Explaining disparities in colorectal cancer screening among five Asian ethnic groups: A population-based study in California

<p>Abstract</p> <p>Background</p> <p>Data from the California Health Interview Survey (CHIS) indicate that levels and temporal trends in colorectal cancer (CRC) screening prevalence vary among Asian American groups; however, the reasons for these differences have not been fully investigated.</p> <p>Methods</p> <p>Using CHIS 2001, 2003 and 2005 data, we conducted hierarchical regression analyses progressively controlling for demographic characteristics, English proficiency and access to care in an attempt to identify factors explaining differences in screening prevalence and trends among Chinese, Filipino, Vietnamese, Korean and Japanese Americans (N = 4,188).</p> <p>Results</p> <p>After controlling for differences in gender and age, all Asian subgroups had significantly lower odds of having ever received screening in 2001 than the reference group of Japanese Americans. In addition, Korean Americans were the only subgroup that had a statistically significant decline in screening prevalence from 2001 to 2005 compared to the trend among Japanese Americans. After controlling for differences in education, marital status, employment status and federal poverty level, Korean Americans were the only group that had significantly lower screening prevalence than Japanese Americans in 2001, and their trend to 2005 remained significantly depressed. After controlling for differences in English proficiency and access to care, screening prevalences in 2001 were no longer significantly different among the Asian subgroups, but the trend among Korean Americans from 2001 to 2005 remained significantly depressed. Korean and Vietnamese Americans were less likely than other groups to report a recent doctor recommendation for screening and more likely to cite a lack of health problems as a reason for not obtaining screening.</p> <p>Conclusions</p> <p>Differences in CRC screening trends among Asian ethnic groups are not entirely explained by differences in demographic characteristics, English proficiency and access to care. A better understanding of mutable factors such as rates of doctor recommendation and health beliefs will be crucial for designing culturally appropriate interventions to promote CRC screening.</p

Korean women: breast cancer knowledge, attitudes and behaviors

INTRODUCTION: Clustered within the nomenclature of Asian American are numerous subgroups, each with their own ethnic heritage, cultural, and linguistic characteristics. An understanding of the prevailing health knowledge, attitudes, and screening behaviors of these subgroups is essential for creating population-specific health promotion programs. METHODS: Korean American women (123) completed baseline surveys of breast cancer knowledge, attitudes, and screening behaviors as part of an Asian grocery store-based breast cancer education program evaluation. Follow-up telephone surveys, initiated two weeks later, were completed by 93 women. RESULTS: Low adherence to the American Cancer Society's breast cancer screening guidelines and insufficient breast cancer knowledge were reported. Participants' receptiveness to the grocery store-based breast cancer education program underscores the importance of finding ways to reach Korean women with breast cancer early detection information and repeated cues for screening. The data also suggest that the Asian grocery store-based cancer education program being tested may have been effective in motivating a proportion of the women to schedule a breast cancer screening between the baseline and follow-up surveys. CONCLUSION: The program offers a viable strategy to reach Korean women that addresses the language, cultural, transportation, and time barriers they face in accessing breast cancer early detection information

Pengembangan Lembar Kegiatan Siswa (Lks) Kimia Sma/ma Berbasis Learning Cycle 5e Pada Materi Laju Reaksi

Penelitian ini bertujuan untuk: (1) mengembangkan Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E, (2) mengetahui kualitas Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E, (3) mengetahui efektivitas Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E untuk meningkatkan prestasi belajar siswa. Penelitian dan pengembangan Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E menggunakan prosedur penelitian dan pengembangan dari Borg and Gall yang disederhanakan menjadi 9 tahapan yaitu: (1) penelitian pendahuluan dan pengumpulan data, (2) perencanaan, (3) pengembangan produk, (4) uji coba lapangan awal, (5) revisi produk awal, (6) uji coba pelaksanaan lapangan, (7) penyempurnaan produk hasil uji coba lapangan, (8) uji coba pelaksanaan lapangan, (9) penyempurnaan produk akhir. Analisis Data yang digunakan adalah analisis deskriptif kualitatif. Hasil Penelitian menunjukkan: (1) telah berhasil dikembangkan Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E pada materi Laju Reaksi yang dilakukan berdasarkan tahapan penelitian dan pengembangan R&amp;D yang terdiri dari 9 tahapan, (2) kualitas Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E pada materi Laju Reaksi memiliki kualitas sangat baik pada aspek komponen kelayakan isi, bahasa, penyajian dan kegrafisan dengan persentase sebesar 84,06% berdasarkan penilaian siswa dan 90,88% berdasarkan penilaian guru, (hasil uji efektivitas pada aspek pengetahuan terdapat perbedaan antara kelas eksperimen (pembelajaran dengan menggunakan model Learning Cycle 5E disertai Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E ) dan kelas baseline (pembelajaran dengan menggunakan model pembelajaran Learning Cycle 5E tanpa disertai Lembar Kegiatan Siswa (LKS) berbasis Learning Cycle 5E ),, sedangkan pada aspek sikap dan keterampilan tidak terdapat perbedaan

