BACKGROUND & AIMS: :The purpose of this study was to characterize and compare neuropsychiatric symptoms in a sample of 367 community-dwelling subjects: 70 Hispanics and 230 non-Hispanic white patients with Alzheimer's disease, and 22 Hispanics and 45 non-Hispanic white healthy age-matched controls. Neuropsychiatric symptoms were common among all patients with Alzheimer's disease. In the Alzheimer's disease groups, Hispanic subjects presented to the initial assessment with more symptoms than non-Hispanic white subjects did. In comparison to the non-Hispanic white population, the proportion of Hispanics with neuropsychiatric and behavioral symptoms was higher. These findings have implications for differential sociocultural presentations of Alzheimer's disease among ethnic/racial groups.

背景与目标： ：这项研究的目的是在367名社区居民受试者的样本中表征和比较神经精神症状：70名西班牙裔美国人和230名患有阿尔茨海默氏病的非西班牙裔白人患者，以及22名西班牙裔和45名非西班牙裔白人健康的年龄匹配对照。神经精神症状在所有阿尔茨海默氏病患者中都很常见。在阿尔茨海默氏病组中，西班牙裔受试者比非西班牙裔白人受试者表现出更多的症状。与非西班牙裔白人相比，具有神经精神病学和行为症状的西班牙裔比例更高。这些发现对不同种族/种族的老年痴呆症的社会文化表现形式有所不同。

BACKGROUND & AIMS: OBJECTIVES:The study objectives were to estimate the prevalence of chronic diseases and other health indicators for Hispanics in Missouri, and to compare their prevalence estimates with other racial/ethnic groups. DESIGN / SETTING / PARTICIPANTS: This study, conducted in public health and academic settings, used combined data from the 2002 and 2003 Missouri Behavioral Risk Factor Surveillance System and the 2003 Missouri County-Level Study. Data were post-stratified with Hispanic ethnicity as a separate group. MAIN OUTCOME MEASURES:Twenty health indicators were compared. Logistic regression was used to control for sociodemographic characteristics. RESULTS:Overall, 21.7% (95% confidence interval [CI] 13.4-30.0) of Hispanics, 19.8% (95% CI 14.4-25.2%) of non-Hispanic Blacks, and 12.2% (95% CI 11.2-13.1%) of non-Hispanic Whites had no insurance coverage. Hispanics were significantly less likely to report poor or fair health (12.1%, 95% CI 7.5-16.7%) than non-Hispanic Blacks (21.6%, 95% CI 17.2-26.0%), and less likely to report activity limitation (12.9%, 95% CI 8.0-17.9%) than non-Hispanic Whites (20.2%, 95% CI 19.1-21.2%). Controlling for sociodemographic characteristics, Hispanics had greater physician-diagnosed diabetes (OR = 2.0, 95% CI 1.0-3.3%) and Hispanics aged > or = 50 were less likely to have no sigmoidoscopy or colonoscopy in the past five years (OR = 0.5, 95% CI 0.2-1.0%) compared to non-Hispanic Whites. CONCLUSIONS:Other than lower healthcare coverage and diabetes status, the health indicators for English-speaking Hispanics were similar to, or better than, non-Hispanic Blacks and Whites. However, these data may not represent all Hispanics in Missouri since health status between English-speaking and non-English speaking Hispanics may differ significantly.

背景与目标： 目的：本研究的目的是估计密苏里州西班牙裔人的慢性病和其他健康指标的患病率，并将其与其他种族/族裔人群的患病率进行比较。设计/地点/参与者：本研究在公共卫生和学术环境中进行，使用了2002年和2003年密苏里州行为危险因素监视系统以及2003年密苏里州县级研究的组合数据。将数据与西班牙裔种族作为一个单独的组进行了分层。
主要观察指标：比较二十项健康指标。 Logistic回归用于控制社会人口统计学特征。
结果：总体而言，西班牙裔占21.7％（95％置信区间[CI] 13.4-30.0），非西班牙裔黑人占19.8％（95％CI 14.4-25.2％），以及12.2％（95％CI 11.2-13.1％）的非西班牙裔白人没有保险。与非西班牙裔黑人（21.6％，95％CI 17.2-26.0％）相比，西班牙裔人报告健康状况差或基本健康的可能性（12.1％，95％CI 7.5-16.7％）显着更少，并且报告活动受限的可能性也较小（12.9 ％，95％CI为8.0-17.9％）比非西班牙裔白人（20.2％，95％CI为19.1-21.2％）。控制社会人口统计学特征，西班牙裔患者经医生诊断为糖尿病（OR = 2.0，95％CI 1.0-3.3％），并且过去五年内≥50岁的西班牙裔患者更不可能接受乙状结肠镜或结肠镜检查（OR = 0.5） （95％CI 0.2-1.0％），而非西班牙裔白人。
结论：除了降低医疗保健覆盖率和糖尿病状况外，讲英语的西班牙裔美国人的健康指标与非西班牙裔黑人和白人相似或更好。但是，这些数据可能并不代表密苏里州的所有西班牙裔，因为讲英语和不讲英语的西班牙裔之间的健康状况可能存在很大差异。

