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Arundell LLC, Saunders R, Buckman JEJ, Lewis G, Stott J, Singh S, Jena R, Naqvi SA, Leibowitz J, Pilling S. Differences in psychological treatment outcomes by ethnicity and gender: an analysis of individual patient data. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02610-8. [PMID: 38321296 DOI: 10.1007/s00127-024-02610-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/01/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE There are discrepancies in mental health treatment outcomes between ethnic groups, which may differ between genders. NHS Talking Therapies for anxiety and depression provide evidence-based psychological therapies for common mental disorders. This study examines the intersection between ethnicity and gender as factors associated with psychological treatment outcomes. Aims were to explore by gender: (1) differences in psychological treatment outcomes for minoritized ethnic people compared to White-British people, (2) whether differences are observed when controlling for clinical and socio-demographic factors associated with outcomes, and (3) whether organization-level factors moderate differences in outcomes between ethnic groups. METHODS Patient data from eight NHS Talking Therapies for anxiety and depression services (n = 98,063) was used to explore associations between ethnicity and outcomes, using logistic regression. Stratified subsamples were used to separately explore factors associated with outcomes for males and females. RESULTS In adjusted analyses, Asian (OR = 0.82 [95% CI 0.78; 0.87], p < .001, 'Other' (OR = 0.79 [95%CI 0.72-0.87], p < .001) and White-other (0.93 [95%CI 0.89-0.97], p < .001) ethnic groups were less likely to reliably recover than White-British people. Asian (OR = 1.48 [95% CI 1.35-1.62], p < .001), Mixed (OR = 1.18 [95% CI 1.05-1.34], p = .008), 'Other' (OR = 1.60 [95% CI 1.38-1.84], p < .001) and White-other (OR = 1.18 [95% CI 1.09-1.28], p < .001) groups were more likely to experience a reliable deterioration in symptoms. Poorer outcomes for these groups were consistent across genders. There was some evidence of interactions between ethnic groups and organization-level factors impacting outcomes, but findings were limited. CONCLUSIONS Across genders, Asian, 'Other' and White-other groups experienced worse treatment outcomes across several measures in adjusted models. Reducing waiting times or offering more treatment sessions might lead to increased engagement and reduced drop-out for some patient groups.
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Affiliation(s)
- Laura-Louise C Arundell
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK.
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK.
| | - Rob Saunders
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
| | - Joshua E J Buckman
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Glyn Lewis
- Division of Psychiatry, University College London, London, W1T 7NF, UK
| | - Joshua Stott
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- ADAPT Lab, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
| | - Satwant Singh
- Waltham Forest Talking Therapies, North-East London NHS Foundation Trust, London, UK
| | - Renuka Jena
- Waltham Forest Talking Therapies, North-East London NHS Foundation Trust, London, UK
| | | | - Judy Leibowitz
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
| | - Stephen Pilling
- CORE Data Lab, Centre for Outcomes Research and Effectiveness, Research Department of Clinical, Educational and Health Psychology, University College London, Gower Street, London, UK
- National Collaborating Centre for Mental Health, Royal College of Psychiatrists, London, UK
- iCope, Camden and Islington Psychological Therapies Services, Camden and Islington NHS Foundation Trust, London, UK
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Su D, Yang H, Chen Z, Kong Y, Na X, Lin Q, Zhao A, Zheng Y, Ma Y, Li X, Li Z. Ethnicity-specific blood pressure thresholds based on cardiovascular and renal complications: a prospective study in the UK Biobank. BMC Med 2024; 22:54. [PMID: 38317131 PMCID: PMC10845677 DOI: 10.1186/s12916-024-03259-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 01/15/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The appropriateness of hypertension thresholds for triggering action to prevent cardiovascular and renal complications among non-White populations in the UK is subject to question. Our objective was to establish ethnicity-specific systolic blood pressure (SBP) cutoffs for ethnic minority populations and assess the efficacy of these ethnicity-specific cutoffs in predicting adverse outcomes. METHODS We analyzed data from UK Biobank, which included 444,418 participants from White, South Asian, Black Caribbean, and Black African populations with no history of cardiorenal complications. We fitted Poisson regression models with continuous SBP and ethnic groups, using Whites as the referent category, for the composite outcome of atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease. We determined ethnicity-specific thresholds equivalent to the risks observed in Whites at SBP levels of 120, 130, and 140 mm Hg. We adjusted models for clinical characteristics, sociodemographic factors, and behavioral factors. The performance of ethnicity-specific thresholds for predicting adverse outcomes and associated population-attributable fraction (PAF) was assessed in ethnic minority groups. RESULTS After a median follow-up of 12.5 years (interquartile range, 11.7-13.2), 32,662 (7.4%) participants had incident composite outcomes. At any given SBP, the predicted incidence rate of the composite outcome was the highest for South Asians, followed by White, Black Caribbean, and Black African. For an equivalent risk of outcomes observed in the White population at an SBP level of 140 mm Hg, the SBP threshold was lower for South Asians (123 mm Hg) and higher for Black Caribbean (156 mm Hg) and Black African (165 mm Hg). Furthermore, hypertension defined by ethnicity-specific thresholds was a stronger predictor and resulted in a larger PAF for composite outcomes in South Asians (21.5% [95% CI, 2.4,36.9] vs. 11.3% [95% CI, 2.6,19.1]) and Black Africans (7.1% [95% CI, 0.2,14.0] vs. 5.7 [95% CI, -16.2,23.5]) compared to hypertension defined by guideline-recommended thresholds. CONCLUSIONS Guideline-recommended blood pressure thresholds may overestimate risks for the Black population and underestimate risks for South Asians. Using ethnicity-specific SBP thresholds may improve risk estimation and optimize hypertension management toward the goal of eliminating ethnic disparities in cardiorenal complications.
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Affiliation(s)
- Donghan Su
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Huanhuan Yang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Zekun Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuhao Kong
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Xiaona Na
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Queran Lin
- Clinical Research Design Division, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ai Zhao
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Xiaoyu Li
- Department of Sociology, Tsinghua University, Beijing, China
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing, China.
- Institute for Healthy China, Tsinghua University, Beijing, China.
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Abdurashidova T, Müller M, Schukraft S, Soborun N, Pitta‐Gros B, Kikoïne J, Lu H, Chazymova Z, Dzhorupbekova K, Beishenkulov M, Tzimas G, Kirsch M, Vollenweider P, Mean M, Monney P, Hullin R. European Society of Cardiology guidelines and 1 year outcomes of acute heart failure treatment in Central Asia and Europe. ESC Heart Fail 2024; 11:483-491. [PMID: 38059306 PMCID: PMC10804142 DOI: 10.1002/ehf2.14591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/07/2023] [Indexed: 12/08/2023] Open
Abstract
AIMS Outcomes reported for patients with hospitalization for acute heart failure (AHF) treatment vary worldwide. Ethnicity-associated characteristics may explain this observation. This observational study compares characteristics and 1-year outcomes of Kyrgyz and Swiss AHF patients against the background of European Society of Cardiology guidelines-based cardiovascular care established in both countries. METHODS AND RESULTS The primary endpoint was 1 year all-cause mortality (ACM); the secondary endpoint was 1 year ACM or HF-related rehospitalization. A total of 538 Kyrgyz and 537 Swiss AHF patients were included. Kyrgyz patients were younger (64.0 vs. 83.0 years, P < 0.001); ischaemic or rheumatic heart disease and chronic obstructive pulmonary disease were more prevalent (always P < 0.001). In Swiss patients, smoking, dyslipidaemia, hypertension, and atrial flutter/fibrillation were more frequent (always P ≤ 0.035); moreover, left ventricular ejection fraction (LVEF) was higher (47% vs. 36%; P < 0.001), and >mild aortic stenosis was more prevalent (P < 0.001). Other valvular pathologies were more prevalent in Kyrgyz patients (P < 0.001). At discharge, more Swiss patients were on vasodilatory treatment (P < 0.006), while mineralocorticoid receptor antagonists (P = 0.001), beta-blockers (P = 0.001), or loop diuretics (P < 0.001) were less often prescribed. In Kyrgyz patients, unadjusted odds for the primary and secondary endpoints were lower [odds ratio (OR) 0.68, 95% confidence interval (CI): 0.51-0.90, P = 0.008; OR 0.72, 95% CI: 0.56-0.91, P = 0.006, respectively]. After adjustment for age and LVEF, no difference remained (primary endpoint: OR 1.03, 95% CI: 0.71-1.49, P = 0.894; secondary endpoint: OR 0.82, 95% CI: 0.60-1.12, P = 0.206). CONCLUSIONS On the background of identical guidelines, age- and LVEF-adjusted outcomes were not different between Central Asian and Western European AHF patients despite of large ethnical disparity.
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Affiliation(s)
- Tamila Abdurashidova
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
| | - Martin Müller
- Department of Emergency MedicineUniversity Hospital of Bern, University of BernBernSwitzerland
| | - Sara Schukraft
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
| | - Nisha Soborun
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
| | - Barbara Pitta‐Gros
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
| | - John Kikoïne
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
| | - Henri Lu
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
| | - Zalina Chazymova
- Cardiac Care UnitNational Center of Cardiology and Internal MedicineBishkekKyrgyzstan
| | - Kanzaada Dzhorupbekova
- Department of StatisticsNational Center of Cardiology and Internal MedicineBishkekKyrgyzstan
| | - Medet Beishenkulov
- Cardiac Care UnitNational Center of Cardiology and Internal MedicineBishkekKyrgyzstan
| | - Georgios Tzimas
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
| | - Matthias Kirsch
- Division of Cardiac Surgery, Cardiovascular DepartmentLausanne University Hospital, University of LausanneLausanneSwitzerland
| | - Peter Vollenweider
- Department of Internal MedicineLausanne University Hospital, University of LausanneLausanneSwitzerland
| | - Marie Mean
- Department of Internal MedicineLausanne University Hospital, University of LausanneLausanneSwitzerland
| | - Pierre Monney
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
| | - Roger Hullin
- Division of Cardiology, Cardiovascular DepartmentLausanne University Hospital, University of LausanneRue du Bugnon 461001LausanneSwitzerland
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104
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Cattaneo C, Kulisevsky J. The Effects of Safinamide in Chinese and Non-Chinese Patients with Parkinson's Disease. Adv Ther 2024; 41:638-648. [PMID: 38070039 PMCID: PMC10838837 DOI: 10.1007/s12325-023-02736-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/09/2023] [Indexed: 02/06/2024]
Abstract
INTRODUCTION Ethnicity differences are an important determinant in the clinical manifestation of Parkinson's disease (PD), but they are not yet widely recognized, particularly regarding the response to dopaminergic medications. The aim of this paper is to analyze the efficacy and safety of safinamide in Chinese patients with PD in the pivotal studies SETTLE and XINDI compared to the non-Chinese population of the SETTLE trial. METHODS SETTLE (NCT00627640) and XINDI (NCT03881371) were phase III, randomized, double-blind, placebo-controlled, multicenter trials. Patients received safinamide or placebo as add-on to levodopa. The primary efficacy endpoint was the change in the mean total daily OFF time. Secondary efficacy endpoints included total daily ON time, ON time with no/non-troublesome dyskinesia, Unified Parkinson's Disease Rating Scale, and Parkinson's Disease Questionnaire-39 items. Safety was evaluated through the frequency of adverse events. Data from 440 non-Chinese and 109 Chinese patients in the SETTLE study, and 305 Chinese patients in the XINDI trial were considered for this post hoc analysis. RESULTS Significant positive results were seen in favor of safinamide in all populations for the primary and secondary endpoints, with no differences in terms of magnitude. No "treatment by ethnicity" interaction was detected for any parameters, confirming the homogeneity of treatment effects between different populations. The safety and tolerability of safinamide in Chinese patients were similar to those in the other ethnic groups, without unexpected adverse reactions. CONCLUSIONS Safinamide was shown to improve PD symptoms and quality of life in different ethnic populations, without any treatment by race interaction. Further studies are warranted to investigate potential differences in a real-life situation. TRIAL REGISTRATION NUMBER SETTLE (NCT00627640) and XINDI (NCT03881371).
