhea among young adults. Methods: We conducted a cross-sectional survey with 310 young adults aged 19 -25 years between June 2011 and June 2012. The study collected socio-demographic, behavioral and other risk factors for STIs utilizing a pre-design standardized questionnaire. Gonorrhea and chlamydia status of the participants were established by testing urine samples using PCR-based diagnostic technique. Descriptive and multivariable regression analyses were used to examine risk factors for STIs. Results: About 12.6% survey participants had at least one STI test positive. Lower education was associated with STIs but was not statistically significant (Odd Ratio for no schooling was 8.24, 95% CI 0.93 -72.86, Odd Ratio for high school education was 2.05, 95% CI 0.25 -16.63 compared to associate or college level education). No other predictors were associated with STIs. The average age of the first sexual intercourse was lower, and the number of sexual partners was higher compared to their national counterparts. Conclusion: We found a higher percentage of STI-positive individuals compared to previously reported county-level estimates. Education was the single and most important predictor of positive STI status.

Spontaneous Baroreflex Sensitivity in Normotensive African-American Men

Purpose: African-American men (AAM) have a greater risk of hypertension (HTN) than Caucasian men (CM). To reduce this risk, determining the differences in mechanisms involved in HTN and understanding the relationship between these mechanisms and factors affecting blood pressure (BP) in AAM and CM is necessary. One such mechanism is spontaneous baroreflex sensitivity (sBRS) and two factors are cardiorespiratory fitness (CRF) and arterial stiffness (AS). The aims of this study were to determine, firstly, whether there are differences in sBRS between young, normotensive AAM and CM, and secondly, to determine if CRF and AS are significant predictors of sBRS in young, normotensive AAM and CM. Methods: Twenty-three normotensive AAM and 36 CM were recruited from Southern Connecticut State University. Measures included anthropometric, sBRS (alpha-index), and CRF (maximal oxygen consumption [VO2max]), as well as AS (carotid-femoral pulse wave velocity [Cf-PWV]). Independent t-tests were used to determine differences between groups and multiple regression analysis was used to determine how much of the variation in sBRS was explained by CRF and AS. Results: The sBRS was significantly lower in AAM (10.3 ± 3.8 ms/mmHg) vs. CM (13.3 ± 5.7 ms/ mmHg), P = 0.03. CRF and AS were not significant predictors of sBRS in AAM (P = 0.25) and CM (P = 0.30). There was no relationship between, sBRS, CRF and AS;CRF was significantly reduced in AAM vs. CM (45.1 ± 6.3 vs. 52.1 ± 7.5 mL·kg?1·min?1, P ≤ 0.001). Conclusions: Young normotensive AAM demonstrated significantly lower sBRS vs. CM, irrespective of having fair CRF and normal BP. CRF and AS are not significant predictors of sBRS in young, normotensive AAM and CM. The attenuation in sBRS in AAM did not result in AAM having higher BP versus CM. This finding underscores the need for more detailed examination of the role of sBRS in the etiology of HTN in AAM.

Obesity in African-American Early to Middle-Aged Females: Prevention and Treatment through Education

The objective of this study was to develop an educational program for African-American females on diet and exercise in the treatment and prevention of obesity. African-American female participants aged 30-50 with a Body Mass Index (BMI) over 25 were recruited for inclusion in the study. A qualitative assessment was completed which observed the attitudes, personal beliefs, dietary and physical risk factors regarding weight loss before and after an educational intervention which focused specifically on the targeted population. Pre- and post-assessment questionnaires were utilized in this study. This design intended to measure whether the educational intervention affected real change among the participant’s lifestyle choices. Results revealed that most participants initially did not consider themselves to be overweight or obese and that after the education intervention, realized that they were overweight or obese. Many participants felt that their support systems were adequate. Initially, participants consumed fried foods and high calorie drinks. After the educational intervention, many preferred baked foods and decreased the intake of high calorie drinks. Emotions were also identified as a cause of overeating. Many participants found the educational sessions beneficial to their weight loss and fitness efforts. Challenges such as lack of adequate social support and emotions controlling eating patterns still exist in this population and need to be addressed. The creation of standardized protocols to directly address emotional needs at every medical visit would assist in identification of problems which could negatively affect lifestyle choices.