BACKGROUND & AIMS: OBJECTIVE:To examine (a) ethnic differences in blood alcohol level (BAL) and preinjury chronic alcohol use (PI-ETOH) within a severe closed head injury (CHI) sample and (b) the main and interaction effects of BAL, PI-ETOH, and ethnicity on functional outcome following severe CHI. PARTICIPANTS:A total of 434 Hispanic, Anglo-Caucasian, and African-American individuals with severe CHI. DESIGN:Retrospective cohort study. SETTING:Consecutive admissions to a level 1 trauma center. MAIN MEASURES:After admission to the trauma center, BAL was collected for each patient. Additional information regarding PI-ETOH was collected in a subset of patients (N = 116). Functional outcome was measured using the Disability Rating Scale (DRS) at 6 months after injury. RESULTS:A one-way analysis of variance revealed ethnic differences in mean BAL. Hierarchical multiple regression indicated that BAL did not predict DRS outcomes after controlling for pertinent covariates. An interaction effect between PI-ETOH and ethnicity was observed, such that presence of chronic alcohol use predicted worse functional outcome for Anglo-Caucasians and African-Americans, but more favorable outcome for Hispanics. CONCLUSIONS:Ethnic differences in BALs within our severe traumatic brain injury sample mirrored ethnic drinking patterns observed in the general population, with Hispanics having the highest BALs. A paradoxical relationship between PI-ETOH and functional outcome was observed for Hispanics.

背景与目标： 目的：研究（a）重度闭合性颅脑损伤（CHI）样本中血液酒精水平（BAL）和损伤前慢性饮酒（PI-ETOH）的种族差异，以及（b）BAL，PI-BAL的主要作用和相互作用严重的CHI后，ETOH和种族对功能结局的影响。
参与者：共有434名患有严重CHI的西班牙裔，盎格鲁-高加索人和非裔美国人。
设计：回顾性队列研究。
地点：1级创伤中心连续入院。
主要指标：入院创伤中心后，为每位患者收集BAL。在部分患者中收集了有关PI-ETOH的其他信息（N = 116）。伤后6个月使用残疾评定量表（DRS）测量功能结局。
结果：方差的单向分析显示平均BAL的种族差异。分层多元回归分析表明，在控制了相关协变量之后，BAL并不能预测DRS的预后。观察到PI-ETOH与种族之间的相互作用，例如，长期饮酒的存在预示着盎格鲁高加索人和非裔美国人的功能性结局较差，而西班牙裔则更有利。
结论：我们严重的颅脑外伤样本中BAL的种族差异反映了在普通人群中观察到的民族饮酒模式，而西班牙裔的BAL最高。西班牙裔人观察到PI-ETOH与功能结局之间存在自相矛盾的关系。

BACKGROUND & AIMS: CONTEXT:Hypoadiponectinemia has emerged as an independent risk factor for type 2 diabetes and cardiovascular disease. Although associations of adiponectin with central obesity and insulin resistance have been reported, very little data are available from studies using detailed measures of insulin sensitivity (S(I)) and/or body fat distribution in ethnic groups at high risk for metabolic disease. OBJECTIVE:The aim of the study was to identify the correlates of adiponectin in 1636 nondiabetic Hispanics and African-Americans. DESIGN:A cross-sectional analysis of participants in the Insulin Resistance Atherosclerosis Family Study was conducted. S(I) was determined from frequently sampled iv glucose tolerance tests with minimal model analysis. Subcutaneous and visceral adipose tissues (SAT, VAT, respectively) were determined with computed tomography. Triglyceride, high-density lipoprotein, C-reactive protein, and adiponectin were measured in fasting samples. Generalized estimating equation (GEE) models were used to identify factors associated with adiponectin concentration. SETTING:A multicenter study using a family-based design was conducted. PARTICIPANTS:A total of 1636 nondiabetic Hispanic and African-American subjects participated. MAIN OUTCOME MEASURES:Circulating adiponectin concentration was measured. RESULTS:Age, female gender, high-density lipoprotein, SAT, and S(I) were positive independent correlates of adiponectin, whereas glucose, CRP, and VAT were negative independent correlates (all P < 0.05). Ethnicity was not an independent correlate of adiponectin in this model (P = 0.27); however, an ethnicity by VAT interaction term was retained, indicating a stronger negative association of VAT with adiponectin in African-Americans compared with Hispanics. CONCLUSION:Directly measured S(I), VAT, and SAT were independently correlated with adiponectin in Hispanic and African-American subjects. The inverse association of VAT with adiponectin was stronger in African-Americans compared with Hispanics, a finding that suggests possible ethnic differences in the effects of visceral obesity.

