BACKGROUND The incidence of early-onset colorectal cancer(EOCRC,<45 years of age at onset)is on the rise among adults,including African Americans(AA).AIM To examine differences between EOCRC and late-onset colorect...BACKGROUND The incidence of early-onset colorectal cancer(EOCRC,<45 years of age at onset)is on the rise among adults,including African Americans(AA).AIM To examine differences between EOCRC and late-onset colorectal cancer(LOCRC)among AA patients and any effect during coronavirus disease(COVID)by comparing data during pre-COVID(2015-2019)and the COVID era(2020-2023).METHODS We conducted a retrospective review of Howard University Hospital records from 2015 to 2023 for colorectal cancer patients that included demographics,clinicals,pathology,and colonoscopy records.A three-year interval analysis was performed to compare post-COVID era(2020-2023)to preceding years to discern temporal trends.RESULTS The study included 138 LOCRC and 13 EOCRC cases of which>80%of patients were AA.Compared to pre-COVID,LOCRC cases increased in number from 55 to 83,and EOCRC cases increased from 6 to 7 during COVID.There was no change in mean age for LOCRC(64.7 years vs 65.3 years)but mean age increased for EOCRC(37.3 years vs 41.5 years).Males predominated in both groups particularly during the pandemic.More than 65%of LOCRC patient colonoscopies were for diagnostic purposes.Gastrointestinal bleeding as a colonoscopy indication and reduced bowel preparation quality were increased during the pandemic.EOCRC patients showed a shift from stage 4(49.2%)to stage 2(30%)and LOCRC patients staging trends changed from stage 4(40%)to stage 3(28.6%).CONCLUSION We report increase in colorectal cancer cases during the COVID-19 era,especially among young AA males.EOCRC and LOCRC patients showed distal location predominance,most commonly in recto-sigmoid region.The decrease in staging or metastasis,which might be due to growing awareness and earlier detection among patients.展开更多
As the population of older Asian Americans continues to grow rapidly,understanding their mental health needs has become increasingly critical.This literature review summarizes current issues,developments,and future di...As the population of older Asian Americans continues to grow rapidly,understanding their mental health needs has become increasingly critical.This literature review summarizes current issues,developments,and future directions in addressing the mental health challenges faced by older Asian Americans in the last five years.We briefly touch on the comparative prevalence of mental health disorders experienced by ethnic subgroups.Additionally,we review recent studies highlighting the role of the coronavirus disease 2019,racism,social support,cultural stigma,and self-rated health as significant factors influencing mental well-being of this population.We discuss the utilization of health services among older Asian Americans.We conclude with thoughts for future research,emphasizing the importance of longitudinal studies,consideration of diverse Asian American ethnic subgroups,and culturally sensitive diagnostic and treatment approaches.展开更多
AIM To determine whether and to what extent the gut microbiome is involved in regulating racial disparity in colorectal cancer(CRC).METHODS All patients were recruited and experiments were performed in accordance with...AIM To determine whether and to what extent the gut microbiome is involved in regulating racial disparity in colorectal cancer(CRC).METHODS All patients were recruited and experiments were performed in accordance with the relevant guidelines and regulations by the Institutional Review Boards(IRB),committees of the John D.Dingell VAMC and Wayne State University guidelines.African American(AA)and Caucasian American(CA)patients were scheduled for an outpatient screening for colonoscopy,and no active malignancy volunteer patients were doubly consented,initially by the gastroenterologist and later by the study coordinator,for participation in the study.The gut microbial communities in colonic effluents from AAs and CAs were examined using 16 sRNA profiling,and bacterial identifications were validated by performing SYBR-based Real Time PCR.For metagenomic analysis to characterize the microbial communities,multiple software/tools were used,including Metastats and R statistical software.RESULTS It is generally accepted that the incidence and mortality of CRC is higher in AAs than in CAs.However,the reason for this disparity is not well understood.We hypothesize that the gut microbiome plays a role in regulating this disparity.Indeed,we found significant differences in species richness and diversity between AAs and CAs.Bacteroidetes was more abundant in AAs than in CAs.In particular,the pro-inflammatory bacteria Fusobacterium nucleatum and Enterobacter species were significantly higher in AAs,whereas probiotic Akkermansia muciniphila and Bifidobacterium were higher in CAs.The polyphyletic Clostridia class showed a divergent pattern,with Clostridium XI elevated in AAs,and Clostridium IV,known for its beneficial function,higher in CAs.Lastly,the AA group had decreased microbial diversity overall in comparison to the CA group.In summary,there were significant differences in pro-inflammatory bacteria and microbial diversity between AA and CA,which may help explain the CRC disparity between groups.CONCLUSION Our current investigation,for the first time,demonstrates microbial dysbiosis between AAs and CAs,which could contribute to the racial disparity of CRC.展开更多
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 co...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.展开更多
