A couple of common misconceptions about Hispanics were highlighted in talks by David E. Hayes-Bautista, Ph.D., who visited UAMS and the Clinton School of Public Service last week.
Hayes-Bautista, a distinguished professor of medicine from the University of California, Los Angeles, noted that Latinos are often incorrectly lumped with other minorities when health disparities are discussed.
Like other minorities, Hispanics have the commonly cited risk factors of lower income, low education and low access to health care. And yet, for many conditions, the health of Hispanics is just as good as whites and in some cases better. For example, Hispanics in the United States have a 30 percent lower rate of heart disease – the leading cause of death – than whites.
“Whoa, lower?” Hayes-Bautista asked during a presentation to UAMS faculty. “Shouldn’t it be higher?”
The same is true for cancer, the second leading cause of death. Hispanics nationally have a nearly 40 percent lower rate of cancer deaths than whites. In Arkansas, Hispanics have a 70 percent lower death rate from cancer.
Hayes-Bautista said Hispanics/Latinos bring healthy behaviors from their native countries. For example, the smoking rate among Hispanics is about half that of whites in Arkansas.
But those good behaviors are weakened in their U.S.-born children, who have higher rates of poor health behaviors.
For more than three decades he has studied the “Latino Epidemiological Paradox,” the tendency of Latino Americans to have health outcomes comparable to or better than their non-Hispanic white counterparts in the United States, and the implications of this paradox for populations, chronic diseases and communicable diseases.
Hayes-Bautista’s study of Hispanic culture and history led him to write the book El Cinco de Mayo: An American Tradition, a topic he presented at the Clinton School. The public event and reception was sponsored by the UAMS Translational Research Institute and the UAMS Center for Diversity Affairs, as well as the Clinton School.
Cinco de Mayo marks the Mexican military victory over the invading French army on May 5, 1862, but it’s more widely celebrated in the United States than in Mexico. The victory, he explained, prevented an alliance that would have benefited the Confederacy. Hispanics were against slavery and sided with the Union. The May 5 victory was the turning point in France’s attempt to create a monarchy over Mexico that would ally with the Confederacy. For U.S. Latinos from Mexico, the victory became a rallying cry for the Union.
In 1996, Cinco de Mayo got a U.S. postage stamp, and in 2005 it became an annual celebration in the White House and is now recognized widely across the country.
“If you ask these millions of people why are we celebrating, nobody knows. It’s just a party for some,” Hayes-Bautista said.
His talk at the Clinton School will be available soon at: http://www.clintonschoolspeakers.com.
Hayes-Bautista is also director of the Center for the Study of Latino Health and Culture at the UCLA David Geffen School of Medicine. For the past five years, he has been chosen one of the 101 Top Leaders of the Latino Community in the U.S. by Latino Leaders Magazine. In 2012, he received the Association of American Medical Colleges Herbert W. Nickens Award for his lifelong concerns about the educational, societal and health care needs of underrepresented groups.
Hayes-Bautista has written or edited nine books on Latino health and culture and is a frequent contributor of opinion pieces to major newspapers. He has published articles in journals ranging from Academic Medicine to Salud Pública de México. He has authored dozens of proposals for funded research projects, and has given hundreds of presentations to medical and lay communities and to government agencies concerned with the nation’s health care system. Some of his center’s research on the emergence of the Latino population and society in California during the Spanish colonial, Mexican Republic, and U.S. statehood periods appears in his recent book, El Cinco de Mayo: An American Tradition (U.C. Press, 2012).
Other co-sponsors of his two-day visit were the UAMS College of Pharmacy, Arkansas Center for Health Disparities in the UAMS Fay W. Boozman College of Public Health, League of United Latin American Citizens, and the Joel E. Anderson Institute on Race and Ethnicity at the University of Arkansas at Little Rock.
The Central Arkansas Chapter of the American Statistical Association (CASA) is sponsoring a one-day short course about the Analysis of Incomplete Data on Friday, April 28, 2017, from 9 a.m. – 4:30 p.m. in the College of Public Health building, room 8240.
Biased results and inefficient estimates are just some of the risks of incorrectly dealing with incomplete data, a common problem in applied research. This course will emphasize practical implementation of proposed strategies for dealing with missing data, including discussion of software to implement recommended procedures.
The instructor is Ofer Harel, Ph.D., professor of statistics at the University of Connecticut. Harel received his doctorate in statistics in 2003 from the Pennsylvania State University and post-doctoral training in biostatistics at the University of Washington. He has served as a biostatistical consultant nationally and internationally since 1997 and has been involved with a variety of research fields including Alzheimer’s, diabetes, nutrition, HIV/AIDS, and alcohol and drug abuse prevention.
The cost to attend the short course is $90 for CASA members, $100 for non-members, and $35 for full time students. Lunch is included in the registration fee. See printable registration form.
The registration fee may be paid by check with a check payable to Central Arkansas Statistical Association, credit card (send an email to James Selig firstname.lastname@example.org with the completed registration form and you will receive an invoice through PayPal that can be paid with a credit card), or by IDT (email the completed registration form to email@example.com with a note that you will be paying by IDT to Account #: 117-1003693, GL Code: 631400 and include the account to be charged).
To join the March 16 lecture at ACH via live streaming on your PC, MAC, iPad or iPhone:
- Visit www.archildrens.org/video
- Click on the Peds PLACE icon
- Click on the topic and date listed above (or search)
- If watching LIVE, remember that you can send in questions for the speaker
Tools should make life easier, and that applies to the tools researchers use accessing the Arkansas clinical Data Repository (AR-CDR), formerly the UAMS Enterprise Data Warehouse.
