Chronic hepatitis B (CHB) disproportionately affects minority groups in the US, particularly Asian Americans, with numerous factors contributing to this disparity. Of the 2.4 million people living with chronic HBV in ...Chronic hepatitis B (CHB) disproportionately affects minority groups in the US, particularly Asian Americans, with numerous factors contributing to this disparity. Of the 2.4 million people living with chronic HBV in the US, 60% are Asian American. Many are unaware of their status and lack access to proper clinical care, with less than ten percent receiving necessary antiviral treatment. Barriers to screening and care include lack of disease awareness, language and cultural barriers, and financial constraints. Additionally, healthcare providers and systems in the US often overlook the importance of CHB, leading to inadequate care. In response, the Center for Viral Hepatitis (CVH) has implemented a community-based outreach program over the past sixteen years, employing a multifaceted approach involving all sectors of society and various organizations to combat health disparities in CHB. This grassroots campaign has proven highly effective, leveraging CVH’s leadership in spearheading numerous collaborative activities with community members, healthcare professionals, and policymakers. We have summarized the key points of CVH's efforts and their significance in combating CHB-related health disparities. The CHB Screening and Awareness Campaign, tailored to the Asian American community, serves as a successful model for increasing CHB screening, linkage-to-care, and addressing socio-cultural barriers and health literacy. Insights from these outreach programs have guided the development of culturally relevant resources and education initiatives. These findings suggest that such community-driven approaches are essential for addressing health disparities. The strategies and outcomes of CVH’s efforts can inform future health initiatives for other minority communities in the US and globally.展开更多
After tobacco use, chronic hepatitis B(CHB) viral infections are the most important cause of cancer globally in that 1 out of 3 individuals have been infected with the hepatitis B virus(HBV). Though infection rates ar...After tobacco use, chronic hepatitis B(CHB) viral infections are the most important cause of cancer globally in that 1 out of 3 individuals have been infected with the hepatitis B virus(HBV). Though infection rates are low(< 1%) in the United States, Asian Americans who comprise about 6% of the population experience about 60% of the CHB burden. This paper reviews the magnitude of hepatitis B(HBV) burden among Asian Americans and the progress being made to mitigate this burden, primarily through localized, communitybased efforts to increase screening and vaccination among Asian American children, adolescents, and adults. This review brings to light that despite the numerous community-based screening efforts, a vast majority of Asian Americans have not been screened and that vaccination efforts, particularly for adults, are sub-optimal. Greater efforts to integrate screenings by providers within existing healthcare systems are urged. Evidence-based strategies are offered to implement CDC's three major recommendations to control and prevent hepatitis B through targeted screening and enhanced vaccination efforts.展开更多
