Disparities in colorectal cancer in African-Americans vs Whites: Before and after diagnosis

There are differences between African-American and white patients with colorectal cancer, concerning their characteristics before and after diagnosis. Whites are more likely to adhere to screening guidelines. This is also the case among people with positive family history. Colorectal cancer is more frequent in Blacks. Studies have shown that that since 1985, colon cancer rates have dipped 20% to 25% for Whites, while rates have gone up for African-American men and stayed the same for African-American women. Overall, African-Americans are 38% to 43% more likely to die from colon cancer than are Whites. Furthermore, it seems that there is an African-American predominance in right-sited tumors. African Americans tend to be diagnosed at a later stage, to suffer from better differentiated tumors, and to have worse prognosis when compared with Whites. Moreover, less black patients receive adjuvant chemotherapy for resectable colorectal cancer or radiation therapy for rectal cancer. Caucasians seem to respond better to standard chemotherapy regimens than AfricanAmericans. Concerning toxicity, it appears that patients of African-American descent are more likely to develop 5-FU toxicity than Whites, possibly because of their different dihydropyridine dehydrogenase status. Last but not least, screening surveillance seems to be higher among white than among black long-term colorectal cancer survivors. Socioeconomic and educational status account for most of these differences whereas little evidence exists for a genetic contribution in racial disparity. Understanding the nature of racial differences in colorectal cancer allows tailoring of screening and treatment interventions.

Inflammation,microbiome and colorectal cancer disparity in African-Americans:Are there bugs in the genetics?

Dysregulated interactions between host inflammation and gut microbiota over the course of life increase the risk of colorectal cancer(CRC).While environmental factors and socio-economic realities of race remain predominant contributors to CRC disparities in African-Americans(AAs),this review focuses on the biological mediators of CRC disparity,namely the under-appreciated influence of inherited ancestral genetic regulation on mucosal innate immunity and its interaction with the microbiome.There remains a poor understanding of mechanisms linking immune-related genetic polymorphisms and microbiome diversity that could influence chronic inflammation and exacerbate CRC disparities in AAs.A better understanding of the relationship between host genetics,bacteria,and CRC pathogenesis will improve the prediction of cancer risk across race/ethnicity groups overall.

Fictionalized Cowboys Vs Real Cowboys ——Based on the Analysis of The Virginian

Using the text analysis of The Virginian, this paper intends to explore the differences between the Virginian and real cow-boys in the Cowboys Era to prove that the Virginian, as a typical cowboy hero, is fictionalized and has not given the whole truthabout cowboys. Further,it is hoped that this paper can help people get a better understanding of the American cowboys and providethem a different angle to read western cowboy stories.

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.

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.

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.

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.

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.

Toni Morrison:Strong Voice for African-Americans

Toni Morrison,the winner of the Nobel Prize for Literature in 1993,has been hailed as one of the greatest American authors of the 20th century.Her works explore and portray blacks’destiny,history,and spiritual world,emphasizing on gender,race,and culture.Song of Solomon and Beloved,the two novels the thesis has selected to make analysis are crucial to her writing career.Toni Morrison’s great many literary works anatomize the survival and psychological pain of African Americans under the restrain and repression of mainstream culture,trying to find out a solution.

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.

A Comparative Study of British Gentleman Culture and American Cowboy Culture

This paper makes a comparative analysis by selecting British gentleman culture and American cowboy culture,the two distinctive cultures,to trace their roots,explore their connotations,and search for their similarities and differences,so as to better understand the respective characteristics of British and American cultures.The result shows that although the two cultures have different styles,which can interpret two different ethnic cultures,they are related by blood and have certain commonalities.

African-American's Awareness of Cultural Heritage: Alice Walker's Everyday Use

Alice Walker's famous short story Everyday Use reveals African American's awareness of cultural heritage, which is deeply affected by the"double consciousness"as well as their racial identification in the Civil Rights Movement. Through the exploration of the cultural conflict reflected in Everyday Use by relating to the influence on black people produced by the AfricanAmerican Civil Rights Movement, and the discussion of the different attitudes of the mother and her daughters towards their cultural heritage, the essay aims to reinforce Alice Walker's claim that any attempt to lay too much emphasis on the ideas of utilitarian return to black people's traditional culture is shallow and superficial.

混沌武士 Cowboy Bebop归来?

