Most long-term survivors retrospectively report that cancer either positively influenced their lives or had little long-term impact. Those who express Resentment report that pain, physical deformities, and social isolation significantly reduced their QOL. This qualitative study highlights how cancer survivors incorporate the cancer experience within their overall lives.
Minority and low socioeconomic status women are under-represented in clinical research due to logistical, informational, attitudinal, and sociocultural barriers. The primary objective of this study was to explore factors associated with research participation among African American and low socioeconomic status White women using the Theory of Planned Behavior. A secondary goal was to assess differences in barriers to research participation by age and race. A combination of qualitative (focus groups) and quantitative (trust scale) methodologies was employed. Ten focus groups were held, organized by age and race. Content analysis revealed three predominant themes: fear, distrust, and hope. Older women had higher trust; there was no difference in trust by race. The results suggest that women have conflicting feelings about research that cross ethnic lines and should be addressed by researchers. Effective strategies for overcoming barriers and increasing representation are those that establish ongoing relationships with relevant communities.
OBJECTIVE -The objective of this study was to determine the association between smoking and incident diabetes among U.S. adults. RESEARCH DESIGN AND METHODS -The Insulin Resistance AtherosclerosisStudy (IRAS) was a prospective study of the associations of insulin sensitivity and cardiovascular risk factors. We examined the relationship between smoking status categories (never, former, and current) and incident 5-year type 2 diabetes among 906 participants free of diabetes at baseline. We also considered the effect of pack-year categories (never, former Ͻ20 pack-years, former Ն20 pack-years, current Ͻ20 pack-years, and current Ն20 pack-years) upon diabetes incidence.RESULTS -Of current smokers, 96 (25%) developed diabetes at 5 years, compared with 60 (14%) never smokers. After multivariable adjustment, current smokers exhibited increased incidence of diabetes compared with never smokers (odds ratio [OR] 2.66, P ϭ 0.001). Similar results were found among current smokers with Ն20 pack-years with normal glucose tolerance (5.66, P ϭ 0.001).CONCLUSIONS -Smoking shares a robust association with incident diabetes, supporting the current Surgeon General's warnings against cigarette smoking. Diabetes Care 28:2501-2507, 2005C igarette smoking exacts an indisputable and devastating toll on public health. Diabetes also presents a formidable public health burden (1), and its prevalence is expected to increase dramatically by the year 2025 (2). Although cigarette smoking has been established as a risk factor for cardiovascular disease, its association with type 2 diabetes is less clear. Exploring this relationship is prudent because diabetes and cardiovascular disease share many risk factors, including older age, upper body fat distribution, and physical inactivity (3,4).Several (5-7) but not all (8,9) prospective, population-based studies have demonstrated that cigarette smoking is associated with an increased risk of diabetes. However, as Eliasson notes in his review (10), many studies have relied upon self-report of glucose tolerance status and anthropometric measures. Also, although the prevalence of diabetes is higher among women, African Americans, and Hispanic Americans (11), most studies have been conducted largely among white men. Finally, the degree to which the relationship between cigarette smoking and incident diabetes is dosedependent is not conclusive.In consideration of these issues, the purpose of this investigation was to determine the association between smoking and incidence of diabetes among participants in the Insulin Resistance Atherosclerosis Study (IRAS). The IRAS sample provides an excellent opportunity to examine this relationship in a cohort with equal representation according to sex and three ethnic groups, while using repeated direct and standardized measures of glucose tolerance, blood pressure, and anthropometric measures.RESEARCH DESIGN AND METHODS -Briefly, the major purpose of IRAS was to assess the crosssectional and prospective relationships between insulin resistance and clinical and subcl...
The next step is to develop culturally appropriate educational interventions that increase knowledge about breast cancer and screening guidelines, enhance health-related social support, and address barriers and perhaps cancer fatalism in older, low-income, African American women.
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