目的研究华裔中年女性每日维生素B12(vitamin B12,VB12)摄入量与焦虑症的关系。方法本研究数据来自美国妇女健康研究(Study of Women’s Health Across the Nation,SWAN)。焦虑症通过参与者自评量表的方式评估,维生素B(B1,B2,B3,B6,B9,B...目的研究华裔中年女性每日维生素B12(vitamin B12,VB12)摄入量与焦虑症的关系。方法本研究数据来自美国妇女健康研究(Study of Women’s Health Across the Nation,SWAN)。焦虑症通过参与者自评量表的方式评估,维生素B(B1,B2,B3,B6,B9,B12)的每日摄入量由1986年版饮食频率调查问卷推算,Fisher确切概率法比较组间率的差异,Mann⁃Whitney U比较两组变量通体均值的差异,logistic回归分析VB12与焦虑症之间的关系,限制性三次样条分析两者的非线性关系。结果在纳入研究的241例女性中,10例(4.1%)患有焦虑症。焦虑组倾向有更高的脉搏和总胆固醇(P分别为0.034,0.009)。焦虑组女性的每日总VB12摄入量的中位数(下、上四分位数)为1.78(1.01,2.03)μg/d,低于对照组的2.34(1.47,3.27)μg/d(P=0.027)。在焦虑组中,符合VB12每日膳食营养素推荐供给量(RDA)标准的女性少于对照组(P=0.023)。总VB12摄入量与焦虑症呈负相关关系,且低水平VB12摄入量人群发生焦虑症的风险更高(OR=10.25,95%CI:1.28~82.22)。在调节了年龄后,这种关系依然存在。在充分调整潜在混杂因素年龄、脉搏和总胆固醇后,总VB12摄入量仍然与焦虑症负相关(OR=0.36,95%CI:0.15~0.84)。此外,低水平VB12摄入量的焦虑症风险更高(OR=19.42,95%CI:2.08~180.98)。符合VB12摄入量RDA标准的人群发生焦虑症的风险低于VB12摄入量不足人群(OR=0.12,95%CI:0.02~0.98)。在调整协变量后,这种关系依然存在(OR=0.08,95%CI:0.01~0.66)。限制性三次样条表明,随着VB12摄入量的增高,焦虑症发生风险先处于平台期,随后逐渐下降。结论总VB12摄入量与焦虑症呈负相关关系。由于是横断面研究,因此VB12可能是焦虑症的保护因素;而低水平VB12也可能是焦虑症所致。展开更多
Although severe and chronic mental disorders are common among Asian Americans in residential treatment programs, little has been known about the prevalence and predictors of co-occurring substance use in this populati...Although severe and chronic mental disorders are common among Asian Americans in residential treatment programs, little has been known about the prevalence and predictors of co-occurring substance use in this population. The purpose of this study was to examine predictors of co-occurring substance use among Asian Americans with mental disorders in residential treatment programs. This cross-sectional study included 375 clinical records of Asian Americans from residential treatment programs between 2007 and 2011. Demographic variables, principal psychiatric diagnoses, and data on alcohol, stimulant, and marijuana use were obtained from the clinical records. Separate binary logistic regression analyses were used to examine the demographic and diagnostic contributions to the risk of each type of substance use. Findings of this study indicated that the prevalence of co-occurring substance use was about 53% in Asian Americans with mental disorders. Binary logistic regression analyses revealed that male gender, older age, and depressive disorder predicted more alcohol use, but homelessness and schizophrenia predicted less alcohol use. Male gender, homelessness, and smoking predicted more stimulant use. Male gender and younger age predicted more marijuana use. Based on the findings of this study, awareness about co-occurring substance use problems of ethnic minority psychiatric clients should be increased and appropriate substance use prevention and treatment programs should be developed and provided for high-risk groups.展开更多
BACKGROUND It has been recognized for a long time that gastric cancer behavior and outcomes might be different between patients living in Asian countries vs patients living in Western countries.It is not clear if thes...BACKGROUND It has been recognized for a long time that gastric cancer behavior and outcomes might be different between patients living in Asian countries vs patients living in Western countries.It is not clear if these differences would persist between patients of Asian ancestry and patients of other racial subgroups within the multiethnic communities of North America.The current study hypothesizes that these differences will present within North American multiethnic communities.AIM To evaluate the impact of race on survival outcomes of non-metastatic gastric cancer patients in the United States.METHODS This is a secondary analysis of a randomized controlled trial(CALGB 80101 study)that evaluated two adjuvant chemoradiotherapy schedules following resection of non-metastatic gastric cancer.Kaplan-Meier analysis and log-rank testing were utilized to explore the overall and disease-free survival differences according to the race of the patients.Univariate and multivariate Cox regression analyses were then used to explore factors affecting overall and disease-free survivals.RESULTS A total of 546 patients were included in the current analysis.Of which,73.8%have white