Treatment Of African Americans Research Articles

Addressing the “Negro Problem”: Rethinking the Coon and the Mammy in King of the Zombies and Revenge of the Zombies

This article explores two 1940s B-horror zombie movies to argue that the revitalization of the “coon” and the “mammy” from the slave era in the early twentieth century was part and parcel of the dominant culture’s efforts to contain and control the “monstrous black” of the white imagination. Furthermore, I posit that the dehumanization and Othering that characterized white America’s treatment of African Americans is not a thing of the past. The article advocates for a transatlantic and trans-temporal orientation from scholars, which would allow them to reassess Hollywood films in relation to the systemic racism that pervades American culture and that circumscribes the choices that African American actors had in the past and continue to have today.

A delta-opioid receptor genetic variant is associated with abstinence prior to and during cocaine dependence treatment

IntroductionAn intronic polymorphism in the delta-opioid receptor gene (OPRD1) was previously associated with cocaine dependence in African-Americans. However, it is not known if the polymorphism (rs678849) is associated with dependence-related phenotypes within the cocaine dependent population. MethodsCocaine and alcohol dependent subjects were randomized to either topiramate or placebo. Abstinence from cocaine use was confirmed by urine drug screens for benzoylecgonine three times per week. Cocaine withdrawal and craving were assessed at randomization using the Cocaine Selective Severity Assessment (CSSA) and Minnesota Cocaine Craving Scale (MCCS), respectively. Subjects were also interviewed using the Addiction Severity Index (ASI). Genotype at rs678849 was determined for 105 African-American subjects and compared to cocaine abstinence, as well as scores for CSSA, MCCS, and ASI. ResultsAfrican-American patients with the C/T or T/T genotypes (n=40) were more likely to be abstinent at the first urine drug screen and more likely to be abstinent for the week prior to randomization compared to patients with the C/C genotype (n=65). Subjects carrying the T allele were also more likely to have abstinent weeks over the course of the trial compared to those with the C/C genotype (RR=1.88, 95% CI=1.59-2.22, p=0.0035). No effects of rs678849 genotype on withdrawal, craving, or addiction severity were observed. ConclusionsA polymorphism in OPRD1 appears to be associated with both cocaine dependence and cocaine use during treatment in African-Americans. Follow-up studies to confirm the effect on cocaine use are warranted.

Disparities in Psychiatric Diagnosis and Treatment for Youth with Systemic Lupus Erythematosus: Analysis of a National US Medicaid Sample.

To estimate the national prevalence and racial/ethnic differences in psychiatric diagnoses and pharmacologic treatment in a US Medicaid beneficiary population of youth with systemic lupus erythematosus (SLE). We included youth aged 10 to 18 years with a diagnosis of SLE (defined as ≥ 3 outpatient visit claims with an International Classification of Diseases, 9th ed. code of 710.0, each > 30 days apart) in the US Medicaid Analytic Extract database from 2006 and 2007. This database contains all inpatient and outpatient Medicaid claims from 49 states and the District of Columbia. We calculated the prevalence of psychiatric diagnoses and treatment, and used logistic regression to compare depression and anxiety diagnoses, antidepressant, and anxiolytic use among racial/ethnic groups. Of 970 youth with SLE, 15% were white, 42% were African American, 27% were Latino, and 16% were of other races/ethnicities. Diagnoses of depression were present for 19%, anxiety for 7%, acute stress/adjustment for 6%, and other psychiatric disorders for 18%. Twenty percent were prescribed antidepressants, 7% were prescribed anxiolytics, 6% were prescribed antipsychotics, and 5% were prescribed stimulants. In adjusted analyses, African Americans were less likely than whites to be diagnosed with depression (OR 0.56, 95% CI 0.34-0.90) or anxiety (OR 0.49, 95% CI 0.25-0.98), or to be prescribed anxiolytics (OR 0.23, 95% CI 0.11-0.48). We present population-level estimates showing high psychiatric morbidity in youth with SLE, but less prevalent diagnosis and treatment in African Americans. Mental health interventions should address potential racial/ethnic disparities in care.