背景与目标： 背景：低脂联素血症已成为2型糖尿病和心血管疾病的独立危险因素。尽管已经报道了脂联素与中枢性肥胖和胰岛素抵抗的相关性，但在代谢性疾病高危人群中，使用胰岛素敏感性（S（I））和/或体脂分布的详细测量方法的研究提供的数据很少。
目的：本研究的目的是鉴定脂联素在1636名非糖尿病性西班牙裔美国人和非裔美国人中的相关性。
设计：对胰岛素抵抗动脉粥样硬化家族研究的参与者进行了横断面分析。 S（I）是通过频繁采样的静脉糖耐量测试和最少的模型分析确定的。皮下和内脏脂肪组织（分别为SAT，VAT）通过计算机断层扫描确定。在禁食样品中测量甘油三酸酯，高密度脂蛋白，C反应蛋白和脂联素。使用广义估计方程（GEE）模型来确定与脂联素浓度相关的因素。
地点：使用基于家庭的设计进行了多中心研究。
参与者：共有1636名非糖尿病性西班牙裔和非裔美国人受试者参加。
主要观察指标：测量循环脂联素浓度。
结果：年龄，女性，高密度脂蛋白，SAT和S（I）与脂联素呈正相关，而葡萄糖，CRP和VAT与脂联素呈负相关（均P <0.05）。在该模型中，种族并不是脂联素的独立相关因素（P = 0.27）；但是，保留了通过VAT交互作用的种族，这表明与西班牙裔美国人相比，非洲裔美国人中VAT与脂联素之间的负相关性更强。
结论：在西班牙裔和非裔美国人受试者中，直接测量的S（I），VAT和SAT与脂联素独立相关。与西班牙裔美国人相比，非裔美国人的增值税与脂联素的反向关联更强，这一发现表明内脏肥胖的影响可能存在种族差异。

BACKGROUND & AIMS: :There are increasing numbers of medically uninsured populations in the United States today. Despite rising concerns with the health status of the uninsured, a dearth of information exists about their health seeking and health communication behaviors. Because Hispanics experience elevated risks of being medically uninsured, and have less access to health care services and health information resources, it is imperative that health communicators understand ways to reach this population. This study investigates Hispanics' connections to various media and interpersonal resources for health information and explores the extent to which the uninsured and the insured differ in terms of their health communication choices, and health seeking behaviors. Results from a survey of 737 Hispanics in Los Angeles show that ethnically targeted television and interpersonal communication networks were the preferred sources of health information. The uninsured and insured populations differed significantly in the ways that they access health care and seek health information, including the use of online health information. Implications of the findings are discussed for understanding health knowledge gaps and the design of mediated health communication campaigns to reach the medically vulnerable and Hispanic populations.

背景与目标： ：今天，美国医疗保险人群的数量正在增加。尽管人们对未保险者的健康状况越来越关注，但仍缺乏有关其寻求健康和健康交流行为的信息。由于拉美裔人遭受医疗保险的风险增加，并且无法获得医疗保健服务和健康信息资源，因此，健康交流者必须了解如何覆盖这一人群。这项研究调查了西班牙裔美国人与各种媒体和人际关系资源之间的联系，以获取健康信息，并探讨了未保险者和被保险者在健康交流选择和寻求健康行为方面的差异。洛杉矶对737名西班牙裔美国人的一项调查结果表明，针对种族的电视和人际交流网络是健康信息的首选来源。未保险人群和被保险人群在获得医疗保健和寻求健康信息（包括使用在线健康信息）的方式上存在显着差异。讨论了研究结果的含义，以了解健康知识方面的差距以及为医疗脆弱人群和西班牙裔人群设计的中介健康交流活动的设计。

BACKGROUND & AIMS: OBJECTIVES:To investigate the association between race and hypertension among Hispanics and non-Hispanics by using data from the National Health Interview Survey (NHIS), an annual survey of US households and to compare the strength of these associations among Hispanics and non-Hispanics. DESIGN AND METHODS:Analyses were limited to Hispanics and non-Hispanics 18 years of age and older who self-identified as White or Black/African-American during the 2000-2002 NHIS for a final sample of 88,453 adults including 12,083 Hispanics. Hypertension was self-reported during the survey interview. Covariates included in the analyses as potential confounders were sociodemographic characteristics and risk factors for hypertension. RESULTS:Hispanic Blacks had higher prevalence of self-reported hypertension than Hispanic Whites. Hispanic Blacks had higher odds of hypertension than non-Hispanic and Hispanic Whites. However, these associations did not achieve significance level. No difference was seen on the strength of the association between race and hypertension among Hispanics and non-Hispanics (OR 1.31 vs 1.52, P interaction for race and ethnicity .91). The protective effect for hypertension on Hispanics had been disappearing over time (P interaction race/ethnicity and survey year .002). CONCLUSIONS:This study underscores that racial categorization could be a significant predictor of health status for Hispanics in our society. As time goes by, we are curious to see how embedding in US racial categories and assimilation into Western culture influence the life and health of Hispanics.

