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Robbins, Jessica C., and Kimberly Seibel. "ADAPTIVE GARDENING PRACTICES AMONG OLDER AFRICAN AMERICANS IN DETROIT." Innovation in Aging 3, Supplement_1 (November 2019): S515. http://dx.doi.org/10.1093/geroni/igz038.1901.
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Abstract It is well established that gardening can promote physical, social, and emotional wellbeing for many older adults in varied circumstances (Milligan, Gatrell, and Bingley 2004; Nicklett, Anderson, and Yen 2016; Wang and MacMillan 2013). In post-industrial cities formed by historical and ongoing processes of structural inequality such as Detroit, Michigan, gardening is beneficial for residents in terms of health, economic activity, community-building, and city beautification (Lawson 2005; Pitt 2014; Pothukuchi 2015; White 2011). However, research has less frequently investigated how gardening can promote wellbeing for older adults living in contexts of urban structural inequality. This poster addresses this gap by exploring how older African American gardeners in Detroit adapt their gardening practices to changing physical abilities and capacities. Drawing on ethnographic research conducted during one gardening season (March-October 2017) with older African Americans in Detroit (n= 27), we employ a selective-optimization-with-compensation framework (Baltes and Baltes 1990) to understand the modifications that older Detroiters make in their gardening practices as they age. Findings demonstrate that older African Americans in Detroit engage in gardening in flexible, creative ways that accommodate new physical limitations, while also connecting to changes occurring in the city of Detroit. This study thus has implications for further understanding how gardening can benefit older adults, and how older adults can contribute vitality to contexts of structural inequality.
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Pattin, Anthony J., and Ledric Sherman. "Experiences Among African American Community Members With Pharmacy-Based Immunization Services in Detroit, Michigan." Journal of Pharmacy Technology 34, no. 6 (September 19, 2018): 259–65. http://dx.doi.org/10.1177/8755122518801288.
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Background: Although vaccination rates improved modestly in the United States during the 2014-2015 season, racial and ethnic disparities in the use of vaccines persist. Pharmacy-based immunization programs expand access to immunization services; however, African Americans in one metropolitan community did not have the same level of access to this service as non-Hispanic whites. Objective: To examine the experiences of African Americans with pharmacy-based services and identify how pharmacies and pharmacy organizations can better service patients in urban communities with similar dynamics. Methods: This qualitative study utilized focus group discussions among African American residents in Detroit, Michigan, where there are reported disparities in access to pharmacists that immunize to learn more about their experiences with pharmacy-based immunization services. Results: Three major themes emerged: the pharmacy location is often more convenient and accessible than doctors’ offices, there is clear communication with the pharmacist, and perceived lower immunization fees at pharmacies. Participants found pharmacies easier to access in their community for immunization services. Consistent interaction with familiar pharmacists and pharmacy staff members facilitated strong relationships and dialogue between pharmacists and patients. Patients perceived costs for vaccines to be less at the pharmacy than at their physicians’ offices. Conclusions: Participants reported positive experiences with pharmacy-based immunization services and expansion of these services may influence more African Americans to receive recommended vaccines in this community.
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Mitchell, Jamie, Tam Perry, Vanessa Rorai, Joan Ilardo, Peter Lichtenberg, and James Jackson. "Building and Sustaining a Community Advisory Board of African American Older Adults as the Foundation for Volunteer Research Recruitment and Retention in Health Sciences." Ethnicity & Disease 30, Suppl (November 19, 2020): 755–64. http://dx.doi.org/10.18865/ed.30.s2.755.
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Older African Americans’ participation in health-related research is severely limited; they are not involved in sufficient numbers to ensure the applicability of advancements in medical and behavioral health. This research participation gap exacerbates older African Americans’ vulnerability to poor health outcomes and disparities. The Michigan Center for Urban African American Aging Research employs a progressive community-based participatory model that utilizes a structured community advisory board (CAB) of African American older adults in metro Detroit, Michigan to oversee the research recruitment and retention of fellow minority older adult research participants. CAB members develop and support community health programming that provides free resources to older adults and also serves as fertile ground for recruiting participants in a volunteer research registry. CAB members are also provided ongoing training on social and behavioral health research and are supported in acting as a consultancy to outside researchers where they can be compensated for their expertise and engagement. This community-engaged model of sustaining a CAB of African American older adults offers key lessons learned on building relationships and trust, valuing and leveraging community members’ expertise and time, sharing decision-making, and fostering genuine community all while promoting research recruitment and retention among underserved populations.Ethn Dis. 2020;30(Suppl 2):755-764; doi:10.18865/ed.30.S2.755
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Marks, Alexis Braun, Mason Christensen, Amanda Ford, Steven Gentry, Ashley Johnson Bavery, and Matthew Jaber Stiffler. "Locating Arab Americans in Greater Detroit: An Overview of MENA Archives in Southeast Michigan." American Archivist 86, no. 2 (September 1, 2023): 370–90. http://dx.doi.org/10.17723/2327-9702-86.2.370.
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ABSTRACT Southeast Michigan is home to one of the largest, most highly concentrated populations of people of Middle Eastern and North African (MENA) descent in the United States. This case study includes summaries of MENA-related collections at four separate repositories: the Bentley Historical Library at the University of Michigan, the Arab American National Museum, the Dearborn Historical Museum, and Eastern Michigan University Archives. This region not only provides unparalleled archival holdings, but researchers and archivists are actively working with local MENA communities to create future collections. In this study, staff from each of the four profiled institutions have contributed a summary that links collections across institutions and illustrates the importance of visiting two or more sites to fully understand the region's Arab American community. The authors reveal how researchers can find a rich collection of artifacts and photographs, oral histories, personal papers and organizational records, published materials, and government documents all within a half-hour drive of the Detroit Metro Airport. These collections, which are local, national, and international in scope, make metropolitan Detroit a crucial research site for historians, anthropologists, sociologists, and other scholars examining the life and culture of MENA communities across the United States.
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Jiagge, Evelyn, Joseph Kwaku Oppong, Jessica Bensenhaver, Francis Aitpillah, Kofi Gyan, Ishmael Kyei, Ernest Osei-Bonsu, et al. "Breast Cancer and African Ancestry: Lessons Learned at the 10-Year Anniversary of the Ghana-Michigan Research Partnership and International Breast Registry." Journal of Global Oncology 2, no. 5 (October 2016): 302–10. http://dx.doi.org/10.1200/jgo.2015.002881.
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Women with African ancestry in western, sub-Saharan Africa and in the United States represent a population subset facing an increased risk of being diagnosed with biologically aggressive phenotypes of breast cancer that are negative for the estrogen receptor, the progesterone receptor, and the HER2/neu marker. These tumors are commonly referred to as triple-negative breast cancer. Disparities in breast cancer incidence and outcome related to racial or ethnic identity motivated the establishment of the International Breast Registry, on the basis of partnerships between the Komfo Anokye Teaching Hospital in Kumasi, Ghana, the University of Michigan Comprehensive Cancer Center in Ann Arbor, Michigan, and the Henry Ford Health System in Detroit, Michigan. This research collaborative has featured educational training programs as well as scientific investigations related to the comparative biology of breast cancer in Ghanaian African, African American, and white/European American patients. Currently, the International Breast Registry has expanded to include African American patients throughout the United States by partnering with the Sisters Network (a national African American breast cancer survivors’ organization) and additional sites in Ghana (representing West Africa) as well as Ethiopia (representing East Africa). Its activities are now coordinated through the Henry Ford Health System International Center for the Study of Breast Cancer Subtypes. Herein, we review the history and results of this international program at its 10-year anniversary.
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Booker, Vaughn A. "“God’s Spirit Lives in Me”." Nova Religio 22, no. 1 (August 1, 2018): 5–33. http://dx.doi.org/10.1525/nr.2018.22.1.5.
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This article explores the work of the Rev. Charleszetta “Mother” Waddles (1912–2001), an independent African American Christian minister who operated the Perpetual Mission for Saving Souls of All Nations in Detroit, Michigan. It argues that Mother Waddles sought to reshape and repurpose the spiritual rhetoric of New Thought theology—especially the concept of “positive thinking”—for her daily practice as a home missionary and for others living in similar circumstances. Mother Waddles was distinct from other twentieth-century, African American New Thought messengers because she sought to speak to and change the lives and mindsets of other impoverished African Americans without making a theological case for their divine entitlement to material prosperity or by encouraging their desire for financial wealth. Her undated, self-published book, Attributes and Attitudes, offered twelve divine virtues that every potential home (urban) missionary worker should embody—as well as twelve negative attitudes they must reject—in order to serve others.
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Robbins, Jessica C., and Kimberly A. Seibel. "Temporal aspects of wellbeing in later life: gardening among older African Americans in Detroit." Ageing and Society 40, no. 12 (July 18, 2019): 2614–34. http://dx.doi.org/10.1017/s0144686x19000813.
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AbstractGardening has well-established physical, social and emotional benefits for older adults in varied circumstances. In Detroit, Michigan (United States of America), as in many cities, policy makers, funders, researchers, community organisations and residents regard gardening as a means of transforming bodies, persons, communities, cities and broader polities. We draw on ethnographic research conducted during one gardening season with 27 older African Americans in Detroit to foreground the social dimensions of wellbeing in later life and thus develop a more robust and nuanced understanding of gardening's benefits for older adults. Based on anthropological understandings of personhood and kinship, this article expands concepts of wellbeing to include social relations across multiple scales (individual, interpersonal, community, state) and temporalities (of the activity itself, experiences of ageing, city life). Even when performed alone, gardening fosters connections with the past, as gardeners are reminded of deceased loved ones through practices and the plants themselves, and with the future, through engagement with youth and community. Elucidating intimate connections and everyday activities of older African American long-term city residents counters anti-black discourses of ‘revitalisation’. An expansive concept of wellbeing has implications for understanding the generative potential of meaningful social relations in later life and the vitality contributed by older adults living in contexts of structural inequality.
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Lammers, Philip Edward, Velmalia Matthews-Smith, Ya-Lin Yun, Yumei Pan, Snjezana Zaja-Milatovic, Amy Sullivan, Rosana Eisenberg, et al. "Somatic mutation spectrum of non-small cell lung cancers (NSCLCs) from African Americans (AAs)." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): 6038. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.6038.