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Affiliation(s)
| | - Jaime Kulisevsky
- Movement Disorders Unit, Sant Pau Hospital, Universitat Autonoma de Barcelona, CIBERNED, Universitat Oberta de Catalunya, Barcelona, Spain
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105
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Elsafoury S, Jones HE, Kelvin EA. Impact of the Affordable Health Care Act (ACA) on Racial/Ethnic Inequities in Access to and Utilization of Healthcare in New York City. J Racial Ethn Health Disparities 2024; 11:406-415. [PMID: 36781587 DOI: 10.1007/s40615-023-01528-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 02/15/2023]
Abstract
The Affordable Care Act (ACA) expanded health insurance coverage in the USA, but whether it increased healthcare utilization or reduced racial/ethnic inequities in access to and utilization of care is unclear. We evaluated the ACA impact on health insurance coverage, unmet medical need, and having a personal doctor and whether this impact was modified by racial/ethnic identity among New York City (NYC) residents. We used data from multiple years of the Community Health Survey (2009-2017) and used logistic regression to assess whether having health insurance, unmet medical need, or a personal doctor varied pre- (2009-2012) versus post-ACA (2013-2017), adjusting for age, sex, nativity status, and general health. We assessed effect measure modification by race/ethnicity and stratified if we found significant interaction. We found that health insurance coverage and having a personal doctor increased post-ACA (aOR = 1.44, p < 0.001 and aOR = 1.09, p = 0.024, respectively) while having unmet medical need decreased (aOR = 0.90, p = 0.004). There was little indication of interaction between ACA and race/ethnicity; in stratified models, the ACA had a stronger impact on health insurance coverage for those of other race than all other groups (aOR = 2.16, p = 0.002 versus aOR 1.22-1.54 for white, Black, and Hispanic adults) and a stronger impact on having a personal doctor for Hispanic adults (aOR 1.27, p < 0.001 versus weaker non-significant associations for other groups), with no effect modification for unmet medical need. Thus, it appears that ACA improved healthcare access and utilization but did not have a major impact on reducing racial/ethnic inequities in these outcomes in NYC.
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Affiliation(s)
- Shaimaa Elsafoury
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health, City University of New York, 55 West 125Th Street, New York, NY, 10027, USA
| | - Heidi E Jones
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
- CUNY Institute for Implementation Science in Population Health, City University of New York, 55 West 125Th Street, New York, NY, 10027, USA
| | - Elizabeth A Kelvin
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA.
- CUNY Institute for Implementation Science in Population Health, City University of New York, 55 West 125Th Street, New York, NY, 10027, USA.
- Department of Occupational Health, Epidemiology & Prevention, Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, Hempstead, NY, USA.
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106
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Muthu MS, Vandana S, Akila G, Anusha M, Kandaswamy D, Aswath Narayanan MB. Global variations in eruption chronology of primary teeth: A systematic review and meta-analysis. Arch Oral Biol 2024; 158:105857. [PMID: 38128337 DOI: 10.1016/j.archoralbio.2023.105857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/12/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVES This systematic review aimed to assess global variations in the eruption chronology of primary teeth in children and the role of sexes, jaws, and socio-economic status on eruption timing. DESIGN An extensive search of electronic databases, grey literature, and hand-searching was carried out until April 2023 RESULTS: A total of 42,109 children, with an age range of 0-83 months were included from 42 studies (22 in Asia, 7 in Europe, 5 in Africa, 4 in North America, 3 in Oceania and 1 in South America). The mandibular central incisor was the first tooth to erupt at 6 months in North America and 13.5 months in Asia while the mandibular second molar erupted at 20.1 months in Europe and 29 months in South America. CONCLUSIONS The age of primary teeth eruption was advanced in the European population followed by North America, Africa, Oceania, and Asia while it was delayed in the South American population. Meta-analysis showed that tooth eruption was earlier in the left quadrant than the right but the role of other factors (sexes, jaws, and socio-economic status) was insignificant. Population-specific data on primary teeth emergence may serve as a baseline for future research. In clinical practice, these population-based eruption charts can serve as a valuable asset for diagnosis and treatment planning in children.
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Affiliation(s)
- M S Muthu
- Centre for Early Childhood Caries Research (CECCRe), Department of Pediatric Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India; Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, United Arab Emirates
| | - S Vandana
- Department of Oral Pathology and Microbiology, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai 600116, Tamil Nadu, India.
| | - G Akila
- Department of Public Health Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai 600116, Tamil Nadu, India
| | - M Anusha
- Department of Pediatric Dentistry, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India
| | - D Kandaswamy
- Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, Tamil Nadu, India
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Wu P, Wu SG, He ZY. Nomogram Update to Predict the High Genomic Risk Breast Cancer by Different Races. Clin Breast Cancer 2024; 24:e61-e70.e3. [PMID: 38007348 DOI: 10.1016/j.clbc.2023.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/08/2023] [Accepted: 10/20/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE To develop a nomogram to predict the high-risk recurrence score (RS) and to customize the nomogram for different races in early-stage hormone receptor (HoR)-positive, human epidermal growth factor receptor-2 (HER2)-negative breast cancer. METHODS Patients diagnosed between 2010 and 2015 were included from the surveillance, epidemiology, and end results oncotype DX database. The nomogram was assessed with a receiver operating characteristic curve to measure the area under the curve (AUC) with a 95% confidence interval (95% CI). The nomogram was developed and internally validated for discrimination and calibration, and then validated in different races. RESULTS A total of 48,464 patients were included and randomly assigned to the training cohort (n = 36370, 75.0%) and validation cohort (n = 12,094, 25.0%). Patients in the training cohort were identified to develop the nomogram, including 32,683 (89.9%) White women, 3135 (8.6%) Black women, and 552 (1.5%) Chinese women. Five independent predictive factors for high-risk RS were included to develop the nomogram, including tumor grade, progesterone receptor status, histological subtype, race, and tumor stage. The AUC was 0.696 (95% CI, 0.682-0.710) in the training cohort and 0.700 (95% CI, 0.676-0.724) in the validation cohort. There was no significant difference between the training cohort and the validation cohort. When validating the nomogram classified by race, the AUC was 0.694 (95% CI, 0.682-0.706) for the White cohort, 0.708 (95% CI, 0.673-0.743) for the Black cohort, and 0.653 (95% CI, 0.565-0.741) for the Chinese cohort. CONCLUSION The developed nomogram for predicting high-risk RS is available for different races in patients with HoR+/HER2- breast cancer, which could be used as qualified surrogates before ordering the 21-gene RS testing.
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Affiliation(s)
- Peng Wu
- School of Medicine, Sun Yat-sen University, Shenzhen, People's Republic of China
| | - San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Center, Xiamen Key Laboratory of Radiation Oncology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, People's Republic of China.
| | - Zhen-Yu He
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, People's Republic of China.
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108
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Chibwe J, Heydari S, Shoari N. A ward level analysis of child pedestrian casualty frequencies in Greater London. J Safety Res 2024; 88:85-92. [PMID: 38485389 DOI: 10.1016/j.jsr.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/30/2023] [Accepted: 10/18/2023] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Child pedestrian safety remains a challenge despite the remarkable progress that has been attained in recent years, particularly, in high income jurisdictions such as London. This study sought to identify and quantify the magnitude of the effects of various explanatory variables, from the domains of transport, built and natural environment, socio-demographic and economic factors, on ward level child pedestrian injury frequencies in Greater London. METHOD We adopted a multilevel random parameters model to investigate the factors associated with child pedestrian injuries given the hierarchical nature of the data comprising of wards nested within boroughs. RESULTS We found that crime, the Black, Asian, and Minority Ethnic (BAME) population, school enrollment, and the proportion of the population who walk five times a week had an increasing effect on the number of child pedestrian casualties. Conversely, the proportion of the population with a level 4 qualification and the number of cars per household had a decreasing effect. CONCLUSIONS Our study identified high child pedestrian injury frequency wards and boroughs: Stratford and New Town had the highest expected child pedestrian injury frequencies followed by Selhurst, Westend, and Greenford Broadway. Some inner London boroughs are among the highest injury frequency areas; however, a higher number of high child pedestrian injury boroughs are in outer London. PRACTICAL APPLICATIONS The paper provides recommendations for policy makers for targeted child pedestrian safety improvement interventions and prioritization to optimize the utilization of often constrained resources. The study also highlights the importance of considering social inequities in policies that aim at improving child traffic safety.
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Affiliation(s)
- Joseph Chibwe
- Transportation Research Group, Department of Civil, Maritime and Environmental Engineering, University of Southampton, Southampton, UK.
| | - Shahram Heydari
- Transportation Research Group, Department of Civil, Maritime and Environmental Engineering, University of Southampton, Southampton, UK.
| | - Niloofar Shoari
- MRC Centre for Environment & Health, Department of Epidemiology and Biostatistics, Imperial College London, London, UK.
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109
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Totapally BR, Martinez PA, Sendi P, Sachdeva R. Racial Inequities in Mortality Rate in Hospitalized Children. J Natl Med Assoc 2024; 116:56-69. [PMID: 38151422 DOI: 10.1016/j.jnma.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/16/2023] [Accepted: 12/03/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND AND OBJECTIVES Racial/ethnic inequities for inpatient mortality in children at a national level in the U.S. have not been explored. The objective of this study was to evaluate differences in inpatient mortality rate among different racial/ethnic groups, using the Kids' Inpatient Database. METHODS A cross-sectional study of children of ages greater than 28 days and less than 21 years discharged during 2012 and 2016. Racial/ethnic groups - White, Black, Hispanic, Asian and Pacific Islander and Native Americans were analyzed in two cohorts, Cohort A (all discharges) and Cohort B (ventilated children). RESULTS A total of 4,247,604 and 79,116 discharges were included in cohorts A and B, respectively. Univariate analysis showed that the inpatient mortality rate was highest among Asian and Pacific Islander children for both cohorts: A (0.47% [0.42-0.51]), B (10.9% [9.8-12.1]). Regression analysis showed that Asian and Pacific Islander and Black children had increased odds of inpatient mortality compared to White children: A (1.319 [1.162-1.496], 1.178 [1.105-1.257], respectively) and B (1.391 [1.199-1.613], 1.163 [1.079-1.255], respectively). Population-based hospital mortality was highest in Black children (1.17 per 10,000 children). CONCLUSIONS Inpatient mortality rates are significantly higher in U.S. children of Asian and Pacific Islander and Black races compared to White children. U.S. population-based metrics such as hospitalization rate, ventilation rate, and hospital mortality rate are highest in Black children. Our data suggest that lower median household income alone may not account for a higher inpatient mortality rate. The causes and prevention of racial and ethnic inequities in hospitalized children need to be explored further.
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Affiliation(s)
- Balagangadhar R Totapally
- Division of Critical Care Medicine, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL, 33155, United States; Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199. United States.
| | - Paul A Martinez
- Division of Critical Care Medicine, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL, 33155, United States; Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199. United States
| | - Prithvi Sendi
- Division of Critical Care Medicine, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL, 33155, United States; Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199. United States
| | - Ramesh Sachdeva
- Division of Critical Care Medicine, Nicklaus Children's Hospital, 3100 SW 62nd Avenue, Miami, FL, 33155, United States; Herbert Wertheim College of Medicine, Florida International University, Miami, FL, 33199. United States
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110
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Owosela BO, Steinberg RS, Leslie SL, Celi LA, Purkayastha S, Shiradkar R, Newsome JM, Gichoya JW. Identifying and improving the "ground truth" of race in disparities research through improved EMR data reporting. A systematic review. Int J Med Inform 2024; 182:105303. [PMID: 38088002 DOI: 10.1016/j.ijmedinf.2023.105303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/20/2023] [Accepted: 11/18/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Studies about racial disparities in healthcare are increasing in quantity; however, they are subject to vast differences in definition, classification, and utilization of race/ethnicity data. Improved standardization of this information can strengthen conclusions drawn from studies using such data. The objective of this study is to examine how data related to race/ethnicity are recorded in research through examining articles on race/ethnicity health disparities and examine problems and solutions in data reporting that may impact overall data quality. METHODS In this systematic review, Business Source Complete, Embase.com, IEEE Xplore, PubMed, Scopus and Web of Science Core Collection were searched for relevant articles published from 2000 to 2020. Search terms related to the concepts of electronic medical records, race/ethnicity, and data entry related to race/ethnicity were used. Exclusion criteria included articles not in the English language and those describing pediatric populations. Data were extracted from published articles. This review was organized and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement for systematic reviews. FINDINGS In this systematic review, 109 full text articles were reviewed. Weaknesses and possible solutions have been discussed in current literature, with the predominant problem and solution as follows: the electronic medical record (EMR) is vulnerable to inaccuracies and incompleteness in the methods that research staff collect this data; however, improved standardization of the collection and use of race data in patient care may help alleviate these inaccuracies. INTERPRETATION Conclusions drawn from large datasets concerning peoples of certain race/ethnic groups should be made cautiously, and a careful review of the methodology of each publication should be considered prior to implementation in patient care.