背景与目标： 目的：通过使用美国国家年度健康调查（NHIS）的数据，调查西班牙裔和非西班牙裔之间种族和高血压之间的联系，并比较这些联系在西班牙裔和非西班牙裔之间的强度。
设计与方法：分析仅限于18岁及以上的西班牙裔和非西班牙裔，他们在2000-2002年NHIS期间自认是白人或黑人/非裔美国人，最终样本为88,453名成人，其中包括12,083名西班牙裔。高血压是在调查访谈中自我报告的。由于潜在的混杂因素，分析中包括的协变量是社会人口统计学特征和高血压的危险因素。
结果：西班牙裔黑人的自我报告的高血压患病率高于西班牙裔白人。西班牙裔美国人的黑人患高血压的几率高于非西班牙裔美国人和西班牙裔美国人。但是，这些关联没有达到显着性水平。西班牙裔和非西班牙裔之间种族和高血压之间的关联强度没有差异（OR 1.31 vs 1.52，种族和族裔的P交互作用为.91）。随着时间的流逝，对高血压对西班牙裔的保护作用逐渐消失（P相互作用种族/民族和调查年份.002）。
结论：本研究强调种族分类可能是我们社会中西班牙裔健康状况的重要预测指标。随着时间的流逝，我们很好奇地看到，嵌入美国种族类别和同化西方文化如何影响西班牙裔的生活和健康。

BACKGROUND & AIMS: BACKGROUND:An understanding of dietary patterns in diverse populations may guide the development of food-based, rather than nutrient-based, recommendations. OBJECTIVE:We identified and determined predictors of dietary patterns in low-income black and Hispanic adults with diagnosed diabetes. DESIGN:A food-frequency questionnaire was used to assess dietary intake in 235 adults living in the South Bronx, New York City, NY. We used principal factor analysis with promax rotation to identify dietary patterns. Multivariate linear regression models were used to test associations between demographic variables and dietary pattern scores. RESULTS:The following 5 dietary patterns were identified: pizza and sweets, meats, fried foods, fruit and vegetables, and Caribbean starch. The Caribbean starch and fruit and vegetables patterns were high in fruit and vegetables and low in trans fats. In multivariate analyses, sex, language spoken, years living in the United States, and region of birth were significant predictors of dietary patterns. Compared with English speakers, Spanish speakers were less likely to have high scores in pizza and sweets (P = 0.001), meat (P = 0.004), and fried food (P = 0.001) patterns. Participants who lived longer in the United States were less likely to have a meat (P = 0.024) or Caribbean starch pattern (P < 0.001). In Hispanics, the consumption of foods in the Caribbean starch pattern declined for each year that they lived in the United States. CONCLUSIONS:In adults with diagnosed diabetes who were living in the South Bronx, a Caribbean starch pattern, which included traditional Hispanic and Caribbean foods, was consistent with a healthier dietary pattern. In developing dietary interventions for this population, one goal may be to maintain healthy aspects of traditional diets. This trial was registered at clinicaltrials.gov as NCT00797888.

背景与目标： 背景：了解不同人群的饮食模式可能会指导以食物为基础而非以营养为基础的建议的发展。
目的：我们确定并确定了诊断为糖尿病的低收入黑人和西班牙裔成年人的饮食习惯。
设计：使用食物频率问卷调查了纽约州南布朗克斯市的235名成年人的饮食摄入量。我们使用具有promax旋转的主因子分析来确定饮食模式。多元线性回归模型用于检验人口统计学变量与饮食模式得分之间的关​​联。
结果：确定了以下5种饮食模式：比萨饼和糖果，肉类，油炸食品，水果和蔬菜以及加勒比淀粉。加勒比地区的淀粉，水果和蔬菜的模式在水果和蔬菜中含量较高，而反式脂肪含量较低。在多元分析中，性别，说的语言，在美国的生活年限和出生地区是饮食习惯的重要预测指标。与讲英语的人相比，讲西班牙语的人在比萨饼和糖果（P = 0.001），肉类（P = 0.004）和油炸食品（P = 0.001）方面得分较高的可能性较小。在美国寿命更长的参与者食用肉类（P = 0.024）或加勒比淀粉型（P <0.001）的可能性较小。在西班牙裔中，以加勒比地区的淀粉为食的食物在美国居住的每一年都在下降。
结论：居住在南布朗克斯区的被诊断患有糖尿病的成年人的加勒比淀粉模式，包括传统的西班牙和加勒比食物，与健康的饮食模式相符。在制定针对该人群的饮食干预措施时，一个目标可能是保持传统饮食的健康状况。该试验已在Clinicaltrials.gov上注册为NCT00797888。

BACKGROUND & AIMS: :Higher socioeconomic status smokers are more successful at smoking cessation. Few studies have investigated the prospective association between multiple measures of socioeconomic status and Hispanic smoking cessation. We assessed four measures to examine which predicted smoking cessation. Hispanics without debt had 18.5 times higher odds of 30-day cessation (odds ratio = 18.47, 95% confidence interval = 3.26-104.66, p < .01) and 11-fold increased odds of 7-day point prevalence abstinence (odds ratio = 11.32, 95% confidence interval = 2.45-52.24, p < .01) at 3-month follow-up. Yearly income, education, work status, money to see a doctor, and money for medications were not predictive of smoking cessation. Debt level may better measure socioeconomic inequities by capturing objective and subjective social status associated with Hispanic smoking cessation.

