The Creativity and Commitment of Organ Procurement Personnel Overcome the Logistical Complexities of International Organ Donations

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107510/1/ajt12710.pd

Ethnicity, educational attainment, and physical health of older adults in the United States

ObjectiveMinorities’ diminished returns theory suggests that socioeconomic status (SES) resources generate fewer health benefits for racial and ethnic minority groups, compared to the majority group. The current study aimed to compare Hispanic and non‐Hispanic white older adults for the association between educational attainment and poor physical self‐rated health (SRH).MethodsThe first wave of the University of Michigan National Poll on Healthy Aging (UM‐NPHA) included 1820 older adults who were 50‐80 years old and were either non‐Hispanic white (n = 1618) or Hispanic white (n = 202). The main independent variable of interest was educational attainment. The main dependent variable of interest was poor physical SRH. Gender, age, marital status, and employment status were covariates. Ethnicity was the focal effect modifier.ResultsOverall, higher level of educational attainment was associated with better physical SRH. A significant interaction was found between ethnicity and level of educational attainment, which was indicative of a smaller physical SRH gain due to high educational attainment for Hispanic white compared to non‐Hispanic white older adults. In ethnic‐specific models, we found evidence suggesting that high educational attainment reduced the odds of poor physical SRH for non‐Hispanic whites but not for Hispanic whites.ConclusionCompared to non‐Hispanic whites, Hispanic whites gain less physical SRH benefits from their educational attainment.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149760/1/agm212050_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149760/2/agm212050.pd

Fear of Neighborhood Violence During Adolescence Predicts Development of Obesity a Decade Later: Gender Differences Among African Americans

Background: African American youth are more likely than other racial and ethnic groups to be obese. African American youth are also more likely to live in disadvantaged neighborhoods which increase their victimization, observation, and fear of violence. Objectives: This study tested if victimization, observation, and fear of violence in the neighborhood during adolescence predict trajectory of body mass index (BMI) in the 3rd decade of life in African Americans. Patients and Methods: Data came from an 18-year community-based cohort. We used multi-group latent growth curve modeling for data analysis, considering neighborhood violence at age 15 (i.e. victimization, observation, and fear) as predictors, and the linear slope for the average change in BMI from age 21 to 32 as the outcome, with age and socioeconomic status (i.e. intact family and parental employment) as covariates. Results: Fear of neighborhood violence at age 15 was predictive of an increase in BMI from age 21 to 32 among female but not male African Americans. Victimization and observation of violence at age 15 did not predict BMI change from age 21 to 32 among female or male African Americans. Conclusions: Fear of neighborhood violence is a contributing factor to increased risk of obesity for female African American youth who live in disadvantaged areas. This finding has implications for prevention of obesity among African American women who are at highest risk for obesity in the United States. Initiatives that enhance neighborhood safety are critical strategies for obesity prevention among African American women

Confirmatory factor analysis of the 12-item center for epidemiologic studies depression scale among blacks and whites

Background: The Center for Epidemiologic Studies Depression (CES-D) scale is one of the most widely used tools to measure depressive symptoms in epidemiological studies. Given the importance of cross-racial measurement equivalence of the CES-D scale for research, we performed confirmatory factor analysis (CFA) of the 12-item CES-D in a nationally representative sample of Black and White adults in the United States. Methods: We used data from the National Survey of American Life (NSAL), 2001-2003. A total number of 3570 Blacks (African-Americans) and 891 non-Hispanic Whites were included in the present study. CFA was carried out on the 12-item CES-D scale using multi-group structural equation modeling. Results: For both Blacks and Whites, the best fitting model was found to be the 3-factor model, indicating invariance of factor structure between Blacks and Whites. A statistically different fit of the models with and without constraints indicated lack of invariance of factor loadings between Blacks and Whites. Some of the positive (i.e., "as good" and "hopeful") and interpersonal (i.e., "people were unfriendly") items showed poor loadings, even in the 3-factor solution that allowed separate domains for positive affect, negative affect, and interpersonal problems. Despite the good fit of our final model, more items (i.e., "as good," "hopeful," "keeping mind," and "everything effort") had poorer loadings in Blacks than Whites (i.e., "as good"). Conclusion: There is invariance in factor structure but lack of invariance in factor/item loadings between Blacks and Whites. These findings have implications for cross-racial studies of depressive symptoms using CES-D scale among Blacks and Whites. Further research is warranted to scrutinize the role of socioeconomics and culture in explaining the lack of invariance of the CES-D scale between Blacks and Whites. � 2016 Assari and Moazen-Zadeh