The AR-CDR has been a pillar of UAMS’ translational research infrastructure since its establishment in 2011 with support from the Translational Research Institute (TRI).
In 2015, UAMS leadership made improving researcher access to the AR-CDR a priority with the creation of the AR-CDR work group, led by Charlotte Hobbs, M.D., Ph.D., executive associate dean for research in the College of Medicine. The work group also included representatives from UAMS Information Technology, TRI, and the Department of Biomedical Informatics.
TRI, through its Clinical and Translational Science Award (CTSA) Consortium activities, discovered TriNetX, a federated clinical data network of providers, including pharmaceutical companies and contract research organizations (CROs), as well as 21 CTSA institutions. TriNetX presented to the work group, and TRI Director Laura James, M.D., and TRI Executive Program Manager Amy Jo Jenkins, M.S., led the effort to make UAMS part of the federated network, integrating it with the AR-CDR.
Jenkins organized an onboarding team of 16 people from TRI, the Department of Biomedical Informatics and UAMS Information Technology for acquiring and installing the network’s cohort estimation tool, establishing a security protocol, and training. “The work of our interdepartmental team was phenomenal,” Jenkins said. “UAMS had the fastest onboarding in the network’s history.”
The collaboration began in September, providing all UAMS researchers with three significant benefits:
- It includes a user-friendly search tool for exploring the rich clinical data repository as a preliminary step in developing clinical research studies.
- It helps match investigators with industry sponsored clinical trials.
- It can link cohort data at multiple network sites in the future.
Another key change recommended by the work group is the addition of the AR-CDR’s first director, Ahmad Baghal, M.D., who joined UAMS in October.
Baghal predicts the new search engine, the UAMS Research Cohort Estimation Tool, will be popular with researchers.
“We now have an intuitive cohort estimation tool; anybody can learn to use it in 10 minutes,” he said.
Apples to Apples
The primary tool for research cohort identification has been i2b2 (Integrating Biology and the Bedside). While it remains a component of AR-CDR, it has moved to the background with the UAMS Research Cohort Estimation Tool offering a self-service capability that provides researchers with deidentified aggregates for a study cohort.
“A nice feature of the new cohort estimation tool is the future ability to expand a study cohort by including other collaborating institutions in a query search. The good thing about the tool is that data received from different institutions are mapped to a single, unified ontology,” Baghal said.
Brad Martin, Ph.D., Pharm.D., gave the new system a trial run and came away impressed.
“Comparing the new query tool to the previous platform, i2b2, is kind of like comparing Windows to DOS,” said Martin, a professor in the UAMS College of Pharmacy. “The cohort estimation tool allows for an intuitive approach to understanding patterns in the data warehouse. One of the most impressive features of the new platform is that it allows users to build temporality into the queries. For example, users can build queries that require a diagnosis before some drug exposure or vice versa, which is critical for research and quality improvement analyses.”
The information researchers gather from their cohort estimation queries will help them determine whether to pursue additional, identifying data elements (e.g., demographics, procedures and diagnoses). To receive the identifiable data, researchers must seek IRB approval and submit a data request using the Request Services portal button on the TRI website (tri.uams.edu).
Additional information is also on the TRI website, including an online training tutorial. The Arkansas Clinical Data Repository (AR-CDR) page is in the main menu under Services, or simply type AR-CDR in the search field to find it.
In addition, Baghal will meet with research groups for more specialized training.
New Clinical Trial Opportunities
Another powerful feature of UAMS’ membership in the federated network is the abundance of new prospects for UAMS participation in industry sponsored clinical trials. The network serves as a matchmaker, helping the pharmaceutical industry identify researchers to conduct clinical trials.
“As members of the network, there are mutually beneficial opportunities for our researchers and the pharmaceutical industry looking for collaborators,” James said.
Jenkins has served as the liaison to industry sponsors looking for sites to run their clinical trials. After receiving an inquiry, she attempts to find an interested investigator through the UAMS Service Line research liaisons or the Rockefeller Cancer Institute. She facilitates the required confidentiality agreements and works with the sponsor to get their trial placed at UAMS.
Since becoming part of the network, UAMS has received 22 inquiries about clinical trial opportunities. UAMS faculty are pursuing clinical trials in stem cell transplantation, cytomegalovirus infection, pain management, irritable bowel disease, renal disease, diabetes and prostate cancer.
“The network collaboration is helping UAMS faculty be at the front end of clinical trial opportunities as trials are being rolled out from pharmaceutical sponsors,” James said. “It increases our visibility to the broader research industry, and that’s good for UAMS and our patients.”
The first SMART IRB webinar on April 12, 3:30 – 4:30 p.m., will provide an overview of the SMART IRB Online Reliance System, which will be available to researchers later this spring. UAMS is among the Clinical and Translational Science Award (CTSA) Consortium SMART IRB participating institutions.
The Online Reliance System is a unique tool that helps institutions establish and document single IRB review arrangements. By using this system:
- Investigators can create and submit requests to use a single IRB for their studies.
- Collaborating institutions can work together to identify a Reviewing IRB and track and document reliance arrangements on a study-by-study basis.
- Users have a clear understanding of next steps and are notified when action is required.
The webinar will be led by Nichelle Cobb, Ph.D., chief regulatory operations officer for Implementation for SMART IRB, and director of the Health Sciences IRBs Office at the University of Wisconsin-Madison.