背景与目标： ：较高的社会经济地位的吸烟者戒烟会更成功。很少有研究调查社会经济地位的多种指标与西班牙裔戒烟之间的前瞻性关联。我们评估了四种措施以检查预测吸烟的预测。没有债务的西班牙裔美国人在30天戒烟的几率高18.5倍（赔率= 18.47，95％的置信区间= 3.26-104.66，p <.01），而7天戒断率的几率增加了11倍（赔率=随访3个月时为11.32，95％置信区间= 2.45-52.24，p <.01）。年收入，教育程度，工作状态，看医生的钱以及用药的钱不能预测戒烟。债务水平可以通过捕获与西班牙裔戒烟有关的客观和主观社会地位来更好地衡量社会经济不平等。

BACKGROUND & AIMS: OBJECTIVE:We aimed to identify factors that are independently associated with the metabolic clearance rate of insulin (MCRI) and to examine the association of MCRI with incident type 2 diabetes in nondiabetic Hispanics and African Americans. RESEARCH DESIGN AND METHODS:We investigated 1,116 participants in the Insulin Resistance Atherosclerosis Study (IRAS) Family Study with baseline examinations from 2000 to 2002 and follow-up examinations from 2005 to 2006. Insulin sensitivity (S(I)), acute insulin response (AIR), and MCRI were determined at baseline from frequently sampled intravenous glucose tolerance tests. MCRI was calculated as the ratio of the insulin dose over the incremental area under the curve of insulin. Incident diabetes was defined as fasting glucose ≥126 mg/dL or antidiabetic medication use by self-report. RESULTS:We observed that S(I) and HDL cholesterol were independent positive correlates of MCRI, whereas fasting insulin, fasting glucose, subcutaneous adipose tissue, visceral adipose tissue, and AIR were independent negative correlates (all P < 0.05) at baseline. After 5 years of follow-up, 71 (6.4%) participants developed type 2 diabetes. Lower MCRI was associated with a higher risk of incident diabetes after adjusting for demographics, lifestyle factors, HDL cholesterol, indexes of obesity and adiposity, and insulin secretion (odds ratio 2.01 [95% CI 1.30-3.10], P = 0.0064, per one-SD decrease in loge-transformed MCRI). CONCLUSIONS:Our data showed that lower MCRI predicts the incidence of type 2 diabetes.

背景与目标： 目的：我们旨在确定与胰岛素代谢清除率（MCRI）独立相关的因素，并研究非糖尿病性西班牙裔美国人和非裔美国人中MCRI与2型糖尿病的相关性。
研究设计和方法：我们调查了1,116例胰岛素抵抗性动脉粥样硬化研究（IRAS）参与者，其基线检查时间为2000年至2002年，随访时间为2005年至2006年。胰岛素敏感性（S（I）），急性胰岛素反应（ AIR）和MCRI在基线时通过频繁采样的静脉葡萄糖耐量测试确定。 MCRI被计算为胰岛素剂量在胰岛素曲线下增量区域上的剂量。空腹糖尿病定义为空腹血糖≥126mg / dL或通过自我报告使用抗糖尿病药物。
结果：我们观察到，S（I）和HDL胆固醇是MCRI的独立正相关，而空腹胰岛素，空腹葡萄糖，皮下脂肪组织，内脏脂肪组织和AIR在基线时是独立的负相关（所有P <0.05）。经过5年的随访，有71名（6.4％）参与者患上2型糖尿病。调整了人口统计学，生活方式因素，HDL胆固醇，肥胖和肥胖指数以及胰岛素分泌后，MCRI降低与罹患糖尿病的风险更高相关（赔率比为2.01 [95％CI 1.30-3.10]，P = 0.0064，每人-SD在loge转换的MCRI中减少）。
结论：我们的数据表明较低的MCRI可以预测2型糖尿病的发生率。

BACKGROUND & AIMS: :More than one-third of the approximately two million people entering publicly funded substance abuse treatment in the United States do not complete treatment. Additionally, racial and ethnic minorities with addiction disorders, who constitute approximately 40 percent of the admissions in publicly funded substance abuse treatment programs, may be particularly at risk for poor outcomes. Using national data, we found that blacks and Hispanics were 3.5-8.1 percentage points less likely than whites to complete treatment for alcohol and drugs, and Native Americans were 4.7 percentage points less likely to complete alcohol treatment. Only Asian Americans fared better than whites for both types of treatment. Completion disparities for blacks and Hispanics were largely explained by differences in socioeconomic status and, in particular, greater unemployment and housing instability. However, the alcohol treatment disparity for Native Americans was not explained by socioeconomic or treatment variables, a finding that warrants further investigation. The Affordable Care Act could reduce financial barriers to treatment for minorities, but further steps, such as increased Medicaid funding for residential treatment and better cultural training for providers, would improve the likelihood of completing treatment and increase treatment providers' cultural competence.

