Major Discrimination Research Articles

On the way towards zero discrimination; What do people living with HIV think?

<strong>Background: </strong>Sri Lanka is a country with a low prevalence of HIV infection. Nevertheless, number of people infected with HIV continues to rise with a considerable gap between the number identified and estimated. It is well known that stigma and discrimination to people living with HIV play a major role preventing people accessing services for HIV testing, care and support, worldwide.Sri Lanka is no exception. <strong>Methods: </strong>We interviewed 102 HIV patients using an interviewer administered questionnaire. In depth interviews were conducted with some of them. <strong>Results</strong>: Major discrimination was within the health sector with 43% being discriminated at health care settings. 28.4% of them had to undergo testing for HIV, before foreign employment. The rates of voluntary testing were very low. 80% of people living with HIV (PLHIV) have disclosed the positive status, someone else. <strong>Conclusions: </strong>A multi sectoral approach is necessary to provide care, support and treatment without stigma and discrimination. There should be self help groups of PLHIV to help each other and to liaise with healthcare personnel when required. DOI: <a href="http://dx.doi.org/10.4038/sljv.v3i1.5410">http://dx.doi.org/10.4038/sljv.v3i1.5410</a> Sri Lanka Journal of Venereology Vol.3(1) 2012 pp.33-37

Gaining a better understanding of respiratory health inequalities among cities: An ecological case study on elderly males in the larger French cities

BackgroundIn recent years, there have been a growing number of studies on spatial inequalities in health covering a variety of scales, from small areas to metropolitan areas or regions, and for various health outcomes. However, few investigations have compared health status between cities with a view to gaining a better understanding of the relationships between such inequalities and the social, economic and physical characteristics. This paper focuses on disparities in respiratory health among the 55 largest French cities. The aim is to explore the relationships between inter-urban health patterns, city characteristics and regional context, and to determine how far a city’s health status relates to the features observed on different geographical scales.MethodsWe used health data describing hospitalizations for Chronic Obstructive Pulmonary Disease (COPD) as a proxy for respiratory health, and the total number of hospitalizations (overall) as a proxy for general health. This last indicator was used as a benchmark. A large set of indicators relating to socioeconomic, physical and amenity aspects of the cities (urban units) was also constructed. Data were analyzed using linear correlations and multiple linear regression models.ResultsThe results suggest that socioeconomic characteristics are major discriminators for inequalities in respiratory health status among urban units. Indeed, once combined to socioeconomic characteristics, only a climate indicator remained significant among the physical indicators. It appeared that the pollution indicators which were significantly correlated with COPD hospitalization rates loosed significance when associated to the socio-economic indicators in a multiple regression. The analysis showed that among the socio-economic indicators, an employment indicator derived at the regional scale, and two indicators reflecting the unequal intra-urban spatial distribution of population according to their education, were the most efficient to describe differences in the respiratory health status of urban units.ConclusionIn order to design effective urban policies, it is essential to gain a better understanding of the differences among cities in their entirety, rather than solely differences across small urban areas or individuals.

1072 TELOMERIC DYSFUNCTION IN RELATION TO OXIDATIVE DNA DAMAGE IN LIVER CARCINOGENESIS

this study was to define markers of cirrhosis and HCC using SR-FTIR microspectroscopy. Methods: The study has been focused on liver samples obtained from surgical specimens including normal livers (n = 7) and patients with HCC on cirrhosis from alcohol (n = 6) or HCV (n =6) aetiology. Frozen tissue sections stained with H&E were performed for histological examination. Adjacent tissue sections were investigated using SR-FTIR microspectroscopy experiments. The variance was addressed by multivariate statistical methods such as principal component analysis (PCA). Results: We strived firstly to discriminate the spectroscopic profile of healthy and pathological liver. The infrared spectral pattern of cirrhosis or HCC exhibited significant differences in the composition of lipids, proteins and sugars when compared with tissue from normal liver. Then, we investigated the spectral differences that discriminate tumor tissue from cirrhosis. Detailed analysis demonstrates a frequency shift in proteins suggesting changes in the proteome but the major discrimination was observed on sugars. Furthermore, SR-FTIR experiments followed by PCA analysis allowed the discrimination between hyperplastic and dysplastic cirrhotic nodules on sugars. Infrared signatures of dysplastic nodules superimposed with HCC suggesting that FTIR microspectroscopy allows diagnosing tissue changes associated with early stages of cancer. Finally, experiments were performed on a conventional IR microscope using an internal IR source. Despite the lower spatial resolution of such a device, it was possible to reproduce the results obtained in the exploratory phase using synchrotron radiations. Conclusions: Infrared microspectroscopy allows discriminating various grades of cirrhosis and HCC. This approach that can be easily implemented into hospitals may open new avenues for clinical applications and personalized medicine.