After tobacco use, chronic hepatitis B(CHB) viral infections are the most important cause of cancer globally in that 1 out of 3 individuals have been infected with the hepatitis B virus(HBV). Though infection rates ar...After tobacco use, chronic hepatitis B(CHB) viral infections are the most important cause of cancer globally in that 1 out of 3 individuals have been infected with the hepatitis B virus(HBV). Though infection rates are low(< 1%) in the United States, Asian Americans who comprise about 6% of the population experience about 60% of the CHB burden. This paper reviews the magnitude of hepatitis B(HBV) burden among Asian Americans and the progress being made to mitigate this burden, primarily through localized, communitybased efforts to increase screening and vaccination among Asian American children, adolescents, and adults. This review brings to light that despite the numerous community-based screening efforts, a vast majority of Asian Americans have not been screened and that vaccination efforts, particularly for adults, are sub-optimal. Greater efforts to integrate screenings by providers within existing healthcare systems are urged. Evidence-based strategies are offered to implement CDC's three major recommendations to control and prevent hepatitis B through targeted screening and enhanced vaccination efforts.展开更多
AIM: To investigate whether older Chinese Americans perceive dementia as a mental illness and the relationship between such perception and their general understanding of dementia remains unclear. Our study aims to und...AIM: To investigate whether older Chinese Americans perceive dementia as a mental illness and the relationship between such perception and their general understanding of dementia remains unclear. Our study aims to understand this relationship and its future implication on improving dementia literacy among ethnic minorities.METHODS: Elderly Chinese American participants from the Greater Los Angeles were asked to complete an 11-item dementia questionnaire, following a community health seminar. Cross-sectional survey data was analyzed using standard statistical methods.RESULTS: The questionnaire received an 88.3% response rate. Among 316 responders, only 28.8%(n = 91) of elderly Chinese Americans identified dementia as a mental illness, and 71.2%(n = 225) did not recognize its mental disease origin. Furthermore, in comparison between these two groups, the first group demonstrated significantly higher level of baseline knowledge of the disease.CONCLUSION: This study reveals that only approximately 1 out of 4 older Chinese Americans recognized dementia as a mental illness, consistent with previous studies on Asian Americans. Our study however showed that when dementia was being perceived as a mental illness, such perception was associated with a higher level of baseline dementia understanding. The current study suggested the potential of improving older Chinese Americans dementia literacy by increasing awareness of its mental illness origin.展开更多
Ever since the establishment of Israeli statehood in 1948, the United States has been its staunch supporter. This is because of their common beliefs in values, political system and ideology, and America’s interests i...Ever since the establishment of Israeli statehood in 1948, the United States has been its staunch supporter. This is because of their common beliefs in values, political system and ideology, and America’s interests in the Middle East. However one important factor cannot be ignored., the influence of Jewish Americans’ political forces on U. S. Middle East policy. Since few articles deal with such a topic systematically in China, this essay tries to make a preliminary study on it.展开更多
The paper is intended to analyze John Steinbeck＇ s Americans and the land by the method of literary stylistics, which based on the theory of ecocriticism. The lexical choice, the syntactical structure and Steinbeck＇...The paper is intended to analyze John Steinbeck＇ s Americans and the land by the method of literary stylistics, which based on the theory of ecocriticism. The lexical choice, the syntactical structure and Steinbeck＇s ecological ideas can be revealed through the interpretation of his work. Between the lines, his deep love and pity for nature is all-around. What Steinbeck aspire for is the harmonious relationship between man and nature, and he appealed to human beings for protecting the living environment.展开更多
Fast-food is always the one of the main culture in America just like it has been known.It is not only very important in Americans’lives,but can reflect some of their outlooks on life.This thesis gives an analysis of ...Fast-food is always the one of the main culture in America just like it has been known.It is not only very important in Americans’lives,but can reflect some of their outlooks on life.This thesis gives an analysis of reflection of Americans’outlooks on life in fast-food culture.Five types of Americans’outlooks on life have been surveyed:working hard and playing hard,optimism and open-mindedness,treating the time as the life,self-independence and believing the equality.Beginning with the introduction of the emergence and development of fast-food culture in America,the thesis brings why the fast-food can be popularized among Americans to light.Consequently,we can find that some of the Americans’outlooks on life can be consistent with their fast-food culture.This thesis will be divided into four parts.The first part is the introduction and the last conclusion.The focus of this thesis is laid on the two middle parts which first display the five types of Americans’outlooks on life,then give the analysis of the reflection in fast-food culture.This thesis attempts to explore the Americans’outlooks on life.Although by the thesis we can not learn about a nation completely,we still know some aspects of their outlooks on life from fast-food culture.Key words:outlook;Americans;fast-food;展开更多