The effects of genes implicated in cardiovascular disease on blood pressure response to treatment among treatment-naive hypertensive African Americans in the GenHAT study.

African Americans have the highest prevalence of hypertension in the United States. Blood-pressure control is important to reduce cardiovascular disease (CVD)-related morbidity and mortality in this ethnic group. Genetic variants have been found to be associated with BP response to treatment. Previous pharmacogenetic studies of blood-pressure response to treatment in African Americans suffer limitations of small sample size as well as a limited number of candidate genes, and often focused on one antihypertensive treatment. Using 1,131 African-American treatment naïve participants from the Genetics of Hypertension Associated Treatment (GenHAT) Study, we examined whether variants in 35 candidate genes might modulate blood-pressure response to four different antihypertensive medications, including an angiotensin converting enzyme (ACE) inhibitor (lisinopril), a calcium channel blocker (amlodipine), and an α-adrenergic blocker (doxazosin) as compared to a thiazide diuretic (chlorthalidone) after 6 months of follow-up. Several suggestive gene by treatment interactions were identified. For example, among participants with two minor alleles of REN rs6681776, diastolic blood-pressure response was much improved on doxazosin compared to chlorthalidone (on average −9.49 mmHg vs. −1.70 mmHg) (P=0.007). Although several suggestive loci were identified, none of the findings passed significance criteria after correction for multiple testing. Given the impact of hypertension and its sequelae in this population, this research highlights the potential for genetic factors to contribute to blood-pressure response to treatment. Continued concerted research efforts focused on genetics are needed to improve treatment response in this high risk group.

Addressing the “Negro Problem”: Rethinking the Coon and the Mammy in <em>King of the Zombies</em> and <em>Revenge of the Zombies</em>

This article explores two 1940s B-horror zombie movies to argue that the revitalization of the “coon” and the “mammy” from the slave era in the early twentieth century was part and parcel of the dominant culture’s efforts to contain and control the “monstrous black” of the white imagination. Furthermore, I posit that the dehumanization and Othering that characterized white America’s treatment of African Americans is not a thing of the past. The article advocates for a transatlantic and trans-temporal orientation from scholars, which would allow them to reassess Hollywood films in relation to the systemic racism that pervades American culture and that circumscribes the choices that African American actors had in the past and continue to have today.

Healing the Racial Divide: A Catholic Racial Justice Framework Inspired by Dr. Arthur Falls by Lincoln Rice (review)

