Medical Matters

Race and Sex Impact Treatment in Newly Diagnosed A-Fib

Most notable disparities seen for catheter ablation, receipt of oral anticoagulants


For patients newly diagnosed with atrial fibrillation, race and sex may affect treatment, according to a study published in the July issue of Heart Rhythm.

The Matchless Woman

Meet the ‘matchless’ woman on a desperate search for a marrow donor

Until she hit 40, Dr. Tracy Jalbuena was one of the fortunate few who seem to have it all. She had a husband she loved, two healthy children, the perfect job and a house in an idyllic spot in Maine.

“My husband and I used to joke that in a movie, this is the part where the couple discovers they’ve moved into a house built on top of a cemetery and all hell breaks loose,” Jalbuena, now 43, says. “And then it did.”
Tracy Jalbuena, with her mother Kathryn Jalbuena, and dad, Numeriano Jalbuena. Jalbuena’s mother is of German and Irish ancestry and her father is Filipino, which makes it difficult for Tracy to find a bone marrow donor match.

Jalbuena’s charmed life ended with a string of medical misfortunes that would turn her world upside down and spotlight the heart-wrenching challenges of finding a bone marrow match for mixed race patients.

In 2012 Jalbuena started to experience symptoms that at first seemed so minor they were easy to dismiss, even for a doctor like herself. But those subtle signs heralded the beginning of her extremely rare illness, leaving her with an uncertain future and depending on someone, somewhere donating bone marrow that would match her exceedingly rare tissue type.

In early 2012, “I started feeling a little more tired,” Jalbuena remembers. “My joints were stiff. I had night sweats. I started thinking I was getting old.”

But then she noticed bubbles in her urine, a sign that she was spilling protein out of her kidneys, and her body started to swell. All those disparate symptoms suddenly crystallized in her mind. She realized something might be terribly wrong.

When test results pointed to a problem with the cells in her bone marrow, Jalbuena understood the diagnosis would be dire.

“I was driving home by myself and I hyperventilated the whole way,” she remembers. “I knew then it was really bad and life changing and I was never going to get back to where [I] was before.”
In March 2012 Jalbuena was diagnosed with primary amyloidosis, a rare condition in which some of the bone marrow cells go haywire and start producing abnormal proteins that can gunk up all the major organs of the body. About 3,000 new cases of AL are diagnosed each year, according to the Amyloidosis Foundation.

In Jalbuena’s case, there was some good news: only her kidneys were involved so far.

“It was a very heavy diagnosis,” she says. “It’s very scary when you’re 40 and you have two little kids at home.”

The best treatment for the disease involves killing off the patient’s bone marrow through chemotherapy and sometimes radiation and then transplanting some of her own stem cells that had been harvested and frozen earlier. Those cells migrate to the bones and create new, hopefully healthy, marrow. It’s not a cure, but it can be a very long-lasting treatment when it works.

The process was tough. “I came home in mid-July, tired, depressed and bald,” Jalbuena says.

Within months, it was clear the therapy was helping. By February, life was starting to come back to normal. Jalbuena was back at work part-time, exercising and traveling with her family.

But then in May 2014 she started to experience intense pain in her spine. She immediately went to her doctors.

Scans showed that the pain in her back was caused by a tumor in the bone. Worse, there were other tumors in bones all over her body. Though she had battled back the amyloidosis, Jalbuena now had developed another type of bone marrow disease, multiple myeloma, a cancer of the very same plasma cells that are involved in amyloidosis.

After hearing the diagnosis Jalbuena and her husband, James, got in the car and drove to a spot where they could look out at the ocean.

“I remember collapsing into his lap and sobbing and saying I can’t do this again,” she remembers, her voice cracking. “I felt like I had just reclaimed my life and things were going well again. It was really hard.”

While it’s not unheard of for a patient to have both amyloidosis and multiple myeloma, it’s extremely rare, says Dr. Jacob Laubach, one of Jalbuena’s current doctors and a professor of medicine at the Harvard Medical School and the clinical director of the Jerome Lipper Multiple Myeloma Center at the Dana Farber Cancer Institute.