race(vs 12.8%black Americans and 8.2% Asian Americans).Using Kaplan-Meier analysis/log-rank testing,Asian Americans appear to have better overall and disease-free survival outcomes compared to other United States racial groups(White Americans,Black Americans,and other racial groups)(P=0.011;P=0.010;respectively).Moreover,in an adjusted multivariate model,Asian American race seems to be associated with better overall and disease-free survival(hazard ratio:0.438;95% confidence interval:0.254-0.754),P=0.003;(hazard ratio:0.460;95% confidence interval:0.280-0.755,P=0.002;respectively).CONCLUSION Asian American patients with non-metastatic gastric cancer have better overall and disease-free survival compared to other racial groups in the United States.Further preclinical and clinical research is needed to clarify the reasons behind this observation.展开更多
文摘Chronic hepatitis B (CHB) disproportionately affects minority groups in the US, particularly Asian Americans, with numerous factors contributing to this disparity. Of the 2.4 million people living with chronic HBV in the US, 60% are Asian American. Many are unaware of their status and lack access to proper clinical care, with less than ten percent receiving necessary antiviral treatment. Barriers to screening and care include lack of disease awareness, language and cultural barriers, and financial constraints. Additionally, healthcare providers and systems in the US often overlook the importance of CHB, leading to inadequate care. In response, the Center for Viral Hepatitis (CVH) has implemented a community-based outreach program over the past sixteen years, employing a multifaceted approach involving all sectors of society and various organizations to combat health disparities in CHB. This grassroots campaign has proven highly effective, leveraging CVH’s leadership in spearheading numerous collaborative activities with community members, healthcare professionals, and policymakers. We have summarized the key points of CVH's efforts and their significance in combating CHB-related health disparities. The CHB Screening and Awareness Campaign, tailored to the Asian American community, serves as a successful model for increasing CHB screening, linkage-to-care, and addressing socio-cultural barriers and health literacy. Insights from these outreach programs have guided the development of culturally relevant resources and education initiatives. These findings suggest that such community-driven approaches are essential for addressing health disparities. The strategies and outcomes of CVH’s efforts can inform future health initiatives for other minority communities in the US and globally.
文摘After tobacco use, chronic hepatitis B(CHB) viral infections are the most important cause of cancer globally in that 1 out of 3 individuals have been infected with the hepatitis B virus(HBV). Though infection rates are low(< 1%) in the United States, Asian Americans who comprise about 6% of the population experience about 60% of the CHB burden. This paper reviews the magnitude of hepatitis B(HBV) burden among Asian Americans and the progress being made to mitigate this burden, primarily through localized, communitybased efforts to increase screening and vaccination among Asian American children, adolescents, and adults. This review brings to light that despite the numerous community-based screening efforts, a vast majority of Asian Americans have not been screened and that vaccination efforts, particularly for adults, are sub-optimal. Greater efforts to integrate screenings by providers within existing healthcare systems are urged. Evidence-based strategies are offered to implement CDC's three major recommendations to control and prevent hepatitis B through targeted screening and enhanced vaccination efforts.