如果说最近比较抢眼的片子,“混沌武士(SamuraiChamploo)”绝对是不该错过的一部。在“Cowboy Bebop”之后,除了在“Animatrix”中小(?)身手之外,一直沉寂到现在的渡边信一郎终于带着这部新作出现在fans面前。

A Cowboy of the East

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1st degree acromioclavicular sprain, elevated 1st rib, or both? A case study of a rodeo cowboy

Objective: To present a case of a rodeo cowboy who suffered a seemingly routine 1st degree acromioclavicular (AC) sprain. The AC sprain was exacerbated by an elevated 1st rib. Background: Saddle bronc riding is one of three rough stock events in North American rodeo and the least common event for injury relative to bull riding and bareback riding. Shoulder injury in rodeo rough stock events make up 9.3% of all injuries. Approximately 28% of injuries in rodeo are considered minor sprains. The professional cowboy was thrown from his horse landing on the tip of his shoulder. The cowboy presented with a routine 1st degree AC sprain based on the Tossey and Rockwood definitions. Differential Diagnosis: Due to the mechanism of injury and forces produced with the cowboy being thrown to the ground, elimination of serious neck injury was critical. A scanning examination revealed some neck dysfunction. A cervical rotation, lateral flexion special test confirmed the additional elevated 1st rib in addition to the 1st degree AC sprain. Treatment: A chiropractic adjustment of the 1st rib reduced pain in the AC joint from a 6/10 to 1/10 immediately. Subsequently, the patient iced and was treated with one other 1st rib adjustment at a later date. Uniqueness: There were no cases of 1st degree AC sprains with an associated elevated first rib in the literature. It was very unique to relieve to the patient’s shoulder symptoms so dramatically in a short period of time with manual therapy to the first rib. Conclusions: It is important to follow a thorough history and physical examination of patients who suffer from a 1st degree AC sprain. The use of a scanning examination will help identify the primary source of pain (i.e. neck and/or shoulder). Manual therapy of the 1st rib may be useful in the treatment.

The Black American Church: A Reactionary and Ideological Apparatus of Slavery

This work argues that Denmark Vesey,Nat Turner,Gabriel Prosser,David Walker,Henry Highland Garnet,amongst a few others were the reactionary(dialectical)exceptions to the black church,not the norm,an(ideological)institution established to interpellate and indoctrinate blacks to accept their conditions in slavery.In other words,the aforementioned were the enslaved who used Christian dogma to(negative dialectically)respond to the barbarity of slavery by violently convicting white Christian society for not living up to its values,ideas,and ideals given the treatment of African people by so-called Christians.In the latter sense it was reactionary;in the former,it was an ideological apparatus of domination and control for the institution of slavery.The contemporary attempt to racially vindicate the black church as a sui generis revolutionary institution overflowing with Africanisms is ahistorical and ideological reaped in pseudoscientific propositions stemming from postmodern and post-structural theories.

An intervention to reduce psychosocial and biological indicators of stress in African American lupus patients: The balancing lupus experiences with stress strategies study

Objective: Very little is known about the impact of psychosocial stress on African American lupus patients. Due to the exposure of African Americans to a unique trajectory of stressors throughout life, it may be critical to understand the relationship between psychosocial stress and underlying biological mechanisms that influence disease activity and pathology in this high risk group. Methods: The Balancing Lupus Experiences with Stress Strategies (BLESS) study piloted the validated “Better Choices, Better Health” Chronic Disease Self-Management Program (CDSMP) in 30 African-American lupus patients participating in the SLE Clinic Database Project at the Medical University of South Carolina (MUSC). Measures of psychosocial and biological indicators of stress were collected in all of the patients in each of the study conditions before and after intervention activities, as well as four months’ post-intervention, to assess the effectiveness of the program in reducing perceived and biological indicators of stress. Results: Participation in the workshops had large effects upon depression (d = 1.63 and d = 1.68), social/role activities limitations (d =1.15), health distress (d = 1.13 and d = 0.78), fatigue (d = 1.03), pain (d = 0.96), and lupus self-efficacy (d = 0.85). Neither the differences in cortisol or DHEA levels pre- and post-intervention were found to be significantly different between intervention participants and controls. Conclusion: The intervention workshops acted to reduce perceived stress and improve quality of life. Our findings imply that comparable, if not more significant gains in relevant health indicators are possible in African American patients when provided the opportunity to participate in CDSMP’s.

The Political Messages Embodied in Marvel’s Film Black Panther

Black Panther is the first superhero film in Marvel’s history that is directed and acted predominantly by African-American artists.The complementary academic review,high box office and audience rating are highly attributed to the political elements embodied in the movie.A breakthrough is achieved in the conventional cinematic image of the African-American man through the creation of a black hero playing the role of world savior.It also presents a prosperous and advanced image of Africa,fulfilling and expanding the African-American people’s imagination of their spiritual home.Moreover,in responding to the Black Panther movement in black history,the film implicitly explores three possible routes of struggle for the black ethnic group and conveys a political message to the audience.

Seeking Self-Emancipation Through Communal Redemption in Toni Morrison＇s Beloved

Toni Morrison, as an African-American woman writer, attracts the greatest attention in recent years. Being the winner of the Nobel Prize for Literature in 1993, she has been hailed as a stand of the Black Women＇s Literature in the 20th century. She is deeply concerned about the spiritual world of black women. Morrison has always put stress on the relationship between individual and community; her idea that what affects the black community can have an influence on individuals is an important part in her books that cannot be neglected. By way of the approach of text analysis, this paper tries to elaborate Morrison＇s important idea that estrangement from the community inevitably means a lack of communal support and understanding, which is harmful to the healthy formation of individual identity in one of her important works Beloved （1987）.