背景与目标： ：在美国，约有200万人接受公共资助的药物滥用治疗，其中超过三分之一的人没有完成治疗。此外，患有成瘾性疾病的种族和少数民族大约占公共资助的药物滥用治疗计划中入院人数的40％，可能特别容易遭受不良后果的威胁。使用国家数据，我们发现黑人和西班牙裔美国人完成酒精和毒品治疗的可能性比白人低3.5-8.1个百分点，而美洲原住民完成酒精治疗的可能性降低了4.7个百分点。在这两种治疗方式中，只有亚裔美国人的表现要好于白人。黑人和西班牙裔人的完成差距主要是由于社会经济地位的差异，尤其是失业率上升和住房不稳定造成的。但是，没有通过社会经济或治疗变量来解释美国原住民在酒精治疗方面的差异，这一发现值得进一步研究。 《平价医疗法案》可以减少对少数群体进行治疗的经济障碍，但是进一步的措施，例如增加用于住院治疗的医疗补助资金以及对提供者的文化培训，将增加完成治疗的可能性，并提高治疗提供者的文化能力。

BACKGROUND & AIMS: BACKGROUND:Acculturation has been linked to an increased prevalence of alcohol-related problems. However, most of the research has been conducted with Hispanic populations in metropolitan areas of the United States, none of which is on the U.S.-Mexico border. This study examines the association between acculturation, heavy episodic drinking, and DSM-IV alcohol abuse and dependence among Hispanics in the Texas-Mexico border. METHODS:The study used data from a survey conducted (2002 to 2003) along the Texas-Mexico border and included 472 male and 484 female Hispanic adults from El Paso, the Rio Grande Valley, and colonias. Based on the Acculturation Rating Scale for Mexican Americans-II scale, respondents were coded into 4 acculturation categories: "very Mexican oriented,"Mexican bicultural,"Anglo bicultural," or "very Anglo/Anglicized.". RESULTS:Acculturation was related to lower rates of alcohol use disorders among men and a higher frequency of heavy episodic drinking among women. Multivariate analyses indicate that men who report heavy episodic drinking and those who are "very Mexican,"bicultural Mexican," or "bicultural Anglo" are more at higher risk for alcohol abuse and/or dependence compared with "very Anglo/Anglicized" men. For women, acculturation level did not predict alcohol disorders. Statistical analyses included testing for bivariate associations and multivariate logistic regression predicting heavy episodic drinking alcohol abuse or dependence. CONCLUSIONS:This study suggests that acculturation has different effects on drinking for men and women. This finding needs some attention as literature also indicates that women drink more and may develop more alcohol-related problems as they acculturate. This increase in women's drinking is probably because of U.S. society's more liberal norms governing female drinking. The "bimodal" distribution of risk, in which only men in "very Anglo" group are at a lower risk than the others, may be unique to the Border. The association between acculturation and alcohol use disorders does not appear to be linear and the effect of acculturation is not uniform on individuals' drinking behavior.

背景与目标： 背景：适应症与酒精相关问题的患病率上升有关。但是，大多数研究是针对美国大都市地区的拉美裔人群进行的，这些人群都不在美国-墨西哥边境。这项研究检查了在德克萨斯州-墨西哥边境的文化容忍度，大量饮酒和DSM-IV酒精滥用与西班牙裔之间的依赖性之间的联系。
方法：该研究使用的数据来自德克萨斯州-墨西哥边境（2002年至2003年），包括来自埃尔帕索，里奥格兰德河谷和科洛尼亚斯的472名西班牙裔成年人和484名女性西班牙裔成年人。根据“墨西哥裔美国人II的文化适应等级量表”，将受访者分为4个文化适应类别：“非常墨西哥化”，“墨西哥双重文化”，“盎格鲁双重文化”或“非常盎格鲁/盎格鲁化”。
结果：适应与男性饮酒障碍的发生率较低和女性频繁发作性饮酒的频率较高有关。多变量分析表明，与“非常盎格鲁/英国化”男性相比，报告大量饮酒和“非常墨西哥”，“双文化墨西哥”或“双文化盎格鲁”的男性更容易遭受酒精滥用和/或依赖。对于女性而言，文化适应程度并不能预测酒精中毒，统计分析包括双变量关联测试和多元逻辑回归分析，以预测严重的偶发性饮酒或依赖。
结论：这项研究表明，适应对男性和女性的饮酒有不同的影响。这一发现需要引起注意，因为文献还表明女性在饮酒时会饮酒更多，并可能发展出更多与酒精有关的问题。女性饮酒量的增加可能是由于美国社会对女性饮酒的规范更为宽松。边界是独一无二的“双峰”风险分布，其中只有“非常盎格鲁”群体中的男子处于比其他人更低的风险中。适应与酒精使用障碍之间的关联似乎不是线性的，并且适应对个体的饮酒行为的影响也不统一。