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Affiliation(s)
- Babajide O Owosela
- Emory University School of Medicine, Department of Medicine, Atlanta, GA, USA
| | - Rebecca S Steinberg
- Emory University School of Medicine, Department of Medicine, Atlanta, GA, USA
| | - Sharon L Leslie
- Emory University, Woodruff Health Sciences Center Library, Atlanta, GA, USA
| | - Leo A Celi
- Harvard T.H. Chan School of Public Health, Cambridge, MA, USA
| | - Saptarshi Purkayastha
- Indiana University-Purdue University Indianapolis, Department of BioHealth Informatics, Indianapolis, IN, USA
| | - Rakesh Shiradkar
- Emory University School of Medicine, Winship Cancer Institute, Atlanta, GA, USA
| | - Janice M Newsome
- Emory University School of Medicine, Department of Radiology, Atlanta, GA, USA
| | - Judy W Gichoya
- Emory University School of Medicine, Department of Radiology, Atlanta, GA, USA.
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111
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Patel P, Effiom OA, Akinshipo AWO, Akintoye SO. Differential Profile of Primary and Recurrent Ameloblastomas Among Afro-descendants and Non-Afro-descendants-a Systematic Review. J Racial Ethn Health Disparities 2024; 11:92-100. [PMID: 36596981 PMCID: PMC10437082 DOI: 10.1007/s40615-022-01500-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023]
Abstract
Ameloblastoma is an aggressively growing jaw tumor with high recurrent properties. Reports on global and racial distribution of ameloblastoma are variable and inconclusive. The role of race and ethnicity on ameloblastoma growth characteristics, genetic mutational profile, and recurrence is also still unclear. The primary aim of this systematic review was to assess genetic, racial, and ethnic distribution of primary and recurrent ameloblastoma from published literature. The secondary aim was to assess potential correlations between ethnicity, genetic mutation, and disparities in ameloblastoma treatment outcomes in Afro-descendants and non-Afro-descendants. Twenty-three eligible articles were selected based on preferred reporting items for systematic review and meta-analysis (PRISMA), and a total of 169 ameloblastoma cases were evaluated. Data on patient demographics, ameloblastoma growth characteristics, and genetic status were collected for quantitative analysis. Among a total of 169 ameloblastoma cases, Afro-descendant patients had higher primary and recurrent ameloblastomas at 15.5% and 4.7% respectively compared to non-Afro-descendant at 10.7% and 1.8% respectively. Additionally, BRAF V600E was positively associated with 48.8% of all ameloblastomas and strong predilection for Afro-descendants. Despite the paucity of information on genetic profile of ameloblastomas in the Afro-descendant patient cohort, this ethnic group still accounted for 2.95% of all BRAF V600E-positive tumors. These suggest that Afro-descendants are understudied regarding ameloblastoma characteristics, genetic profile, and recurrence profile. Mutational analysis of ameloblastoma tumors in Afro-descendants should be promoted.
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Affiliation(s)
- Parth Patel
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Olajumoke A Effiom
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Abdul-Warith O Akinshipo
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Sunday O Akintoye
- Department of Oral and Maxillofacial Pathology/Biology Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria.
- Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, 240 S 40th Street, Philadelphia, PA, USA.
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Irizar P, Pan D, Taylor H, Martin CA, Katikireddi SV, Kannangarage NW, Gomez S, La Parra Casado D, Srinivas PN, Diderichsen F, Baggaley RF, Nellums LB, Koller TS, Pareek M. Disproportionate infection, hospitalisation and death from COVID-19 in ethnic minority groups and Indigenous Peoples: an application of the Priority Public Health Conditions analytical framework. EClinicalMedicine 2024; 68:102360. [PMID: 38545088 PMCID: PMC10965404 DOI: 10.1016/j.eclinm.2023.102360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 04/21/2024] Open
Abstract
The COVID-19 pandemic has resulted in disproportionate consequences for ethnic minority groups and Indigenous Peoples. We present an application of the Priority Public Health Conditions (PPHC) framework from the World Health Organisation (WHO), to explicitly address COVID-19 and other respiratory viruses of pandemic potential. This application is supported by evidence that ethnic minority groups were more likely to be infected, implying differential exposure (PPHC level two), be more vulnerable to severe disease once infected (PPHC level three) and have poorer health outcomes following infection (PPHC level four). These inequities are driven by various interconnected dimensions of racism, that compounds with socioeconomic context and position (PPHC level one). We show that, for respiratory viruses, it is important to stratify levels of the PPHC framework by infection status and by societal, community, and individual factors to develop optimal interventions to reduce inequity from COVID-19 and future infectious diseases outbreaks.
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Affiliation(s)
- Patricia Irizar
- Faculty of Humanities, School of Social Sciences, University of Manchester, UK
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, UK
- Leicester NIHR Biomedical Research Centre, UK
- Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK
- Development Centre for Population Health, University of Leicester, UK
- Li Ka Shing Centre for Health Information and Discovery, Oxford Big Data Institute, University of Oxford, UK
| | - Harry Taylor
- Department of Global Health and Social Medicine, King’s College London, UK
| | - Christopher A. Martin
- Department of Respiratory Sciences, University of Leicester, UK
- Leicester NIHR Biomedical Research Centre, UK
- Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK
- Development Centre for Population Health, University of Leicester, UK
| | | | | | | | | | | | | | - Rebecca F. Baggaley
- Leicester NIHR Biomedical Research Centre, UK
- Development Centre for Population Health, University of Leicester, UK
- Department of Population Health Sciences, University of Leicester, UK
| | - Laura B. Nellums
- Lifespan and Population Sciences, School of Medicine, University of Nottingham, UK
| | | | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, UK
- Leicester NIHR Biomedical Research Centre, UK
- Department of Infectious Diseases and HIV Medicine, University Hospitals of Leicester NHS Trust, UK
- Development Centre for Population Health, University of Leicester, UK
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113
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Jennison T, Kulenkampff C, Lee J, Mahmood A. Is ethnicity a risk factor for mortality in major trauma? A single-centred cohort study. Ann R Coll Surg Engl 2024; 106:118-122. [PMID: 36688835 PMCID: PMC10830339 DOI: 10.1308/rcsann.2022.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2022] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Many studies have found varying health outcomes in patients from different minority ethnic groups. There has been limited research into the outcomes in major trauma dependent on ethnicity. The aim was to analyse whether ethnicity was an independent risk factor for 30-day mortality in patients presenting to a major trauma centre when adjusting for confounders. METHODS This was a retrospective review of all patients presenting to a single major trauma centre from 2010 to 2020. Data were collected on patient demographics and variables including mechanism and injury severity score. Logistic regression was used to determine significant predictors of mortality. RESULTS There were 10,668 data sets with ethnicity data; of these 9,098 were of White ethnicity, 1,143 were Asian and 427 were classified as Black. The 30-day mortality rate was 7.76% for White ethnicities, 6.91% for Asian ethnicity and 5.15% for people of Black ethnicity. On multivariate logistic regression, ethnicity (p = 0.076) was not associated with 30-day mortality. Age, Injury Severity Score (ISS), Probability of Survival (PS) score, shock and Glasgow Coma Scale (GCS; p < 0.001) were associated with 30-day mortality. White ethnicity had an odds ratio (OR) of mortality of 1.16 (95% confidence interval [CI] 0.658-2.040) (p = 0.609) compared with Black ethnicity and an OR of 0.74 (95% CI 0.546-1.001) (p = 0.050) compared with Asian patients. Black patients had an OR of mortality of 0.65 (95% CI 0.351-1.193) (p = 0.164) compared with the Asian population. CONCLUSION Ethnicity is not a significant risk factor for 30-day mortality in trauma patients.
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Affiliation(s)
- T Jennison
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - C Kulenkampff
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - J Lee
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - A Mahmood
- University Hospitals Birmingham NHS Foundation Trust, UK
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114
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Boley S, Sidebottom A, Stenzel A, Watson D. Racial Disparities in Opioid Administration Practices Among Undifferentiated Abdominal Pain Patients in the Emergency Department. J Racial Ethn Health Disparities 2024; 11:416-424. [PMID: 36795292 DOI: 10.1007/s40615-023-01529-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 01/22/2023] [Accepted: 01/27/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVES The purpose of this study was to examine racial disparities in opioid prescribing practices for patients presenting to the emergency department (ED) with a common chief complaint of abdominal pain. METHODS Treatment outcomes were compared for non-Hispanic White (NH White), non-Hispanic Black (NH Black), and Hispanic patients seen over 12 months in three emergency departments in the Minneapolis/St. Paul metropolitan area. Multivariable logistic regression models were used to estimate odds ratios (OR) with 95% confidence intervals (CI) to measure the associations between race/ethnicity and outcomes of opioid administration during ED visits and discharge opioid prescriptions. RESULTS A total of 7309 encounters were included in the analysis. NH Black (n = 1988) and Hispanic patients (n = 602) were more likely than NH White patients (n = 4179) to be in the 18-39 age group (p < 0. 001). NH Black patients were more likely to report public insurance than NH White or Hispanic patients (p < 0.001). After adjusting for confounders, patients who identified as NH Black (OR: 0.64, 95% CI: 0.56-0.74) or Hispanic (OR: 0.78, 95% CI: 0.61-0.98) were less likely to be given opioids during their ED encounter when compared to NH White patients. Similarly, NH Black patients (OR: 0.62, 95% CI: 0.52-0.75) and Hispanic patients (OR: 0.66, 95% CI: 0.49-0.88) were less likely to receive a discharge opioid prescription. CONCLUSIONS These results confirm that racial disparities exist in the ED opioid administration within the department as well as at discharge. Future studies should continue to examine systemic racism as well as interventions to alleviate these health inequities.
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Affiliation(s)
- Sean Boley
- Emergency Care Consultants, Minneapolis, MN, USA.
| | | | - Ashley Stenzel
- Care Delivery Research, Allina Health, Minneapolis, MN, USA
| | - David Watson
- Research Institute, Children's Minnesota, Minneapolis, MN, USA
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115
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Williams MJ, Orlando C, Akisanya J, Amezcua L. Multiple Sclerosis in Black and Hispanic Populations: Serving the Underserved. Neurol Clin 2024; 42:295-317. [PMID: 37980120 DOI: 10.1016/j.ncl.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2023]
Abstract
Multiple sclerosis has historically been characterized as a disease that affects young women of European ancestry, but recent studies indicate that the incidence and prevalence of the disease is much higher in Black and Hispanic populations than previously recognized. There is evidence that there is a more severe disease course in these populations. , but the intersection of genetic underpinnings and social determinants of health (SDOH) is poorly understood due to the lack of diversity in clinical research. Improving health disparities will involve multiple stakeholders in efforts to improve SDOH and raise awareness about research involvement and the importance of developing personalized health care plans to combat this disease.
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Affiliation(s)
- Mitzi J Williams
- Joi Life Wellness Multiple Sclerosis Center, 767 Concord Road, SE, Smyrna, GA 30082, USA.
| | - Christopher Orlando
- Department of Neurology, University of Southern California, Keck School of Medicine, 1520 San Pablo Street, Suite 3000, Los Angeles, CA, USA. https://twitter.com/OrlandoMDMPH
| | - Jemima Akisanya
- Georgetown Department of Neurology, 10401 Hospital Drive, Suite 102, Clinton, MD 20735, USA. https://twitter.com/MimasMyelin
| | - Lilyana Amezcua
- Department of Neurology, University of Southern California, Keck School of Medicine, 1520 San Pablo Street, Suite 3000, Los Angeles, CA, USA
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116
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Dzekem BS, Aschebrook-Kilfoy B, Olopade CO. Air Pollution and Racial Disparities in Pregnancy Outcomes in the United States: A Systematic Review. J Racial Ethn Health Disparities 2024; 11:535-544. [PMID: 36897527 PMCID: PMC10781802 DOI: 10.1007/s40615-023-01539-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 03/11/2023]
Abstract
BACKGROUND Exposure to air pollutants and other environmental factors increases the risk of adverse pregnancy outcomes. There is growing evidence that adverse outcomes related to air pollution disproportionately affect racial and ethnic minorities. The objective of this paper is to explore the importance of race as a risk factor for air pollution-related poor pregnancy outcomes. METHODS Studies investigating the effects of exposure to air pollution on pregnancy outcomes by race were reviewed. A manual search was conducted to identify missing studies. Studies that did not compare pregnancy outcomes among two or more racial groups were excluded. Pregnancy outcomes included preterm births, small for gestational age, low birth weight, and stillbirths. RESULTS A total of 124 articles explored race and air pollution as risk factors for poor pregnancy outcome. Thirteen percent of these (n=16) specifically compared pregnancy outcomes among two or more racial groups. Findings across all reviewed articles showed more adverse pregnancy outcomes (preterm birth, small for gestational age, low birth weight, and stillbirths) related to exposure to air pollution among Blacks and Hispanics than among non-Hispanic Whites. CONCLUSION Evidence support our general understanding of the impact of air pollution on birth outcomes and, specifically, of disparities in exposure to air pollution and birth outcomes for infants born to Black and Hispanic mothers. The factors driving these disparities are multifactorial, mostly social, and economic factors. Reducing or eliminating these disparities require interventions at individual, community, state, and national level.