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6038 Background: In the AA population, previous studies have presented conflicting data on the frequency of EGFR mutations (Reinersman JTO 2011;Leidner JCO 2009), while frequencies of other gene mutations and translocations, including anaplastic lymphoma kinase (ALK), have not been described. Methods: 161 archival FFPE tumor specimens from self reported AA patients with any stage NSCLC from 1997-2010 were collected from 3 sites in Tennessee (132 samples) and one site in Michigan (29 samples). Samples were evaluated for known recurrent driver mutations in EGFR, KRAS, BRAF, NRAS, AKT1, PI3KCA, PTEN, HER-2, MEK1 by standard SNaPshot/sizing assays, and translocations in ALK by FISH. Clinical data was collected on 119 patients. Chi-square was used to compare the frequency of mutations in subgroups and Kaplan-Meier and log rank were used to calculate and compare PFS between groups. Results: 5.0% of tumors had EGFR mutations, 14.9% had KRAS mutations, 0.6% had a BRAF, AKT1, PI3KCA, or HER2 mutation, and 0% had NRAS, PTEN, or MEK1 mutations. Of 35 ‘pan-negative’ non-squamous specimens, 0 had ALK translocations. PFS was the same in those with and without KRAS mutation (p=0.74) and showed a trend towards improvement in those with EGFR mutation (p=0.08). The frequency of EGFR mutations was higher in samples from Detroit versus those from Tennessee (17% vs 2.3%, p<0.01), as was the frequency of adenocarcinoma (62% vs 44%, p<0.05). The frequency of EGFR mutations in never smokers was higher in the samples from Detroit versus Tennessee (83% vs 7.1%, p<0.01). Conclusions: In the largest tumor mutational profiling study of NSCLC from AAs to date, EGFR mutations occurred less frequently than would be expected from a North American population. We noted a regional difference, with fewer EGFR mutations in Tennessee than in Michigan, a finding that may have been the result of more adenocarcinoma samples from Michigan. The rates of other mutations and translocations including ALK were low. While lung cancer tumors should continue to undergo routine molecular testing to prioritize therapy, future comprehensive genotyping efforts should focus on identifying novel driver mutations in this population. Funding: 5RC1CA162260 R01CA060691 R01CA87895.
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Lau, Yan Kwan, Harihar Bhattarai, Tanner J. Caverly, Pei-Yao Hung, Evelyn Jimenez-Mendoza, Minal R. Patel, Michele L. Coté, Douglas A. Arenberg, and Rafael Meza. "Lung Cancer Screening Knowledge, Perceptions, and Decision Making Among African Americans in Detroit, Michigan." American Journal of Preventive Medicine 60, no. 1 (January 2021): e1-e8. http://dx.doi.org/10.1016/j.amepre.2020.07.004.
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Ramsay, Jessica E., Mary R. Janevic, Cainnear K. Hogan, Dominique L. Edwards, and Cathleen M. Connell. "Using the Replicating Effective Programs Framework to Adapt a Heart Health Intervention." Health Promotion Practice 20, no. 5 (May 14, 2018): 760–69. http://dx.doi.org/10.1177/1524839918775740.
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Heart disease is the leading cause of death in the United States. African Americans and people of low socioeconomic status suffer disproportionately from heart disease–related morbidity and mortality. In Detroit, Michigan, a primarily African American and low-income urban area, heart disease mortality is at twice the national rate. Despite evidence for the effectiveness of self-management support interventions in reducing chronic disease burden for older adults, few are adapted for communities most in need. This article describes the process of adapting Take PRIDE, an evidence-based heart disease self-management intervention, for older adults in Detroit via the Replicating Effective Programs (REP) framework. Working within a community–academic partnership, we found REP useful in facilitating the identification of diverse stakeholders, core versus adaptable elements of the intervention and barriers to implementation. We also made several modifications to the REP framework in order to better fit our project needs. Overall, we found REP to be an effective, flexible tool that allowed us to successfully adapt a disease-management intervention for this setting. Processes, lessons learned, and recommendations offered in this article may help researchers and practitioners working to expand access to self-management support for populations most affected by chronic disease.
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Mitchell, Jamie, Tam Perry, Vicki Johnson-Lawrence, and Vanessa Rorai. "Building and Sustaining a Community Advisory Board of African American Older Adults for Volunteer Research." Innovation in Aging 4, Supplement_1 (December 1, 2020): 844. http://dx.doi.org/10.1093/geroni/igaa057.3096.
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Abstract Older African Americans’ (AA) participation in health-related research is severely limited; they are not involved in sufficient numbers and for sufficient duration to ensure the applicability of advancements in medical and behavioral health. This research participation gap exacerbates older AAs vulnerability to poor health outcomes and disparities. The Michigan Center for Urban African American Aging Research employs a progressive community-based participatory model that utilizes a structured community advisory board (CAB) of older AAs in metro Detroit to oversee the research recruitment and retention of fellow AA older adult research participants. CAB members are provided ongoing training on social and behavioral health research, supported in acting as a consultancy to outside researchers where they can be compensated for their expertise and engagement, and empowered as gatekeepers of a participant research registry of over 1000 AA older adults. This model has broad potential for advancing community engaged research with AA older adults.
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Robbins, Jessica. "Could Practices of Remembrance Reduce Social Isolation in Late Life? Ethnographic Evidence From Poland and Detroit." Innovation in Aging 4, Supplement_1 (December 1, 2020): 668. http://dx.doi.org/10.1093/geroni/igaa057.2313.
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Abstract Because social isolation can have negative effects on older adults’ wellbeing, programs that reduce social isolation have potential to improve older adults’ wellbeing. One presumed aspect of these programs’ significance is the social connection occurring through the programs themselves. However, drawing on ethnographic data collected in Poland and Detroit, this presentation argues that practices of remembrance, in which older adults connect with deceased kin and loved ones, may offer possibilities for reducing social isolation. In Poland, older adults engage in practices of storytelling in which they remember deceased kin and lost homes and homelands. In Detroit, Michigan, older African Americans who garden remember their deceased kin and friends through the practice of gardening itself. This presentation presents a cross-cultural analysis of how older adults’ practices of remembrance may offer opportunities to reduce social isolation—even for older adults who live alone—by connecting to meaningful relations, times, and places.
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Marshall, Carly, Isabelle Havis, Emily Herreshoff, Cate Lewis, and Vikas Kotagal. "Racial Differences in Trust and Risk Disclosure Preferences Among Older Registered Research Volunteers Screened for Prodromal Synucleinopathies." Gerontology and Geriatric Medicine 8 (March 2022): 233372142210941. http://dx.doi.org/10.1177/23337214221094184.
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Background/Objectives The equitable enrollment of minority participants in synucleinopathy trials is an emerging public health concern. Differing views regarding risk disclosure may influence research involvement in at-risk adults. Methods We conducted a brief mailed survey, including questions about trust and hypothetical risk disclosure preferences, to 100 participants in the Healthier Black Elders Center cohort in Detroit, MI and 100 participants in the Claude D. Pepper Older Americans Independence Center Research Participant Program at the University of Michigan. Results 125 recipients without a diagnosis of a neurodegenerative disorder returned the survey, 52 (41.6%) of whom identified as being Black or African American. Black respondents reported less trust in medical providers (t=2.02, p=0.045) and medical researchers (t=2.52, p=0.013) and a greater desire to be informed about the presence of unchangeable risk factors for neurodegenerative disorders (t=2.02, p=0.045). Conclusions These findings have implications for the recruitment of representative populations in prodromal neurodegenerative research.
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McNeill, Cynthera, Nancy George, and Raenita Glover. "An Evaluation of Sisters Informing Healing Living Empowering: Increasing HIV Knowledge Among African American Adolescent Females Using an Evidence-Based HIV Prevention Intervention." Journal of Doctoral Nursing Practice 10, no. 1 (2017): 4–10. http://dx.doi.org/10.1891/2380-9418.10.1.4.
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Background: In Detroit, Michigan, 85% of HIV cases are among African American youth. Approximately 53.4% of African American high school females have had sexual intercourse; 44.7% did not use a condom during the last sexual encounter. School-based sexual health education may be limited regarding HIV prevention. Sexual health education that is culturally and gender-specific is needed to provide knowledge that may impact condom self-efficacy and address the HIV epidemic among African American adolescents in Detroit. Community-based organizations may be used to implement an evidence-based educational intervention. Methods: A 1-group, pretest/posttest design was used to evaluate knowledge of HIV and condom use among 11 African American adolescent females who participated in an evidence-based intervention, Sisters Informing Healing Living Empowering (SIHLE), during 3-hr sessions over 4 consecutive Saturdays. There was 100% attendance among participants for all sessions. Knowledge of HIV and condom use was measured with a 16-item true/false survey before and after the intervention. Results: A significant difference between HIV knowledge at pretest and HIV knowledge at posttest was noted, z = −2.322, p = .02. Conclusion: Nurses and community stakeholders can be instrumental in addressing the HIV epidemic by implementing evidence-based interventions that increase knowledge of HIV prevention and condom use.
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Su, Wan-Ting K., Cara Cannella, Jessica Haeusler, Indra Adrianto, Ilan Rubinfeld, and Albert M. Levin. "Synergistic effects of social determinants of health and race-ethnicity on 30-day all-cause readmission disparities: a retrospective cohort study." BMJ Open 14, no. 7 (July 2024): e080313. http://dx.doi.org/10.1136/bmjopen-2023-080313.
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Objective The objective of this study is to assess the effects of social determinants of health (SDOH) and race-ethnicity on readmission and to investigate the potential for geospatial clustering of patients with a greater burden of SDOH that could lead to a higher risk of readmission. Design A retrospective study of inpatients at five hospitals within Henry Ford Health (HFH) in Detroit, Michigan from November 2015 to December 2018 was conducted. Setting This study used an adult inpatient registry created based on HFH electronic health record data as the data source. A subset of the data elements in the registry was collected for data analyses that included readmission index, race-ethnicity, six SDOH variables and demographics and clinical-related variables. Participants The cohort was composed of 248 810 admission patient encounters with 156 353 unique adult patients between the study time period. Encounters were excluded if they did not qualify as an index admission for all payors based on the Centers for Medicare and Medicaid Service definition. Main outcome measure The primary outcome was 30-day all-cause readmission. This binary index was identified based on HFH internal data supplemented by external validated readmission data from the Michigan Health Information Network. Results Race-ethnicity and all SDOH were significantly associated with readmission. The effect of depression on readmission was dependent on race-ethnicity, with Hispanic patients having the strongest effect in comparison to either African Americans or non-Hispanic whites. Spatial analysis identified ZIP codes in the City of Detroit, Michigan, as over-represented for individuals with multiple SDOH. Conclusions There is a complex relationship between SDOH and race-ethnicity that must be taken into consideration when providing healthcare services. Insights from this study, which pinpoint the most vulnerable patients, could be leveraged to further improve existing models to predict risk of 30-day readmission for individuals in future work.
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Zenk, Shannon N., Amy J. Schulz, Barbara A. Israel, Graciela Mentz, Patricia Y. Miranda, Alisha Opperman, and Angela M. Odoms-Young. "Food shopping behaviours and exposure to discrimination." Public Health Nutrition 17, no. 5 (March 27, 2013): 1167–76. http://dx.doi.org/10.1017/s136898001300075x.
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AbstractObjectiveThe present study examined food shopping behaviours, particularly distance to grocery shop, and exposure to discrimination.DesignCross-sectional observational study utilizing data from a community survey, neighbourhood food environment observations and the decennial census.SettingThree communities in Detroit, Michigan, USA.SubjectsProbability sample of 919 African-American, Latino and white adults in 146 census blocks and sixty-nine census block groups.ResultsOn average, respondents shopped for groceries 3·1 miles (4·99 km) from home, with 30·9 % shopping within 1 mile (1·61 km) and 22·3 % shopping more than 5 miles (8·05 km) from home. Longer distance to shop was associated with being younger, African-American (compared with Latino), a woman, higher socio-economic status, lower satisfaction with the neighbourhood food environment, and living in a neighbourhood with higher poverty, without a large grocery store and further from the nearest supermarket. African-Americans and those with the lowest incomes were particularly likely to report unfair treatment at food outlets. Each mile (1·61 km) increase in distance to shop was associated with a 7 % increase in the odds of unfair treatment; this relationship did not differ by race/ethnicity.ConclusionsThe study suggests that unfair treatment in retail interactions warrants investigation as a pathway by which restricted neighbourhood food environments and food shopping behaviours may adversely affect health and contribute to health disparities. Efforts to promote ‘healthy’ and equitable food environments should emphasize local availability and affordability of a range of healthy food products, as well as fair treatment while shopping regardless of race/ethnicity or socio-economic status.