Reviewed by: Healing the Racial Divide: A Catholic Racial Justice Framework Inspired by Dr. Arthur Falls by Lincoln Rice Karen Johnson Healing the Racial Divide: A Catholic Racial Justice Framework Inspired by Dr. Arthur Falls. By Lincoln Rice. Eugene, OR: Wipf & Stock Publishers, 2014. 197 pp. $27.95. If something was going on in Chicago in the mid-twentieth century related to racial justice, chances are, Dr. Arthur Falls knew about it. Arthur Falls was a black Catholic medical doctor who devoted his life to achieving racial justice. He held leadership positions in the Federated Colored Catholics and the Chicago Urban League, advised the Fellowship of Reconciliation and the Congress of Racial Equality, and founded the Chicago branch of the Catholic Worker. Arthur and his wife, Lillian Proctor Falls, integrated the all-white suburb of Western [End Page 96] Springs in 1952, and in 1961, after pursuing other avenues to integrate Chicago’s hospitals, Falls and nine other doctors sued corporations owning Chicago hospitals to gain admission to the hospital staffs. Falls practiced a multifaceted approach to racial justice. He believed that interracial partnerships alone would make his beloved Catholic Church – and the nation – live up to the high calling of racial justice. Drawing strength from the church’s teaching on the mystical body of Christ, Falls argued that racism was a sin and that Christians must demonstrate their discipleship by countering the world’s wisdom of segregation and discrimination. Yet he was a member of a church that too often embodied racism, from archbishops to school children. Falls, though, did not give up hope and insisted that African Americans must be militant, partner with white people, and utilize insights from the social sciences to achieve racial justice. Although Falls was a significant figure in his time, today he is relatively unknown. Moral theologian Lincoln Rice, however, has brought Falls back to the table by laying out the chronology of Falls’s life and analyzing Falls’s thought and writing. As a historian, I wanted Rice to embed Falls more in his historical context and account, in particular, for some of Falls’s class biases. Nonetheless, Rice has made a significant contribution. Rice discovered Falls’s six-hundred page typed memoir manuscript, complete with Falls’s hand-written edits, and then filled in other aspects of Falls’s life by relentlessly tracking Falls through numerous archives. Falls’s memoir and Rice’s annotated bibliography of sources related to Falls are great windows into numerous aspects of black Catholic life and will benefit many researchers. Rice’s historical work on Falls is the basis for his theological work of developing a new understanding of Catholic racial justice. Situating himself among both Catholic as well as non-Catholic theologians who draw on African Americans’ experiences to deepen “our comprehension of the mysteries of the Christian faith” and to create effective solutions to achieve racial justice (30), Rice contends that a Catholic theory of racial justice is illegitimate if it does not employ black sources or focus on African Americans’ agency. As Rice shows, however, most Catholic resources for racial justice, including the majority of the bishops’ statements, neither listen to minorities’ voices nor suggest that the oppressed have any role to play in their own liberation. Instead, they mostly imply that white people ought to be more civil in their treatment of African Americans, a solution that depends on moral suasion and hardly accounts for the systemic nature of racism. Rice, based on Falls’s praxis and theology, offers a different answer. [End Page 97] Rice argues that Catholic racial justice ought to be “an organized struggle for the realization of the mystical body of Christ in the context of racial injustice in our society and within our Church” (148). Rice pushes Falls’s analysis of racism further, arguing that the sin of racism is a heresy because it attacks the church’s integrity and compromises the Christian faith. Rice suggests that Catholics concerned with racial justice, and especially the oppressed, ought to model themselves on Falls and remain in the church despite “frustration and constant rejection” (144). The tension can be resolved, Rice says, through active, organized struggle. Rice concludes by...

"Marie Howland-19th-Century Leader for Women's Economic Independence

Marie Howland (1836–1921) was an important working-class figure in the early U.S. women's movement who mounted an inspired challenge to separate spheres and the prevailing domestic ideology. Well before Edward Bellamy and Charlotte Perkins Gilman, she called for domestic work to be respected, paid, and collectively organized. Howland made it her life's work to remove barriers to economic independence for women through the overhaul of social and economic institutions that posited the home as the center of female existence and exploited workers. She wanted women to have the economic freedom to marry for love, not economic necessity, leave a bad marriage, survive widowhood, or not marry at all. By delving into Howland's early years in rural New Hampshire and the Lowell textile mills, her close association with radical bohemians in New York City, and her later participation in experimental communities, the following treatise provides a long overdue, comprehensive account of her life and work. My inquiry reveals how Marie Howland promoted women's freedom within a class analysis, rejecting Marxism and embracing the utopian socialist theory of Charles Fourier. It also offers an in-depth look at her popular utopian novel, Papa's Own Girl, where a cooperative community of economically independent women and enlightened men replace the patriarchy and individual competitiveness of the emerging, but by no means entrenched, industrial order. In addition, my treatise focuses on Howland's efforts to put ideas into practice. Unwilling to limit her activism to intellectual discussions, she lived in a Fourierist household in New York City, a cooperative settlement in western Mexico, and the single-tax community of Fairhope, Alabama. She pushed the Grange and the International Workingman's Association to focus on women's issues. She also made sure that her personal relationships with men were based on free love and mutual respect, not economic necessity and legal contract. I also examine how Howland dedicated her life to changing gender and class relations, but made little effort to improve conditions for African Americans. Like many white reformers, she drew on popular scientific theories of biological difference to justify the unequal treatment of African Americans. Besides shedding light on important intellectual and social developments, like phrenology, free love, Fourierism, the Grange, and theosophy, this examination of Marie Howland reveals the complexities, possibilities, and limitations of the women's rights movement before the passage of the 19th Amendment.

