Hip fracture incidence among elderly Hispanics

OBJECTIVES: This study estimated hip fracture incidence for elderly Hispanics in the United States. METHODS: A cohort of Spanish-surnamed 1992 Medicare enrollees was followed for 2 years. Hip fractures were identified by inpatient diagnostic code. RESULTS: For Hispanic women, the national age-adjusted hip fracture rate was 7.3 per 1000 person-years; for men, the rate was 3.3. Rates varied markedly, with higher rates for the predominantly Mexican-American southwestern states than for Puerto Ricans. CONCLUSIONS: Nationally, the Hispanic population is at intermediate risk of hip fracture between Blacks and Whites, but geographic variation suggests that Mexican Americans are at higher risk than Puerto Ricans.     

Differences in familism values and caregiving outcomes among Korean, Korean American, and White American dementia caregivers.

Recent theories have suggested that burden and distress among dementia caregivers may be higher in American culture, which emphasizes individualism, and lower in cultures with higher levels of familism. However, immigrants may experience higher levels of burden because of acculturation with attendant values, conflicts and stresses. Forty-four Korean caregivers and 32 Korean American caregivers were compared with 54 White American caregivers on sociodemographic variables, familism, burden, anxiety, and depression. Familism was highest in Korean caregivers and lowest in Whites, with Korean Americans in the middle. Koreans and Korean Americans reported higher levels of burden. Koreans showed higher levels of depression and of anxiety than White American caregivers, with Koreans and Korean Americans higher than Whites on anxiety. These results suggest a need for greater specificity in theories about familism values, with attention to the specific meaning of familism in different cultures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Repair of nonsevere rheumatic aortic valve disease during other valvular procedures: is it safe?

Many studies have suggested that African Americans have a higher prevalence of hypertension than whites. The authors conducted a prospective study of hypertension incidence from 1987-1988 to 1994-1995 in 140 African American and 237 white adults aged 30 to 54 years at baseline. The study participants were screened for participation in the Trials of Hypertension Prevention, phase 1, an 18-month lifestyle modification intervention trial aimed at lowering blood pressure, at the Baltimore Clinical Center. Baseline age, blood pressure, body mass index, and heart rate were similar in the two groups. Compared with whites, however, African Americans had a lower percentage of men, college graduates, and households with an income > or = $40,000 per year. African Americans also had lower mean urinary sodium to creatinine ratio and potassium to creatinine ratio, but a similar sodium to potassium ratio. The incidence of hypertension (blood pressure > or = 160/95 mm Hg and/or taking antihypertensive medication) over 7 years of follow-up was nearly identical: 25.7% in African Americans and 25.3% in whites. Baseline age, gender, blood pressure, and heart rate were all associated with the incidence of hypertension. Even after adjustment for these covariables, the risk of hypertension was not higher in African Americans compared with whites. These results indicate that middle-aged African Americans and whites have a similar risk of developing hypertension given the same age, initial blood pressure, and body mass index at baseline.     

Culture and judgement of causal relevance.

The authors hypothesized that because the causal theories of East Asians were more holistic and complex than those of Americans, the amount of information considered before making a final attribution would be larger for East Asians than for Americans. This hypothesis was supported through 4 studies. When participants attempted to explain a deviant behavior (Study 1) or a prosocial behavior (Study 2), Korean participants took into consideration a greater amount of information than did either American or Asian American participants. Study 3 replicated the findings of Studies 1 and 2 within each culture. Finally, Study 4 established a link between the present findings and past research on culture and attribution. Namely, Study 4 found that Koreans made more external attributions than Americans because Koreans considered more information than did Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social Security: The challenge of the 1980s.

Contends that in the 1980s the Social Security (SS) system has become the chief target for budget cutters in the Administration as an effort to save money. SS insures the earnings of 95% of all Americans against losses due to retirement, disability, catastrophic illness, or death. The financing of SS is too serious a matter to be subjected to budgetary politics. The status of SS is discussed vis-à-vis a short-term problem related to economic and demographic trends and their impact on SS trust funds and a long-term problem tied to a projected "aging boom" around the year 2020. Solutions proposed to the SS problem by the National Commission on Social Security are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

At the intersection of culture and religion: A cultural analysis of religion's implications for secondary control and social affiliation.