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Nriagu, Jerome, Raghavendra Senthamarai-Kannan, Hikmet Jamil, Monty Fakhori, and Summer Korponic. "Lead Poisoning Among Arab American and African American Children in the Detroit Metropolitan Area, Michigan." Bulletin of Environmental Contamination and Toxicology 87, no. 3 (July 2, 2011): 238–44. http://dx.doi.org/10.1007/s00128-011-0346-4.
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Singh, Sunny R. K., Kannan Thanikachalam, Hiba Jabbour-Aida, Laila M. Poisson, and Gazala Khan. "COVID-19 and Cancer: Lessons Learnt from a Michigan Hotspot." Cancers 12, no. 9 (August 22, 2020): 2377. http://dx.doi.org/10.3390/cancers12092377.
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(1) Background: Outcomes with coronavirus disease 2019 (COVID-19) have been worse in those with comorbidities and amongst minorities. In our study, we describe outcomes amongst cancer patients in Detroit, a major COVID-19 hotspot with a predominant inner-city population. (2) Methods: We retrospectively analyzed 85 patients with active invasive cancers who were infected with COVID-19. The primary outcome was death or transition to hospice. (3) Results: The majority were males (55.3%, n = 47), ≤70 years old (58.5%, n = 50), and African Americans (65.5%, n = 55). The most common primary site was prostate (18.8%, n = 16). Inpatient admission was documented in 85.5% (n = 73), ICU admission in 35.3% (n = 30), and primary outcome in 43.8% (n = 32) of hospitalized patients. On a multivariate analysis, factors associated with increased odds of a primary outcome included an age of >70 years versus ≤70 years (OR 4.7, p = 0.012) and of male gender (OR 4.8, p = 0.008). Recent cancer-directed therapy was administered in 66.7% (n = 20) of ICU admissions versus 39.5% (n = 17) of general floor admissions (Chi-square p-value of 0.023). (4) Conclusions: High rates of mortality/transition to hospice and ICU utilization were noted amongst our patients with active invasive cancer, following a COVID-19 infection. Men and those of >70 years of age had a greater than four-fold increase in odds of death or transition to hospice.
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Baker, Rachel. "Toward a Politics of Accountability: Feminist ethics of care and whiteness in Detroit's foreclosure crisis." Radical Housing Journal 1, no. 1 (April 4, 2019): 69–86. http://dx.doi.org/10.54825/nial2618.
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In the decade since the 2008 mortgage crisis, residents of Detroit, Michigan have continued to sustain anemic levels of preventable foreclosures by tax delinquency. The city’s decades-long over assessment of property values and proceeding windfall of tax foreclosures are happening amid a post-bankruptcy governance regime to remarketize housing and land that has been accumulated by the city through forfeitures and seizures. Over 50% of the city’s households, rented or owned, are led by African American women. Growing economic inequality and community efforts to keep Detroit a majority black city have roused organized responses against territorial reconfigurations that could drive further political-economic division and displacement. The Tricycle Collective, a woman-led non-profit that assisted Detroit households in avoiding tax foreclosure, will be examined here for their use of a feminist ethics of care in their approach to foreclosure prevention. This article considers the potential for harm in exercising an ethics of care within a deeply racialized housing market, without the intention of constructing next steps for advocates and activists to direct opposition toward the ongoing crisis of racialized dispossession. Speaking through critical race studies, urban geography and feminist theory, a feminist ethics of care will be deconstructed alongside what I call a “politics of accountability”, as a framework for action and analysis.
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Martens, Nancy, Sophie Hanna, Hannah Adams, Loraine DiCerbo, Bruno Giordani, and Voyko Kavcic. "SELF-PERCEIVED COGNITIVE CHANGES IN OLDER BLACK ADULTS DURING COVID-19." Innovation in Aging 7, Supplement_1 (December 1, 2023): 814–15. http://dx.doi.org/10.1093/geroni/igad104.2628.
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Abstract The COVID-19 pandemic has had myriad effects on health and well-being. Contracting the COVID-19 virus and concerns of social and physical consequences during pandemic-related restrictions have been proven to negatively impact health. To better understand possible effects of COVID-19 on Black community-dwelling older adults’ perceived cognitive changes, we conducted a pilot study with 48 community-dwelling African Americans with measures obtained over 24 months from 10/2020 to 10/2022. Participants were recruited from the Wayne State University Institute of Gerontology Healthier Black Elders Center, and Michigan Alzheimer’s Disease Research Center, and the general Detroit Area (Mage=73.07, Range=65-87 years). The Cognitive Change Index (CCI) was used as a self-report measure of perceived change over the last five years. The COVID Impact Survey (CIS) was used to assess the burden of COVID-19 on daily living. To evaluate emotional-being, the Perceived Stress Scale (PSS responses referred to the last month) and the Geriatric Depression Scale (GDS, within the last week) were administered. Stepwise regression models showed CIS outcome measures did not predict CCI. GDS outcome measures predicted CCI to some degree (R2adj = .15, p = .008), whereas PSS was the strongest predictor (R2adj = .50, p < .001). Results suggest that for older community-dwelling African Americans, past COVID-19 pandemic experiences did not affect their self-evaluated cognitive changes. Higher levels of self-perceived stress within the last month best predicted their subjective cognitive decline. Future research should involve interventions focused on stress reduction, and clinicians should consider stress level when diagnosing cognitive status in older adults.
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Kieffer, Edith C., Brandy R. Sinco, Ann Rafferty, Michael S. Spencer, Gloria Palmisano, Earl E. Watt, and Michele Heisler. "Chronic Disease – Related Behaviors and Health Among African Americans and Hispanics in the REACH Detroit 2010 Communities, Michigan, and the United States." Health Promotion Practice 7, no. 3_suppl (June 7, 2006): 256S—264S. http://dx.doi.org/10.1177/1524839906289353.
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Sealy-Jefferson, Shawnita, Brittney Butler, Shibani Chettri, Hikma Elmi, Allison Stevens, Chinenye Bosah, Rhonda Dailey, and Dawn P. Misra. "Neighborhood Evictions, Marital/Cohabiting Status, and Preterm Birth among African American Women." Ethnicity & Disease 31, no. 2 (April 14, 2021): 197–204. http://dx.doi.org/10.18865/ed.31.2.197.
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Introduction: Housing stability is an important determinant of health, but no studies to our knowledge have examined the spill-over effects of neighborhood eviction rates on individual risk of preterm birth (PTB) among African American women.Objective: We assessed whether living in a neighborhood with high eviction rates was associated with risk of PTB among African American women, and whether marital/cohabiting status modified the association.Methods: We spatially linked interview, medical record, and current address data from the Life-course Influences on Fetal Environments Study (2009-2011, N=1386) of postpartum African American women from Metropolitan Detroit, Michigan, to publicly available data on block-group level rates of eviction filings and judgements. PTB was defined as birth before 37 completed weeks of gestation and occurred in 16.3% of the sample (n=226). Eviction rate variables were rescaled by their interquartile ranges (75th vs 25th percentiles). Women self-reported whether they were married to, or cohabiting with, the father of their baby during the in-person interview. We used Modified Poisson regression with robust error variance to estimate relative risks of PTB associated with each eviction variable separately and included an interaction term with marital/cohabiting status (P<.10 considered significant) in adjusted models.Results: In the overall sample, neighborhood eviction filings and judgements did not predict PTB, but the associations were modified by marital/cohabiting status (P for interaction = .02, and .06, respectively). Among women who were married/cohabiting, those who lived in neighborhoods with high eviction filings (adjusted relative risk: 1.25, 95% CI: 1.06, 1.47) and eviction judgements (adjusted relative risk: 1.18, 95% CI: 1.05, 1.33) had higher risk of PTB than women who did not. Little evidence of an association was observed for women who were not married/cohabiting.Conclusions: Future studies should examine the mechanisms of the reported associations to identify novel intervention targets (eg, addressing landlord discrimination) and policy solutions (eg, ensuring a living wage and providing affordable housing assistance to everyone who qualifies) to reduce the burden of PTB among African Americans. Ethn Dis. 2021;31(2):197-204; doi:10.18865/ed.31.2.197
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Brennan, Shane. "Visionary Infrastructure: Community Solar Streetlights in Highland Park." Journal of Visual Culture 16, no. 2 (August 2017): 167–89. http://dx.doi.org/10.1177/1470412916685743.
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This article develops the concept of ‘visionary infrastructure’, defined as infrastructure that provides visions of and begins to build more sustainable futures for local communities, through the case study of a solar-powered street lighting project in Highland Park, Michigan, near Detroit. After the local utility company repossessed most of the city’s streetlights, residents began building their own grassroots public lighting network. This infrastructure is visionary because it allows members of the largely African American community to determine precisely how their city is illuminated, and thus how seeing operates therein. By shifting control over the conditions of urban visuality from state and corporate officials to local residents, the lighting project intervenes in a long history of light on the street as a racialized tool of state surveillance and policing. And it shows how utility infrastructure can become a key site and mode of contemporary political resistance.
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Zachariah, Mareena S., Alexa Lupi, Anurag Dawadi, Ana Vazquez, and Todd Lucas. "Disparities in Home Dialysis and Links to Kidney Transplantation: Inequities Among African American ESRD Patients in Detroit, Michigan." Journal of the American Society of Nephrology 31, no. 10S (October 2020): 416. http://dx.doi.org/10.1681/asn.20203110s1416b.
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Wright, E. Missy, Katie R. Griffes, and Daniel R. Gould. "A Qualitative Examination of Adolescent Girls’ Sport Participation in a Low-Income, Urban Environment." Women in Sport and Physical Activity Journal 25, no. 2 (October 2017): 77–88. http://dx.doi.org/10.1123/wspaj.2016-0002.
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Even though African American girls and/or girls in low-income, urban environments are specifically challenged with their sport involvement, little research has focused specifically on this population’s experience with sport. The purpose of this study was to examine various factors related to sport participation for adolescent girls (predominantly African American) living in a low-income urban environment. The study examined the barriers that might impede their sport involvement, the benefits they perceive, and the reasons why they do or do not participate. Four focus groups were conducted in Detroit, Michigan (a large urban Midwestern city). Participants were grouped by age, as well as sport participation status (current sort participants and girls who have not participated in organized sport for at least one year). Each group consisted of 4 girls. Results revealed various reasons why the participants engaged in sport, including that sport occupies their time and that it is fun, while reasons like lack of opportunities and the negative role of others were some of the reasons provided for not participating in sport. These girls face numerous barriers to sport participation, such as logistical, financial, and cosmetic. Positive psychosocial development and scholarships were noted as benefits to participation. Directions for future research and programmatic level applications are described in light of these findings.
