Dr. Patricia E. Bath

Dr. Patricia Bath was the first woman ophthalmologist to be appointed to the faculty of the University of California at Los Angeles School of Medicine Jules Stein Eye Institute.

Dr. Bath was the first woman to chair an ophthalmology residency program in the United States.

Dr. Patricia Bath discovered and invented a new device and technique for cataract surgery known as laserphaco. Dr. Bath is the first African American woman doctor to receive a patent for a medical invention.

Born: November 4, 1942, Birthplace: Harlem, New York - Patricia E. Bath, an ophthalmologist and laser scientist, is an innovative research scientist and advocate for blindness prevention, treatment, and cure. Her accomplishments include the invention of a new device and technique for cataract surgery known as laserphaco, the creation of a new discipline known as "community ophthalmology," and appointment as the first woman chair of ophthalmology in the United States, at Drew-UCLA in 1983.

Dr. Patricia E. Bath

Patricia Bath's dedication to a life in medicine began in childhood, when she was first heard about Dr. Albert Schweitzer's service to lepers in the Congo. After excelling in her studies in high school and university and earning awards for scientific research as early as age sixteen, Dr. Bath embarked on a career in medicine. She received her medical degree from Howard University College of Medicine in Washington, D.C., interned at Harlem Hospital from 1968 to 1969, and completed a fellowship in ophthalmology at Columbia University from 1969 to 1970. Following her internship, Dr. Bath completed her training at New York University between 1970 and 1973, where she was the first African American resident in ophthalmology. Bath married and had a daughter Eraka, born 1972.

While motherhood became her priority, she also managed to complete a fellowship in corneal transplantation and keratoprosthesis (replacing the human cornea with an artificial one).

As a young intern shuttling between Harlem Hospital and Columbia University, Bath was quick to observe that at the eye clinic in Harlem half the patients were blind or visually impaired. At the eye clinic at Columbia, by contrast, there were very few obviously blind patients. This observation led her to conduct a retrospective epidemiological study, which documented that blindness among blacks was double that among whites. She reached the conclusion that the high prevalence of blindness among blacks was due to lack of access of ophthalmic care. As a result, she proposed a new discipline, known as community ophthalmology, which is now operative worldwide. Community ophthalmology combines aspects of public health, community medicine, and clinical ophthalmology to offer primary care to underserved populations. Volunteers trained as eye workers visit senior centers and daycare programs to test vision and screen for cataracts, glaucoma, and other threatening eye conditions. This outreach has saved the sight of thousands whose problems would otherwise have gone undiagnosed and untreated. By identifying children who need eyeglasses, the volunteers give these children a better chance for success in school.

Bath was also instrumental in bringing ophthalmic surgical services to Harlem Hospital's Eye Clinic, which did not perform eye surgery in 1968. She persuaded her professors at Columbia to operate on blind patients for free, and she volunteered as an assistant surgeon. The first major eye operation at Harlem Hospital was performed in 1970 as a result of her efforts.

In 1974 Bath joined the faculty of UCLA and Charles R. Drew University as an assistant professor of surgery (Drew) and ophthalmology (UCLA). The following year she became the first woman faculty member in the Department of Ophthalmology at UCLA's Jules Stein Eye Institute. As she notes, when she became the first woman faculty in the department, she was offered an office "in the basement next to the lab animals." She refused the spot. "I didn't say it was racist or sexist. I said it was inappropriate and succeeded in getting acceptable office space. I decided I was just going to do my work." By 1983 she was chair of the ophthalmology residency training program at Drew-UCLA, the first woman in the USA to hold such a position.

Despite university policies extolling equality and condemning discrimination, Professor Bath experienced numerous instances of sexism and racism throughout her tenure at both UCLA and Drew. Determined that her research not be obstructed by the "glass ceilings," she took her research abroad to Europe. Free at last from the toxic constraints of sexism and racism her research was accepted on its merits at the Laser Medical Center of Berlin, West Germany, the Rothschild Eye Institute of Paris, France, and the Loughborough Institute of Technology, England. At those institutions she achieved her "personal best" in research and laser science, the fruits of which are evidenced by her laser patents on eye surgery.

Bath's work and interests, however, have always gone beyond the confines of a university. In 1977, she and three other colleagues founded the American Institute for the Prevention of Blindness, an organization whose mission is to protect, preserve, and restore the gift of sight. The AIPB is based on the principle that eyesight is a basic human right and that primary eye care must be made available to all people, everywhere, regardless of their economic status. Much of the work of the AIPB is done though ophthalmic assistants, who are trained in programs at major universities. The institute supports global initiatives to provide newborn infants with protective anti-infection eye drops, to ensure that children who are malnourished receive vitamin A supplements essential for vision, and to vaccinate children against diseases (such as measles) that can lead to blindness.

As director of AIPB, Bath has traveled widely. On these travels she has performed surgery, taught new medical techniques, donated equipment, lectured, met with colleagues, and witnessed the disparity in health services available in industrial and developing countries.

Dr. Bath is also a laser scientist and inventor. Her interest, experience, and research on cataracts lead to her invention of a new device and method to remove cataracts—the laserphaco probe. When she first conceived of the device in 1981, her idea was more advanced than the technology available at the time. It took her nearly five years to complete the research and testing needed to make it work and apply for a patent. Today the device is use worldwide. With the keratoprosthesis device, Dr. Bath was able to recover the sight of several individuals who had been blind for over 30 years.

In 1993, Bath retired from UCLA Medical Center and was appointed to the honorary medical staff. Since then, she has been an advocate of telemedicine, the use of electronic communication to provide medical services to remote areas where health care is limited. She has held positions in telemedicine at Howard University and St. George's University in Grenada.

Dr. Bath's greatest passion, however, continues to be fighting blindness. Her "personal best moment" occurred on a humanitarian mission to North Africa, when she restored the sight of a woman who had been blind for thirty years by implanting a keratoprosthesis. "The ability to restore sight is the ultimate reward," she says.

What was my biggest obstacle?

Sexism, racism, and relative poverty were the obstacles which I faced as a young girl growing up in Harlem. There were no women physicians I knew of and surgery was a male-dominated profession; no high schools existed in Harlem, a predominantly black community; additionally, blacks were excluded from numerous medical schools and medical societies; and, my family did not possess the funds to send me to medical school. [Dr. Bath says her mother scrubbed floors so she could go to medical school.]

Despite official university policies extolling equality and condemning discrimination, Bath experienced both sexism and racism during her tenure at both UCLA and Drew. Determined that her research not be obstructed by the "glass ceilings," she took her research abroad to Europe, where her research was accepted on its merits at the Laser Medical Center of Berlin, West Germany, the Rothschild Eye Institute of Paris, France, and the Loughborough (England) Institute of Technology. At those institutions she excelled in research and laser science, the fruits of which are evidenced by her patents for laser eye surgery.

How do I make a difference?

I am most proud of my invention of a new technique and concept for cataract surgery, known as laserphaco, which is defined by my publications as well as patents.

Who was my mentor?

Newspaper accounts of the humanitarian work of Dr. Albert Schweitzer (who treated lepers in Africa) and my personal relationship with my family physician, Dr. Cecil Marquez, inspired me with the ambition to become a physician. Both my parents shared my admiration for these two role models and encouraged me to pursue my ambition.

TEXT and IMAGE CREDIT: Government information at NLM Web sites is in the public domain. Public domain information may be freely distributed and copied, but it is requested that in any subsequent use the National Library of Medicine (NLM) be given appropriate acknowledgement. Changing the Face of Medicine

Hair straightening chemicals not linked to breast cancer risk in African-Americans

PHILADELPHIA - Chemical "relaxers" used to straighten hair are not associated with an increased risk of developing breast cancer among African-American women, say researchers who followed 48,167 Black Women's Health Study participants.

In the May issue of Cancer Epidemiology, Biomarkers & Prevention, researchers from Boston University and Howard University Cancer Center found no increase in breast cancer risk due to the type of hair relaxer used or the frequency and duration of use. Women who used relaxers seven or more times a year over a 20 year span or longer had the same risk as women who used the chemicals for less than a year, researchers say.

