European Ethnic Backgrounds Research Articles

The Clinical Relevance of Diabetes Distress versus Major Depression in Type 2 Diabetes: A Latent Class Analysis from the Fremantle Diabetes Study Phase II.

The nosological position and clinical relevance of the concept of diabetes distress (DD) are uncertain. The aim of this study was to use latent class analysis (LCA) to categorise classes of people with type 2 diabetes and to compare their characteristics. Data from 662 participants in the longitudinal observational Fremantle Diabetes Study Phase II were analysed. LCA identified latent subgroups based on individual responses to the Patient Health Questionnaire-9, the Generalised Anxiety Disorder Scale, and the 5-item Problem Areas in Diabetes Scale. Four classes were identified: Class 1 (65.7%, no symptoms), Class 2 (14.0%, DD), Class 3 (12.6%, subsyndromal depression (SSD)), and Class 4 (7.6%, major depression (MD)). Multinomial regression analysis with Class 1 as reference showed significant associations between the DD class and Southern European and Asian ethnic background, HbA1c, and BMI. The SSD class was significantly associated with HbA1c, cerebrovascular disease, and coronary heart disease (CHD). The MD class had significant associations with age (inversely), Southern European ethnic background, HbA1c, BMI, and CHD. In conclusion, LCA identified a pure DD group comprising 14.0% of participants. The only variable uniquely associated with the DD class was Asian ethnic background. Although identification of DD may have some utility in assessing the psychological wellbeing of individuals with type 2 diabetes, it adds little to the assessment of depressive disorder and its significant clinical sequalae.

Unraveling Chinese talk about emotion.

Research in cross-cultural psychiatry has asserted that Chinese people have a higher tendency to report somatic symptoms of their psychological distress than people with a European ethnic background. However, recent studies have reached inconsistent conclusions and most have confounded language use with culture in their study designs. Focusing on the varying degrees of orientation to Chinese culture, the present study examined the words freely listed by two Chinese groups of university students (mainland Chinese and Hong Kong Chinese) when describing their illness experience. Words were categorized into somatic, emotion, and somatic-emotion clusters. Overall, the Chinese participants were more willing to talk about their emotions than their somatic symptoms in an anonymous survey. The enculturated mainland Chinese participants-who reported greater Chinese cultural identity-used significantly more emotion words but fewer somatic-emotion words than the Hong Kong Chinese participants. No group differences were found in somatic words. In contrast to previous findings, the current study failed to find support for the relationship between orientation to Chinese culture and somatic symptom reporting when controlling for language use.

Identifying Health-Related Conditions Associated with Tinnitus in Young Adults.

The present study investigated the epidemic of tinnitus in college-aged young adults. Our first objective was to identify health conditions associated with tinnitus in young adults. The second objective was to evaluate the predictive utility of some known risk factors. A cross-sectional design was used to investigate the prevalence and risk factors for tinnitus. A questionnaire was distributed, reaching out to a large college-aged population. A total of 2258 young adults aged 18-30 years were recruited from April 2021 to February 2022. A questionnaire was administered to investigate the epidemiology of tinnitus in a population of college-aged young adults. About 17.7% of young adults reported bothersome tinnitus perception lasting for ≥5 min in the last 12 months. The prevalence of chronic tinnitus (bothersome tinnitus for ≥1 year) and acute tinnitus (bothersome tinnitus for <1 year) was 10.6% and 7.1%, respectively. About 19% of the study sample reported at least one health condition. Individuals reporting head injury, hypertension, heart disease, scarlet fever, and malaria showed significantly higher odds of reporting chronic tinnitus. Meningitis and self-reported hearing loss showed significant associations with bothersome tinnitus. The prevalence of chronic tinnitus was significantly higher in males reporting high noise exposure, a positive history of reoccurring ear infections, European ethnic background, and a positive health history. Risk modeling showed that noise exposure was the most important risk factor for chronic tinnitus, followed by sex, reoccurring ear infections, and a history of any health condition. A positive history of COVID-19 and self-reported severity showed no association with tinnitus. Individuals reporting reoccurring ear infections showed a significantly higher prevalence of COVID-19. While young adults with health conditions are at a higher risk of reporting tinnitus, the predictive utility of a positive health history remains relatively low, possibly due to weak associations between health conditions and tinnitus. Noise, male sex, reoccurring ear infections, European ethnicity, and a positive health history revealed higher odds of reporting chronic tinnitus than their counterparts. These risk factors collectively explained about 16% variability in chronic tinnitus, which highlights the need for identifying other risk factors for chronic tinnitus in young adults.