Tom Brokaw: Cancer has ‘deepened my awe of my wife’

The really bad news was that the best therapy for multiple myeloma wasn’t an option for Jalbuena. That’s because it is the same therapy she’d been given for amyloidosis and, clearly, it hadn’t prevented her from developing multiple myeloma.

The only other option would be getting a bone marrow transplant from someone whose tissues matched Jalbuena’s. And that’s where things got really tricky.

None of her siblings turned out to be a match. And her particular genetic combination turned out to be exceedingly rare. Jalbuena’s mom is of German and Irish ancestry, while her dad is Filipino.

If she’d been Caucasian there would be a 97 percent chance of finding a match among the people who are in the bone marrow registry.

“For Filipinos it’s a lot lower, probably closer to 83 percent,” says Tonya Davis, community engagement representative for the Be the Match Registry. “And then because Tracy is of mixed race, that poses an extra challenge. Those patients have more varied tissue types.”

As of yet, a perfect match hasn’t been found among the 11 million Americans who have volunteered to be marrow donors, says her mother, Kathryn Jalbuena.

For more about Tracy Jalbuena visit her page on Be the Match here

Sometimes it seemed to Jalbuena that her daughter’s unique qualities were working against her.

“My husband and I have always known that our first born was a one-of-a-kind, with a personality that stands out and shines brightly,” says Kathryn Jalbuena. “But when it comes to this misfortune it means no match.”

Chemotherapy has bought Tracy Jalbuena some time while her family mounts a campaign to try to get more people of mixed Filipino and European ancestry to volunteer to become donors.

A study published earlier this year in the New England Journal of Medicine found the chemotherapy regime Jalbuena is now taking could keep the disease at bay for more than two years.

If a perfect match is found, Jalbuena has a 30 percent chance of being completely cured, Laubach says.

But, he adds, “the relapse rate at three years is at least 50 percent, if not higher, and there’s a high rate of transplant-related mortality — estimated at 15 percent — in contrast to the auto transplant where patients receive their own cells as Tracy did in the past where the mortality rate is less than 1 percent. The [donor]transplant is being considered in her case because the disease has become somewhat aggressive and because she is quite young to have been diagnosed with myeloma.”

Ultimately, for Jalbuena, the most important thing is to have as much time with her kids as possible.

“People tell me I am very brave,” she says. “But it doesn’t feel like that. It’s sort of like I just keep waking up every day and doing the things I need to do. ”

Source: Today

Medical Monday

DNA SNAPSHOT

 

Already genetic sleuths can determine a suspect’s eye and hair color fairly accurately. It is also possible, or might soon be, to predict skin color, freckling, baldness, hair curliness, tooth shape and age.

 

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Medical Monday

Racial Disparities in Outcomes of Adult Heart Transplantation

TAKE-HOME MESSAGE

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Medical Monday

Neuroscientists May Have Discovered How Our Brains Can Overcome Racial Prejudice

If the public response to the shooting deaths of Michael Brown and Eric Garner has made one thing clear, it’s that many consider the U.S. to be far from a post-racial society. America has certainly made progress since the Civil Rights Act of 1964 — the number of interracial marriages has surged, the education achievement gap between races has shrunk (class matters more now) and we’ve elected a black president into office twice.

Fifty years later, however, we’re still living in a world where unarmed young black men fear being slain by the police; a world in which data shows how skin color overwhelmingly affects one’s chance of getting handcuffed, arrested, convicted and sentenced to death row. It’s not hard to see why so many Americans feel that, despite all we’ve achieved, overcoming racism for good is an impossible endeavor.

Demonstrators gather in Philadelphia on Dec. 3. Image Credit: Mark Makela via Getty

But recent research from neuroscientists suggests there is indeed hope for change, and it may not be as impossible as we imagine. According to the science, being a part of a diverse group — connected by a bond that isn’t race — may help our brains perceive everyone in that group as part of “your people,” regardless of racial makeup. If we know an individual is part of our group, our brains seem to react to the individual as being part of our group first and foremost — not an “other.”

These findings may have important policy implications, from considering the demographics of our police forces, as Attorney General Eric Holder recently suggested the Ferguson Police Department should, to the way schools admit students and how we plan our cities in general.

The science

Psychologists have long known that humans have a propensity to distinguish between people who are like us — members of our “in group” — and those who aren’t.

But the concept of a group is rather flexible. According to Lehigh University psychologist Dominic Packer, we should think of a group basically as a psychological state.

“A group exists when a set of people start to feel like a group,” he said.

So while it’s become the norm to form groups along racial, ethnic and religious lines, these distinctions aren’t special — they’re just convenient. Knowing this, a team of researchers, including Packer, and led by New York University social neuroscientist Jay Van Bavel, used neuroimaging tools to see how our brains reacted to forced changes in groups.

They examined whether people of mixed races feel closer to each other when they’re on the same team. To do this, Van Bavel’s team expanded on a basic setup that similar studies have used: Researchers assign white study participants to different teams, one of which is mixed race, and tell everyone to memorize the faces of their teammates and opponents. Researchers then measure participants’ neural activity while they perform simple tasks

In a 2008 study, participants watched photos of other participants’ faces flash across a screen for two seconds apiece. They first had to categorize the faces based on team membership and again based on race, and then rate their like and dislike of other participants on a scale of 1-6. While participants performed the identification tasks, researchers used neuroimaging tools to measure their response rates and observe activity changes in different areas of their brains.

Images showed that the amygdala, a key part of the brain for emotion, flared up in the brains of white participants when they viewed photos of their team members, regardless of race. In this context, researchers believe that amygdala activity reacted to what was most important and worthy of participants’ attention: their team members. When race isn’t relevant to group formation, Van Bavel explained, the brain seems to ignore racial differences to focus on what matters: whoever is in your group.

In a follow-up 2011 study, Van Bavel saw something surprising happen in a region of the brain called the Fusiform Face Area (FFA), which is critical for facial recognition. Shortly after getting their team assignments, participants performed a similar face-identification task and exhibited markedly heightened activity in FFA in response to members of their own team. Basically, people quickly identified their team members as people they should remember and disregarded non-team members as faceless outsiders to lump together.

In subsequent studies, Van Bavel changed up the basic group structure. For example, in a 2012 study, he made someone from each team a spy, a role that involved interacting with the opposing team. As Van Bavel suspected, the most gung-ho team members (based on a self-assessment) had the strongest recollection for in-group faces whereas the spies had heightened memories for the faces of people on other teams.

Demonstrators take over a bridge in New York to protest the decision in the Eric Garner trial. Image Credit: Associated Press

What it all means

Taken together, these conclusions suggest that once we’re part of a group, our brains tell us to think, act and feel like a member, regardless of the group’s racial makeup. Essentially, spending time in other groups creates brain-based bonds that may make people more likely to see others as distinguishable individuals, as opposed to just part of a group. This is a critical component to eliminating racial prejudice because distinguishing individuals is the first step toward connecting with another human.

“Responses to race that we think of as burned pretty deeply into the brain may be hard to override or regulate,” Van Bavel said. “But it seems that if we can see a member of another race as part of our in-group, then we can reorient how we see the world and interpret people, which may help overcome biases.”

Why this could be big

Van Bavel’s findings contradict a well-observed psychological phenomenon with real-life implications called “own-race bias,” which says people are better at remembering same-race faces than others. In terms of criminal justice, own-race bias translates to misidentifying suspects in police lineups, which leads to false convictions. In fact, as of a few years ago, around 40% of falsely convicted death-row inmates were victims of cross-race identification errors.

There’s no easy, or even identifiable, way to uproot systemic inequality. And there’s certainly a wide gap between brain activity and public conduct. But, at the very least, knowledge that we can create brain-based bonds useful for overcoming prejudicial feelings is reason enough to keep plugging away at the problem.

“It’s quite hopeful that creating minimal groups can completely trump something like racial bias,” said Emile Bruneau, an MIT neuroscientist from MIT who’s worked with Van Bavel on other research, “and that group difference can be eliminated if people focus on something else. [Van Bavel’s research] shows how flexible the brain is, and that flexibility is something we can hang hope on.”

Source: Science.Mic

Medical Monday

The Other Jewish Genetic Diseases

With Ashkenazic Disorders Getting All the Attention, America’s Sephardic Jews Often Lack Specialized Screening Programs

 

Randall Belinfante was a bit baffled.

KURT HOFFMAN

When he and his wife went to take blood tests in preparation for starting a family in 2003, he discovered that the screening included a panel of tests for Ashkenazic Jewish genetic disorders. But Belinfante is Sephardic.

“We told them at the time that we were not Ashkenazi, but they told us they don’t do testing for Sephardic diseases, just for Ashkenazi ones,” recalled Belinfante, who traces his ancestry to the Iberian Peninsula via the Balkans, Holland and England. “So they went ahead and did the Ashkenazi tests anyway.”

With a note of bemusement, Belinfante, who is the librarian and archivist at the New York-based American Sephardi Federation, added, “Surprisingly enough, they found we did not have any of the Ashkenazi Jewish diseases.”

Since screening for Tay-Sachs disease began close to 40 years ago, Ashkenazic Jews have dominated the scene when it comes to Jewish genetic disorders. Having been reproductively isolated for centuries — and having grown from just a handful of founders into a population of millions in a relatively short span of time — Ashkenazic Jews are a relatively homogeneous group that has inherited a host of rare genetic disorders and has proved to be a rich source of information for geneticists.

But what about the others in the Jewish community? What about Sephardic Jews? Are they also susceptible to a unique group of genetic disorders rarely shared by other groups? Does a Sephardic couple planning on having children also need to be screened for certain diseases?

“There is no disease that you can call a Sephardic genetic disease,” said Rabbi Elie Abadie, who is a physician and director of the Jacob E. Safra Institute of Sephardic Studies at Yeshiva University. Why this would be so and what this means — as is so often the case with genetics — has as much to do with history as with biology.

“Non-Ashkenazi Jews are collectively much more diverse than Ashkenazi Jews,” explained Aviva Ben-Ur, a professor in the Judaic and Near Eastern Studies department at the University of Massachusetts Amherst who authored the new book “Sephardic Jews in America: A Diasporic History” (NYU Press).

The term “Sephardic” itself often tends to obscure this diversity. At its root, the word refers to Jews who can trace their origins back to the Iberian Peninsula, but it is often used as a catchall label for any Jew who is simply not Ashkenazic. Although even many non-Ashkenazic Jews themselves may employ the label, it glosses over a diversity of communities stretching from the Balkans, to North Africa, to the Arab world, to the Caucasus and beyond. The genetic picture is not far behind.

“You can’t say ‘Sephardic genetic diseases,’ because most of the disorders are specific to the community of birth,” said Dr. Joël Zlotogora, a professor of human genetics at the Hebrew University of Jerusalem and an expert in the field of Jewish population genetics. “Moroccan Jews are different from Tunisian Jews and so on. For non-Ashkenazi Jews you have to look by country of birth.”

In Israel today, where non-Ashkenazic Jews represent a much larger proportion of the Jewish population than they do in North America, the medical establishment is very attuned to this reality. When an Israeli Jew comes for genetic screening, if the individual is not Ashkenazic, he or she is tested for the disorders known to exist among the Jews within his or her country of origin or the country of origin of the individual’s parents or grandparents and great-grandparents.

Several years ago, Israel’s Ministry of Health put up a Web site dedicated to genetics that publishes a list of disorders. A quick review of the list reveals the distinctions and distinctiveness of which Zlotogora speaks. Separate lists exist for Ashkenazic Jews, as well as for Algerian, Libyan, Tunisian, Moroccan, Iraqi, Iranian, Syrian, Yemenite, Kurdish, Bukharan, Georgian, Indian, Ethiopian, Caucasian and Karaite Jews.

There are a small number of disorders listed that are shared across several communities, in particular among Jews from North Africa. These diseases, explained Zlotogora, became common because they conferred some advantage to a person who is just a carrier — i.e. has one mutated and one healthy gene — for the disease but does not get sick. Beta-thalassemia and glucose-6-phosphate dehydrogenase deficiency (G6PD), both blood disorders that can cause certain types of anemia, are prime examples. Being a carrier for one of these diseases provides some protection against malaria.

Like their Ashkenazic counterparts, non-Ashkenazic communities developed unique sets of genetic disorders because they were isolated reproductively from the populations around them. But they were also, for the most part, isolated geographically and thus reproductively, from each other. The acceptance of marriage between relatives, even between first cousins, also contributed to the spread of some genetic mutations, as it did in the Ashkenazic world.

According to a 2001 survey by the World Sephardi Federation, non-Ashkenazic Jews account for approximately 26% of world Jewry. In Israel today, they are about half of the Jewish population. Their sizable presence since Israel’s founding has led to a growth in the study, understanding and awareness of the genetic disorders affecting their communities. “With time we have more and more disordersamong non-Ashkenazim that we are able to test for,” Zlotogora said.

Statistics on the number of non-Ashkenazic Jews in the United States are more difficult to come by. Those that do exist, explained Ben-Ur, “are not based on any kind of systematic survey.” The World Sephardi Federation survey estimates that only 4.5% of American and Canadian Jews are not Ashkenazic. But some have claimed that this estimate may be too low.

Most of America’s non-Ashkenazic Jews arrived over the past half-century from the Middle East and Central Asia. “Because they make up a very small percentage of American Jewry, much more attention is paid to Ashkenazi Jews in all areas of society,” said Abadie, who is also the founding rabbi at Congregation Edmond J. Safra in New York. This, he said, includes the area of genetic disorders.

It was just last month that the United States got its first genetic-disease screening program tailored to a specific non-Ashkenazic Jewish community. In mid-July, the Medical Genetics Institute at the Cedars-Sinai Medical Center in Los Angeles began a population-based program to screen Iranian Jews for four genetic disorders that occur with relative frequency in that community.

Beyond the program at Cedars-Sinai, however, someone trying to find information in the United States on genetic disorders for specific non-Ashkenazic communities would be a bit hard-pressed.

The American Sephardi Federation puts out a list of four diseases under the title “Sephardic Recessive Disorders,” and several Jewish genetic screening centers around the country list the same four disorders on their Web sites. These four diseases — beta-thalassemia; G6PD; familial Mediterranean fever (FMF), which causes recurrent fevers and rashes; and glycogen storage disease type III (GSD III), a severe metabolic disorder — are shared across several non-Ashkenazic communities in the Mediterranean basin and North Africa.

Yet they, too, are “erroneously called Sephardic genetic diseases,” said Abadie, because “they are diseases that manifest themselves in Sephardic Jews also.” Beta-thalassemia, G6PD and FMF are found among many populations in North Africa and the Mediterranean. And GSD III is present in other North African groups, as well.

Dr. Harry Ostrer, director of the Human Genetics Program at New York University Medical Center and a leading scholar of Jewish genetics, called this list “incomplete.”

“There is a noticeable gap in the availability of testing for Ashkenazi and non-Ashkenazi Jews” in the United States, said Ostrer, who in 2007 initiated a mapping of the Jewish genome akin to the Human Genome Project called the Jewish HapMap Project. “We’re going to have to come to grips with it pretty soon.”

When a non-Ashkenazic Jew comes to NYU’s genetics unit for screening, the staff devises a panel based on the person’s community of origin. But for some conditions it is simply not possible to find an American lab equipped to conduct the necessary test, Ostrer noted.

An informal survey by the Forward of Jewish genetic screening centers found that although many provide counseling for the four disorders commonly listed as “Sephardic,” they cannot perform the tests themselves.

“We help them, but we can’t do the testing for the Sephardic diseases through the Victor Center,” said Faye Shapiro, a genetic counselor at the Victor Center for Jewish Genetic Diseases at the Albert Einstein Medical Center in Philadelphia. The Victor Centers, of which there are three — in Philadelphia, Miami and Boston — offer screening for Jewish genetic disorders at substantially reduced rates. Their lab, however, doesn’t test for non-Ashkenazic diseases, so such tests must be sent out to commercial labs at full cost.

Shapiro went on to explain that, whereas many Ashkenazic diseases are life-threatening or very debilitating, both FMF and G6PD — so common across populations that most American hospitals screen newborns for it — can be made livable with the proper treatment and precautions. In the United States, tests for thalassemia, a disease that can become quite severe as it progresses, are also readily available, given the disease’s presence among all Mediterranean populations. GSD III is very severe, but it is extremely rare in the United States, she added.

The relative lack of attention paid to recessive disorders among non-Ashkenazic communities in the United States may be due, in part, to attitudes within the communities themselves. “They like to be private about their lives. They like to be anonymous,” Abadie commented. Abadie, who is part of the Syrian community, said that when leaders of his community were asked to participate in the Jewish HapMap Project, they declined. He added that reluctance about testing remains strong, because uncovering a carrier may stigmatize a family. “The Sephardic community is close-knit and families know each very other well,” and therefore, he added, the communities feel they know which families are carriers for certain diseases.

Ostrer, however, said that scientists would take issue with this reasoning, because since carriers do not get the disease, “you can’t rely on family history. That’s the whole point of screening.”

In speaking with Syrian, Iranian, Bukharan and other non-Ashkenazic Jewish groups for the HapMap project, Ostrer said that he and his colleagues found there to be “considerable interest” in screening.

“I think we need to be doing it,” he concluded, adding that he hopes to begin offering tailored programs soon. “We treat them as very distinct communities. I hope that others will do so in the future as well.”

Read more: http://forward.com/articles/112426/the-other-jewish-genetic-diseases/#ixzz3LJgx3SqW

Medical Monday

How Lung Cancer Is Treated Often Based On Insurance, Race And Medical Facilities

Unfortunately, not all patients receive the same medical care. Insurance, income and geographic locations can play a role in treatment and access to doctors.

Recent findings published in the Journal of Thoracic Oncology show that African Americans, Hispanics and those who receive community hospital care are significantly less likely than other patients to receive treatment for early stage non-small cell lung cancer.

“We found significant disparities for treatment of a curable cancer based on race, insurance status, and whether or not treatment was at an academic or community hospital,” said lead study author Dr. Matthew Koshy, a physician in the department of radiation oncology at the University of Illinois at Chicago College of Medicine, and lead author of the study, in a news release. “Reducing these disparities could lead to significant improvements in survival for many people with inoperable early stage lung cancer.”

The study is the first to examine patients with stage 1 non-small cell cancer. Treatment during the early stages offers the best chances for long-term survival. However, findings revealed that African Americans 40 percent less likely to be treated with conventional radiation treatments. Furthermore, Hispanics were 60 percent less likely to be treated with the same help.

Findings also revealed that patients were about two-and-a-half times more likely to receive SBRT in academic hospitals than in community ones and seven times more likely to receive SBRT at a high-volume medical center than at a low-volume center.

Researchers concluded that better access to medical facilities could help with doctors and treatments to those in need, as well as targeting health problems during their early stages.

Source: ScienceWorld Report

Medical Monday

New forensic tool detects ethnicity and gender in single hair

 

A cutting-edge technique to identify human hair could one day be helping to catch criminals according to a new study from researchers in Canada.

The tool produces results faster than current DNA analysis techniques used in law enforcement, and in early tests showed a 100% success rate at identifying gender and ethnicity.

The new tool is the work of Diane Beauchemin, a professor in the department of chemistry at Queen’s University in Kingston, Ontario, and MSc student Lily Huang. They describe their proof of concept study in the Journal of Analytical Atomic Spectrometry.

Prof. Beauchemin says her first “foray into forensic chemistry was developing a method of identifying paint that could help solve hit and run cases.” Applying a similar approach to hair analysis was Ms. Huang’s idea, she adds, so they started working on it last year.

Blood samples recovered at a crime scene are often used to identify gender and ethnicity, but blood deteriorates quickly and is prone to contamination.

However, hair is very stable. The reason it is a promising avenue for forensics is because of the unique mix of elements it contains, which varies according to diet, ethnicity, gender the environment and working conditions. They get into the hair from sweat secretions.

The team found they could identify gender from the elements magnesium, sulfur, strontium and zinc. And to discriminate ethnicity they used lithium, molybdenum, sulfur, strontium, chromium, potassium, nickel, zinc and lead.

The process takes just 85 seconds to complete. First they grind up the hair sample, burn it (using a method called electrothermal vaporization), and then analyze the vapor it produces (using inductively coupled plasma optical emission spectrometry).

Current forensic methods used to analyze hair are time-consuming and use corrosive solvents and reagents, Prof. Beauchemin told Chemistry World.

Method is robust and can be used universally

Ms. Huang says the method is “very robust and can be used universally. One of our samples even included dyed hair and the test was 100% accurate. The test was able to distinguish East Asians, Caucasians and South Asians.”

a hand picking a strand of hair from a hairbrush
Current forensic methods used to analyze hair are time-consuming and use corrosive solvents and reagents.

The team is already talking to law enforcement agencies about the next step in using the new method.

And the researchers are also planning to develop the method so it can pinpoint exactly where in the world a hair sample is from, as well as add more ethnicities and age to the repertoire.

To extend the repertoire of variables the method can identify means measuring more elements, but Prof. Beauchemin says this would not take more time, because their detection is simultaneous.

In 2010, Medical News Today learned how researchers are working on a method of forensic identification using hand bacteria. The method uses the fact that when we handle objects we leave behind bacterial communities that are uniquely identifiable.

Source: Medical News Today

Medical Monday

 

For racially diverse patients with disabilities, increased barriers to health care

Summary:
It’s well established that Americans with disabilities and those in underserved racial/ethnic groups face significant disparities in access to health care. Now, researchers are beginning to examine the unique patterns of health care inequalities experienced by racially and ethnically diverse patients with disabilities.

It’s well established that Americans with disabilities and those in underserved racial/ethnic groups face significant disparities in access to health care. Now, researchers are beginning to examine the unique patterns of health care inequalities experienced by racially and ethnically diverse patients with disabilities, according to a special October supplement to Medical Care. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

“This special issue of Medical Care is focused on the intersection of disability, race, and ethnicity and the particular health care barriers faced by people at this intersection,” accord to an introductory article by the supplement guest editors, led by Willi Horner-Johnson, PhD, of Oregon Health & Science University, Portland. The goal is to set a new research agenda for research into health care disparities affecting adults with disabilities who are also members of underserved racial and ethnic groups.

Analyzing Disparities by Both Disability and Race/Ethnicity

Despite an extensive body of research on health care disparities, researchers have only begun to explore issues of diversity among people with disabilities, or how disability may affect inequities related to race and ethnicity. “This supplement is among the first efforts in the peer-reviewed literature to bridge the gap between these two fields of research,” the guest editors write.

The special issue includes nine papers, contributed by leading experts, presenting original research and new insights on disparities at the intersection of disability and race/ethnicity. An opening commentary calls for collaborative approaches to merging these historically separate “tracks” of health disparities research. Original research papers present evidence of racial and ethnic disparities within various groups of people with disabilities. One paper provides a snapshot of “difference, disparity, and disability” at the national level.

Other studies report on racial differences in the use of assistive technology by veterans with severe disabilities; and in health care services for young people with muscular dystrophy, even with similar health care benefits. Another paper reports relatively low racial/ethnic disparities in accessing preventive care among adults with intellectual and developmental disabilities.

“Braid the Strands” to Achieve Health Equity

Another set of papers looks at unique issues at the intersection of disability, race, and ethnicity. Analysis of nationally representative data confirms separate disparities by disability and race/ethnicity, but finds limited evidence of “interaction or additive effects” between the two. Other papers address the “critical gap” in research on racial/ethnic differences in barriers to health care among people with disabilities and the challenges facing immigrant families of individuals with developmental disabilities.

The special issue concludes with a commentary from Dr Camara Phyllis Jones of Morehouse School of Medicine, Atlanta. Dr Jones discusses the “parallels and intersections” between disability and race/ethnicity — including the need to “braid the strands” to achieve health equity. She writes, “Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying historical injustices, and providing resources according to need.”

The editors and contributors to the special issue hope their efforts will provide a starting point for building a more robust set of research data on the health care issues facing the growing number of Americans who have disabilities and belong to underserved racial or ethnic groups. “As healthcare transformation proceeds, efforts to reduce inequity in health care will gain increasing prominence,” Dr Horner-Johnson and colleagues conclude. “Our hope is that these efforts will take into account the full range of patient diversity and needs, including those at the intersection of disability, race, and ethnicity.”

Analyzing Disparities by Both Disability and Race/Ethnicity

Despite an extensive body of research on health care disparities, researchers have only begun to explore issues of diversity among people with disabilities, or how disability may affect inequities related to race and ethnicity. “This supplement is among the first efforts in the peer-reviewed literature to bridge the gap between these two fields of research,” the guest editors write.

The special issue includes nine papers, contributed by leading experts, presenting original research and new insights on disparities at the intersection of disability and race/ethnicity. An opening commentary calls for collaborative approaches to merging these historically separate “tracks” of health disparities research. Original research papers present evidence of racial and ethnic disparities within various groups of people with disabilities. One paper provides a snapshot of “difference, disparity, and disability” at the national level.

Other studies report on racial differences in the use of assistive technology by veterans with severe disabilities; and in health care services for young people with muscular dystrophy, even with similar health care benefits. Another paper reports relatively low racial/ethnic disparities in accessing preventive care among adults with intellectual and developmental disabilities.

“Braid the Strands” to Achieve Health Equity

Another set of papers looks at unique issues at the intersection of disability, race, and ethnicity. Analysis of nationally representative data confirms separate disparities by disability and race/ethnicity, but finds limited evidence of “interaction or additive effects” between the two. Other papers address the “critical gap” in research on racial/ethnic differences in barriers to health care among people with disabilities and the challenges facing immigrant families of individuals with developmental disabilities.

The special issue concludes with a commentary from Dr Camara Phyllis Jones of Morehouse School of Medicine, Atlanta. Dr Jones discusses the “parallels and intersections” between disability and race/ethnicity — including the need to “braid the strands” to achieve health equity. She writes, “Achieving health equity requires valuing all individuals and populations equally, recognizing and rectifying historical injustices, and providing resources according to need.”

The editors and contributors to the special issue hope their efforts will provide a starting point for building a more robust set of research data on the health care issues facing the growing number of Americans who have disabilities and belong to underserved racial or ethnic groups. “As healthcare transformation proceeds, efforts to reduce inequity in health care will gain increasing prominence,” Dr Horner-Johnson and colleagues conclude. “Our hope is that these efforts will take into account the full range of patient diversity and needs, including those at the intersection of disability, race, and ethnicity.”

The journal’s special issue can be found at: http://journals.lww.com/lww-medicalcare/toc/2014/10001

 

Source: Science Daily

 

 

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Molecular Testing for Cancer Therapy Varies Based on Ethnicity

 

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