BACKGROUND It has been recognized for a long time that gastric cancer behavior and outcomes might be different between patients living in Asian countries vs patients living in Western countries.It is not clear if thes...BACKGROUND It has been recognized for a long time that gastric cancer behavior and outcomes might be different between patients living in Asian countries vs patients living in Western countries.It is not clear if these differences would persist between patients of Asian ancestry and patients of other racial subgroups within the multiethnic communities of North America.The current study hypothesizes that these differences will present within North American multiethnic communities.AIM To evaluate the impact of race on survival outcomes of non-metastatic gastric cancer patients in the United States.METHODS This is a secondary analysis of a randomized controlled trial(CALGB 80101 study)that evaluated two adjuvant chemoradiotherapy schedules following resection of non-metastatic gastric cancer.Kaplan-Meier analysis and log-rank testing were utilized to explore the overall and disease-free survival differences according to the race of the patients.Univariate and multivariate Cox regression analyses were then used to explore factors affecting overall and disease-free survivals.RESULTS A total of 546 patients were included in the current analysis.Of which,73.8%have white race(vs 12.8%black Americans and 8.2% Asian Americans).Using Kaplan-Meier analysis/log-rank testing,Asian Americans appear to have better overall and disease-free survival outcomes compared to other United States racial groups(White Americans,Black Americans,and other racial groups)(P=0.011;P=0.010;respectively).Moreover,in an adjusted multivariate model,Asian American race seems to be associated with better overall and disease-free survival(hazard ratio:0.438;95% confidence interval:0.254-0.754),P=0.003;(hazard ratio:0.460;95% confidence interval:0.280-0.755,P=0.002;respectively).CONCLUSION Asian American patients with non-metastatic gastric cancer have better overall and disease-free survival compared to other racial groups in the United States.Further preclinical and clinical research is needed to clarify the reasons behind this observation.展开更多
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 ...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.展开更多
Objective:To explore the double psychosocial threats of the COVID-19 pandemic,targeted behavior toward Chinese Americans,and the correlates to their mental health.Methods:A quantitative,cross-sectional,and descriptive...Objective:To explore the double psychosocial threats of the COVID-19 pandemic,targeted behavior toward Chinese Americans,and the correlates to their mental health.Methods:A quantitative,cross-sectional,and descriptive design was utilized by using a purposive convenience sample of 301 Chinese Americans over the age of 18 residing in the United States.Online data collection was conducted through the social media platform WeChat from April 8–21,2021.Descriptive statistical analysis was used for the participants’demographic charac-teristics,Multidimensional Scale of Perceived Social Support(MSPSS),Double Threat Situations,COVID-19 Racial Discrimination,and General Anxiety Disorder-7(GAD-7).Stepwise logistic regression was conducted to verify predictors for anxiety levels by GAD-7.Results:In this sample(N=301),127(42.19%)were male and 174(57.81%)were female.The average age was 41.67(SD=5.89).Among MSPSS subscales,social support from family(MSPSS-Fam,79.73%,n=240)and social support from significant others(MSPSS-SO,73.75%,n=222)were high.231(76.74%)reported threats due to their Chinese ethnic background during the COVID-19 outbreak.Predictors for the high anxiety level by GAD-7 were COVID-19 racial discrimination from the local community(OR=0.47,95%CI=0.39–0.71,p<0.001),media/online(OR=0.36,95%CI=0.26–0.53,p<0.001),the perceived threat from the COVID-19 virus(OR=0.33,95%CI=0.23–0.51,p<0.001)and Perceived racism threat from Chinese back-ground related to COVID-19(OR=0.31,95%CI=0.21–0.49,p<0.001).Conclusions:COVID-19 double-threats(The virus and racial discrimination)situations are significantly related to the high level of anxiety among Chinese Americans.The sense of belonging and social perceptions of Chinese immigrants is closely related to public health problems in Western societies and needs to be addressed at all levels.Ourfindings call for the attention of health-care workers to specific racism double-threatened situations and high mental health risks,as well as direct and indirect ethnic discrimination that Chinese Americans are experiencing during this pandemic,the long-term influ-ences and effective coping ways related to this issue should be explored in further research.展开更多
Hypertension is a leading risk factor for stroke and cardiovascular disease in the United States.Chinese Americans have poorer control of high blood pressure than Caucasian Americans and are at higher risk for hyperte...Hypertension is a leading risk factor for stroke and cardiovascular disease in the United States.Chinese Americans have poorer control of high blood pressure than Caucasian Americans and are at higher risk for hypertension.This review presents and discusses the factors known to be associated with health disparities affecting Chinese Americans with hypertension,including biological,genetic,sociocultural and environmental factors,as well as health behaviors,and health literacy.Culturally appropriate interventions are needed to decrease racial and ethnic health disparities.展开更多
This year, I got an opportunity to teach Chinese Culture to some American students for three months. During this process, I had observed many cultural differences between Chinese and Americans. And how to understand t...This year, I got an opportunity to teach Chinese Culture to some American students for three months. During this process, I had observed many cultural differences between Chinese and Americans. And how to understand the definition of culture was quite far away between us. But one point we all agreed upon was that immersion in the culture of another country can lead to increased appreciation for one’s own.展开更多
