Trust and glycemic control in black patients with diabetic retinopathy: A pilot study

Diabetic retinopathy (DR) is more prevalent in blacks than whites because, compared to whites, blacks on average have worse glycemic control. Both of these racial disparities reflect differences in sociocultural determinants of health, including physician mistrust. This randomized, controlled 6-month pilot trial compared the efficacy of a culturally tailored behavioral health/ophthalmologic intervention called Collaborative Care for Depression and Diabetic Retinopathy (CC-DDR) to enhanced usual care (EUC) for improving glycemic control in black patients with DR (n = 33). The mean age of participants was 68 years (SD 6.1 years), 76% were women, and the mean A1C was 8.7% (SD 1.5%). At baseline, 14 participants (42%) expressed mistrust about ophthalmologic diagnoses. After 6 months, CC-DDR participants had a clinically meaningful decline in A1C of 0.6% (SD 2.1%), whereas EUC participants had an increase of 0.2% (SD 1.1%) (f [1, 28] = 1.9; P = 0.176). Within CC-DDR, participants with trust had a reduction in A1C (1.4% [SD 2.5%]), whereas participants with mistrust had an increase in A1C (0.44% [SD 0.7%]) (f [1, 11] = 2.11; P = 0.177). EUC participants with trust had a reduction in A1C (0.1% [SD 1.1%]), whereas those with mistrust had an increase in A1C (0.70% [SD 1.1%]) (f [1, 16] = 2.01; P = 0.172). Mistrust adversely affected glycemic control independent of treatment. This finding, coupled with the high rate of mistrust, highlights the need to target mistrust in new interventions to improve glycemic control in black patients with DR. © 2019 by the American Diabetes Association

Overcoming the Legacy of Mistrust: African Americans’ Mistrust of Medical Profession

Recent studies show that racism still exists in the American medical profession, the fact of which legitimizes the historically long-legacy of mistrust towards medical profession and health authorities among African Americans. Thus, it was suspected that the participation of black patients in end-of-life care has always been significantly low stemmed primarily from their mistrust of the medical profession. On the other hand, much research finds that there are other reasons than the mistrust which makes African Americans feel reluctant to the end-of-life care, such as cultural-religious difference and genuine misunderstanding of the services. If so, two crucial questions are raised. One is how pervasive or significant the mistrust is, compared to the other factors, when they opt out of the end-of-life care. The other is if there is a remedy or solution to the seemingly broken relationship. While no studies available answer these questions, we have conducted an experiment to explore them. The research was performed at two Philadelphia hospitals of Mercy Health System, and the result shows that Black patients’ mistrust is not too great to overcome and that education can remove the epistemic obstacles as well as overcome the mistrust

Is mistrust self-fulfilling?

We study experimentally the effect of expectations on trustworthiness. Most subjects respond with untrustworthy behavior if they find out that little is expected from them. This suggests that guilt aversion plays an important role in inducing trustworthiness.trust; trustworthiness; reciprocity; guilt aversion

Mistrust in podcast

Brent, a POLIS Summer School student is the latest guest-blogger. He gives a flavour of how American politics can seep in to a summer sojourn in London thanks to New Media. And as it does, it raises questions about how partial American media can be

Insecure Communities: Latino Perceptions of Police Involvement in Immigration Enforcement

This report presents findings from a survey of Latinos regarding their perceptions of law enforcement authorities in light of the greater involvement of police in immigration enforcement. Lake Research Partners designed and administered a randomized telephone survey of 2,004 Latinos living in the counties of Cook (Chicago), Harris (Houston), Los Angeles, and Maricopa (Phoenix).The survey was designed to assess the impact of police involvement in immigration enforcement on Latinos' perceptions of public safety and their willingness to contact the police when crimes have been committed. The survey was conducted in English and Spanish by professional interviewers during the period November 17 to December 10, 2012.Survey results indicate that the increased involvement of police in immigration enforcement has significantly heightened the fears many Latinos have of the police, contributing to their social isolation and exacerbating their mistrust of law enforcement authorities.These findings reveal one of the unintended consequences of the involvement of state and local police in immigration enforcement -- a reduction in public safety as Latinos' mistrust of the police increases as a result of the involvement of police in immigration enforcement

A one-valued logic for non-one-sidedness

Does it make sense to employ modern logical tools for ancient philosophy? This well-known debate2 has been re-launched by the indologist Piotr Balcerowicz, questioning those who want to look at the Eastern school of Jainism with Western glasses. While plainly acknowledging the legitimacy of Balcerowicz's mistrust, the present paper wants to propose a formal reconstruction of one of the well-known parts of the Jaina philosophy, namely: the saptabhangi, i.e. the theory of sevenfold predication. Before arguing for this formalist approach to philosophy, let us return to the reasons to be reluctant at it

If You Believe You Believe, You Believe. A Constitutive Account of Knowledge of One’s Own Beliefs

Can I be wrong about my own beliefs? More precisely: Can I falsely believe that I believe that p? I argue that the answer is negative. This runs against what many philosophers and psychologists have traditionally thought and still think. I use a rather new kind of argument, – one that is based on considerations about Moore's paradox. It shows that if one believes that one believes that p then one believes that p – even though one can believe that p without believing that one believes that p