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PART II: Doctors Find Ways to Stop African-American Resistance to Clinical Trials

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By Pharoh Martin, NNPA National Correspondent –

(NNPA) - One of history's most glaring violation of medical ethics occurred in Tuskegee, Ala. That was when federal researchers experimented on close to 400 impoverished African-American sharecroppers who suffered from syphilis. The experiments started in 1932 and lasted for 40 years.

Early in the study, researchers found that penicillin was an effective treatment for the disease; yet the U.S. Public Health Service purposely withheld the treatment from its Black participants for decades.

The fallout from that controversial study not only led to a total reform of medical ethics as well as an avalanche of new federal laws and regulations regarding protections for participants in clinical studies but that study and similar incidents shattered whatever trust the Black community had for such research.

“I can tell you as a researcher at a major university that that sort of thing is highly unlikely and almost impossible to happen now,” said Dr. Elijah Saunders, professor of cardiology and medicine at University of Maryland School of Medicine. “But to try to convince the Black public, especially many of the not very well educated part of the Black public, is still very difficult. That distrust is still out there and it still carries over.”

For many African-Americans, clinical trials run deep as a stigma. Their fear is of being turned into human guinea pigs or being recast in another experiment similar to Tuskegee.

According to Saunders research colleague, Dr. Stephen Liggett, professor of medicine at University of Maryland School of Medicine, even though there have been great advances in the field bioethics and protections for participants of clinical trials the general mistrust of the African-American community has led to an under-representation of Black participants in medical research, which can have a substantial effect on findings.

“We know the risk of having certain diseases and their response to therapy is dependent upon a person’s genetic makeup,” said Liggett, who works in pharmacogenetics, the relationship between a person’s genetic makeup and their response to drugs. “The African-American community represents a unique genetic makeup that must be considered when one is designing a clinical trial. For example, we would need to know if a treatment for high blood pressure really works to save lives in those of African descent, of Asian descent, of European descent, etc.

Otherwise, what will happen, and this is unfortunate, if a trial gets approved but doesn’t have proper ethnic representation, once it’s approved, it will be prescribed to everyone.”

Saunders has spent more than half of his 20 year career in research specifically working with African-Americans. He said that there are some cases where drugs may not work the same way in Blacks as they do in Whites. The change can show up as a side effect, as a different response to the drug or may even work at all.

"I don’t want you to think that this is extremely common but it’s common enough, especially in my area, I do studies and clinical trials in hypertension and high blood pressure,” Saunders said. One example that Saunders pointed out is regarding his research involving ACE inhibitors, a popular drug to treat high blood pressure. His research team found that these drugs don’t work the same for Black as it does for Whites.

They had to use a higher dose in order for it to be effective and even found a side effect in the form of a persistent severe cough that was found more consistently in Blacks more than with their White counterparts. Saunders, who is African-American and well-known in his Baltimore community, fortunately, does not have as hard of a time finding Black participants for his trials as other researchers.

He has developed a special way of recruiting participants from the African-American community. He carried a blood pressure program to community churches and barber shops. These church workers and barbers would be trained to screen local residents for high blood pressure and could refer them to doctors for treatment.

“It sounds simple but if Black people didn’t have that kind of screening readily available for them in the community they would never know that they had high-blood pressure,” said Saunders. Since the program started in 1985 thousands of people in Baltimore were referred, according to Saunders.

“High-blood pressure is so common and it’s killing so many Black people that every effort should be made to get them into clinical trials because the drugs is going to be used on them whether or not they are in the trials and the more researchers know about the drugs before it gets to market the safer it would be and probably the more effective it will be,” said Saunders.

“So we want to encourage Black people and let them know that the chances of them being hurt or being used as guinea pigs is almost nil in this day and time.” Africans-Americans suffer from high-blood pressure at a significantly higher rate than other racial groups. According to the Center for Disease Control, more than 44 percent of Black women suffer from hypertension compared to 28 percent of White women. The rates for Black and White men share a similar trend though not as great. Clinical trials are now regulated and approved by a governing body called the Institutional Review Board (IRB), which is empowered by the Food and Drug Administration and the Department of Health and Human Services.

Participants in clinical trials should only volunteer for IRB-approved studies, Liggett said. All sanctioned studies carry an IRB number that can be verified. Participants must see an informed consent document that must be read in-depth and understood before signed. "Read the informed consent document completely," Liggett advises. "If they have questions they should be able to have them readily answered by a physician before they sign the form. Anything that deviates from that should send up a red flag.” Federal guidelines stipulate that an informed consent form is written simply enough so that a person with a fourth or fifth grade education could read and understand it.

