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Heather J Fullerton - One of the best experts on this subject based on the ideXlab platform.

  • changing Ethnic Disparity in ischemic stroke mortality in us children after the stop trial
    JAMA Pediatrics, 2013
    Co-Authors: Laura L Lehman, Heather J Fullerton
    Abstract:

    Importance A prior report showed higher stroke mortality in US black children compared with white children (1979-1998), a Disparity likely due in part to sickle cell disease, which leads to a high risk of childhood ischemic stroke. We hypothesized that this Disparity has diminished since the publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP trial) in 1998 demonstrating the efficacy of long-term blood transfusions for primary stroke prevention. Objective To evaluate the demographics and secular trends in mortality from ischemic and hemorrhagic stroke (as a primary cause of death) in US children ( Design We used death certificate data from the National Center for Health Statistics, 1988 through 2007. Setting United States. Participants Children who died in 1988 through 2007 in the United States. Intervention Publication of the STOP trial. Main Outcome Measures Incidence rate ratios were calculated as the measure of relative risk. Results Among 1.6 billion person-years of US children (1988-2007), there were 4425 deaths attributed to stroke, yielding an average of 221 deaths per year; 20% were ischemic; 67%, hemorrhagic; and 12%, unspecified. The relative risk of ischemic stroke mortality for black vs white children dropped from 1.74 from 1988 through 1997 to 1.27 from 1998 through 2007. The Ethnic Disparity in hemorrhagic stroke mortality, however, remained relatively stable between these 2 periods: black vs white relative risk, 1.90 (1988-1997) and 1.97 (1998-2007). Conclusions and Relevance The excess risk of death from ischemic, but not hemorrhagic, stroke in US black children has decreased over the past decade. This may be related to the implementation of an effective ischemic stroke prevention strategy for children with sickle cell disease.

  • abstract 2602 changing Ethnic Disparity in ischemic stroke mortality in us children after the stop trial
    Stroke, 2012
    Co-Authors: Laura L Lehman, Heather J Fullerton
    Abstract:

    Objective: A prior report showed higher stroke mortality in U.S. black children compared to white children (1979-1998), a Disparity likely due in part to sickle cell disease. We hypothesized that this Disparity has diminished since the publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP) trial in 1998 demonstrating the efficacy of chronic blood transfusions for primary stroke prevention. Because most childhood strokes in the setting of sickle cell disease are ischemic, we would expect a greater impact on Ethnic disparities in ischemic than hemorrhagic stroke. Methods: We evaluated the demographics and secular trends in mortality from ischemic and hemorrhagic stroke in U.S. children Results: A total of 1,555,045,537 person-years were included in the study. There were 4,425 deaths attributed to childhood stroke (as primary cause of death) within this cohort, yielding an average of 221 deaths per year. Ischemic strokes accounted for 20% of deaths; hemorrhagic strokes accounted for 67% (12% were unspecified). The relative risk of ischemic stroke mortality for black versus white children from 1988 to 1998 was 1.74 (95% CI 1.42-2.13, p Conclusion: The excess risk of death from ischemic, but not hemorrhagic, stroke in U.S. black children has decreased over the past decade. This may be related to the implementation of an effective primary stroke prevention strategy for children with sickle cell disease.

Pingyan Chen - One of the best experts on this subject based on the ideXlab platform.

  • Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018.
    BMC public health, 2021
    Co-Authors: Jianhong Pan, Dong Han, Rui Liao, Zijie Liu, Dingyun You, Pingyan Chen
    Abstract:

    BACKGROUND Racial and Ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist Ethnic disparities in stillbirth risk in mainland China. METHODS Pregnancy outcomes and Ethnicity data were obtained from the National Free Preconception Health Examination Project (NEPHEP), a nationwide prospective population-based cohort study conducted in Yunnan China from 2010-2018. The Han majority and other four main minorities including Yi, Dai, Miao, Hani were investigated in the analysis. The stillbirth hazards were estimated by life-table analysis. The excess stillbirth risk (ESR) was computed for Chinese minorities using multivariable logistic regression. RESULTS Compared with other four minorities, women in Han majority were more likely to more educated, less multiparous, and less occupied in agriculture. The pattern of stillbirth hazard of Dai women across different gestation intervals were found to be different from other Ethnic groups, especially in 20-23 weeks with 3.2 times higher than Han women. The ESR of the Dai, Hani, Miao, and Yi were 45.05, 18.70, -4.17 and 12.28%, respectively. Adjusted for maternal age, education, birth order and other general risk factors, the Ethnic Disparity still persisted between Dai women and Han women. Adjusted for preterm birth further (gestation age