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CHRISOMALIS, STEPHEN. "What's so improper about fractions? Prescriptivism and language socialization at Math Corps." Language in Society 44, no. 1 (January 26, 2015): 63–85. http://dx.doi.org/10.1017/s0047404514000748.
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AbstractMathematical prescriptivism is a language ideology found in school mathematics that uses a discourse of rationality to proscribe language forms perceived as illogical or inefficient. The present study is based on a three-year ethnographic investigation of Math Corps, a community of practice in Detroit, Michigan, in which prescriptive language in the classroom is used both to highlight beneficial algorithms and to build social solidarity. Although motivated by the analogy with English orthographic reform, prescriptivism at Math Corps avoids potentially harmful criticism of community members of the sort often experienced by African American students. A playful linguistic frame, the prescriptive melodrama, highlights valued prescriptions, thereby enculturating students into the locally preferred register, the ‘Math Corps way’, which encompasses social, moral, linguistic, and mathematical practices and norms. A sociolinguistic and anthropological perspective on prescriptivism within communities of practice highlights positive alternatives to the universalizing prescriptions found in other English contexts. (Prescriptivism, language ideology, mathematics education, community of practice, Math Corps, linguistic anthropology, language socialization)*
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Ramo, Aula, Harshita Mehrotra, Ifeoma Onwubiko, Jawad Sheqwara, and Zaher K. Otrock. "Correlation between ABO Blood Groups and Disease Severity and Mortality in Hospitalized COVID-19 Patients." Blood 136, Supplement 1 (November 5, 2020): 43–44. http://dx.doi.org/10.1182/blood-2020-141688.
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Introduction After appearance of the novel Coronavirus 2019 in Wuhan, China, new epicenters of the now pandemic appeared nationally. The new Coronavirus disease 2019 (COVID-19) is associated with a syndrome of acute hypoxemic respiratory failure that can lead to admission to intensive care unit (ICU), invasive mechanical ventilation, and at times, death. The first two COVID-19 cases in the State of Michigan were reported in March 10, 2020. During the subsequent weeks, Michigan became one of the early national epicenters of the current COVID-19 pandemic. Early observational studies have suggested a correlation between susceptibility to COVID-19 infection and type A blood group, and furthermore, increased risk of respiratory failure and worse outcome. We conducted this retrospective study to evaluate the association between ABO blood groups and disease severity/mortality in hospitalized COVID-19 patients. Methods We reviewed the records of hospitalized patients with PCR-confirmed COVID-19 testing managed at Henry Ford Health System (HFHS) between March 10 and April 30, 2020. Henry Ford Health System (HFHS) serves inner city and metropolitan Detroit in Michigan, with diverse demographics including African American, Middle Eastern, and Caucasian populations. Age, gender, race, ABO blood groups, comorbidities, disease severity (defined as intensive care unit admission), intubation, and mortality variables were collected for 1488 eligible patients. Survival data was updated on July 15, 2020. Results were presented as median plus range, or percentages as indicated. In the univariate analysis, Student's t-test and Pearson's Chi-square/Fisher's exact test were used to determine the significance and odds ratio (OR) for the independent variables as related to outcome. A multivariate analysis was performed using logistic regression to identify the risk factors for mortality. A backward stepwise (Wald) selection model was performed, with significance level for removal from the model set at 0.1. All tests of significance were two-sided, and a p value of < 0.05 was regarded as significant. All statistical analyses were performed using SPSS (Statistical Package for Social Sciences) software, version 22 (SPSS Inc., Chicago, IL, USA). This study was approved by the Institutional Review Board of HFHS. Results 1488 hospitalized COVID-19 positive patients with available ABO blood group were included. The median age of patients was 68 years (Range 19-99 years); 801 (54%) were females. Most patients (n=856; 58%) were African Americans. 485 (32.6%) patients had blood group A, 276 (18.5%) had group B, 658 (44.2%) had group O, and 69 (4.6%) had group AB. 469 (31.5%) patients required ICU admission, 370 of whom were intubated. On last follow up, 411 (27.6%) patients were dead. ABO blood groups and Rhesus factor (D antigen) were not associated with the ICU admission, intubation, or mortality. Male gender, age ≥65 years, some underlying diseases such as obesity, coronary artery disease chronic obstructive pulmonary disease and malignancy were associated with increased mortality. African American patients were almost 40% less likely to die (OR = 0.56; 95% CI: 0.44-0.7; p < 0.001). Table 1 shows the parameters analyzed as predictors of mortality using univariate and multivariate logistic regression. Multivariate analysis showed that age (≥65 years) (OR = 4.27; 95% CI: 3.19-5.71; p < 0.001), male gender (OR = 1.57; 95% CI: 1.23-2.01; p < 0.001), Caucasian race (OR=1.46; 95% CI: 1.14-1.86; p = 0.003), and COPD (OR = 1.49; 95% CI: 1.09-2.04; p = 0.013) were associated with mortality. Conclusion According to our study, ABO blood groups and Rhesus factor did not correlate with disease severity, use of mechanical ventilation, or mortality in hospitalized COVID-19 patients. Elderly patients, male gender, patients with COPD were at increased risk of death. Contrary to perceived belief, African Americans were not at increased risk of mortality, compared to Caucasians with COVID-19 infection. Caucasians were more likely to die from COVID-19 infection. Disclosures No relevant conflicts of interest to declare.
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Khoja, Lilah, Maxwell Salvatore, Minh Tung Phung, Isabella De Sa, Heatherlun Uphold, Justin Colacino, Alison M. Mondul, Bhramar Mukherjee, Dana Dolinoy, and Celeste Leigh Pearce. "Abstract 830: Michigan cancer and research on the environment study (MI-CARES) cohort: Baseline methods and participant characteristics." Cancer Research 84, no. 6_Supplement (March 22, 2024): 830. http://dx.doi.org/10.1158/1538-7445.am2024-830.
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Abstract Michigan has a long history of adverse environmental exposures, many of which are still ongoing, like the Flint water crisis, extreme air pollution burden, and widespread PFAS exposure. Michigan is also home to a diverse population of Latinx, Black, White, and Middle Eastern/North African (MENA) Americans. Because minority populations are underrepresented in environment and cancer research despite being at greater risk of being exposed to environmental hazards and having worse cancer outcomes, Michigan is uniquely positioned for studying the associations between environmental exposures and cancer risk. In June 2022, the Michigan Cancer and Research on the Environment Study (MI-CARES) began recruitment with a goal of establishing a cohort of over 100,000 Michiganders to examine these associations. Any Michigander aged 18-49 is eligible to enroll in MI-CARES. By focusing on this age range, we will capture exposures during important windows of susceptibility prior to the onset of most cancers.While recruitment is open to all state-wide, efforts are focused on six environmental injustice hotspots, identified using the MiEJScreen tool, a relative summary score capturing pollution burden and population vulnerability: the metro areas of Kalamazoo, Grand Rapids, Flint, Lansing, Detroit, and Bay City-Saginaw.MI-CARES will enroll equal numbers of Black, Latinx, MENA, and White participants. To support participation in diverse communities, study materials are available in Arabic, English, and Spanish. MI-CARES has employed a multifaceted community engagement strategy and is recruiting from these communities directly and with the help of community partners. An incentive of $10 is also provided to participants who successfully complete the questionnaire.To democratize participation, MI-CARES enrollment can be completely remote, but in-person and paper-based enrollment is available. Enrollment includes a baseline questionnaire, consent for data linkage, and annual follow-up surveys. Participants are also asked to provide saliva and blood spot samples via a mailed at-home biospecimen collection kit. Biospecimens will be analyzed for environmental exposures like heavy metals and for intermediate cancer markers including inflammation, cellular aging, immune function, and altered metabolism. Participant data will be linked to neighborhood-level exposure databases, administrative databases like cancer registries and death indices, and to the Michigan Neonatal Biobank. More than 4,000 Michiganders have enrolled in MI-CARES. Data on initial cohort members including environmental exposure history and demographic characteristics will be presented. MI-CARES is part of the Cohorts for Environmental Exposures and Cancer Risk (CEECR) consortium, which is funded by the National Cancer Institute and the National Institute for Environmental Health Sciences. Citation Format: Lilah Khoja, Maxwell Salvatore, Minh Tung Phung, Isabella De Sa, Heatherlun Uphold, Justin Colacino, Alison M. Mondul, Bhramar Mukherjee, Dana Dolinoy, Celeste Leigh Pearce. Michigan cancer and research on the environment study (MI-CARES) cohort: Baseline methods and participant characteristics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 830.
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Meehan, Ashley A., Michael Yeh, Annette Gardner, Tiera L. DeFoe, Alberto Garcia, Patrick Vander Kelen, Martha P. Montgomery, et al. "COVID-19 Vaccine Acceptability Among Clients and Staff of Homeless Shelters in Detroit, Michigan, February 2021." Health Promotion Practice 23, no. 1 (October 23, 2021): 35–41. http://dx.doi.org/10.1177/15248399211049202.
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Understanding COVID-19 vaccine acceptability among clients and staff of homeless shelters can inform public health efforts focused on communicating with and educating this population about COVID-19 vaccines and thus improve vaccine uptake. The objective of this study was to assess COVID-19 vaccine acceptability and uptake among people in homeless shelters in Detroit, Michigan. A cross-sectional study was conducted from February 9 to 23, 2021. Seventeen homeless shelters were surveyed: seven male-only, three male/female, and seven women and family shelters. All clients and staff aged ≥18 years and able to complete a verbal survey in English or with a translator were eligible to participate; of the 168 individuals approached, 26 declined, leaving a total sample of 106 clients and 36 staff participating in the study. The median client and staff ages were 44 and 54 years, respectively. Most participants (>80%) identified as non-Hispanic Black or African American. Sixty-one (57.5%) clients and 27 (75.5%) staff had already received or planned to receive a COVID-19 vaccination. Twelve (11.3%) clients and four (11.1%) staff were unsure, and 33 (31.1%) clients and five (13.9%) staff did not plan to get vaccinated. Reasons for hesitancy were concerns over side effects (29 clients [64.4%] and seven staff [77.8%]) and unknown long-term health impacts (26 clients [57.8%] and six staff [66.7%]). More than half of the clients had already received or planned to receive the vaccine. Continuing efforts such as vaccine education for hesitant clients and staff and having accessible vaccine events for this population may improve acceptability and uptake.
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Ang, Jocelyn Y., Nirupama Kannikeswaran, Katherine Parker, Eric McGrath, Nahed Abdel-Haq, Harbir Arora, Jorge L. Lua, et al. "COVID-19 among Minority Children in Detroit, Michigan during the Early National Surge of the Pandemic." Global Pediatric Health 8 (January 2021): 2333794X2110227. http://dx.doi.org/10.1177/2333794x211022710.