Lynn Rosenberg is professor of epidemiology at Boston University School of Public Health. She received her M.S. in chemistry from Boston University and M.S. in biostatistics and Sc.D. in epidemiology from Harvard University. Dr. Rosenberg’s research has been in the areas of cancer epidemiology, cardiovascular epidemiology, and drug epidemiology, with a recent emphasis on women’s health. She has carried out multiple studies of risk factors for cancers, including cancer of the breast, cervix, and colon, and for myocardial infarction. Particular interests have been the health effects of oral and injectable contraceptives and of noncontraceptive estrogens. Several important hypotheses have been raised by her studies: that alcohol consumption increases the incidence of breast cancer and that use of nonsteroidal anti-inflammatory drugs decreases the incidence of large bowel cancer. Both hypotheses were subsequently confirmed in numerous studies. Currently, she is PI of the long-running Case-Control Surveillance Study, which has been in progress since 1975; multiple case-control studies are conducted within the same administrative framework to assess the unanticipated effects of medications on the incidence of various cancers. She heads a cross-sectional study of the effect of injectable progestin contraceptives on bone mineral density in African women and women of mixed race in South Africa . She is also PI of the Black Women’s Health Study, the largest follow-up study of the health of African-American women yet conducted. The study, conducted in collaboration with investigators at Howard University, follows 59,000 black women from across the U.S. to assess risk factors for outcomes that include breast cancer, other cancers, hypertension, diabetes, systemic lupus erythematosus, uterine fibroids, and preterm birth. Dr. Rosenberg is the author of over 200 scientific papers.

"This is good news," said the study's lead investigator, Lynn Rosenberg, Sc.D., professor of epidemiology at Boston University School of Public Health. "The present study is definitive that hair relaxers don't cause breast cancer, as much as an epidemiologic study can be." Previous research shows that breast cancer incidence is higher among African-American women age 40 or younger than among Caucasian women of the same age, and this increased risk is not fully explained by known risk factors, such as race and family history. At all ages, African-American women are more likely to die of breast cancer than are Caucasian women. To shed light on these findings and to study potential causes of breast cancer and other serious illnesses that affect black women, the Black Women's Health Study was launched across the United States in 1995. More than 59,000 women completed an initial questionnaire and more than 80 percent have answered follow-up questions every two years since, including questions about use of hair relaxers. Hair relaxers can enter the body through cuts or lesions in the scalp. These products are not fully monitored by the Food and Drug Administration, and thus could contain potentially harmful compounds, Rosenberg said. Manufacturers of hair relaxers and hair dyes are not required to list all ingredients of their products on the packages, as some may be considered trade secrets, she said. "Because hair relaxers are more widely used by younger African-American women than they are used by older African-American women, a connection with increased risk of breast cancer in younger women seemed possible," Rosenberg said. "Also, millions of African-American women use hair relaxers, and substances that are used by millions of women over a span of many years should be monitored for safety." The researchers found that younger women used hair relaxers more than older women did. They also discovered that the majority of women used hair relaxers before age 20 and a third used the chemicals at least seven times a year.

But when they examined the association between use of hair relaxers and breast cancer, based on 574 newly diagnosed cases of breast cancer identified during the follow-up period, they found no connection between use of relaxers and breast cancer incidence overall or among the younger women, even if use had been frequent and of long duration.

The study was funded by the National Cancer Institute. Co-authors include Julie Palmer, Sc.D., and Deborah Boggs, M.S., of Boston University School of Public Health, and Lucile Adams-Campbell, Ph.D., of Howard University Cancer Center. ###

The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes nearly 26,000 basic, translational, and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 70 other countries.

AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special Conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment, and patient care.

AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. Its most recent publication, CR, is a magazine for cancer survivors, patient advocates, their families, physicians, and scientists. It provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship, and advocacy.

Contact: Greg Lester lester@aacr.org 267-646-0554 American Association for Cancer Research

A Survey of African American College Students: Reactions to the Terrorist Acts of September 11, 2001

ED456377 - A Survey of African American College Students: Reactions to the Terrorist Acts of September 11, 2001. Full text in PDF format. ERIC #: ED456377 Title: A Survey of African American College Students: Reactions to the Terrorist Acts of September 11, 2001. Authors: Duncan, Cecil.

Descriptors: Black Colleges; Black Students; College Students; Coping; Higher Education; Interpersonal Communication; Posttraumatic Stress Disorder; Resilience (Personality); Student Reaction; Student Surveys

A survey instrument was developed to identify the impact the World Trade Center and the Pentagon bombings of September 11, 2001, had on African American college students attending an Historically Black College-University (HBCU) in the South. The survey was administered to 136 students 8 days after the bombings in an effort to gain insight into their immediate impact on a select group of Americans.

Students who participated in the study appeared to have experienced a number of reactions typical of persons who were in close proximity to a disaster but were not direct victims themselves. They did not have symptoms consistent with posttraumatic stress syndrome disorder.

Most had serious concerns about flying, while a sizable minority felt unsafe in general. Few blamed Middle Easterners in general for the terrorist acts, and even fewer wanted profiling to be used as a means of identifying terrorists. The respondents appeared to be doing what they needed to do to return to normalcy, and talking about the incident may be the most therapeutic thing they did. Several limitations of the study are discussed, including that it occurred just eight days after the bombings, which may have been too early to assess the impact on the participants. (JDM)

African-Americans twice as likely as Caucasians to die following a liver operation

Timothy M. Pawlik received his undergraduate degree from Georgetown University and his medical degree from Tufts University School of Medicine. He completed his surgical training at the University of Michigan Hospital and spent two years at the Massachusetts General Hospital as a surgical oncology research fellow. Dr. Pawlik went on for advanced training in surgical oncology at The University of Texas M. D. Anderson Cancer Center in Houston. His main clinical interests include alimentary tract surgery, with a special interest in hepatic and pancreatobiliary diseases. Dr. Pawlik also has an interest in medical ethics and completed a fellowship in medical ethics at the Harvard School of Public Health as well as a Masters in Theology from Harvard Divinity School in Boston.

CHICAGO (September 3, 2008) – New research published in the Journal of the American College of Surgeons shows African Americans are more than twice as likely as Caucasians to die in the hospital after surgical removal of part of the liver -- an increasingly used procedure for the treatment of liver cancer. In recent years, a large body of evidence has emerged revealing significant racial disparities in health care and outcomes in the United States. Previous studies have documented racial disparities in surgical mortality after cardiovascular and cancer procedures. Because of such studies, the identification and elimination of these disparities has become a national public health priority. "Our study shows a racial divide in regards to in-hospital mortality after major hepatectomy," according to Timothy Pawlik, MD, MPH, FACS, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md. "This finding is of special note because of the magnitude of the observed gap in outcomes." Using hospital discharge data from the Nationwide Inpatient Sample, researchers retrospectively reviewed 3,552 patients who underwent major hepatectomy between 1998 and 2005. The overall racial makeup was 59 percent Caucasian, 6 percent African-American, 5 percent Hispanic, 7 percent Asian/Pacific Islander and 24 percent other or unknown, which included records with missing race and those from states that do not report race. "There has previously not been any research on racial disparities in the outcomes of liver resection, but it is an important issue to examine as the use of hepatic resection has increased dramatically in the U.S.,"

added Hari Nathan, MD, department of surgery, Johns Hopkins University School of Medicine and the study's lead investigator. "Given this increase, studies are needed to clarify the nature of this disparity and identify targets for intervention."

The odds of dying following this type of liver operation were twice as high for African Americans compared with Caucasians. After adjustment for clinical, hospital, and socioeconomic risk factors, data revealed that African-American patients were twice as likely to die compared to Caucasian patients (odds ratio 2.15, 95 percent confidence, interval 1.28 to 3.61).