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Affiliation(s)
- Bonaventure S Dzekem
- Biological Sciences Division, Department of Medicine, The University of Chicago, Chicago, IL, USA.
- Center for Global Health, Biological Science Division, The University of Chicago, 5841 S Maryland Ave, suite G-120, Chicago, IL, 60637, USA.
- Internal Medicine Residency Program, Department of Medicine, The University of Chicago, Chicago, IL, USA.
| | | | - Christopher O Olopade
- Biological Sciences Division, Department of Medicine, The University of Chicago, Chicago, IL, USA
- Center for Global Health, Biological Science Division, The University of Chicago, 5841 S Maryland Ave, suite G-120, Chicago, IL, 60637, USA
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Sandoval MH, Portaccio MEA, Albala C. Ethnic differences in disability-free life expectancy and disabled life expectancy in older adults in Chile. BMC Geriatr 2024; 24:116. [PMID: 38297194 PMCID: PMC10829324 DOI: 10.1186/s12877-024-04728-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/19/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Although about 10% of the Latin American population is indigenous, ethnic differences in disability-free life expectancy (DFLE) and life expectancy with disability (DLE) are unknown. OBJECTIVE To estimate disability-free life expectancy and disabled life expectancy among Mapuche (the largest indigenous group) and non-indigenous older adults aged 60 years or more in Chile. METHOD Disability was measured following a methodology that combines limitations of daily living, cognitive impairment and dependence previously validated in Chile. Finally, the DFLE was estimated using Sullivan's method combining life tables by ethnicity and disability proportions from the EDES survey designed for the study of ethnic differentials in health and longevity in Chile. RESULTS Non-Indigenous people have a higher total and Disability-free life expectancy compared to Mapuche people at all ages. While at age 60 a Mapuche expects to live 18.9 years, of which 9.4 are disability-free, a non-Indigenous expects to live 26.4 years, of which 14 are disability-free. In addition, although the length of life with disability increases with age for both populations, Mapuche who survive to age 80 or 90 expect to live 84% and 91% of their remaining life with disability, higher proportions compared to non-indigenous people (62.9% and 75%, respectively). CONCLUSIONS This is the first study addressing inequities in DFLE between the Mapuche and non-Indigenous population, reflected in lower total life expectancy, lower DFLE and higher DLE in Mapuche compared to the non-Indigenous population. Our results underscore the need for increased capacity to monitor mortality risks among older people, considering ethnic differences.
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Affiliation(s)
- Moisés H Sandoval
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.
| | | | - Cecilia Albala
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
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Pardede EL, Venhorst VA. Does Ethnicity Affect Ever Migrating and the Number of Migrations? The Case of Indonesia. Eur J Popul 2024; 40:6. [PMID: 38289487 PMCID: PMC10828312 DOI: 10.1007/s10680-023-09694-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 12/18/2023] [Indexed: 02/02/2024]
Abstract
This paper is the first to examine to what extent ethnicity affects ever migrating and the number of migrations across the lifespan for the case of internal migration in Indonesia. We use all five waves of the Indonesia Family Life Survey (IFLS) to study migration behaviour of respondents belonging to some of the largest ethnic groups in Indonesia. Our logistic regression results show that the Minangkabau, Betawi, Madurese, Balinese, Buginese and Makassarese, and Sasak, Bima and Dompu are less likely to ever migrate than the Javanese. Using only migrants and controlling for the first migration and other characteristics, truncated negative binomial regression results show that, in comparison with the Javanese, the Minangkabau and Banjarese have a higher expected number of migrations while the numbers are lower for the Betawi and Balinese. Thus, ethnicity contributes to ever migrating as well as the number of migrations, but we find that the differences between the ethnic groups diminish for the latter. These results also point out that a higher likelihood of ever migrating does not always correspond with a higher number of migrations, highlighting the importance of studying migration count to complement the study of migration as a one-time event.
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Affiliation(s)
- Elda Luciana Pardede
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Master's Programme in Population and Labour Economics, Department of Economics, Faculty of Economics and Business, Universitas Indonesia, Nathanael Iskandar Building, Lembaga Demografi, 3rd Floor, Kampus UI, 16424, Depok, Jawa Barat, Indonesia
| | - Viktor Andreas Venhorst
- Department of Economic Geography, Faculty of Spatial Sciences, University of Groningen, PO Box 800, 9700 AD, Groningen, The Netherlands.
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Mayor E, Bietti LM. Language use on Twitter reflects social structure and social disparities. Heliyon 2024; 10:e23528. [PMID: 38293550 PMCID: PMC10825303 DOI: 10.1016/j.heliyon.2023.e23528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 11/24/2023] [Accepted: 12/05/2023] [Indexed: 02/01/2024] Open
Abstract
Large-scale mental health assessments increasingly rely upon user-contributed social media data. It is widely known that mental health and well-being are affected by minority group membership and social disparity. But do these factors manifest in the language use of social media users? We elucidate this question using spatial lag regressions. We examined the county-level (N = 1069) associations of lexical indicators linked to well-being and mental health, notably depression (e.g., first-person singular pronouns, negative emotions) with markers of social disparity (e.g., the Area Deprivation Index-3) and ethnicity, using a sample of approximately 30 million content-coded tweets (U.S. county-level aggregation). Results confirmed most expected associations: County-level lexical indicators of depression are positively linked with county-level area disparity (e.g., economic hardship and inequity) and percentage of ethnic minority groups. Predictive validity checks show that lexical indicators are related to future health and mental health outcomes. Lexical indicators of depression and adjustment coded from tweets aggregated at the county level could play a crucial role in prioritizing public health campaigns, particularly in socially deprived counties.
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Chan DZ, Grey C, Doughty RN, Lund M, Lee MAW, Poppe K, Harwood M, Kerr A. Widening ethnic inequities in heart failure incidence in New Zealand. Heart 2024; 110:281-289. [PMID: 37536757 DOI: 10.1136/heartjnl-2023-322795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/23/2023] [Indexed: 08/05/2023] Open
Abstract
OBJECTIVE Ethnic inequities in heart failure (HF) have been documented in several countries. This study describes New Zealand (NZ) trends in incident HF hospitalisation by ethnicity between 2006 and 2018. METHODS Incident HF hospitalisations in ≥20-year-old subjects were identified through International Classification of Diseases, 10th Revision-coded national hospitalisation records. Incidence was calculated for different ethnic, sex and age groups and were age standardised. Trends were estimated with joinpoint regression. RESULTS Of 116 113 incident HF hospitalisations, 12.8% were Māori, 5.7% Pacific people, 3.0% Asians and 78.6% Europeans/others. 64% of Māori and Pacific patients were aged <70 years, compared with 37% of Asian and 19% of European/others. In 2018, incidence rate ratios compared with European/others were 6.0 (95% CI 4.9 to 7.3), 7.5 (95% CI 6.0 to 9.4) and 0.5 (95% CI 0.3 to 0.8) for Māori, Pacific people and Asians aged 20-49 years; 3.7 (95% CI 3.4 to 4.0), 3.6 (95% CI 3.2 to 4.1) and 0.5 (95% CI 0.4 to 0.6) for Māori, Pacific people and Asians aged 50-69 years; and 1.5 (95% CI 1.4 to 1.6), 1.5 (95% CI 1.3 to 1.7) and 0.5 (95% CI 0.5 to 0.6) for Māori, Pacific people and Asians aged ≥70 years. Between 2006 and 2018, ethnicity-specific rates diverged in ≥70-year-old subjects due to a decline in European/others (annual percentage change (APC) -2.0%, 95% CI -2.5% to -1.6%) and Asians (APC -3.3%, 95% CI -4.4% to -2.1%), but rates remained unchanged for Māori and Pacific people. In contrast, regardless of ethnicity, rates either increased or remained unchanged in <70-year-old subjects. CONCLUSION Ethnic inequities in incident HF hospitalisation have widened in NZ over the past 13 years. Urgent action is required to address the predisposing factors that lead to development of HF in Maori and Pacific people.
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Affiliation(s)
- Daniel Zl Chan
- Department of Cardiology, Te Whatu Ora Health New Zealand Te Tai Tokerau, Whangarei, New Zealand
| | - Corina Grey
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
- Performance Improvement, Te Whatu Ora Health New Zealand Te Toka Tumai Auckland, Auckland, New Zealand
| | - Rob N Doughty
- Department of Medicine, The University of Auckland, Auckland, New Zealand
- Greenlane Cardiovascular Service, Te Whatu Ora Health New Zealand Te Toka Tumai Auckland, Auckland, New Zealand
| | - Mayanna Lund
- Department of Cardiology, Te Whatu Ora Health New Zealand Counties Manukau, Auckland, New Zealand
| | - Mildred Ai Wei Lee
- Department of Cardiology, Te Whatu Ora Health New Zealand Counties Manukau, Auckland, New Zealand
| | - Katrina Poppe
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
- Department of Medicine, The University of Auckland, Auckland, New Zealand
| | - Matire Harwood
- Te Kupenga Hauora Māori (Department of Māori Health), The University of Auckland Department of General Practice and Primary Health Care, Auckland, New Zealand
| | - Andrew Kerr
- Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand
- Department of Cardiology, Te Whatu Ora Health New Zealand Counties Manukau, Auckland, New Zealand
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Wu Y, Wang Y, Dang Z, Zhang Y, Wang Y, Tong L, Peng W. Ethnic differences in eating patterns and their associations with obesity among adults in West China. Br J Nutr 2024; 131:321-332. [PMID: 37642161 DOI: 10.1017/s0007114523001745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Despite observed ethnic differences in eating patterns and obesity, evidence in China is limited. This study examined ethnic differences in eating patterns and their associations with weight outcomes among multi-ethnic adults in West China. A cross-sectional survey collected self-reported data on demographics, eating behaviours, weight and height in 2021. Principal component analysis and multivariate regression were conducted to identify eating patterns and examine their associations with weight outcomes. In total, 4407 subjects aged ≥ 18 years were recruited across seven provinces in West China. Four eating patterns were identified: 'meat-lover' - characterised by frequent consumption of meat and dairy products, 'indulgent' - by frequent intakes of added salt, sugar, alcohol and pickled food, 'diversified-eating' - by frequently consuming food with diversified cooking methods and eating out and 'nutri-health-concerned' - by good food hygiene behaviours and reading food labels. Ethnic differences in eating patterns were observed. Compared with Han, Hui were less likely to exhibit meat-lover or diversified-eating patterns; Tibetans were less likely to have meat-lover or nutri-health-concerned patterns; Mongolians were more likely to have indulgent pattern. BMI was positively associated with meat-lover pattern in both genders (exp(β): 1·029; 95 % CI: 1·001, 1·058 for men; 1·018; 1·000, 1·036 for women) and negatively associated with nutri-health-concerned pattern in women (0·983; 0·966, 1·000). Mongolians were two times more likely to be overweight/obese than Han (OR: 3·126; 1·688, 5·790). Considerable ethnic differences existed in eating patterns in West China. Mongolians were more likely to be overweight/obese, which was associated with their indulgent eating patterns. Ethnic-specific healthy eating intervention programs are needed.