Abstract P641: Angiotensin Receptor Blocker Improves Pressure Natriuresis in Select African-Americans

Objective: Hypertension in ~30-60% of African-Americans (AAs) is resistant to single or combination therapy, indicating the necessity for novel screening strategies in this population. Our research supports a strategy that identifies a subset of AAs (approximately 1 in 3) who increase their retained sodium load during mental stress (MS) with an accompanying volume-mediated increase in blood pressure (BP) that remains elevated until the volume expansion diminishes. We hypothesize is due to activation of the renin-angiotensin system (RAS). Design and Method: We conducted a double blind placebo controlled crossover trial comparing the effects of irbesartan to placebo on sodium handling and consequent BP during MS. Subjects included 213 AA adults, of which 168 (78%) completed the study. After 7 days of vehicle (placebo or irbesartan) subjects underwent a 3 hr protocol comprised of 1 hr rest, 1 hr competitive video games, and 1 hr recovery. Blood and urine were obtained after each hour and BP every 15 mins. A 1 week washout ensued before subjects crossed over to repeat with the alternate vehicle. Subjects were divided into those who exhibited expected increases in urinary sodium excretion (U Na V) (Excreters) or reduced U Na V (Retainers) during MS as defined by previous data. Statistical analysis was performed using crossover methods with a pooled analysis that assumes equal variances and the Satterthwaite test of treatment difference (Stest) that assumes unequal variances. Results: Both statistical tests revealed that U Na V increased significantly for retainers (n=55) on irbesartan (p<0.002 and p<0.015, mean ± SD (pooled =7.15 ± 6.78, Stest =7.15)) normalizing the sodium response to MS. Irbesartan also enhanced U Na V during MS in excreters (n=113) with significant differences (p<0.001 and p<0.001, mean ± SD (pooled = 4.18 ± 9.03, Stest =4.18)). Overall SBP response was significantly reduced with treatment (p< 0.001 and p< 0.001, mean ± SD (pooled = -5.08 ± 3.19, Stest = -5.08)). Conclusion: Agents that block the RAS are not usually considered effective in AAs. However, our results suggest identification and treatment of AAs who increase their retained sodium load during MS with these agents will reduce the percentage of AAs with hypertension resistant to standard therapy.

