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1
DUBOIS, SYLVIE, and MEGAN MELANÇON. "Creole is, Creole ain't: Diachronic and synchronic attitudes toward Creole identity in southern Louisiana." Language in Society 29, no. 2 (April 2000): 237–58. http://dx.doi.org/10.1017/s0047404500002037.
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Creole identity in Louisiana acquired diverse meanings for several ethnic groups during the French and Spanish regimes, before and after the purchase of the Louisiana Territory, and through the last part of the 20th century. In spite of a strong shift toward “Black” identity by many African Americans in the state, those who are fluent Creole French speakers now seem to be the repository of Louisiana Creole identity. This article presents a diachronic study of the different meanings applied to Creole identity which resulted from dramatic social, political, and economic changes. It also delimits and defines the actual attributes of Creole identity within two representative African American communities. Because of the historical and political conditions underlying Creole identity, African Americans who still identify as Creoles insist on linguistic attributes, rather than on the criterion of race, as essential characteristics of their ethnic identity.
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Greene, Matthew, Chiquita Briley, Shakera Williams, Jamila Freightman, and Denise Holston. "African American Satisfaction With the SNAP-Ed Program: A Qualitative Exploration." Current Developments in Nutrition 6, Supplement_1 (June 2022): 836. http://dx.doi.org/10.1093/cdn/nzac065.020.
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Abstract Objectives Nutrition educators and public health professionals are increasingly focused on structural racism and its contribution to racial disparities in rates of food insecurity and obesity. In the context of these barriers to healthful eating affecting marginalized populations, nutrition education programs must be carefully evaluated to determine whether they meet the needs of those populations. This study aimed to assess African Americans perceptions of and satisfaction with the SNAP-Ed program in Louisiana. Methods Three trained African American facilitators conducted five focus group discussions (FGD) with 25 African American participants in SNAP-Ed. The discussion guide for FGD was based on issues identified by SNAP-Ed leadership in Louisiana and revised by African American implementers of SNAP-Ed. FGD were recorded and transcribed verbatim. Transcripts were coded independently using inductive and in-vivo coding by two members of the research team using Dedoose software. Results Participants were generally satisfied with the program and thought information was important for African Americans in the context of medical issues faced by their community. However, participants viewed lessons as race neutral and thought they should include more information about African American history and culture. Participants also noted a lack of engagement with the African American stressed the need for African American staff to better engage with the African American community. Conclusions The SNAP-Ed program in Louisiana may need to be modified to specifically address African American food history and culture. The implementation of the program should be modified to include more African American SNAP-Ed staff and better engage with the African American community. Funding Sources SNAP-Ed.
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Kao, Yu-Hsiang, Michael D. Celestin, Qingzhao Yu, Sarah Moody-Thomas, Krysten Jones-Winn, and Tung-Sung Tseng. "Racial and Income Disparities in Health-Related Quality of Life among Smokers with a Quit Attempt in Louisiana." Medicina 55, no. 2 (February 13, 2019): 48. http://dx.doi.org/10.3390/medicina55020048.
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Background and objectives: Smoking is associated with a lower health-related quality of life (HRQOL). However, there is little information about the association between HRQOL in relation to race, income, and smoking status. The present study aimed to assess the association between HRQOL and smoking status for those of different races and income levels. Materials and Methods: This study applied a cross-sectional design using data from the 2017 patient survey of the Louisiana Tobacco Control Initiative. We obtained 1108 responses from patients at eight Louisiana public hospitals. The EuroQol (EQ-5D) US index score assessed HRQOL. Smoking status was classified into four groups: never smoked, former smoker, current smoker with a quit attempt, and current smoker without a quit attempt. Multivariate linear regression analyses were used to estimate the HRQOL for black or African Americans and whites. Results: The patients were predominantly black or African American (58.9%) with lower-income (71.2%). Bivariate analyses showed that there were differences in income levels between black or African Americans and whites (p = 0.006). Moreover, black or African Americans (median = 0.80) had a higher mean of HRQOL than whites (median = 0.76). Among lower-income black or African Americans, current smokers with a quit attempt had a lower HRQOL than current smokers (coefficient = −0.12; p < 0.01). Conclusions: Racial and income disparities were evident with regards to HRQOL, with lower-income black or African Americans who were current smokers with a quit attempt having a lower HRQOL. Intervention programs for smoking cessation should target lower-income black or African American smokers who have a prior quit attempt and provide effective cessation services to help them quit smoking and improve their HRQOL.
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Frazier, Denise. "The Nickel: A History of African-Descended People in Houston’s Fifth Ward." Genealogy 4, no. 1 (March 24, 2020): 33. http://dx.doi.org/10.3390/genealogy4010033.
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This paper will chronicle the unique stories that have come to exemplify the larger experience of Fifth Ward as a historically African American district in a rapidly changing city, Houston. Fifth Ward is a district submerged in the Southern memory of a sprawling port city. Its 19th century inception comprised of residents from Eastern Europe, Russia, and other religious groups who were fleeing persecution. Another way to describe Fifth Ward is much closer to the Fifth Ward that I knew as a child—an African American Fifth Ward and, more personally, my grandparents’ neighborhood. The growing prosperity of an early 20th century oil-booming Houston had soon turned the neighborhood into an economic haven, attracting African Americans from rural Louisiana and east Texas. Within the past two decades, Latino communities have populated the area, transforming the previously majority African American ward. Through a qualitative familial research review of historic documents, this paper contains a cultural and economic analysis that will illustrate the unique legacies and challenges of its past and present residents. I will center my personal genealogical roots to connect with larger patterns of change over time for African Americans in this distinct cultural ward.
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Booker, Staja, Keela Herr, and Toni Tripp-Reimer. "Patterns and Perceptions of Self-Management for Osteoarthritis Pain in African American Older Adults." Pain Medicine 20, no. 8 (December 12, 2018): 1489–99. http://dx.doi.org/10.1093/pm/pny260.
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AbstractObjectiveTo explore and describe older African Americans’ patterns and perceptions of managing chronic osteoarthritis pain.MethodsA convergent parallel mixed-methods design incorporating cross-sectional surveys and individual, semistructured interviews.SettingOne hundred ten African Americans (≥50 years of age) with clinical osteoarthritis (OA) or provider-diagnosed OA from communities in northern Louisiana were enrolled.ResultsAlthough frequency varied depending on the severity of pain, older African Americans actively used an average of seven to eight self-management strategies over the course of a month to control pain. The average number of self-management strategies between high and low education and literacy groups was not statistically different, but higher-educated adults used approximately one additional strategy than those with high school or less. To achieve pain relief, African Americans relied on 10 self-management strategies that were inexpensive, easy to use and access, and generally perceived as helpful: over-the-counter (OTC) topicals, thermal modalities, land-based exercise, spiritual activities, OTC and prescribed analgesics, orthotic and assistive devices, joint injections, rest, and massage and vitamins.ConclusionsThis is one of the first studies to quantitatively and qualitatively investigate the self-management of chronic OA pain in an older African American population that happened to be a predominantly higher-educated and health-literate sample. Findings indicate that Southern-dwelling African Americans are highly engaged in a range of different self-management strategies, many of which are self-initiated. Although still an important component of chronic pain self-management, spirituality was used by less than half of African Americans, but use of oral nonsteroidal anti-inflammatory drugs and opioids was relatively high.
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Greene-Hayes, Ahmad. "“A Very Queer Case”." Nova Religio: The Journal of Alternative and Emergent Religions 26, no. 4 (May 1, 2023): 58–84. http://dx.doi.org/10.1525/nr.2023.26.4.58.
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In this article, I present the case of Clementine Barnabet, an Afro-Creole teenager who was arrested in 1911 and convicted in 1912 for allegedly committing “Voodoo murders” in southwest Louisiana and Texas. The press, the police, and other Louisiana officials, along with an author employed by the Louisiana Writers’ Project in the 1930s, used racialized and sexualized hyperbole to deem Barnabet a participant in a “Voodoo cult,” purportedly called the Church of the Sacrifice. Moreover, in their quest for information about Barnabet and her beliefs, white Americans also imagined a monolithic Black religion—specifically, a sensationalized Voodoo religion—practiced by all people of African descent in the region regardless of their self-identification as Christians or practitioners of conjure, or both. Thus, I propose reviewing Barnabet’s case not as an attempt to determine her guilt or innocence, but rather as a means of deconstructing white American eroticized racial fantasy in the production of a normative American Christian religion and the concurrent misrepresentation of Black religions.
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Booker, Staja Q., Toni Tripp-Reimer, and Keela A. Herr. "“Bearing the Pain”: The Experience of Aging African Americans With Osteoarthritis Pain." Global Qualitative Nursing Research 7 (January 2020): 233339362092579. http://dx.doi.org/10.1177/2333393620925793.
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Studies document that osteoarthritis-related joint pain is more severe in African American older adults, but research on the personal experience of osteoarthritis pain self-management in this population is limited. Using a qualitative descriptive design, our objective was to extend our understanding of the experience of life with osteoarthritis pain. Eighteen African Americans (50 years and older) were recruited from Louisiana to participate in a single semi-structured, in-depth interview. A conventional content analysis revealed that “Bearing the pain” characterized how older African Americans dealt with osteoarthritis. Bearing the pain comprised three actions: adjusting to pain, sharing pain with others, and trusting God as healer. We discovered that a metapersonal experience subsumes the complex biopsychosocial-cultural patterns and the intricate interaction of self, others, and God in living with and managing osteoarthritis pain. Study findings have implications for application of more inclusive self-management frameworks and interventions.
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Holden, Stephanie. "Community Assessment of Colorectal Cancer Screening Compliance in Northwest Louisiana." International Quarterly of Community Health Education 40, no. 4 (November 9, 2019): 273–79. http://dx.doi.org/10.1177/0272684x19885515.
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Background In the United States, colorectal cancer (CRC) screening rates have steadily increased. The state of Louisiana has persistent lower screening rates compared to the United States and other states, and with African Americans experiencing the highest CRC incidence rates. Aggregate national and state data can be problematic in isolating key health issues and data in rural areas. Study Purpose: At the Louisiana parish-level, which is comparable to county municipalities in other U.S. states, the research study examined endoscopy CRC screening among African American Medicare beneficiaries. Method Using cluster sampling, survey-based data from two neighboring parishes in northwest Louisiana were collected. The survey instrument was adapted from the Medicare Current Beneficiary Survey. Results The key study variables were CRC screening compliance, residence location, self-reported CRC knowledge, and physician recommendation. The findings showed significant differences in CRC screening compliance between the two parishes. Participants with CRC knowledge score of at least 3 out of 5 were more likely to be compliant with CRC screening. The findings demonstrated the importance of isolating geo-specific data, especially in rural areas, to plan effective health education or intervention strategies.