1071 CONVENTIONAL AND DC-Beads-MEDIATED TRANSARTERIAL CHEMOEMBOLIZATION: ANY DIFFERENCE IN NEOANGIOGENESIS?

this study was to define markers of cirrhosis and HCC using SR-FTIR microspectroscopy. Methods: The study has been focused on liver samples obtained from surgical specimens including normal livers (n = 7) and patients with HCC on cirrhosis from alcohol (n = 6) or HCV (n =6) aetiology. Frozen tissue sections stained with H&E were performed for histological examination. Adjacent tissue sections were investigated using SR-FTIR microspectroscopy experiments. The variance was addressed by multivariate statistical methods such as principal component analysis (PCA). Results: We strived firstly to discriminate the spectroscopic profile of healthy and pathological liver. The infrared spectral pattern of cirrhosis or HCC exhibited significant differences in the composition of lipids, proteins and sugars when compared with tissue from normal liver. Then, we investigated the spectral differences that discriminate tumor tissue from cirrhosis. Detailed analysis demonstrates a frequency shift in proteins suggesting changes in the proteome but the major discrimination was observed on sugars. Furthermore, SR-FTIR experiments followed by PCA analysis allowed the discrimination between hyperplastic and dysplastic cirrhotic nodules on sugars. Infrared signatures of dysplastic nodules superimposed with HCC suggesting that FTIR microspectroscopy allows diagnosing tissue changes associated with early stages of cancer. Finally, experiments were performed on a conventional IR microscope using an internal IR source. Despite the lower spatial resolution of such a device, it was possible to reproduce the results obtained in the exploratory phase using synchrotron radiations. Conclusions: Infrared microspectroscopy allows discriminating various grades of cirrhosis and HCC. This approach that can be easily implemented into hospitals may open new avenues for clinical applications and personalized medicine.

Processing of ultrasound in a bush cricket's brain

The processing and categorization of conspecific and heterospecific acoustic signals is an important task of the central nervous system. In orthopteran species, carrier frequency (besides temporal cues) is one of the major discriminators. In the bush cricket species Ancistrura nigrovittata Brunner von Wattenwyl (Phaneropteridae, Barbitistini), ultrasound has potentially different meanings and may elicit vastly different behaviours depending on the context it is perceived in. In the present study, data are presented of the morphology and neuronal responses of three local brain neurones (LBNs) that respond best to ultrasound. All neurones show dense arborizations in the lateral protocerebrum, where ascending interneurones terminate. The LBN2 and LBN9 neurones are entirely restricted to one side of the brain, whereas LBN5 crosses the midline, thereby linking both hemispheres. The response maxima for LBN2 overlap closely with the peak carrier frequencies found in a species‐specific duet, which consists of sonic (16 kHz, male), as well as ultrasonic (24–28 kHz, female) sound. By contrast, LBN9 responds only to ultrasound in the range of the female reply, whereas the male song induces exceptionally long‐lasting inhibition. The LBN5 neurone shows strongest spike activity to a broad range of ultrasonic frequencies, as long as the pulse duration remains short. All three brain neurones respond to ultrasound in a unique way and may be involved in the shaping of different behavioural outcomes.

Upper tropospheric conditions in relation to the cloud top features of 15 August 2010 convective storms

This study focuses on 15 August 2010, when many severe convective storms occurred over parts of central and Eastern Europe, with some of these exhibiting various interesting cloud-top characteristics observed by weather satellites. The importance of the phenomena of cold-U and cold-ring features in the infrared brightness temperature enhanced imagery stems from the fact that storms exhibiting these features are very often accompanied by severe weather. Therefore, besides the general description of the atmospheric conditions in the area, we seek possible reasons for the different cloud-top appearance of these storms from the perspective of Meteosat Second Generation and polar-orbiting weather satellites. Two main issues are discussed in this paper - the unusually warm appearance of the cloud-top of the “Prague hailstorm” and the presence of cold-ring and cold-U shaped storms in close proximity to the warmer “Prague hailstorm”. Both of these issues prove that the storm top appearance is very sensitive to the upper tropospheric and lower stratospheric conditions, with the first one strongly reflecting variations in the tropopause height due to the presence of the jet-stream over the region. The second topic addresses the strength of the storm relative upper level winds as a major discriminator between the cold-U and cold-ring storm top categories. Due to the above mentioned facts, 15 August 2010 was selected as one of the prime cases of interest for the Convection Working Group.

