Effects of Race, Cardiac Mass, and Cardiac Load on Myocardial Function Trajectories from Childhood to Young Adulthood: The Augusta Heart Study.

Background The overall goal of this longitudinal study was to determine if the Black population has decreased myocardial function, which has the potential to lead to the early development of congestive heart failure, compared with the White population. Methods and Results A total of 673 subjects were evaluated over a period of 30 years including similar percentages of Black and White participants. Left ventricular systolic function was probed using the midwall fractional shortening (MFS). A longitudinal analysis of the MFS using a mixed effect growth curve model was performed. Black participants had greater body mass index, higher blood pressure readings, and greater left ventricular mass compared with White participants (all P<0.01). Black participants had a 0.54% decrease of MFS compared with White participants. As age increased by 1 year, MFS increased by 0.05%. As left ventricular mass increased by 1 g, MFS decreased by 0.01%. As circumferential end systolic stress increased by 1 unit, MFS decreased by 0.04%. The MFS trajectories for race differed from early age to young adulthood. Conclusions Changes in myocardial function mirror the race-dependent variations in blood pressure, afterload, and cardiac mass, suggesting that myocardial function depression occurs early in childhood in populations at high cardiovascular risk such as Black participants.

Predictors of Underrepresented Nursing Students' School Satisfaction, Success, and Future Education Intent.

BACKGROUND: The United States is steadily becoming more diverse. If current trends continue, the minority population will be the majority by 2043. In contrast to the U.S. population, nursing (the largest health care workforce) is composed of a nearly 76% White population. The literature reports that underrepresented minorities (URM) in nursing programs encounter multiple barriers to academic success. METHOD: A secondary data analysis of a national cohort of URM accelerated nursing students was conducted to examine three factors associated with microaggression-predictors of academic (NCLEX) success, satisfaction, and intent to pursue advanced education-among a cohort of URM accelerated nursing students who had received a national diversity scholarship (n = 2,250). RESULTS: These three factors were predicted by institutional climate, mentoring, social interactions, the prematriculation preparation program, and other psychological, social, and cultural barriers. CONCLUSION: To increase nursing diversity and ensure a culturally competent profession, programs must attend to these factors. [J Nurs. Educ. 2018;57(3):142-149.].