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Tallaksen, Amund R. "Junkies and Jim Crow: The Boggs Act of 1951 and the Racial Transformation of New Orleans’ Heroin Market." Journal of Urban History 45, no. 2 (September 20, 2017): 230–46. http://dx.doi.org/10.1177/0096144217731339.
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This article details the origin and passage of the Boggs Act of 1951, as well as a similar drug law passed at the state level in Louisiana. Both laws featured strict mandatory minimum sentences for drug crimes, which led to a demographic transformation of New Orleans’ heroin markets in the early 1950s: As New Orleans’ Italian-American Mafiosi retreated from the lower echelons of the heroin economy, entrepreneurial African Americans took their place. In turn, many black leaders came to support both stricter drug laws and increased police focus on crime in black neighborhoods. This demand was rooted in African Americans’ frustration with the New Orleans Police Department and its Jim Crow practice of ignoring intra-racial black crime. It also became important for black leaders to distance themselves from the “criminal element”—an otherwise potent political symbol for white segregationists.
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Johnson, Eboneé T., Rana A. Yaghmaian, Andrew Best, Fong Chan, and Reginald Burrell. "Evaluating the Measurement Structure of the Abbreviated HIV Stigma Scale in a Sample of African Americans Living With HIV/AIDS." Rehabilitation Research, Policy, and Education 30, no. 1 (2016): 65–76. http://dx.doi.org/10.1891/2168-6653.30.1.65.
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Purpose: The purpose of this study was to validate the 10-item version of the HIV Stigma Scale (HSS-10) in a sample of African Americans with HIV/AIDS.Method: One hundred and ten African Americans living with HIV/AIDS were recruited from 3 case management agencies in Baton Rouge, Louisiana. Measurement structure of the HSS-10 was evaluated using exploratory and confirmatory factor analysis.Results: Factor analysis results support a 2-factor factorial structure for the HSS-10 (social stigma and self-stigma). The HSS-10 demonstrates good reliability and factorial validity, and it correlates moderately with related constructs in the expected directions.Conclusion: HSS-10 is a brief, reliable, and valid instrument for assessing HIV stigma and can be used as a clinical rehabilitation and research tool to assess the contribution of stigma as a major cause of health disparities and outcomes in African Americans living with HIV/AIDS.
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Holston, Denise, and Matthew Greene. "Attitudes Towards COVID-19 Prevention Behaviors and Preferences for Virtual Nutrition Education in Louisiana Differ by Race." Current Developments in Nutrition 5, Supplement_2 (June 2021): 226. http://dx.doi.org/10.1093/cdn/nzab029_027.
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Abstract Objectives The objective of this cross-sectional study was to assess the attitudes of potential SNAP-Ed participants in Louisiana towards COVID-19 mitigation behaviors and their preferences for virtual nutrition education. Methods SNAP-Ed staff in Louisiana distributed an electronic survey to potential participants and community partners which asked participants to report their attitudes about behaviors used to slow the spread of COVID-19 and preferences for the delivery of virtual nutrition education. Pearson chi squared tests were used to assess differences in responses across categories of race, age, and SNAP-Ed eligibility. Unadjusted odds ratios were then calculated using logistic regression to evaluate the effects of race, age, and SNAP-Ed eligibility on each dependent variable of interest. Finally, adjusted odds ratios were calculated using a model which included age, eligibility for SNAP-Ed, and race. Results Of 458 participants, the majority were white (62%), female (91%), aged 18–50 (65%), and eligible for SNAP-Ed (57%). Most agreed with the importance of handwashing (99%), maintaining physical distance (95%), and wearing face masks (79%). African Americans had significantly higher odds of agreeing that it was important to wear a mask compared to white participants, and this did not change in the adjusted model which included SNAP-Ed eligibility and age category (Adjusted OR 15.90 [6.25, 40.4]) African Americans were also more concerned about the risk posed by in-person programming and more likely to report that they would prefer live virtual lessons, online quizzes, and workbooks than white participants. Conclusions It may be appropriate for nutrition education conducted with this population to occur in person, because most potential participants agree with COVID-19 precautions. However, educators working with majority white populations should exercise caution given that the participants who felt it was not important to wear masks were overwhelmingly white. Attitudes expressed by African American participants indicate that nutrition education for African Americans may better reach participants if it is done virtually rather than in-person. Funding Sources SNAP-Ed
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Devkota, B., and ES Arnbrecht. "Racial differences of colorectal cancer in a single institution in Northeast Louisiana primarily serving the underserved population." Health Renaissance 10, no. 1 (March 12, 2012): 5–7. http://dx.doi.org/10.3126/hren.v10i1.5998.
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Background: Colorectal cancer (CRC) screening has helped decrease the incidence of CRC in the last two decades. Still African Americans share a higher burden of CRC disease in the United States in comparison to Caucasians. Objective: To study racial differences of colorectal cancer in low income patients. Methods: Retrospective chart review of all admitted patients with a diagnosis of CRC was done by the lead author over a period of eight months. Results: This study, drawn from a poor, diverse population of Louisiana residents suggests socioeconomic factors may explain observed differences in CRC rates between African Americans and Caucasians. Conclusion: Large scale surveillance studies that address social determinants of CRC are needed to further explore this association. DOI: http://dx.doi.org/10.3126/hren.v10i1.5998 HREN 2012; 10(1): 5-7
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Malekian, Fatemah, Sebhatu Sebhatu Gebrelul, James F. Henson, Kasundra D. Cyrus, Mfamara Goita, and Betty M. Kennedy. "The efects of whey protein and resistant starch on body weight." Functional Foods in Health and Disease 5, no. 8 (August 31, 2015): 275. http://dx.doi.org/10.31989/ffhd.v5i8.210.
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Background: Obesity is widely recognized as one of the most critical health threats to families and children across the country. Obesity is a very serious health problem for people in Louisiana and especially in African Americans Children with 40.5% in the State classified as either overweight or obese as compared to 41.2% nationally. African American women have the highest rates of being overweight or obese (79.8%) compared to non-Hispanic whites (57.9%). In 2007, African Americans were 1.4 times as likely to be obese as whites. Therefore this study was designed to test the impact of dietary whey protein (WP) and resistant starch (RS) shakes/smoothies on reduction of body fat via increased satiety and increased energy expenditure in African Americans. Methods: Twenty eight African American males and females, age 21-43 years old were randomly divided into two groups. For a period of 24-weeks, the treatment group consumed WP and RS shakes/smoothies for breakfast and received nutrition education. For the same period, the control group consumed the same shake/smoothies but with starch powder and received nutrition education. The data was analyzed using SAS version 9.3. Results: At the end of the 24 week study, the treatment group lost a mean body weight of approximately 7 kg (P ≤ 0.008) that was significantly different from the control group (P ≤ 0.209). In addition, the treatment group exhibited a significant decrease of ~6 cm in waist circumference (P ≤ 0.023). There was no significant effect on mean blood pressure in treatment and control group.Conclusion: The findings from this study suggest that a combination of WP and RS in the form of shake/smoothie consumed for breakfast along with a nutrition education component may be an effective method in decreasing body weight, improving waist circumferences and cumulative food intake in African American males and females. Key Words: Whey Protein, Resistant Starch, Obesity, Breakfast shakes, Nutrition education
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Beech, Bettina M., and Isabel C. Scarinci. "Smoking Attitudes and Practices among Low-Income African-Americans: Qualitative Assessment of Contributing Factors." American Journal of Health Promotion 17, no. 4 (March 2003): 240–48. http://dx.doi.org/10.4278/0890-1171-17.4.240.
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Purpose. Studies have shown that African-American adolescents are less likely to smoke cigarettes than white youth. National data suggest that this pattern changes in late adolescence and early adulthood. Specifically, African-American adults have a relatively high smoking prevalence rate when compared with other racial/ethnic groups. The purpose of this study was to qualitatively examine the sociocultural factors associated with smoking attitudes and practices among low-income African-American young adults. Design. Cross-sectional qualitative study. Settings. High schools, 2-year colleges, housing developments, and trade schools in New Orleans, Louisiana, and Memphis, Tennessee. Subjects. One hundred eighteen low-income African Americans between 18 and 35 years of age (65 men and 53 women). Measure/Procedure. Fourteen focus groups were conducted with the target population. Nonmonetary incentives were provided for each participant in the 1-hour sessions. The majority of focus group moderators were African-American females trained in focus group moderation. Participants were recruited through flyers and project liaisons at each field location. Results. Themes elicited from the focus groups were classified according to the PEN-3 model, and they included: lighting cigarettes for parents as a first experience with cigarettes, perceived stress relief benefits of smoking, use of cigarettes to extend the sensation of marijuana, and protective factors against smoking such as respect for parental rules. Conclusion. The results indicate that there are specific contextual and familial factors that can contribute to smoking initiation, maintenance, and cessation among low-income African-American young adults. Limitations of this study include the exploratory nature of focus groups and the relatively small sample size. Further studies are necessary to quantitatively examine the role of these factors on smoking patterns in this population.
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Johnson, Jerah. "Jim Crow laws of the 1890s and the origins of New Orleans jazz: correction of an error." Popular Music 19, no. 2 (April 2000): 243–51. http://dx.doi.org/10.1017/s0261143000000143.
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A seriously misleading error has crept into almost all the literature on the origins of New Orleans jazz. The error mistakenly attributes to the Jim Crow laws of the 1890s a significant role in the formation of the city's jazz tradition.Jazz historians have done a reasonably good job of depicting the two black communities that existed in new Orleans from the time of the Louisiana Purchase in 1803 until the twentieth century. One community comprised a French-speaking Catholic group who lived mostly in downtown New Orleans, i.e. the area of the city down-river from Canal Street. Before the Civil War this group, commonly called Creoles, or Black Creoles, but more accurately called Franco-Africans, comprised free people of colour as well as slaves, and after the war consisted of their descendants who perpetuated the group's language, religion and musical tradition, which combined French, African and Caribbean elements.Members of the other black community were English-speaking Protestants who lived mostly in uptown new Orleans. That group, before the Civil War, was made up largely of slaves brought to New Orleans by Americans who flooded into Louisiana after the 1803 Purchase, though it also included some free people of colour. After the war, the descendants of these immigrants continued their language, religion and musical tradition, which came mostly from the rural South. There Anglo-Africans were generally less prosperous and less educated than the downtown Franco-African or Creole community.
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Pisu, Maria, and David Geldmacher. "Disparities Research at the Deep South Alzheimer’s Disease Center of the University of Alabama at Birmingham." Innovation in Aging 5, Supplement_1 (December 1, 2021): 100. http://dx.doi.org/10.1093/geroni/igab046.379.
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Abstract Residents of the US Deep South (Alabama, Georgia, Louisiana, Mississippi, and South Carolina) have a 20–30% higher risk of developing Alzheimer’s disease or related dementia (ADRD). Moreover, >20% of African Americans, who are at higher ADRD risk than whites, live in this region. Therefore, one important goals of the Deep South Alzheimer’s Disease Center (DS-ADC) of the University of Alabama at Birmingham is to spearhead research to address these disparities. This panel presents current DS-ADC research, with two presentations focusing on the local patient population and the last two on the Deep South population compared to the rest of the nation. Addressing the challenge of recruiting representative samples in clinical research, the first paper is part of a research program to understand difference that may exist between African American and white research participants. The second paper examines patients with multiple conditions, in particular dementia and cancer, showing a marked disadvantage in cognition outcomes for African Americans. The next two papers take a broader perspective to better understand the population of older adults with ADRD in the Deep South and in the rest of the US. The third paper examines socioeconomic and medical contexts of African American and white older Medicare beneficiaries with ADRD, and the fourth paper examines differences in utilization of specialists, ADRD drugs, and hospitalizations in the two regions taking these contexts into account. The discussant will close the session by placing these studies in the larger context of the disparities research at the DS-ADC.
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Harville, Emily W., Tri Tran, Xu Xiong, and Pierre Buekens. "Population Changes, Racial/Ethnic Disparities, and Birth Outcomes in Louisiana After Hurricane Katrina." Disaster Medicine and Public Health Preparedness 4, S1 (September 2010): S39—S45. http://dx.doi.org/10.1001/dmp.2010.15.
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ABSTRACTObjective: To examine how the demographic and other population changes affected birth and obstetric outcomes in Louisiana, and the effect of the hurricane on racial disparities in these outcomes.Methods: Vital statistics data were used to compare the incidence of low birth weight (LBW) (<2500 g), preterm birth (PTB) (37 weeks' gestation), cesarean section, and inadequate prenatal care (as measured by the Kotelchuck index), in the 2 years after Katrina compared to the 2 years before, for the state as a whole, region 1 (the area around New Orleans), and Orleans Parish (New Orleans). Logistic models were used to adjust for covariates.Results: After adjustment, rates of LBW rose for the state, but preterm birth did not. In region 1 and Orleans Parish, rates of LBW and PTB remained constant or fell. These patterns were all strongest in African American women. Rates of cesarean section and inadequate prenatal care rose. Racial disparities in birth outcomes remained constant or were reduced.Conclusions: Although risk of LBW/PTB remained higher in African Americans, the storm does not appear to have exacerbated health disparities, nor did population shifts explain the changes in birth and obstetric outcomes.(Disaster Med Public Health Preparedness. 2010;4:S39-S45)
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Swaminathan, Renugadevi, James D. Morris, and Terry C. Davis. "Rural-urban disparities in colorectal cancer screening: An insight from a statewide database." Journal of Clinical Oncology 38, no. 4_suppl (February 1, 2020): 69. http://dx.doi.org/10.1200/jco.2020.38.4_suppl.69.
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69 Background: The Healthy People 2020 initiative aims to increase colorectal cancer (CRC) screening. The common CRC screening options are FIT, FOBT, sigmoidoscopy, and colonoscopy. Colonoscopy allows visualization of the entire colon and offers therapeutic benefit whereas stool tests are less invasive, cost-effective and are easily available. Inequities exist in CRC screening among rural residents which may be contributed to a lower level of education, income, health insurance and access to health care. The purpose of the study is to identify the impact of geographic region on the preference of CRC screening modality among Louisiana adults. Methods: We performed a retrospective cohort study among age-eligible Louisiana adults who had CRC screening either with colonoscopy or stool-based tests using the 2016 Behavioral Risk Factor Surveillance System database (n = 1372). We examined demographic characteristics among participants who had CRC screening with colonoscopy versus who had a stool-based test. Multivariable logistic regression analysis evaluated the association of geographic region and the preference of CRC screening. Results: Participants age 65-75 years old were 36% less likely to have a colonoscopy as compared to age 50-64 years (p = 0.0008). African Americans and Hispanic Americans were 34% (p < 0.006) and 55% (p = 0.057) less likely to have a colonoscopy as compared to Caucasian Americans, respectively. Medicaid and Medicare participants were 82% (p < 0.0001) and 52% (p < 0.0001) less likely to have a colonoscopy compared to participants with private insurance, respectively. After adjusting for age, race/ethnicity, education, income, and insurance the odds of screening colonoscopy was 29% lower for rural residents compared to urban residents of Louisiana (OR 0.71 95% CI 0.53 - 0.94). Conclusions: Individuals residing in rural parishes of Louisiana were more likely to have a stool-based test for CRC screening. Health care providers while considering the reliability and feasibility of CRC screening modality should also incorporate patient’s preferences while offering the screening tests to increase the rate of CRC screening.
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Ellis, Edgar T., Brian J. Fairman, Shelbie D. Stahr, L. Joseph Su, and Ping-Ching Hsu. "Abstract B096: Cigarette smoking and prostate cancer aggressiveness among African and European American men." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): B096. http://dx.doi.org/10.1158/1538-7755.disp23-b096.
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Abstract Background: Smoking is a modifiable lifestyle factor linked to prostate cancer (PCa) risk, but its association with PCa aggressiveness is unclear. Further, African-American men are likelier to smoke and be at risk for PCa. Therefore, we examined racial disparities in the association between cigarette smoking and PCa aggressiveness. Methods: Data for this study came from the North Carolina-Louisiana Prostate Cancer Project, a registry-based cohort study of incident PCa cases from 2004-2009 (n = 1,457). We defined PCa aggressiveness as high (Gleason score ≥ 8, Gleason score = 7 and TNM T3-T4, or prostate-specific antigen (PSA) score > 20 ng/mL) or low (Gleason score < 7, TNM T1-T2, and PSA < 10 ng/mL). We classified cigarette smoking as current, former, or never. Our analyses used multivariable logistic regression to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI). Results: One-third (35%) of PCa cases were high-aggressive. Half (48%) of the study sample was African-American. Current smoking, but not former smoking, was associated with high-aggressive PCa compared to never (OR = 2.2; 95% CI [1.5, 3.3]). African-Americans who currently smoked had higher odds of high-aggressive PCa than those who never smoked (OR = 3.2; 95% CI [1.9, 5.4]), as did those who formerly smoked (OR = 1.8; 95% CI [1.2, 2.3]). However, smoking did not significantly predict PCa aggressiveness in European-Americans. Conclusion: Cigarette smoking is associated with PCa aggressiveness, an association moderated by race. Future research should investigate the biological and social effects of smoking and PCa aggressiveness between racial groups. Citation Format: Edgar T. Ellis, Brian J. Fairman, Shelbie D. Stahr, L. Joseph Su, Ping-Ching Hsu. Cigarette smoking and prostate cancer aggressiveness among African and European American men [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B096.
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Parsons, Sharon. "HIV Beliefs Among African Americans with HIV/AIDS in the Deep South Can Time Heal Old Wounds?" Journal of Health Care and Research 2, no. 2 (May 11, 2021): 70–84. http://dx.doi.org/10.36502/2021/hcr.6191.
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This study explored rumors about HIV among HIV+ African Americans in Louisiana, comparing the results of surveys conducted in 2000/2001 and 2010/2011. This investigation sought to determine if the passage of time would diminish malicious intent and benign neglect beliefs. The study employed quantitative descriptive statistics to produce the comparison. This research should be considered exploratory only because of the stated limitations. The results indicated that the benign-neglect belief of government truthfulness about the disease had not diminished in the decade. In contrast, the strength of belief in the malicious-intent rumor of HIV/AIDS as genocide had declined. The study further examined relationships between the HIV beliefs and certain characteristics of the samples. Bivariate analyses revealed that education was not related to HIV beliefs in 2000/2001 but was related to the HIV/AIDS as genocide in 2010/2011. Further, emotional well-being was mildly related to HIV beliefs in both samples. Several recommendations are offered for future research. Although this study frequently used the term “conspiracy” – the common nomenclature for this type of research, the author joins with others to caution researchers to rethink labeling these beliefs among African Americans as conspiracies. That label too easily casts Black Americans in a light as being paranoid rather than understandably suspicious considering the lived experiences of that group in the Deep South.
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Maronge, Genevieve Folse, Xiao-cheng Wu, Vivien Chen, Xiangrong Li, Brian C. Boulmay, and Michelle Marie Loch. "Higher incidence and mortality rates of cervical cancer in African-American women in Louisiana." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e17522-e17522. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e17522.
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e17522 Background: Cervical cancer [CC] incidence in the United States has decreased over the last thirty years in black and white Americans, however it is recognized that black women [BW] have higher incidence and mortality rates than white women [WW]. We evaluated race-specific incidence of CC, mortality rates of CC, and HPV vaccine usage rates in Louisiana [LA] during the last decade, the state with the second highest proportion of black Americans in the United States [US]. Methods: Data from Surveillance, Epidemiology, and End Results (SEER) registries were analyzed for trends in incidence and mortality rate [MR] in BW and WW in LA and the US. SEER 13 and SEER 18 data were used and standardized to the 2000 US population to estimate annual age-adjusted incidence and mortality rates. Results: The incidence of CC in WW in LA was 8.2 per 100,000 from 2006 to 2009, and 7.9 per 100,000 in WW in US. The incidence in BW in LA was 13.3 per 100,000, as compared to the US at 9.7 per 100,000, a 36% higher incidence in BW. The MR in WW in LA and the US was 2.4 and 2.2 per 100,000. The MR for BW in LA was 5.8 per 100,000 and the US was 4.3 per 100,000, a 37% higher incidence in BW. WW in LA and the US showed a peak in incidence between the ages of 35 and 45 from 2006 to 2009. The incidence in BW in LA peaked at 37.1 per 100,000 at age 85 and the incidence in BW in the US peaked at 25.6 per 100,000 at age 85. HPV vaccination rates for LA females ages 13-15 in 2008 and 2009 were 16.1% and 35.4%. Conclusions: BW in LA were twice as likely to be diagnosed with CC than WW with a higher MR. Though the incidence rate of CC is decreasing in WW and BW in the US and in WW in LA, it is increasing in BW in LA and continues to trend up throughout life in BW compared to WW. The high incidence of CC in BW in LA highlights the need to improve utilization of the HPV vaccine. A screening and treatment program targeting CC was implemented within the last decade in the LA public hospital system with the goal of reducing CC incidence and mortality.
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Al-Dahir, Sara, Martha Earls, Christopher Gillard, Brittany Singleton, and Erica Hall. "Assessing the Impact of COVID-19 Phased Vaccine Eligibility on COVID-19 Vaccine Intent among African Americans in Southeastern Louisiana: A Community-Based, Cohort Study." International Journal of Environmental Research and Public Health 19, no. 24 (December 13, 2022): 16737. http://dx.doi.org/10.3390/ijerph192416737.