Researchers believe that differences in preoperative health status may underlie some of the observed disparity in outcomes, a theory supported by the finding that African-American patients who died in the hospital as a complication of a hepatectomy did so much sooner than their Caucasian counterparts. Hospital factors may also explain racial disparities in outcomes, insofar as minority patients might receive care at hospitals with generally poorer outcomes. ###

About the American College of Surgeons

The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and to improve the care of the surgical patient. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 72,000 members and is the largest organization of surgeons in the world. For more information, visit www.facs.org.

Contact: Sally Garneski pressinquiry@facs.org 312-202-5409 Weber Shandwick Worldwide

Periodic limb movement during sleep is less common in African-Americans; associated with insomnia

Christopher L. Drake, Ph.D. Make An Appointment 1-800-HENRYFORD (1-800-436-7936) Specialties: Sleep Medicine Office Locations: Henry Ford Hospital 2799 West Grand Boulevard Detroit, MI, 48202 Board Certifications: American Board of Sleep Medicine. Post Graduate Training: Ph.D. - Bowling Green State University (OH) - Psychology

Study is the first to determine the prevalence of periodic limb movements during sleep in a population-based sample using standardized criteria Westchester, Ill. – A study in the Sept. 1 issue of the journal Sleep is the first to objectively determine the prevalence of periodic limb movements during sleep (PLMS) in a population-based sample, finding a lower prevalence of PLMS in African-Americans and a higher rate of insomnia complaints in people with PLMS. Results show that the overall prevalence of PLMS is 7.6 percent, with a lower prevalence of 4.3 percent in African-Americans and a higher prevalence of 9.3 percent in Caucasians. Complaints of insomnia are reported by 45 percent of people with PLMS, compared with only 25 percent of people without PLMS. "The study is consistent with the idea that genetic factors may play a role in the development of PLMS," said principal investigator Christopher L. Drake, PhD, senior bioscientific staff at the Sleep Disorders and Research Center at Henry Ford Hospital in Detroit, Mich.

According to the American Academy of Sleep Medicine, PLMS involves uncontrollable, repetitive muscle movements such as extending the big toe or bending the ankle. These frequent movements occur in one or both legs during sleep and often result in brief arousals, and in some cases, full awakenings from sleep.

The AASM also reports that low brain iron may play a role in worsening PLMS. According to the authors, studies demonstrate higher iron stores in African-Americans, providing a possible explanation for the racial differences found in the study. The results also are consistent with previous findings of racial differences for PLMS in children as young as five to seven years of age, suggesting that the racial differences found in adults may be present from an early age and pointing to potential genetic factors.

Data were collected as a part of a larger epidemiological study on daytime sleepiness in the general population of tri-county Detroit. The final sample included 592 individuals between the ages of 18 and 65 years, with an average age of 42 years. African-Americans made up 31.5 percent of the study group.

Participants were evaluated during a 24-hour laboratory assessment, which included an overnight polysomnogram and a five-nap, daytime, multiple sleep latency test. Participants also recorded sleep diaries two weeks prior to the laboratory assessment.

PLMS was defined as an average of 15 or more leg movements per hour of sleep. Individuals with PLMS were slightly but significantly older. Self-reported symptoms of either sleepiness or sleep disturbance were higher in participants with PLMS (56 percent) than in those without PLMS (29 percent). ###

Information for patients and the public about PLMS is available from the American Academy of Sleep Medicine at www.sleepeducation.com/Disorder.aspx?id=10.

Sleep is the official journal of the Associated Professional Sleep Societies, LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. For a copy of the study, "Periodic Limb Movements during Sleep: Population Prevalence, Clinical Correlates and Racial Differences," or to arrange an interview with an AASM spokesperson, please contact Kelly Wagner, AASM public relations coordinator, at (708) 492-0930, ext. 9331, or kwagner@aasmnet.org.

How media covered Katrina aftermath affects response by blacks and whites

Cheryl Kaiser is an Assistant Professor in the UW Department of Psychology. She is affiliated with the Social/Personality and Diversity Science Research Areas. Broadly speaking, her research examines the self and social perception, particularly as these topics relate to prejudice and intergroup relations. Much of her research examines factors that affect whether individuals perceive prejudice-related threats, their cognitive, emotional, and behavioral responses to these threats, and the implications of how they cope with these threats for well being and interpersonal relationships. She is also interested in the application of this research for law and legal processes. Cheryl R. Kaiser Department of Psychology University of Washington Seattle, Washington 98195 U.S.A. Phone: (206) 616-1435 ckaiser@u.washington.edu

New research shows that black and white Americans responded differently when exposed to a video presentation that described Hurricane Katrina and then blamed the botched relief efforts on one of two causes: either government incompetence or racism, because the majority of Katrina's victims were black. "In laboratory experiments over the last decade, whites have tended to have negative reactions including negative emotions and attitudes towards minorities when racism was blamed for or cited as the reason for something. When Katrina happened it offered an opportunity to look at a real world problem that came into our living rooms and the belief system, or world view, that everyone has," said Cheryl Kaiser, a University of Washington assistant professor of psychology and lead author of a new study. The study is noteworthy because, unlike previous research that looked at claims of discrimination, whites did not express outright negativity toward blacks. Instead it indicated that whites who were exposed to racial discrimination claims displayed strong positive attitudes toward whites rather than negative attitudes at blacks. Blacks tended to have less favorable attitudes toward whites after seeing the race-blame video than the government-incompetence video, but the difference was not significant. Blacks also showed strong positive attitudes toward blacks in both scenarios.

For the study Kaiser and her colleagues from Syracuse and Michigan State universities recruited 93 white and 60 black undergraduate college students. The majority in each group were women.

Each participant viewed the video presentation individually on a computer monitor equipped with headphones. All of the students watched a five-minute clip taken from a National Geographic program about the hurricane. Then the video content was divided into two experimental conditions.

In a race-blame condition, half the participants viewed a six-minute series of segments in which Katrina victims, public figures and journalists claimed that the government had responded slowly to the disaster because the majority of victims were black. The other participants saw a six-minute government-incompetence series of clips in which victims, public figures and journalists said government incompetence caused the ineffective disaster response. Then all of the participants viewed a three-minute slide show, consisting of 96 photographs, showing the physical damage and physical suffering caused by the hurricane.

After the video presentation, each participant filled out questionnaires that assessed their attachment to their own racial group and their attitudes toward blacks, whites and a number of filler groups such as teachers and politicians. In addition, they were asked to provide an explanation for the disaster response they recalled being made most often in the video they saw.

Kaiser said that media coverage that focused on racial explanations for the aftermath of Katrina did affect white Americans' attitudes and could have potentially important consequences for intergroup relations.

"Our sense is some white Americans couldn't understand the claims of racism and it was hard for them to think skin color was responsible for people surviving the hurricane and getting relief. This study helps us understand why discrimination claims make a large number of people in the U.S. uncomfortable. These claims act as a threat to the perceived fairness of our system and people who are at the top, generally white, want to maintain the status quo," she said. ###

The paper, published in the current issue of the journal Social Justice Research, was funded by grants from the National Science Foundation. Co-authors are Collette Eccleston, an assistant psychology professor at Syracuse, and Nao Hagiwara, a psychology doctoral student at Michigan State.

Contact: Joel Schwarz joels@u.washington.edu 206-543-2580 University of Washington

Study points to 1 cause of higher rates of transplanted kidney rejection in blacks

HLA region of Chromosome 6

A Johns Hopkins research team reports it may have an explanation for at least some of the higher organ rejection rates seen among black - as compared to white - kidney transplant recipients. In a study of 50 healthy adult men, 25 black and 25 white, significantly different amounts of certain immune system cells were found between the races. These cells, known as human leukocyte antigen-specific, or HLA-specific B cells, when "sensitized" produce antibodies linked to transplanted kidney rejection, says Andrea Zachary, professor of medicine at Johns Hopkins and lead researcher of the study.

It's been long known that HLA-reactive antibodies produced by B cells are one of the ways that transplanted organs are rejected. Zachary developed a novel method for counting HLA-specific B cells more accurately, leading to the hypothesis that B cell numbers make a difference in transplant retention and rejection.