Ethnic variation in the cross-sectional association between domains of depressive symptoms and clinical depression

Background: The degree by which depressive symptoms and clinical depression reflect each other may vary across populations. The present study compared Blacks and Whites for the magnitude of the cross-sectional associations between various domains of depressive symptoms and endorsement of clinical disorders of depression. Methods: Data came from the National Survey of American Life, 2001-2003. We included 3570 Black (African-Americans) and 891 Non-Hispanic Whites. Predictors were positive affect, negative affect, and interpersonal problems measured using the 12-item Center for Epidemiologic Studies Depression Scale (CES-D). Outcomes were lifetime major depressive disorder (MDD), lifetime major depressive episode (MDE), 12-month MDE, 30-day MDE, and 30-day major depressive disorder with hierarchy (MDDH) based on the Composite International Diagnostic Interview (CIDI). Logistic regression models were applied in the pooled sample as well as Blacks and Whites. Results: Regarding CES-D, Blacks had lower total scores, positive affect, negative affect, and interpersonal problems compared to Whites (p < 0.05 for all comparisons). Blacks also had lower odds of meeting criteria for lifetime MDD and MDE, 12-month MDE, and 30-day MDE and MDDH (p < 0.05 for all comparisons). For most depressive diagnoses, ethnicity showed a positive and significant interaction with the negative affect and interpersonal problems domains, suggesting stronger associations for Blacks compared to Whites. The CES-D total score and CES-D positive affect domain did not interact with ethnicity on CIDI-based depressive diagnoses. Conclusion: Stronger associations between multiple domains of depressive symptoms and clinical depression may be due to higher severity of depression among Blacks, when they endorse the CIDI criteria for the disorder. This finding may explain some of previously observed ethnic differences in social, psychological, and medical correlates of depressive symptoms and clinical depression in the general population as well as clinical settings. � 2016 Assari and Moazen-Zadeh

The prevalence of hepatitis B surface antigen and anti-hepatitis B core antibody in Iran: A population-based study

Background: Hepatitis B virus infection is a very common cause of chronic liver disease worldwide. It is estimated that 3 of Iranians are chronically infected with hepatitis B virus. Current population-based studies on both rural and urban prevalence of hepatitis B virus infection in Iran are sparse with results that do not always agree. We performed this study to find the prevalence of hepatitis B surface antigen, anti-hepatitis B core antibody, and associated factors in the general population of three provinces of Iran. Methods: We randomly selected 6,583 subjects from three provinces in Iran, namely Tehran, Golestan, and Hormozgan. The subjects were aged between 18 and 65 years. Serum samples were tested for hepatitis B surface antigen and anti-hepatitis B core antibody. Various risk factors were recorded and multivariate analysis was performed. Results: The prevalence of hepatitis B surface antigen and anti-hepatitis B core antibody in Iran was 2.6 and 16.4, respectively. Predictors of hepatitis B surface antigen or anti-hepatitis B core antibody in multivariate analysis included older age, not having high-school diploma, living in a rural area, and liver disease in a family member. We did not find any significant differences between males and females. Conclusion: In spite of nationwide vaccination of newborns against hepatitis B virus since 1992, hepatitis B virus infection remains a very common cause of chronic liver disease in Iran which should be dealt with for at least the next 30-50 years