BACKGROUND & AIMS: Since less than one-third of patients in need of a BMT find related donors, most patients will rely on registries of volunteer donors. For patients from minority ethnic groups the chances of finding matched unrelated donors are lower, in part due to the smaller representation of minorities in the registries. Our purpose was to determine the representation of Hispanics in the National Marrow Donor Program (NMDP), the largest registry of volunteer marrow donors in the United States. We analyzed a database provided by the NMDP that contained information on minorities. The number of Hispanic volunteer donors has increased 110-fold in the last 6 years. The proportion of Hispanics in the registry has also increased from 1.1% to 6%. Nevertheless, the proportion of Hispanic patients that received unrelated marrow transplants facilitated by the NMDP has increased only from 2.8% to 3.9% since 1989. Only 19.7% of the formal searches initiated by Hispanic patients resulted in transplants compared to the 30.4% observed in the Caucasian population. Despite increments in the number and proportion of Hispanic volunteer donors, the proportion of Hispanics that receive BMT from unrelated donors remains low. We conclude that, in addition to increased recruitment efforts, other strategies will be necessary in order to find enough marrow donors to meet the needs of the Hispanic population.

背景与目标： 由于需要BMT的患者中不到三分之一找到相关的捐献者，因此大多数患者将依赖志愿捐献者的登记簿。对于少数族裔的患者，找到匹配的无关亲属的机会较低，这部分是由于登记处中少数族裔的代表较少。我们的目的是确定西班牙裔美国人在国家骨髓捐献者计划（NMDP）中的代表情况，该计划是美国最大的志愿者骨髓捐献者注册表。我们分析了NMDP提供的数据库，其中包含有关少数群体的信息。在过去的6年中，西班牙裔志愿捐助者的数量增加了110倍。西班牙裔美国人在注册表中的比例也从1.1％增加到6％。然而，自1989年以来，接受NMDP促进的无关骨髓移植的西班牙裔患者比例仅从2.8％增至3.9％。由西班牙裔患者发起的正式搜索中只有19.7％进行了移植，而在美国，这一比例为30.4％。高加索人口。尽管拉美裔志愿捐助者的数量和比例有所增加，但从无关亲属捐助者那里接受BMT的拉美裔比例仍然很低。我们得出的结论是，除了加大招募力度之外，还需要其他策略，以便找到足够的骨髓捐献者来满足西班牙裔人口的需求。

BACKGROUND & AIMS: :While leukemia rates are thought to be lower in South and Central America, no study has systematically investigated incidence rates of the leukemia subtypes among Hispanics in the U.S. This was a retrospective cohort study, using data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, 1992 - 2001, to compare leukemia incidence rates as a function of race and ethnicity. It was found that in adults, Hispanics had lower incidence rates for each of the major types of leukemia as compared to non-Hispanic Whites: For AML, elderly Whites had an incidence rate ratio (IRR) of 1.61 in comparison to Hispanics (p < 0.001) and 1.27 in comparison to Blacks (p < 0.001); for CML, the IRR among the elderly was 1.42 that of Hispanics (p < 0.001) and 1.22 that of Blacks (p = 0.003); and for CLL, the IRR was 2.31 times that of Hispanics (p < 0.001) and 1.48 times that of Blacks (p < 0.001). In ALL, however, Hispanics aged 0 - 19 had a significantly higher incidence rate than Whites and Blacks, with an IRR of 1.32 compared to Whites (p < 0.001), and 2.62 compared to Blacks (p < 0.001). In AML, CML, and CLL, among people age 65 or older, white non-Hispanics have higher incidence rates than Blacks, and Blacks have higher incidence rates than Hispanics. Childhood ALL incidence rates are highest among Hispanics, and lowest among Blacks.

背景与目标： ：虽然在南美洲和中美洲，白血病的发生率较低，但尚无系统研究美国拉美裔人中白血病亚型的发生率的研究。这是一项回顾性队列研究，使用了来自监测，流行病学和最终结果的数据（美国国家癌症研究所（SEER）计划，1992年至2001年，用于比较白血病发病率与种族和种族的关系。发现在成年人中，西班牙裔美国人与非西班牙裔白人相比，每种主要白血病的发病率均较低：对于AML，老年白人与西班牙裔美国人相比的发病率比率（IRR）为1.61（p < 0.001）和1.27（相对于黑人）（p <0.001）；对于CML，老年人的内部收益率是西班牙裔的1.42（p <0.001）和黑人的1.22（p = 0.003）；对于CLL，IRR是西班牙裔的2.31倍（p <0.001）和黑人的1.48倍（p <0.001）。然而，在所有人群中，0-19岁的西班牙裔美国人的发病率明显高于白人和黑人，与白人相比，IRR为1.32（p <0.001），与黑人相比，IRR为2.62（p <0.001）。在AML，CML和CLL中，在65岁或65岁以上的人群中，非西班牙裔白人的发病率高于黑人，而黑人的患病率高于西班牙裔。儿童期ALL发病率在西班牙裔中最高，在黑人中最低。