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The purpose of this study was to explore the impact of eligibility for the coronavirus 2019 (COVID-19) vaccine at the time of the vaccine rollout as a predictor of vaccine intent within the African American community. Methods: Four hundred eighty-seven African American participants in southeastern Louisiana were surveyed from January–April of 2021, with follow-up surveys occurring in Fall 2021. Survey domains included demographics, vaccine hesitancy, discrimination in the healthcare setting, and knowledge and experiences with COVID-19. Descriptive statistics, Chi-square tests, and binary logistic regression were performed. Results: Participants eligible for the vaccine were 1.61 times as likely to express positive vaccine intent versus ineligible participants. Additional predictors of vaccine intent were age, insurance status and coverage, and female sex at birth. In the multivariable logistic analysis, eligible individuals were 2.07 times as likely to receive the vaccine versus ineligible individuals. Conclusions: Vaccine eligibility for the COVID-19 vaccine was a significant predictor of intent to vaccinate in the African American community. Younger individuals were less likely to have a positive intent, correlating with the eligibility of ages 16+ occurring 5 months post-vaccine approval.
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Cunha, Olívia M. G. "Travel, Ethnography, and Nation in the Writings of Rómulo Lachatañéré and Arthur Ramos." New West Indian Guide / Nieuwe West-Indische Gids 81, no. 3-4 (January 1, 2007): 219–57. http://dx.doi.org/10.1163/22134360-90002482.
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Analyses how the traveling to and residence in the US of Arthur Ramos from Brazil and Rómulo Lachtañéré from Cuba, between 1939 and 1952, influenced their (anthropological) writings on Afro-American cultures and religions, specifically with regard to the relation between nation and race. Author describes that while Ramos and Lachatañéré went to the US under differing conditions, in the case of Lachatañéré in exile, and had dissimilar intellectual and political perspectives, their writings during and after their stay revealed identical approaches to interpreting the relation between nation and race in respectively Brazil and Cuba. She describes how Ramos and Lachatañéré developed a broader perspective on Afro-American culture, whilst moving in the same intellectual, anthropological circles, including contacts with Melville Herskovits and Fernando Ortiz, in the US. Author relates how both compared between African-Americans, in Louisiana in the case of Ramos and in New York in the case of Lachatañéré, and Afro-Brazilians and Afro-Cubans (including Caribbean migrants in the US), and thus between different race relations in the US, Brazilian, and Cuban contexts.
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Cunha, Olívia M. G. "Travel, Ethnography, and Nation in the Writings of Rómulo Lachatañéré and Arthur Ramos." New West Indian Guide / Nieuwe West-Indische Gids 81, no. 3-4 (January 1, 2008): 219–57. http://dx.doi.org/10.1163/13822373-90002482.
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Analyses how the traveling to and residence in the US of Arthur Ramos from Brazil and Rómulo Lachtañéré from Cuba, between 1939 and 1952, influenced their (anthropological) writings on Afro-American cultures and religions, specifically with regard to the relation between nation and race. Author describes that while Ramos and Lachatañéré went to the US under differing conditions, in the case of Lachatañéré in exile, and had dissimilar intellectual and political perspectives, their writings during and after their stay revealed identical approaches to interpreting the relation between nation and race in respectively Brazil and Cuba. She describes how Ramos and Lachatañéré developed a broader perspective on Afro-American culture, whilst moving in the same intellectual, anthropological circles, including contacts with Melville Herskovits and Fernando Ortiz, in the US. Author relates how both compared between African-Americans, in Louisiana in the case of Ramos and in New York in the case of Lachatañéré, and Afro-Brazilians and Afro-Cubans (including Caribbean migrants in the US), and thus between different race relations in the US, Brazilian, and Cuban contexts.
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Goenjian, Haig A., Ernest S. Chiu, Mary Ellen Alexander, Hugo St Hilaire, and Michael Moses. "Incidence of Cleft Pathology in Greater New Orleans before and after Hurricane Katrina." Cleft Palate-Craniofacial Journal 48, no. 6 (November 2011): 757–61. http://dx.doi.org/10.1597/09-246.
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Background Reports after the 2005 Hurricane Katrina have documented an increase in stress reactions and environmental teratogens (arsenic, mold, alcohol). Objective To assess the incidence of cleft pathology before and after the hurricane, and the distribution of cleft cases by gender and race. Methods Retrospective chart review of cleft lip with or without cleft palate (CUP) and cleft palate (CP) cases registered with the Cleft and Craniofacial Team at Children's Hospital of New Orleans, the surgical center that treated cleft cases in Greater New Orleans between 2004 and 2007. Live birth data were obtained from the Louisiana State Center for Health Statistics. Results The incidence of cleft cases, beginning 9 months after the hurricane (i.e., June 1, 2006) was significantly higher compared with the period before the hurricane (0.80 versus 1.42; p = .008). Within racial group comparisons showed a higher incidence among African Americans versus whites (0.42 versus 1.22; p = .01). The distribution of CUP and CP cases by gender was significant ( p = .05). Conclusion The increase in the incidence of cleft cases after the hurricane may be attributable to increased stress and teratogenic factors associated with the hurricane. The increase among African Americans may have been due to comparatively higher exposure to environmental risk factors. These findings warrant further investigation to replicate the results elsewhere in the Gulf to determine whether there is a causal relationship between environmental risk factors and increased cleft pathology.
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Bensen, Jeannette T., Zongli Xu, Paul M. McKeigue, Gary J. Smith, Elizabeth T. H. Fontham, James L. Mohler, and Jack A. Taylor. "Admixture mapping of prostate cancer in African Americans participating in the North Carolina-Louisiana Prostate Cancer Project (PCaP)." Prostate 74, no. 1 (September 4, 2013): 1–9. http://dx.doi.org/10.1002/pros.22722.
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Ntamwana, Simon. "MEN’S SEXUAL TRAUMA RESISTANCE IN BLACK AMERICAN FOLKLORE: A POSTCOLONIAL CRITICISM OF NEGRO “WOMAN TALES”." International Journal of Humanity Studies (IJHS) 6, no. 2 (March 1, 2023): 276–87. http://dx.doi.org/10.24071/ijhs.v6i2.5702.
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The purpose of this paper “Men’s Sexual Trauma Resistance in Black American Folklore: A Postcolonial Criticism of Negro “Woman Tales” from the Gulf States” was to discuss the reflection of postcolonial sexual trauma and resistance to it through storytelling among African Americans in the Gulf States. The study was concerned with 3 folktales classified under the cycle “Woman Tales”. The folktales were selected from the collection made by Zora Neale Hurston in the southern states of Alabama, Florida, and Louisiana from 1927 to 1930 and compiled in the book Every Tongue Got to confess: Negro Folktales from the Gulf States (2001). The postcolonial approach and trauma theory based on the interpretative qualitative method and library research was used in the discussion of the selected folktales. It was found that the performance of the “Woman Tales” is informed by the black men’s traumatic memories of slavery and post-slavery emasculation. Black male narrators imitate trauma narratives in which they reflect male sexual trauma and recreate black woman identity to contain it. Through this imitation and reflection, the folktales challenge the legacy of the plantation patriarchy by reconstructing a woman's identity that is docile to black masculinity.
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Tabung, Fred, Susan E. Steck, L. Joseph Su, James L. Mohler, Elizabeth T. H. Fontham, Jeannette T. Bensen, James R. Hebert, Hongmei Zhang, and Lenore Arab. "Intake of Grains and Dietary Fiber and Prostate Cancer Aggressiveness by Race." Prostate Cancer 2012 (2012): 1–10. http://dx.doi.org/10.1155/2012/323296.
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Purpose. To examine the associations among intake of refined grains, whole grains and dietary fiber and aggressiveness of prostate cancer in African Americans (AA,n=930) and European Americans (EA,n=993) in a population-based, case-only study (The North Carolina-Louisiana Prostate Cancer Project, PCaP).Methods. Prostate cancer aggressiveness was categorized as high, intermediate or low based on Gleason grade, PSA level and clinical stage. Dietary intake was assessed utilizing the NCI Diet History Questionnaire. Logistic regression (comparing high to intermediate/low aggressive cancers) and polytomous regression with adjustment for potential confounders were used to determine odds of high prostate cancer aggressiveness with intake of refined grains, whole grains and dietary fiber from all sources.Results. An inverse association with aggressive prostate cancer was observed in the 2nd and 3rd tertiles of total fiber intake (OR = 0.70; 95% CI, 0.50–0.97 and OR = 0.61; 95% CI, 0.40–0.93, resp.) as compared to the lowest tertile of intake. In the race-stratified analyses, inverse associations were observed in the 3rd tertile of total fiber intake for EA (OR = 0.44; 95% CI, 0.23–0.87) and the 2nd tertile of intake for AA (OR = 0.57; 95% CI, 0.35–0.95).Conclusions. Dietary fiber intake was inversely associated with aggressive prostate cancer among both AA and EA men.
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Datta, Y. "How America Became an Economic Powerhouse on the Backs of African-American Slaves and Native Americans." Journal of Economics and Public Finance 7, no. 5 (December 1, 2021): p121. http://dx.doi.org/10.22158/jepf.v7n5p121.