"Now that we have an accurate way to count these cells, we are able to confirm what we long suspected, that blacks might have a bigger army of HLA-specific B cells," says Zachary who presented her findings at the Congress of the International Transplant Society in Sydney, Australia on Aug. 12.

Zachary says that patients become sensitized when exposed to HLA in blood or tissue that is not their own. Sensitized HLA-specific B cells then produce antibodies that attack transplanted organs containing foreign HLA. Patients can become sensitized from a blood transfusion, transplantation or pregnancy.

"If the recipient is not sensitized, B cells represent only a patient's potential for making antibodies," says Zachary. "However about a third of patients in need of a kidney are sensitized since they're often on their second or third transplantation and may have undergone transfusions. In the study, Zachary and her team gathered blood samples from 25 adult black males and 25 adult white males. They were all healthy and all non-sensitized. They also gathered blood samples from 10 sensitized adult black males and 25 sensitized white males.

Results showed that the black non-sensitized males tested had an average of 17.2 percent more HLA-sensitive B cells than the white non-sensitized males tested. Among the sensitized group, black males had an average of 22.9 percent more HLA-sensitive B cells than white males.

HLA antigens are proteins that sit on the surface of blood and tissue cells. Each person has a specific set, similar to a fingerprint. Rejection of a transplant occurs when the recipient's immune system sees the donor's HLA antigens as foreign and attacks those antigens with cells or antibodies. The amount of antibody made depends on the number of B cells a recipient has.

"Knowing that blacks have an increased number of HLA-specific B cells - which increases their opportunity for antibody-mediated rejection - we may be able to customize treatments for black recipients to account for these differences and lessen the likelihood that the organ will be rejected," says Zachary. ###

Additional Johns Hopkins researchers who worked on this study are Mary S. Leffell, Ph.D.; and Dessislava Kopchaliifka, Ph.D., of the Department of Medicine and J. Keith Melancon, M.D., of the Department of Surgery.

Contact: Eric Vohr evohr1@jhmi.edu 410-955-8665 Johns Hopkins Medical Institutions

Muscle mass may not fully explain higher creatinine in blacks with kidney disease

Credit: Joy Hsu, MD Usage Restrictions: None

New theories needed to account for racial differences Why do black patients with advanced kidney disease have higher levels of creatinine, a standard indicator of kidney function, than whites" Contrary to what doctors have thought,

the difference may not necessarily reflect differences in muscle mass related to younger age or differences in body composition, reports a study in the July 2008 issue of the Clinical Journal of the American Society of Nephrology (CJASN).

Led by Dr Joy Hsu of University of California, San Francisco, School of Medicine, the researchers measured serum creatinine concentrations and estimated body composition in more than 3,000 dialysis patients. Doctors measure creatinine to estimate how well a patient's kidneys are functioning—a higher creatinine level is generally a sign of lower kidney function. Creatinine levels were compared for black patients versus those of other racial/ethnic groups.

As in previous studies, blacks had higher creatinine levels than non-black patients. "A widely assumed explanation for this racial difference is that black patients tend to develop end-stage kidney disease earlier than whites," Dr Hsu explains. "So blacks on dialysis tend to be younger than whites and persons of other races and ethnicities and so may have more muscle mass, and creatinine is a natural breakdown product of muscle."

To test this assumption, the researchers used a technique called bioelectrical impedance analysis to estimate the patients' muscle mass. "We hypothesized that adjusting for muscle mass and related factors would eliminate or reduce the racial differences in serum creatinine level," says Dr Hsu.

However, even after adjustment, creatinine levels continued to be significantly higher for black patients. "The higher creatinine levels in black patients compared to non-black patients could not be entirely explained by differences in age, sex, body size, or muscle mass," according to Dr Hsu.

In the United States, rates of kidney disease—including end-stage renal disease (ESRD), requiring dialysis or transplantation to replace lost kidney function—are substantially higher among blacks than whites. The higher serum creatinine levels in black patients are another significant difference. "It is also unclear how this racial difference in creatinine levels is related to racial differences in kidney disease," says Dr. Hsu.

If muscle mass isn't necessarily the answer, more research will be needed to find the real reason why black patients have higher blood creatinine levels than white patients, Dr. Hsu adds. "Perhaps the answer or answers to this question will help explain why blacks are affected by progressive chronic kidney disease more so than whites." ###

The study, entitled "Higher Serum Creatinine Concentrations in Blacks with Chronic Kidney Disease: Beyond Nutritional Status and Body Composition," is available online at cjasn.asnjournals.org/ and in print in the July 2008 issue of CJASN.

The American Society of Nephrology (ASN) is a not-for-profit organization of 11,000 physicians and scientists dedicated to the study of nephrology and committed to providing a forum for the promulgation of information regarding the latest research and clinical findings on kidney diseases. ASN publishes the Journal of the American Society of Nephrology (JASN), the Clinical Journal of the American Society of Nephrology (CJASN), and the Nephrology Self-Assessment Program (NephSAP).

Contact: Shari Leventhal sleventhal@asn-online.org 202-416-0658 American Society of Nephrology

Racial Differences in Treating Vision Disorders

Study Alerts Eye Doctors of Racial Differences in Treating Vision Disorders

Blacks are more likely to lose vision due to increased pressure in the brain than other races, reports an Emory Eye Center researcher in the March 11, 2008 issue of Neurology, the journal of the American Academy of Neurology

The pressure, called idiopathic intracranial hypertension, was identified as causing the disorder, says Beau Bruce, MD, a neuro-ophthalmology fellow at the Emory University School of Medicine and lead researcher for the study.

"The racial factor is purely just that," says Dr. Bruce. "Other factors such as differences in diagnosis, treatment or care don't seem to matter. We found that intracranial hypertension clearly affects black people more aggressively. This would tell us that ophthalmologists and others treating blacks need to monitor their vision very closely."

Timothy W. Olsen, MD, director of Emory Eye Center, says, "Dr. Bruce and colleagues have discovered an interesting association that warrants further investigation. Identification of the key risk factors certainly help clinicians in patient management."

Idiopathic intracranial hypertension has no known cause. Those affected may experience headache, ringing in the ears and vision problems. Blurriness and double vision are typical. This disease is most common in young, obese black women.

Seventeen years of records at Emory Eye Center were reviewed for the study. All patients in the study had intracranial hypertension. Of the 450 patients, 197 were black, 246 were white, five were Hispanic and two were Asian. The black patients were 3.5 times more likely to end of up severe vision loss in at least one eye. Further, they were five times more likely to become legally blind than the non-black patients.

Dr. Bruce notes that the black patients in his study did have other risk factors including weight (higher body mass index), higher frequency of low blood iron and higher pressures around the brain than other study participants. Vision loss in blacks could be explained somewhat by those factors, he says.

Research to Prevent Blindness, Inc. and the National Institutes of Health helped fund the study.

About Emory Eye Center - The Department of Ophthalmology and Emory Eye Center have a mission to conduct pioneering research into blinding eye diseases, to educate and train eye professionals, and to provide excellent patient care. The Department includes 23 ophthalmologists, seven optometrists, nine basic scientists, 11 post-doctoral fellows, and nine researchers in other Emory departments who hold joint appointments in the Department of Ophthalmology. Ophthalmology research is supported by $6 million in NIH funding. The Department has remained in the top rankings by U.S. News & World Report for the 11 years the magazine has held a ranking for Ophthalmology. For more information visit Emory Eye Center

Media Contact: Joy Bell jbell@emory.edu (404) 778-3711 WEB: The Woodruff Health Sciences Center of Emory University

Promoting seat belt use among black motorists

Nathaniel C. Briggs, M.D., M.Sc. Assistant Professor. Family & Community Medicine (615) 327-5502 Fax (Fax) 1005 Dr. D.B. Todd Boulevard. 2nd Floor, Old Hospital, Room D206, Nashville, TN 37208 nbriggs@mmc.edu. WED: Meharry Medical College - Faculty

New study investigates link between seat belt laws and racial disparities in seat belt use Seat belts reduce injuries and deaths in motor vehicle crashes, but previous studies have found that blacks buckle up significantly less often than whites. An article in the August issue of the American Journal of Preventive Medicine by researchers from Meharry Medical College may shed some new light on the racial disparity in seatbelt use, and how it could be eliminated.