“The pendulum is just about where it need to be,” said Liggett. “You can go so far in one direction and you can never get anyone enrolled and it would be a bureaucratic problem from the beginning. But you don’t want it to be too loose and not give the patients the proper protections and informed content for a study. I think we are right where we need to be and that’s after many years of ethical discussions.”

Blacks, Latinos Hit Hardest Amidst Nation's Worst Foreclosure Crisis

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By Nisa Islam Muhammad, Special to the NNPA from the Final Call –

(NNPA) - Luis and Michelle Gonzalez wanted the American dream of home ownership. They shopped around and found an affordable house in a good neighborhood. Things were going fine until Gonzalez lost his job. Their dream has become a nightmare with foreclosure looming.

“I don't know how we got here,” said Michelle Gonzalez. “We could afford this home but the mortgage kept going up and up and up. I didn't know this was going to happen. We want our home but it may be too late.”

This family has joined the ranks of Latinos and Blacks in California experiencing significantly higher foreclosure rates than non-Hispanic borrowers in the state, according to first-of-its-kind research released in August by the Center for Responsible Lending.

California leads the United States in the worst foreclosure crisis since the Great Depression. Across the country, foreclosures have hit an all-time high, with nearly 1 in 10 homes with a mortgage currently in some stage of foreclosure.

In the Golden State, nearly 1 in 8—or approximately 702,000—homes is currently in foreclosure, the economy is in ruins and unemployment stands at 12 percent and higher in Latino and Black communities.

These groups represent more than half of all foreclosures, with 48 percent of foreclosures hitting Latinos and 8 percent hitting Blacks.These borrowers were more likely to receive higher-cost subprime mortgages with loan terms that typically increased the risk of default, compared with safer loans made to similarly situated non-Hispanic White borrowers.

“Whether we are from Los Angeles or Modesto, all Californians are severely impacted by the foreclosure crisis,” said Paul Leonard, director of the Center for Responsible Lending California office.“We need solutions now that ease the pain everywhere.” His office has been at the forefront of efforts to respond to the state's foreclosure crisis.

The report, “Dreams Deferred: Impacts and Characteristics of the California Foreclosure Crisis,” analyzed more than 600,000 foreclosures in the state and also found that over three-quarters of all California foreclosures were on relatively modest properties, not “McMansions” as often believed.

Additionally, while major cities like Los Angeles and Sacramento have suffered the greatest number of foreclosures, communities in the Central Valley and Inland Empire have been severely harmed by high concentrations of foreclosures.

The report explains multifaceted damages to families from foreclosures. First, the disruption and upheaval associated with being evicted from one's home, and the effects this displacement can have on a family's education, health and employment, are significant.

“Where will we live now? Where will my children go to school? I don't have answers. This is so terrible,” said Luis Gonzalez.

Second is the loss of homeownership and the tax benefits and wealth that historically have accompanied it. Homeownership has been the primary source of economic mobility and financial security in this country, as home equity is often tapped to start a new business, pay for higher education and secure retirement.

In addition, home equity provides a financial cushion against unexpected financial hardships, such as job loss, divorce or medical expenses. Homeownership is also the primary means by which wealth is transferred to future generations.

The foreclosure crisis threatens the financial stability and mobility of families across the country, not just now but also into the future. Further, in addition to the individuals and families who lose their homes to foreclosure, nearby homeowners are affected when they experience depreciated home values, as are communities, which suffer the financial and non-financial consequences of abandoned properties and neighborhood blight.

“NCLR has sounded the alarm for the last two years about the devastating impact foreclosures have had on communities of color, but this report reveals a shocking level of concentration among Latino homeowners in California,” said Janet Murguía, president and CEO of the National Council of La Raza, a Latino rights group.

“Dishonest brokers peddled their high-cost loans, steered our families into risky products designed to fail and now Latinos and all of California are paying the price.”

The report provides policy recommendations to reduce unnecessary foreclosures:

Require servicers to complete the review of loan modification applications before beginning the foreclosure process.This is the central feature of California bill SB 1275 which will be considered by the full California Assembly this week before being sent to the governor.

Incorporate principal reduction into loan modification programs, especially where housing prices have contributed to a lack of affordability.

Lift the ban on judicial modification of principal residence mortgages by bankruptcy judges.

Expand funding and capacity of housing counseling agencies and legal aid providers.