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The objective of this paper is to make the case that the United States became an economic super-power in the nineteenth century on the backs of African-American slaves and Native Americans.It was in 1619, when Jamestown colonists bought 20-30 slaves from English pirates. The paper starts with ‘The 1619 Project’ whose objective is to place the consequences of slavery--and the contributions of black Americans--at the very center of the story we tell ourselves about who we are as a nation.Slavery was common in all thirteen colonies, and at-least twelve Presidents owned slaves. The enslaved people were not recognized as human beings, but as property: once a slave always a slave.The U.S. Constitution, adopted in 1788, never mentions slavery, yet slavery is at the very heart of the constitution. The U.S. government used the Declaration of Independence as a license to commit genocide on the Native Americans, and to seize their land.Racist ideas have persisted throughout American history, based on the myth that blacks are intellectually inferior compared to whites. However, in a 2012 article in the Scientific American, the authors reported that 85.5% of genetic variation is within the so-called races, not between them. So, the consensus among Western researchers today is that human races do not represent a scientific theory, but are sociocultural constructs.After end of the Civil War, the 13th Amendment to the U.S. Constitution abolished slavery in America, and the 15th Amendment protected the voting rights of African Americans.However, in the Confederate South, Jim Crow laws legalized racial segregation between 1870-1968. In 1965, thanks to the Civil Rights movement, the Voting Rights Act was passed to overcome barriers created by Jim Crow laws to the legal rights of African Americans under the 15th Amendment.British and American innovations in cotton technology sparked the Industrial Revolution during the latter part of the eighteenth century. The British cotton manufacturing exploded in the 1780s. Eighty years later in 1860, Manchester, England stood at the center of a world-spanning empire—the empire of cotton. There were three pillars of the Industrial Revolution. One was the centuries-earlier conquest by Europeans of a colossal expanse of lands in the New World. It was the control of huge territories in America, that made monoculture farming of cotton possible. Second was that the Europeans drastically—and unilaterally--altered the global competitive landscape of cotton. They did it by using their military might, and the willingness to use it—often violently--to their advantage.The third—and the most important--was slavery: without which there would be no Industrial Revolution. America was tremendously suited for cotton production. The climate and soil of a large part of American South met the conditions under which the cotton plant thrived. More importantly, the plantation owners in America commanded unlimited supplies of the three crucial ingredients that went into the production of cotton: labor, land, and credit. And this was topped by their unbelievable political power.In 1793 Eli Whitney’s revolutionary cotton gin increased ginning productivity fifty times, and thus removed the bottleneck of removing seeds from cotton. Because of relying on monoculture farming, the problem the cotton planters were facing was soil exhaustion. So, they wanted the U.S. government to acquire more land. Surprisingly, in 1803 America was able to strike an unbelievable deal with the French--the Louisiana Purchase--which doubled the territory of the United States. In 1819 America acquired Florida from Spain, and in 1845 annexed Texas from Mexico.Between 1803 and 1838, under President Andrew Jackson, America fought a multi-front war against the Native Americans in the Deep South, and expropriated vast tracts of their land, that culminated in the ethnic cleansing of the Deep South.With an unlimited supply of land—and slave labor--even soil exhaustion did not slow down the cotton barons; they just moved further west and farther south. New cotton fields now sprang up in the sediment-rich lands along the banks of Mississippi. So swift was this move westward that, by the end of the 1830s, Mississippi was producing more cotton than any other southern state. By 1860, there were more millionaires per capita in Mississippi Valley than anywhere else in America.The New Orleans slave market was the largest in America--where 100,000 men, women, and children were packaged, priced, and sold.The entry of the United States in the cotton market quickly began to reshape the global cotton market. By 1802 America was the single-most supplier of cotton to Britain.For eighty years--from the 1780s to 1865--almost a million people were herded down the road from the upper South to the lower South and the West, to toil on cotton plantations. The thirty-odd men walked in coffles, the double line hurrying in lock-step. Each hauled twenty pounds of iron, chains that draped from neck-to-neck, and wrist-to-wrist, binding them all together. They walked for miles, days, and weeks, and many covered over 700 miles.The plantation owners devised a cruel system of controlling their slaves that the enslaved called “the pushing system.” This system constantly increased the number of acres each slave was expected to cultivate. In 1805 each “hand” could tend to five acres of a cotton field. Fifty years later that target had been doubled to ten acres.Overseers closely monitored enslaved workers. Each slave was assigned a daily quota of number of pounds of cotton to pick. If the worker failed to meet it, he received as many lashes on his back as the deficit. However, if he overshot his quota, the master might “reward” him by raising his quota the next day.One of the most brutal weapons the planters used against the slaves, was the whip: ten feet of plaited cowhide. When facing the specter of an overseer’s whip, slaves were so terrified that they could not speak in sentences. They danced, trembled, babbled, and lost control of their bodies.When seeking a loan, the planters used slaves as a collateral. With extraordinarily high returns from their businesses, the planters began to expand their loan portfolio: sometimes using the same slave worker as collateral for multiple mortgages. The American South produced too much cotton. However, consumer demand could not keep up with the excessive supply, that then led to a precipitous fall in prices, which, in turn, set off the Panic of 1837. And that touched off a major depression.The slaveholders were using advanced management and accounting practices long before the techniques that are still in use today.The manufacture of sugar from sugarcane began in Louisiana Territory in 1795. In sugar mills, children, alongside with adults, toiled like factory workers with assembly-like precision and discipline under the constant threat of boiling hot kettles, open furnaces, and grinding rollers. To attain the highest efficiency, sugar factories worked day and night where there is no distinction as to the days of the week. Fatigue might mean losing an arm to the grinding rollers, or being flayed for not being able to keep up. Resistance was often met with sadistic cruelty.The expansion of slavery in the first eight decades after American independence, drove the evolution and modernization of the United States. In the course of a single life time, the South grew from a narrow coastal strip of worn-out tobacco plantations, to a continental cotton empire. As a result, the United States became a modern, industrial, and capitalistic economy. This is the period in which America rose from being a minor European trading partner, to becoming the world’s leading economy. Finally, we hope that we have successfully been able to make the argument that America became an economic powerhouse in the nineteenth century not only on the backs of African-American slaves, but also on the genocide of Native Americans, and their stolen lands.
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Thetford, Kelsey, Theresa W. Gillespie, Young-il Kim, Barbara Hansen, and Isabel C. Scarinci. "Willingness of Latinx and African Americans to Participate in Nontherapeutic Trials: It Depends on Who Runs the Research." Ethnicity & Disease 31, no. 2 (April 14, 2021): 263–72. http://dx.doi.org/10.18865/ed.31.2.263.
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Background: Inclusion of racial/ethnic minorities in cancer-related research remains inadequate, continuing to impact disparate health outcomes. Data regarding enrollment of racial/ethnic minorities in nontherapeutic, health-related research is sparse, and even less is known about enrollment of those with a double disparity of racial/ethnic minorities in rural settings.Objective: To examine perspectives of Latinx and African American (AA) healthy volunteers from rural and urban settings in five southern US states and Puerto Rico regarding their trust in research and their willingness to participate in nontherapeutic research trials based on who conducts the research.Methods: This study was conducted in 2013 in rural and urban communities across Alabama, Florida, Georgia, Mississippi, Louisiana, and Puerto Rico. A 38-item questionnaire based on the Tuskegee Legacy Project Questionnaire assessed willingness, motivators, and barriers to participation in nontherapeutic cancer-related research. The sample was segmented into four subgroups by urban/rural location and race/ethnicity.Results: Of 553 participants (rural Latinx=151, urban Latinx=158, rural AA=122, urban AA=122), more than 90% had never been asked to participate in research, yet 75% of those asked agreed to participate. Most had positive views regarding health-related research. Trust in who conducted research varied by subgroup. Personal doctors and university hospitals were most trusted by all subgroups; for-profit and tobacco companies were least trusted. Both Latinx subgroups trusted pharmaceutical companies more than AAs; local hospitals and for-profit businesses were more trusted by AAs. Both rural subgroups trusted research by insurance companies more than their urban counterparts.Conclusions: If asked, rural and urban AA and Latinx healthy volunteers were willing to participate in health-related research, with personal doctors and university hospitals considered the most trusted sources to encourage/conduct research.Ethn Dis. 2021;31(2):263-272; doi:10.18865/ed.31.2.263
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Grim, V. "African Americans at Mars Bluff, South Carolina. By Amelia Wallace Vernon. Baton Rouge: Louisiana State University Press, 1993. 309 pp. Hardbound, $29.95." Oral History Review 23, no. 2 (December 1, 1996): 110–13. http://dx.doi.org/10.1093/ohr/23.2.110.
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Jackson, Simone, and Staja Booker. "TWO SIDES OF THE SAME COIN: OPIOIDS AND CANNABIS FOR PAIN MANAGEMENT IN AFRICAN AMERICAN OLDER ADULTS." Innovation in Aging 7, Supplement_1 (December 1, 2023): 871. http://dx.doi.org/10.1093/geroni/igad104.2805.
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Abstract Approximately 50 million U.S. adults live with chronic pain. Example treatments for chronic pain include opioids and the re-emerging cannabinoid pain management (CPM). However, older African Americans (AAs) are more likely to use pain treatments that are considered safe, affordable, and socially acceptable. We examined the perception of opioid and cannabis use for pain management in AA older adults by conducting: (1) secondary data analyses from two studies to quantify patterns of opioid and cannabis use, (2) a concept analysis to delineate the concept of CPM, and (3) developing data-driven model cases for CPM. Study 1 was a cross-sectional survey with 110 AA adults (age 50 and older) in Louisiana, and study 2 was observational with 72 AA adults (age 55 and older) in Florida with self-reported osteoarthritis. Both samples were primarily women, 79-81% respectively. Only 33% and 1.3% reported using opioid analgesics, while less than 4% in both studies reported using medical or recreational cannabis. Using Walker and Avant’s concept analysis approach, the (A) attributes of CPM include lower side effect profile and social acceptability; (B) antecedents include chronic pain, motivation to seek alternative treatment, access to cannabis dispensaries, family and professional support, and health literacy; and (C) the consequences are pain relief, lower mortality, self-efficacy, reduced anxiety, and empowerment. Lastly, based on our quantitative and qualitative data, we developed two model cases demonstrating support for and against CPM. These results illuminate the need to further understand the barriers and facilitators to using opioids and CPM in older AAs.
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Hall, Kaitlyn. "Loyola University New Orleans College of Law: A History." Journal of Curriculum Studies Research 4, no. 1 (February 18, 2022): 76–78. http://dx.doi.org/10.46303/jcsr.2022.7.
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Maria Isabel Medina's chronicle of Loyola University New Orleans College of Law examines the prominent Jesuit institution across its hundred-year history, from its founding in 1914 through the first decade of the twenty-first century. With a mission to make the legal profession attainable to Catholics, and other working-class persons, Loyola's law school endured the hardships of two world wars, the Great Depression, the tumult of the civil rights era, and the aftermath of Hurricane Katrina to emerge as a leader in legal education in the state.Exploring the history of the college within a larger examination of the legal profession in New Orleans and throughout Louisiana, Medina provides details on Loyola's practical and egalitarian approach to education. As a result of the school's principled focus, Loyola was the first law school in the state to offer a law school clinic, develop a comprehensive program of legal-skills training, and to voluntarily integrate African Americans into the student body.The transformative milestones of Loyola University New Orleans College of Law parallel pivotal points in the history of the Crescent City, demonstrating how local culture and environment can contribute to the longevity of an academic institution and making Loyola University New Orleans College of Law a valuable contribution to the study of legal education.
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Strait, John Byron, and Gang Gong. "An Evolving Residential Landscape in Post-Katrina New Orleans." International Journal of Applied Geospatial Research 3, no. 4 (October 2012): 1–19. http://dx.doi.org/10.4018/jagr.2012100101.
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Residential landscapes across the United States have been significantly altered in recent years by the increased racial and ethnic diversity evident within urban areas. In New Orleans, Louisiana, residential landscapes were particularly impacted by the disruptive influences associated with Hurricane Katrina, a storm that ultimately transformed the demographic make-up of this urban area. This research investigates the impacts that increased diversity has had on the levels of residential segregation among racial and/or ethnic groups in New Orleans from 2000 to 2010. Empirical analysis entailed the measurement of two dimensions of segregation evident among Non-Hispanic whites, African-Americans, Hispanics and Asians. Measures of residential exposure were decomposed in order to investigate the relative impacts of metropolitan-wide compositional change and intra-urban redistributive change on segregation among the four groups. During the 2000s, New Orleans exhibited very modest forms of residential integration. Results suggest that Non-Hispanic whites, Asians, and Hispanics exhibited some degree of “ethnic (or racial) self-selectivity” that functioned to concentrate these groups residentially, although these forces were partially overwhelmed by other forces operating at both the neighborhood and metropolitan scales. The evidence further suggests that the residential experiences among minorities were strongly impacted by the redistributive behavior of whites.