Background: Diabetes and diabetes-related complications are major causes of morbidity and mortality in the United States. Depressive symptoms and perceived stress have been identified as possible risk factors for beta...Background: Diabetes and diabetes-related complications are major causes of morbidity and mortality in the United States. Depressive symptoms and perceived stress have been identified as possible risk factors for beta cell dysfunction and diabetes. The purpose of this study was to assess associations between depression symptoms and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes. Participants and Methods: Informed consent and data were available for 462 participants (231 African Americans and 231 Haitian Americans) for this cross-sectional study. A demographic questionnaire developed by the Primary Investigator was used to collect information regarding age, gender, smoking, and ethnicity. Diabetes status was determined by self-report and confirmed by fasting blood glucose. Anthropometrics (weight, and height and waist circumference) and vital signs (blood pressure) were taken. Blood samples were drawn after 8 10 hours over-night fasting to measure lipid panel, fasting plasma glucose and serum insulin concentrations. The homeostatic model assessment, version 2 (HOMA2) computer model was used to calculate beta cell function. Depression was assessed using the Beck Depression Inventory-II (BDI-II) and stress levels were assessed using the Perceived Stress Scale (PSS). Results: Moderate to severe depressive symptoms were more likely for persons with diabetes (p = 0.030). There were no differences in perceived stress between ethnicity and diabetes status (p = 0.283). General linear models for participants with and without type 2 diabetes using beta cell function as the dependent variable showed no association with depressive symptoms and perceived stress;however, Haitian Americans had significantly lower beta cell function than African Americans both with and without diabetes and adjusting for age, gender, waist circumference and smoking. Further research is needed to compare these risk factors in other race/ethnic groups.展开更多
<strong>Background:</strong> African Americans (AA) are disproportionally affected by cardiovascular disease as compared to other racial-ethnic groups. Exposure to adverse socioeconomic conditions may part...<strong>Background:</strong> 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. <strong>Methods:</strong> 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. <strong>Results:</strong> 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. <strong>Conclusion:</strong> 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. <strong>Main Points:</strong> 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.展开更多
Managers and regulators are concerned about potential human health effects from exposure on lands contaminated by chemicals and radionuclides. Determining target cleanup levels is partly dependent upon future land use...Managers and regulators are concerned about potential human health effects from exposure on lands contaminated by chemicals and radionuclides. Determining target cleanup levels is partly dependent upon future land use, and potential exposure from human use. This paper provides data from surveys of activity patterns of people attending festivals in four states, located in the vicinity of Department of Energy facilities. There were significant differences in both participation rates, and activity rates as a function of both location and ethnicity that can be used by managers to track exposure, land use, and preferred activities on natural lands. In general, 1) a higher percent of Native Americans engaged in consumptive activities than others, 2) a higher percent of Caucasians engaged in some non-consumptive activities than Native Americans, 3) a higher percentage of Native Americans engaged in activities on sacred grounds, 4) activity rates were generally higher for Native Americans for consumptive activities and religious/cultural than for Caucasians, 5) fishing rates were higher than other consumptive activities, and camping/hiking were higher than other non-con- sumptive activities, and 6) hunting rates were higher in subjects from Idaho than elsewhere. Baseline human use is critical for monitoring potential exposure, and provides the basis for monitoring, risk assessment and future land use, and these data can be used by managers for assessment and management. Tracking changes over time will reflect changing recreational, subsistence, and cultural/religious trends that relate to land use, public perceptions, and exposure.展开更多
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...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.展开更多
Although severe and chronic mental disorders are common among Asian Americans in residential treatment programs, little has been known about the prevalence and predictors of co-occurring substance use in this populati...Although severe and chronic mental disorders are common among Asian Americans in residential treatment programs, little has been known about the prevalence and predictors of co-occurring substance use in this population. The purpose of this study was to examine predictors of co-occurring substance use among Asian Americans with mental disorders in residential treatment programs. This cross-sectional study included 375 clinical records of Asian Americans from residential treatment programs between 2007 and 2011. Demographic variables, principal psychiatric diagnoses, and data on alcohol, stimulant, and marijuana use were obtained from the clinical records. Separate binary logistic regression analyses were used to examine the demographic and diagnostic contributions to the risk of each type of substance use. Findings of this study indicated that the prevalence of co-occurring substance use was about 53% in Asian Americans with mental disorders. Binary logistic regression analyses revealed that male gender, older age, and depressive disorder predicted more alcohol use, but homelessness and schizophrenia predicted less alcohol use. Male gender, homelessness, and smoking predicted more stimulant use. Male gender and younger age predicted more marijuana use. Based on the findings of this study, awareness about co-occurring substance use problems of ethnic minority psychiatric clients should be increased and appropriate substance use prevention and treatment programs should be developed and provided for high-risk groups.展开更多