BACKGROUND & AIMS: PURPOSE:We investigated comorbidities and endometrial cancer survival by ethnicity because Hispanic whites (HWs) have worse survival than non-Hispanic whites (NHWs). METHODS:An endometrial cancer cohort (1992-2004) established with the Surveillance, Epidemiology and End Results-Medicare-linked database (n = 3,286) was followed through 2007. Endometrial cancer-specific and other cause mortality were evaluated with multivariate hazard ratios (mHRs). RESULTS:HWs were more likely than NHWs to have regional/distant disease (31.7 vs. 24.8 %), diabetes (31.7 vs. 11.0 %), and hypertension (49.4 vs. 37.6 %). HWs had poorer endometrial cancer-specific survival than NHWs (age-adjusted HR = 1.28; 95% CI 1.01-1.61), but not after adjustment for tumor characteristics and treatment (mHR = 1.02; 95% CI 0.81-1.29). In contrast, even after adjustment for cancer-related factors, other cause mortality in HWs was elevated (mHR = 1.27; 95% CI 1.01-1.59), but not after further adjustment for comorbid conditions (mHR = 1.07; 95% CI 0.85-1.35). CONCLUSIONS:Comorbidities, particularly diabetes, were more common in HWs than in NHWs and impacted other cause mortality. Improving diabetes management may be an effective means of improving other cause mortality. This may be particularly true for HWs, given their particularly high prevalence of diabetes.

背景与目标： 目的：我们按种族调查了合并症和子宫内膜癌的存活率，因为西班牙裔白人（HWs）的生存率较非西班牙裔白人（NHWs）差。
方法：通过监测，流行病学和最终结果-医疗保险相关数据库（n = 3,286）建立的子宫内膜癌队列（1992-2004）一直持续到2007年。 mHRs）。
结果：HWs比NHWs更容易发生区域性/远距离疾病（31.7 vs. 24.8％），糖尿病（31.7 vs. 11.0％）和高血压（49.4 vs. 37.6％）。硬体患者的子宫内膜癌特异性生存率较NHW差（年龄调整后的HR = 1.28; 95％CI 1.01-1.61），但在调整肿瘤特征和治疗后未见异常（mHR = 1.02; 95％CI 0.81-1.29）。相比之下，即使在调整了癌症相关因素后，硬件中的其他原因死亡率也有所提高（mHR = 1.27; 95％CI 1.01-1.59），但在对合并症进行了进一步调整后并未升高（mHR = 1.07; 95％CI 0.85- 1.35）。
结论：合并症，尤其是糖尿病，在家庭医院中比在家庭医院中更为常见，并且会影响其他原因的死亡率。改善糖尿病管理可能是改善其他原因死亡率的有效手段。考虑到HW的糖尿病患病率特别高，这可能尤其如此。

BACKGROUND & AIMS: INTRODUCTION:We estimated the prevalence and correlates of mild cognitive impairment (MCI) among middle-aged and older diverse Hispanics/Latinos. METHODS:Middle-aged and older diverse Hispanics/Latinos enrolled (n = 6377; 50-86 years) in this multisite prospective cohort study were evaluated for MCI using the National Institute on Aging-Alzheimer's Association diagnostic criteria. RESULTS:The overall MCI prevalence was 9.8%, which varied between Hispanic/Latino groups. Older age, high cardiovascular disease (CVD) risk, and elevated depressive symptoms were significant correlates of MCI prevalence. Apolipoprotein E4 (APOE) and APOE2 were not significantly associated with MCI. DISCUSSION:MCI prevalence varied among Hispanic/Latino backgrounds, but not as widely as reported in the previous studies. CVD risk and depressive symptoms were associated with increased MCI, whereas APOE4 was not, suggesting alternative etiologies for MCI among diverse Hispanics/Latinos. Our findings suggest that mitigating CVD risk factors may offer important pathways to understanding and reducing MCI and possibly dementia among diverse Hispanics/Latinos.

背景与目标： 简介：我们估算了中老年不同西班牙裔/拉丁裔的轻度认知障碍（MCI）的患病率和相关性。
方法：使用美国国家老龄化-阿尔茨海默氏症协会的诊断标准，评估了该多站点前瞻性队列研究中（n = 6377; 50-86岁）的中老年和不同西班牙裔/拉丁裔（M = 6377; 50-86岁）。
结果：总体MCI患病率为9.8％，在西班牙裔/拉丁美洲裔人群之间有所不同。老年，高心血管疾病（CVD）风险和抑郁症状升高是MCI患病率的重要相关因素。载脂蛋白E4（APOE）和APOE2与MCI没有显着相关。
讨论：西班牙裔/拉丁美洲裔背景的MCI患病率各异，但没有以前的研究报道的那么广泛。 CVD风险和抑郁症状与MCI升高有关，而APOE4则不相关，这表明在多种西班牙裔/拉丁裔中MCI的替代病因。我们的研究结果表明，减轻CVD危险因素可能为理解和减少不同西班牙裔/拉丁裔之间的MCI以及痴呆症提供重要途径。