Religion helps people maintain a sense of control, particularly secondary control—acceptance of and adjustment to difficult situations—and contributes to strengthening social relationships in a religious community. However, little is known about how culture may influence these effects. The current research examined the interaction of culture and religion on secondary control and social affiliation, comparing people from individualistic cultures (e.g., European Americans), who tend to be more motivated toward personal agency, and people from collectivistic cultures (e.g., East Asians), who tend to be more motivated to maintain social relationships. In Study 1, an analysis of online church mission statements showed that U.S. websites contained more themes of secondary control than did Korean websites, whereas Korean websites contained more themes of social affiliation than did U.S. websites. Study 2 showed that experimental priming of religion led to acts of secondary control for European Americans but not Asian Americans. Using daily diary methodology, Study 3 showed that religious coping predicted more secondary control for European Americans but not Koreans, and religious coping predicted more social affiliation for Koreans and European Americans. These findings suggest the importance of understanding sociocultural moderators for the effects of religion. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Relation of parental birth weights to infant birth weight among African Americans and whites in Illinois: a transgenerational study

The authors used a transgenerational data set of Illinois vital records to ascertain the relation between parental birth weights and infant birth weight. The infant generation consisted of all African Americans and whites born in Illinois during 1989-1991. The parent generation included the mothers and fathers who were also born in Illinois between 1956 and 1975. In the infant cohort, the rate of low birth weight (LBW) (<2,500 g) was 11.7% for African Americans (n = 15,287) versus 5.0% for whites (n = 117,708) (relative risk (RR) = 2.3, 95% confidence interval (CI) 2.2-2.5). For African Americans, the LBW rate was 17.9% among those born to LBW mothers (n = 1,943) compared with 10.8% among those born to non-LBW mothers (n = 13,344) (RR = 1.8, 95% CI 1.6-1.9). For whites, the LBW rate was 8.5% among those born to LBW mothers (n = 2,174) compared with 4.8% among those born to non-LBW mothers (n = 115,534) (RR = 1.7, 95% CI 1.6-2.0). A weaker association was observed between paternal birth weight and infant birth weight. The authors conclude that parental birth weights are important risk factors for LBW in both African Americans and whites.     

Inflammatory breast carcinoma incidence and survival: the surveillance, epidemiology, and end results program of the National Cancer Institute, 1975-1992

BACKGROUND: Little is known about the cause of inflammatory breast carcinoma (IBC), the most aggressive form of breast cancer. To the authors' knowledge, no studies have investigated whether IBC risk factors are different from those for breast carcinoma overall, and there has been only one report of IBC incidence and survival patterns. METHODS: The authors used data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute for the period 1975-1992 to calculate age-adjusted incidence and survival rates for 913 white and 121 African American women with IBC involving dermal invasion of lymphatic ducts and 166,375 white and 13,674 African American women with other types of breast carcinoma (non-IBC). RESULTS: Between 1975-1977 and 1990-1992, IBC incidence doubled, increasing among whites from 0.3 to 0.7 cases per 100,000 person-years and among African Americans from 0.6 to 1.1 cases. However, rates for African Americans varied due to the small numbers of IBC cases. The twofold increase in IBC incidence was higher than that observed for non-IBC during the same period (27% for African Americans and 25% for whites). IBC patients were significantly younger at diagnosis than non-IBC patients; and among both IBC and non-IBC patients, African Americans were younger than whites. Overall survival was significantly worse for IBC patients than for non-IBC patients and for African Americans than for whites. Among whites, 3-year survival improved more for IBC patients than for non-IBC patients between 1975-1979 and 1988-1992, increasing from 32% to 42% for IBC patients (P=0.0001) and from 80% to 85% for non-IBC patients (P=0.0001). CONCLUSIONS: The disparities observed in incidence trends and age at diagnosis, particularly according to race, highlight the need for further investigation of the differences between IBC and non-IBC incidence.     

Connecting and separating mind-sets: Culture as situated cognition.