Ethnic diversity and cord blood banking: satisfying the unmet need

Background aimsIn this study, the authors sought to assess whether cord blood units (CBUs) collected from donors of non-European ethnic backgrounds are utilized for umbilical cord blood transplantation (UCBT) at a different rate than those of European ethnic backgrounds. The authors also examined potential methods of enriching these under-represented ethnic backgrounds in cord blood bank (CBB) inventories without increasing financial overheads and without compromising total inventory utilization or post-transplant outcomes. MethodsData from N = 6506 searchable or shipped Anthony Nolan Cell Therapy Centre grafts were used in this study. Banked grafts were graded from A+ to D based on total nucleated cell and CD34+ cell content. Utilizations of each grade group were further stratified by graft ethnic background. The Mantel–Cox log-rank test was performed in conjunction with Kaplan–Meier survival analysis to compare utilization rates and post-transplant outcomes. For shipped grafts, levels of HLA matching at HLA-A, HLA-B and HLA-DR loci were also analyzed by graft ethnic background and grade using data from the Eurocord/EBMT registry. ResultsOverall utilization of non-European grafts did not significantly differ from that of European grafts (2.5% versus 2.2%, P = 0.23). However, significant differences were found when stratifying utilization rates by cell content. The probability of non-European D grade grafts being utilized was 3-fold higher than that of European D grade grafts (1.1% versus 0.4%, P = 0.03) and comparable to that of European C grade grafts (1.1% versus 0.9%, P = 0.90). No significant differences were found between D and C grade grafts in terms of overall survival (OS) (P = 0.12), in part due to a disproportionate utilization of D grade grafts for pediatric UCBT (74% versus 39%, age difference P < 0.001). Furthermore, non-European graft shipments were 4-fold less likely to be a 6/6 HLA match to their recipients relative to European graft shipments (7% versus 29%). ConclusionsThe authors have identified a niche for CBUs of low cell content collected from donors of non-European ethnic backgrounds that has been overlooked by previous studies. Banking of these CBUs for pediatric UCBT instead of CBUs from European donors containing modestly higher cell content is an ethical approach to increasing the ethnic diversity of CBB inventory—and, consequently, the probability of non-European recipients finding a 6/6 HLA-matched graft—without compromising post-transplant OS or overall rate of inventory utilization.

The prevalence of monogenic diabetes in Australia: the Fremantle Diabetes Study Phase II.

To determine the prevalence of monogenic diabetes in an Australian community. Longitudinal observational study of a cohort recruited between 2008 and 2011. Urban population of 157 000 people (Fremantle, Western Australia). 1668 (of 4639 people with diabetes) who consented to participation (36.0% participation). Prevalence of maturity-onset diabetes of the young (MODY) and permanent neonatal diabetes in patients under 35 years of age, from European and non-European ethnic backgrounds, who were at risk of MODY according to United Kingdom risk prediction models, and who were then genotyped for relevant mutations. Twelve of 148 young participants with European ethnic backgrounds (8%) were identified by the risk prediction model as likely to have MODY; four had a glucokinase gene mutation. Thirteen of 45 with non-European ethnic backgrounds (28%) were identified as likely to have MODY, but none had a relevant mutation (DNA unavailable for one patient). Two patients with European ethnic backgrounds (one likely to have MODY) had neonatal diabetes. The estimated MODY prevalence among participants with diagnosed diabetes was 0.24% (95% confidence interval [CI], 0.08-0.66%), an overall population prevalence of 89 cases per million; the prevalence of permanent neonatal diabetes was 0.12% (95% CI, 0.02-0.48%) and the population prevalence 45 cases per million. One in 280 Australians diagnosed with diabetes have a monogenic form; most are of European ethnicity. Diagnosing MODY and neonatal diabetes is important because their management (including family screening) and prognosis can differ significantly from those for types 1 and 2 diabetes.