PD30-12 RACIAL DISPARITIES IN THE SURGICAL CARE OF LOCALIZED PROSTATE CANCER

You have accessJournal of UrologyProstate Cancer: Localized II1 Apr 2015PD30-12 RACIAL DISPARITIES IN THE SURGICAL CARE OF LOCALIZED PROSTATE CANCER Marianne Schmid, Christian Meyer, Gally Reznor, Julian Hanske, Jesse Sammon, Firas Abdollah, Akshay Sood, Deepansh Dalela, Brandon Mahal, Adam Kibel, Felix Chun, Paul Nguyen, Mani Menon, Margit Fisch, and Quoc-Dien Trinh Marianne SchmidMarianne Schmid More articles by this author , Christian MeyerChristian Meyer More articles by this author , Gally ReznorGally Reznor More articles by this author , Julian HanskeJulian Hanske More articles by this author , Jesse SammonJesse Sammon More articles by this author , Firas AbdollahFiras Abdollah More articles by this author , Akshay SoodAkshay Sood More articles by this author , Deepansh DalelaDeepansh Dalela More articles by this author , Brandon MahalBrandon Mahal More articles by this author , Adam KibelAdam Kibel More articles by this author , Felix ChunFelix Chun More articles by this author , Paul NguyenPaul Nguyen More articles by this author , Mani MenonMani Menon More articles by this author , Margit FischMargit Fisch More articles by this author , and Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1833AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prostate cancer (PCa) mortality is higher among African Americans (AA) than among non-Hispanic white men (NHWM). Understanding variations in quality of care is an important objective of research in racial disparities. We sought to evaluate racial variations in the use and outcomes of radical prostatectomy (RP) in patients with localized, non-metastatic PCa. METHODS The SEER-Medicare databases for the period from 1991 to 2009 were used to identify 26,482 AA and NHWM with localized PCa, who underwent RP within the first year of PCa diagnosis. We stratified patients according to ethnicity and compared process of care (i.e. time to treatment, lymph node dissection) as well as outcome measures (i.e. complications, emergency department visits, readmissions, PCa-specific mortality and all-cause mortality, costs). Cox proportional hazards regression, multivariable logistic regression and quantile regression were used to study racial disparities in outcomes and their association with process of care and outcome measures. RESULTS Compared to NHWM, AA were more likely to experience delayed treatment (59.4 vs. 69.5%, p<0.001); the top 50% wait 7 days longer for surgery (p<0.001). Furthermore, they were less likely to undergo lymph node dissection at surgery and were more likely to experience postoperative complications, transfusions, emergency department visits, readmissions and mortality (all p<0.05, Table). Surgical treatment of AA is associated with higher incremental annual cost (top 50% spend 1185.471$ more). However, compared with NHWM, AA did not experience worse PCa- specific mortality (Hazard ratio [HR]: 1.07, 95% confidence interval [CI]: 0.97-1.17, p=0.161) or all-cause mortality (HR: 1.07; 95% CI: 0.80- 1.42). CONCLUSIONS While AA experience worse quality of care for localized PCa (e.g. delayed treatment, postoperative complications) and higher treatment costs compared to NHWM, there were no difference in PCa-specific or all-cause mortality when treated with RP as definitive treatment. The current results indicate that surgical treatment for AA may mitigate the gap in survival classically reported between AA and NHWM afflicted with PCa. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e658-e659 Peer Review Report Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marianne Schmid More articles by this author Christian Meyer More articles by this author Gally Reznor More articles by this author Julian Hanske More articles by this author Jesse Sammon More articles by this author Firas Abdollah More articles by this author Akshay Sood More articles by this author Deepansh Dalela More articles by this author Brandon Mahal More articles by this author Adam Kibel More articles by this author Felix Chun More articles by this author Paul Nguyen More articles by this author Mani Menon More articles by this author Margit Fisch More articles by this author Quoc-Dien Trinh More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Light treatment for seasonal Winter depression in African-American vs Caucasian outpatients.

To compare adherence, response, and remission with light treatment in African-American and Caucasian patients with Seasonal Affective Disorder. Seventy-eight study participants, age range 18-64 (51 African-Americans and 27 Caucasians) recruited from the Greater Baltimore Metropolitan area, with diagnoses of recurrent mood disorder with seasonal pattern, and confirmed by a Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders-IV, were enrolled in an open label study of daily bright light treatment. The trial lasted 6 wk with flexible dosing of light starting with 10000 lux bright light for 60 min daily in the morning. At the end of six weeks there were 65 completers. Three patients had Bipolar II disorder and the remainder had Major depressive disorder. Outcome measures were remission (score ≤ 8) and response (50% reduction) in symptoms on the Structured Interview Guide for the Hamilton Rating Scale for Depression (SIGH-SAD) as well as symptomatic improvement on SIGH-SAD and Beck Depression Inventory-II. Adherence was measured using participant daily log. Participant groups were compared using t-tests, chi square, linear and logistic regressions. The study did not find any significant group difference between African-Americans and their Caucasian counterparts in adherence with light treatment as well as in symptomatic improvement. While symptomatic improvement and rate of treatment response were not different between the two groups, African-Americans, after adjustment for age, gender and adherence, achieved a significantly lower remission rate (African-Americans 46.3%; Caucasians 75%; P = 0.02). This is the first study of light treatment in African-Americans, continuing our previous work reporting a similar frequency but a lower awareness of SAD and its treatment in African-Americans. Similar rates of adherence, symptomatic improvement and treatment response suggest that light treatment is a feasible, acceptable, and beneficial treatment for SAD in African-American patients. These results should lead to intensifying education initiatives to increase awareness of SAD and its treatment in African-American communities to increased SAD treatment engagement. In African-American vs Caucasian SAD patients a remission gap was identified, as reported before with antidepressant medications for non-seasonal depression, demanding sustained efforts to investigate and then address its causes.