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Affiliation(s)
- Yang Wu
- Department of Sociology, Jiangxi University of Finance and Economics, Nanchang, People's Republic of China
| | - Yanxiang Wang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, People's Republic of China
| | - Zhancui Dang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, People's Republic of China
| | - Yangrui Zhang
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, People's Republic of China
| | - Youfa Wang
- Global Health Institute, School of Public Health, Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Li Tong
- Department of Traditional Chinese Medicine, Medical College, Qinghai University, Xining, People's Republic of China
- Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Xining, People's Republic of China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining, People's Republic of China
- Qinghai Provincial Key Laboratory of Traditional Chinese Medicine Research for Glucolipid Metabolic Diseases, Medical College, Qinghai University, Xining, People's Republic of China
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Winkler SS, Tian C, Casablanca Y, Bateman NW, Jokajtys S, Kucera CW, Tarney CM, Chan JK, Richardson MT, Kapp DS, Liao CI, Hamilton CA, Leath CA, Reddy M, Cote ML, O'Connor TD, Jones NL, Rocconi RP, Powell MA, Farley J, Shriver CD, Conrads TP, Phippen NT, Maxwell GL, Darcy KM. Racial, ethnic and country of origin disparities in aggressive endometrial cancer histologic subtypes. Gynecol Oncol 2024; 184:31-42. [PMID: 38277919 DOI: 10.1016/j.ygyno.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/22/2023] [Accepted: 01/08/2024] [Indexed: 01/28/2024]
Abstract
OBJECTIVE This study investigated the risk of an aggressive endometrial cancer (EC) diagnosis by race, ethnicity, and country of origin to further elucidate histologic disparities in non-Hispanic Black (NHB), Hispanic, Asian/Pacific Islander (API), American Indian/Alaskan Native (AIAN) vs. non-Hispanic White (NHW) patients, particularly in Hispanic or API subgroups. METHODS Patient diagnosed between 2004 and 2020 with low grade (LG)-endometrioid endometrial cancer (ECC) or an aggressive EC including grade 3 EEC, serous carcinoma, clear cell carcinoma, mixed epithelial carcinoma, or carcinosarcoma in the National Cancer Database were studied. The odds ratio (OR) and 95% confidence interval (CI) for diagnosis of an aggressive EC histology was estimated using logistic modeling. RESULTS There were 343,868 NHW, 48,897 NHB, 30,013 Hispanic, 15,015 API and 1646 AIAN patients. The OR (95% CI) for an aggressive EC diagnosis was 3.07 (3.01-3.13) for NHB, 1.08 (1.06-1.11) for Hispanic, 1.17 (1.13-1.21) for API and 1.07 (0.96-1.19) for AIAN, relative to NHW patients. Subset analyses by country of origin illustrated the diversity in the OR for an aggressive EC diagnosis among Hispanic (1.18 for Mexican to 1.87 for Dominican), Asian (1.14 Asian Indian-Pakistani to 1.48 Korean) and Pacific Islander (1.00 for Hawaiian to 1.33 for Samoan) descendants. Hispanic, API and AIAN patients were diagnosed 5-years younger that NHW patients, and the risk for an aggressive EC histology were all significantly higher than NHW patients after correcting for age. Insurance status was another independent risk factor for aggressive histology. CONCLUSIONS Risk of an aggressive EC diagnosis varied by race, ethnicity, and country of origin. NHB patients had the highest risk, followed by Dominican, South/Central American, Cuban, Korean, Thai, Vietnamese, and Filipino descendants.
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Affiliation(s)
- Stuart S Winkler
- Division of Gynecologic Oncology, Department of Gynecologic Surgery and Obstetrics, Brooke Army Medical Center, San Antonio, TX, USA
| | - Chunqiao Tian
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, USA
| | - Yovanni Casablanca
- Division of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Nicholas W Bateman
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, USA
| | - Suzanne Jokajtys
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Calen W Kucera
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Christopher M Tarney
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - John K Chan
- Palo Alto Medical Foundation, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA
| | - Michael T Richardson
- Department of Obstetrics and Gynecology, University of California, Los Angeles School of Medicine, Los Angeles, CA. USA
| | - Daniel S Kapp
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Cheng-I Liao
- Division of Obstetrics and Gynecology, Pingtung Veterans General Hospital, Pingtung, Taiwan
| | - Chad A Hamilton
- Gynecologic Oncology Section, Women's Services and The Ochsner Cancer Institute, Ochsner Health, New Orleans, LA, USA
| | - Charles A Leath
- Division of Gynecologic Oncology, University of Alabama at Birmingham, O'Neal Comprehensive Cancer Center, Birmingham, AL, USA
| | - Megan Reddy
- California Pacific Medical Center, San Francisco, CA, USA
| | - Michele L Cote
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN, USA
| | - Timothy D O'Connor
- Institute for Genome Sciences, Department of Medicine, Program in Personalized and Genomic Medicine, University of Maryland School of Medicine, University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
| | - Nathaniel L Jones
- Division of Gynecologic Oncology, Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA
| | - Rodney P Rocconi
- Division of Gynecologic Oncology, Cancer Center & Research Institute, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Matthew A Powell
- Division of Gynecologic Oncology, Siteman Cancer Center, Washington University, St Louis, MO, USA
| | - John Farley
- Division of Gynecologic Oncology, Center for Women's Health, Cancer Institute, Dignity Health St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| | - Craig D Shriver
- Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Thomas P Conrads
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - Neil T Phippen
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - G Larry Maxwell
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Women's Health Integrated Research Center, Women's Service Line, Inova Health System, Falls Church, VA, USA
| | - Kathleen M Darcy
- Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; Murtha Cancer Center Research Program, Department of Surgery, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, USA.
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Reece S, Moss RH, Tanveer Z, Hammad M, Pickett KE, Dickerson J. Exploring the feasibility of evaluating a community alliance welfare advice programme co-located in primary care in Bradford: an uncontrolled before and after study. BMC Public Health 2024; 24:300. [PMID: 38273264 PMCID: PMC10811861 DOI: 10.1186/s12889-024-17773-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Welfare advice services co-located in health settings are known to improve financial security. However, little is known on how to effectively evaluate these services. This study aims to explore the feasibility of evaluating a welfare advice service co-located in a primary care setting in a deprived and ethnically diverse population. It seeks to investigate whether the proposed evaluation tools and processes are acceptable and feasible to implement and whether they are able to detect any evidence of promise for this intervention on the mental health, wellbeing and financial security of participants. METHODS An uncontrolled before and after study design was utilised. Data on mental health, wellbeing, quality of life and financial outcomes were collected at baseline prior to receiving welfare advice and at three months follow-up. Multiple logistic and linear regression models were used to explore individual differences in self-reported financial security and changes to mental health, wellbeing and quality of life scores before and after the provision of welfare advice. RESULTS Overall, the majority of key outcome measures were well completed, indicating participant acceptability of the mental health, wellbeing, quality of life and financial outcome measures used in this population. There was evidence suggestive of an improvement in participant financial security and evidence of promise for improvements in measured wellbeing and health-related quality of life for participants accessing services in a highly ethnically diverse population. Overall, the VCS Alliance welfare advice programme generated a total of £21,823.05 for all participants, with participants gaining an average of £389.70 per participant for participants with complete financial outcome data. CONCLUSIONS This research demonstrates the feasibility of evaluating a welfare advice service co-located in primary care in a deprived and ethnically diverse setting utilising the ascribed mental health, wellbeing and quality of life and financial outcome tools. It provides evidence of promise to support the hypothesis that the implementation of a welfare advice service co-located in a health setting can improve health and wellbeing and reduce health inequalities.
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Affiliation(s)
- Sian Reece
- Hull York Medical School, York, North Yorkshire, UK.
| | - Rachael H Moss
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
| | - Zahrah Tanveer
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
| | - Mohammed Hammad
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
| | - Kate E Pickett
- Department of Health Sciences, University of York, Heslington Road, York, North Yorkshire, UK
| | - Josie Dickerson
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK
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Bao SL, Olarewaju G, Wang L, Sang J, Zhu J, Lachowsky NJ, Lal A, Ablona A, Ho D, Baharuddin F, Villa L, Lambert S, Dulai J, Moore DM. Ethno-racial variations in mental health symptoms among sexually-active gay, bisexual, and other men who have sex with men in Vancouver, Canada: a longitudinal analysis. BMC Public Health 2024; 24:282. [PMID: 38267930 PMCID: PMC10807146 DOI: 10.1186/s12889-024-17743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Minority stress from racism and heterosexism may uniquely interact to impact the mental health of racialized sexual minorities. We examined variations in anxiety and depressive symptoms by reported by ethno-racial identity among gay, bisexual, and other men who have sex with men (gbMSM) in Vancouver, Canada. METHODS We recruited gbMSM aged ≥ 16 years from February 2012 to February 2015 using respondent-driven sampling (RDS). Participants completed computer assisted self-interviews (CASI) at enrollment and every 6 months until February 2017. We examined factors associated with moderate/severe anxiety and depression scores (> 10) on the Hospital Anxiety and Depression Scale (HADS) and differences in key explanatory variables including sociodemographic, psychosocial, and substance use factors. We used multivariable mixed effects models to assess whether moderate/severe scores were associated with ethno-racial identity across all visits. RESULTS After RDS-adjustment, of 774 participants, 79.9% of participants identified as gay. 68.6% identified as white, 9.2% as Asian, 9.8% as Indigenous, 7.3% as Latin American, and 5.1% as other ethno-racial identities. Participants contributed a median of 6 follow-up visits (Q1-Q3: 4-7). In the multivariable analysis, Asian participants had decreased odds of moderate/severe anxiety scores compared to white participants (aOR = 0.39; 95% CI: 0.18-0.86), and Latin American participants had decreased odds of moderate/severe depression scores compared to both white (aOR = 0.17; 95% CI: 0.08-0.36) and Asian (aOR = 0.07; 95% CI: 0.02-0.20) participants. CONCLUSION Asian and Latino gbMSM reported decreased mental health symptoms compared to white participants. Asian and Latino gbMSM in Vancouver appear to manage multiple minority stressors without adversely affecting their mental health.
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Affiliation(s)
- Seraph L Bao
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Gbolahan Olarewaju
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Lu Wang
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6T 1Y6, Canada
| | - Jordan Sang
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6T 1Y6, Canada
| | - Julia Zhu
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6T 1Y6, Canada
| | - Nathan J Lachowsky
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6T 1Y6, Canada
- University of Victoria, Victoria, BC, Canada
| | - Allan Lal
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6T 1Y6, Canada
| | - Aidan Ablona
- Momentum Health Study People of Colour Advisory Board, Vancouver, BC, Canada
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Darren Ho
- Momentum Health Study People of Colour Advisory Board, Vancouver, BC, Canada
- Community Based Research Centre, Vancouver, BC, Canada
| | - Fahmy Baharuddin
- Momentum Health Study People of Colour Advisory Board, Vancouver, BC, Canada
- Living Positive Resource Centre, Kelowna, BC, Canada
| | - Lorenz Villa
- Momentum Health Study People of Colour Advisory Board, Vancouver, BC, Canada
| | - Sandy Lambert
- Momentum Health Study People of Colour Advisory Board, Vancouver, BC, Canada
| | - Joshun Dulai
- Momentum Health Study People of Colour Advisory Board, Vancouver, BC, Canada
| | - David M Moore
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
- BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6T 1Y6, Canada.
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Busby J, McDowell PJ, Pfeffer PE, Mansur AH, Heaney LG. Ethnic variation in asthma phenotypic presentation and outcomes: a cross-sectional analysis of the UK Biobank. Thorax 2024; 79:186-190. [PMID: 38071553 DOI: 10.1136/thorax-2023-221101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Ethnic disparities exist within asthma; however, country of birth is rarely investigated. We described demographic and clinical characteristics by ethnicity and country of birth within the UK Biobank. Lung function and asthma hospitalisations were similar for white, black and North-East Asian participants, however, South-East (SE) Asians more commonly had an FEV1 below the lower limits of normal (LLN; 53.8% vs 32.3%, p<0.001), blood eosinophilia (38.6% vs 23.8%, p<0.001) and asthma hospitalisation (12.5% vs 8.3%, p<0.001) than white participants. First-generation SE Asian immigrants had poorer lung function (57.7% vs 27.7% FEV1 below LLN, p<0.001) than UK/Ireland born participants. These data demonstrate inter-ethnic and intra-ethnic disparities.
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Affiliation(s)
- John Busby
- Centre for Public Health, Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
| | - P Jane McDowell
- Centre for Experimental Medicine, Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
- Belfast Health & Social Care NHS Trust, Belfast, UK
| | | | - Adel Hasan Mansur
- University of Birmingham & Heartlands Hospital, University Hospitals Birmingham, Birmingham, UK
| | - Liam G Heaney
- Centre for Experimental Medicine, Queen's University Belfast School of Medicine Dentistry and Biomedical Sciences, Belfast, UK
- Belfast Health & Social Care NHS Trust, Belfast, UK
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Klein R, Snyder ED, Koch J, Volerman A, Alba-Nguyen S, Julian KA, Thompson V, Ufere NN, Burnett-Bowie SAM, Kumar A, White BAA, Park YS, Palamara K. Analysis of narrative assessments of internal medicine resident performance: are there differences associated with gender or race and ethnicity? BMC Med Educ 2024; 24:72. [PMID: 38233807 PMCID: PMC10795394 DOI: 10.1186/s12909-023-04970-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 12/13/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Equitable assessment is critical in competency-based medical education. This study explores differences in key characteristics of qualitative assessments (i.e., narrative comments or assessment feedback) of internal medicine postgraduate resident performance associated with gender and race and ethnicity. METHODS Analysis of narrative comments included in faculty assessments of resident performance from six internal medicine residency programs was conducted. Content analysis was used to assess two key characteristics of comments- valence (overall positive or negative orientation) and specificity (detailed nature and actionability of comment) - via a blinded, multi-analyst approach. Differences in comment valence and specificity with gender and race and ethnicity were assessed using multilevel regression, controlling for multiple covariates including quantitative competency ratings. RESULTS Data included 3,383 evaluations with narrative comments by 597 faculty of 698 residents, including 45% of comments about women residents and 13.2% about residents who identified with race and ethnicities underrepresented in medicine. Most comments were moderately specific and positive. Comments about women residents were more positive (estimate 0.06, p 0.045) but less specific (estimate - 0.07, p 0.002) compared to men. Women residents were more likely to receive non-specific, weakly specific or no comments (adjusted OR 1.29, p 0.012) and less likely to receive highly specific comments (adjusted OR 0.71, p 0.003) or comments with specific examples of things done well or areas for growth (adjusted OR 0.74, p 0.003) than men. Gendered differences in comment specificity and valence were most notable early in training. Comment specificity and valence did not differ with resident race and ethnicity (specificity: estimate 0.03, p 0.32; valence: estimate - 0.05, p 0.26) or faculty gender (specificity: estimate 0.06, p 0.15; valence: estimate 0.02 p 0.54). CONCLUSION There were significant differences in the specificity and valence of qualitative assessments associated with resident gender with women receiving more praising but less specific and actionable comments. This suggests a lost opportunity for well-rounded assessment feedback to the disadvantage of women.
