The Influence of Race on Health Status Outcomes One Year After an Acute Coronary Syndrome

ObjectivesThe goal of this study was to compare health status (symptoms, function, and quality of life) outcomes of whites and blacks one year after an acute coronary syndrome (ACS).BackgroundAlthough racial differences in the use of angiography and revascularization after ACS are known to exist, differences in health status outcomes have not been described.MethodsWe conducted a prospective registry of 1,159 consecutive ACS patients treated between February 1, 2000 and October 31, 2001. One-year health status was quantified with the Seattle Angina Questionnaire (SAQ) and Short Form-12 Physical Component Score (SF-12 PCS). Multivariable models were used to adjust for racial differences in sociodemographic, clinical, and treatment characteristics.ResultsMortality rates were similar among the 196 black and 963 white patients (7.1% vs. 7.0%, p = 0.93); 81 died during follow-up, and 199 (17%) could not be interviewed. At one year, blacks had a higher prevalence of angina (43.4% vs. 27.1%), worse quality of life (SAQ score = 70.6 ± 28.3 vs. 83.9 ± 20.8), and poorer physical function (SF-12 PCS = 36.8 ± 12.3 vs. 43.2 ± 11.4; p < 0.0001 for all). Multivariable models, including hospital treatments, revealed a trend for more angina (odds ratio 1.46 [95% confidence interval 0.91 to 2.34]) and significantly worse quality of life (mean difference = −7.7 ± 2.4, p = 0.002) and physical function (−3.6 ± 1.3, p = 0.005).ConclusionsBlacks have more angina, worse quality of life, and worse physical function one year after an ACS than do whites. Closer surveillance of black ACS patients is needed to determine whether additional treatment can improve their outcomes

"Monstrous and indefensible"? Newspaper accounts of sexual assaults on children in nineteenth-century England and Wales

This material has been published in Women's Criminality in Europe, 1600–1914 edited by Edited by Manon van der Heijden, Marion Pluskota, Sanne Muurling, https://doi.org/10.1017/9781108774543. This version is free to view and download for private research and study only. Not for re-distribution or re-use. © 2020 Cambridge University Press.Popular crime reportage of sexual violence has a long history in England. Despite the fact that from the 1830s onwards newspapers and periodicals – and sometimes even law reports – were increasingly liable to skim over the reporting of sexual offences as ‘unfit for publication’, this does not mean that such reportage vanished entirely. Instead, certain linguistic codes and euphemisms were invoked to maintain a respectable discourse. Given the serious problems with gaps in the surviving archival record for modern criminal justice, newspapers remain an essential tool for understanding the history of sexual violence in nineteenth century England and Wales. Using keyword searches in digitized newspaper databases such as the British Newspaper Archive and Welsh Newspapers Database, this chapter examines the continuities and changes in the reporting of sexual violence against children between 1800 and 1900, and explores what these euphemisms and elisions reveal about attitudes to gender and crime in nineteenth-century England and Wales.Peer reviewe

Gender and release from imprisonment: Convict licensing systems in mid to late 19th century England

This paper draws on the research undertaken into the lives and prison experiences of around 650 male and female convicts who were released on licence (an early form of parole) from sentences of long term imprisonment (three years to life) in England in the mid- to late-nineteenth century. Our project confirmed the patterns of offending seen in other studies of female and male offending, namely, that women were committed to periods of long-term imprisonment overwhelmingly for crimes of larceny and sometimes low-level violence (or their criminal backgrounds indicated this type of low-level disorderly behaviour) and only in the minority for crimes of serious interpersonal violence. Similarly, the majority of men were also committed to the convict system for larceny. Yet how male and female offenders were treated by the prison licensing system did differ significantly. The vast majority of all prisoners, male and female, were released early on licence from their prison terms, even those who had committed very serious offences. All licences had several conditions in them and licence-holders were free so long as they met these conditions. Any breach of the above conditions meant that the individual would be returned to prison to serve out the remainder of their sentence.However, a proportion of female offenders were released slightly earlier than their male counterparts, though not directly into the community but on a conditional licence to Female Refuges. Out of the 288 women researched in our project, 200 of them were released in this manner; under further confinement in a refuge. Women stayed in such refuges for on average between six and nine months, before their final release was then approved by the Directors of the Convict Prisons

Listeria pathogenesis and molecular virulence determinants

The gram-positive bacterium Listeria monocytogenes is the causative agent of listeriosis, a highly fatal opportunistic foodborne infection. Pregnant women, neonates, the elderly, and debilitated or immunocompromised patients in general are predominantly affected, although the disease can also develop in normal individuals. Clinical manifestations of invasive listeriosis are usually severe and include abortion, sepsis, and meningoencephalitis. Listeriosis can also manifest as a febrile gastroenteritis syndrome. In addition to humans, L. monocytogenes affects many vertebrate species, including birds. Listeria ivanovii, a second pathogenic species of the genus, is specific for ruminants. Our current view of the pathophysiology of listeriosis derives largely from studies with the mouse infection model. Pathogenic listeriae enter the host primarily through the intestine. The liver is thought to be their first target organ after intestinal translocation. In the liver, listeriae actively multiply until the infection is controlled by a cell-mediated immune response. This initial, subclinical step of listeriosis is thought to be common due to the frequent presence of pathogenic L. monocytogenes in food. In normal indivuals, the continual exposure to listerial antigens probably contributes to the maintenance of anti-Listeria memory T cells. However, in debilitated and immunocompromised patients, the unrestricted proliferation of listeriae in the liver may result in prolonged low-level bacteremia, leading to invasion of the preferred secondary target organs (the brain and the gravid uterus) and to overt clinical disease. L. monocytogenes and L. ivanovii are facultative intracellular parasites able to survive in macrophages and to invade a variety of normally nonphagocytic cells, such as epithelial cells, hepatocytes, and endothelial cells. In all these cell types, pathogenic listeriae go through an intracellular life cycle involving early escape from the phagocytic vacuole, rapid intracytoplasmic multiplication, bacterially induced actin-based motility, and direct spread to neighboring cells, in which they reinitiate the cycle. In this way, listeriae disseminate in host tissues sheltered from the humoral arm of the immune system. Over the last 15 years, a number of virulence factors involved in key steps of this intracellular life cycle have been identified. This review describes in detail the molecular determinants of Listeria virulence and their mechanism of action and summarizes the current knowledge on the pathophysiology of listeriosis and the cell biology and host cell responses to Listeria infection. This article provides an updated perspective of the development of our understanding of Listeria pathogenesis from the first molecular genetic analyses of virulence mechanisms reported in 1985 until the start of the genomic era of Listeria research