More than 4,000,000 immigrants traveled from Italy to the United States between 1880 and 1924. Most were peasants, largely illiterate, and with no sense of an Italian identity as their ancestral home had only been lib...More than 4,000,000 immigrants traveled from Italy to the United States between 1880 and 1924. Most were peasants, largely illiterate, and with no sense of an Italian identity as their ancestral home had only been liberated from centuries of foreign rule in 1861. This study utilizes primary and secondary documents, as well as archival sources and interviews to determine the role of sport in the transition to an Italian identity, and then an American identity within the assimilation process. Second generation youth adopted American sport forms, and some became national heroes in contrast to the stereotype of Italian gangsters. By the 1950s Italians had become icons of popular culture, yet negative stereotypes persisted and assimilation remained fragmented.展开更多
文摘BACKGROUND The incidence of early-onset colorectal cancer(EOCRC,<45 years of age at onset)is on the rise among adults,including African Americans(AA).AIM To examine differences between EOCRC and late-onset colorectal cancer(LOCRC)among AA patients and any effect during coronavirus disease(COVID)by comparing data during pre-COVID(2015-2019)and the COVID era(2020-2023).METHODS We conducted a retrospective review of Howard University Hospital records from 2015 to 2023 for colorectal cancer patients that included demographics,clinicals,pathology,and colonoscopy records.A three-year interval analysis was performed to compare post-COVID era(2020-2023)to preceding years to discern temporal trends.RESULTS The study included 138 LOCRC and 13 EOCRC cases of which>80%of patients were AA.Compared to pre-COVID,LOCRC cases increased in number from 55 to 83,and EOCRC cases increased from 6 to 7 during COVID.There was no change in mean age for LOCRC(64.7 years vs 65.3 years)but mean age increased for EOCRC(37.3 years vs 41.5 years).Males predominated in both groups particularly during the pandemic.More than 65%of LOCRC patient colonoscopies were for diagnostic purposes.Gastrointestinal bleeding as a colonoscopy indication and reduced bowel preparation quality were increased during the pandemic.EOCRC patients showed a shift from stage 4(49.2%)to stage 2(30%)and LOCRC patients staging trends changed from stage 4(40%)to stage 3(28.6%).CONCLUSION We report increase in colorectal cancer cases during the COVID-19 era,especially among young AA males.EOCRC and LOCRC patients showed distal location predominance,most commonly in recto-sigmoid region.The decrease in staging or metastasis,which might be due to growing awareness and earlier detection among patients.
文摘As the population of older Asian Americans continues to grow rapidly,understanding their mental health needs has become increasingly critical.This literature review summarizes current issues,developments,and future directions in addressing the mental health challenges faced by older Asian Americans in the last five years.We briefly touch on the comparative prevalence of mental health disorders experienced by ethnic subgroups.Additionally,we review recent studies highlighting the role of the coronavirus disease 2019,racism,social support,cultural stigma,and self-rated health as significant factors influencing mental well-being of this population.We discuss the utilization of health services among older Asian Americans.We conclude with thoughts for future research,emphasizing the importance of longitudinal studies,consideration of diverse Asian American ethnic subgroups,and culturally sensitive diagnostic and treatment approaches.
基金Supported by Department of Veteran Affairs,No.1I101BX001927National Institutes of Health,No.1R21CA175916
文摘AIM To determine whether and to what extent the gut microbiome is involved in regulating racial disparity in colorectal cancer(CRC).METHODS All patients were recruited and experiments were performed in accordance with the relevant guidelines and regulations by the Institutional Review Boards(IRB),committees of the John D.Dingell VAMC and Wayne State University guidelines.African American(AA)and Caucasian American(CA)patients were scheduled for an outpatient screening for colonoscopy,and no active malignancy volunteer patients were doubly consented,initially by the gastroenterologist and later by the study coordinator,for participation in the study.The gut microbial communities in colonic effluents from AAs and CAs were examined using 16 sRNA profiling,and bacterial identifications were validated by performing SYBR-based Real Time PCR.For metagenomic analysis to characterize the microbial communities,multiple software/tools were used,including Metastats and R statistical software.RESULTS It is generally accepted that the incidence and mortality of CRC is higher in AAs than in CAs.However,the reason for this disparity is not well understood.We hypothesize that the gut microbiome plays a role in regulating this disparity.Indeed,we found significant differences in species richness and diversity between AAs and CAs.Bacteroidetes was more abundant in AAs than in CAs.In particular,the pro-inflammatory bacteria Fusobacterium nucleatum and Enterobacter species were significantly higher in AAs,whereas probiotic Akkermansia muciniphila and Bifidobacterium were higher in CAs.The polyphyletic Clostridia class showed a divergent pattern,with Clostridium XI elevated in AAs,and Clostridium IV,known for its beneficial function,higher in CAs.Lastly,the AA group had decreased microbial diversity overall in comparison to the CA group.In summary,there were significant differences in pro-inflammatory bacteria and microbial diversity between AA and CA,which may help explain the CRC disparity between groups.CONCLUSION Our current investigation,for the first time,demonstrates microbial dysbiosis between AAs and CAs,which could contribute to the racial disparity of CRC.
