Ventricular conduction and long-term heart failure outcomes and mortality in African Americans: insights from the Jackson Heart Study.

BACKGROUND: QRS prolongation is associated with adverse outcomes in mostly white populations, but its clinical significance is not well established for other groups. We investigated the association between QRS duration and mortality in African Americans. METHODS AND RESULTS: We analyzed data from 5146 African Americans in the Jackson Heart Study stratified by QRS duration on baseline 12-lead ECG. We defined QRS prolongation as QRS≥100 ms. We assessed the association between QRS duration and all-cause mortality using Cox proportional hazards models and reported the cumulative incidence of heart failure hospitalization. We identified factors associated with the development of QRS prolongation in patients with normal baseline QRS. At baseline, 30% (n=1528) of participants had QRS prolongation. The cumulative incidences of mortality and heart failure hospitalization were greater with versus without baseline QRS prolongation: 12.6% (95% confidence interval [CI], 11.0-14.4) versus 7.1% (95% CI, 6.3-8.0) and 8.2% (95% CI, 6.9-9.7) versus 4.4% (95% CI, 3.7-5.1), respectively. After risk adjustment, QRS prolongation was associated with increased mortality (hazard ratio, 1.27; 95% CI, 1.03-1.56; P=0.02). There was a linear relationship between QRS duration and mortality (hazard ratio per 10 ms increase, 1.06; 95% CI, 1.01-1.12). Older age, male sex, prior myocardial infarction, lower ejection fraction, left ventricular hypertrophy, and left ventricular dilatation were associated with the development of QRS prolongation. CONCLUSIONS: QRS prolongation in African Americans was associated with increased mortality and heart failure hospitalization. Factors associated with developing QRS prolongation included age, male sex, prior myocardial infarction, and left ventricular structural abnormalities.

Short reflections on the history of African communication

This article aims to propose a chronological subdivision in the history of African communication. African communication today is one of the most important axes for implementing development strategies, sustaining education, health, and schooling programmes, and so on. However, many of these programmes fail due to a lack of or ineffective communication between international organisations, local elite and lay people. The reasons for this situation must be found in Africa’s history of communication, which has undergone radical transformations in its different phases. Using the functionalist analysis drawn up by Jakobson, this article proposes a new chronological subdivision of Africa’s history of communication, reflecting on the current contradictions in contemporary communication in Africa.

Cabinet Card of African Canadian by Photographer W. J. Rea, of Windsor [n.d.]

An unidentified African Canadian man is featured in this cabinet card by W. J. Rea, photographer, of Windsor, Ontario. The man appears to be in official dress, possibly of a religious or legal nature. This cabinet card bears the stamp of the photographer, W. J. Rea, in black ink along the bottom of the card and on the reverse. While it is undated, it is likely from the 1870s or 1880s. This cabinet card was in the possession of Iris Sloman Bell, of St. Catharines, Ontario. The Sloman - Bell family descendants include African American slaves from the United States who settled in Canada."Cabinet card photographs were first introduced in 1866. They were initially employed for landscapes rather than portraitures. Cabinet cards replaced Carte de visite photographs as the popular mode of photography. Cabinet cards became the standard for photographic portraits in 1870. Cabinet cards experienced their peak in popularity in the 1880's. Cabinet cards were still being produced in the United States until the early 1900's and continued to be produced in Europe even longer. The best way to describe a cabinet card is that it is a thin photograph that is mounted on a card that measures 4 1/4″ by 6 1/2″. Cabinet cards frequently have artistic logos and information on the bottom or the reverse of the card which advertised the photographer or the photography studio's services." Source: http://cabinetcardgallery.wordpress.com/category/cabinet-card-history/

Cabinet Card of Young African Canadian by The Dominion Photo Studio, Toronto [n.d.]