Survey: Most 'Re-employed' Workers Say They're Overqualified for New Job

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Special to the NNPA from the Louisiana Weekly –

(NNPA) - Workers who suffered a spell of un em ployment during Great Recession are, on average, less satisfied with their new jobs than workers who didn't. These re-employed workers are more likely to consider themselves over-qualified for their current position. And six-in-ten say they changed careers or seriously thought about it while they were unemployed, according to a recent survey from the Pew Research Center's Social and Demographic Trends project.

An estimated 26 percent (or 36 million) of the 139 million currently em ployed workers in the United States suffered at least one spell of unemployment during the Great Recession that began in December, 2007.

For these re-employed workers, the Great Recession has been a financial and emotional roller coaster ride, according to a nationally representative survey of 2,967 conducted from May 11 to May 31, 2010. A majority of the re-employed (55 percent) report their family is worse off financially now than before the recession started. More than a third (35%) report they have had to make major changes in their lifestyle because of the bad economy; by contrast, just 20 percent of Americans who didn't lose their job during the recession say the same.

Comparing Past, Present Jobs

According to the survey, somewhat less than half (45 percent) of re-employed workers lost a full-time job but then found full-time work during the recession. An additional 14 percent moved laterally from one part-time job to another.

At the same time, about one-in-eight re-employed workers (13 percent) moved from part-time to full-time employment. While the sample is too small to say with certainty, this group of new full-time workers is dominated by young people, suggesting that many may have gotten their first "real" job. But for one-in-four re-employed workers, the recession likely marks a backward step in their careers. Fully 26 percent of re-employed workers used to have a full-time job and now work part-time.

Employed workers who had been out of work during the recession are somewhat less satisfied with their present jobs than their colleagues who were not unemployed during the recession. Nearly 78 percent of all workers who lost a job during the downturn say they are satisfied with their current job. That is 11 percentage points lower than the satisfaction levels of workers who did not experience a spell of unemployment.

Nor do the re-employed get the same sense of fulfillment from their current jobs as their colleagues who did not lose a job. About four in 10 workers (39 percent) who experienced job loss during the recession say they get a sense of identity from their current position. For the remainder, their job is just what they do to put bread on the table. In contrast, more than half (52 percent) of all workers who did not lose their jobs during the recession get a sense of identity from their jobs.

Other findings in this survey suggest re-employed workers may have settled for the best-available job in an anemic job market. A majority of re-employed adults (54 percent) say they are overqualified for their current job, compared with 36 percent of other workers. Only a third report they have the right qualifications for their new job, more than 20 percentage points lower than the proportion of workers who did not lose their job.

Not surprisingly, among adults who lost a full-time job, those who found another full-time position are significantly more positive about their new job than those who accepted part-time employment (46 percent vs. 24 percent).

More than eight in 10 (82 percent) full-time to full-time workers also say they are satisfied with their job (82 percent), nearly as high a job satisfaction level as among all workers. In contrast, about seven-in-ten (72 percent) workers who lost full-time jobs and now work part-time are satisfied with their job.

Full-time to full-time workers also are more likely than part-timers to say they get a sense of identity from their current job (48 percent vs. 34 percent).

Career Changes

Many re-employed workers spent the time they were out of work reconsidering their job and career options. According to the survey, about four in 10 re-employed workers (39 percent) say that when they were unemployed they moved or seriously considered moving to an area where jobs were more plentiful. About six in 10 changed careers or contemplated doing so, while 36 percent sought job retraining programs or went back to school.

Taken together, the survey finds that three-quarters of all re-employed workers took one of the three steps or thought seriously about doing so-and nearly half (45 percent) at least did or considered doing two or more options.

Men and younger workers are significantly more likely than other workers to have contemplated making major changes in their working lives to get a job when they were out of work.

According to the survey, re-employed men are significantly more likely than re-employed women to say they seriously thought about moving or actually moved to a new area where jobs were more plentiful (45 percent vs. 31 percent). A somewhat larger share of these working men also report they had pursued a job retraining program or more formal education (39 percent vs. 33 percent) while unemployed. But the same share of men and women (60%) report that while they were unemployed, they changed careers or seriously thought about going into a new field.

Among re-employed workers ages 18 to 29, nearly half (47 percent) say they considered picking up stakes and moving to where the jobs were, compared with 22 percent of those 50 or older.

Those age differences are not surprising in that young adults are the least likely to be married, have a family, own a house or have other characteristics that tend to keep people anchored in their current communities.