Perceived Discrimination and DSM-IV–Based Alcohol and Illicit Drug Use Disorders

We examined the relationship between everyday and major discrimination and alcohol and drug use disorders in a nationally representative sample of African Americans and Black Caribbeans. With data from the National Survey of American Life Study, we employed multivariable logistic regression analyses--while controlling for potential confounders--to examine the relationship between everyday and major discrimination and substance use disorders on the basis of Diagnostic and Statistical Manual of Mental Disorders criteria. Every 1 unit increase in the everyday discrimination scale positively predicted alcohol (odds ratio [OR] = 1.02; P < .01) and drug use (OR = 1.02; P < .05) disorders. Similarly, each additional major discrimination event positively predicted alcohol (OR = 1.10; P < .05) and drug use (OR = 1.15; P < .01) disorders. To our knowledge, this study is the first to examine problematic usage patterns rather than infrequent use of alcohol and drugs in a national sample of African American and Black Caribbean adults and the first to examine this particular relationship in a national sample of Black Caribbeans.

Are benefits conferred with greater socioeconomic position undermined by racial discrimination among African American men?

Backgroundconventional wisdom suggests that increased socioeconomic resources should be related to better health. Considering the body of evidence demonstrating the significant association between racial discrimination and depression, we examined whether exposure to racial discrimination could attenuate the positive effects of increased levels of socioeconomic position (SEP) among African Americans. Specifically, this paper investigated the joint interactive effects of SEP and racial discrimination on the odds of depression among African Americans. Methodsracial discrimination was measured using two measures, major and everyday discrimination. Study objectives were achieved using data from the National Survey of American Life, which included a nationally representative sample of African Americans (n=3570). Logistic regression models were used to estimate the effects of SEP and racial discrimination on the odds of depression. Resultsreports of racial discrimination were associated with increased risk of depression among African American men who possessed greater levels of education and income. Among African American men, significant, positive interactions were observed between education and experiences of major discrimination, which were associated with greater odds of depression (P=0.02). Additionally, there were positive interactions between income and both measures of racial discrimination (income x everyday discrimination, P=0.013; income x major discrimination, P=0.02), which were associated with increased odds of depression (P=0.02). Conclusionsit is possible that experiences of racial discrimination could, in part, diminish the effects of increased SEP among African American men.

Chromatin occupancy analysis reveals genome-wide GATA factor switching during hematopoiesis

AbstractThere are many examples of transcription factor families whose members control gene expression profiles of diverse cell types. However, the mechanism by which closely related factors occupy distinct regulatory elements and impart lineage specificity is largely undefined. Here we demonstrate on a genome wide scale that the hematopoietic GATA factors GATA-1 and GATA-2 bind overlapping sets of genes, often at distinct sites, as a means to differentially regulate target gene expression and to regulate the balance between proliferation and differentiation. We also reveal that the GATA switch, which entails a chromatin occupancy exchange between GATA2 and GATA1 in the course of differentiation, operates on more than one-third of GATA1 bound genes. The switch is equally likely to lead to transcriptional activation or repression; and in general, GATA1 and GATA2 act oppositely on switch target genes. In addition, we show that genomic regions co-occupied by GATA2 and the ETS factor ETS1 are strongly enriched for regions marked by H3K4me3 and occupied by Pol II. Finally, by comparing GATA1 occupancy in erythroid cells and megakaryocytes, we find that the presence of ETS factor motifs is a major discriminator of megakaryocyte versus red cell specification.