This unidentified African Canadian man is photographed at the Dominion Photo Studio, located at 388 Queen St. West in Toronto. The photographer's name is not known. No date is provided, however, the Dominion Studio is listed as operating from 1893-1894. The reverse of the card displays the Dominion Photo Studio stamp in gold lettering (image also attached). The gentleman in this cabinet card is possibly a relative of the Sloman - Bell family, who settled in the London and St. Catharines areas of Ontario. This cabinet card was among the family memorabilia in the possession of Iris Sloman Bell, of St. Catharines. Relatives of the Sloman - Bell family include former African American slaves who came to Canada.The Dominion Portait Co. is listed as operating from 1893-1894 in Toronto. There is an additional listing for the Dominion Portrait Co. (Gourlay and Clark props.) for 1894. Source: Phillips, Glen C. The Ontario photographers list (1851-1900). Sarnia: Iron Gate Publishing Co., 1990. "Cabinet card photographs were first introduced in 1866. They were initially employed for landscapes rather than portraitures. Cabinet cards replaced Carte de visite photographs as the popular mode of photography. Cabinet cards became the standard for photographic portraits in 1870. Cabinet cards experienced their peak in popularity in the 1880's. Cabinet cards were still being produced in the United States until the early 1900's and continued to be produced in Europe even longer. The best way to describe a cabinet card is that it is a thin photograph that is mounted on a card that measures 4 1/4″ by 6 1/2″. Cabinet cards frequently have artistic logos and information on the bottom or the reverse of the card which advertised the photographer or the photography studio's services." Source: http://cabinetcardgallery.wordpress.com/category/cabinet-card-history/

Les politiques de stérilisation sexuelle au Canada et aux États-Unis : une pratique à l'intersection de rapports de genre, de race et de classe

Dans ce mémoire, l’objectif poursuivi sera d’éclairer les dynamiques de genre, de race, de classe, de nation et de handicap à travers le phénomène du contrôle des capacités reproductives des femmes. Dans un premier temps, j’essaierai de comprendre comment les passés coloniaux du Canada et des États-Unis ont structuré leur rapport à la reproduction et comment celle-ci est devenue un enjeu politique de premier plan au sein de l’idéologie eugéniste. Dans un deuxième temps, j’explorerai quel a été le rôle de la science dans la mise en place, en Occident, de systèmes experts capables de guider la société vers le Progrès. Ces réflexions me permettront de retracer quel a été le contexte d’émergence des lois sur la stérilisation sexuelle et quels discours de légitimation ont été mis de l’avant afin de justifier l’appropriation des capacités reproductives de certaines populations jugées « indésirables ». Ainsi, je poserai l’hypothèse que les valeurs et présupposés « scientifiques » racistes, sexistes et classistes sous-jacents à l’élaboration de ces lois ont mené à des stérilisations forcées de certains groupes minorisés, c’est-à-dire les femmes autochtones au Canada et les femmes noires aux États-Unis. Je tenterai alors d’évaluer si, effectivement, les politiques de stérilisation aux Canada et aux États-Unis ont été discriminatoires dans leur formulation et dans leur mise en application à l’égard de ces populations. Finalement, je mobiliserai les figures de la welfare queen et de la squaw afin de comprendre comment ces identités assignées ont permis de légitimer un traitement différencié à leur égard et comment elles structurent encore aujourd’hui leur rapport à la sexualité et à la reproduction.

Comparación de la severidad y extensión de la enfermedad coronaria multivaso por Syntax Score en una poblaciòn de las Antillas Holandesas vs controles nacionales

En la Enfermedad Coronaria (EC) existen factores genéticos, socioculturales, medioambientales y raciales adicionales a los factores de riesgo cardiovascular mayores que podrían influir en su presentación. Se desconoce el impacto de la raza en la severidad de la enfermedad coronaria en los pacientes extranjeros que son enviados a nuestro Servicio. Objetivos: Comparar la severidad de la EC multivaso en una población de pacientes de las Antillas y Nacionales, pareados por la escala Framingham. Metodología: Realizamos un estudio de corte transversal, comparando pacientes colombianos contra pacientes provenientes de las Antillas holandesas con similares factores de riesgo según escala de Framingham, catalogándolos por grupos de riesgo bajo, intermedio, alto y muy alto. Todos con EC severa multivaso documentada por angiografía coronaria desde enero del 2009 hasta Junio de 2011. Se excluyeron pacientes con antecedentes de intervención percutánea o quirúrgica previa. Resultados: Ingresaron 115 pacientes internacionales y 115 pacientes nacionales. La relación hombres/mujeres 3:1. La proporción de grupos de riesgo fue de bajo riesgo 2.5%, intermedio 15%, alto 19.3%, y muy alto 63.4%. El Syntax Score en pacientes nacionales fue 14.3+/-7.4 y en internacionales 22.2+/-10.5 p: 0.002. Conclusiones: En pacientes provenientes de las Antillas Holandesas, valorados en nuestra institución, se observó una mayor severidad de la enfermedad coronaria comparada con una población nacional con factores de riesgo similares. Estos hallazgos sugieren la influencia de la raza y factores genéticos en la severidad y extensión de la EC