基金Supported by In whole with Federal funds from the National Cancer Institute,National Institutes of Health,under Contract,No.HHSN261200800001E
文摘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.
文摘After tobacco use, chronic hepatitis B(CHB) viral infections are the most important cause of cancer globally in that 1 out of 3 individuals have been infected with the hepatitis B virus(HBV). Though infection rates are low(< 1%) in the United States, Asian Americans who comprise about 6% of the population experience about 60% of the CHB burden. This paper reviews the magnitude of hepatitis B(HBV) burden among Asian Americans and the progress being made to mitigate this burden, primarily through localized, communitybased efforts to increase screening and vaccination among Asian American children, adolescents, and adults. This review brings to light that despite the numerous community-based screening efforts, a vast majority of Asian Americans have not been screened and that vaccination efforts, particularly for adults, are sub-optimal. Greater efforts to integrate screenings by providers within existing healthcare systems are urged. Evidence-based strategies are offered to implement CDC's three major recommendations to control and prevent hepatitis B through targeted screening and enhanced vaccination efforts.
文摘AIM: To investigate whether older Chinese Americans perceive dementia as a mental illness and the relationship between such perception and their general understanding of dementia remains unclear. Our study aims to understand this relationship and its future implication on improving dementia literacy among ethnic minorities.METHODS: Elderly Chinese American participants from the Greater Los Angeles were asked to complete an 11-item dementia questionnaire, following a community health seminar. Cross-sectional survey data was analyzed using standard statistical methods.RESULTS: The questionnaire received an 88.3% response rate. Among 316 responders, only 28.8%(n = 91) of elderly Chinese Americans identified dementia as a mental illness, and 71.2%(n = 225) did not recognize its mental disease origin. Furthermore, in comparison between these two groups, the first group demonstrated significantly higher level of baseline knowledge of the disease.CONCLUSION: This study reveals that only approximately 1 out of 4 older Chinese Americans recognized dementia as a mental illness, consistent with previous studies on Asian Americans. Our study however showed that when dementia was being perceived as a mental illness, such perception was associated with a higher level of baseline dementia understanding. The current study suggested the potential of improving older Chinese Americans dementia literacy by increasing awareness of its mental illness origin.
文摘Ever since the establishment of Israeli statehood in 1948, the United States has been its staunch supporter. This is because of their common beliefs in values, political system and ideology, and America’s interests in the Middle East. However one important factor cannot be ignored., the influence of Jewish Americans’ political forces on U. S. Middle East policy. Since few articles deal with such a topic systematically in China, this essay tries to make a preliminary study on it.
文摘The paper is intended to analyze John Steinbeck＇ s Americans and the land by the method of literary stylistics, which based on the theory of ecocriticism. The lexical choice, the syntactical structure and Steinbeck＇s ecological ideas can be revealed through the interpretation of his work. Between the lines, his deep love and pity for nature is all-around. What Steinbeck aspire for is the harmonious relationship between man and nature, and he appealed to human beings for protecting the living environment.