Abstract LB-439: Distinct tumorigenic pathways within the hereditary nonpolyposis colorectal cancer

Abstract Background Identification of families with hereditary nonpolyposis colorectal cancer (HNPCC) allows for surveillance that has been proved to reduce morbidity and mortality from colorectal cancer (CRC). The HNPCC subset can broadly be divided into tumors caused by germline mismatch-repair (MMR) gene mutations, referred to as Lynch syndrome (LS), and those with an undefined genetic background, designated as familial colorectal cancer type X (FCC-X). Recognition of FCC-X tumor is challenging due to the lack of MMR defect and limited information is available about the global gene expression patterns in FCC-X tumors. We aimed at comprehensive pathway mapping of the global gene expression profile in FCC-X tumors with comparison to LS and sporadic CRC as controls. Materials and methods Tumour specimens were obtained from the national Danish HNPCC Register. RNA was extracted from 3-5 10-µm sections using the High Pure RNA Paraffin Kit (Roche, Castle Hill, Australia). The Whole-genome cDNA-mediated annealing selection extension and ligation (DASL) assay (Illumina, San Diego, CA) containing &amp;gt;24,000 probes in &amp;gt;18,000 genes was used for whole genome expression analysis. Expression values were analysed using the GenomeStudio software (Illumina, San Diego, CA) and imported into MeV 4.6.02. Canonical pathways were identified using DAVID Bioinformatics Resources 6.7. Results RNA was obtained from 180 tumors (60 LS, 60 FCC-X, 30 sporadic MSI-CRC and 30 sporadic MSS-CRC. Samples with &amp;lt;7000 genes represented (n=48) were excluded. Expression data from the remaining 132 samples were cubic normalized and a presence filter of 80% was applied (detection p-values ≤0.01). Sequence Alignment and Modeling (SAM) system analysis identified 3873 genes that differed significantly between LS/sporadic MSI-CRC and FCC-X/sporadic MSS-CRC. Using DAVID Bioinformatics resources, we identified 5 significantly up-regulated pathways in FCC-X/MSS-CRC including vascular smooth muscle contraction, G-protein coupled receptor signaling, calcium signaling, Wnt signalling and integrin cell surface interactions. For LS/MSI-CRC, we also identified 5 up-regulated pathways related antigen processing and presentation, DNA replication, cell cycle progression, and telomere maintenance. Conclusions Gene expression profiling using the DASL technology from 132 CRC identified MSI status as the major discriminator. Our data indicates that vascular smooth muscle contraction, G-protein coupled receptor signaling, calcium signaling, Wnt signaling, and integrin cell surface interactions pathways are up-regulated in FCC-X and MSS-CRC. These data provide strong evidence that these pathways play a role in development of CRC in these families and FCC-X should be considered as different clinical entity. These data also identify key signaling pathways as potential therapeutic targets in FCC- X tumors. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr LB-439. doi:1538-7445.AM2012-LB-439

Investigating the Relationship between Perceived Discrimination, Social Status, and Mental Health.

A growing body of evidence suggests that experiences with discrimination have implications for mental health and that these associations may vary by social status. We use data from the Chicago Community Adult Health Study (CCAHS) to examine how two types of perceived discrimination, chronic everyday discrimination and major lifetime discrimination, are linked to mental health, and how this association varies by race/ethnicity, gender, and socioeconomic status. Results indicate that everyday discrimination is generally independently linked to greater depressive symptoms, loneliness, and hostility across all social status groups. Major discrimination is not associated with depressive symptoms or loneliness after adjusting for a host of covariates, but is associated with hostility, especially for certain groups. These findings highlight the need to examine multiple indicators of discrimination and mental health, and to pay attention to both differences and similarities in these associations by social status.

Hematologic Features of Hepatosplenic T-Cell Lymphoma

To the Editor We read with interest the article by Chen and colleagues1 in which they describe the clinical and pathologic characteristics of 7 cases of the rare CD4–/CD8– γδ subtype of T-cell large granular lymphocytic (T-LGL) leukemia. The authors state that 16 cases of CD4–/CD8– γδ T-cell neoplasm had initially been identified, but 9 had been excluded because they represented “various other types of γδ T-cell lymphoma/leukemia involving the blood and bone marrow.”1 It is unfortunate that the data on which these exclusions were made was not provided. This information would have been valuable, especially in determining whether any of the 9 excluded cases were, in fact, hepatosplenic T-cell lymphoma (HSTL), another rare disease with phenotypic similarities with CD4–/CD8– γδ T-LGL leukemia. The data from the resulting 7 cases described in the published series infer that the lack of isochromosome (7q), a feature of HSTL, was a major discriminator, as 6 of 6 tested cases were negative. However, the authors downplay the significance of cytogenetics by only stating that it “may be helpful in difficult cases” in distinguishing between CD4–/CD8– γδ T-LGL leukemia and HSTL. Instead they claim that, although the distinction between these 2 entities can be difficult, it may be readily achieved on morphologic studies and the pattern of splenic and marrow infiltration.1 We want to make particular comment on the …