Higher bone resorption excretion in South Asian women vs. White Caucasians and increased bone loss with higher seasonal cycling of vitamin D: Results from the D-FINES cohort study

Few data exist on bone turnover in South Asian women and it is not well elucidated as to whether Western dwelling South Asian women have different bone resorption levels to that of women from European ethnic backgrounds. This study assessed bone resorption levels in UK dwelling South Asian and Caucasian women as well as evaluating whether seasonal variation in 25-hydroxyvitamin D [25(OH)D] is associated with bone resorption in either ethnic group.Data for seasonal measures of urinary N-telopeptide of collagen (uNTX) and serum 25(OH)D were analysed from n=373 women (four groups; South Asian postmenopausal n=44, South Asian premenopausal n=50, Caucasian postmenopausal n=144, Caucasian premenopausal n=135) (mean (±SD) age 48 (14) years; age range 18–79years) who participated in the longitudinal D-FINES (Diet, Food Intake, Nutrition and Exposure to the Sun in Southern England) cohort study (2006–2007).A mixed between-within subjects ANOVA (n=192) showed a between subjects effect of the four groups (P<0.001) on uNTX concentration, but no significant main effect of season (P=0.163). Bonferroni adjusted Post hoc tests (P≤0.008) suggested that there was no significant difference between the postmenopausal Asian and premenopausal Asian groups. Season specific age-matched-pairs analyses showed that in winter (P=0.04) and spring (P=0.007), premenopausal Asian women had a 16 to 20nmolBCE/mmol Cr higher uNTX than premenopausal Caucasian women.The (amplitude/mesor) ratio (i.e. seasonal change) for 25(OH)D was predictive of uNTX, with estimate (SD)=0.213 (0.015) and 95% CI (0.182, 0.245; P<0.001) in a non-linear mixed model (n=154). This showed that individuals with a higher seasonal change in 25(OH)D, adjusted for overall 25(OH)D concentration, showed increased levels of uNTX. Although the effect size was smaller than for the amplitude/mesor ratio, the mesor for 25(OH)D concentration was also predictive of uNTX, with estimate (SD)=−0.035 (0.004), and 95% CI (−0.043, −0.028; P<0.001).This study demonstrates higher levels of uNTX in premenopausal South Asian women than would be expected for their age, being greater than same-age Caucasian women, and similar to postmenopausal Asian women. This highlights potentially higher than expected bone resorption levels in premenopausal South Asian women which, if not offset by concurrent increased bone formation, may have future clinical and public health implications which warrant further investigation. Individuals with a larger seasonal change in 25(OH)D concentration showed an increased bone resorption, an association which was larger than that of the 25(OH)D yearly average, suggesting it may be as important clinically to ensure a stable and steady 25(OH)D concentration, as well as one that is high enough to be optimal for bone health.

CLINICAL PREDICTORS OF FAMILIAL DEPRESSION IN HAN CHINESE WOMEN

BackgroundA number of clinical features potentially reflect an individual's familial vulnerability to major depression (MD), including early age at onset, recurrence, impairment, episode duration, and the number and pattern of depressive symptoms. However, these results are drawn from studies that have exclusively examined individuals from a European ethnic background. We investigated which clinical features of depressive illness index familial vulnerability in Han Chinese females with MD.MethodsWe used lifetime MD and associated clinical features assessed at personal interview in 1,970 Han Chinese women with DSM-IV MD between 30–60 years of age. Odds Ratios were calculated by logistic regression.ResultsIndividuals with a high familial risk for MD are characterized by severe episodes of MD without known precipitants (such as stress life events) and are less likely to feel irritable/angry or anxious/nervous.ConclusionsThe association between family history of MD and the lack of a precipitating stressor, traditionally a characteristic of endogenous or biological depression, may reflect the association seen in other samples between recurrent MD and a positive family history. The symptomatic associations we have seen may reflect a familial predisposition to other dimensions of psychopathology, such as externalizing disorders or anxiety states. Depression and Anxiety 0:1–6, 2011. © 2011 Wiley-Liss, Inc.

