Racism as a determinant of health: a systematic review and meta-analysis

Despite a growing body of epidemiological evidence in recent years documenting the health impacts of racism, the cumulative evidence base has yet to be synthesized in a comprehensive meta-analysis focused specifically on racism as a determinant of health. This meta-analysis reviewed the literature focusing on the relationship between reported racism and mental and physical health outcomes. Data from 293 studies reported in 333 articles published between 1983 and 2013, and conducted predominately in the U.S., were analysed using random effects models and mean weighted effect sizes. Racism was associated with poorer mental health (negative mental health: r = -.23, 95% CI [-.24,-.21], k = 227; positive mental health: r = -.13, 95% CI [-.16,-.10], k = 113), including depression, anxiety, psychological stress and various other outcomes. Racism was also associated with poorer general health (r = -.13 (95% CI [-.18,-.09], k = 30), and poorer physical health (r = -.09, 95% CI [-.12,-.06], k = 50). Moderation effects were found for some outcomes with regard to study and exposure characteristics. Effect sizes of racism on mental health were stronger in cross-sectional compared with longitudinal data and in non-representative samples compared with representative samples. Age, sex, birthplace and education level did not moderate the effects of racism on health. Ethnicity significantly moderated the effect of racism on negative mental health and physical health: the association between racism and negative mental health was significantly stronger for Asian American and Latino(a) American participants compared with African American participants, and the association between racism and physical health was significantly stronger for Latino(a) American participants compared with African American participants.<br /

High thermoelectric performance of a heterogeneous PbTe nanocomposite

In this paper, we propose a heterogeneous material for bulk thermoelectrics. By varying the quenching time of Na doped PbTe, followed by hot pressing, we synthesized heterogeneous nanocomposites, a mixture of nanodot nanocomposites and nanograined nanocomposites. It is well-known that by putting excess amounts of Na (i.e., exceeding the solubility limit) into PbTe, nanodots with sizes as small as a few nanometers can be formed. Nanograined regions with an average grain size of ca. 10 nm are observed only in materials synthesized with an extremely low quenching rate, which was achieved by using a quenching media of iced salt water and cold water. Dimensionless thermoelectric figures of merit, zT, of those heterogeneous nanocomposites exhibited a zT around 2.0 at 773 K, which is a 25% increase compared to zT of a homogeneous nanodot nanocomposite with the largest quenching time in our experiment, i.e. furnace cooled. The power factor increase is 5%, and the thermal conductivity reduction is 15%; thus, zT increase mainly comes from the thermal conductivity reduction

Pharmacology of intra-articular triamcinolone

Introduction: The inflammatory joint diseases of juvenile inflammatory arthritis (JIA), rheumatoid arthritis (RA) and osteoarthritis (OA): and also mild to moderate joint injury, all require a multidisciplinary approach to management. Intra-articular injections of corticosteroids have been shown to be a very beneficial adjunctive treatment in the management of the above disorders. It is, therefore, important that clinicians have a good understanding of the clinical actions of intra-articular injections. Objective: This article explores the pharmacokinetics, pharmacodynamics, and clinical pharmacology of triamcinolone acetonide (TA) and triamcinolone hexacetonide (TH) in JIA, RA, and OA. Methods: Literature search of TA and TH articles was conducted using key word searches in the PubMed and Google Scholar databases and through references within found articles. Results: TA and TH intra-articular injections have been shown to provide good clinical benefit for up to 6 months and even longer. TH has been shown to decrease in the expression of citrullinated proteins, the monoclonal antibody F95, and peptidylarginine deiminase 4 in RA synovium. TA and TH intra-articular injections have a low side effect profile which is similar to other corticosteroid. They have minimal to no mineralocorticoid adverse effects and facial flushing 2–3 days post injections is the most common side effect recorded, and in almost all cases is no worse than nuisance. Conclusion: TA and TH are useful adjunct therapies in the management of JIA, RA, OA, and mild to moderate joint injury.</p