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Background. The COVID-19 pandemic has shed light on communities of racial/ethnic minority groups in the US where long-standing health issues and structural inequities are now known to have resulted in increased risk for infection, severe illness, and death from the virus. The objective of our study was to describe demographic characteristics, clinical presentations, medical interventions and outcomes of pediatric patients with COVID-19 treated at Children’s Hospital of Michigan (CHM), a tertiary care center in urban Detroit, an early hotspot during the initial surge of the SARS-CoV-2 pandemic. Methods. A retrospective chart review was performed of children ≤18 years of age who had polymerase chain reaction (RT-PCR) testing via NP swab or serum IgG antibody testing for SARS-CoV-2 during March 1, 2020–June 30, 2020. Results. Seventy-eight COVID-19 infected children were identified of whom 85.8% (67/78) were from minority populations (African American, Hispanic). Hospitalization rate was 82% (64/78). About 44% (34/78) had an associated comorbidity with asthma and obesity being most common. Although all ages were affected, infants <1 year of age had the highest hospitalization rate (19/64, 30%). In all disease severity categories, dichotomized non-whites had more severe disease by percentage within race/ethnicity than Whites, and also within percent disease severity ( P-value = .197). Overall, 37% of hospitalized patients required intensive care. Conclusions. Extremely high rates of COVID-19 hospitalization and requirement of ICU care were identified in our patient population. Further studies are needed to better understand the contributing factors to this health disparity in disadvantaged communities.
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Cassano, Graham, and Terressa A. Benz. "Introduction: Flint and the Racialized Geography of Indifference." Critical Sociology 45, no. 1 (March 12, 2018): 25–32. http://dx.doi.org/10.1177/0896920517753697.
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In this introduction to the Critical Sociology symposium, “The Flint Water Crisis and the Failure of Neoliberal Governance,” the authors outline the social and cultural conditions for the racialized underdevelopment of Flint and Detroit in the late 20th and early 21st centuries. We begin with an examination of the racially coded rhetoric of Oakland County manager, L. Brooks Patterson, and the manner in which those racial codes reveal the deep roots of white suburban anxiety and racism in the history of economic and spatial apartheid in Michigan. Turning to Flint itself, we draw upon Andrew Highsmith’s recent history of the city, Demolition Means Progress (2015), and examine 20th century red-lining, school segregation, and neoliberal policy decisions as they interacted, effectively rendering Flint’s African American population invisible and, finally, through emergency management, nearly powerless. We close with a survey of the articles within the symposium. Each contribution to the symposium finds that even within the structural and political limitations imposed by neoliberalism, residents and activists continue to find productive spaces for resistance.
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McLaughlin, K. A., A. Nandi, K. M. Keyes, M. Uddin, A. E. Aiello, S. Galea, and K. C. Koenen. "Home foreclosure and risk of psychiatric morbidity during the recent financial crisis." Psychological Medicine 42, no. 7 (November 21, 2011): 1441–48. http://dx.doi.org/10.1017/s0033291711002613.
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BackgroundA defining feature of the US economic downturn of 2008–2010 was the alarming rate of home foreclosure. Although a substantial number of US households have experienced foreclosure since 2008, the effects of foreclosure on mental health are unknown. We examined the effects of foreclosure on psychiatric symptomatology in a prospective, population-based community survey.MethodData were drawn from the Detroit Neighborhoods and Health Study (DNHS), waves 1 and 2 (2008–2010). A probability sample of predominantly African-American adults in Detroit, Michigan participated (n=1547). We examined the association between home foreclosure between waves 1 and 2 and increases in symptoms of DSM-IV major depression and generalized anxiety disorder (GAD).ResultsThe most common reasons for foreclosure were an increase in monthly payments, an increase in non-medical expenses and a reduction in family income. Exposure to foreclosure between waves 1 and 2 predicted symptoms of major depression and GAD at wave 2, controlling for symptoms at wave 1. Even after adjusting for wave 1 symptoms, sociodemographics, lifetime history of psychiatric disorder at wave 1 and exposure to other financial stressors between waves 1 and 2, foreclosure was associated with an increased rate of symptoms of major depression [incidence density ratio (IDR) 2.4, 95% confidence interval (CI) 1.6–3.6] and GAD (IDR 1.9, 95% CI 1.4–2.6).ConclusionsWe provide the first prospective evidence linking foreclosure to the onset of mental health problems. These results, combined with the high rate of home foreclosure since 2008, suggest that the foreclosure crisis may have adverse effects on the mental health of the US population.
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Brown, Sara, Victoria Tutag Lehr, Nathan French, and Christopher Alan Giuliano. "Can a Short Video Improve Inhaler Use in Urban Youth?" Journal of Pediatric Pharmacology and Therapeutics 22, no. 4 (July 1, 2017): 293–99. http://dx.doi.org/10.5863/1551-6776-22.4.293.
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OBJECTIVE The primary aim was to determine whether watching a short video in the inpatient setting could produce an immediate improvement in pediatric patients' asthma knowledge and inhaler technique. METHODS This prospective, quasi-experimental, pre-post study was conducted in a single center, in Detroit, Michigan, which primarily serves an urban, African-American population. Patients were eligible if they were between 8- and 16-years-old, had asthma, and would be discharged with an albuterol metered-dose inhaler. The primary outcome was improvement in the composite score of a knowledge and technique assessment before and after watching a 5-minute video. The lead author developed the video with content validation by pharmacists, pediatricians, elementary school teachers, and a pediatric health education specialist. Secondary outcomes at 30 days included change in asthma control and whether the video was revisited after discharge. RESULTS Thirty patients were enrolled. Their average age was 11 ± 2.1 years; they were primarily African American (83%), female (53%), and insured by Medicaid (87%). The composite score of technique assessment and written quiz increased by 3.53 (95% confidence interval [CI] 2.81 to 4.85) of a possible 16 points after watching the video. There was no significant change in asthma control at 30 days as measured by the asthma control test (2, 95% CI −0.53 to 4.53). Eight of 22 patients revisited the video after discharge. CONCLUSIONS A brief educational video delivered during a pediatric inpatient visit in an urban medical center resulted in an immediate improvement in patients' disease knowledge and inhaler technique.
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Janevic, Mary R., Varick Shute, Susan L. Murphy, and John D. Piette. "Acceptability and Effects of Commercially Available Activity Trackers for Chronic Pain Management Among Older African American Adults." Pain Medicine 21, no. 2 (September 11, 2019): e68-e78. http://dx.doi.org/10.1093/pm/pnz215.
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Abstract Background Wearable activity trackers may facilitate walking for chronic pain management. Objective We assessed the acceptability of a commercially available tracker and three alternative modes of reporting daily steps among older adults in a low-income, urban community. We examined whether using the tracker (Fitbit ZipTM) was associated with improvements in functioning and activity. Design Randomized controlled pilot and feasibility trial. Subjects Fifty-one African American adults in Detroit, Michigan, aged 60 to 85 years, with chronic musculoskeletal pain (28 in the intervention group, 23 controls). Methods Participants completed telephone surveys at baseline and eight weeks. Intervention participants wore trackers for six weeks, alternately reporting daily step counts via text messages, automated telephone calls, and syncing (two weeks each). We used multimethods to assess satisfaction with trackers and reporting modalities. Adherence was indicated by the proportion of expected days on which valid step counts were reported. We assessed changes in pain interference, physical function, social participation, walking frequency, and walking duration. Results More than 90% of participants rated trackers as easy to use, but some had technical or dexterity-related difficulties. Text reporting yielded 79% reporting adherence vs 69% each for automated calls and syncing. Intervention participants did not show greater improvement in functioning or walking than controls. Conclusions With appropriate support, wearable activity trackers and mHealth reporting for chronic pain self-care are feasible for use by vulnerable older adults. Future research should test whether the effects of trackers on pain-related outcomes can be enhanced by incorporating behavior change strategies and training in evidence-based cognitive-behavioral techniques.
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Murayama, Hiroshi, Michael S. Spencer, Brandy R. Sinco, Gloria Palmisano, and Edith C. Kieffer. "Does Racial/Ethnic Identity Influence the Effectiveness of a Community Health Worker Intervention for African American and Latino Adults With Type 2 Diabetes?" Health Education & Behavior 44, no. 3 (December 9, 2016): 485–93. http://dx.doi.org/10.1177/1090198116673821.
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Background. Community health worker (CHW) interventions are known to be an effective strategy to improve health behaviors and outcomes in relation to diabetes, particularly for racial/ethnic communities. Although understanding the function of identity with same race/ethnicity among clients of CHW interventions could contribute to more effective program design, few studies have explored whether levels of racial/ethnic identity among participants can influence the effectiveness of CHW interventions. Aims. We tested the relationship between level of racial/ethnic identity and changes in hemoglobin A1c and diabetes self-efficacy among low-income African American and Latino adults with type 2 diabetes who participated in a CHW intervention. Methods. Data came from a randomized controlled trial of the CHW intervention with a 6-month delayed control group design for 164 African American and Latino adults in Detroit, Michigan. Racial/ethnic identity was created from two items and classified into high, moderate, and low. We combined the two arms (immediate and delayed) into one because there was no significant difference in baseline characteristics, other than age and postintervention self-efficacy, and multivariable linear regression models were applied in the analysis. Results. Possession of high racial/ethnic identity was associated with greater improvement both in hemoglobin A1c and diabetes self-efficacy at 6 months. Moreover, among those with high hemoglobin A1c at preintervention, higher racial/ethnic identity had a greater impact on hemoglobin A1c improvement, compared with those with lower identity. Conclusions. This study suggests the importance of considering racial/ethnic identity of the participants in designing and operating the CHW intervention for racial/ethnic minority population.
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Sivapalan, Shaveena, Khalid Berdi, Ali Shamsa, Maria Vlachaki, Aye Thet, Jeffrey Falk, Carrie Dul, and Paul Chuba. "Abstract PO4-09-07: Overall Survival According to Race and Socioeconomic Status Among Women Treated for BreastCancer at Ascension Health Hospitals in Metropolitan Detroit." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO4–09–07—PO4–09–07. http://dx.doi.org/10.1158/1538-7445.sabcs23-po4-09-07.
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Abstract Background: Despite increasing public awareness and education regarding racial inequality, African American (AA) patients continue to carry higher likelihood of death from breast cancer due to both cancer phenotype and remediable factors of access to care and socioeconomic status. Patients and Methods: We identified 3,241 patients treated for breast cancer between 2006 and 2015 at Ascension St John Hospital (Detroit MI), Ascension Macomb Oakland Hospital (Warren MI) and Ascension Providence Hospital (Southfield MI). Of these, 2530 (78.1%) were categorized as White (W), 658 (20.3%) as African American (AA), and 53 (1.6%) as Other. We considered known risk factors of race and zip code as well as marital status and having any Medicaid insurance (7.4%). 58.55% of patients were married, 15.88% never married, 13.9% widowed, and 11.6% divorced or separated. There were 632 (19.5%) cases represented from the 50 most affluent zip codes in Michigan (median income $83,125 to $140,372), 400 (12.3%) from the 50 least affluent zip codes (median income $14,909 to $33,500), 2199 (67.8%) from the intermediate zip codes, and 10 (0.31%) unknown or out of state. Tumors subtypes were 62% Luminal A (HR+/HER2-), 9.5% Basal (HR-/HER2-), 3.74% Her2 Enriched (HR-/HER2+), and 8% Triple Positive (HR+/HER2+). There were 279 Stage T0 Receptor positive DCIS and 64 Receptor Negative DCIS. 57.3% had lumpectomy or partial mastectomy as the first course of surgery, 27.9% had some form of mastectomy and 14.7 percent mastectomy with reconstruction. SAS for Windows 9.4, Cary, NC and Tableau 2023.1 was used for descriptive and crude analysis. Results: As expected overall survival was highly statistically associated (p< 0.0001) with the variables: age, race, subtype, node positivity and AJCC pathologic stage. Socioeconomic risk factors including zip code (p< 0.0001), marital status (p=0.0006), and carrying Medicaid insurance (p< 0.0001) statistically influenced overall survival. When considering the 50 most affluent zip codes, just 3.79% were African American (AA), with a greater proportion diagnosed at Stage I (49.85%) as compared to the 50 least affluent zip codes (81.97% AA; 37.74% Stage I, p= 0.022). Conclusions: As expected, breast cancer survival was influenced by race, tumor, and patient characteristics. This analysis allows for evaluation of the relative influence of biologic factors (e.g.tumor subtype and cancer stage) and socioeconomic indicators including zip code (stratified by median income) and insurance status. Citation Format: Shaveena Sivapalan, Khalid Berdi, Ali Shamsa, Maria Vlachaki, Aye Thet, Jeffrey Falk, Carrie Dul, Paul Chuba. Overall Survival According to Race and Socioeconomic Status Among Women Treated for BreastCancer at Ascension Health Hospitals in Metropolitan Detroit [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-09-07.