Defining polypharmacy in the elderly: A systematic review protocol

Introduction: Ageing-along with its associated physiological and pathological changes-places individuals at a higher risk of multimorbidity and treatment-related complications. Today, polypharmacy, a common and important problem related to drug use, occurs subsequent to this multimorbidity in the elderly in all populations. In recent decades, several scientific investigations have studied polypharmacy and its correlates, using different approaches and definitions, and their results have been inconclusive. Differences in definitions and approaches in these studies form a barrier against reaching a conclusion regarding the risk factors and consequences of polypharmacy. It is therefore imperative to establish an appropriate definition of polypharmacy. Methods and analysis: A systematic review will be conducted using PubMed, Scopus, Web of Science, EMBASE, PsycINFO and AgeLine bibliographic databases, as well as the grey literature on polypharmacy in older adults to answer these two questions: What definitions in the literature are being used for polypharmacy in older people?, and Which definitions are more comprehensive and applicable? 2 independent reviewers will conduct the primary screening of the articles and data extraction, and eligible sources will be selected after discussing nonconformities. All extracted data from selected articles will be categorised based on the type of study participants, study design and setting, the methodological quality of primary studies and any other potential source of heterogeneity, and results will be summarised in a table, which will contain the levels of evidence and methodological quality of the included studies. The most comprehensive definition of polypharmacy will be selected from the final list of definitions through an international expert webinar. Ethics and Dissemination: This research is exempt from ethics approval because the work is carried out on published documents. We will disseminate this protocol in a related peer-reviewed journal

Fear, Loss, Social Isolation, and Incomplete Grief Due to COVID-19: A Recipe for a Psychiatric Pandemic

The experience of the loss of the relatives, which is naturally one of the most stressful events in a person's life, has turned into a new concept and challenge for survivors and mental health professionals during the coronavirus era. We discussed how restrictions caused by social distancing potentially increase the likelihood of a phenomenon called complicated grief or prolonged bereavement disorder and multilayer response by case finding to increase the access to public education to manage this complicated situation. © 2020 Iran University of Medical Sciences. All rights reserved

Sources of academic stress among Iranian adolescents: a multilevel study from Qazvin City, Iran

Background: Academic stress can cause mental and physical problems and affect adolescents’ healthy development. This study aimed to estimate academic stress and explore its sources at the individual- and school levels among school-going adolescents in the city of Qazvin, Iran. Results: This cross-sectional study used a stratified cluster sampling to recruit 1724 students aged 12–19 years from 53 schools in Qazvin City. Data were collected using a validated self-administered questionnaire. The mean academic stress score was 45.7 (95% CI 45.2, 46.3). The stress level was statistically higher among older 47.5 (95% CI 46.7, 48.3) than younger 44.1 (95% CI 43.4, 44.9) adolescents. The main academic stressors included: future uncertainty 69.7 (95% CI 68.8, 70.7), academic competition 58.5 (95% CI 57.3, 59.6), and interaction with teachers 56.1 (95% CI 55.3, 56.9). Gender, educational period, school type, family socioeconomic status, and father’s education were associated with academic stress. Conclusions: We conducted a multilevel study using a random sample of male and female students in the city of Qazvin, Iran. Results indicated moderate levels of stress among Iranian adolescents. The academic stress was associated with several individual and school-level variables. Students and their families and teachers need education on stress prevention methods and coping mechanisms. Future research should focus on developing and testing multilevel policies and interventions to improve students’ mental health and academic performance. Keywords: Academic stress, Adolescence, Students, Multilevel analysis, Ira

An explanatory model of depression among female patients in Fars, Kurds, Turks ethnic groups of Iran

Background: Depressive disorder is globally estimated to be as many as one in five visits to primary health care. Approximately more than 50 of depressed women in primary care are not diagnosed. As a part of a major investigation into perceptions of women's depression, this study explored how female patients and their relatives conceptualize patients' conditions in three ethnic groups in Iran (Fars, Kurds and Turks). Methods: Qualitative methods were used for data collection. Depressed women and their relatives were purposively selected from the public psychiatric clinics affiliated to university of medical sciences in the three study cities. Twentyfive depressed women and 14 relatives were interviewed in three ethnic groups. Results: One theme "illness meaning", including three categories: perceived symptoms, label of the illness, and effects of the illness was found through the content analysis. The participants perceived symptoms of illness as somatic and psychological depending on the participant's assumed reason for the onset of the illness. There were most similarities in term used for of the illness in the three ethnic groups. Most of the study participants described the illness in terms of nerve problems/illness, and depression "afsordehgi". The most important effects that depressed women had experienced because of their illness were marital conflict or a guilt feeling originating from their inability to support family. Conclusion: These findings suggest the need to recognize and choose appropriate diagnostic approach for depressed women in the context of Iran