Abstract 2707: Social Determinants are Associated with Heat Shock Protein-70 in African American and Non-Hispanic White Women with Cardiovascular Disease

Background: African American (AA) women are nearly twice as likely as non-Hispanic White (NHW) women to develop cardiovascular disease (CVD). The additional burden of CVD borne by AA women is attributed to socioeconomic status, psychosocial stress, and greater numbers of risk factors. Compelling evidence demonstrates that inflammatory biomarkers, such as heat shock protein-70 (hsp-70) are associated with CVD risk. Yet, little is known about how social determinants, such as perceived discrimination, subjective social status, and socioeconomic status, contribute to these inflammatory markers in women with CVD. Purpose: The purpose of this pilot study was to examine the extent to which social determinants are associated with hsp-70 while controlling for age, race, and body mass index (BMI) in AA and NHW women with CVD. Methods: The sample was comprised of 10 AA and 21 NHW (mean age=68.7) undergoing elective percutaneous coronary intervention or carotid endarterectomy. Participants completed the MacArthur Scale of Subjective Social Status ladders for both Community and United States. In addition, the, DASDS-Major Life Discrimination, and sociodemographic survey were completed. A blood sample was collected prior to intervention and was analyzed for hsp-70. Results: Lower levels of subjective social status for community (r=-0.52, p=.02) and US (r= -0.43, p=.05) were associated with higher levels of hsp-70 controlling for age, race, and BMI. Further, greater reported frequency of major life discrimination (r=.520, p=.02) were related to elevated levels of hsp-70 adjusting for age, race, and BMI. Conclusions: Results indicate that social determinants, in particular subjective social status and perceived discrimination, are associated with the inflammatory biomarker, hsp-70. Our findings support the importance of social mediators in the inflammatory cascade. Although longitudinal studies with larger samples sizes are required to confirm these results, findings imply that social determinants, which may be amenable to nursing intervention, play a more important role in predicting inflammatory markers of CVD than race.

Classification of Swiss cheese starter and adjunct cultures using Fourier transform infrared microspectroscopy

The acceptability of Swiss cheese largely depends on the flavor profile, and strain variations of cheese cultures will affect the final quality. Conventional biochemical methods to identify the cultures at the strain level are time-consuming and expensive, and require skilled labor. Our objective was to develop rapid classification methods of starter cultures at the strain level by using a combination of hydrophobic grid membrane filters and Fourier transform infrared (FTIR) spectroscopy. Forty-four pulsed-field gel electrophoresis–verified strains of starter and nonstarter cultures including Streptococcus thermophilus, Propionibacterium freudenreichii, and Lactobacillus spp. were analyzed. The strains were grown on their respective agar media, transferred to broth media, and incubated. Then, cultures were centrifuged and the pellets were resuspended in saline solution (10μL). Aliquots (2μL) of the suspended bacterial solution were placed onto a grid of the hydrophobic grid membrane filters, having 6 grids per each strain analyzed. The dried filters were read by FTIR microspectroscopy fitted with an attenuated total reflectance probe. Collected spectra were statistically analyzed by a soft independent modeling of class analogy (SIMCA) for pattern recognition. Classification models were developed for Streptococcus thermophilus, Propionibacterium freudenreichii, and Lactobacillus spp. strains. The models showed major discrimination in the spectral region from 1,200 to 900cm−1 associated with signals from phosphate-containing compounds and various polysaccharides in the cell wall. The developed method allowed for rapid classification of several Swiss cheese starter and nonstarter cultures at the strain level. This information provides a detailed overview of microbiological status, which would enable corrective measures to be taken early in the cheese making process, limiting production of inferior quality cheese and minimizing defects. This method could be an effective tool to identify and monitor activity of cheese and other dairy starter cultures.