Introduction to the special issue on achieving healthy weight in black American communities.

The prevalence of obesity is high in the United States, and highest among racial and ethnic minority groups. This special issue of Obesity Reviews is based upon evidence reviews prepared for and presented at a national invited workshop convened by the African American Collaborative Obesity Research Network (AACORN) in August of 2012. A set of potential topics was developed, a priori, and AACORN network members and colleagues with relevant expertise were invited to lead evidence reviews. The result is 10 articles focused on providing a comprehensive picture of what is known and unknown about interventions to prevent and treat obesity or improve weight-related behaviours in African American adults and children. Evidence reviews included in this special issue focus on children and adolescents (n=2); adults from various perspectives (n=5); eHealth interventions (n=1); interventions within faith organizations (n=1); and environmental and policy change interventions (n=1). Overall, the reviews show a small evidence base for research on African Americans and call for additional prioritization of funding to include studies that can inform action and bring progress in obesity prevention and treatment in African Americans on par with the scope and seriousness of the problem.

Improving approaches to hypertension treatment in African Americans: lessons learned from the Jackson Heart Study.

Improving approaches to hypertension treatment in African Americans: lessons learned from the Jackson Heart Study.

Changing Psychiatric Perception of African-Americans With Affective Disorders

This article explored the origins and implications of the underdiagnosis of affective disorders in African-Americans. MEDLINE and old collections were searched using relevant key words. Reference lists from the articles that were gathered from this procedure were reviewed. The historical record indicated that the psychiatric perception of African-Americans with affective disorders changed significantly during the last 200 years. In the antebellum period, the mental disorders of slaves mostly went unnoticed. By the early 20th century, African-Americans were reported to have high rates of manic-depressive disorder compared with whites. By the mid-century, rates of manic-depressive disorder in African-Americans plummeted, whereas depression remained virtually nonexistent. In recent decades, diagnosed depression and bipolar disorder, whether in clinical or research settings, were inexplicably low in African-Americans compared with whites. Given these findings, American psychiatry needs to appraise the deep-seated effects of historical stereotypes on the diagnosis and treatment of African-Americans.

Racial differences in delay of treatment for localized prostate cancer (CaP): A population-based study.

6037 Background: African-Americans (AA) are diagnosed with more advanced CaP than Caucasians (CA) and are more likely to die from CaP. Treatment delay is a potentially modifiable obstacle to care and clinically may be more important in AA patients because of more aggressive cancer at diagnosis. We examined time from diagnosis to curative treatment (surgery or radiation) in AA and CA patients in the Surveillance, Epidemiologic and End Results (SEER)-Medicare linked database. Methods: 21,454 CA and 2,506 AA patients who were diagnosed with non-metastatic CaP from 2004-08 and received treatment within 12 months of diagnosis were included. Linear regression was used to examine factors associated with number of days from diagnosis to treatment initiation, and logistic regression to assess odds of treatment within 6 months of diagnosis. Results: AA patients were more likely to have high-risk CaP than CA patients (39 vs. 35%), and less likely to have low-risk CaP (27 vs. 31%) (p&lt;.001). Time to treatment was significantly prolonged for AA patients in all risk groups of CaP, and the difference was most prominent for high-risk patients (median 105 days for AA vs. 96 days for CA, p=.002). Racial differences in time to treatment persisted in multivariable analysis (Table). Sensitivity analyses examining the proportion of AA and CA patients initiating treatment within 6 months of diagnosis revealed similar results. Conclusions: AA patients, especially those with high-risk CaP, experience longer treatment delays than CA patients. This is the first large-scale study to examine treatment delays in AA and CA patients with CaP. The differences found may contribute to our understanding of racial disparities in CaP treatment outcomes. [Table: see text]