Niveles de vitamina d y prevalencia de déficit de vitamina d en mujeres postmenopáusicas mayores de 50 años en Bogotá

Objetivo: Describir los niveles de vitamina D y calcular prevalencia de déficit de vitamina D en mujeres postmenopáusicas mayores de 50 años que asisten a consulta de medicina general en una muestra en de la ciudad de Bogotá durante el periodo 2013-2014. Pacientes y métodos: Realizamos un estudio descriptivo para estimar el déficit de VD en mujeres postmenopáusicas entre 50 y 80 años en la ciudad de Bogotá y la prevalencia de hipovitaminosis D. Durante el periodo octubre 2013 a octubre 2014 se analizaron 320 muestras, se identificaron las características socio-demográficas, patológicas y la exposición a radiación ultravioleta de cada participante. Se realizó un análisis descriptivo de las variables, se estableció su asociación con el déficit de vitamina D su aporte estadístico con al mismo. Resultados :El promedio de edad en la muestra fue de 61 años y el promedio de edad en la que reportaron la ultima menstruación fue a los 43 años. Con respecto a las características socio-demográficas 50% de las mujeres pertenecieron a los estratos 3 y 4, únicamente 11% de los pacientes realizaron una carrera universitaria y 73% de la mujeres fueron amas de casa. Con respecto a los niveles de vitamina D, 81% de los pacientes presentaron niveles anormales y el promedio de 25(OH)D en la población estudio fue de 19,81ng/ml. Conclusión: La prevalencia de déficit de vitamina D en mujeres bogotanas postmenopáusicas es significativo. Se requiere incrementar la exposición solar o dar suplencia con vitamina D para disminuir el riesgo de fracturas.

Pre-school contributions to future achievements

This paper provides recent evidence about the beneÖts of attending preschool on future performance. A non-parametric matching procedure is used over two outcomes: math and verbal scores at a national mandatory test (Saber11) in Colombia. It is found that students who had the chance of attending preschool obtain higher scores in math (6.7%) and verbal (5.4%) than those who did not. A considerable fraction of these gaps comes from the upper quintiles of studentís performance, suggesting that preschool matters when is done at high quality institutions. When we include the number of years at the preschool, the gap rises up to 12% in verbal and 17% in math.

Análisis de la ayuda oficial al desarrollo. estudio de caso: programa conjunto de UNICEF y UNFPA sobre la mutilación genital femenina en Kenia (2008-2012)

El interés de este estudio de caso es analizar el Programa Conjunto de UNFPA y UNICEF sobre MGF/E en Kenia bajo la luz de los postulados poscolonialistas. Partiendo de la idea de que la MGF es una manifestación de las desigualdades de género, se argumenta que el PC reproduce la imagen de la mujer keniana como una víctima del poder masculino. A partir de esta imagen se deslegitima el orden cultural de los grupos que siguen esta tradición, afectando las lógicas de unidad y cohesión de la sociedad. El análisis de este tipo de dinámicas permite comprender mejor los procesos de intervención de las organizaciones internacionales sobre las estructuras sociales de actores frágiles del sistema internacional.

Sexual blinging of women : Alice Walker's african character tashi and issue of female genital cutting

This thesis provides a reading of the different forms of representation that can be attributed to the character Tashi, the protagonist of the novel Possessing the Secret of Joy (1992), written by the African American writer Alice Walker. Before this work Tashi had already appeared in two previous novels by Walker, first, in The Color Purple (1982) and then, as a mention, in The Temple of My Familiar (1989). With Tashi, the author introduces the issue of female circumcision, a ritual Tashi submits herself to at the beginning of her adult life. The focus of observation lies in the ways in which the author’s anger is transformed into a means of creative representation. Walker uses her novel Possessing the Secret of Joy openly as a political instrument so that the expression “female mutilation” (term used by the author) receives ample attention from the media and critics in general. The aim of this investigation is to evaluate to what extent Walker’s social engagement contributes to the development of her work and to what extent it undermines it. For the analysis of the different issues related to “female genital cutting”, the term I use in this thesis, the works of feminist critics and writers such as Ellen Gruenbaum, Lightfoot-Klein, Nancy Hartsock, Linda Nicholson, Efrat Tseëlon and the Egyptian writer and doctor Nawal El Saadawi will be consulted. I hope that this thesis can contribute as an observation about Alice Walker’s use of her social engagement in the creation of her fictional world.