10 Evaluating a nurse led triage process in treating patients with left bundle branch block (LBBB) referred for primary percutaneous coronary intervention (pPCI)

Background The Freeman Hospital (FRH) performs over 900 pPCI a year. Patients with suspected Acute Myocardial Infarction (AMI) are referred either by paramedics or networked hospitals for consideration of pPCI via a Telmed system, which is triaged by experienced CCU nurses. The pPCI Pathway can be activated in patients with LBBB suspected of having an AMI. However, there remains considerable variation in the clinical utility of new or presumed new LBBB as a ST-elevation myocardial infarction (STEMI)-equivalent ECG diagnostic criterion. The major discriminators the triage staff use in this population are ECG findings and symptoms suggestive of AMI. Our aim was to evaluate outcomes in patients with LBBB accepted to FRH or referred to local hospitals for assessment. Methods Consecutive patients referred to FRH with LBBB and suspected AMI from 1st August 2009 to 30th November 2009 were analysed by recording: 1) Peak Troponin Level 2) Angiographic findings 3) Revascularisation rates. Results 1069 patients were referred for consideration of pPCI. 177 (16.6%) of patients had new or presumed new LBBB. 33 (18.6%) patients were accepted by FRH and 144 patients (81.4%) were declined and referred to their local hospitals for assessment. Abstract 10 Table 1 Troponin levels in patients with LBBB referred for consideration of pPCI. 26.5% of patients with LBBB referred for consideration of pPCI had moderately to highly raised troponin. Of the 33 patients admitted to FRH, 13 underwent inpatient angiography and 9 patients had significant coronary disease (coronary stenosis 70%–100% in at least one coronary artery). Of those, 5 had PCI and 1 required urgent CABG. Only one patient had a 100% coronary occlusion believed to be an acute occlusion. 4 patients had unobstructed coronaries and were managed medically. Of the 132 patients declined for pPCI only 2 (1.5%) were referred back to FRH for PCI. Neither of these patients was found to have a 100% acute occlusion of a coronary artery. Conclusion Revascularisation was performed in only 6/33 (18.2%) accepted for assessment and only 2/132 (1.5%) were referred back to the centre for PCI. The sensitivity of the triage process in detecting patients with LBBB requiring urgent revascularisation is 75% and the specificity is 83%. The sensitivity of detecting patients with an acutely occluded artery diagnosed at angiography is 100% with a specificity of 81%. In a high volume Heart Attack Centre a nurse led triage is effective at discriminating patients with LBBB requiring immediate coronary intervention.

Performance status is the most powerful risk factor for early death among patients with advanced soft tissue sarcoma

Background:We investigated prognostic factors (PFs) for 90-day mortality in a large cohort of advanced/metastatic soft tissue sarcoma (STS) patients treated with first-line chemotherapy.Methods:The PFs were identified by both logistic regression analysis and probability tree analysis in patients captured in the Soft Tissue and Bone Sarcoma Group (STBSG) database (3002 patients). Scores derived from the logistic regression analysis and algorithms derived from probability tree analysis were subsequently validated in an independent study cohort from the French Sarcoma Group (FSG) database (404 patients).Results:The 90-day mortality rate was 8.6 and 4.5% in both cohorts. The logistic regression analysis retained performance status (PS; odds ratio (OR)=3.83 if PS=1, OR=12.00 if PS ⩾2), presence of liver metastasis (OR=2.37) and rare site metastasis (OR=2.00) as PFs for early death. The CHAID analysis retained PS as a major discriminator followed by histological grade (only for patients with PS ⩾2). In both models, PS was the most powerful PF for 90-day mortality.Conclusion:Performance status has to be taken into account in the design of further clinical trials and is one of the most important parameters to guide patient management. For those patients with poor PS, expected benefits from therapy should be weighed up carefully against the anticipated toxicities.

Age-related predictors of institutionalization: results of the German study on ageing, cognition and dementia in primary care patients (AgeCoDe)

In the last decades, many community-based studies have addressed predictors of nursing home placement (NHP) among the elderly. So far, predictors have not been analyzed separately for different age groups. For a German GP-sample of 3,208 subjects aged 75 years and older, socio-demographic, clinical, and psychometric parameters were requested every 1.5 years over three waves. Logistic regression models determined predictors of NHP for total sample and for two different age groups. A CART analysis identified factors discriminating best between institutionalized and non-institutionalized individuals. Of the overall sample, 4.7% of the sample (n = 150) was institutionalized during the study period. Baseline characteristics associated with a higher risk of NHP for the total sample were age, living without spouse, cognitive and functional impairment and depression. In the CART analysis, age was the major discriminator at the first level (at age 81). In subgroup regression analyses, for the younger elderly (age 75-81) being single as well as cognitive and functional impairment increased the risk of NHP; in the advanced elderly (age 82+) being widowed and subjective memory impairment were significant predictors for NHP, and cognitive and functional impairment became non-significant as predictors of NHP. Predictors of NHP may differ in old age groups. The fact that many predictors show inconsistent results as predictors of NHP in the international literature may be attributed to the lack of differentiation in age groups.