Filipina American women's breast cancer knowledge, attitudes, and screening behaviors

BACKGROUND: Filipino Americans are the fastest growing Asian minority group in the United States. There is limited knowledge about their breast cancer knowledge, screening practices and attitudes. METHODS: As part of the evaluation of the Asian Grocery Store-Based Cancer Education Program, 248 Filipino American women completed baseline and follow-up surveys, while an additional 58 took part in focus groups. RESULTS: Compliance with annual clinical breast exam guidelines among women 40 to 49 years old was 43%, and annual mammography use among women 50 and over was 56%. The Asian Grocery Store-Based Cancer Education Program and complementary focus group study identified multiple barriers that hindered women from attending education programs, with time as the most frequently reported barrier. CONCLUSION: The Asian Grocery Store-Based Cancer Education Program was reported to be a culturally acceptable and effective way of disseminating breast cancer information and one that addressed the women's most frequently reported barrier, lack of time

Conducting Health Research in Korean American Churches: Perspectives from Church Leaders

Korean Americans experience many challenges to obtaining adequate health care coverage and access to needed services. Because a large proportion of Korean Americans attend churches on a regular basis, churches may be a promising venue where health programs can be delivered. In order to gain an in-depth understanding of Korean American churches with respect to conducting future health intervention research, we conducted exploratory interviews and focus groups with 58 leaders from 23 Korean American churches and three community organizations. From these interviews and focus groups, we found that Korean churches and church leaders seek to meet a variety of social and health needs of their congregation and their surrounding community. Several leaders have stated that assisting with social and medical needs of their members is an important component of their current ministry. They described profound health needs of their congregations and have suggested various ways in which the university can partner with the local churches to help address these needs through research. Additionally, they described various resources churches can provide to researchers such as: their personal assistance, church volunteer base, church facility, and church network and contacts. Our findings suggest that Korean churches have a high potential to serve an important role in the health of Korean Americans. On the basis of the promising results of the present study, we are planning to conduct a cross sectional survey of Korean church leaders and members in Los Angeles County to substantiate our findings in a larger representative sample

How the other half lives: CRISPR-Cas's influence on bacteriophages

CRISPR-Cas is a genetic adaptive immune system unique to prokaryotic cells used to combat phage and plasmid threats. The host cell adapts by incorporating DNA sequences from invading phages or plasmids into its CRISPR locus as spacers. These spacers are expressed as mobile surveillance RNAs that direct CRISPR-associated (Cas) proteins to protect against subsequent attack by the same phages or plasmids. The threat from mobile genetic elements inevitably shapes the CRISPR loci of archaea and bacteria, and simultaneously the CRISPR-Cas immune system drives evolution of these invaders. Here we highlight our recent work, as well as that of others, that seeks to understand phage mechanisms of CRISPR-Cas evasion and conditions for population coexistence of phages with CRISPR-protected prokaryotes.Comment: 24 pages, 8 figure

Epidemiology of Malaria in an Area Prepared for Clinical Trials in Korogwe, North-eastern Tanzania.

Site preparation is a pre-requesite in conducting malaria vaccines trials. This study was conducted in 12 villages to determine malariometric indices and associated risk factors, during long and short rainy seasons, in an area with varying malaria transmission intensities in Korogwe district, Tanzania. Four villages had passive case detection (PCD) of fever system using village health workers. Four malariometric cross-sectional surveys were conducted between November 2005 and May 2007 among individuals aged 0-19 years, living in lowland urban, lowland rural and highland strata. A total of 10,766 blood samples were collected for malaria parasite diagnosis and anaemia estimation. Blood smears were stained with Giemsa while haemoglobin level was measured by HaemoCue. Socio-economic data were collected between Jan-Apr 2006. Adjusting for the effect of age, the risk of Plasmodium falciparum parasitaemia was significantly lower in both lowland urban, (OR = 0.26; 95%CI: 0.23-0.29, p < 0.001) and highlands, (OR = 0.21; 95%CI: 0.17-0.25, p < 0.001) compared to lowland rural. Individuals aged 6-9 years in the lowland rural and 4-19 years in both lowland urban and highlands had the highest parasite prevalence, whilst children below five years in all strata had the highest parasite density. Prevalence of splenomegaly and gametocyte were also lower in both lowland urban and highlands than in lowland rural. Anaemia (Hb <11 g/dl) prevalence was lowest in the lowland urban. Availability of PCD and higher socio-economic status (SES) were associated with reduced malaria and anaemia prevalence. Higher SES and use of bed nets in the lowland urban could be the important factors for low malaria infections in this stratum. Results obtained here were used together with those from PCD and DSS in selecting a village for Phase 1b MSP3 vaccine trial, which was conducted in the study area in year 2008

Physical and mental health comorbidity is common in people with multiple sclerosis: nationally representative cross-sectional population database analysis