Nathaniel C. Briggs, M.D. and his Meharry - State Farm Alliance research team found that racial differences in seatbelt use vary according to the type of seatbelt law enforced by individual states. In states with secondary seatbelt laws, where motorists can be cited for a seatbelt law violation only if stopped for another offense, blacks are significantly less likely to wear seatbelts than whites. In states with primary laws, where motorists can be stopped solely for not wearing a seat belt, the disparity disappears.

Although 49 states (all except New Hampshire) and the District of Columbia have seat belt laws, only 25 have primary laws. Therefore, Briggs et al. believe that, if the 24 states with secondary seatbelt laws upgraded to a primary law, the disparity in seat belt use between blacks and whites would be eliminated virtually throughout the country. In turn, this could lead to a reduction in the disproportionate number of motor vehicle crash-related injuries and deaths reported among blacks.

While two previous studies found that disparities in seatbelt use between black and white motorists were reduced under primary laws, the studies were limited in scope and the research was inconclusive.

Using data from the Fatality Analysis Reporting System (FARS), a U.S. population-based archive of information on motor vehicle crash fatalities maintained by the National Highway Traffic Safety Administration (NHTSA), investigators looked at seatbelt use among 11,574 black and 73,639 white occupants of passenger cars or light trucks who were aged 16 years and older and fatally injured in crashes between January 1, 1999 and December 31, 2003. In the 33 U.S. states with accurate reporting of decedent race, 7 states had primary seat belt laws, 22 states had secondary laws and an additional 4 states transitioned from secondary to primary laws during the study period.

Compared with secondary-law states, seat belt use in primary-law states was 18 percent higher among blacks and 15 percent higher among whites. In secondary-law states blacks are only 89 percent as likely as whites to use seatbelts, whereas in primary-law states blacks are 105 percent as likely as whites to buckle up. The low prevalence of seatbelt use in secondary law states is largely limited to urban areas, where blacks are only 75 percent as likely as whites to wear seatbelts. The black-white seatbelt use disparity in secondary law states also seems to be limited to motorists ages 16-29 and 50+. Regardless of state seat belt law, black-white seat belt use disparities were most marked at the extremes of driving age.

While it is unclear what accounts for the increased seatbelt use among black motorists in primary law states, Briggs et al. suggest that the findings may reflect concerns of blacks about the possibility of racial profiling, or differential enforcement, whereby law enforcement officers could selectively stop and cite minority motorists for seatbelt law violations.

The authors note that "The issue of differential enforcement has received little attention in the peer-reviewed literature, and should be addressed using methodologically robust epidemiologic studies. In the interim, however, the passage of primary seat belt laws, in conjunction with provisions or companion legislation to monitor and prevent racial profiling, appears to be justified given the possibility that we can achieve racial parity in motor vehicle crash mortality rates." ###

The article is "Seat belt Law Enforcement and Racial Disparities in Seat belt Use" by Nathaniel C. Briggs, M.D., M.Sc., David G. Schlundt, Ph.D., Robert S. Levine, M.D., Irwin A. Goldzweig, M.S., Nathan Stinson, Jr., M.D., Dr.P.H., and Rueben C. Warren, D.D.S., Dr.P.H.

The article appears in the American Journal of Preventive Medicine, Volume 31, Issue 2 (August 2006) published by Elsevier).

Contact: Charlotte Seidman eajpm@ucsd.edu 858-457-7292 American Journal of Preventive Medicine

Negative perception of blacks rises with more news watching, studies say

Caption: Communication professor Travis Dixon found in a pair of studies that the more people watched either local or network news, the more likely they were to draw on negative stereotypes about blacks. Credit: Photo by L. Brian Stauffer, U. of I. News Bureau. Usage Restrictions: Photo may be used only with stories about the research described in the news release. Please credit: Photo by L. Brian Stauffer, U. of I. News Bureau.

Watching the news should make you more informed, but it also may be making you more likely to stereotype, says a University of Illinois researcher. In a pair of recently published studies, communication professor Travis Dixon found that the more people watched either local or network news, the more likely they were to draw on negative stereotypes about blacks. Significantly, the effect was independent of viewers' existing racial attitudes, Dixon said. "We've shown that just watching the news – just news consumption alone – has an impact on one's stereotypical conceptions," he said. In other words, even among those who may think of themselves as largely prejudice-free, those who watch more local or network news are prone to more often see blacks as intimidating, violent or poor, Dixon said. The studies were published in successive March and June issues of the Journal of Communication. Each was based on data collected in a telephone survey of 506 Los Angeles County residents conducted from November 2002 through January 2003.

In related research, Dixon also is working on studies about stereotyping in the news coverage of Hurricane Katrina and of terrorism.

The study on local news, published in the March issue, built on prior research in several cities – Chicago, Philadelphia and Los Angeles among them – showing local TV news, particularly crime news, as almost always "racialized" in its portrayal of blacks and often other groups, Dixon said. One of the Los Angeles studies, conducted in the mid- to late 1990s, was led by Dixon, and analyzed the news content of individual stations.

In all of the analyses, Dixon said, blacks are overrepresented as perpetrators, whites are overrepresented as victims, and black-on-white crime is overrepresented relative to crime within racial groups. The overrepresentation is relative to police department crime statistics, not population.

"All of these things are inconsistent with what's really happening out there in the quote-unquote real world," Dixon said. "Some news reporters will say they're holding up this mirror (to the real world), but it's a distorted mirror."

Dixon, therefore, said he was not surprised by his findings that those in Los Angeles who watched more local news were more likely to draw on negative stereotypes about blacks. He even found that those who watched the stations that most overrepresented blacks as perpetrators, based on his earlier analysis, were more likely to use or believe those stereotypes.

(Dixon noted that though his analysis of local news content was a decade old, he had seen little evidence of significant change in the way those stations cover the news.)

Dixon is careful not to label either reporters or news consumers as inherently or overtly prejudiced or racist. Instead, he talks about how stereotypes get repeated and therefore reinforced in the mind, a process called "chronic activation." Those stereotypes then come more-readily to mind, consciously or unconsciously, when seeing or interacting with a member of that group, a process called "chronic accessibility."

Through much local television news, "we keep seeing these black perpetrators all the time, so that becomes more accessible and not other conceptions," Dixon said. As a result, any black male is more likely to be seen as potentially violent or a criminal, he said.

What did surprise Dixon, however, was seeing that network news broadcasts, not heavy on crime coverage, had a similar effect on viewers and their tendency to "access" stereotypes. The findings, which he found "disconcerting," contradicted his assumption that those who stayed well-informed through network news would be less prejudiced and hold fewer stereotypes of blacks.

In trying to explain the connection, he believes part of it may be in the way network news often "frames" an issue or topic, such as poverty or welfare, by finding individuals to focus on.

In doing so, they often fall back on stereotypes, he said. "Network news is more subtle, but it's still there."

In his survey, Dixon collected information on a number of factors that could influence stereotypical beliefs other than news-watching – such as gender, age, race, education, political ideology, income, racism, overall television exposure, newspaper exposure, neighborhood diversity and the community's crime rate.

His conclusions about the effect of news-watching came after taking all those factors into account through statistical analysis. "We found that more than a quarter of stereotypical beliefs can be explained just by how much news you watch," he said. If one assumes that respondents may suppress their honest feelings, given that the subject involves race, then the effect could be assumed to be even larger, he said.

Researchers often are careful to note that survey results showing strong associations between two factors – in this case, news-watching and stereotypical belief – do not necessarily mean that one causes the other. Dixon suggests that there may be a causal connection here, however, because his survey work builds on previous experiment-based research with college students, in which different groups were tested after watching different versions of news broadcasts.