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Bedimo, Ariane Lisann, Steven D. Pinkerton, Deborah A. Cohen, Bradley Gray, and Thomas A. Farley. "Condom distribution: a cost–utility analysis." International Journal of STD & AIDS 13, no. 6 (June 1, 2002): 384–92. http://dx.doi.org/10.1258/095646202760029804.
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Objective: To explore the cost-effectiveness of a condom distribution programme. Methods: We conducted a cost-utility analysis of a social marketing campaign in which over 33 million condoms were made freely available throughout Louisiana. Surveys among 275,000 African Americans showed that condom use increased by 30%. Based on the estimated cost of the intervention and costs of HIV/AIDS-associated medical treatment, we estimated the quality-adjusted life years (QALYs) saved, and number of HIV infections averted by the programme. Results: The programme was estimated to prevent 170 HIV infections and save 1909 QALYs. Over $33 million in medical care costs were estimated to be averted, resulting in cost savings. Sensitivity analyses showed that these results were quite stable over a range of estimates for the main parameters. Condom increases as small as 2.7% were still cost-saving. Conclusion: Condom distribution is a community-level HIV prevention intervention that has the potential to reach large segments of the general population, thereby averting significant numbers of HIV infections and associated medical costs. The intervention is easy to scale up to large populations or down to small populations. The financial and health benefits of condom social marketing support making it a routine component of HIV prevention services nationally.
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Hossain, Fokhrul, Denise Danos, Jovanny Zabaleta, Jiande Wu, Mary Anne Lynch, Luis Del Valle, Xiao-Cheng Wu, Augusto Ochoa, Chindo Hicks, and Lucio Miele. "Abstract 2525: Understanding triple-negative breast cancer immune microenvironment by disease stages, obesity, and race." Cancer Research 82, no. 12_Supplement (June 15, 2022): 2525. http://dx.doi.org/10.1158/1538-7445.am2022-2525.
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Abstract Background: Triple-negative breast cancer (TNBC) is a molecularly heterogeneous group of clinically aggressive malignancies. There are well-recognized health disparities in TNBC outcomes, and the risk of TNBC is higher among African-Americans (AA). It is unclear whether immunological features of the tumor microenvironment (TME) associated with disease stage, socioeconomic factors, or comorbidities such as obesity may affect tumor immunity. The incidence of TNBC and obesity in Louisiana is among the highest in the nation, and we have documented disparities in incidence linked to race and disparities in mortality linked to social determinants of health. Recent studies described immunologic characteristics of the TNBC TME. However, the possible association of immunogenomic portraits of TNBCs with race, comorbidities or socioeconomic factors remains understudied. Methods: We studied the expression of immunity-associated genes in clinically annotated TNBCs from Louisiana AA and European-American (EA) patients with or without obesity. Primary invasive breast cancer cases with confirmed TNBC diagnosis were identified by the Louisiana Tumor Registry (LTR). Sections of FFPE tissue containing ≥ 50% tumor were identified and processed for RNA-Sequencing [(n = 256; White women:125 (Lean: 50 and Obese:75) and Black women:131 (Lean:28 and Obese: 103)] at Translational Genomic Core, LSUHSC. Categorical outcomes were compared via Chi-squared tests, and survival was compared via log-rank tests. Spearman correlation analysis was used to determine associations between CIBERSORT cell populations and stage of disease at diagnosis. Results: We found that race was associated with the stage of TNBC, and AA patients were more often diagnosed with a later stage of TNBC (p=0.0447). However, race was not associated with survival (p=0.4673). Obesity was not associated with stage at diagnosis (p=0.7256). Stage at diagnosis was the strongest determinant of survival (p<0.0001). We utilized CIBERSORT analysis to identify and quantify immune cell populations within the TME. Later stage at diagnosis was associated with increased T follicular helper cells (p=0.0038), M1 macrophages (p= 0.0032), and activated mast cells (p=0.0487). Conversely, later stage of disease was associated with decreased resting mast cells (p=0.0004) and monocytes (p=0.0455). Immunosuppressive Treg cells were positively associated with stage at diagnosis in AA patients (p=0.0273) but not in EA patients (p=0.9141). Conclusions: Stage at diagnosis was the strongest determinant of survival and was associated with significant differences in TME immune cell populations. Stage, race and obesity were associated with the presence of immunosuppressive Treg cells. If confirmed, these findings may help understand the variability in immunotherapy responses in TNBC. Citation Format: Fokhrul Hossain, Denise Danos, Jovanny Zabaleta, Jiande Wu, Mary Anne Lynch, Luis Del Valle, Xiao-Cheng Wu, Augusto Ochoa, Chindo Hicks, Lucio Miele. Understanding triple-negative breast cancer immune microenvironment by disease stages, obesity, and race [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2525.
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Menegaux, F., L. Farnan, J. L. Mohler, E. Th Fontham, and J. Bensen. "Use of non-steroidal anti-inflammatory drugs and prostate cancer aggressiveness among African and European Americans: The North Carolina-Louisiana Prostate Cancer Project (PCAP)." Revue d'Épidémiologie et de Santé Publique 66 (July 2018): S247. http://dx.doi.org/10.1016/j.respe.2018.05.037.
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Gadinsky, Naomi, Melissa Lina Keeport, Adeline Jae Hyun Shin, Sudesh Srivastav, and Rebecca Kruse-Jarres. "Disease and treatment characteristics of breast cancer in an urban, low-income hospital following a major hurricane: A temporal and racial analysis." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e12503-e12503. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e12503.
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e12503 Background: The Medical Center of Louisiana, New Orleans (MCLNO) serves a metropolitan area and is the only hospital delivering care to the indigent population in the area. Hurricane Katrina devastated New Orleans on 8/29/05. No oncology services were available for two years. We examined characteristics/care for patients with breast cancer 2 years after re-opening clinics compared with the subsequent 2.5 years. Differences between Whites (W) and African Americans (AA) were examined and compared to state and national averages. Methods: After IRB approval, we reviewed charts of patients establishing care for breast cancer at MCLNO between 09/07-05/12: Group 1 (09/07-08/09) vs. Group 2 (09/09 – 05/12). Racial analysis was done between W and AA independent of temporal factors. Results: Our cohort included 153 patients (25 W, 105 AA , and 23 other race): Group 1- 68 patients, Group 2- 85. There were no significant temporal or racial differences in age, race, insurance, menopausal status, family history, cancer type, stage, or treatment regimen. More AA were triple negative (25.5% AA, 0% W; p= 0.002). Compared to state and national averages, our patients underwent more mastectomies: 58% mastectomy (M) and 42% lumpectomy (L) - compared to Louisiana (M - 50.7%, L - 48.7%) and the National (M - 42.0%, L - 57.8%) data. Our cohort presented with more advanced disease: 10.5% presented with stage IV breast cancer, which is higher than the state average (6.0%) and the national average (5.5%). Conclusions: Despite the suspicion that tumor presentation would be worse after a delay in access to care due to Katrina and that AA might have even worse characteristics, our data showed this not to be the case. Interesting was the finding that triple negative cancers seemed to be an AA phenomenon. It is important to continue following these patients to see how these presenting and prognostic factors will affect long term patient outcomes. [Table: see text]
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Adeola, Francis O., and J. Steven Picou. "Social Capital and the Mental Health Impacts of Hurricane Katrina: Assessing Long-Term Patterns of Psychosocial Distress." International Journal of Mass Emergencies & Disasters 32, no. 1 (March 2014): 121–56. http://dx.doi.org/10.1177/028072701403200106.
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Hurricane Katrina was the most costly disaster in U.S. history, creating severe physical and mental health impacts among the population exposed along the Gulf Coast. The physical and economic assessments have been the focus of many previous studies with inadequate attention paid to the long-term emotional and psychosocial toll on survivors. This study evaluates the socio-demographic and contextual variations in Katrina's depressive and psychosocial stress impacts among a random sample of survivors in the most devastated counties/parishes of Louisiana and Mississippi three years after the storm. Our primary objective was to assess the influence of social capital, or lack of it, for mental health outcomes. Using a comprehensive random digit dialing telephone survey data-set, descriptive and multivariate statistical techniques including differences of means, factor analysis, multivariate discriminant analysis, and Ordinary Least Squares regression analysis, were utilized to test hypotheses derived from social capital theory. Strong support was found for the hypothesized relationships; empirical evidence clearly shows that lack of social capital predicts both depression and symptoms of posttraumatic stress disorder. The results further reveal that Katrina's mental health impacts are not evenly distributed. Depression, stress, and psychosocial impacts are skewed toward African Americans, older adults, women, unmarried adults, less educated, and people with weak social networks. Theoretical and applied policy implications of these findings are discussed for understanding lingering mental health problems three years post-Katrina.
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Kramer, Jordan J., Robert Scott Libby, Allison H. Feibus, Nora M. Haney, Ian R. McCaslin, Krishnarao Moparty, Raju Thomas, Jonathan L. Silberstein, and A. Oliver Sartor. "Racial variation in the outcome of subsequent prostate biopsies in men with an initial diagnosis of atypical small acinar proliferation (ASAP)." Journal of Clinical Oncology 34, no. 2_suppl (January 10, 2016): 141. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.141.
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141 Background: African Americans (AA) are known to have more aggressive prostate cancer (PCa) and a greater probability of death from PCa. We sought to determine predictors of subsequent detection and risk stratification of PCa in a racially diverse group of men who presented with atypical small acinar proliferation (ASAP) on initial prostate biopsy. Methods: Upon receiving IRB approval, a retrospective analysis was performed on men from the Southeast Louisiana Veterans Health Care System and Tulane University Medical Center who presented with ASAP on initial prostate biopsy and subsequently received confirmatory prostate biopsies from September 2000 through July 2015. Confirmatory biopsy with a greater than 3-year interval from the initial were excluded. Self-identified race, age, body mass index (BMI), transrectal ultrasound (TRUS) volume, serum prostate-specific antigen (PSA), PSA velocity (PSAV), PSA density (PSAD), and elapsed time between biopsies were evaluated to determine if they were predictors of subsequent PCa diagnosis in patients with an initial finding of ASAP. Results: Of the 106 men in the analysis cohort, 75 (71%) were AA and 31 (29%) were not African American (non-AA). AA had higher PSA, PSAV, and PSAD (all p < 0.05). Age, BMI and TRUS volume were not statistically different between AA and non-AA. PCa was diagnosed in subsequent biopsy in 42 (40%) patients without significant racial variation; 30 (40%) AA vs 12 (39%) non-AA. Of the 42 men with PCa, 25 (24%) met Epstein pathological criteria for significant disease, although without racial variation; 18 (24%) AA vs 7 (23%) Non-AA. Only 10 (9%) men, again without racial variation, had any component of Gleason 4; 7 (9%) AA vs 3 (10%) non-AA. On multivariate analysis, increasing age, PSA and PSAD were significant predictors of cancer on repeat biopsy while race, BMI, TRUS volume and number of cores with ASAP were not. Conclusions: AA diagnosed with ASAP on initial prostate biopsy do not have increased risk of PCa on confirmatory biopsy compared to non-AA. Regardless of race, most cancers were low grade and lower volume, and AA with ASAP should be managed in a similar manner to non-AA with ASAP.