Comparative risk of microalbuminuria and proteinuria in UK residents of south Asian and white European ethnic background with type 2 diabetes: a report from UKADS

Objective:This study investigated and compared the prevalence of microalbuminuria and overt proteinuria and their determinants in a cohort of UK resident patients of white European or south Asian ethnicity with type 2 diabetes mellitus.Research design and methods:A total of 1978 patients, comprising 1486 of south Asian and 492 of white European ethnicity, in 25 general practices in Coventry and Birmingham inner city areas in England were studied in a cross-sectional study. Demographic and risk factor data were collected and presence of microalbuminuria and overt proteinuria assessed.Trial registration number:ISRCTN 38297969.Main outcome measures:Prevalences of microalbuminuria and overt proteinuria.Results:Urinary albumin:creatinine measurements were available for 1852 (94%) patients. The south Asian group had a lower prevalence of microalbuminuria, 19% vs. 23% and a higher prevalence of overt proteinuria, 8% vs. 3%, χ2 = 15.85, 2df, P = 0.0004. In multiple logistic regression models, adjusted for confounding factors, significantly increased risk for the south Asian vs. white European patients for overt proteinuria was shown; OR (95% CI) 2.17 (1.05, 4.49), P = 0.0365. For microalbuminuria, an interaction effect for ethnicity and duration of diabetes suggested that risk for south Asian patients was lower in early years following diagnosis; OR for SA vs. WH at durations 0 and 1 year were 0.56 (0.37, 0.86) and 0.59 (0.39, 0.89) respectively. After 20 years’ duration, OR = 1.40 (0.63, 3.08).Limitations:Comparability of ethnicity defined groups; statistical methods controlled for differences between groups, but residual confounding may remain. Analyses are based on a single measure of albumin:creatinine ratio.Conclusions:There were significant differences between ethnicity groups in risk factor profiles and microalbuminuria and overt proteinuria outcomes. Whilst south Asian patients had no excess risk of microalbuminuria, the risk of overt proteinuria was elevated significantly, which might be explained by faster progression of renal dysfunction in patients of south Asian ethnicity.

An Australian cardiovascular risk equation for type 2 diabetes: the Fremantle Diabetes Study

There is no valid cardiovascular disease (CVD) risk prediction equation for Australians with diabetes. The aim of this study is to develop and validate a multivariate risk function for 5-year cardiovascular risk prediction in Australian type 2 diabetes patients. The Fremantle Diabetes Study is a community-based longitudinal observational study. A total of 1240 type 2 diabetic patients (95.8% of the baseline cohort) with all required risk factor data were followed from baseline (1993-1996) for 5 years or until they experienced a cardiovascular event or died, whichever came first. CVD during follow up was defined as hospitalization for/with myocardial infarction or stroke, and death from cardiac or cerebrovascular causes or sudden death. Validation of the algorithm was performed on an independent diabetic cohort from the Busselton Health Study. During 5570 patient-years of follow up, 185 (14.9%) had at least one CVD event and 175 (14.1%) died (57.7% from CVD). Variables in the final model comprised age, sex, prior CVD, ln(urinary albumin : creatinine ratio), lnHbA(1c), ln(high density lipoprotein-cholesterol), Southern European ethnic background and Aboriginality. The mean 5-year predicted risk of a CVD event was 15.5%. Applied to the Busselton cohort, discrimination of the model was good (AUC = 0.84, P < 0.001) as was the goodness-of-fit (Hosmer-Lemeshow C-test, P= 0.85) and accuracy (mean squared error (95% confidence interval) = 0.09 (0-0.76)). The positive and negative predictive values for a 10% 5-year CVD risk cut-off were 23.4% and 97.7% respectively. This simple diabetes-specific 5-year CVD risk equation is the first validated, population-based Australian model. It should have a role in diabetes management in primary and specialist care.