Among the re-employed, younger workers also are more likely than older adults to report having pursued job retraining or having sought more schooling to help them find a job (44 percent for those 18 to 29 vs. 26 percent for workers 50 or older).

Younger workers are less likely than the older re-employed to say they considered abandoning their occupations while they were jobless - perhaps because they have not yet chosen their life's work. Overall, more than half (55 percent) of those ages 18 to 29 say they switched careers or seriously thought about doing so. That compares with 65 percent of those ages 30 to 49 and 62 percent who are 50 or older.

But what about those who found work after periods of unemployment? How good were the jobs they ultimately found? The survey suggests that reality roughly comports with the expectations of job seekers.

When the "re-employed" - those currently working who were unemployed sometime during the recession-were asked about their new jobs, striking differences emerged by the length that an individual was out of work.

Overall, about three-quarters of the re-employed say their current job is either better than their former job (43 percent) or about as good (30 percent). Only 24 percent say it's worse. But these results differ dramatically by duration of unemployment. By more than a three-to-one ratio, those out of work for less than six months say their new job is better than say it is worse (53 percent vs. 17 percent).

The verdict is more measured among those who were jobless six months or longer. Among this group, about three-in-ten (30 percent) say their new job is worse, while 36 percent.

Embattled Rwandan Leader Sworn-in

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Special to the NNPA from GIN –

(GIN) – Despite fierce criticism by rights groups and the foreign press for suppressing political opposition and freedom of speech, Rwandan President Paul Kagame was sworn-in for his final term in the company of more than a dozen African leaders and distinguished guests.

Addressing a large crowd of Rwandans and more than a dozen African heads of state, Kagame said he would not succumb to lessons from self-proclaimed critics, including human rights organizations, NGOs and the media.

Kagame said that despite the fact that African governments do what every credible government is expected to do, they are often accused of being corrupt and not responsive to the needs of their populations.

“These external actors turn around and promote the dangerous ideas of those who have fallen out with the system, ignoring the choices of the majority of our people … it is evidence of hypocrisy and a patronizing attitude towards our entire continent,” the President added.

“We need to continue to govern effectively, provide expected public goods and empower our citizens,” he said.

Kagame was sworn in for a second seven-year term after winning the Aug. 9 presidential elections with an overwhelming 93 per cent of the popular vote.

Attending the ceremony were presidents Goodluck Jonathan of Nigeria, Joseph Kabila of the DRC, Idriss Deby of Chad, and Ellen Johnson-Sirleaf of Liberia. Also, the presidents of Kenya, Congo-Brazzaville, Burkina Faso, Gabon, Zambia, Central African Republic, Togo, Benin and Ethiopia. The UN secretary-general was represented by economist Jeffrey Sachs. w/pix of Pres. Paul Kagame holding Constitution.

Text Message Sparks Major Strike Against Price Hikes in Mozambique

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Special to the NNPA from GIN –

(GIN) – In another sign of the power of new technologies, a simple SMS message to cellphone users in Mozambique’s capital city Maputo brought thousands of citizens to the streets to protest soaring cost of living increases.

The anonymous SMS message read: "Mozambican, prepare yourself to enjoy the great day of the strike… Let's protest the increase in energy, water, mini-bus taxi and bread prices. Send to other Mozambicans."

On Sept. 1, residents of poor neighborhoods responded, breaking store windows, vandalizing banks and setting up barricades with rubber tires. Police responded with rubber bullets and live fire. Over 286 were arrested, 400 were wounded and 13 left for dead in the clashes.

In a press interview with French news agency AFP, Samira, a 35-year-old who lives in Mafalala, a zone of tin shacks on the edge of Maputo, said, ”That message went around to the whole world... Even me, when I saw the message I forwarded it to other people. To my friends, my sister. 'I'm asking you, please read this message'."

At first, Members of Cabinet insisted that the price increases were "irreversible", but more SMSes circulated criticizing the government's response.

"Mozambicans, the government appears to have met just for a coffee and whiskey and not to resolve the problems of the people," said one message.

Joao Pereira, a lecturer at Eduardo Mondlane University, Mozambique, said cellphone technology was giving the poor a voice in politics in a country with a weak opposition, and where the media is dominated by the state-owned newspaper and television station.

"This technology is a new way of giving a voice, of giving power, of giving a means of expression that poor people themselves don't have,"

After an emergency meeting this week, the Cabinet reversed course and agreed to cancel the bread price hike, scale back an increase in electric bills, and withdraw increases in water prices.

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BVN National News Wire