文摘Fast-food is always the one of the main culture in America just like it has been known.It is not only very important in Americans’lives,but can reflect some of their outlooks on life.This thesis gives an analysis of reflection of Americans’outlooks on life in fast-food culture.Five types of Americans’outlooks on life have been surveyed:working hard and playing hard,optimism and open-mindedness,treating the time as the life,self-independence and believing the equality.Beginning with the introduction of the emergence and development of fast-food culture in America,the thesis brings why the fast-food can be popularized among Americans to light.Consequently,we can find that some of the Americans’outlooks on life can be consistent with their fast-food culture.This thesis will be divided into four parts.The first part is the introduction and the last conclusion.The focus of this thesis is laid on the two middle parts which first display the five types of Americans’outlooks on life,then give the analysis of the reflection in fast-food culture.This thesis attempts to explore the Americans’outlooks on life.Although by the thesis we can not learn about a nation completely,we still know some aspects of their outlooks on life from fast-food culture.Key words:outlook;Americans;fast-food;
文摘BACKGROUND It has been recognized for a long time that gastric cancer behavior and outcomes might be different between patients living in Asian countries vs patients living in Western countries.It is not clear if these differences would persist between patients of Asian ancestry and patients of other racial subgroups within the multiethnic communities of North America.The current study hypothesizes that these differences will present within North American multiethnic communities.AIM To evaluate the impact of race on survival outcomes of non-metastatic gastric cancer patients in the United States.METHODS This is a secondary analysis of a randomized controlled trial(CALGB 80101 study)that evaluated two adjuvant chemoradiotherapy schedules following resection of non-metastatic gastric cancer.Kaplan-Meier analysis and log-rank testing were utilized to explore the overall and disease-free survival differences according to the race of the patients.Univariate and multivariate Cox regression analyses were then used to explore factors affecting overall and disease-free survivals.RESULTS A total of 546 patients were included in the current analysis.Of which,73.8%have white race(vs 12.8%black Americans and 8.2% Asian Americans).Using Kaplan-Meier analysis/log-rank testing,Asian Americans appear to have better overall and disease-free survival outcomes compared to other United States racial groups(White Americans,Black Americans,and other racial groups)(P=0.011;P=0.010;respectively).Moreover,in an adjusted multivariate model,Asian American race seems to be associated with better overall and disease-free survival(hazard ratio:0.438;95% confidence interval:0.254-0.754),P=0.003;(hazard ratio:0.460;95% confidence interval:0.280-0.755,P=0.002;respectively).CONCLUSION Asian American patients with non-metastatic gastric cancer have better overall and disease-free survival compared to other racial groups in the United States.Further preclinical and clinical research is needed to clarify the reasons behind this observation.
基金the National Institute on Minority Health and Health Disparities of the National Institutes of Health,No.G12MD007597.
文摘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.
基金supported by the Project of National Social Science Foundation of China(21BMZ018)the Philosophy and Social Science Project of Yunnan Province(YB2020093).
文摘Objective:To explore the double psychosocial threats of the COVID-19 pandemic,targeted behavior toward Chinese Americans,and the correlates to their mental health.Methods:A quantitative,cross-sectional,and descriptive design was utilized by using a purposive convenience sample of 301 Chinese Americans over the age of 18 residing in the United States.Online data collection was conducted through the social media platform WeChat from April 8–21,2021.Descriptive statistical analysis was used for the participants’demographic charac-teristics,Multidimensional Scale of Perceived Social Support(MSPSS),Double Threat Situations,COVID-19 Racial Discrimination,and General Anxiety Disorder-7(GAD-7).Stepwise logistic regression was conducted to verify predictors for anxiety levels by GAD-7.Results:In this sample(N=301),127(42.19%)were male and 174(57.81%)were female.The average age was 41.67(SD=5.89).Among MSPSS subscales,social support from family(MSPSS-Fam,79.73%,n=240)and social support from significant others(MSPSS-SO,73.75%,n=222)were high.231(76.74%)reported threats due to their Chinese ethnic background during the COVID-19 outbreak.Predictors for the high anxiety level by GAD-7 were COVID-19 racial discrimination from the local community(OR=0.47,95%CI=0.39–0.71,p<0.001),media/online(OR=0.36,95%CI=0.26–0.53,p<0.001),the perceived threat from the COVID-19 virus(OR=0.33,95%CI=0.23–0.51,p<0.001)and Perceived racism threat from Chinese back-ground related to COVID-19(OR=0.31,95%CI=0.21–0.49,p<0.001).Conclusions:COVID-19 double-threats(The virus and racial discrimination)situations are significantly related to the high level of anxiety among Chinese Americans.The sense of belonging and social perceptions of Chinese immigrants is closely related to public health problems in Western societies and needs to be addressed at all levels.Ourfindings call for the attention of health-care workers to specific racism double-threatened situations and high mental health risks,as well as direct and indirect ethnic discrimination that Chinese Americans are experiencing during this pandemic,the long-term influ-ences and effective coping ways related to this issue should be explored in further research.
文摘Hypertension is a leading risk factor for stroke and cardiovascular disease in the United States.Chinese Americans have poorer control of high blood pressure than Caucasian Americans and are at higher risk for hypertension.This review presents and discusses the factors known to be associated with health disparities affecting Chinese Americans with hypertension,including biological,genetic,sociocultural and environmental factors,as well as health behaviors,and health literacy.Culturally appropriate interventions are needed to decrease racial and ethnic health disparities.
文摘This year, I got an opportunity to teach Chinese Culture to some American students for three months. During this process, I had observed many cultural differences between Chinese and Americans. And how to understand the definition of culture was quite far away between us. But one point we all agreed upon was that immersion in the culture of another country can lead to increased appreciation for one’s own.