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Mabvakure, Batsirai M., Shiting Li, Deborah de la Caridad Delgado Herrera, William Benjamin, Lucia Martinez Cruz, Siddhi Patil, Elham Mohebbi, et al. "Abstract LB137: Comparison of HPV virus-induced oropharyngeal cancer by self-reported race and the potential implications on treatment." Cancer Research 84, no. 7_Supplement (April 5, 2024): LB137. http://dx.doi.org/10.1158/1538-7445.am2024-lb137.
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Abstract African Americans exhibit lower survival rates from Human Papillomavirus (HPV)-induced squamous cell carcinomas in comparison to other population groups. While socioeconomic status and access to healthcare may contribute to these disparities, mounting evidence indicates that significant biological differences between diverse ancestries play a role in the severity of different cancers such as breast cancer, colorectal cancer, and squamous cell carcinomas. The purpose of the study is to investigate diagnostic and biological differences in HPV-induced squamous cell carcinomas of the oropharynx by self-reported race. The study population consists of oropharynx cases identified at the University of Michigan (non-Hispanic White) and through the Louisiana Tumor Registry (African American). A total of 52 individuals from two study sites were included in this study, 40 of whom are men, two are women and 10 are unknown. Forty-four percent (23/52) of individuals were African Americans (AA), and 46 % (19/52) were Non-Hispanic White (NHW). Formalin-fixed paraffin-embedded (FFPE) tumors from these patients were tested for p16 expression via immunohistochemistry as a proxy for HPV status. Fifty-two percent (27/52) tested negative (p16-) and 48% (25/52) tested positive (p16+). Total RNA from these samples was extracted, sequenced, and bioinformatically analyzed to test for the presence of HPV. Among AA samples, 61% were negative for both p16 and HPV RNA (p16-/RNA-), 26% were p16+/RNA-, 13% were p16+/RNA+ and none were p16-/RNA+. Among NHWs, 37% were p16-/RNA-, 16% were p16-/RNA+, 47% were p16+/RNA+ and none were p16+/RNA-. Interestingly, 6 of 20 HPV RNA- AA samples were p16+, whereas 0 of 7 HPV RNA- NHW samples were p16+. We performed data dimensionality reduction using Principal Component Analysis (PCA) implemented in the PCAtools Bioconductor package. Four groups were separated in a plot of the first two PCs, comprising, (i) all p16+/RNA+ (18/18), (ii) dominantly p16-/RNA- (6/7), (iii) p16-/RNA- mixed with p16+/RNA-, and (iv) p16-/RNA+ in the middle of all the groups and mixing with some p16+/RNA+ samples. A total of 13/17 (76%) p16-/RNA- samples in group (iii) that were mixed with p16+/RNA- samples were AA, 3 (18%) were NHW and 1 was unknown. Based on clinical data, the PCA group (iii) consisted of samples that were characterized as invasive, keratinizing, and moderately differentiated, whereas group (ii) samples were mostly clinically characterized as nonkeratinizing. A total of 13/14 AA samples that tested p16-/RNA- possessed similar clinical attributes as samples classified as p16+/RNA-, suggesting that the p16 expression via immunohistochemistry test might be classifying a significant percent of HPV-negative AA samples as positive. Taken together, these results suggest that the p16 immunohistochemistry test for oropharyngeal cancer may be overly sensitive for classifying AA oropharynx cancer samples. Clinical decisions regarding treatment for AA based on this test have the potential to negatively impact outcomes. Citation Format: Batsirai M. Mabvakure, Shiting Li, Deborah de la Caridad Delgado Herrera, William Benjamin, Lucia Martinez Cruz, Siddhi Patil, Elham Mohebbi, Gregory T. Wolf, Anju Duttargi, Christina Lefante, Mei-Chin Hsieh, Nisha J. D'Silva, Maureen Sartor, Laura Rozek. Comparison of HPV virus-induced oropharyngeal cancer by self-reported race and the potential implications on treatment [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr LB137.
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Echeverri, Margarita, David Anderson, Jacqueline M. Haas, Marc E. Johnson, Friar Sergio A. Serrano, and Anna María Nápoles. "Testing the Preliminary Validity of a Multidimensional Framework for Studying the Effects of Cancer Health Literacy on Cancer Screening Behaviors among Diverse Populations." International Journal of Environmental Research and Public Health 17, no. 9 (April 25, 2020): 2987. http://dx.doi.org/10.3390/ijerph17092987.
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The objective of this study was to evaluate the applicability of a multidimensional framework to explore factors associated with cancer literacy and its effects on receiving cancer screenings among diverse populations. Based on the conceptual framework, we developed and pilot-tested the Multidimensional Cancer Literacy Questionnaire (MCLQ) among 1500 individuals (African Americans, Latinos and Whites) in Louisiana. Exploratory factor analysis was used to identify the MCLQ underlying structure and predominant factors explaining each of the dimensions in the model. A total of 82 items (explaining 67% of the total variance) in the MCLQ were grouped into 20 factors associated with three key dimensions related to cancer literacy. Preliminary validity of the MCLQ was supported: Cronbach alpha for the scale score was 0.89 and internal consistency reliability coefficients for each factor were all above 0.67. The Facilitators Domain included five factors (28 items) that may positively influence individuals to have early-detection cancer screenings. The Barriers Domain included seven factors (26 items) explaining aspects that may negatively influence individuals to have cancer screenings. The Cultural Domain included eight factors (28 items) related to aspects that influence positively or negatively individuals’ perceptions regarding cancer as a disease, screenings and treatments. A multidimensional framework to study cancer literacy, including cultural attitudes, beliefs and practices, as well as facilitators and barriers, among diverse populations, will increase understanding of factors influencing individuals’ approach to cancer prevention and screening. Results will inform further testing of the multidimensional framework and questionnaire.
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Antwi, Samuel O., Susan E. Steck, L. Joseph Su, James R. Hébert, Hongmei Zhang, Elizabeth T. H. Fontham, Gary J. Smith, Jeannette T. Bensen, James L. Mohler, and Lenore Arab. "Dietary, supplement, and adipose tissue tocopherol levels in relation to prostate cancer aggressiveness among African and European Americans: The North Carolina-Louisiana Prostate Cancer Project (PCaP)." Prostate 75, no. 13 (June 5, 2015): 1419–35. http://dx.doi.org/10.1002/pros.23025.
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Lewis, Chance W. "African American Male Teachers in Public Schools: An Examination of Three Urban School Districts." Teachers College Record: The Voice of Scholarship in Education 108, no. 2 (February 2006): 224–45. http://dx.doi.org/10.1177/016146810610800202.
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Currently, African American students constitute approximately 20% of the public school population, while African American male teachers constitute 1% of the teaching force. In this article, the author presents the findings of a study that examined the disproportionate number of African American male teachers in America's K-12 public schools. More specifically, the researcher surveyed 147 African American male teachers in three urban school districts in Louisiana to better understand what strategies school districts could implement to increase the presence of African American male teachers. The recommendations are presented in this article.
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Clark, Emily. "MOVING FROM PERIPHERY TO CENTRE: THE NON-BRITISH IN COLONIAL NORTH AMERICA." Historical Journal 42, no. 3 (September 1999): 903–10. http://dx.doi.org/10.1017/s0018246x99008687.
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Life and religion at Louisbourg, 1713–1758. By A. J. B. Johnston. London: McGill-Queen's University Press, 1984, paperback edition, 1996. Pp. xxxii+227. ISBN 0-7735-1525-9. £12.95.The New Orleans Cabildo: Colonial Louisiana's first city government, 1769–1803. By Gilbert C. Din and John E. Harkins. London: Louisiana State University Press, 1996. Pp. xvii+330. ISBN 0-8071-2042-1. £42.75.Revolution, romanticism, and the Afro-Creole protest tradition in Louisiana, 1718–1868. By Caryn Cossé Bell. London: Louisiana State University Press, 1997. Pp. xv+325. ISBN 0-8071-2096-0. £32.95.Hopeful journeys: German immigration, settlement and political culture in colonial America, 1717–1775. By Aaron Spencer Fogleman. Pennsylvania: University of Pennsylvania Press, 1996. Pp. xii+257. ISBN 0-8122-1548-6. £15.95.Britannia lost the war of American independence but still reigns over the historiography of colonial North America. This is a problem now that historians of early America have embarked on an attempt to apply an Atlantic world perspective to colonial development. The complex web of human, cultural, economic, and political encounters and exchanges among Europe, Africa, and the Americas spreads well beyond the familiar terrain of Britain and its thirteen mainland colonies. While the histories of Indians and enslaved Africans are beginning to find their way into the historical narrative of early America to challenge the British hegemony, non-British Europeans remain virtually invisible, except as opponents in the imperial wars that punctuated the colonial era. These four books illustrate obstacles that must be overcome to remedy this gap and offer glimpses of the rewards to be gained by drawing the history of continental Europeans previously treated as peripheral into the centre of the major debates currently shaping early American history.
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Matthews-Greer, Janice M., Gloria C. Caldito, Sharon D. Adley, Regina Willis, Angela C. Mire, Richard M. Jamison, Kenny L. McRae, John W. King, and Wun-Ling Chang. "Comparison of Hepatitis C Viral Loads in Patients with or without Human Immunodeficiency Virus." Clinical Diagnostic Laboratory Immunology 8, no. 4 (July 1, 2001): 690–94. http://dx.doi.org/10.1128/cdli.8.4.690-694.2001.