文摘目的研究华裔中年女性每日维生素B12(vitamin B12,VB12)摄入量与焦虑症的关系。方法本研究数据来自美国妇女健康研究(Study of Women’s Health Across the Nation,SWAN)。焦虑症通过参与者自评量表的方式评估,维生素B(B1,B2,B3,B6,B9,B12)的每日摄入量由1986年版饮食频率调查问卷推算,Fisher确切概率法比较组间率的差异,Mann⁃Whitney U比较两组变量通体均值的差异,logistic回归分析VB12与焦虑症之间的关系,限制性三次样条分析两者的非线性关系。结果在纳入研究的241例女性中,10例(4.1%)患有焦虑症。焦虑组倾向有更高的脉搏和总胆固醇(P分别为0.034,0.009)。焦虑组女性的每日总VB12摄入量的中位数(下、上四分位数)为1.78(1.01,2.03)μg/d,低于对照组的2.34(1.47,3.27)μg/d(P=0.027)。在焦虑组中,符合VB12每日膳食营养素推荐供给量(RDA)标准的女性少于对照组(P=0.023)。总VB12摄入量与焦虑症呈负相关关系,且低水平VB12摄入量人群发生焦虑症的风险更高(OR=10.25,95%CI:1.28~82.22)。在调节了年龄后,这种关系依然存在。在充分调整潜在混杂因素年龄、脉搏和总胆固醇后,总VB12摄入量仍然与焦虑症负相关(OR=0.36,95%CI:0.15~0.84)。此外,低水平VB12摄入量的焦虑症风险更高(OR=19.42,95%CI:2.08~180.98)。符合VB12摄入量RDA标准的人群发生焦虑症的风险低于VB12摄入量不足人群(OR=0.12,95%CI:0.02~0.98)。在调整协变量后,这种关系依然存在(OR=0.08,95%CI:0.01~0.66)。限制性三次样条表明,随着VB12摄入量的增高,焦虑症发生风险先处于平台期,随后逐渐下降。结论总VB12摄入量与焦虑症呈负相关关系。由于是横断面研究,因此VB12可能是焦虑症的保护因素;而低水平VB12也可能是焦虑症所致。
文摘Although severe and chronic mental disorders are common among Asian Americans in residential treatment programs, little has been known about the prevalence and predictors of co-occurring substance use in this population. The purpose of this study was to examine predictors of co-occurring substance use among Asian Americans with mental disorders in residential treatment programs. This cross-sectional study included 375 clinical records of Asian Americans from residential treatment programs between 2007 and 2011. Demographic variables, principal psychiatric diagnoses, and data on alcohol, stimulant, and marijuana use were obtained from the clinical records. Separate binary logistic regression analyses were used to examine the demographic and diagnostic contributions to the risk of each type of substance use. Findings of this study indicated that the prevalence of co-occurring substance use was about 53% in Asian Americans with mental disorders. Binary logistic regression analyses revealed that male gender, older age, and depressive disorder predicted more alcohol use, but homelessness and schizophrenia predicted less alcohol use. Male gender, homelessness, and smoking predicted more stimulant use. Male gender and younger age predicted more marijuana use. Based on the findings of this study, awareness about co-occurring substance use problems of ethnic minority psychiatric clients should be increased and appropriate substance use prevention and treatment programs should be developed and provided for high-risk groups.
文摘BACKGROUND It has been recognized for a long time that gastric cancer behavior and outcomes might be different between patients living in Asian countries vs patients living in Western countries.It is not clear if these differences would persist between patients of Asian ancestry and patients of other racial subgroups within the multiethnic communities of North America.The current study hypothesizes that these differences will present within North American multiethnic communities.AIM To evaluate the impact of race on survival outcomes of non-metastatic gastric cancer patients in the United States.METHODS This is a secondary analysis of a randomized controlled trial(CALGB 80101 study)that evaluated two adjuvant chemoradiotherapy schedules following resection of non-metastatic gastric cancer.Kaplan-Meier analysis and log-rank testing were utilized to explore the overall and disease-free survival differences according to the race of the patients.Univariate and multivariate Cox regression analyses were then used to explore factors affecting overall and disease-free survivals.RESULTS A total of 546 patients were included in the current analysis.Of which,73.8%have white race(vs 12.8%black Americans and 8.2% Asian Americans).Using Kaplan-Meier analysis/log-rank testing,Asian Americans appear to have better overall and disease-free survival outcomes compared to other United States racial groups(White Americans,Black Americans,and other racial groups)(P=0.011;P=0.010;respectively).Moreover,in an adjusted multivariate model,Asian American race seems to be associated with better overall and disease-free survival(hazard ratio:0.438;95% confidence interval:0.254-0.754),P=0.003;(hazard ratio:0.460;95% confidence interval:0.280-0.755,P=0.002;respectively).CONCLUSION Asian American patients with non-metastatic gastric cancer have better overall and disease-free survival compared to other racial groups in the United States.Further preclinical and clinical research is needed to clarify the reasons behind this observation.