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Affiliation(s)
- Robin Klein
- Department of Medicine, Division of General Internal Medicine, Emory University School of Medicine, 80 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA.
| | - Erin D Snyder
- Department of Medicine, Division of General Internal Medicine, University of Alabama Birmingham School of Medicine, Birmingham, AL, USA
| | - Jennifer Koch
- Department of Medicine, University of Louisville, Louisville, KY, USA
| | - Anna Volerman
- Departments of Medicine and Pediatrics, University of Chicago, Chicago, IL, USA
| | - Sarah Alba-Nguyen
- Department of Medicine, Division of Hospital Medicine, University of California, San Francisco, CA, USA
| | - Katherine A Julian
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Vanessa Thompson
- Department of Medicine, Division of General Internal Medicine, University of California, San Francisco, CA, USA
| | - Nneka N Ufere
- Department of Medicine, Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Anshul Kumar
- Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Bobbie Ann A White
- Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Yoon Soo Park
- Department of Medical Education, University of Illinois Chicago, Chicago, IL, USA
| | - Kerri Palamara
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
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de Jesus GM, Dias LA, Barros AKC, Araujo LDMDS, Schrann MMF. Do girls wash dishes and boys play sports? Gender inequalities in physical activity and in the use of screen-based devices among schoolchildren from urban and rural areas in Brazil. BMC Public Health 2024; 24:196. [PMID: 38229021 PMCID: PMC10792968 DOI: 10.1186/s12889-024-17672-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024] Open
Abstract
OBJECTIVE The aim of the study was to analyze gender inequalities in types of physical activity (PA) and in the use of screen-based devices among schoolchildren from both urban and rural areas in Brazil. METHODS Data from two population-based surveys conducted in 2019 (urban areas: n = 2,479; 52.6% girls; age = 9.2 ± 1.51 years) and 2022 (rural areas: n = 979; 42.6% girls; age = 9.4 ± 1.52 years) were used. PA (active play, nonactive play, home chores, and structured physical activities) and the use of screen-based devices (TV, cellphone, videogame, and computer) were self-reported in a previous-day-recall online questionnaire (Web-CAAFE). Absolute gender inequalities were evaluated and presented as equiplots. Relative gender inequalities were evaluated by the prevalence ratio (PR) and respective 95% confidence intervals (95% CI), which were estimated by Poisson regression, with adjustments for age and BMI z scores. RESULTS Girls from urban and rural areas presented a lower prevalence of active play and a higher prevalence of home chores. The prevalence of nonactive play among girls from urban areas was also lower; however, their prevalence of structured physical activities was higher, especially among girls aged seven to nine years. Girls in both urban and rural areas presented a higher prevalence of TV viewing and lower use of video games. CONCLUSION The gender inequalities observed in the types of physical activities and in the use of screen-based devices could be considered potential correlates of the likelihood of girls' and boys' compliance with the physical activity guidelines.
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Affiliation(s)
- Gilmar Mercês de Jesus
- Public Health Post-Graduate Program, State University of Feira de Santana, Travessa Pássaro Vermelho,32, Santa Mônica II, CEP: 44082- 320, Feira de Santana, Brazil.
| | - Lizziane Andrade Dias
- Public Health Post-Graduate Program, State University of Feira de Santana, Travessa Pássaro Vermelho,32, Santa Mônica II, CEP: 44082- 320, Feira de Santana, Brazil
| | - Anna Karolina Cerqueira Barros
- Public Health Post-Graduate Program, State University of Feira de Santana, Travessa Pássaro Vermelho,32, Santa Mônica II, CEP: 44082- 320, Feira de Santana, Brazil
| | - Lara Daniele Matos Dos Santos Araujo
- Public Health Post-Graduate Program, State University of Feira de Santana, Travessa Pássaro Vermelho,32, Santa Mônica II, CEP: 44082- 320, Feira de Santana, Brazil
| | - Mayva Mayana Ferreira Schrann
- Public Health Post-Graduate Program, State University of Feira de Santana, Travessa Pássaro Vermelho,32, Santa Mônica II, CEP: 44082- 320, Feira de Santana, Brazil
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Uggla C, Saarela J. First Partner Choice in a Native Minority: The Role of Own and Parental Ethnolinguistic Affiliation. Eur J Popul 2024; 40:3. [PMID: 38227147 DOI: 10.1007/s10680-023-09683-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/16/2023] [Indexed: 01/17/2024]
Abstract
Despite increasing diversity within many societies, ethnically endogamous unions remain common. In contexts where one ethnic minority has lived alongside the majority for centuries, understanding who partners with whom is central to understanding how ethnic boundaries are maintained or dissolved. This study examines the role of own and parental ethnolinguistic affiliation for the first partner choice in Finland. We provide a unique test of the relevance of ethnic endogamy across two generations, in a context where both groups are native, but one (Finnish speakers) overwhelmingly outnumbers the other (Swedish speakers). Using register data on the total population, we examine how a person's ethnolinguistic affiliation and background affect the choice of the first cohabiting partner in terms of the partner's ethnolinguistic affiliation and background. We apply discrete-time competing risk models for men and women born 1970-1983. Results indicate that Swedish-registered individuals with two Swedish-registered parents are, by far, the most likely to partner with another Swedish-registered person with endogamous background. Partnering with a Swedish-registered person with exogamous background is most likely among individuals who themselves come from mixed unions. Patterns are remarkably consistent across gender, and adjustments for education and residential area only marginally alter the results.
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Affiliation(s)
- Caroline Uggla
- Demography Unit, Department of Sociology, Stockholm Univeristy, Stockholm, Sweden.
- Åbo Akademi, Vasa, Finland.
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Lee YX, Auwerda ST, Jellema K, Vliet Vlieland TPM, Arwert HJ. Ethnic disparities in long-term outcomes and health care usage after stroke in the Netherlands. Disabil Health J 2024:101582. [PMID: 38246799 DOI: 10.1016/j.dhjo.2024.101582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Poststroke health-related quality of life (HRQOL) is an important outcome that may be influenced by ethnicity. OBJECTIVE To compare long-term HRQOL, mental health and healthcare utilization between stroke survivors with a European (EUB) and non-European background (NEUB) in a hospital population. METHODS In this retrospective cohort study patients completed questionnaires 2-5 years after stroke. Assessments included the EuroQol-5D-3L (EQ-5D), Short Form (SF-36, with physical and mental component summary scales, PCS and MCS), Hospital Anxiety and Depression Scale (HADS; scores ≥8 indicate clinically relevant complaints) and a questionnaire on the usage of services from physicians and/or healthcare professionals (HCP) in the past 6 months. Linear and logistic regression analysis was used, adjusted for age, sex, level of education and functional outcome. RESULTS We included 207 patients (169 EUB, 38 NEUB); mean age 63.8 years (SD 14.4); 60.4 % male; mean follow up 36.3 months (SD 9.9). The EQ-5D and the PCS were higher in EUB versus NEUB patients (42.9 vs 35.4, p < 0.01; 0.76 vs 0.60, p < 0.01). The MCS showed a comparable, non-significant trend. The percentage of patients with HADS depression ≥8 was higher in NEUB patients versus EUB patients (54.3 % vs 29.8 %; p > 0.01). Significantly more NEUB patients had visited two or more physicians in the past six months compared to EUB patients (52.0 % vs 26.0 %; p = 0.01) whereas the use of services from HCP was similar. CONCLUSIONS NEUB stroke patients had worse outcomes regarding HRQOL and depressive symptoms compared to EUB patients. NEUB patients visited more physicians.
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Affiliation(s)
- Y X Lee
- Haaglanden Medical Center, Department of Neurology, Lijnbaan 32, 2512 VA, The Hague, the Netherlands.
| | - S T Auwerda
- Basalt Rehabilitation Center, Vrederustlaan 180, 2543 SW, The Hague, the Netherlands.
| | - K Jellema
- Haaglanden Medical Center, Department of Neurology, Lijnbaan 32, 2512 VA, The Hague, the Netherlands.
| | - T P M Vliet Vlieland
- Leiden Universitary Medical Center, Department of Orthopaedics, Rehabilitation and Physical Therapy, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.
| | - H J Arwert
- Haaglanden Medical Center, Department of Rehabilitation, Lijnbaan 32, 2512 VA, The Hague, the Netherlands; Basalt Rehabilitation Center, Lijnbaan 32, 2512 VA, The Hague, the Netherlands.
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130
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Isaksson M, Isaksson J, Schwab-Stone M, Ruchkin V. Longitudinal associations between community violence exposure, posttraumatic stress symptoms, and eating disorder symptoms. J Eat Disord 2024; 12:6. [PMID: 38212849 PMCID: PMC10785541 DOI: 10.1186/s40337-024-00965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Eating disorder (ED) symptoms have been associated with different types of traumatic events, such as exposure to sexual and physical violence, and emotional abuse. However, the relation between ED symptoms and community violence exposure (CVE) is underexplored, despite the latter's adverse effects on many aspects of adolescent functioning. The primary aim of this study was to evaluate the relation between CVE and ED symptoms in adolescents, while also investigating the potential mediating and moderating roles of posttraumatic stress (PTS) symptoms, gender, and ethnicity. METHODS Data were collected longitudinally over two consecutive years in the city of New Haven, CT, in the United States. Participants were 2612 adolescent students from the public school system (1397 girls and 1215 boys) with an average age of 12.8 years (SD = 1.29). The students were comprised of several different ethnic groups, including Caucasians, African Americans and Hispanic Americans. Associations between CVE (no exposure, witnessing, and victimization) and PTS symptoms at year one, and ED symptoms (thoughts and compensatory behaviors) at year two, were assessed with self-rating instruments. Moderation and mediation analyses were conducted using a variant of linear regression (Hayes PROCESS macro). RESULTS ED symptoms at year two were significantly associated with both witnessing and being a victim of community violence at year one, with most or all of the relations being explained by PTS symptoms. Overall, neither gender nor ethnicity had a meaningful moderating effect in the observed relations. CONCLUSIONS The findings support the notion that assessing and addressing PTS symptoms might be beneficial when treating individuals with ED symptoms who have experienced community violence, irrespective of gender or ethnicity.
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Affiliation(s)
- Martina Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, S-751 85, Uppsala, Sweden
| | - Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, S-751 85, Uppsala, Sweden
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Mary Schwab-Stone
- Child Study Center, Yale University School of Medicine, New Haven, USA
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, S-751 85, Uppsala, Sweden.
- Child Study Center, Yale University School of Medicine, New Haven, USA.
- Sala Forensic Psychiatric Clinic, Sala, Sweden.
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131
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Robinson HS, Vøllestad NK, Bennetter KE, Waage CW, Jenum AK, Richardsen KR. Pelvic girdle pain in pregnancy and early postpartum - prevalence and risk factors in a multi-ethnic cohort. BMC Musculoskelet Disord 2024; 25:21. [PMID: 38166902 PMCID: PMC10759664 DOI: 10.1186/s12891-023-07135-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Pelvic girdle pain (PGP) is common during and after pregnancy. It has been assumed that Scandinavian women report more PGP than women of other ethnicities. However, there are few population-based studies on ethnic differences and few with ethnicity as risk factor for PGP. The purposes of the present study were: To examine the prevalence of self-reported PGP through pregnancy and early postpartum in a multi-ethnic cohort. To investigate how ethnicity and patient characteristics were associated with risk of PGP during pregnancy and early postpartum. To investigate if clinical and personal factors obtained in gestation week (GW) 15 were associated with PGP in GW28 and postpartum week (PPW) 14. METHODS This study analyzed questionnaire data from 823 women from the Stork - Groruddalen mult-iethnic cohort study in Norway. Chi-square tests were used to investigate ethnic differences in prevalence of self-reported PGP, and logistic regression analyses to identify factors associated with self-reported PGP. RESULTS Women from South-Asia and Middle East reported 10-20% higher prevalence of self-reported PGP at all time points compared with Western women. Ethnicity was associated with PGP in GW15 and PPW14, adjusted for parity. Pain locations in pelvic area (PGP locations) in GW15, especially combined symphysis and posterior PGP, gave the highest risk (OR=7.4) for PGP in GW28 and in PPW14 (OR = 3.9). Being multiparous was a risk for PGP in PPW14 (OR=1.9). CONCLUSIONS Women of South Asian and Middle Eastern background had higher risk of self-reported PGP than Western women. Ethnicity was associated with PGP in GW15 and PPW14, after adjustments for parity. PGP locations in GW15 was the most prominent risk factor for PGP in GW28 and PPW14, whilst ethnicity was not significant in multivariable analyses.