Perceived Discrimination and Depressive Symptoms, Smoking, and Recent Alcohol Use in Pregnancy

Perceived discrimination is associated with poor mental health and health-compromising behaviors in a range of vulnerable populations, but this link has not been assessed among pregnant women. We aimed to determine whether perceived discrimination was associated with these important targets of maternal health care among low-income pregnant women. Face-to-face interviews were conducted in English or Spanish with 4,454 multiethnic, low-income, inner-city women at their first prenatal visit at public health centers in Philadelphia, Penn, USA, from 1999 to 2004. Perceived chronic everyday discrimination (moderate and high levels) in addition to experiences of major discrimination, depressive symptomatology (CES-D >or= 23), smoking in pregnancy (current), and recent alcohol use (12 months before pregnancy) were assessed by patients' self-report. Moderate everyday discrimination was reported by 873 (20%) women, high everyday discrimination by 238 (5%) women, and an experience of major discrimination by 789 (18%) women. Everyday discrimination was independently associated with depressive symptomatology (moderate = prevalence ratio [PR] of 1.58, 95% CI: 1.38-1.79; high = PR of 1.82, 95% CI: 1.49-2.21); smoking (moderate = PR of 1.19, 95% CI: 1.05-1.36; high = PR of 1.41, 95% CI: 1.15-1.74); and recent alcohol use (moderate = PR of 1.23, 95% CI: 1.12-1.36). However, major discrimination was not independently associated with these outcomes. This study demonstrated that perceived chronic everyday discrimination, but not major discrimination, was associated with depressive symptoms and health-compromising behaviors independent of potential confounders, including race and ethnicity, among pregnant low-income women.

Stepwise mechanism for transcription fidelity

BackgroundTranscription is the first step of gene expression and is characterized by a high fidelity of RNA synthesis. During transcription, the RNA polymerase active centre discriminates against not just non-complementary ribo NTP substrates but also against complementary 2'- and 3'-deoxy NTPs. A flexible domain of the RNA polymerase active centre, the Trigger Loop, was shown to play an important role in this process, but the mechanisms of this participation remained elusive.ResultsHere we show that transcription fidelity is achieved through a multi-step process. The initial binding in the active centre is the major discrimination step for some non-complementary substrates, although for the rest of misincorporation events discrimination at this step is very poor. During the second step, non-complementary and 2'-deoxy NTPs are discriminated against based on differences in reaction transition state stabilization and partly in general base catalysis, for correct versus non-correct substrates. This step is determined by two residues of the Trigger Loop that participate in catalysis. In the following step, non-complementary and 2'-deoxy NTPs are actively removed from the active centre through a rearrangement of the Trigger Loop. The only step of discrimination against 3'-deoxy substrates, distinct from the ones above, is based on failure to orient the Trigger Loop catalytic residues in the absence of 3'OH.ConclusionsWe demonstrate that fidelity of transcription by multi-subunit RNA polymerases is achieved through a stepwise process. We show that individual steps contribute differently to discrimination against various erroneous substrates. We define the mechanisms and contributions of each of these steps to the overall fidelity of transcription.

Impact of perceived racial discrimination on health screening in black women.

Perceived discrimination has been shown to be related to health screening behavior. The present study examines the effect of discrimination on cancer screening among women in the Black Women's Health Study. Five self-report items measured discrimination in everyday life and three items measured experiences of major discrimination. Logistic regression was used to test associations of discrimination with Pap smear, mammography, or colonoscopy utilization. At the start of follow-up, 88.8% had a Pap smear in the previous year, 52.7% had a mammogram, and 20.0% had received a colonoscopy. Both everyday and major discrimination were associated with not having received a Pap smear, even after adjusting for other variables. Discrimination was not associated with mammography or colonoscopy utilization. In conclusion, perceived everyday and major discrimination is associated with poorer utilization of Pap smears for cervical cancer screening among Black women.