Treatment of Heart Failure in African Americans— A Call to Action

Advances in heart failure treatment have not necessarily translated into equity in improved outcomes for African Americans. Heart failure in African Americans is characterized by a higher prevalence, especially at younger ages; more-adverse course with more frequent hospitalizations; and higher mortality rates compared to the general population. Despite this distinct disease profile, African Americans are remarkably underrepresented in large heart failure trials. This paper reviews the unique course of heart failure in African Americans and discusses treatment in the context of clinical trial evidence. African Americans with heart failure may respond differently to some standard therapies compared to whites, but low levels of enrollment of AAs in large clinical trials preclude valid conclusions in certain cases. An important exception is the African American Heart Failure Trial (AHeFT), a well-designed, prospective, randomized, placebo-controlled, double-blind study, that added a combination of fixed-dose isosorbide dinitrate/hydralazine (ISDN/ HYD) to standard therapy and showed a 43% improvement in survival and a 33% reduction in first hospitalizations. Despite compelling evidence from AHeFT, post hoc secondary analyses, and recommendations from current practice guidelines, ISDN/HYD remains underutilized in African Americans with heart failure. In this paper, we put forth a call to action for racial equity in clinical research and treatment in African Americans with heart failure.

A Savagist Abroad: Anti-Colonial Theory and the Quiet Violence in Twain's Western Oeuvre

Over the past several decades, two concerns have dominated the scholarship around the writings of Mark Twain: interventions into the debate over Twain’s discursive treatment of African Americans, particularly its appropriateness to secondary school learning, and discussion of Twain’s less studied writings with respect to his critique of imperialism. Despite its intricate relation to both of these topics, the “Native presence” in Twain’s writing—a phrase I pointedly borrow from Toni Morrison—has received comparatively little attention. Yet this discursive presence of Native Americans, whether they are actually en-charactered or not, is perhaps one of the most pervasive and apparently hypocritical elements of Twain’s writing, from its inception in the 1850s through the publication of Adventures of Huckleberry Finn in 1884, as well as beyond (the author’s career importantly spanning the most intense era of U.S. aggression toward Indian nations). Because Twain routinely spoke the unspeakable in ways that helped make the thoughts and attitudes of his land-aggressive western readers toward Native Americans more acceptable in the broader public conversation, his words often serve as a classic illustration of literary savagism as delineated by Roy Harvey Pearce in his pivotal theoretical observations from Savagism and Civilization. 1 Given the persistent split between post-colonial studies (of which in terest in the cultures of U.S. imperialism and Twain’s anti-imperialism is a by-product) and the understudied dynamics of U.S. imperialism, both material and literary, on the North American continent itself, the complexities of Twain’s references to Native America and their contexts merit collective and sustained scholarly inquiry. In particular, scholars working in the field of Native American Studies are poised to contribute significantly to our understanding of Twain’s impact on nonwhites globally. Such scholars can offer specific and credible, rather than generalized and under-theorized, insight into the historical contexts of Twain’s public and private commentary. I will attempt here to situate historically Twain’s regionalist writings—

Response Rates of Chronic Hepatitis C Treatment in African Americans and Caucasians: A Meta-Analysis