Consumo de álcool e risco para doença coronariana na região metropolitana de São Paulo: uma análise do Projeto GENACIS

OBJETIVOS: Examinar a associação entre consumo de álcool e risco para doença coronariana em amostra populacional. MÉTODOS: Estudo transversal, de base populacional, conduzido de janeiro/2006 a junho/2007, na região metropolitana de São Paulo, como parte do estudo internacional (Gender, Alcohol, and Culture: an International Study). Os sujeitos (1.501, sendo 609 homens e 892 mulheres) eram residentes da região metropolitana de São Paulo, tinham 30 anos ou mais de idade e foram selecionados aleatoriamente, a partir de amostragem complexa por conglomerados. Todos os indivíduos consentiram em participar da pesquisa. A variável dependente foi risco cardíaco avaliado através do WHO Rose Angina Questionnaire. A análise multivariada consistiu em regressão logística, tendo sido realizado ajuste para uso de tabaco e índice de massa corpórea. RESULTADOS: A taxa de resposta foi 75%. Ser mulher, ter mais idade, ser negro, fumante e ter um índice de massa corpórea elevado, foram associados a maior risco para doença coronariana. Indivíduos que nunca beberam na vida (OR = 2,22) e ex-bebedores (OR = 2,42) tiveram maior risco de doença cardíaca do que aqueles que informaram beber até 19 g de álcool por dia, sem episódios de beber excessivo. Entre os que tiveram episódios de embriaguês observou-se uma tendência a maior risco (OR = 3,95, p = 0,09). CONCLUSÕES: Nossos achados sugerem um menor risco para doença coronariana entre os bebedores moderados. Destaca-se que os estudos que avaliam o impacto do álcool sobre doença cardíaca precisam identificar o padrão de uso de álcool dos sujeitos, visto que este aspecto pode modificar o risco. Políticas públicas são necessárias para reduzir o uso nocivo de álcool e a morbidade a ele relacionada no país.

Quando gestos não políticos são políticos: a tradução brasileira de Giovanni's Room, de James Baldwin, e a questão da homossexualidade

This work is part of a research project on the role of translations of African-American literature in Brazil and their relation to issues of identity, discourse and aesthetics. It analyzes the translation, by Affonso Blacheyre, of Giovanni's room (1956), by James Baldwin, which was published in 1967 in Brazil. Baldwin is revered for his role in the Civil Rights Movement, having produced works that portray the contradictions of a democratic, but, at the same time, racist society. Giovanni's room was first rejected by his publisher for addressing homosexuality. The text displayed on the book flaps of the translation praises Baldwin's "work with language", in contrast to his anti-racism in other works. The praise of aesthetics of Giovanni's room is noteworthy, in contrast with the absence of any remarks on its critique of the marginalization of homosexuality. The focus on the aesthetics of the work corresponded to characters speaking a more formal register in the translation. Discourses on identity strengthening were less apparent in the 60s in Brazil in comparison to nowadays. The emphasis on aesthetics represented a seemingly "non-political" gesture that made it less shocking in the context of military dictatorship prevalent in the country at the time.

Transatlantic negotiations on "hell"?: W. E. B. Du Bois's visit to fascist Germany and Theodor W. Adorno's exile in the land of the culture industry

In 1936, the African-American intellectual W.E.B. Du Bois visited Nazi Germany for a period of five months. Two years later, the eleven-year-long American exile of the German philosopher Theodor W. Adorno began. From the latter’s perspective, the United States was the “home” of the Culture Industry. One intuitively assumes that these sojourns abroad must have amounted to “hell on earth” for both the civil rights activist W.E.B. Du Bois and the subtle intellectual Adorno. But was this really the case? Or did they perhaps arrive at totally different conclusions? This thesis deals with these questions and attempts to make sense of the experiences of both men. By way of a systematic and comparative analysis of published texts, hitherto unpublished documents and secondary literature, this dissertation first contextualizes Du Bois’s and Adorno’s transatlantic negotiations and then depicts them. The panoply of topics with which both men concerned themselves was diverse. In Du Bois’s case it encompassed Europe, science and technology, Wagner operas, the Olympics, industrial education, race relations, National Socialism and the German Africanist Diedrich Westermann. The opinion pieces which Du Bois wrote for the newspaper “Pittsburgh Courier” during his stay in Germany serve as a major source for this thesis. In his writings on America, Adorno concentrated on what he regarded as the universally victorious Enlightenment and the predominance of mass culture. This investigation also sheds light on the correspondences between the philosopher and Max Horkheimer, Thomas Mann, Walter Benjamin, Siegfried Kracauer and Oskar and Maria Wiesengrund. In these autobiographical texts, Adorno’s thoughts revolve around such diverse topics as the American landscape, his fears as German, Jew and Left-Hegelian as well as the loneliness of the refugee. This dissertation has to refute the intuitive assumption that Du Bois’s and Adorno’s experiences abroad were horrible events for them. Both men judged the foreign countries in which they were staying in an extremely differentiated and subtle manner. Du Bois, for example, was not racially discriminated against in Germany. He was also delighted by the country’s rich cultural offerings. Adorno, for his part, praised the U.S.’s humanity of everyday life and democratic spirit. In short: Although both men partly did have to deal with utterly negative experiences, the metaphor of “hell on earth” is simply untenable as an overall conclusion.