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Affiliation(s)
- Hilde Stendal Robinson
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway.
| | - Nina K Vøllestad
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway
| | | | - Christin W Waage
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Institute of Health and Society, Department of General Practice, University of Oslo, Oslo, Norway
| | - Kåre Rønn Richardsen
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
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132
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Taguchi S, Sugawara K, Gonoi W, Hanaoka S, Shiomi S, Kishitani K, Uemura Y, Akamatsu N, Inui S, Tanaka K, Yagi K, Kawai T, Nakagawa T, Fukuhara H, Abe O, Seto Y, Gonzalez MC, Prado CM, Kume H. The importance of ethnic-specific cut-offs of low muscle mass for survival prediction in oncology. Clin Nutr 2024; 43:134-141. [PMID: 38041939 DOI: 10.1016/j.clnu.2023.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/13/2023] [Accepted: 11/23/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND & AIMS While skeletal muscle index (SMI) is the most widely used indicator of low muscle mass (or sarcopenia) in oncology, optimal cut-offs (or definitions) to better predict survival are not standardized. METHODS We compared five major definitions of SMI-based low muscle mass using an Asian patient cohort with gastrointestinal or genitourinary cancers. We analyzed 2015 patients with surgically-treated gastrointestinal (n = 1382) or genitourinary (n = 633) cancer with pre-surgical computed tomography images. We assessed the associations of clinical parameters, including low muscle mass by each definition, with cancer-specific survival (CSS) and overall survival (OS). RESULTS During a median follow-up period of 61 months, 303 (15%) died of cancer, and 147 died of other causes. An Asian-based definition diagnosed 17.8% of patients as having low muscle mass, while the other Caucasian-based ones classified most (>70%) patients as such. All definitions significantly discriminated both CSS and OS between patients with low or normal muscle mass. Low muscle mass using any definition but one predicted a lower CSS on multivariate Cox regression analyses. All definitions were independent predictors of lower OS. The original multivariate model without incorporating low muscle mass had c-indices of 0.63 for CSS and 0.66 for OS, which increased to 0.64-0.67 for CSS and 0.67-0.70 for OS when low muscle mass was considered. The model with an Asian-based definition had the highest c-indices (0.67 for CSS and 0.70 for OS). CONCLUSIONS The Asian-specific definition had the best predictive ability for mortality in this Asian patient cohort.
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Affiliation(s)
- Satoru Taguchi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kotaro Sugawara
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Wataru Gonoi
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
| | - Shouhei Hanaoka
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shinichiro Shiomi
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenjiro Kishitani
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukari Uemura
- Biostatistics Section, Department of Data Science, Center of Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuhiko Akamatsu
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shohei Inui
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koji Tanaka
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koichi Yagi
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taketo Kawai
- Department of Urology, Teikyo University School of Medicine, Tokyo, Japan
| | - Tohru Nakagawa
- Department of Urology, Teikyo University School of Medicine, Tokyo, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
| | - Osamu Abe
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - M Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Campman SL, Boyd A, Coyer L, Schinkel J, Agyemang C, Galenkamp H, Koopman ADM, Chilunga FP, Schim van der Loeff MF, van Houtum L, Leenstra T, Stronks K, Prins M. SARS-CoV-2 vaccination uptake in six ethnic groups living in Amsterdam, the Netherlands: A registry-based study within the HELIUS cohort. Prev Med 2024; 178:107822. [PMID: 38103796 DOI: 10.1016/j.ypmed.2023.107822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/01/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE Ethnic minority groups have experienced a disproportionate burden of COVID-19, and should therefore be especially encouraged to receive SARS-CoV-2 vaccination. This study compared first-dose uptake of the primary SARS-CoV-2 vaccination series across six ethnic groups in Amsterdam, the Netherlands in 2021. METHODS We analyzed data from participants of the population-based HELIUS cohort. We linked their data to the SARS-CoV-2 vaccination registry data of the Public Health Service of Amsterdam. We included registry data from January 6, 2021 (the start of the Dutch vaccination campaign) until September 6, 2021 (a date by which all adults in the Netherlands could have received one or two vaccine doses). SARS-CoV-2 vaccination uptake was defined as having received at least one vaccine dose of the primary vaccination series. We examined the association between ethnicity and vaccination uptake using multivariable logistic regression, while accounting for the age and sex distribution of ethnic groups in Amsterdam. RESULTS We included 19,006 participants (median age 53 years [interquartile range 41-62], 57% female). SARS-CoV-2 vaccination uptake was highest in the South-Asian Surinamese group (60.3%, 95%CI = 58.2-62.3%), followed by the Dutch (59.6%, 95%CI = 58.0-61.1%), Ghanaian (54.1%, 95%CI = 51.7-56.5%), Turkish (47.7%, 95%CI = 45.9-49.6%), African Surinamese (43.0%, 95%CI = 41.2-44.7%), and Moroccan (35.8%, 95%CI = 34.1-37.5%) groups. After adjusting for age, sex, perceived social support, and presence of relevant comorbidities, participants of African Surinamese, Ghanaian, Turkish and Moroccan origin were significantly less likely to be vaccinated than those of Dutch origin. CONCLUSIONS Prevention strategies should continue tailoring to specific ethnic groups to encourage vaccination uptake and reduce barriers to vaccination.
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Affiliation(s)
- Sophie L Campman
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands.
| | - Anders Boyd
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands; Stichting hiv monitoring, Amsterdam, the Netherlands
| | - Liza Coyer
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands
| | - Janke Schinkel
- Amsterdam UMC location University of Amsterdam, Department of Medical Microbiology and Infection Prevention, Meibergdreef 15, Amsterdam, the Netherlands
| | - Charles Agyemang
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Henrike Galenkamp
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, the Netherlands
| | - Anitra D M Koopman
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, the Netherlands
| | - Felix P Chilunga
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, the Netherlands
| | - Maarten F Schim van der Loeff
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands
| | - Lieke van Houtum
- Department of Healthy Living, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - Tjalling Leenstra
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Karien Stronks
- Amsterdam UMC location University of Amsterdam, Department of Public and Occupational Health, Amsterdam, the Netherlands; Amsterdam Public Health, Health Behaviors and Chronic Diseases, Amsterdam, the Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Infectious Diseases, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam Institute for Infection and Immunity, Infectious Diseases, Amsterdam, the Netherlands
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Bayram E, Liu H, Luo S, Di Luca DG, Skipworth M, Damron Solomon L, Dahodwala N, Litvan I. Ethnoracial differences for caregiving burden in Parkinson's disease. Parkinsonism Relat Disord 2024; 118:105927. [PMID: 37952272 PMCID: PMC10911683 DOI: 10.1016/j.parkreldis.2023.105927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/27/2023] [Accepted: 11/01/2023] [Indexed: 11/14/2023]
Abstract
INTRODUCTION Caregivers play an important role in Parkinson's disease (PD) treatment, especially as the disease progresses. As the symptom profile and needs of people with PD (PwP) differ across ethnoracial groups, whether caregiving needs also differ for different ethnoracial groups should be investigated. METHODS Data were obtained from the Parkinson's Foundation funded Parkinson's Outcomes Project for PwP identifying as Hispanic (n = 495), non-Hispanic Asian (n = 170), non-Hispanic Black (n = 162), or non-Hispanic White (n = 7687). Cross-sectional and longitudinal total Multidimensional Caregiver Strain Index (MCSI) and domain-specific scores for caregiving burden were compared across the ethnoracial groups. Effect of demographics and clinical variables, interaction of these variables with ethnoracial groups for caregiver burden was assessed. RESULTS Care partners of PwP identifying as non-Hispanic Asian experienced the most burden. PwP identifying as non-Hispanic White were oldest, yet their care partners experienced the least burden. Care partners of PwP identifying as non-Hispanic Asian experienced more burden in physical and social domains, care partners of PwP identifying as Hispanic experienced more burden in financial and elder demanding/manipulative domains. Over time, burden increased similarly across the ethnoracial groups. Effect of frequency of falls, hospital admission, neuropsychiatric disorder and social support on burden over time differed across the groups. CONCLUSION PwP from different ethnoracial groups can experience different levels of caregiving burden. Predictors for caregiving burden, such as social support and falls can have different impacts based on ethnicity and race. Caregiver needs should also be assessed and culturally competent support should be provided to benefit all affected by PD.
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Affiliation(s)
- Ece Bayram
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
| | - Hongliang Liu
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Sheng Luo
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
| | - Daniel G Di Luca
- Department of Neurology, Washington University in St. Louis, MO, USA.
| | - Michael Skipworth
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
| | - Lisa Damron Solomon
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
| | - Nabila Dahodwala
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Irene Litvan
- Parkinson and Other Movement Disorders Center, Department of Neurosciences, University of California San Diego, La Jolla, CA, USA.
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Davis JA, Thurlapati A, Weeda E, Gaffney KJ, Smith D, Maldonado A, Granger K, Martin KE, Williams YM, Herrington T, Velayati A, Bakos JK, Green K, Hashmi H. Impact of race and ethnicity on outcomes after autologous stem cell transplantation for patients with newly diagnosed multiple myeloma. Ann Hematol 2024; 103:251-258. [PMID: 37851073 DOI: 10.1007/s00277-023-05503-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/09/2023] [Indexed: 10/19/2023]
Abstract
Non-Hispanic Black patients are disproportionally affected by multiple myeloma (MM) and whether efficacy outcomes after autologous stem cell transplant (ASCT) differ by race and ethnicity remains an area of active investigation. This study included 449 patients enriched with a large proportion of non-Hispanic Black patients and sought to highlight the impact of race and ethnicity on outcomes after HDT-ASCT for patients with newly diagnosed MM. We found induction chemotherapy followed by high-dose therapy-ASCT and maintenance chemotherapy is associated with long-term PFS and OS, regardless of race or ethnicity.
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Affiliation(s)
- James A Davis
- Division of Malignant Hematology and Bone Marrow Transplant, Department of Pharmacy, Medical University of South Carolina, 86 Jonathan Lucas St, Charleston, SC, 29425, USA.
| | - Aswani Thurlapati
- Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
| | - Erin Weeda
- Medical University of South Carolina College of Pharmacy, Charleston, SC, USA
| | - Kelly J Gaffney
- Division of Malignant Hematology and Bone Marrow Transplant, Department of Pharmacy, Medical University of South Carolina, 86 Jonathan Lucas St, Charleston, SC, 29425, USA
| | - Deidra Smith
- Division of Malignant Hematology and Bone Marrow Transplant, Department of Pharmacy, Medical University of South Carolina, 86 Jonathan Lucas St, Charleston, SC, 29425, USA
| | - Andy Maldonado
- Division of Malignant Hematology and Bone Marrow Transplant, Department of Pharmacy, Medical University of South Carolina, 86 Jonathan Lucas St, Charleston, SC, 29425, USA
| | - Katelynn Granger
- Division of Malignant Hematology and Bone Marrow Transplant, Department of Pharmacy, Medical University of South Carolina, 86 Jonathan Lucas St, Charleston, SC, 29425, USA
| | - Kristy E Martin
- Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
| | - Yolanda M Williams
- Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
| | - Taylor Herrington
- Medical University of South Carolina College of Pharmacy, Charleston, SC, USA
| | - Arash Velayati
- Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
| | - Jonathan K Bakos
- Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
| | - Kimberly Green
- Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
| | - Hamza Hashmi
- Department of Hematology and Bone Marrow Transplant, Medical University of South Carolina, Hollings Cancer Center, Charleston, SC, USA
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Sarr R. Experiences of ethnic minoritised young people in a specialist child and adolescent mental health service: A qualitative analysis as part of a mixed methods service evaluation. Clin Child Psychol Psychiatry 2024; 29:127-140. [PMID: 37848347 PMCID: PMC10748456 DOI: 10.1177/13591045231208571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
BACKGROUND There have been several reports of inequalities for ethnic minoritised service users across National Health Service mental health services in the United Kingdom. This research aims to explore the perspectives and experiences of young people from ethnic minoritised groups accessing psychological therapy in a National Specialist Child and Adolescent Mental Health Service in England. METHOD Semi-structured interviews were conducted to investigate how young people perceived their ethnicity and how it was considered during psychological therapy. Nine young people were interviewed, and a thematic analysis was conducted. RESULTS Qualitative analysis revealed five themes: (1) adolescence, ethnicity, and identity; (2) ethnicity as a meaningful part of the therapeutic intervention; (3) therapeutic alliance to facilitate dialogue; (4) aversion to ethnicity exploration; and (5) treading lightly: a fine line between sensitive and overly cautious. CONCLUSIONS The study illustrated the complexity of considering ethnicity in therapy due to conflicting views and preferences and the need for further research.