People perceive meaningful wholes and later separate out constituent parts (D. Navon, 1977). Yet there are cross-national differences in whether a focal target or integrated whole is first perceived. Rather than construe these differences as fixed, the proposed culture-as-situated-cognition model explains these differences as due to whether a collective or individual mind-set is cued at the moment of observation. Eight studies demonstrated that when cultural mind-set and task demands are congruent, easier tasks are accomplished more quickly and more difficult or time-constrained tasks are accomplished more accurately (Study 1: Koreans, Korean Americans; Study 2: Hong Kong Chinese; Study 3: European- and Asian-heritage Americans; Study 4: Americans; Study: 5 Hong Kong Chinese; Study 6: Americans; Study 7: Norwegians; Study 8: African-, European-, and Asian-heritage Americans). Meta-analyses (d = .34) demonstrated homogeneous effects across geographic place (East–West), racial–ethnic group, task, and sensory mode—differences are cued in the moment. Contrast and separation are salient individual mind-set procedures, resulting in focus on a single target or main point. Assimilation and connection are salient collective mind-set procedures, resulting in focus on multiplicity and integration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rethinking individualism and collectivism: Evaluation of theoretical assumptions and meta-analyses.

Are Americans more individualistic and less collectivistic than members of other groups? The authors summarize plausible psychological implications of individualism-collectivism (IND-COL), meta-analyze cross-national and within-United States IND-COL differences, and review evidence for effects of IND-COL on self-concept, well-being, cognition, and relationality. European Americans were found to be both more individualistic--valuing personal independence more--and less collectivistic--feeling duty to in-groups less--than others. However, European Americans were not more individualistic than African Americans, or Latinos, and not less collectivistic than Japanese or Koreans. Among Asians, only Chinese showed large effects, being both less individualistic and more collectivistic. Moderate IND-COL effects were found on self-concept and relationality, and large effects were found on attribution and cognitive style. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is biliary lithogenesis affected by length and implantation of cystic duct? Study of 270 patients with endoscopic retrograde cholangiopancreatography

BACKGROUND: White children have a much higher incidence rate of acute lymphoblastic leukemia (ALL) than do African American children. This discrepancy, coupled with the geographic and temporal variations in the incidence of childhood ALL, have led to speculation that factors associated with socioeconomic status (SES) may play an important role in its etiology. Because most of the variation is accounted for by the occurrence of a peak in incidence between the ages of 2 and 5 years, the purpose of this study was to compare the SES of children diagnosed with ALL between the peak ages of 2-5 years with those children diagnosed at other ages (birth-1 year and 6-14 years). METHODS: Patients included 4210 children who were diagnosed with ALL between January 1, 1989 and December 31, 1991 by a member institution of the Children's Cancer Group or the Pediatric Oncology Group. Of these children, 3614 were white and 596 were African American. The SES of a case was defined as the SES of the child's zip code of residence at the time of diagnosis. Five sociodemographic variable categories for each zip code were obtained from the 1990 U.S. Census including per capita income, number of housing units by household income, number of housing units by level of urbanization, number of persons older than 25 years by educational attainment, and number of persons by occupation. Mean values were compared for white children versus African American children, and peak ages (2-5 years) versus nonpeak ages (birth-1 year and 6-14 years) for both whites and African Americans. In addition, Wilcoxon's rank sum tests were performed. RESULTS: There were statistically significant differences between the means in each of the socioeconomic categories when African Americans were compared with whites. However, within race, the means of the SES variables for white children diagnosed during the peak ages (2-5 years) were not significantly different from children diagnosed at other ages (birth-1 year and 6-14 years). Similarly, all but one of the comparisons for African American children yielded nonstatistically significant results. Similar results were obtained from the Wilcoxon's rank sum tests. CONCLUSIONS: The results of this analysis suggest that age differences in childhood ALL incidence may not be solely accounted for by SES differences.     

Body measurements, bone mass, and fractures. Does the East differ from the West?

There are population differences in hip fractures between the East and West. The hip fracture incidence in Asians is approximately 40% to 50% of that in whites in the United States. There also are differences in body measurements and bone mass between the population groups. This article discusses the role of body measurements in relation to bone mass and bone loss at different stages of life and interrelationship of these variables with fracture risks.     