Gross Motor Development of Asian and European Children on Four Motor Assessments: A Literature Review

The purpose of this article is to review the evidence surrounding similarities and differences in motor development in children of Asian and European ethnic backgrounds to ensure the appropriateness of mixed ethnicity normative comparison data. A review of published studies indicates variability in rate and possibly sequence of motor development in children of European and Asian origins. Assessment tools used to discriminate motor development in children of different ethnic backgrounds should be interpreted with caution until there is sufficient information regarding the appropriateness of comparisons among children of different ethnic origins.

Options: Racial/Ethnic Identification of Children of Intermarried Couples*

Objective.Whites of various European ethnic backgrounds usually have weak ethnic attachment and have options to identify their ethnic identity (Waters, 1990). What about children born to interracially married couples?Methods.I use 1990 Census data—the last census in which only one race could be chosen—to examine how African American‐white, Latino‐white, Asian American‐white, and American Indian‐white couples identify their children's race/ethnicity.Results.Children of African American‐white couples are least likely to be identified as white, while children of Asian American‐white couples are most likely to be identified as white. Intermarried couples in which the minority spouse is male, native born, or has no white ancestry are more likely to identify their children as minorities than are those in which the minority spouse is female, foreign born, or has part white ancestry. In addition, neighborhood minority concentration increases the likelihood that biracial children are identified as minorities.Conclusion.This study shows that choices of racial and ethnic identification of multiracial children are not as optional as for whites of various European ethnic backgrounds. They are influenced by race/ethnicity of the minority parent, intermarried couples' characteristics, and neighborhood compositions.

Normal Spirometric Values in Healthy Hispanic Americans

FVC, FEV1, FEV1/FVC, and FEF25-75% were measured in 259 (116 men and 143 women) healthy nonsmoking Hispanic American volunteers from Utah and California. Linear regression equations were created for women greater than or equal to age 20 years and men greater than or equal to age 25 years using height, age, and weight as independent variables and the spirometric indices as dependent variables. Weight was a significant predictor only for female FEV1. The raw data from this study were compared with data from our previous studies in North American Indians and Salt Lake City whites with Middle European ethnic backgrounds. No differences were found for any of the age and height coefficients. The only differences found were in the comparisons of the equation intercepts (bias) for male FVC and FEV1 between data for the Salt Lake City white subjects and both Hispanic American and North American Indian men. These small biases could be explained by technical or sampling biases or they may represent small ethnic differences. Although the differences from our Salt Lake City study are small, we recommend that ethnic-specific equations be used where they are available.

Auto‐immune (lupoid) hepatitis: An entity in the spectrum of chronic active liver disease*

The concept of auto-immune hepatitis as a disease entity evolved from the descriptions of 'chronic active hepatitis' (CAH) in the 1950s. Several types of CAH are distinguished by disease-specific features. The distinctive (but not exclusive) markers for auto-immune CAH include: a negative test for HBsAg; female; Northern European ethnic background; multisystem disease expression; histological CAH with large areas of periportal piecemeal necrosis and plasmacytosis; pronounced hypergammaglobulinaemia; serum auto-antibodies the HLA B8-DR3 phenotype; responsiveness to corticosteroid therapy; and rarity of supervening hepatocellular carcinoma. Much weight is attached to the serological marker auto-antibodies to nuclear or smooth muscle (actin) antigens (ANA, SMA). However, these auto-antibodies do not have an absolute association with auto-immune CAH: the serological reactions are not yet standardized; titres decrease with remission of disease; and other auto-antibodies mark variant forms of auto-immune hepatitis. A more confident acceptance of auto-immune hepatitis as an entity requires detection of a liver-specific antigen, a valid experimental disease model in animals, and a better understanding of immune-mediated damage to liver cells.

Ethnicity and Sex as Correlates of Depression Symptoms in a Canadian University Sample

Differences in the extent of depression symptoms were explored in a sample of Canadian university students representing Anglo-Celtic, South European, North European, East European, South Asian, and East Asian ethnocultural backgrounds in Toronto, one of the world's most ethnically diverse cities. Consistent with expectations, sex and ethnic differences in the self-reported strength of depression symptoms, as measured by the Beck Depression Inventory (BDI), were found. Women scored higher overall on total BDI scores and were proportionally more apt to be classified as mildly depressed (by having scored 10 or more on the BDI) than men. Similarly, as regards ethnicity, students from South Asian and South European ethnic backgrounds scored higher on the BDI and were also more likely to be classifiable as mildly depressed than those from either East European or Anglo-Celtic backgrounds. An explanation emphasizing the role of societal discrimination in producing feelings of learned helplessness and subsequent depression is proposed to account for the sex and ethnic differences in depression symptoms we and others have observed.