&lt;b&gt;Background&lt;/b&gt; Comorbidity in Multiple Sclerosis (MS) is associated with worse health and higher mortality. This study aims to describe clinician recorded comorbidities in people with MS. &lt;p&gt;&lt;/p&gt; &lt;b&gt;Methods&lt;/b&gt; 39 comorbidities in 3826 people with MS aged ≥25 years were compared against 1,268,859 controls. Results were analysed by age, gender, and socioeconomic status, with unadjusted and adjusted Odds Ratios (ORs) calculated using logistic regression. &lt;p&gt;&lt;/p&gt; &lt;b&gt;Results&lt;/b&gt; People with MS were more likely to have one (OR 2.44; 95% CI 2.26-2.64), two (OR 1.49; 95% CI 1.38-1.62), three (OR 1.86; 95% CI 1.69-2.04), four or more (OR 1.61; 95% CI 1.47-1.77) non-MS chronic conditions than controls, and greater mental health comorbidity (OR 2.94; 95% CI 2.75-3.14), which increased as the number of physical comorbidities rose. Cardiovascular conditions, including atrial fibrillation (OR 0.49; 95% CI 0.36-0.67), chronic kidney disease (OR 0.51; 95% CI 0.40-0.65), heart failure (OR 0.62; 95% CI 0.45-0.85), coronary heart disease (OR 0.64; 95% CI 0.52-0.71), and hypertension (OR 0.65; 95% CI 0.59-0.72) were significantly less common in people with MS. &lt;p&gt;&lt;/p&gt; &lt;b&gt;Conclusion&lt;/b&gt; People with MS have excess multiple chronic conditions, with associated increased mental health comorbidity. The low recorded cardiovascular comorbidity warrants further investigation

The REstart or STop Antithrombotics Randomised Trial (RESTART) after stroke due to intracerebral haemorrhage: study protocol for a randomised controlled trial

Background For adults surviving stroke due to spontaneous (non-traumatic) intracerebral haemorrhage (ICH) who had taken an antithrombotic (i.e. anticoagulant or antiplatelet) drug for the prevention of vaso-occlusive disease before the ICH, it is unclear whether starting antiplatelet drugs results in an increase in the risk of recurrent ICH or a beneficial net reduction of all serious vascular events compared to avoiding antiplatelet drugs. Methods/design The REstart or STop Antithrombotics Randomised Trial (RESTART) is an investigator-led, randomised, open, assessor-blind, parallel-group, randomised trial comparing starting versus avoiding antiplatelet drugs for adults surviving antithrombotic-associated ICH at 122 hospital sites in the United Kingdom. RESTART uses a central, web-based randomisation system using a minimisation algorithm, with 1:1 treatment allocation to which central research staff are masked. Central follow-up includes annual postal or telephone questionnaires to participants and their general (family) practitioners, with local provision of information about adverse events and outcome events. The primary outcome is recurrent symptomatic ICH. The secondary outcomes are: symptomatic haemorrhagic events; symptomatic vaso-occlusive events; symptomatic stroke of uncertain type; other fatal events; modified Rankin Scale score; adherence to antiplatelet drug(s). The magnetic resonance imaging (MRI) sub-study involves the conduct of brain MRI according to a standardised imaging protocol before randomisation to investigate heterogeneity of treatment effect according to the presence of brain microbleeds. Recruitment began on 22 May 2013. The target sample size is at least 720 participants in the main trial (at least 550 in the MRI sub-study). Discussion Final results of RESTART will be analysed and disseminated in 2019. Trial registration ISRCTN71907627 (www.isrctn.com/ISRCTN71907627). Prospectively registered on 25 April 2013

Genome-wide DNA methylation analysis for diabetic nephropathy in type 1 diabetes mellitus

BACKGROUND: Diabetic nephropathy is a serious complication of diabetes mellitus and is associated with considerable morbidity and high mortality. There is increasing evidence to suggest that dysregulation of the epigenome is involved in diabetic nephropathy. We assessed whether epigenetic modification of DNA methylation is associated with diabetic nephropathy in a case-control study of 192 Irish patients with type 1 diabetes mellitus (T1D). Cases had T1D and nephropathy whereas controls had T1D but no evidence of renal disease. METHODS: We performed DNA methylation profiling in bisulphite converted DNA from cases and controls using the recently developed Illumina Infinium(R) HumanMethylation27 BeadChip, that enables the direct investigation of 27,578 individual cytosines at CpG loci throughout the genome, which are focused on the promoter regions of 14,495 genes. RESULTS: Singular Value Decomposition (SVD) analysis indicated that significant components of DNA methylation variation correlated with patient age, time to onset of diabetic nephropathy, and sex. Adjusting for confounding factors using multivariate Cox-regression analyses, and with a false discovery rate (FDR) of 0.05, we observed 19 CpG sites that demonstrated correlations with time to development of diabetic nephropathy. Of note, this included one CpG site located 18 bp upstream of the transcription start site of UNC13B, a gene in which the first intronic SNP rs13293564 has recently been reported to be associated with diabetic nephropathy. CONCLUSION: This high throughput platform was able to successfully interrogate the methylation state of individual cytosines and identified 19 prospective CpG sites associated with risk of diabetic nephropathy. These differences in DNA methylation are worthy of further follow-up in replication studies using larger cohorts of diabetic patients with and without nephropathy