Correlates of periodontal decline and biologic markers in older adults

BACKGROUND: There is limited information on infectious and host responses distinguishing older people with or without active periodontitis. This study measured bacterial and serum cytokine and high-sensitivity C-reactive protein (hsCRP) levels in older persons. METHODS: Elders (mean age: 67 years), whose periodontal status had declined most or least (20% worst or 20% best) over 5 years, were enrolled. Two years later, they were classified as periodontally declining (active periodontitis [AP]), if they had at least five teeth with probing depth (PD) > or =5 mm, or stable (stable periodontally [SP]), if they did not. Groups were compared with respect to demographics, PD, clinical loss of attachment, subgingival bacteria, serum hsCRP, interleukin (IL)-1beta and -6, and chronic diseases. RESULTS: Ten AP and 24 SP subjects were identified; 13% of women and 44% of men from the original sample were in the AP group (P <0.05). Most Asians were SP; most whites and all African Americans were classified as having AP (P <0.01). More AP elders had osteoporosis (P <0.01), but the AP and SP groups did not differ with respect to IL-1beta and -6 or hsCRP. Bacterial counts were higher in the AP group for Parvimonas micra (previously Peptostreptococcus micros or Micromonas micros) (7.7 x 10(5) cells versus 3.8 x 10(5) cells; P <0.05), Prevotella intermedia (25.7 x 10(5) cells versus 9.8 x 10(5) cells; P <0.01), Tannerella forsythia (previously T. forsythensis) (16.2 x 10(5) cells versus 8.0 x 10(5) cells; P <0.05), and Streptococcus mutans (6.2 x 10(5) cells versus 2.0 x 10(5) cells; P <0.01). Three risk factors were most predictive of periodontal decline: PD, osteoporosis, and being white or African American. CONCLUSION: Periodontal decline was associated with osteoporosis, ethnicity, PD, gender, serum hsCRP, and levels of four bacterial species.

Characteristics of a spina bifida population including North American Caucasian and Hispanic individuals.

BACKGROUND: Meningomyelocele (MM) is a common human birth defect. MM is a disorder of neural development caused by contributions from genes and environmental factors that result in the NTD and lead to a spectrum of physical and neurocognitive phenotypes. METHODS: A multidisciplinary approach has been taken to develop a comprehensive understanding of MM through collaborative efforts from investigators specializing in genetics, development, brain imaging, and neurocognitive outcome. Patients have been recruited from five different sites: Houston and the Texas-Mexico border area; Toronto, Canada; Los Angeles, California; and Lexington, Kentucky. Genetic risk factors for MM have been assessed by genotyping and association testing using the transmission disequilibrium test. RESULTS: A total of 509 affected child/parent trios and 309 affected child/parent duos have been enrolled to date for genetic association studies. Subsets of the patients have also been enrolled for studies assessing development, brain imaging, and neurocognitive outcomes. The study recruited two major ethnic groups, with 45.9% Hispanics of Mexican descent and 36.2% North American Caucasians of European descent. The remaining patients are African-American, South and Central American, Native American, and Asian. Studies of this group of patients have already discovered distinct corpus callosum morphology and neurocognitive deficits that associate with MM. We have identified maternal MTHFR 667T allele as a risk factor for MM. In addition, we also found that several genes for glucose transport and metabolism are potential risk factors for MM. CONCLUSIONS: The enrolled patient population provides a valuable resource for elucidating the disease characteristics and mechanisms for MM development.