Response Rates of Chronic Hepatitis C Treatment in African Americans and Caucasians: A Meta-Analysis

Effect of increased body mass index on asthma risk, impairment and response to asthma controller therapy in African Americans

Objective:To explore whether obesity alters the risk, impairment and response to treatment in African Americans with asthma.Methods:The data used for this secondary analysis are from a 1-year study in African American subjects comparing fluticasone propionate/salmeterol 100/50 µg combination (FSC) and fluticasone propionate 100 µg (FP). Subjects were retrospectively stratified by body mass index (BMI) <20 [underweight], 20–24.9 [normal weight], 25–29.9 [overweight], 30–34.9 [obese I], 35–39.9 [obese II], and ≥40 [obese III] kg/m2. Outcomes studied included impairment domains: FEV1, morning and evening peak expiratory flow (AM and PM PEF), daily albuterol use, daily symptom scores and future risk domain: exacerbations.Clinical trial registration:www.clinicaltrials.gov; NCT00102765Results:There were 475 subjects evenly distributed between FSC and FP by baseline parameters. There were 207 subjects with a BMI ≥30, including 70 subjects with a BMI ≥40. Baseline BMI ≥40 was associated with numerically lower baseline AM and PM PEF. There was an attenuation of response to both treatments for only PM PEF (p < 0.05). By contrast, subjects with lower degrees of obesity or overweight did not differ from those with normal weight. The total population exacerbation rate was 2-fold greater in obese III subjects (39%) compared with subjects in other BMI categories (16–21%) (p < 0.05). A potential study limitation is the retrospective analysis of existing data.Discussion:Response to treatment was attenuated for PM PEF for subjects with BMI ≥40 and was also associated with an increased rate of asthma exacerbations.

The View from the Cotton: Reconsidering the Southern Tenant Farmers’ Union

Abstract Having been evicted from their farms because of incentives created by the New Deal’s Agricultural Adjustment Act, sharecroppers in Arkansas formed the bir acial Southern Tenant Farmers’ Union (STFU) in 1934. Led by socialists and radicals, the organization ultimately claimed upward of thirty thousand members and constituted an assault on the social, economic, and racial status quo of the South. Historians have celebrated the STFU, especially its commitment to biracial cooperation and equality. This article digs beneath this carefully constructed image of the union to scrutinize the internal dynamics of the movement. It revises a number of interpretations surrounding the STFU Although the greatest obstacles to the union’s success were external, it also faced internal divisions that diminished its efficacy. The STFU’s decentralized structure did not foster strong connections between leadership and membership, resulting in misunderstandings. But most importantly, the union struggled to live up to its creed of biracialism and equal treatment of African Americans. Ultimately, the STFU was less an aberration that tirelessly confronted the social and racial ills of the South and more an organization that reflected some of those ills even as it grappled with them.

The View from the Cotton: Reconsidering the Southern Tenant Farmers' Union

Having been evicted from their homes because of incentives created by the New Deal's AGricultural ADjustment Act, sharecroppers in Arkansas formed the biracial Southern Tenant Farmers' Union (STFU) in 1934. Led by socialists and radicals, the organization ultimately claimed upward of thirty thousand members and constituted an assault on the social, economic, and racial status quo of the South. Historians have celebrated the STFU, especially its commitment to biracial cooperation and equality. This article digs beneath this carefully constructed image of the union to scrutinize the internal dynamics of the movement. It revises a number of interpretations surrounding the STFU. Although the greatest obstacles to the union's success were external, it also faced internal divisions that diminished its efficacy. The STFU's decentralized structure did not foster strong connections between leadership and membership, resulting in misunderstandings. But most importantly, the union struggled to live up to its creed of biracialism and equal treatment of African Americans. Ultimately, the STFU was less an aberration that tirelessly confronted the social and racial ills of the South and more an organization that reflected some of those ills even as it grappled with them.