The prior research "makes us more confident that what's happening here is causal and not just correlational," Dixon said.

"News viewers need to be empowered to know that media effects are real and that they need to be more conscious of the potential effects," Dixon said. "The fact is we still largely live in a segregated society, so our perceptions of other groups largely come through the media," he said.

"Viewers need to take a little bit more of an active role in demanding better coverage and turning off the tube when it's not good." ###

Contact: Craig Chamberlain cdchambe@illinois.edu 217-333-2894 University of Illinois at Urbana-Champaign

March on Washington for Jobs and Freedom (I Have a Dream) VIDEO

As far as black Americans were concerned, the nation's response to Brown was agonizingly slow, and neither state legislatures nor the Congress seemed willing to help their cause along. Finally, President John F. Kennedy recognized that only a strong civil rights bill would put teeth into the drive to secure equal protection of the laws for African Americans.

On June 11, 1963, he proposed such a bill to Congress, asking for legislation that would provide "the kind of equality of treatment which we would want for ourselves." Southern representatives in Congress managed to block the bill in committee, and civil rights leaders sought some way to build political momentum behind the measure.

A. Philip Randolph, a labor leader and longtime civil rights activist, called for a massive march on Washington to dramatize the issue.

He welcomed the participation of white groups as well as black in order to demonstrate the multiracial backing for civil rights. The various elements of the civil rights movement, many of which had been wary of one another, agreed to participate.The National Association for the Advancement of Colored People, the Congress of Racial Equality, the Southern Christian Leadership Conference, the Student Non-violent Coordinating Committee and the Urban League all managed to bury their differences and work together.

The leaders even agreed to tone down the rhetoric of some of the more militant activists for the sake of unity, and they worked closely with the Kennedy administration, which hoped the march would, in fact, lead to passage of the civil rights bill.

On August 28, 1963, under a nearly cloudless sky, more than 250,000 people, a fifth of them white, gathered near the Lincoln Memorial in Washington to rally for "jobs and freedom." The roster of speakers included speakers from nearly every segment of society -- labor leaders like Walter Reuther, clergy, film stars such as Sidney Poitier and Marlon Brando and folksingers such as Joan Baez. Each of the speakers was allotted fifteen minutes, but the day belonged to the young and charismatic leader of the Southern Christian Leadership Conference.

Dr. Martin Luther King Jr. had originally prepared a short and somewhat formal recitation of the sufferings of African Americans attempting to realize their freedom in a society chained by discrimination. He was about to sit down when gospel singer Mahalia Jackson called out, "Tell them about your dream, Martin! Tell them about the dream!" Encouraged by shouts from the audience, King drew upon some of his past talks, and the result became the landmark statement of civil rights in America -- a dream of all people, of all races and colors and backgrounds, sharing in an America marked by freedom and democracy.

For further reading: Herbert Garfinkel, When Negroes March: The March on Washington...(1969); Taylor Branch, Parting the Waters: America in the King Years, 1954-1963 (1988); Stephen B. Oates, Let the Trumpet Sound: The Life of Martin Luther King Jr. (1982). usinfo.state.gov

Audio in Real Media format Martin Luther King "I have a dream" - Digital Library SunSITE Manager: manager@sunsite.berkeley.edu The Library, 299 Evans Hall #6000, University of California, Berkeley USA 94720-0001. WEB: The Berkeley Digital Library SunSITE

"I HAVE A DREAM" (1963) TRANSCRIPT

I am happy to join with you today in what will go down in history as the greatest demonstration for freedom in the history of our nation.

Five score years ago, a great American, in whose symbolic shadow we stand today, signed the Emancipation Proclamation. This momentous decree came as a great beacon light of hope to millions of Negro slaves who had been seared in the flames of withering injustice. It came as a joyous daybreak to end the long night of their captivity.

But 100 years later, the Negro still is not free. One hundred years later, the life of the Negro is still sadly crippled by the manacles of segregation and the chains of discrimination. One hundred years later, the Negro lives on a lonely island of poverty in the midst of a vast ocean of material prosperity. One hundred years later, the Negro is still languished in the corners of American society and finds himself an exile in his own land. And so we've come here today to dramatize a shameful condition.

In a sense we've come to our nation's capital to cash a check. When the architects of our republic wrote the magnificent words of the Constitution and the Declaration of Independence, they were signing a promissory note to which every American was to fall heir. This note was a promise that all men - yes, black men as well as white men - would be guaranteed the unalienable rights of life, liberty, and the pursuit of happiness.

It is obvious today that America has defaulted on this promissory note insofar as her citizens of color are concerned. Instead of honoring this sacred obligation, America has given the Negro people a bad check, a check that has come back marked "insufficient funds."

But we refuse to believe that the bank of justice is bankrupt. We refuse to believe that there are insufficient funds in the great vaults of opportunity of this nation. And so we've come to cash this check, a check that will give us upon demand the riches of freedom and security of justice. We have also come to his hallowed spot to remind America of the fierce urgency of now. This is no time to engage in the luxury of cooling off or to take the tranquilizing drug of gradualism. Now is the time to make real the promises of democracy. Now is the time to rise from the dark and desolate valley of segregation to the sunlit path of racial justice. Now is the time to lift our nation from the quicksands of racial injustice to the solid rock of brotherhood. Now is the time to make justice a reality for all of God's children.

It would be fatal for the nation to overlook the urgency of the moment. This sweltering summer of the Negro's legitimate discontent will not pass until there is an invigorating autumn of freedom and equality. Nineteen sixty-three is not an end but a beginning. Those who hoped that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as usual. There will be neither rest nor tranquility in America until the Negro is granted his citizenship rights. The whirlwinds of revolt will continue to shake the foundations of our nation until the bright day of justice emerges.

But there is something that I must say to my people who stand on the warm threshold which leads into the palace of justice. In the process of gaining our rightful place we must not be guilty of wrongful deeds. Let us not seek to satisfy our thirst for freedom by drinking from the cup of bitterness and hatred. We must forever conduct our struggle on the high plane of dignity and discipline. We must not allow our creative protest to degenerate into physical violence. Again and again we must rise to the majestic heights of meeting physical force with soul force. The marvelous new militancy which has engulfed the Negro community must not lead us to a distrust of all white people, for many of our white brothers, as evidenced by their presence here today, have come to realize that their destiny is tied up with our destiny. And they have come to realize that their freedom is inextricably bound to our freedom. We cannot walk alone.

And as we walk, we must make the pledge that we shall always march ahead. We cannot turn back. There are those who are asking the devotees of civil rights, "When will you be satisfied?" We can never be satisfied as long as the Negro is the victim of the unspeakable horrors of police brutality. We can never be satisfied as long as our bodies, heavy with the fatigue of travel, cannot gain lodging in the motels of the highways and the hotels of the cities. We cannot be satisfied as long as the Negro's basic mobility is from a smaller ghetto to a larger one. We can never be satisfied as long as our children are stripped of their selfhood and robbed of their dignity by signs stating "for whites only." We cannot be satisfied as long as a Negro in Mississippi cannot vote and a Negro in New York believes he has nothing for which to vote. No, no we are not satisfied and we will not be satisfied until justice rolls down like waters and righteousness like a mighty stream.

I am not unmindful that some of you have come here out of great trials and tribulations. Some of you have come fresh from narrow jail cells. Some of you have come from areas where your quest for freedom left you battered by storms of persecution and staggered by the winds of police brutality. You have been the veterans of creative suffering. Continue to work with the faith that unearned suffering is redemptive.

Go back to Mississippi, go back to Alabama, go back to South Carolina, go back to Georgia, go back to Louisiana, go back to the slums and ghettos of our northern cities, knowing that somehow this situation can and will be changed.

Let us not wallow in the valley of despair. I say to you today my friends - so even though we face the difficulties of today and tomorrow, I still have a dream. It is a dream deeply rooted in the American dream.