文摘Background: Diabetes and diabetes-related complications are major causes of morbidity and mortality in the United States. Depressive symptoms and perceived stress have been identified as possible risk factors for beta cell dysfunction and diabetes. The purpose of this study was to assess associations between depression symptoms and perceived stress with beta cell function between African and Haitian Americans with and without type 2 diabetes. Participants and Methods: Informed consent and data were available for 462 participants (231 African Americans and 231 Haitian Americans) for this cross-sectional study. A demographic questionnaire developed by the Primary Investigator was used to collect information regarding age, gender, smoking, and ethnicity. Diabetes status was determined by self-report and confirmed by fasting blood glucose. Anthropometrics (weight, and height and waist circumference) and vital signs (blood pressure) were taken. Blood samples were drawn after 8 10 hours over-night fasting to measure lipid panel, fasting plasma glucose and serum insulin concentrations. The homeostatic model assessment, version 2 (HOMA2) computer model was used to calculate beta cell function. Depression was assessed using the Beck Depression Inventory-II (BDI-II) and stress levels were assessed using the Perceived Stress Scale (PSS). Results: Moderate to severe depressive symptoms were more likely for persons with diabetes (p = 0.030). There were no differences in perceived stress between ethnicity and diabetes status (p = 0.283). General linear models for participants with and without type 2 diabetes using beta cell function as the dependent variable showed no association with depressive symptoms and perceived stress;however, Haitian Americans had significantly lower beta cell function than African Americans both with and without diabetes and adjusting for age, gender, waist circumference and smoking. Further research is needed to compare these risk factors in other race/ethnic groups.
文摘<strong>Background:</strong> 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. <strong>Methods:</strong> 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. <strong>Results:</strong> 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. <strong>Conclusion:</strong> 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. <strong>Main Points:</strong> 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.
文摘Managers and regulators are concerned about potential human health effects from exposure on lands contaminated by chemicals and radionuclides. Determining target cleanup levels is partly dependent upon future land use, and potential exposure from human use. This paper provides data from surveys of activity patterns of people attending festivals in four states, located in the vicinity of Department of Energy facilities. There were significant differences in both participation rates, and activity rates as a function of both location and ethnicity that can be used by managers to track exposure, land use, and preferred activities on natural lands. In general, 1) a higher percent of Native Americans engaged in consumptive activities than others, 2) a higher percent of Caucasians engaged in some non-consumptive activities than Native Americans, 3) a higher percentage of Native Americans engaged in activities on sacred grounds, 4) activity rates were generally higher for Native Americans for consumptive activities and religious/cultural than for Caucasians, 5) fishing rates were higher than other consumptive activities, and camping/hiking were higher than other non-con- sumptive activities, and 6) hunting rates were higher in subjects from Idaho than elsewhere. Baseline human use is critical for monitoring potential exposure, and provides the basis for monitoring, risk assessment and future land use, and these data can be used by managers for assessment and management. Tracking changes over time will reflect changing recreational, subsistence, and cultural/religious trends that relate to land use, public perceptions, and exposure.
文摘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.
文摘Although severe and chronic mental disorders are common among Asian Americans in residential treatment programs, little has been known about the prevalence and predictors of co-occurring substance use in this population. The purpose of this study was to examine predictors of co-occurring substance use among Asian Americans with mental disorders in residential treatment programs. This cross-sectional study included 375 clinical records of Asian Americans from residential treatment programs between 2007 and 2011. Demographic variables, principal psychiatric diagnoses, and data on alcohol, stimulant, and marijuana use were obtained from the clinical records. Separate binary logistic regression analyses were used to examine the demographic and diagnostic contributions to the risk of each type of substance use. Findings of this study indicated that the prevalence of co-occurring substance use was about 53% in Asian Americans with mental disorders. Binary logistic regression analyses revealed that male gender, older age, and depressive disorder predicted more alcohol use, but homelessness and schizophrenia predicted less alcohol use. Male gender, homelessness, and smoking predicted more stimulant use. Male gender and younger age predicted more marijuana use. Based on the findings of this study, awareness about co-occurring substance use problems of ethnic minority psychiatric clients should be increased and appropriate substance use prevention and treatment programs should be developed and provided for high-risk groups.
文摘More than 4,000,000 immigrants traveled from Italy to the United States between 1880 and 1924. Most were peasants, largely illiterate, and with no sense of an Italian identity as their ancestral home had only been liberated from centuries of foreign rule in 1861. This study utilizes primary and secondary documents, as well as archival sources and interviews to determine the role of sport in the transition to an Italian identity, and then an American identity within the assimilation process. Second generation youth adopted American sport forms, and some became national heroes in contrast to the stereotype of Italian gangsters. By the 1950s Italians had become icons of popular culture, yet negative stereotypes persisted and assimilation remained fragmented.