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ABSTRACT A better understanding of how human immunodeficiency virus (HIV) coinfection affects the course of hepatitis C virus (HCV) infection is required to select patients with HIV who would benefit from current HCV therapy. Between June 1996 and March 2000, HCV RNA levels were quantified for 1,279 patients at the Louisiana State University Health Sciences Center; 28 of these patients were coinfected with HIV. HCV loads were quantified by the Bayer branched-DNA assay with a lower limit of detection of 0.2 Meq/ml. We compared the median HCV RNA levels of for patients coinfected with HIV and HCV and patients infected only with HCV who were in the same age range (23 to 55 years). The median HCV load for the 28 patients coinfected with HCV and HIV (17.8 Meq/ml) was significantly greater (P < 0.05) than that for similarly aged patients infected only with HCV (6.1 Meq/ml). The HCV load did not correlate with age or sex for either group of patients. A significant (R = −0.4; P < 0.05) negative correlation was observed between HCV load and CD4 count in the coinfected group, for whom the CD4 counts at the time of HCV load analysis ranged from 6 to 1,773/mm3. The increased HCV load in patients coinfected with HCV and HIV compared to that in patients infected only with HCV and the inverse relationship of the HCV load to the CD4 count indicate that immunosuppression results in decreased control of HCV replication. In addition, we report significantly higher HCV loads among coinfected African Americans than Caucasians.
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Glantz, M. H. "Hurricane Katrina as a "teachable moment"." Advances in Geosciences 14 (April 10, 2008): 287–94. http://dx.doi.org/10.5194/adgeo-14-287-2008.
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Abstract. By American standards, New Orleans is a very old, very popular city in the southern part of the United States. It is located in Louisiana at the mouth of the Mississippi River, a river which drains about 40% of the Continental United States, making New Orleans a major port city. It is also located in an area of major oil reserves onshore, as well as offshore, in the Gulf of Mexico. Most people know New Orleans as a tourist hotspot; especially well-known is the Mardi Gras season at the beginning of Lent. People refer to the city as the "Big Easy". A recent biography of the city refers to it as the place where the emergence of modern tourism began. A multicultural city with a heavy French influence, it was part of the Louisiana Purchase from France in early 1803, when the United States bought it, doubling the size of the United States at that time. Today, in the year 2007, New Orleans is now known for the devastating impacts it withstood during the onslaught of Hurricane Katrina in late August 2005. Eighty percent of the city was submerged under flood waters. Almost two years have passed, and many individuals and government agencies are still coping with the hurricane's consequences. And insurance companies have been withdrawing their coverage for the region. The 2005 hurricane season set a record, in the sense that there were 28 named storms that calendar year. For the first time in hurricane forecast history, hurricane forecasters had to resort to the use of Greek letters to name tropical storms in the Atlantic and Gulf (Fig.~1). Hurricane Katrina was a Category 5 hurricane when it was in the middle of the Gulf of Mexico, after having passed across southern Florida. At landfall, Katrina's winds decreased in speed and it was relabeled as a Category 4. It devolved into a Category 3 hurricane as it passed inland when it did most of its damage. Large expanses of the city were inundated, many parts under water on the order of 20 feet or so. The Ninth Ward, heavily populated by African Americans, was the site of major destruction, along with several locations along the Gulf coasts of the states of Mississippi and Alabama, as well as other parts of Louisiana coastal areas (Brinkley, 2006). The number of deaths officially attributed to Hurricane Katrina was on the order of 1800 to 2000 people. The cost of the hurricane in terms of physical damage has been estimated at about US $250 billion, the costliest natural disaster in American history. It far surpassed the cost of Hurricane Andrew in 1992, the impacts of which were estimated to be about $20 billion. It also surpassed the drought in the US Midwest in 1988, which was estimated to have cost the country $40 billion, but no lives were lost. Some people have referred to Katrina as a "superstorm". It was truly a superstorm in terms of the damage it caused and the havoc it caused long after the hurricane's winds and rains had subsided. The effects of Katrina are sure to be remembered for generations to come, as were the societal and environmental impacts of the severe droughts and Dust Bowl days of the 1930s in the US Great Plains. It is highly likely that the metropolitan area of New Orleans which people had come to know in the last half of the 20th century will no longer exist, and a new city will likely replace it (one with a different culture). Given the likelihood of sea level rise on the order of tens of centimeters associated with the human-induced global warming of the atmosphere, many people wonder whether New Orleans will be able to survive throughout the 21st century without being plagued by several more tropical storms (Gill, 2005). Some (e.g., Speaker of the US House of Representatives Hastert) have even questioned whether the city should be restored in light of the potential impacts of global warming and the city's geographic vulnerability to tropical storms.
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Devarakonda, Srinivas S., Binu S. Nair, Ryan A. Gonzales, Runhua Shi, Nebu Koshy, Gary Burton, Jonathan Glass, and Francesco Turturro. "Impact of Health Care Funding on overall Survival of Patients with Multiple Myeloma and Monoclonal Gammopathy of Uncertain Significance." Blood 116, no. 21 (November 19, 2010): 3821. http://dx.doi.org/10.1182/blood.v116.21.3821.3821.
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Abstract Abstract 3821 Introduction: The impact of socioeconomic status on patients with cancer has been previously reported. Health care funding improves access to care and thus outcome. There is little information on the impact of health care funding on hematological malignancies including multiple myeloma. Objectives: To analyze the effect of health care funding on the survival of patients with multiple myeloma (MM) and monoclonal gammopathy of uncertain significance (MGUS) in North Louisiana. A retrospective study of all patients diagnosed with multiple myeloma/MGUS and treated at Louisiana State University Health Science Center in Shreveport, LA between the years 1997 and 2010 was completed. Methods: Electronic medical records from our hospital and Social Security Death Index were used to identify patients and to define patient characteristics, demographic factors, medical funding source and date of death. Medical funding was defined as being funded (Medicaid, Medicare or private insurance) or non-funded (free care or self pay). Descriptive statistics, Product-Limit methods were used to estimate survival and Log rank test was used to compare the survival difference for each factor. Result: 257 patients were reviewed, of which 208 had multiple myeloma and 49 had MGUS. Median age of patients with MGUS and MM was 59 years and 60 years respectively (range 30–93).There were 92 (37%) Caucasians and 165 (63%) African Americans, 114 (44%) male and 143 (56%) female patients, and 177 (69%) were funded and 80 (31%) were non-funded. Of the patients with MM, 49 (23.5%) were stage 1, 23 (11%) were stage 2, 95 (45.6%) were stage 3A and 41 (19.7%) were stage 3B disease. The 5-year survival for MM was 60% and 42% for funded and non-funded patients respectively (p=0.03). The 5-year survival for MGUS was 95% and 62% for funded and non-funded patients respectively (p=0.012). Funded patients with MM had an overall survival of 6.2 years while it was 3.8 years for the non-funded (p=0.012). The survival difference relative to race and sex was not statistically significant. Conclusion: Our analysis demonstrates that patients with multiple myeloma and MGUS with funding have statistically significant increased overall survival compared to patients with no funding. Presumably patients with funding have better access to medical care, which would allow for earlier diagnosis, more effective therapy of smaller tumor burden and access to all therapeutic options. Lead time bias could contribute to some of the improved survival but is doubtful. To our knowledge, this is the first study to explore the impact of health funding on the survival of patients with multiple myeloma and MGUS, however validation with a larger prospective study is needed. Disclosures: No relevant conflicts of interest to declare.
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Gupta, Sanjay, Harvey M. Rappaport, and Lonnie T. Bennett. "Polypharmacy among Nursing Home Geriatric Medicaid Recipients." Annals of Pharmacotherapy 30, no. 9 (September 1996): 946–50. http://dx.doi.org/10.1177/106002809603000905.
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OBJECTIVE: To determine the factors that influence the number of different drugs prescribed to geriatric Medicaid recipients residing in Louisiana's intermediate care facilities I (ICFs I). DESIGN: Observational and cross-sectional with descriptive and analytic components. PARTICIPANTS: All geriatric Medicaid recipients in Louisiana ICFs I during 1994 (n= 19 932). METHODS: Relevant data on sex, age, race, geographic region of a recipient, number of prescribing physicians, number of pharmacies used, and the number of drugs prescribed to a recipient were extracted from the state Medicaid files. Frequencies for the seven study variables were calculated. Regression analysis was used to evaluate the influence of the six predictor variables on the number of drugs prescribed. RESULTS: The study population was 73.63% women, 60.07% 81 years of age and older, 70.65% white, 23.21% African-American, 6.14% other races, and 29.83% from predominantly rural north Louisiana. A total of 44.60% of the residents received prescriptions from one physician, 8.41% of the residents were single pharmacy users, and 45.65% were prescribed more than 10 drugs during the year. The regression model accounted for 20.53% of the total variation in the number of drugs prescribed to a recipient. Race, geographic region, number of prescribing physicians, and number of pharmacies used by a recipient influenced the number of drugs prescribed. CONCLUSIONS: To reduce the number of drugs prescribed and polypharmacy among geriatric Medicaid recipients, Louisiana's ICFs I should minimize the number of physicians and pharmacies used in this population.
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Delgado-Guay, Marvin Omar, Silvia Tanzi, Maria Teresa San-Miguel, Janet L. Williams, Julio Allo, Gary B. Chisholm, and Eduardo Bruera. "Characteristics and outcomes of advanced cancer patients referred to outpatient supportive care who missed their appointment." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e20612-e20612. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20612.
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e20612 Background: Supportive Care Outpatient Clinics (SCOC) offer comprehensive care and symptom management to patients with advanced cancer (AdCa). Missed appointments (MA) are frequent but they are no studies on the clinical outcomes of patients who fail to show for consultation. Methods: We determined the frequency of MA, including clinical and demographic data, and reviewed clinic appointment records for 218 consecutive kept (KA) and 218 MA for distinct patients referred to SCOC from January to December 2011. Results: 218/1,352 (16%) AdCa who were referred to our SCOC, missed their appointment. The median age was 57 years (interquartile range 49-67). The mean (range) time between referral and appointment was 7.4 days (0-71) for KA vs. 9.1 days (0-89) for MA (p=0.0062). Age, gender, marital status, and cancer types or stages, and reasons for referral to SCOC were not significantly different between MA and KA patients. African Americans had more MA 49/218 (22%) vs. 31/217 (14%), p=0.06. The reasons for MA were: admission to the hospital 17/218 (8%), death 4/218 (2%), appointment with primary oncologist 37/218 (18%), other appointments 19/218 (9%), visits to emergency room(ER) 9/218(9%), and unknown 111/218(54%). MA patients visited more the ER at 2 weeks 16/214 (7%) vs. 5/217 (2%), p=0.01, and 4 weeks 17/205(8%) vs. 8/217(4%), p=0.06. Median survival for MA patients was 177 days (range:127-215) vs. 253 days (range:192-347) for KA patients (p=0.013). Multivariate analysis showed that MA were associated to the time between referral and scheduled appointment (OR: 1.026/day, p=0.03), referral from targeted therapy services (OR:2.177, p=0.004), living at Texas/Louisiana regions (OR;2.345, p=0.002), having advanced directives (OR:0.154, P<0.0001), and being referred for symptom control (OR:0.024, p=0.0003). Conclusions: AdCa with MA have worse survival and increased ER utilization. We identified AdCa at higher risk for MA who should undergo more aggressive follow up. More research on MA prevention is needed.