I have a dream that one day this nation will rise up and live out the true meaning of its creed: "We hold these truths to be self-evident, that all men are created equal."

I have a dream that one day on the red hills of Georgia the sons of former slaves and the sons of former slave owners will be able to sit down together at the table of brotherhood.

I have a dream that one day even the state of Mississippi, a state sweltering with the heat of injustice, sweltering with the heat of oppression, will be transformed into an oasis of freedom and justice.

I have a dream that my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character.

I have a dream today.

I have a dream that one day down in Alabama, with its vicious racists, with its governor having his lips dripping with the words of interposition and nullification - one day right there in Alabama little black boys and black girls will be able to join hands with little white boys and white girls as sisters and brothers.

I have a dream today.

I have a dream that one day every valley shall be exalted, and every hill and mountain shall be made low, the rough places will be made plain, and the crooked places will be made straight, and the glory of the Lord shall be revealed and all flesh shall see it together.

This is our hope. This is the faith that I go back to the South with. With this faith we will be able to hew out of the mountain of despair a stone of hope. With this faith we will be able to transform the jangling discords of our nation into a beautiful symphony of brotherhood. With this faith we will be able to work together, to pray together, to struggle together, to go to jail together, to stand up for freedom together, knowing that we will be free one day.

This will be the day, this will be the day when all of God's children will be able to sing with new meaning "My country 'tis of thee, sweet land of liberty, of thee I sing. Land where my father's died, land of the Pilgrim's pride, from every mountainside, let freedom ring!"

And if America is to be a great nation, this must become true. And so let freedom ring from the prodigious hilltops of New Hampshire. Let freedom ring from the mighty mountains of New York. Let freedom ring from the heightening Alleghenies of Pennsylvania.

Let freedom ring from the snow-capped Rockies of Colorado. Let freedom ring from the curvaceous slopes of California.

But not only that; let freedom ring from Stone Mountain of Georgia.

Let freedom ring from Lookout Mountain of Tennessee.

Let freedom ring from every hill and molehill of Mississippi - from every mountainside.

Let freedom ring. And when this happens, and when we allow freedom ring - when we let it ring from every village and every hamlet, from every state and every city, we will be able to speed up that day when all of God's children - black men and white men, Jews and Gentiles, Protestants and Catholics - will be able to join hands and sing in the words of the old Negro spiritual: "Free at last! Free at last! Thank God Almighty, we are free at last!"

Distribution statement: Accepted as part of the Douglass Archives of American Public Address douglass.speech.nwu.edu on May 26, 1999. Prepared by D. Oetting nonce.com/oetting.

Permission is hereby granted to download, reprint, and/or otherwise redistribute this file, provided this distribution statement is included and appropriate point of origin credit is given to the preparer and Douglass.

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why MS affects African-Americans differently than Caucasians

Assistant Professor of Neurology, Professional Background: M.D., Medical College of Georgia, 2001. Office: 440 Sparks Center, 1720 7th Ave S, Birmingham AL 35294-0017. Phone: (205) 934-2402 / 996-2092. Email: rinkerj@uab.edu, FAX: (205) 975-6030. Personal Info: Dr. Rinker, a native of Charlotte, North Carolina, graduated from medical school and received his M.D. degree from the Medical College of Georgia in Augusta, Georgia. He completed a one-year internship in internal medicine in 2002 and a three-year neurology residency training program in June of 2005 at Barnes-Jewish Hospital, St. Louis, Missouri. Following his residency training, he worked under the mentorship of Dr. Anne Cross at Washington University School of Medicine for two years, completing a post-doctoral fellowship and mentored training program in clinical investigation in June of 2007. The Department of Neurology is pleased that he has accepted the position of Assistant Professor in the Division of Neuroimmunology and Multiple Sclerosis Center starting July 9, 2007.

New clue why MS affects African-Americans differently than Caucasians ST. PAUL, MN -- Differences in immune systems have been found in African Americans with multiple sclerosis (MS) compared to Caucasians, possibly offering a clue why African Americans experience more disability with MS than Caucasians, according to a study published in the July 3, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology. For the study, researchers compared levels of antibodies in the cerebrospinal fluid of 66 African Americans to 132 Caucasians with MS. The study found antibody levels in the cerebrospinal fluid of African Americans with MS were 29 percent higher than levels found in affected Caucasians. “The findings show that ethnic differences in MS extend to the immune response system, which plays a central role in MS,” said study author John R. Rinker, MD, with the Washington University School of Medicine in St. Louis, MO, and member of the American Academy of Neurology. Rinker says the reason for this biological difference is unknown, but may be related to differences in genetic background. “It remains possible that genes are unevenly distributed between ethnic groups to account for different susceptibility to some diseases,” said Rinker. “In MS, recent genetic studies have begun to identify certain genes which may explain why African Americans experience more disability, but the products of these genes and the mechanism of their effects remain unknown.” The study found that African Americans had MS for an average of nine years before needing a cane, walker, or wheelchair, compared to an average of 17 years for Caucasians. However, Rinker says the higher values of antibodies in African Americans did not predict an earlier need for help walking. ###

The American Academy of Neurology, an association of more than 20,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease, and multiple sclerosis.

Contact: Angela Babb ababb@aan.com 651-695-2789 American Academy of Neurology

Study: Common wisdom about troubled youth falls apart when race considered

Children playing singing games in Eatonville, Florida in 1935, Credit: Lomax, Alan. "African American Children Playing Singing Games, Eatonville, Florida." June 1935. Southern Mosaic: The John and Ruby Lomax 1939 Southern States Recording Trip, Library of Congress.

COLUMBUS, Ohio – One of the most widely accepted beliefs about the differences between troubled boys and girls may need to be revised, according to new research. Experts have long believed that girls tend to internalize their problems, becoming depressed or anxious, while boys externalize, turning to violence against people or property. But a new study found that this oft-repeated idea didn't hold true for African-American youth who were in the juvenile justice system. For them, whether they internalized or externalized depended not on gender, but on what was happening within their families. The results suggest more attention needs to be paid to the intersection of race, gender and family when it comes to dealing with troubled youth,

said Stephen Gavazzi, co-author of the study and professor of human development and family science at Ohio State University.

"If you look at most studies involving internalizing and externalizing among youth, they generally look at white, middle-class samples," Gavazzi said.

"Most research has not paid attention to race. And when studies do look at race, they are not likely to look at family and gender as well."

In this study, the results showed that Black girls and boys showed similar levels of externalizing and internalizing behavior, once family dysfunction was taken into account. In these families, boys and girls were more likely to show outward aggression if they lived in families with higher levels of dysfunction. Such a relationship was not found in white families.

"Family issues affect children in African-American families differently than they do in white families," Gavazzi said. "That is something that really hasn't been found before."

This study, published in the July 2008 issue of the Journal of Marital and Family Therapy, involved 2,549 youth who appeared before a juvenile court in five counties in Ohio.

The youth were assessed using a measure developed by Gavazzi and his colleagues called the Global Risk Assessment Device (GRAD). The measure is an internet-based assessment tool that asks youth a variety of questions to determine the risks they face for further problems in life.

GRAD asks about prior brushes with the law, family and parenting issues, substance abuse, traumatic events and a variety of other issues. For example, GRAD asks how often they get into fights with adults in their homes, if they have friends who have been in trouble with the law, and how much trouble they have in controlling their anger.

Gavazzi said it is not surprising that family issues affect African-American children differently than they do white children.

"Researchers who study ethnicity and culture have long noted the primacy of family for African Americans," he said. "That's telling us that families matter in a different way for African-American youth than what we're finding for whites."

Gavazzi said he and his colleagues are now trying to identify exactly what is different in African-American families that affects whether youth internalize or externalize problems, and how to best help them.

They are looking, for example, at issues such as family conflict and the amount of monitoring parents do of their children.

"We want to find out if there is some different constellation of things happening in African-American families that can explain some of our findings," he said. ###

Gavazzi conducted the study with Jennifer Bostic, program manager at the OSU Center for Family Research; Ji-Young Lim, assistant professor at Miami University of Ohio; and Courtney Yarcheck, program director of the OSU Center for Family Research.