Body mass index, waist/hip ratio, and coronary heart disease incidence in African Americans and whites. Atherosclerosis Risk in Communities Study Investigators

To study the relation of the amount and distribution of body fat with incident coronary heart disease in two ethnic groups, the authors analyzed prospective data from the Atherosclerosis Risk in Communities Study. Among 14,040 participants aged 45-64 years and free of coronary disease at baseline in 1987-1989, we identified 398 events through 1994, an average of 6.2 years of follow-up. Among African-American women, the multivariable-adjusted relative risks of coronary heart disease across quartiles of body mass index were 1.0, 1.91. 1.54, and 2.15 (p for trend=0.27), and those for waist/hip ratio were 1.0, 2.07, 2.33, and 4.22 (p for trend=0.02). Among African-American men, these respective relative risks were 1.0, 1.03, 0.83, and 1.20 (p for trend=0.76) for body mass index and 1.0, 1.08, 1.87, and 1.68 (p for trend=0.06) for waist/hip ratio. Relative risks for whites were generally similar to those for African Americans. Relative risks were stronger for never smokers than for the overall cohort. Unlike some previous studies, our results suggest that Africa Americans, like whites, are not spared from the coronary heart disease risks accompanying obesity.     

Three streams, one river: a coordinated approach to financing retirement

A national retirement policy that coordinates Medicare, Social Security, and private pension reforms could make substantial progress in dealing with problems related to the baby-boom generation's retirement. Such a policy should include (1) better-designed work incentives for older persons--for example, a $10,000 "retirement bonus" option, paid by Social Security and Medicare, for each year of delayed retirement; (2) allowing workers without employer-sponsored pensions to use Social Security's payroll contribution system to invest in pension accounts; (3) expansion of private long-term care insurance by allowing pension-plan assets to be used for paying premiums; and (4) placing a higher priority on financing for basic Medicare and Social Security benefits than on taxpayer-financed subsidies of far more generous pension benefits.     

Replicating the positivity effect in picture memory in Koreans: Evidence for cross-cultural generalizability.

Older adults’ relatively better memory for positive over negative material (positivity effect) has been widely observed in Western samples. This study examined whether a relative preference for positive over negative material is also observed in older Koreans. Younger and older Korean participants viewed images from the International Affective Picture System (IAPS), were tested for recall and recognition of the images, and rated the images for valence. Cultural differences in the valence ratings of images emerged. Once considered, the relative preference for positive over negative material in memory observed in older Koreans was indistinguishable from that observed previously in older Americans. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Basic epidemiology of fractures of the upper and lower limb among Americans over 65 years of age

Current knowledge regarding the basic epidemiology of fractures is largely limited to a few fracture sites, notably those of the hip and distal forearm. To clarify the patterns of incidence of limb fractures in the elderly, we used data from a 5% sample of the U.S. Medicare population over age 65 years during the years 1986-1990. We identified incident fractures of the proximal humerus, other parts of the humerus, proximal radius/ ulna, shaft of the radius/ulna, distal radius/ulna, pelvis, hip, other parts of the femur, patella, ankle, and other parts of the tibia/fibula from diagnoses and procedures coded on claims for inpatient services, outpatient facility use, and physician services. We used Poisson regression to investigate the relation between demographic factors and fracture risk at these sites. Fractures at the hip were the most common, accounting for 38% of the fractures identified. The proximal humerus, distal radius/ulna, and ankle also were common fracture sites. A pattern of rapidly rising rates with age was seen for fractures of the pelvis, hip, and other parts of the femur among women. Fractures distal to the elbow or knee, however, had, at most, modest increases in incidence with age over 65 years. For each of the fractures studied, women had higher rates than men of the same race, and whites generally had higher rates than blacks of the same gender. Gender-related differences in risk were larger among whites than among blacks, and racial differences in risk were more marked among women than among men.     

Binge drinking in Chinese, Korean, and White college students: Genetic and ethnic group differences.