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Abu Rous, Fawzi, Sunny R. K. Singh, Pin Li, Mohamed Elgamal, Hussna Abunafeesa, Rebecca Chacko, Sowjanya Vuyyala, Yaser Alkhatib, and Philip Kuriakose. "Satisfaction of hem/onc patients with video visits during the COVID-19 pandemic at a tertiary care center in Michigan." Journal of Clinical Oncology 39, no. 28_suppl (October 1, 2021): 185. http://dx.doi.org/10.1200/jco.2020.39.28_suppl.185.
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185 Background: In early 2020, the WHO declared the COVID-19 pandemic a public health emergency. Consequently, medical institutions minimized health care services to facilitate social distancing and telemedicine became the forefront of patient-provider interaction. Herein, we present the results of our study that explored patient satisfaction with video visits during the pandemic at a tertiary care center. Methods: A 12-question survey (table) was emailed following a video visit with a Hem/Onc provider carried out between February and December 2020, questions were answered anonymously. The survey also collected patient demographics. The survey evaluated 5 aspects of telemedicine using a five-point graded scale. Results: A total of 1107 patients responded. Median age was 65 years (25-97) with 51.5% over 65, 64% were females and 36% males. Based on zip codes of primary residence and 2015-2019 US Census data, a significant proportion lived in inner-city Detroit, 77.3% were Caucasians, and 15.2% African Americans. Median household income was 66.8K (Michigan’s median is 57K). Regarding access: ease of scheduling appointments, ease of contacting the office and ability to schedule desired appointments, were respectively given positive responses (good, very good, or fair) by 97.61%, 97.32%, and 98.4%. Regarding CP: ability to explain problem, show concern for worries, include patients in decisions, and discussion of treatment plan, were respectively given positive responses by 99.09%, 99.26%, 98.9%, 99.35%. Regarding telemedicine technology: ease of talking to CP, quality of video, and audio connections, were respectively given positive responses by 94.27%, 90.77%, and 91.42%. For the overall visit assessment, 98.58% gave a positive response for the video staff performance. Regarding their comfort level to return to clinic: 78.75% were comfortable and 10.14% were not. Conclusions: Patients reported an overall high level of satisfaction with telemedicine. One area of improvement is the technological aspect. More than 50% were older than 65 years and a significant proportion lived in underserved areas which indicates that telemedicine is easily accessible. Moreover, around 80% were comfortable to return to clinic while 10% were not which highlights the importance of offering both telemedicine and in-person care.[Table: see text]
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Leidlein, Sabryn, Jo-Ann Rammal, Howard Klausner, and Jeffrey Johnson. "The Characterization of Trauma Patients Utilizing Private Vehicle Transport (PVT) to the Emergency Department (ED)." Prehospital and Disaster Medicine 38, S1 (May 2023): s174. http://dx.doi.org/10.1017/s1049023x2300451x.
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Introduction:Existing studies have identified the national rate of PVT for severely injured patients to be 9-16%, our ED has displayed a PVT incidence of 35.4%, suggesting a substantial difference in ED arrival. This study aims to explore descriptive demographics and injury characteristics of patients who arrived by PVT to our ED.Method:A prospective, single-center observational study conducted in Detroit, Michigan. Included patients aged 15 ≥ years who arrived at the ED by PVT for blunt or penetrating trauma. The sample population consisted of 128 patients from August 2019-April 2021. Each subject completed a survey regarding their injury and prehospital care. A retrospective chart review was conducted to acquire information on their injuries.Results:The mean age was 44.3 ± 20.3 years old, range 15-93. 51/128 female, 77/128 male. Patients comprised 93/128 African American, 19/128 Caucasian, 4/128 Asian, 4/128 Hispanic/Latino, and 8/128 other. The most common insurance was Medicaid, comprising 63/128 patients, 25/128 of patients had Medicare and 38/128 had private coverage. Utilizing ESI indices to evaluate severity levels, 73/128 arrived at the ED with an ESI level of 3, 47/128 level of 2, 5/128 level of 4, and 3/128 level of 1, the most severe. Majority of patients 36/128, presented with trauma-related injuries due to a fall. 25/128 presented with a laceration, and 22/128 presented after a motor vehicle crash. The upper extremities were the most common location of trauma 38/128 followed by the lower extremities 23/128. The mean ED length of stay was 11.18 hours.Conclusion:Overall, the findings from this study allowed us to characterize our population of PVT trauma patients through their demographics and injury characteristics. We were able to establish some descriptive characteristics that delineate the population of patients at our ED in Detroit, which is the first step in identifying why trauma patients choose varying modes of transportation.
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Langton, Christine R., Quaker E. Harmon, and Donna D. Baird. "Family History and Uterine Fibroid Development in Black and African American Women." JAMA Network Open 7, no. 4 (April 3, 2024): e244185. http://dx.doi.org/10.1001/jamanetworkopen.2024.4185.
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ImportanceUterine fibroids are an understudied condition, with earlier onset in Black than White women. Prior studies of the importance of family history on fibroid development are limited by reliance on hospital-based participant selection, poorly defined measures of family history, and nonsystematic fibroid assessment.ObjectiveTo examine whether family history is a risk factor for fibroid development using prospective ultrasonography data to identify incident fibroids and measure fibroid growth and standardized methods to ascertain family history.Design, Setting, and ParticipantsThis prospective community cohort of Black and African American women from the Detroit, Michigan, area was conducted from January 1, 2010, to December 31, 2018, using 4 standardized ultrasonographic examinations during 5 years to detect fibroids 0.5 cm or larger in diameter and measure fibroid growth. Data analysis was performed between May 2022 and January 2024.ExposuresMaternal fibroid history data were gathered directly from participants’ mothers when possible (1425/1628 [88%]), and 2 exposure variables were created: maternal history of fibroids (diagnosed vs not diagnosed) and age at maternal fibroid diagnosis (20-29, 30-39, or ≥40 years vs not diagnosed).Main Outcomes and MeasuresFibroid incidence was assessed using multivariable Cox proportional hazards regression models; fibroid growth was calculated as change in log-volume per 18 months for fibroids matched at successive ultrasonograms.ResultsA total of 1610 self-identified Black and/or African American women aged 23 to 35 years (mean [SD] age, 29.2 [3.4] years) with no prior clinical diagnosis of fibroids at enrollment were available for analysis. Of 1187 fibroid-free participants at enrollment, 442 (37%) had mothers who were diagnosed with fibroids. Compared with participants without a maternal history of fibroids, those reporting maternal history had an adjusted hazard ratio (AHR) of 1.21 (95% CI, 0.96-1.52). Risk was strongest in those whose mothers were diagnosed at a younger age (20-29 years: AHR, 1.56; 95% CI, 1.11-2.21; 30-39 years: AHR, 1.03; 95% CI, 0.71-1.49; ≥40 years: AHR, 1.11; 95% CI, 0.81-1.52; P = .053 for trend). Fibroid growth rates were higher when mothers were diagnosed with fibroids vs not diagnosed (8.0% increased growth; 95% CI, −1.2% to 18.0%).Conclusions and RelevanceIn this prospective cohort study, results supported maternal history of fibroids as a risk factor for incident fibroids, especially when mothers were diagnosed at a younger age. Maternal history was also associated with increased fibroid growth. Asking patients about their family history of fibroids could encourage patient self-advocacy and inform care.
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Ford, Kathleen, Linda Weglicki, Trace Kershaw, Cheryl Schram, Paulette J. Hoyer, and Mary L. Jacobson. "Effects of a Prenatal Care Intervention for Adolescent Mothers on Birth Weight, Repeat Pregnancy, and Educational Outcomes at One Year Postpartum." Journal of Perinatal Education 11, no. 1 (January 2002): 35–38. http://dx.doi.org/10.1624/105812402x88588.
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About one-third of adolescent mothers receive inadequate prenatal care, and babies born to young mothers are more likely to be of low birth weight. The objective of this study is to evaluate a peer-centered prenatal care program for adolescent mothers. Pregnant adolescents were randomly assigned to an experimental or control group in a mastery modeling peer-support intervention designed to improve long- and short-term perinatal outcomes. A sample of 282 urban pregnant adolescents (94% African American, 4% Caucasian, 2% other) participated in the study. Participants were recruited from five clinics located mainly in Detroit, Michigan. Participants in the experimental group received care in a small group setting and learned to perform critical measurements with a peer partner during prenatal visits. Participants in the control group received individual prenatal care in the same clinics. Outcome measures included birth weight, years of schooling completed at one year postpartum, planned and unplanned pregnancy at one year postpartum, and employment and school attendance at one year postpartum. Mothers in the experimental group had a lower rate of low birth weight (6.6% vs. 12.5%, p=0.08). The rate of unplanned pregnancy was also lower for adolescents in the experimental group (13.4% vs. 15.9%), although this difference was not statistically significant. Adolescents who participated in the intervention were more likely to have continued their education during the pregnancy and the postpartum year. The mastery modeling, peer-centered, prenatal care program produced some positive pregnancy outcomes for adolescent mothers.
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Johnson, Leonard B., Sajjad Saeed, Joan Pawlak, Odette Manzor, and Louis D. Saravolatz. "Clinical and Laboratory Features of Community-Associated Methicillin-ResistantStaphylococcus aureus:Is It Really New?" Infection Control & Hospital Epidemiology 27, no. 2 (March 2006): 133–38. http://dx.doi.org/10.1086/500621.