  • Ethnic Disparities in Stillbirth Risk in Yunnan, China: a prospective cohort study, 2010-2018
    2020
    Co-Authors: Jianhong Pan, Dong Han, Rui Liao, Zijie Liu, Dingyun You, Pingyan Chen
    Abstract:

    Abstract Background: Racial and Ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist Ethnic disparities in stillbirth risk in mainland China.Methods: Pregnancy outcomes and Ethnicity data were obtained from the National Free Preconception Health Examination Project (NEPHEP), a nationwide prospective population-based cohort study conducted in Yunnan China from 2010-2018. The Han majority and other four main minorities including Yi, Dai, Miao, Hani were investigated in the analysis. The stillbirth hazards were estimated by life-table analysis. The excess stillbirth risk (ESR) was computed for Chinese minorities using multivariable logistic regression.Results: Compared with other four minorities, women in Han majority were more likely to more educated, less multiparous, and less occupied in agriculture. The pattern of stillbirth hazard of Dai women across different gestation intervals were found to be different from other Ethnic groups, especially in 20-23 weeks with 3.2 times higher than Han women. The ESR of the Dai, Hani, Miao, and Yi were 45.05%, 18.70%, -4.17% and 12.28%, respectively. Adjusted for maternal age, education, birth order and other general risk factors, the Ethnic Disparity still persisted between Dai women and Han women. Adjusted for preterm birth further (gestation age <37 weeks) can reduce 16.91% ESR of Dai women and made the Disparity insignificant. Maternal diseases and congenital anomalies explained little for Ethnic disparities.Conclusions: We identified the Ethnic Disparity in stillbirth risk between Dai women and Han women. General risk factors including sociodemographic factors and maternal diseases explained little. Considerable Ethnic disparities can be attributed to preterm birth.

  • Ethnic Disparities in Stillbirth Risk in Yunnan, China: A Prospective Cohort Study, 2010-2018
    2020
    Co-Authors: Jianhong Pan, Dong Han, Rui Liao, Zijie Liu, Dingyun You, Pingyan Chen
    Abstract:

    Abstract Background: Racial and Ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist Ethnic disparities in stillbirth risk in mainland China. Methods: Data came from 217,070 pregnancies of Yunnan China during 2010-2018 year. The Han majority and other four main minorities including Yi, Dai, Miao, Hani were investigated in the analysis. The stillbirth hazards were estimated by life-table analysis. The excess stillbirth risk (ESR) was computed for Chinese minorities in multiple logistic regression. Results: Compared with other four minorities, women in Han majority were more likely to more educated, less multiparous, and less occupied in agriculture. The pattern of stillbirth hazard of Dai women across different gestation intervals were found to be different from other Ethnic groups, especially in 20-23 weeks with 3.2 times higher than Han women. The ESR of the Dai, Hani, Miao, and Yi were 45.05%, 18.70%, -4.17% and 12.28%, respectively. Adjusted for maternal age, education, parity and other general risk factors, the Ethnic Disparity still persisted between Dai women and Han women. Adjusted for preterm birth further (gestation age <37 weeks) can reduce 19.39% ESR of Dai women and made the Disparity insignificant. Maternal diseases and congenital anomalies explained little for Ethnic disparities.Conclusions: We identified the Ethnic Disparity in stillbirth risk between Dai women and Han women. General risk factors including sociodemographic factors and maternal diseases explained little. Considerable Ethnic disparities can be attributed to preterm birth.

Laura L Lehman - One of the best experts on this subject based on the ideXlab platform.

  • changing Ethnic Disparity in ischemic stroke mortality in us children after the stop trial
    JAMA Pediatrics, 2013
    Co-Authors: Laura L Lehman, Heather J Fullerton
    Abstract:

    Importance A prior report showed higher stroke mortality in US black children compared with white children (1979-1998), a Disparity likely due in part to sickle cell disease, which leads to a high risk of childhood ischemic stroke. We hypothesized that this Disparity has diminished since the publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP trial) in 1998 demonstrating the efficacy of long-term blood transfusions for primary stroke prevention. Objective To evaluate the demographics and secular trends in mortality from ischemic and hemorrhagic stroke (as a primary cause of death) in US children ( Design We used death certificate data from the National Center for Health Statistics, 1988 through 2007. Setting United States. Participants Children who died in 1988 through 2007 in the United States. Intervention Publication of the STOP trial. Main Outcome Measures Incidence rate ratios were calculated as the measure of relative risk. Results Among 1.6 billion person-years of US children (1988-2007), there were 4425 deaths attributed to stroke, yielding an average of 221 deaths per year; 20% were ischemic; 67%, hemorrhagic; and 12%, unspecified. The relative risk of ischemic stroke mortality for black vs white children dropped from 1.74 from 1988 through 1997 to 1.27 from 1998 through 2007. The Ethnic Disparity in hemorrhagic stroke mortality, however, remained relatively stable between these 2 periods: black vs white relative risk, 1.90 (1988-1997) and 1.97 (1998-2007). Conclusions and Relevance The excess risk of death from ischemic, but not hemorrhagic, stroke in US black children has decreased over the past decade. This may be related to the implementation of an effective ischemic stroke prevention strategy for children with sickle cell disease.

  • abstract 2602 changing Ethnic Disparity in ischemic stroke mortality in us children after the stop trial
    Stroke, 2012
    Co-Authors: Laura L Lehman, Heather J Fullerton
    Abstract:

    Objective: A prior report showed higher stroke mortality in U.S. black children compared to white children (1979-1998), a Disparity likely due in part to sickle cell disease. We hypothesized that this Disparity has diminished since the publication of the Stroke Prevention Trial in Sickle Cell Anemia (STOP) trial in 1998 demonstrating the efficacy of chronic blood transfusions for primary stroke prevention. Because most childhood strokes in the setting of sickle cell disease are ischemic, we would expect a greater impact on Ethnic disparities in ischemic than hemorrhagic stroke. Methods: We evaluated the demographics and secular trends in mortality from ischemic and hemorrhagic stroke in U.S. children Results: A total of 1,555,045,537 person-years were included in the study. There were 4,425 deaths attributed to childhood stroke (as primary cause of death) within this cohort, yielding an average of 221 deaths per year. Ischemic strokes accounted for 20% of deaths; hemorrhagic strokes accounted for 67% (12% were unspecified). The relative risk of ischemic stroke mortality for black versus white children from 1988 to 1998 was 1.74 (95% CI 1.42-2.13, p Conclusion: The excess risk of death from ischemic, but not hemorrhagic, stroke in U.S. black children has decreased over the past decade. This may be related to the implementation of an effective primary stroke prevention strategy for children with sickle cell disease.

Jianhong Pan - One of the best experts on this subject based on the ideXlab platform.

  • Ethnic disparities in stillbirth risk in Yunnan, China: a prospective cohort study, 2010-2018.
    BMC public health, 2021
    Co-Authors: Jianhong Pan, Dong Han, Rui Liao, Zijie Liu, Dingyun You, Pingyan Chen
    Abstract:

    BACKGROUND Racial and Ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist Ethnic disparities in stillbirth risk in mainland China. METHODS Pregnancy outcomes and Ethnicity data were obtained from the National Free Preconception Health Examination Project (NEPHEP), a nationwide prospective population-based cohort study conducted in Yunnan China from 2010-2018. The Han majority and other four main minorities including Yi, Dai, Miao, Hani were investigated in the analysis. The stillbirth hazards were estimated by life-table analysis. The excess stillbirth risk (ESR) was computed for Chinese minorities using multivariable logistic regression. RESULTS Compared with other four minorities, women in Han majority were more likely to more educated, less multiparous, and less occupied in agriculture. The pattern of stillbirth hazard of Dai women across different gestation intervals were found to be different from other Ethnic groups, especially in 20-23 weeks with 3.2 times higher than Han women. The ESR of the Dai, Hani, Miao, and Yi were 45.05, 18.70, -4.17 and 12.28%, respectively. Adjusted for maternal age, education, birth order and other general risk factors, the Ethnic Disparity still persisted between Dai women and Han women. Adjusted for preterm birth further (gestation age

  • Ethnic Disparities in Stillbirth Risk in Yunnan, China: a prospective cohort study, 2010-2018
    2020
    Co-Authors: Jianhong Pan, Dong Han, Rui Liao, Zijie Liu, Dingyun You, Pingyan Chen
    Abstract:

    Abstract Background: Racial and Ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist Ethnic disparities in stillbirth risk in mainland China.Methods: Pregnancy outcomes and Ethnicity data were obtained from the National Free Preconception Health Examination Project (NEPHEP), a nationwide prospective population-based cohort study conducted in Yunnan China from 2010-2018. The Han majority and other four main minorities including Yi, Dai, Miao, Hani were investigated in the analysis. The stillbirth hazards were estimated by life-table analysis. The excess stillbirth risk (ESR) was computed for Chinese minorities using multivariable logistic regression.Results: Compared with other four minorities, women in Han majority were more likely to more educated, less multiparous, and less occupied in agriculture. The pattern of stillbirth hazard of Dai women across different gestation intervals were found to be different from other Ethnic groups, especially in 20-23 weeks with 3.2 times higher than Han women. The ESR of the Dai, Hani, Miao, and Yi were 45.05%, 18.70%, -4.17% and 12.28%, respectively. Adjusted for maternal age, education, birth order and other general risk factors, the Ethnic Disparity still persisted between Dai women and Han women. Adjusted for preterm birth further (gestation age <37 weeks) can reduce 16.91% ESR of Dai women and made the Disparity insignificant. Maternal diseases and congenital anomalies explained little for Ethnic disparities.Conclusions: We identified the Ethnic Disparity in stillbirth risk between Dai women and Han women. General risk factors including sociodemographic factors and maternal diseases explained little. Considerable Ethnic disparities can be attributed to preterm birth.

  • Ethnic Disparities in Stillbirth Risk in Yunnan, China: A Prospective Cohort Study, 2010-2018
    2020
    Co-Authors: Jianhong Pan, Dong Han, Rui Liao, Zijie Liu, Dingyun You, Pingyan Chen
    Abstract:

    Abstract Background: Racial and Ethnic disparities in stillbirth risk had been documented in most western countries, but it remains unknown in China. This study was to determine whether exist Ethnic disparities in stillbirth risk in mainland China. Methods: Data came from 217,070 pregnancies of Yunnan China during 2010-2018 year. The Han majority and other four main minorities including Yi, Dai, Miao, Hani were investigated in the analysis. The stillbirth hazards were estimated by life-table analysis. The excess stillbirth risk (ESR) was computed for Chinese minorities in multiple logistic regression. Results: Compared with other four minorities, women in Han majority were more likely to more educated, less multiparous, and less occupied in agriculture. The pattern of stillbirth hazard of Dai women across different gestation intervals were found to be different from other Ethnic groups, especially in 20-23 weeks with 3.2 times higher than Han women. The ESR of the Dai, Hani, Miao, and Yi were 45.05%, 18.70%, -4.17% and 12.28%, respectively. Adjusted for maternal age, education, parity and other general risk factors, the Ethnic Disparity still persisted between Dai women and Han women. Adjusted for preterm birth further (gestation age <37 weeks) can reduce 19.39% ESR of Dai women and made the Disparity insignificant. Maternal diseases and congenital anomalies explained little for Ethnic disparities.Conclusions: We identified the Ethnic Disparity in stillbirth risk between Dai women and Han women. General risk factors including sociodemographic factors and maternal diseases explained little. Considerable Ethnic disparities can be attributed to preterm birth.

Manjunath N K Sharma - One of the best experts on this subject based on the ideXlab platform.

  • Ethnic Disparity and increased prevalence of type 2 diabetes among south asians aetiology and future implications for diabetes prevention and management
    Current Diabetes Reviews, 2018
    Co-Authors: Venugopal Vijayakumar, Ramesh Mavathur, Manjunath N K Sharma
    Abstract:

    Background Type 2 Diabetes Mellitus (T2DM) is turning out to be a global health crisis. Currently available literature clearly indicates an increased risk of type 2 diabetes amongst South Asian population. Objective The objective of this narrative review is to explore the non-modifiable and modifiable risk factors of T2DM in South Asian population, including their beliefs, attitudes, socio economic and cultural barriers and also to explore the possible implications in designing culture specific diabetes prevention and management programs. Methods This narrative review is based upon the data from individual studies and review article known to the authors. Additional relevant studies were identified through PubMed search on Englishlanguage papers published in 2000-2017 using the relevant keywords. Where appropriate, the reference lists of key papers were reviewed to identify additional studies of interest. Results Many genetic and environmental risk factors such as diet, physical inactivity, and sleep contribute to the increased prevalence of diabetes in the Ethnic group. Providing mere knowledge about diabetes and these risk factors might not be sufficient in this particular Ethnic group. It is essential to address their beliefs, attitudes and the cultural barriers faced. Conclusion To overcome the health Disparity in the South Asian Ethnic group, various risk factors associated with diabetes, and the challenges faced are to be considered while designing future diabetes prevention and management strategies.