HEALS: A Faith-Based Hypertension Control Program for African-Americans: A Feasibility Study

Objective: To determine the feasibility of a behavioral faith-based PREMIER study modified hypertension (HTN) control intervention in a semi urban African-American (AA) church. Methods: In a prospective longitudinal study design, a 12-week behavioral HEALS (Healthy Eating and Living Spiritually) intervention was tested for its feasibility and efficacy in a semi urban AA church. High-risk adult church members with HTN were recruited. Program sessions were weekly delivered by the trained church members. Data were analyzed using repeated measures ANOVA. Results: 22 of 34 subjects (65% retention) provided complete information on the outcome measures. Mean systolic blood pressure (SBP) reduction from baseline was 22 mmHg (p < 0.001) and 6.5 mmHg for diastolic BP (p = 0.0048). Mean weight reduction of 3.11 kg from the baseline (p < 0.0001) was also observed. 91% subjects attended 7 - 9 sessions. Conclusion: Promoting behavioral HTN control interventions in high risk AAs by empowering AA church communities is feasible and efficacious.

COVID-19 among African Americans and Hispanics:Does gastrointestinal symptoms impact the outcome?

BACKGROUND The coronavirus disease 2019(COVID-19)disproportionately affected African Americans(AA)and Hispanics(HSP).AIM To analyze the significant effectors of outcome in African American patient population and make special emphasis on gastrointestinal(GI)symptoms,laboratory values and comorbidities METHODS We retrospectively evaluated the medical records of 386 COVID-19 positive patients admitted at Howard University Hospital between March and May 2020.We assessed the symptoms,including the GI manifestations,comorbidities,and mortality,using logistic regression analysis.RESULTS Of these 386 COVID-19 positive patients,257(63.7%)were AAs,102(25.3%)HSP,and 26(6.45%)Whites.There were 257(63.7%)AA,102(25.3%)HSP,26(6.45%)Whites.The mean age was 55.6 years(SD=18.5).However,the mean age of HSP was the lowest(43.7 years vs 61.2 for Whites vs 60 for AAs).The mortality rate was highest among the AAs(20.6%)and lowest among HSP(6.9%).Patients with shortness of breath(SOB)(OR2=3.64,CI=1.73-7.65)and elevated AST(OR2=8.01,CI=3.79-16.9)elevated Procalcitonin(OR2=8.27,CI=3.95-17.3),AST(OR2=8.01,CI=3.79-16.9),ferritin(OR2=2.69,CI=1.24-5.82),and Lymphopenia(OR2=2.77,CI=1.41-5.45)had a high mortality rate.Cough and fever were common but unrelated to the outcome.Hypertension and diabetes mellitus were the most common comorbidities.Glucocorticoid treatment was associated with higher mortality(OR2=5.40,CI=2.72-10.7).Diarrhea was prevalent(18.8%),and GI symptoms did not affect the outcome.CONCLUSION African Americans in our study had the highest mortality as they consisted of an older population and comorbidities.Age is the most important factor along with SOB in determining the mortality rate.Overall,elevated liver enzymes,ferritin,procalcitonin and C-reactive protein were associated with poor prognosis.GI symptoms did not affect the outcome.Glucocorticoids should be used judiciously,considering the poor outcomes associated with it.Attention should also be paid to monitor liver function during COVID-19,especially in AA and HSP patients with higher disease severity.

Impact of Maintenance Steroids versus Rapid Steroid Withdrawal in African-American Kidney Transplant Recipients: Comparison of Two Urban Centers

Background: Rapid steroid withdrawal (RSW) is used increasingly in kidney transplantation but long-term outcomes in African-American (AA) recipients are not well known. We compared 1 and 5 year transplant outcomes in a large cohort of AA patients who were maintained on continued steroid therapy (CST) to those who underwent RSW. Methods: Post-transplant courses of A as receiving kidney allografts from 2003-2011 at two urban transplant centers in Chicago were followed. Prior to outcome analysis, we used Inverse Probability of Treatment Weights (IPTW) to match the two groups on a set of baseline risk factors. Graft and patient survival, GFR at 1 and 5 years, incidence and type of rejection, incidence of post-transplant diabetes mellitus (PTDM), delayed graft function, CMV and BK viremia were compared. Results: There were 150 AA recipients in the CST analytic group and 157 in the RSW analytic group. Graft and patient survival was similar between the two groups. Rates of CMV viremia were higher in the RSW compared to the CST analytic group at 1 year. Biopsy-proven acute rejection and PTDM were similar between the RSW and CST groups. Conclusions: In AA recipients, RSW has similar long-term outcomes to CST.