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Objective.To review the epidemiologic and molecular characteristics of community-associated methicillin-resistantStaphylococcus aureus(CA-MRSA) in Detroit, Michigan, to assess the risk factors for infection and the response to therapy.Design.Prospective clinical and laboratory study of 2003-2004 CA-MRSA isolates. Molecular features were compared with CA-MRSA isolates from 1980.Setting.A 600-bed urban academic medical center.Patients.Twenty-three patients with CA-MRSA infections from 2003-2004 were evaluated. In addition, laboratory analysis was performed on 13 CA-MRSA isolates from 1980.Main Outcome Measures.Laboratory analysis of isolates included antimicrobial susceptibility testing, pulsed-field genotyping, testing for Panton-Valentine leukocidin (PVL) genes, and staphylococcal cassette chromosomemectyping.Results.Patients were predominantly young African American males and presented with skin and soft-tissue infections. All isolates were resistant to erythromycin and highly susceptible to other agents. Patients were generally treated successfully with combination incision and drainage and systemic antibiotics. Among the 23 isolates, 20 (87%) were the same strain. This strain carried the staphylococcal cassette chromosomemectype IV and PVL genes and is genetically identical to USA 300. Thirteen isolates of patients from our community who presented with CA-MRSA infections in 1980 represented a single clone that is unique compared with the 2003-2004 isolates. This strain carried staphylococcal cassette chromosomemectype IVA but did not carry the PVL genes.Conclusions.In our community, CA-MRSA is largely due to a single clone with a type IVmecgene and PVL gene. The type IV staphylococcal cassette chromosomemectype can be demonstrated in CA-MRSA isolates from a remote period, suggesting that earlier outbreaks were not related to healthcare exposure.
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Janevic, Mary, Rebecca Lindsay, Robin Brewer, Yolanda Hill-Ashford, Rebeca Guzman, Sheria Robinson-Lane, Afton Hassett, and Susan Murphy. "ACCEPTABILITY OF PODCASTS TO ENHANCE WELLNESS SKILLS AMONG OLDER ADULTS IN AN UNDERSERVED COMMUNITY." Innovation in Aging 7, Supplement_1 (December 1, 2023): 871–72. http://dx.doi.org/10.1093/geroni/igad104.2806.
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Abstract Podcasts convey information in an accessible, engaging, and memorable way, yet are seldom incorporated into behavioral interventions for older adults. We developed a podcast series as a component of the RESET intervention (Re-Engaging in Self-care, Enjoying Today), the subject of an ongoing NIH-funded randomized controlled trial in Detroit, Michigan. In RESET, community health workers teach self-management and resilience-building skills to small groups of primarily African American older adults, to address challenges to well-being and functioning caused by the COVID-19 pandemic. Participants listen to six podcast episodes, accessible by website, app, or IVR/dial-in, which feature an older-adult host from the community interviewing other community members and topic experts. Each episode is then discussed in the corresponding intervention session. The goal of the current study was to evaluate the first three podcast episodes (Power of Positivity, Eating for Well-being, and Stability in Strength) in a convenience sample of 8 older adults and agency staff from our trial’s Community Advisory Board. Using 5-point Likert scales, all respondents strongly agreed or agreed that the episodes were enjoyable, relevant, and effectively taught key wellness skills. Podcast strengths identified by respondents included: warm interactions between host and guests, motivational tone, and compelling personal stories. Areas for improvement included the need to represent additional perspectives. These data suggest that podcasts are an acceptable way to provide health information to older adults. The ongoing RESET trial will allow us to determine the extent to which podcasts can help bring about behavior change and functional improvement.
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Harmon, Quaker E., David M. Umbach, and Donna D. Baird. "Use of Estrogen-Containing Contraception Is Associated With Increased Concentrations of 25-Hydroxy Vitamin D." Journal of Clinical Endocrinology & Metabolism 101, no. 9 (August 4, 2016): 3370–77. http://dx.doi.org/10.1210/jc.2016-1658.
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Abstract Context: Small studies suggest exogenous estrogen may improve vitamin D status, but the etiology is unclear because women who use hormones may make lifestyle choices that differentially affect vitamin D status. Objective: Our objective was to investigate the association between use of hormonal contraception and 25-hydroxy-vitamin D (25(OH)D). Design: We used linear regression modeling of cross-sectional data to estimate percent change in season-adjusted serum 25(OH)D with estrogen use after adjustment for other factors. Setting: At the enrollment clinic visit (2010–2012) into a cohort study of uterine fibroids, each subject provided a blood sample, had anthropomorphic variables and skin reflectance measured, and answered questionnaires on demographics, dietary and supplement intake, contraceptive use, reproductive and medical history, and behaviors. Participants: A total of 1662 African American women, community volunteers, 23–34 years old, living in the Detroit, Michigan, area were included. Interventions: None. Main Outcomes and Measures: Serum 25(OH)D was measured. Results: Serum 25(OH)D concentrations were low (70% <20 ng/ml). Current use of an estrogen-containing contraceptive was associated with a 20% (95% confidence interval: 14–27) increase in 25(OH)D after adjustment. There was no increase in 25(OH)D among participants who had used estrogen in the past, but were not current users, indicating that results were unlikely to be due to unmeasured confounding by factors related to contraceptive choice. Conclusions: The increase in 25(OH)D with use of estrogen-containing contraceptives raise mechanistic questions regarding the biological pathways involved, and highlights the need for studies that examine possible endogenous estrogen effects on vitamin D.
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Berti, Andrew David, Pramodini Kale-Pradhan, Christopher Giuliano, Bianca Aprilliano, Christopher R. Miller, Basma Alyashae, Ashish Bhargava, and Leonard B. Johnson. "556. Evaluation of Hydroxychloroquine-based Combination Therapies for the Treatment of COVID-19." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S343. http://dx.doi.org/10.1093/ofid/ofaa439.750.
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Abstract Background During the early COVID-19 pandemic a large number of investigational agents were utilized due to lack of therapeutic options. We evaluate the utility of commonly-used investigational agents combined with hydroxychloroquine (HCQ). Methods This multicenter observational cohort study included patients admitted with COVID-19 between March - May 2020 in Detroit, Michigan who received at least 2 doses of HCQ. Our primary outcome was the change in Sequential Organ Failure Assessment (SOFA) score from presentation to day 5 of HCQ therapy with a secondary outcome of in-hospital mortality. Data collected included demographics, Charlson Comorbidity index (CCI), daily SOFA score, laboratory data and COVID-directed therapies. Multiple linear regressions were performed to control for potential confounders between different therapies and change in SOFA score. Results Three hundred thirty-five patients receiving HCQ were included. Patients were 62 ± 14.8 years of age, male (54%) and African-American (82%) with a mean CCI of 1.7 ± 1.9. In our cohort, 32% were admitted to the intensive care unit and 35% expired. Therapies received by more than 20% of patients in addition to HCQ included azithromycin (80%), zinc (76%) and vitamin D (29%). In our unadjusted analysis, a significant improvement in SOFA score was observed with zinc (0.76) while no significant change was observed with azithromycin (-0.46) or vitamin D (0.05). However, there was no significant change in SOFA score after adjusting for confounders for azithromycin, zinc and vitamin D. No difference in mortality was observed between the groups. Conclusion Overall, no benefit in end-organ damage or mortality was observed with the addition of azithromycin, zinc or vitamin D to HCQ. Further studies are needed to confirm this observation. Disclosures All Authors: No reported disclosures
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Beebe-Dimmer, Jennifer Lynn, David Finlay, Julie J. Ruterbusch, Tara Baird, Michael S. Simon, Judith Abrams, and Felicity W. K. Harper. "The impact of high intensity interval training on functional performance, body composition and quality of life in a diverse group of cancer survivors." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 12057. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.12057.
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12057 Background: Given the well-documented benefits of regular exercise to cancer survivors, in 2012, an expert panel assembled by the American Cancer Society recommended that patients engage in at least 150 minutes per week of moderate-to-vigorous physical activity. However, few patients meet this goal. We have also observed racial differences in reported participation in regular exercise among cancer survivors living in Metropolitan Detroit, Michigan. Methods: The CAPABLE study is a 12- week pilot exercise intervention that introduces cancer survivors to the sport of CrossFit. We evaluated the impact of this unique, high-intensity interval training method on functional performance, cardiovascular endurance, body composition and health-related quality of life (HRQOL) as measured by the Functional Assessment of Cancer Therapy (FACT) instrument. All measures were summarized at baseline and program exit. Paired signed rank tests were used to assess change in each of these measures over time. Results: Of the 48 participants enrolled in the pilot, 37 (77%) were considered adherent to the program (attending at least 75% of sessions over the 12-week period). The mean age of participants was 58.5 years, 73% identified as African American and the majority of participants were breast cancer survivors (N = 20). The mean body mass index (BMI) at baseline was 32.8 kg/m2 decreasing to a mean of 31.7 kg/m2 at exit (BMI change -1.1, p < 0.001). Similar changes were observed in % body fat measured by bioelectrical impedance. There were significant improvements in all measures of functional performance over 12-weeks (all p < 0.001). We observed significant and meaningful improvements in reported HRQOL measured by the FACT survey, overall (FACTG total change +9.5 (p < 0.001)) and in each one of the individual domains (physical, social, emotional, and functional well-being). Conclusions: We observed significant improvements in performance, body composition and quality of life among cancer survivors introduced to a high-intensity interval training program. Understanding and eliminating barriers to programs like these are critical to improving outcomes and reducing cancer health disparities. Clinical trial information: NCT03750981 .
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Franco-Palacios, Domingo J., Mei Lu, Mary Grace Fitzmaurice, and George Alangaden. "Outcomes of COVID-19 in a Large Cohort of Lung Transplant Recipients: A Retrospective Study." Transplantology 3, no. 3 (July 22, 2022): 257–66. http://dx.doi.org/10.3390/transplantology3030026.
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Background: Early reports of COVID-19 in lung transplant recipients (LTRs) showed high hospitalization and mortality rates. However, the outcomes of COVID-19 in LTRs since the advent of newer therapies and vaccines have been poorly defined. Methods: We evaluated the risks for SARS-CoV-2-related hospitalization and mortality in a cohort of LTRs at the Henry Ford Lung Transplant Program in Detroit, Michigan during the study period March 2020–March 2022. Univariate logistic regression, followed by multivariable modeling were performed to estimate the odds ratio (OR) with 95% confident intervals (CI). Results: Sixty-four laboratory-confirmed SARS-CoV-2 infections were identified in 59 patients. For the primary analysis of the hospitalization and mortality risks, we included these 59 patients with symptomatic COVID-19. SARS-CoV-2 infections were confirmed with real-time polymerase chain reaction (RT-PCR) from a nasopharynx swab. The mean age (±STD) was 61 (±12), 63% were males, 27% were African Americans, and the time from lung transplant to COVID-19 was 5.5 (±4.8) years. Thirty-four (57.6%) patients were hospitalized, and the inpatient mortality rate was 24% (8/34). A multivariable analysis showed that patients with a higher baseline forced expiratory volume (FEV1) were less likely to be hospitalized (OR = 0.91 and 95% CI 0.87–0.98, p = 0.02). Seventy-five percent (75%; 6/8) of patients on invasive mechanical ventilation died, compared with only 8% mortality rate in those without mechanical ventilation (OR = 36.0 and 95% CI 4.2–310.4, p < 0.01). Although a trend toward a higher risk of death was observed in those infected during the Alpha (p = 0.17) and Delta (p = 0.22) waves, no significant risk was detected after adjusting for other covariates. Five LTRs were diagnosed with COVID-19 twice. Thirty of the sixty-four COVID-19 cases (46.8%) occurred in LTRs that had received at least two doses of any of the available mRNA vaccines at a median of 123 days (IQR 98–164 days) after vaccination. Twelve of the thirty (40%) were hospitalized, and four patients (33%) died during their hospitalizations. Conclusions: In our LTR population, the hospitalization and mortality rates associated with COVID-19 were high despite the increased use of new therapies. Vaccine-breakthrough infections were common and were associated with poor outcomes. Studies are needed to determine optimal prevention and therapeutic strategies to improve COVID-19 outcomes in LTRs.
