Neighborhood social processes as moderators between racial discrimination and depressive symptoms for African American adolescents

Racial discrimination is associated with numerous psychological consequences, including increased depressive symptoms for African American adolescents (Brody et al., 2006; Wong, Eccles, & Sameroff, 2003). Adolescents’ perceptions of their neighborhood can influence how youth interpret and manage racial discrimination (Sampson, Morenoff, & Gannon‐Rowley, 2002). Yet little is known about how adolescent perceptions of neighborhood cohesion and neighborhood disorganization protect or exacerbate the effects of racial discrimination, or how these effects vary by youth’s gender. Therefore, the current study examined whether neighborhood social cohesion and neighborhood disorganization moderated the association between racial discrimination and depressive symptoms for African American adolescents and how the effects differ for boys and girls. Participants were 106 African American adolescents (57% female; mean age 15.14) from an urban metropolitan area. Regression analyses suggest that perceptions of neighborhood social cohesion protected against racial discrimination for boys and girls. Additionally, the results indicate that when boys perceive less neighborhood disorganization, racial discrimination has a greater influence on their depressive symptoms. Findings have implications for intervention and prevention efforts that enhance and utilize positive neighborhood social processes for youth contending with racial discrimination.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145257/1/jcop21970_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145257/2/jcop21970.pd

Patient’s Perception of Community Pharmacist in North Malabar region of Kerala, India: A questionnaire based study

Pharmacists as vital healthcare professionals play significant role in effective medication management and their use among the patients. However the perception of community pharmacist  among the public needs to be assessed for effective role and further patient care. This questionnaire based study was aimed to identify the perception of patients towards the community pharmacist in north Malabar region of Kerala, India. The questionnaire consisted of 16 questions with sections evaluating the demographic details (age, sex, marital status, education level & occupation) and the perception of patients towards the community pharmacist. The results were prepared based upon the responses obtained from 110 patients. The study respondents consisted of 51 (46.36%) adults (18-59 years) and 59 (53.63%) geriatrics (above 60 years). Based on their education level, 9 (8.18%), 35 (31.81%) and 66 (60%) participants were illiterate, secondary school and graduate holders respectively. The respondents of the study informed that the pharmacist enquired about their past medication history (58, 52.73%), any allergic reactions (21, 19.1%) and use of any herbal medication (31, 28.18%) prior to the dispensing process. The patients also responded that proper advice regarding dosage (90%), side effects (25%), storage (12%), healthy eating & exercise (10%) were also provided by the concerned pharmacist. As a matter of fact, 91 out of 110 patients thought the pharmacist service were good, 17 thought they were fairly good and 2 were of the opinion that it was poor. The pharmacy rating was evaluated as good by 32 (29.09%), fairly good by 78 (70.90%) and no respondents were of opinion that the pharmacy was poor in its service. Through this study, we found that the overall perception of patients towards the pharmacist in concerned community pharmacy setting was good. To further improvise their role, continued pharmacy education programmes, better communication skills and good professional training must be imparted among the community pharmacists

Ethnic‐racial Socialization, Perceived Neighborhood Quality, and Psychosocial Adjustment among African American and Caribbean Black Adolescents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167129/1/jora12586.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167129/2/jora12586_am.pd

Mother-adolescent relationship quality as a moderator of associations between racial socialization and adolescent psychological adjustment.

Parents\u27 racial socialization messages, including messages focused on awareness, preparation, and strategies for managing racial discrimination, are necessary to help African American youth successfully navigate their daily lives. However, mixed findings regarding the utility of preparation for bias messages for African American youth\u27s mental health adjustment raise questions about the conditions under which these protective racial socialization messages are most beneficial to African American youth. The current study examined the degree to which communication and trust as well as anger and alienation in the mother-adolescent relationship moderated associations between 2 types of preparation for bias messages, cultural alertness to discrimination and cultural coping with antagonism, and adolescent mental health. Participants were 106 African American adolescents (57% female; mean age = 15.41) who reported about their receipt of racial socialization messages, mother-adolescent relationship quality, and depressive symptoms. Hierarchical regression analyses indicated that positive associations between cultural alertness to racial discrimination and youth depressive symptoms were weaker for boys in the context of higher mother-adolescent communication and trust; communication and trust were not similarly protective for girls. For boys, the positive associations between cultural coping with antagonism messages and depressive symptoms were stronger in the context of high anger and alienation in the mother-adolescent relationship. Findings suggest that qualities of the mother-adolescent relationship, in which preparation for bias messages are delivered, are important for understanding the mental health adjustment of African American adolescents. (PsycINFO Database Recor

Interrupting the Pathway From Discrimination to Black Adolescents’ Psychosocial Outcomes: The Contribution of Parental Racial Worries and Racial Socialization Competency

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/170982/1/cdev13607.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/170982/2/cdev13607_am.pd

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk