Clinical Associate Professor, OMS Program Director,
Division of Oral and Maxillofacial Surgery
Division of Head and Neck Cancer,
Carle Foundation Hospital
Carle Clinic, Division of Oral and Maxillofacial
Surgery, Head and Neck Cancer
Urbana, Illinois
The scientific method is the set of assumptions weight loss 800 calorie diet discount 60 mg alli otc, rules weight loss 05 kg per week order 60 mg alli mastercard, and procedures scientists use to conduct research weight loss inspiration generic 60 mg alli overnight delivery. A research design is the specific method a researcher uses to collect weight loss pills good or bad discount alli 60 mg line, analyze, and interpret data. Psychologists use three major types of research designs in their research, and each provides an essential avenue for scientific investigation. Descriptive research is research that describes what is occurring at a particular point in time. Correlational research is research designed to discover relationships among variables and to allow the prediction of future events from present knowledge. Experimental research is research in which a researcher manipulates one or more variables to see their effects. Each of the three research designs varies according to its strengths and limitations. Descriptive Research Case Study: Sometimes the data in a descriptive research project are based on only a small set of individuals, often only one person or a single small group. More frequently, case studies are conducted on individuals who have unusual or abnormal experiences. The assumption is that by carefully studying these individuals, we can learn something about human nature. Case studies have a distinct disadvantage in that, although it allows us to get an idea of what is currently happening, it is usually limited to static pictures. Although descriptions of particular experiences may be interesting, they are not always transferable to other individuals in similar situations. They are also time consuming and expensive as many professionals are involved in gathering the information. When using naturalistic observation, psychologists observe and record behavior that occurs in everyday settings. For instance, a developmental psychologist might watch children on a playground and 24 describe what they say to each other. However, naturalistic observations do not allow the researcher to have any control over the environment. Laboratory observation, unlike the naturalistic observation, is conducted in a setting created by the researcher. One example of laboratory observation involves a systematic procedure known as the strange situation test, which you will learn about in chapter three. Concerns regarding laboratory observations are that the participants are aware that they are being watched, and there is no guarantee that the behavior demonstrated in the laboratory will generalize to the real world. Survey: In other cases, the data from descriptive research projects come in the form of a survey, which is a measure administered through either a verbal or written questionnaire to get a picture of the beliefs or behaviors of a sample of people of interest. The people chosen to participate in the research, known as the sample, are selected to be representative of all the people that the researcher wishes to know about called the population. A representative sample would include the same percentages of males, females, age groups, ethnic groups, and socio-economic groups as the larger population. Source Surveys gather information from many individuals in a short period of time, which is the greatest benefit for surveys. However, surveys typically yield surface information on a wide variety of factors but may not allow for in-depth understanding of human behavior. Another problem is that respondents may lie because they want to present themselves in the most favorable light, known as social desirability. They also may be embarrassed to answer truthfully or are worried that their results will not be kept confidential. Interviews: Rather than surveying participants, they can be interviewed which means they are directly questioned by a researcher. Interviewing participants on their behaviors or beliefs can solve the problem of misinterpreting the questions posed on surveys. The examiner can explain the questions and further probe responses for greater clarity and understanding. Although this can yield more accurate results, interviews take longer and are more expensive to administer than surveys. Participants can also demonstrate social desirability, which will affect the accuracy of the responses. Psychophysiological Assessment: Researchers may also record psychophysiological data, such as measures of heart rate, hormone levels, or brain activity to help explain development. These measures may be recorded by themselves or in combination with behavioral data to better understand the bidirectional relations between biology and behavior. Special equipment has been developed to allow researchers to record the brain activity of very young and very small research 25 subjects. These electrodes record tiny electrical currents on the scalp of the participant in response to the presentation of stimuli, such as a picture or a sound. Webb, Dawson, Bernier, and Panagiotides (2006) examined face and object processing in children with autism spectrum disorders, those with developmental delays, and those who were typically developing. The children wore electrode caps and had their brain activity recorded as they watched still photographs of faces of their mother or of a stranger, and objects, including those that were familiar or unfamiliar to them. The researchers examined differences in face and object processing by group by observing a component of the brainwaves. Findings suggest that children with autism are in some way processing faces differently than typically developing children and those with more general developmental delays. Source Secondary/Content Analysis involves analyzing information that has already been collected or examining documents or media to uncover attitudes, practices or preferences. There are a number of data sets available to those who wish to conduct this type of research. Census Data is available and widely used to look at trends and changes taking place in the United States. The researcher conducting secondary analysis does not have to recruit subjects, but does need to know the quality of the information collected in the original study. Correlational Research In contrast to descriptive research, which is designed primarily to provide static pictures, correlational research involves the measurement of two or more relevant variables and an assessment of the relationship between or among those variables. For instance, the variables of height and weight are systematically related (correlated) because taller people generally weigh more than shorter people. The Pearson Correlation Coefficient, symbolized by the letter r, is the most common statistical measure of the strength of linear relationships among variables. The strength of the linear relationship is indexed by the distance of the correlation coefficient from zero (its absolute value). The direction of the linear relationship is indicated by the sign of the correlation coefficient. When the straight line indicates that individuals who have high values for one Figure 1. Examples of positive correlations include those between education and income, and between age and mathematical abilities in children. In each case people who score higher on one of the variables also tend to score higher on the other variable. Negative correlations, in contrast, as shown in part (b), occur when high values for one variable tend to be associated with low Some examples of relationships between two variables as shown in scatter plots. Examples of negative correlations include those between the age of a child and the number of diapers the child uses, and between practice and errors made on a learning task. In these cases, people who score higher on one of the variables tend to score lower on the other variable. An important limitation of correlational research designs is that they cannot be used to draw conclusions about the causal relationships among the measured variables. Consider, for instance, a researcher who has hypothesized that viewing violent behavior will cause increased aggressive play in children. He has collected, from a sample of fourth-grade children, a measure of how much violent television each child views during the week, as well as a measure of how aggressively each child plays. The researcher discovers a positive correlation between the two measured variables.
These tests should be performed by trained allergists who can do them properly; who know how to interpret and analyze the results weight loss pills lipofuze buy 60mg alli fast delivery, and who have experience in treating adverse reactions weight loss online programs 60mg alli otc. They are indicated when no other diagnostic methods are available weight loss 45 year old woman alli 60 mg, when the results of previous screening tests are not conclusive weight loss pills xls medical order 60mg alli with mastercard, and the benefit of the test results outweighs the risk involved. They are contra-indicated in patients with previous severe anaphylaxis or with life-threatening conditions. Patch tests with foods, although used by some centres, have not been yet standardized. Probability disease prediction might also be applied in the future to inhalant allergens. Since quality assurance is of paramount importance when in vitro assays are used for diagnostic purposes, the ideal situation would be to refer patients (or send their serum samples) to certified laboratories that use a third generation IgE antibody assay to report quantitative results. They are not sufficiently sensitive and add little to the diagnostic predictive value offered by skin and provocation testing. In Vitro Testing Allergen-specific IgE antibody is the most important serological marker used in the diagnosis of allergic disease to confirm sensitization in an individual who has a positive history of exposure. Its usefulness is limited because the technique is difficult to perform and requires viable basophils. They are especially indicated in patients with extensive skin inflammation, those who can not abstain from antihistamine therapy, are uncooperative, or have a high risk of anaphylaxis. The multi-allergen screen test measures IgE antibodies to multiple allergen specificities in one analysis. It is able to detect the presence of all specificities of IgE antibodies in a single blood specimen. Its high negative predictive value is useful to rule out the presence of sensitization in an individual whose clinical history does not suggest IgE-mediated allergic disease. Defined panels of aeroallergens and food allergens relevant to different age groups are used. If positive, a further clinical history and more extensive IgE antibody testing to individual allergens are required. The multi-allergen screen is most cost effective as an allergy screening test, but produces only qualitative results. Third generation auto-analyzers have allowed accurate, Other Tests Available for the Study of Allergic Diseases Total serum IgE: Total serum IgE has been traditionally used as a marker for atopy. An elevated IgE should stimulate further investigations for specific IgE sensitivity. Serum tryptase: Tryptase released by mast cells is a useful marker of systemic anaphylaxis. Eosinophil cationic protein: Measured in serum, bronchoalveolar lavage or induced sputum. Quantification of eosinophils: Increased absolute and differential counts in the blood correlate with the severity of allergic disease. In sputum, it is useful to assess the response to antiinflammatory treatment of asthma. Environmental determinations: Primarily used for the identification of relevant allergens for skin tests and in vitro tests, reproducible and quantitative measurements of the levels of IgE antibody with a defined specificity. IgE thresholds have been defined for provocation testing below which there is >95% probability that the food challenge will be negative. Currently there are more than 130 allergen components commercially available for in vitro specific IgE testing. Distinction between sensitization to genuine (species-specific) and crossreactive allergens in poly-sensitized patients, especially those with complex or unclear symptoms and/or sensitization patterns. Assessment of the risk of severe systemic versus mild local reactions in food allergy, decreasing the need for risky in vivo provocation testing. Identification of patients and triggering allergens for allergenspecific immunotherapy and evaluation of patients with unsatisfactory response to treatment. Diagnosis and management of rhinitis: Complete guideline of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. Methods in laboratory immunology; principles and interpretation of laboratory tests for allergy. In vivo methods for study of allergy: Mucosal tests, techniques and interpretation. Correlation between skin prick tests using commercial extracts and fresh foods, specific IgE and food challenges. New in vitro methods are required to substitute in vivo provocation tests with foods and drugs. Optimization of microarray technology, in which crude or purified native or recombinant allergens can be spotted in microdot arrays on silica chips to permit extensive panels of specific IgE measurements to be performed with small quantities of serum, is necessary; this method is presently too expensive to be widely used. A further evaluation of the clinical use of specific IgE antibody testing in allergic diseases. A Molecular Diagnostic Algorithm to Guide Pollen Immunotherapy in Southern Europe: Towards Component-Resolved Management of Allergic Diseases. Allergens in allergy diagnosis: a glimpse at emerging new concepts and methodologies. Proceedings of the task force on guidelines for standardizing old and new technologies used for the diagnosis and treatment of allergic diseases. J Allergy Clin Immunol 1988; 82: 487-526 114 Pawankar, Canonica, Holgate, Lockey and Blaiss Section 4. The burden of allergic diseases is huge at both an individual and a familial level. This translates to an increased burden at a national level, making allergies a public health issue. Allergic diseases are complex because both genetic and environmental factors influence disease development. They show a strong familial and intra-individual clustering, suggesting overlapping disease aetiology. It is clear that the recent increase in the prevalence of allergic rhinitis and asthma cannot be due to a change in the gene pool. Allergic rhinitis is a major chronic respiratory disease due to its prevalence, impact on quality of life, work/school performance, economic burden and links with asthma and other co-morbidities. Allergic rhinitis is part of the ``allergic march' during childhood, but intermittent allergic rhinitis is unusual before two years of age and is most prevalent during school age years. Interactions between the lower and the upper airways are well known and have been extensively studied since 1990. Over 80% of asthmatics have rhinitis, and 10-40% of patients with rhinitis have asthma. Most patients with asthma have rhinitis, suggesting the concept of "one airway, one disease", although there are underlying differences between rhinitis and asthma. The socio-economic consequence and impact of allergies is often underestimated and allergic diseases are frequently undertreated, causing substantially elevated direct and indirect costs. Symptom control, improvement in quality of life and rehabilitation to normal (or almost normal) function can be achieved through modern pharmacological treatment. Disease management that follows evidence-based practice guidelines yields better patient results, but such guidelines may recommend the use of resources not available in the family practice setting. Goals for the treatment of rhinitis include unimpaired sleep, ability to perform normal daily activities (including work/school attendance), and sport/leisure activities, with no or minimal sideeffects of drugs. The goal of asthma treatment is to achieve and maintain clinical control of symptoms and normal (or near to normal) lung function. This clinical control includes an absence of daytime symptoms, with no limitations of activities including exercise, no nocturnal symptoms, normal or near-normal lung function, and no (or minimal) exacerbations. The following section lists the most commonly used medications for allergic diseases: H1-antihistamines: H1-blockers or H1-antihistamines are shown to be safe and effective in young children. Cetirizine, when compared with placebo, delayed or, in some cases, prevented, the development of asthma in a sub-group of infants with atopic eczema who were sensitized to grass pollen and, to a lesser extent, house dust mite. Further studies are required to substantiate this finding and should focus specifically on sensitized groups. Oral H1-antihistamines are effective in the treatment of intermittent and persistent rhinitis for all nasal symptoms including nasal obstruction; ocular symptoms; improvement of some asthma outcomes such as reduction in emergency room function tests in some patients.
Prostate weight loss knoxville generic 60mg alli free shipping, lung weight loss 203 thin discount alli 60mg on-line, and liver cancer are major cancers in men weight loss workout plan purchase alli 60 mg with amex, although other cancers dominate in some regions (lip and oral cavity in South Asia and Kaposi sarcoma in Eastern Africa) weight loss after baby order alli 60 mg with visa. Many specific causes are now known (to explain these differences), but a large proportion of global variation for common cancers remains unexplained. Julian Peto, Nature, 2001 " M o s t c o m B r e a s t C m o n l y d i a g n o s e d L u n g T h y r o e r v i x u t L ir vi e r e Breast and cervical cancer are the most M and c o m m o n frequently diagnosed cancers o s tleading causes c a u c a ncancer ideath in many countries int women. Yet primary prevention remains key in sub-Saharan Africa, where there is a need to prioritize the most cost-effective means of reducing the cancer burden. Improved access to diagnosis and treatment, including palliative care, is also essential to improve survival and limit suffering from the disease in the region. Breast (115,000 cases, 25% of all cancers) and cervical cancers (112,000 cases, 24%) are the most frequently diagnosed cancers in women. An estimated 752,000 new cancer cases (4% of the global total) and 506,000 cancer deaths occurred in sub-Saharan Africa in 2018. Although the overall cancer burden in the region is dominated by breast, cervical, and prostate cancers, the cancer profile in sub-Saharan Africa is quite diverse. For example, cervical cancer rates increased by 80% in Zimbabwe and 36% in South Africa, although they have risen and declined recently in Uganda. While the cause of elevated rates for certain cancers such as esophagus is still largely unknown, a westernization of lifestyle. An improved awareness and increased capacity to perform prostatectomies on older men has been suggested to be linked to the increase in prostate cancer rates. There is a large opportunity for cancer prevention and control programs to improve health outcomes in the region. Comparing incidence and mortality rates of all cancers combined across countries, large disparities in terms of incidence-tomortality ratios are apparent. While lung cancer mortality rates in men are decreasing in many countries, they are still increasing in women. Bolivia and Chile exhibit the highest incidence rates of gallbladder cancer worldwide (14 and 9 per 100,000, respectively), possibly related to specific types of indigenous ancestry. The five most common cancers in 2018 were female breast (200,000 new cases, 15% of all cancer cases), prostate (190,000, 14%), colorectal (128,000, 9%), lung (90,000, 7%) and stomach cancer (67,000, 5%). Lung cancer is the leading cause of death (81,000, 12%), followed by colorectal (65,000 10%), prostate (54,000, 8%), female breast (53,000, 8%) and stomach (52,000, 8%). The corresponding cancer mortality risk ranges from 14% (1 in 7 persons) in Uruguay to 7% (1 in 15 persons) in Mexico. There are marked variations in the incidence and mortality rates of specific cancers across countries: for example, cervical cancer varies six-fold for incidence, from 39 per 100,000 in Bolivia to 7 in Guadeloupe, and a striking 15-fold for mortality, from 19 in Jamaica to 1 in Martinique. While the highest prostate cancer incidence rates are seen in the Caribbean, with 189 per 100,000 in Guadeloupe, the lowest are estimated in Honduras (25). Venezuela Colombia Guyana Suriname French Guiana Ecuador Figure 2 Incidence rates vary more than twofold between Estimated incidence and mortality rates in 2018, countries of this region. Incidence is relatively low for infection-related cancers, and high for cancers associated with lifestyle "westernization". For example, Northern America has among the highest incidence of colorectal cancer worldwide. However, because this cancer is amenable to primary prevention and treatment, there is substantial socioeconomic and geographic variation in incidence and mortality within the region. Cancer trends in the two countries are likewise comparable, with mortality rates declining continuously for more than two decades because of improvements in prevention, early detection, and treatment. Progress against tobacco-related diseases as a result of reductions in smoking is reflected in declines for lung cancer, which are slower and more prolonged among women than men because of later uptake of smoking and slower cessation. The most commonly diagnosed cancers are prostate in males and breast in females, while lung cancer remains the most common cause of cancer death in both sexes. Oregon 15 -New Jersey -Delaware 10 California Colorado -Virginia -North Carolina -South Carolina Arizona New Mexico Progress in lung cancer incidence in Northern America is the result Figure 3 of declines in smoking that began Trends in lung cancer incidence earlier. In SouthEastern and Eastern Asia, two infection-related cancers (liver and stomach cancers) continue to be among the most commonly diagnosed cancers and leading causes of cancer death among males. Overall, cancers of the lung (1,166,200 new cases, 15% of all cases), colorectum (914,200, 11%) and female breast (845,400, 10%) are the most common cancers. Cancer rates in the region vary widely, with nearly a fourfold difference across countries. Korea Pakistan Nepal Bhutan Bangladesh Japan Asia, and highest in the overall region in the Republic of Korea (314 cases per 100,000 population). In contrast, lower rates are seen in many countries in South Asia, including Bhutan, Sri Lanka, and India (fewer than 90 cases per 100,000). Mortality rates followed a similar pattern by subregion: Mongolia (170 per 100,000) and China (130) had the highest mortality rates, whereas Sri Lanka (51) and India (61) had the lowest rates. While female breast cancer is the most commonly diagnosed cancer in nearly all countries among women in Asia, marked differences in the Due to the high use of smokeless tobacco products, rates of lip and Figure 2 oral cavity cancers in some countries Highestthis region cavity cancer incidence in lip and oral are up to three times rates inhigher than the global average. Southern, Eastern, and South-Eastern Asia, age-standardized rate (world), males, 2018 Accurate population-based cancer data are a first step to planning prevention, treatment and supportive care programs in countries with an increasing cancer burden like Myanmar. Viet Nam Philippines Malaysia Indonesia the Republic of Korea has some of the highest cancer rates not only in the region but also worldwide. This slower increase partly results from a stabilization or decline in breast and prostate cancers, countered by an increase in colorectal cancer. In Central and Eastern European men, lung cancer incidence and mortality rates are beginning to stabilize or decline. But in women across Europe, who for the most part acquired the smoking habit several decades after men, lung cancer rates are still rising, though there are early signs of stabilization in recent years in some countries, notably in the highest-risk countries of Northern Europe. Cancers of the female breast (523,000 new cases, 13% of all cancer cases), colorectum (500,000, 13%), lung (470,000, 12%), and prostate (450,000, 12%) were the most common cancers on the continent, and combined they represented almost half of the overall cancer burden. For women, breast cancer is the most commonly diagnosed cancer in all European countries. Substantial variation in incidence and mortality rates are observed at the national level, where cancer incidence rates in males vary from 430 per 100,000 in Ireland to 239 in Montenegro. The lifetime risk of a cancer diagnosis ranges from 35% in Ireland-indicating that 1 in 3 persons in Ireland will be diagnosed with cancer over the course of their lifetime-to 25%, or 1 in 4 persons, in Montenegro. The risk of dying from cancer in men varied from 22% in the Republic of Moldova to 10% in Iceland, and in women from 13% in Hungary to 7% in Spain. Europeans represent about one-tenth of the global population, yet one in four of all cancer diagnoses occur in this region. In many European countries, one in three people will be diagnosed with cancer by the age of 75. The overall number of cases estimated for 2018 in the region was around 745,000, with this number predicted to increase to 1. The region forms part of the so-called esophageal cancer belt, which includes Turkmenistan, Tajikistan, Uzbekistan, Kazakhstan, Afghanistan and the eastern part of Turkey, with some of the highest incidence rates worldwide, particularly in men. Cancer cases are predicted to double in this region by 2040- the largest increase of any world region. Georgia- Kazakhstan Breast cancer is the most commonly diagnosed cancer in many countries of this region. Morocco Algeria Uzbekistan Azerbaijan Turkey Armenia- Turkmenistan Tajikistan Kyrgyzstan Tunisia Lebanon- Israel- Syrian Arab Rep. Iraq -Jordan cancer in both sexes combined, with incidence rates in Egypt estimated to be the second-highest worldwide in both men and women. Lung cancer accounts for the greatest number of cancer deaths (11,800, 17%), followed by colorectal (8,100, 12%) and female breast cancer (4,800, 7%). Skin cancers (melanoma and non-melanoma) are the most common cancers and represent a significant public health issue, particularly in Australia and New Zealand. An estimated 181,000 new cancer diagnoses and 69,000 cancer deaths occurred in 2018 in the subregions of Oceania, namely Australasia, Melanesia, Micronesia, and Polynesia. Regional solutions built collaboratively with local leaders have been shown to provide sustainable benefits. Paula Vivili, Director, Public Health Division at the Pacific Community, New Caledonia " 6. Papua New Guinea is unique among the other nations in terms of its relatively large population and burden (8. In Australasia and Polynesia, the cancers with the highest incidence rates include female breast, prostate, lung, and colorectum. Samoa- Fiji- New Caledonia French Polynesia- Vanuatu- Figure 1 Australia and New Zealand have Melanoma skin cancer incidence, both sexes the highest skin melanoma combined, 2018 rates in the world.
The final model does not uncover a significant effect of the interaction between race/ethnicity and educational attainment weight loss visualization discount alli 60mg. Finally weight loss pills best order alli 60mg visa, we also assessed the variance inflation factor to test for variables that may introduce multicollinearity weight loss pills miranda lambert buy 60mg alli amex. Discussion We found that although mental health diagnosis rates for Hispanics were lower weight loss pills 982 buy alli 60mg on line, more Hispanics reported a higher K6 score than their White counterparts, which may indicate a disproportionate Frontiers in Public Health Our findings are consistent with the literature showing that Hispanics face an unmet need for mental healthcare services that is more than double that of their White counterparts (6, 8, 9). Moreover, high psychological distress that does not manifest itself into proportionately high diagnosis rates can also mean that there is an underutilization of services by Hispanic respondents. This is also consistent with research showing that, even when services are readily accessible, Hispanics have lower mental health service utilization rates than Whites (6, 10, 13). Among both Hispanics and Whites, K6 scores were negatively associated with household income. Our findings suggest that low psychological distress and good mental health may be positively associated with increases in socioeconomic position, which is consistent with findings in the available literature (6, 7). Furthermore, research also suggests that acculturation among Hispanics is associated with an increase in the prevalence of psychiatric disorders and illicit drug use (20, 24). Although the mechanism through which acculturation affects mental health is understudied, researchers have posited that Hispanic culture may be protective and exposure to and adoption of some elements of U. Hispanic participants in our study reported lower rates of lifetime and current use of illicit substances than their White counterparts. While high-income Whites report slightly less illicit drug use than low-income Whites, the prevalence of lifetime illicit drug use is three times higher among Hispanics in the highest income stratum relative to those in the lowest. The drastic increase in illicit drug use for Hispanics indicates that increased income may be associated with potential risk factors for illicit drug use. Hispanic and other ethnic identification has been associated with decreased illicit drug use (26). Other research has shown that close social networks and family ties are also a protective factor against illicit drug use among Hispanics (27). This conclusion is supported by our multivariate results, which indicate that mental health disparities between Whites and Hispanics are largely explained after adjustment for income and nativity. A further limitation is that all measures are selfreported and thus subject to bias. The proportion of participants who self-reported as illicit drug users was small, which may have limited our statistical power to assess disparities across groups. Lastly, there were a large proportion of participants who did not provide household income information. Our analysis included only a subpopulation of those with complete information on all variables used, which may have been detrimental to our analysis. One consequence of the small prevalence of self-reported drug use was that the time frame we used in our multivariable model predicting drug use was very long. Lifetime drug use is a very gross variable and may not be indicative of current need for behavioral health services. Little is known about health in Arizona, particularly beyond vital statistics data and data collected in large national surveys that include substantial state samples. Thus, the large sample size, population-based design, inclusion of a large number of minority. In this study, we found evidence of mental health and healthcare disparities between Whites and Hispanics in Arizona. Despite similar prevalence of psychological distress, Hispanics were much less likely to have been diagnosed with a mental health condition. These disparities, combined with the rapid growth of the Hispanic population, suggest that developing culturally- and linguistically appropriate strategies to improve generally poor access and use of mental healthcare services among Hispanics is of critical public health importance. Our work should be a guide for future surveillance and intervention research on the complex relationship between race/ethnicity, socioeconomic status, mental health, and health care. Results from the 2012 National Survey on Drug Use and Health: Mental Health Findings. Inequalities in use of specialty mental health services among Latinos, African Americans, and non-Latino whites. Unmet needs for mental health services for Latino older adults: perspectives from consumers, family members, advocates, and service providers. Disparity in depression treatment among racial and ethnic minority populations in the United States. Gender and racial/ethnic differences in use of outpatient mental health and substance use services by depressed adults. The association between perceived discrimination and underutilization of needed medical and mental health care in a multi-ethnic community sample. Travel distance to outpatient substance use disorder treatment facilities for Spanish-speaking clients. Access to mental health treatment by English language proficiency and race/ethnicity. Limited English proficiency as a barrier to mental health service use: a study of Latino and Asian immigrants with psychiatric disorders. Acculturation and the lifetime risk of psychiatric and substance use disorders among Hispanics. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Acculturation and lifetime prevalence of psychiatric disorders among Mexican Americans in Los Angeles. Substance use among emergency room patients: an exploratory analysis by ethnicity and acculturation 1. Substance use among foreign-born youths in the United States: does the length of residence matter? Risk and protective factors for methamphetamine use and nonmedical use of prescription stimulants among young adults aged 18 to 25. Familias Unidas: a family-centered ecodevelopmental intervention to reduce risk for problem behavior among Hispanic adolescents. The benefits of higher education: sex, racial/ethnic, and socioeconomic group differences. Evidence for negative selection in heterogeneous economic returns to higher education. National Strategic Plan Non Hispanic Drug Abuse Research: From the Molecule to the Community. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Salinas, Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston, School of Public Health, El Paso Regional Campus, 1101 N. A jackknife variance estimate was used to account for clustering and autocorrelation of adjacent census tracts. Discussion: Findings are consistent with other studies that suggest the effects of Hispanic concentration on the foodscape may be positive (beneficially healthy) in border urban settings and negative in non-border. Lower-income, primarily minority communities, on the other hand, are more likely to have little or no access to supermarkets, which obliges them to rely mainly on convenience stores and fast food restaurants that sell a more restricted range of healthy food items (1, 3, 10, 14, 15, 18, 19). This reality has spawned research aimed at identifying and analyzing impacts from "food deserts" in impoverished, racially, and ethnically minority communities (1, 3, 4, 19). Additionally, in food-desert communities, the primary source of food may be fast food restaurants or convenience stores, and with few to no supermarkets within a reasonable driving distance; poor residents are left with only limited options to purchase fresh fruits or vegetables in these areas.
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