ABSTRACT
Jennifer Goode highlights the contributions of Mamie Phipps Clark as a social scientist and an advocate for educational equity for children of color, particularly African American children, and discusses the relevance of Phipps Clark's research on racial identity and segregation to current issues related to equity in schooling.
Subject(s)
Black or African American , Education , Social Segregation , Child , Humans , Racial GroupsABSTRACT
INTRODUCTION: This study aims to characterize longitudinal care management and evaluate the relationship between various patient factors and the likelihood of choosing risk-reducing behaviors in women with increased risk of developing breast cancer. METHODS: A retrospective study was conducted to evaluate all adult female patients who had at least one clinic visit with a surgical provider for discussion of breast cancer risk assessment between January, 2017 to July, 2020 at an academic center. Patients with prior history of breast cancer were excluded. Patient details and strategies pursued at clinic visits were recorded. A time-to-event analysis was performed, and hazard ratios were determined to characterize associations between patient characteristics and time to pursuing risk-reducing care management. RESULTS: There were 283 participants with at least one follow-up visit and 48 (17.0%) ultimately changed their initial strategy to either chemoprevention or prophylactic mastectomy. Patients with gene mutations were 6 times more likely to engage in risk-reducing management compared to those without (hazard ratio (HR) 5.99, P < 0.001). Those with histories of high-risk proliferative changes (HR 7.62, P < 0.001) and hysterectomy (HR 2.99, P = 0.019) were also more likely to engage in risk-reducing management. Age, race, and increased predicted risk of developing breast cancer (estimated by various calculators) were not associated with increased likelihood of engaging in risk-reducing strategies. CONCLUSION: Known gene mutations, history of high-risk proliferative changes, and prior hysterectomy were factors associated with women who were more likely to engage in risk-reducing strategies. These findings, when paired with patient reported outcome measures, may help guide shared decision-making.
Subject(s)
Breast Neoplasms/psychology , Chemoprevention/statistics & numerical data , Prophylactic Mastectomy/statistics & numerical data , Adult , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/genetics , Breast Neoplasms/prevention & control , Chemoprevention/psychology , Female , Humans , Magnetic Resonance Imaging , Mammography , Middle Aged , Prophylactic Mastectomy/psychology , Retrospective StudiesABSTRACT
This research engages nationally representative longitudinal data and a multipopulation LISREL model to investigate variation among black and white Americans in the impact of religiosity and mastery on psychological distress. Guided by the stress and coping perspective and prominent theorizing about how religiosity influences mental health, the model assesses not only direct effects of religiosity and mastery on distress but also the possibility of religiosity and mastery inhibiting distress indirectly (via effects on other coping resources or stressors) and attenuating the distress-inducing properties of individual stressors. Findings solidly support the endorsed proposition of religiosity's being particularly beneficial to blacks' emotional well-being and moderately support the prediction of mastery's being primarily helpful to whites'. Public religiosity substantially eclipses private and subjective religiosity as a facilitator of blacks' emotional well-being, and although main effects dominate, there are significant mediation and moderation effects of religiosity or mastery within each race.