Studies of Asian college students have found that rates of binge drinking are associated with variation in the aldehyde dehydrogenase (ALDH2) gene. Chinese and Koreans have different prevalence rates of the ALDH2?*?2 allele, alcohol use, and alcoholism. The association of ALDH2 status and ethnic group with binge drinking was examined in 328 Chinese, Korean, and White college students. Ethnic group differences were found, with Whites having the highest rate of binge drinking, followed by Koreans and then Chinese. Among Asian participants, ALDH2 status and ethnicity related to binge drinking in an additive manner. Possessing an ALDH2?*?2 allele and being Chinese were protective factors, and being White and being Korean without an ALDH2?*?2 allele were risk factors for binge drinking. These results suggest that ALDH2 status, as well as other factors that differ in Koreans and Chinese, but do not interact with ALDH2, are associated with binge drinking among Asians. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interaction of the maize and Arabidopsis kinase interaction domains with a subset of receptor-like protein kinases: implications for transmembrane signaling in plants

The American population is aging rapidly and individuals are living longer. Yet Americans are saving less and older workers are leaving the labor force at younger and younger ages. The accelerated drop in labor force participation corresponds roughly to the introduction of Social Security and the adaptation of employer-provided pension plans. I have illustrated that Social Security and employer-provided pension plans provide substantial incentive to leave the labor force early. The quantitative effect of this inducement is illustrated by simulating the effects of changes in pension plan and Social Security provisions on the retirement decisions of employees in a large firm, who are covered by a typical defined benefit pension plan. Scheduled Social Security changes would have little effect on the retirement decisions of employees with a typical defined benefit pension plan like the one considered here. But if the pension plan provisions were changed to correspond to the Social Security changes, the effect would be very large. And, although not contemplated by current legislation; it is clear that an increase in the Social Security early retirement age would have a substantial effect on the early retirement rates of the large number of employees not covered by a pension plan.     

Timing of gene expression and oolemma localization of mouse alpha6 and beta1 integrin subunits during oogenesis

PURPOSE: With the introduction of prostate-specific antigen testing, the "Will Rogers phenomenon"--stage migration associated with more sensitive diagnostic and staging procedures--seemed likely to occur. MATERIALS AND METHODS: Yearly values of prostate-specific antigen from 1988 to 1995 were determined for whites (n = 34) and African-Americans (n = 321). Pretreatment levels were used as objective surrogates of tumor cell burden. Changes in clinical stage and pathological grade by calendar year also were determined. RESULTS: There was a statistically significant yearly decline in levels of prostate-specific antigen for African-Americans (12.2% per year). There was no significant decline among whites. Similar trends were seen on multivariate analysis that adjusted for stage and grade. There was clinical stage migration for whites and African-Americans. There was also a shift in tumor grade for both whites and African-Americans. DISCUSSION: Over the past decade, African-Americans have shown a decline in tumor cell burden at the time of diagnosis as reflected by a decline in mean levels of prostate-specific antigen. For whites and African-Americans, there has been a shift to early clinical stages. The Will Rogers phenomenon, as demonstrated in African-Americans by decline in prostate-specific antigen and in whites and African-Americans by clinical stage migration, indicates lead-time and length biases, resulting in a more favorable disease profile at diagnosis for both groups. The decline in prostate-specific antigen among African-Americans indicates that the initial higher tumor cell burden seen in the past was caused by socioeconomic factors rather than inherited differences, and is likely to be ameliorated with widespread prostate-specific-antigen screening.     

Lower thrombolytic use for African Americans with myocardial infarction: an influence of clinical presentation?

BACKGROUND: After myocardial infarction, African Americans have been reported to undergo fewer catheterization and revascularization procedures than whites, but few studies have addressed racial variations in the delivery of thrombolytic therapy. METHODS: We conducted a retrospective analysis of data prospectively collected on consecutive patients admitted with acute myocardial infarction to the 16-bed coronary care unit of a large, urban teaching hospital. RESULTS: Over a 5-year period, 1948 consecutive patients were admitted with acute myocardial infarction to a single coronary care unit. Thrombolysis was administered to 19% of 1024 African Americans and 29% of 924 whites (P <.01). The initial diagnostic impression on admission was "definite" infarction less often in African Americans (30%) than in whites (43%, P <.001), a difference that appeared to largely account for the difference in thrombolytic administration in a multivariable model. Mortality adjusted for age and concomitant illnesses was similar in African Americans compared with whites (relative risk 1.0, 95% confidence interval 0.78 to 1.51). CONCLUSIONS: Much of the racial variation in thrombolytic administration could be accounted for by differences in clinical presentation, an issue that requires further study.