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Beebe-Dimmer, Jennifer, Karynsa Cetin, Cecilia Yee, Scott Stryker, Lois Lamerato, Kendra L. Schwartz, and Vahakn B. Shahinian. "Castration resistance and risk of bone metastases among men with nonmetastatic prostate cancer on androgen-deprivation therapy: A population-based cohort study from the Henry Ford Health System (HFHS) in Detroit, Michigan." Journal of Clinical Oncology 31, no. 6_suppl (February 20, 2013): 163. http://dx.doi.org/10.1200/jco.2013.31.6_suppl.163.
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163 Background: Androgen deprivation therapy (ADT) is the cornerstone treatment of metastatic prostate cancer (PC), but is frequently used in the non-metastatic (M0) setting. After a variable period of hormone sensitivity, most patients develop castration-resistant prostate cancer (CRPC). These men are at increased risk of developing bone metastases (BM), particularly in those with higher serum PSA and shorter PSA doubling time (DT). The epidemiology and natural history of M0 CRPC has not been well studied in a population-based setting. Methods: Using HFHS patient records, a retrospective cohort study was conducted among 723 men diagnosed with M0 PC between 1996 and 2005 (with follow-up [f/u] for outcomes through 12/31/2008), who received ADT, including 613 men with serial PSA measurements for CRPC determination. CRPC was defined as 2 consecutive PSA rises, with “high-risk” defined as PSA ≥ 8 ng/mL or PSA DT ≤ 10 months (mos) after the development of CRPC. The risk of subsequent BM was estimated for the overall cohort and for the CRPC and non-CRPC subsets. Results: The median age among patients in the study was 73 years, 48% were African American, and median f/u time after ADT initiation was 58 mos. 15% (n=93) met criteria for CRPC during f/u (with a median of 23 mos between ADT initiation and establishment of CRPC), with the majority considered being at high risk (n=81). Among the entire cohort, 74 men (10%) developed BM during f/u. The rate of BM was 4 times higher among CRPC patients compared to non-CRPC patients (p<0.001), with a median of 6 mos between CRPC and subsequent BM. No racial difference was observed with either the incidence of CRPC or BM. Conclusions: The HFHS resource allowed for investigation of disease progression in a racially diverse population. A substantial proportion of M0 PC patients on ADT will eventually develop CRPC and once castration-resistant, risk of BM is high.
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Hutchings, Hollis, Qiong Zhang, Sue Grady, Lainie Mabe, and Ikenna C. Okereke. "Gentrification and Air Quality in a Large Urban County in the United States." International Journal of Environmental Research and Public Health 20, no. 6 (March 8, 2023): 4762. http://dx.doi.org/10.3390/ijerph20064762.
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Introduction: Increases in industrialization and manufacturing have led to worsening pollution in some components of air quality. In addition, gentrification is occurring in large cities throughout the world. As these socioeconomic and demographic changes occur, there have been no studies examining the association of gentrification with air quality. To investigate this association, we studied the trends of gentrification, changes in racial distribution and changes in air quality in each zip code of a large urban county over a 40-year period. Methods: We conducted a retrospective longitudinal study over 40 years in Wayne County, Michigan using socioeconomic and demographic data from the National Historical Geographic Information System (NHGIS) and air quality data from the United States Environmental Protection Agency (EPA). To assess gentrification, longitudinal analyses were performed to examine median household income, percentage with a college education, median housing value, median gross rent and employment level. The racial distribution was evaluated in each zip code during the time period. Gentrification was studied in relation to air quality using nonparametric 2-sample Wilcon–Mann–Whitney tests and Binomial Generalized Linear Regression models. Results: Although air quality improved overall over the 40-year period, there was a lesser rate of improvement in gentrified areas. Furthermore, gentrification was strongly associated with racial distribution. The most substantial gentrification occurred from 2010 to 2020, in which a specific cluster of adjacent zip codes in downtown Detroit experienced intense gentrification and a drop in the percentage of African-American residents. Conclusions: Gentrified areas seem to have a less pronounced improvement in air quality over time. This reduction in air quality improvement is likely associated with demolitions and the construction of new buildings, such as sporting arenas and accompanying traffic density. Gentrification is also strongly associated with an increase in non-minority residents in an area. Although previous definitions of gentrification in the literature have not included racial distribution, we suggest that future definitions should include this metric given the strong association. Minority residents who are displaced as a result of gentrification do not experience the improvements in housing quality, accessibility to healthy foods and other associations of gentrification.
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Saadat, Nadia, Fernando Aguate, Alexandra Nowak, Suzanne Hyer, Todd Lydic, Gustavo de los Campos, Vasantha Padmanabhan, Dawn Misra, and Carmen Giurgescu. "460 Changes in Lipid Profiles with Progression of Pregnancy in Black Women." Journal of Clinical and Translational Science 8, s1 (April 2024): 135–36. http://dx.doi.org/10.1017/cts.2024.391.
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OBJECTIVES/GOALS: Pregnant African American (Black women) have higher rates of adverse pregnancy outcomes compared to other races and routine monitoring of lipid levels is not currently in practice in prenatal care. We hypothesized that lipid profiles would show variation across pregnancy indicative of specific requirements during gestation and fetal development. METHODS/STUDY POPULATION: We used an untargeted lipidome analysis approach to investigate lipid metabolism with the progression of pregnancy. Pregnant Black women were recruited at prenatal clinics in Midwest (Metro Detroit, Michigan and Columbus, Ohio), women under 18 or above 45 years of age were not enrolled due to metabolic changes associated with these age groups. Women signed the consent forms and plasma samples were collected at 8-18 weeks at (T1), 22-29 weeks (T2) and 30-36 weeks (T3) of pregnancy. Samples from sixty-three women (mean age 27.41 ± 5.61 years) who had term birth (completed 37 weeks of pregnancy) were subjected to “shotgun” Orbitrap high resolution/ accurate mass spectrometry. Mixed-effects models were used to quantify systematic changes in relative lipid abundances over time using R lme4 and ggplot2 packages. RESULTS/ANTICIPATED RESULTS: Total lipids and some major lipid classes showed a significant increase with the progression of pregnancy. Phospholipids and glycerolipids exhibited a gradual increase throughout pregnancy, while sphingolipids and total sterol lipids displayed a more pronounced increase at the T3 timepoint. Acylcarnitines, hydroxy acylcarnitines and Lyso phospholipids levels significantly decrease from T1 to T3. One of the interesting finding was that non-esterified fatty acids decreased from T1 to T2 and increased again from T2 to T3, suggesting a possible role for these lipids during the later stages of pregnancy. The fatty acids showing this trend included key fatty acids- Linoleic Acid, Arachidonic Acid, Alpha-linolenic acid, Eicosapentaenoic acid, Docosapentaenoic acid, Docosahexaenoic acid. DISCUSSION/SIGNIFICANCE: Mapping lipid trends during pregnancy could lend support to a precision health approach to reduce perinatal health disparities among pregnant Black women. The findings from this study will be used to identify biomarkers and study associations with social and environmental factors responsible for adverse perinatal outcome in pregnant Black women.
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Cassidy-Bushrow, Andrea E., Ganesa Wegienka, Suzanne Havstad, Albert M. Levin, Susan V. Lynch, Dennis R. Ownby, Andrew G. Rundle, Kimberley J. Woodcroft, Edward M. Zoratti, and Christine Cole Johnson. "Race-Specific Association of Caesarean-Section Delivery with Body Size at Age 2 Years." Ethnicity & Disease 26, no. 1 (January 21, 2016): 61. http://dx.doi.org/10.18865/ed.26.1.61.
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<p><span style="font-family: Times New Roman;"><strong><span style="font-size: medium;">Objectives:</span></strong><span style="font-size: medium;"> African American children are at higher risk of obesity than White children and African American women are more likely to undergo caesarean-section (CS) delivery than White women.</span><span style="font-size: medium;"> </span><span style="font-size: medium;">CS is associated with childhood obesity, however, little is known whether this relationship varies by race.</span><span style="font-size: medium;">We examined if the association of CS with obesity at age 2 years varied by race.</span><span style="font-size: medium;"> </span></span></p><p><span style="font-family: Times New Roman;"><strong><span style="font-size: medium;">Design: </span></strong><span style="font-size: medium;">Longitudinal birth cohort.</span><strong></strong></span></p><p><span style="font-family: Times New Roman;"><strong><span style="font-size: medium;">Setting:</span></strong><span style="font-size: medium;"> Birth cohort conducted in a health care system in metropolitan Detroit, Michigan with follow-up at age 2 years.</span></span></p><p><span style="font-family: Times New Roman;"><strong><span style="font-size: medium;">Participants:</span></strong><span style="font-size: medium;"> 639 birth cohort participants; 367 children (57.4%) were born to African American mothers and 230 (36.0%) children were born via CS.</span></span></p><p><span style="font-family: Times New Roman;"><strong><span style="font-size: medium;">Main Outcome Measure: </span></strong><span style="font-size: medium;">Obesity defined as body mass index </span><strong></strong><span style="font-size: medium;">≥95</span><sup><span style="font-size: small;">th</span></sup><span style="font-size: medium;"> percentile at age 2 years.</span></span></p><p><span style="font-family: Times New Roman;"><strong><span style="font-size: medium;">Results:</span></strong><span style="font-size: medium;"> Slightly more children of African American (n=37; 10.1%) than non-African American mothers (n=18; 6.6%) were obese (</span><span style="font-size: medium;">P</span><span style="font-size: medium;">=.12). There was evidence of effect modification between race and delivery mode with obesity at age 2 years (interaction<em> </em></span><span style="font-size: medium;">P</span><span style="font-size: medium;">=.020).</span><span style="font-size: medium;"> </span><span style="font-size: medium;">In children of African-American mothers, CS compared to vaginal birth was associated with a significantly higher odds of obesity (aOR=2.35 (95% CI: 1.16, 4.77), </span><em><span style="font-size: medium;">P</span></em><span style="font-size: medium;">=.017).</span><span style="font-size: medium;"> </span><span style="font-size: medium;">In contrast, delivery mode was not associated with obesity at age 2 years in children of non-African-American mothers (aOR=.47 (95% CI: .13, 1.71), </span><span style="font-size: medium;">P</span><span style="font-size: medium;">=.25).</span><span style="font-size: medium;"> </span></span></p><p><span style="font-family: Times New Roman;"><strong><span style="font-size: medium;">Conclusions:</span></strong><span style="font-size: medium;"> There is evidence for a race-specific effect of CS on obesity at age 2 years; potential underlying mechanisms may be racial differences in the developing gut microbiome or in epigenetic programming.</span><span style="font-size: medium;"> </span><span style="font-size: medium;">Future research is needed to determine if this racial difference persists into later childhood. <em>Ethn Dis.</em> 2016;26(1):61-68; doi:10.18865/ed.26.1.61<br /></span></span></p><p> </p>