Ethnic differences in test anxiety.

Abstract Test anxiety differences were explored among a sample of undergraduates representing Chinese, Anglo, South European, North European, and Eastern European ethnic backgrounds. Given the stress on academic excellence arising from the Confucian ethic permeating Asian cultures, it was hypothesized that Chinese students would be more prone to exhibit high levels of test anxiety than would their peers from other ethnic traditions. Analysis of respondents' scores on the Test Anxiety Scale indicated that, as predicted, students in the Chinese group scored significantly higher in test anxiety than did students from Anglo or European ethnic backgrounds.

Taste perception and diet in individuals with Chinese and European ethnic backgrounds

Taste perception and diet in individuals with Chinese and European ethnic backgrounds

Eastern European Ethnic Groups and American Foreign Policy

Among the more interesting as well as surprising features of the 1976 presidential election was the way in which Eastem Europe became a campaign issue. The Eastem European situation and American policy toward it had received little attention in recent elections, but after Gerald Ford's statement that he did not believe Eastem Europe was under Soviet domination the region acquired fresh significance in the eyes of the American electorateor at least in the eyes of nervous Republican campaign strategists. Jimmy Carter's later pronouncement that he would not use American troops to repel a Soviet invasion of Yugoslavia also kept Eastern Europe in the news. Quite aside from Eastern Europe's intrinsic significance to American foreign policy, the potential importance of the eastem European question to the 1976 election's outcome, as perceived by politicians of both major parties, derived from their awareness that there are large numbers of Americans of Eastem European ethnic background. Whether the voting behavior of these groups has in fact been conditioned by a given party's or administration's stance toward Eastem Europe is a question which we shall consider later. The more concem in this article is with the overall role of the Eastem European ethnic population in the definition and execution of American policy toward Eastem Europe. A central focus is the consideration of how the U.S. national can or should be seen when influential ethnic minorities press for their particular version of that interest. May there not be a general interest which supersedes more particularistic definitions? Is the concept of the general interest meaningful in an avowedly pluralistic society, even in terms of foreign policy? The discussion covers several

Sex Difference in Personality Characteristics of Deprived Adolescents

What little research is available on personality development in deprived children points to ego development characterized by lack of confidence and negative self-images (Bloom, Davis, & Hess, 1965). In a 6-wk. program of summer enrichment for disadvantaged junior high students from American Indian, Mexican, and European ethnic backgrounds, staff ratings of participant improvement in independence, responsibility and cooperation consistently ranked the boys above the girls, a surprising finding in light of the recognized higher school dropout rate for males. It seemed possible that the poorly motivated, recalcitrant behavior of many girls was related to their earlier maturing and a passive acquiescence to a rather hopeless outlook on life. An example of this was an American Indian girl's theme which began in response to the question, Twenty years from now . with I'll probably have ten children though I only want three (Mason, 1967). To test the significance of these behavioral observations of a sex difference in personality characteristics of deprived adolescents. The California Psychological Inventory (Gough, 1957) was administered to participant groups during each of two consecutive summers. In both samples the females, regardless of ethnic group, scored more negatively, poorly motivated and non-conforming than did the males (Mason, in press a). Follow-up evaluation of the over-all effectiveness of the program indicated that one Mexican girl had dropped out of school, while 11 students had dropped out of comparable control groups (Mason, in press b). At the present time, however, 2 Indian girls ate out of school because of illegitimate pregnancies (including the one quoted above) and one Indian girl planning to be married has dropped out. While the greater economic and social usefulness of the disadvantaged adult female supposedly leads to maladjustment for the male, perhaps the reverse is true for disadvantaged adolescents. The present results intlicate that the deprived adolescent girl may be more defeated than her male counterpart and this may be particularly true for the American Indian girl.