Contact: Stephen Gavazzi, (614) 292-5620; Gavazzi.1@osu.edu, Written by Jeff Grabmeier, (614) 292-8457; Grabmeier.1@osu.edu, WEB: Ohio State University

Blacks Twice as Susceptible and More Likely to Die of Severe Sepsis Than Whites

Blacks Twice as Susceptible and More Likely to Die of Severe Sepsis Than Whites

Blacks have almost double the rate of severe sepsis—an overwhelming infection of the bloodstream accompanied by acute organ dysfunction—as whites, according to recent research.

“The difference in incidence was evident by age 20 and continued throughout the adult lifespan. After accounting for differences in poverty and geography, black race remained independently associated with higher severe sepsis incidence,” wrote lead authors Amber E. Barnato, M.D., M.P.H., M.S., of the Center for Research on Health Care at the University of Pittsburgh, and Sherri L. Alexander, Ph.D., of Genentech. Hispanics, on the other hand, have a lower incidence of severe sepsis than whites.

Assistant Professor of Medicine and Health Policy and Management. Associate Director, Clinical Scientist Training Program Office: 200 Meyran Ave. Suite 200. Pittsburgh, PA 15213. Phone: 412-692-4875 Fax: 412-246-6954 Email: barnatoae@upmc.edu

What is more, blacks die more frequently of severe sepsis that either whites or Hispanics. The findings appear in the first issue for February of the American Journal of Respiratory and Critical Care Medicine, published by the American Thoracic Society. Dr. Barnato and colleagues conducted a retrospective population-based analysis of race-specific incidence and ICU case fatality rates for hospital-based infection and severe sepsis in Florida, Massachusetts, New Jersey, New York, Virginia and Texas. They obtained demographic and socioeconomic data from the 2000 U.S. census and clinical data for hospitalized severe sepsis cases from the hospitals’ discharge data.

They compared incidence of severe sepsis, ICU admission and ICU case fatality among races, controlling for age and gender. The total analysis included more than 71 million people. “Blacks do indeed have a higher rate of severe sepsis—almost double that of whites,” wrote Dr. Barnato.

Sherri Alexander, Genentech outcomes/research group, accepting Specialty Award

“Some, but not all of this increase was explained by blacks’ more frequent residence in ZIP codes with higher poverty rates, suggesting that social, rather than biological determinants, such as health behavior and access to primary care, may contribute to this disparity,” Dr. Barnato continued. “In contrast, Hispanic ethnicity appeared protective, conditional on similar regional urbanicity and poverty.”

The investigators considered several possible explanations for their results, including racial variation in susceptibility to particular types of infections or organ dysfunction, and overall health at baseline. “However, the severe sepsis syndrome characteristics were not markedly different among the groups with respect to the site of infection, microbiologic etiology and both the number and type of organ dysfunction,” wrote Dr. Barnato. Furthermore, “the burden of chronic conditions among severe sepsis cases did not differ substantially across racial groups.”

One factor that clearly differed among groups was the type of hospital facilities in which patients received care.

Blacks were more likely to be treated at hospitals with poorer outcomes for severe sepsis than whites. “If a black and white patient with the same clinical characteristics were treated at the same hospital,they would have identical case survival rates,” said Dr. Barnato. “Therefore,” she continued, “it may be that the hospitals that treat most black patients see black and white patients who are sicker than we can measure using these data sources, and/or that these hospitals are providing lower quality care.”

The study could not rule out unmeasured underlying differences such as behavior, pharmaceutical use, healthcare resources and within-hospital variations in treatment by race that may have contributed to the differences in case fatality observed, nor could they dismiss the possibility of a biological basis for racial disparities in susceptibility and outcome of severe sepsis, which could have “potentially important implications for treating sepsis.”

Despite possible explanations for the racial disparities that could not be ruled out, Dr. Barnato points out that “the overall mortality disparity among blacks could be partially ameliorated by focused interventions to improve processes and outcomes of care at the hospitals that are disproportionately black.”

American Thoracic Society

Addressing resilience among black youth

Black children playing leap frog in a Harlem street, ca. 1930. 3O6-NT-171.611c.

APA task force calls for reframing research to address resilience among black youth. Positive feelings about race crucial for resilience and healthy development, according to new report WASHINGTON— African-American youth have proven they can bounce back after facing hardship and adversity,

yet the majority of studies on this population still focus on the negative outcomes of risk factors, according to a task force of the American Psychological Association.

A report released today by APA's Task Force on Resilience and Strength in Black Children and Adolescents calls for reframing research to better understand "how certain factors traditionally considered risk factors can be reconceptualized as adaptive or protective processes."

The seven-member task force reviewed 450 studies and surveys of African-American youth age 5 to 21 across all socioeconomic conditions and geographical areas to understand how factors such as racial identity, racial socialization, emotional regulation and expression, religiosity, and school and family support can prepare African-American children and adolescents to thrive in spite of various societal challenges.

The task force concluded that positive attitudes and behaviors that contribute to the strengths of these young people were de-emphasized in research and the current conceptions of African-American youth don't address healthy coping, adjustment and overall functioning. There is no clear template for how to ensure that African American children reach their full potential -- but there is hope, according to the task force. It called for future research to consider the complexities of racial, ethnic, and cultural factors as well as positive family environments and social support as key variables in identifying the "protective mechanisms" that are so important in promoting strength and resilience among African-American youth.

"Institutional racism and societal prejudice place all African-American youth, including well-resourced youth, at some degree of risk," said Stephanie Irby Coard, PhD, chair of the APA task force. "Understanding what makes them strong requires acknowledging their experience here in the United States and how discrimination affects their daily lives. The study of success is just as important as the study of failure."

Research has shown that diverse cultural groups have different ways of enhancing positive outcomes for their children. African-American family life often encompasses racial identity, spirituality, and a set of shared values that are crucial for children's resilience.

The report offered a portrait of thriving or optimal functioning for African American youth which encompasses four themes; active engagement, flexibility, communalism, and critical-mindedness. The report explored how these themes cut across five widely accepted developmental domains of functioning with the intent of providing researchers, policymakers, educators, practitioners, and the public with a useful lens through which to view African American youth:

Identity Development: Positive racial identity is essential to the well-being of African-American youth and they must be encouraged to develop a positive sense of self in a society that often devalues them through negative stereotypes.

Emotional Development: Coping with emotions effectively is directly related to self-esteem and better mental health. African-American youth need to be made aware of how their emotional expressions resonate across all situations and circumstances.

Social Development: Family and community interaction is crucial to these young people's social development, as is having access to high-quality child care, afterschool programs and religious institutions.

Cognitive Development: African-American youth must believe in their abilities in the classroom. Parents should avoid harsh parenting styles and schools should continue to look at ways to infuse culturally relevant themes into the classroom as a way to improve academic performance.

Physical Health and Development: A wide range of health conditions disproportionately affect African-American youth, including obesity, poor oral health, asthma, violent injury, sickle cell anemia, diabetes, and HIV/AIDS. Research has proven that improved physical health is more likely to lead to improved mental health as well. ###

Task force members:

Chair: Stephanie Irby Coard, PhD, University of North Carolina-Greensboro; Anne Gregory, PhD, University of Virginia; Yolanda Jackson, PhD, University of Kansas; Robert Jagers, PhD, University of Michigan; Le'Roy Reese, PhD, Morehouse School of Medicine; Caryn Rodgers, PhD, Johns Hopkins University; Anita Jones Thomas, PhD, Loyola University Chicago.

Full text of the APA Task Force report in PDF format is available from the APA Public Affairs Office and at apa.org/releases/RSBCAreport.pdf

or more information/interview contact Stephanie Coard, PhD, RSBCA Chair, at (336) 334-4666 or by email at sicoard@uncg.edu.

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 148,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting human welfare.

Contact: Audrey Hamilton ahamilton@apa.org 202-336-5706 American Psychological Association