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Affiliation(s)
- Rachel Sarr
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
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Molokhia M, Wierzbicki AS, Williams H, Kirubakaran A, Devani R, Durbaba S, Ayis S, Qureshi N. Assessment of ethnic inequalities in diagnostic coding of familial hypercholesterolaemia (FH): A cross-sectional database study in Lambeth, South London. Atherosclerosis 2024; 388:117353. [PMID: 38157708 DOI: 10.1016/j.atherosclerosis.2023.117353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 10/06/2023] [Accepted: 10/17/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND AND AIMS Differences in the perceived prevalence of familial hypercholesterolemia (FH) by ethnicity are unclear. In this study, we aimed to assess the prevalence, determinants and management of diagnostically-coded FH in an ethnically diverse population in South London. METHODS A cross-sectional analysis of 40 practices in 332,357 adult patients in Lambeth was undertaken. Factors affecting a (clinically coded) diagnosis of FH were investigated by multi-level logistic regression adjusted for socio-demographic and lifestyle factors, co-morbidities, and medications. RESULTS The age-adjusted FH % prevalence rate (OR, 95%CI) ranged from 0.10 to 1.11, 0.00-1.31. Lower rates of FH coding were associated with age (0.96, 0.96-0.97) and male gender (0.75, 0.65-0.87), p < 0.001. Compared to a White British reference group, a higher likelihood of coded FH was noted in Other Asians (1.33, 1.01-1.76), p = 0.05, with lower rates in Black Africans (0.50, 0.37-0.68), p < 0.001, Indians (0.55, 0.34-0.89) p = 0.02, and in Black Caribbeans (0.60, 0.44-0.81), p = 0.001. The overall prevalence using Simon Broome criteria was 0.1%; we were unable to provide ethnic specific estimates due to low numbers. Lower likelihoods of FH coding (OR, 95%CI) were seen in non-native English speakers (0.66, 0.53-0.81), most deprived income quintile (0.68, 0.52-0.88), smokers (0.68,0.55-0.85), hypertension (0.62, 0.52-0.74), chronic kidney disease (0.64, 0.41-0.99), obesity (0.80, 0.67-0.95), diabetes (0.31, 0.25-0.39) and CVD (0.47, 0.36-0.63). 20% of FH coded patients were not prescribed lipid-lowering medications, p < 0.001. CONCLUSIONS Inequalities in diagnostic coding of FH patients exist. Lower likelihoods of diagnosed FH were seen in Black African, Black Caribbean and Indian ethnic groups, in contrast to higher diagnoses in White and Other Asian ethnic groups. Hypercholesterolaemia requiring statin therapy was associated with FH diagnosis, however, the presence of cardiovascular disease (CVD) risk factors lowered the diagnosis rate for FH.
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Affiliation(s)
- Mariam Molokhia
- School of Life Course and Population Sciences, United Kingdom; King's College London, United Kingdom.
| | - Anthony S Wierzbicki
- Department of Metabolic Medicine/Chemical Pathology, United Kingdom; Guy's & St Thomas' Hospitals, United Kingdom
| | - Helen Williams
- Consultant Pharmacist for CVD, Medicines Use and Safety Team & South East London ICS, United Kingdom
| | - Arushan Kirubakaran
- School of Life Course and Population Sciences, United Kingdom; King's College London, United Kingdom
| | | | - Stevo Durbaba
- School of Life Course and Population Sciences, United Kingdom; King's College London, United Kingdom
| | | | - Nadeem Qureshi
- Department of Primary Care, University of Nottingham, United Kingdom
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de Graaff E, Anderson N, Sadler L, Lakhdhir H, Simon-Kumar R, Peiris-John R, Burgess W, Okesene-Gafa K, Cronin R, McCowan L, Bartlett K. A validation of placental pathology reports by ethnicity in New Zealand, through systematic analysis of histological slides. Placenta 2024; 145:162-168. [PMID: 38142649 DOI: 10.1016/j.placenta.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/06/2023] [Accepted: 12/10/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION Reliability studies of placental examination have shown differing interobserver agreement for certain pathological features, a lack of uniform reporting criteria and variable experience among pathologists. In previous analyses we have shown that placental pathology differs by ethnicity. This validation study was performed to investigate whether bias related to ethnicity is a feature of placental pathology reporting in New Zealand (NZ). METHODS 199 of 1726 eligible perinatal death cases between 2008 and 2017 were selected at random for this audit-type study, including 51 cases from South Asian, Māori and NZ European ethnicity and 46 cases from Pacific mothers. Stored histology slides were blinded and re-examined by an experienced perinatal pathologist, and linked to the corresponding original pathology report. Interobserver agreement (overall, by ethnicity and by gestational age) was described by proportional differences and kappa coefficients. RESULTS Total interobserver agreement between original placental reporting and the validation review was 89.7 %, which differed by pathological feature. There was generally more underreporting than overreporting (3.6 % and 6.7 %, respectively). There was little disagreement by ethnicity (decidual vasculopathy [p = 0.03]), although there were more differences by gestational age (villous morphology [p < 0.01], chorioamnionitis [p = 0.03], high-grade villitis of unknown etiology [p < 0.01], and placental haemorrhage [p = 0.03]). DISCUSSION No systematic bias in placental pathology reporting in NZ was identified by ethnicity or gestational age, as observed differences could be related to the underlying prevalence of pathology. We identified more underreporting than overreporting of pathology in the original reports, emphasizing the importance of placental investigation by specialised perinatal pathologists.
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Affiliation(s)
- Esti de Graaff
- The University of Auckland Faculty of Medical and Health Sciences, Obstetrics & Gynaecology, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Ngaire Anderson
- The University of Auckland Faculty of Medical and Health Sciences, Obstetrics & Gynaecology, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Lynn Sadler
- The University of Auckland Faculty of Medical and Health Sciences, Obstetrics & Gynaecology, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand; Te Toka Tumai Auckland, Te Whatu Ora Health New Zealand, 2 Park Road, Grafton, Auckland, 1023, New Zealand.
| | - Heena Lakhdhir
- Counties Manukau District, Division of Women's Health, Te Whatu Ora - Health New Zealand, 100 Hospital Road, Ōtāhuhu, Auckland, 2025, New Zealand.
| | - Rachel Simon-Kumar
- The University of Auckland School of Population Health, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Roshini Peiris-John
- The University of Auckland Section of Epidemiology and Biostatistics, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Wendy Burgess
- The University of Auckland Faculty of Medical and Health Sciences, Obstetrics & Gynaecology, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Karaponi Okesene-Gafa
- The University of Auckland Faculty of Medical and Health Sciences, Obstetrics & Gynaecology, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand; Counties Manukau District, Division of Women's Health, Te Whatu Ora - Health New Zealand, 100 Hospital Road, Ōtāhuhu, Auckland, 2025, New Zealand.
| | - Robin Cronin
- The University of Auckland Faculty of Medical and Health Sciences, Obstetrics & Gynaecology, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand; Counties Manukau District, Division of Women's Health, Te Whatu Ora - Health New Zealand, 100 Hospital Road, Ōtāhuhu, Auckland, 2025, New Zealand.
| | - Lesley McCowan
- The University of Auckland Faculty of Medical and Health Sciences, Obstetrics & Gynaecology, Building 507, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Kate Bartlett
- Auckland District Health Board LabPlus, Auckland City Hospital, Building 31, Gate 4 Grafton Road, Grafton, Auckland, 1148, New Zealand.
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Zhang L, Huang T, Li C, Xing X, Zou D, Dimitriou D, Tsai T, Li P. Race and Gender Differences in Anterior Cruciate Ligament Femoral Footprint Location and Orientation: A 3D-MRI Study. Orthop Surg 2024; 16:216-226. [PMID: 37953405 PMCID: PMC10782238 DOI: 10.1111/os.13918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 11/14/2023] Open
Abstract
OBJECTIVE The femoral tunnel position is crucial to anatomic single-bundle anterior cruciate ligament (ACL) reconstruction, but the ideal femoral footprint position are mostly based on small-sized cadaveric studies and elderly patients with a single ethnic background. This study aimed to identify potential race- or gender-specific differences in the ACL femoral footprint location and ACL orientation, determine the correlation between the ACL orientation and the femoral footprint location. METHODS Magnetic resonance images (MRIs) of 90 Caucasian participants and 90 matched Chinese subjects were used for reconstruction of three-dimensional (3D) femur and tibial models. ACL footprints were sketched by several experienced orthopedic surgeons on the MRI photographs. The anatomical coordinate system was applied to reflect the ACL footprint location and orientation of scanned samples. The femoral ACL footprint locations were represented by their distance from the origin in the anteroposterior (A/P) and distal-proximal (D/P) directions. The orientation of the ACL was described with the sagittal, coronal and transverse deviation angles. The ACL orientation and femoral footprint position were compared by the two-sided t-test. Multiple regression analysis was used to study the correlation between the orientation and femoral footprint position. RESULTS The average femur footprint A/P position was -6.6 ± 1.6 mm in the Chinese group and -5.1 ± 2.3 mm in the Caucasian group, (p < 0.001). The average femur footprint D/P position was -2.8 ± 2.4 mm in Chinese and - 3.9 ± 2.0 mm in Caucasians, (p = 0.001). The Chinese group had a mean difference of a 1.5 mm (6.1%) more posterior and 1.1 mm (5.3%) more proximal in the position from the flexion-extension axis (FEA). And the males have a sagittal plane elevation about 4-5° higher than females in both racial groups. Furthermore, for every 1% (0.40 mm) increase in A/P and D/P values, the sagittal angle decreased by about 0.12° and 0.24°, respectively; the coronal angle decreased by about 0.10° and 0.30°, respectively. For every 1% (0.40 mm) increase in D/P value, the transverse angle increased by about 0.14°. CONCLUSION The significant race- and gender-specific differences in the femoral footprint and orientation of the ACL should be taken in consideration during anatomic single-bundle ACL reconstruction. Furthermore, the quantitative relationship between the ACL orientation and the footprint location might provide some reference for surgeons to develop a surgical strategy in ACL single-bundle reconstruction and revision.
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Affiliation(s)
- Lihang Zhang
- Guangdong Key Lab of Orthopedic Technology and Implant, General Hospital of Southern Theater Command of PLA, The First School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
| | - Tianwen Huang
- Guangdong Key Lab of Orthopedic Technology and Implant, General Hospital of Southern Theater Command of PLA, The First School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Changzhao Li
- Guangdong Key Lab of Orthopedic Technology and Implant, General Hospital of Southern Theater Command of PLA, The First School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
- Department of Joint SurgeryThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
- Department of BiostatisticsBioinformatics & Biomathematics Georgetown UniversityWashington, DCUSA
| | - Xing Xing
- School of Biomedical Engineering & Med‐X Research InstituteShanghai Jiao Tong UniversityShanghaiChina
| | - Diyang Zou
- Engineering Research Center of Digital Medicine and Clinical TranslationMinistry of EducationShanghaiChina
- Department of Orthopedic Surgery, Shanghai Key Laboratory of Orthopedic Implants and Clinical Translational R&D Center of 3D Printing Technology, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Department of OrthopedicsUniversity Hospital BalgristZurichSwitzerland
| | | | - Tsung‐Yuan Tsai
- Engineering Research Center of Digital Medicine and Clinical TranslationMinistry of EducationShanghaiChina
- Department of Orthopedic Surgery, Shanghai Key Laboratory of Orthopedic Implants and Clinical Translational R&D Center of 3D Printing Technology, Shanghai Ninth People's HospitalShanghai Jiao Tong University School of MedicineShanghaiChina
- Department of OrthopedicsUniversity Hospital BalgristZurichSwitzerland
| | - Pingyue Li
- Guangdong Key Lab of Orthopedic Technology and Implant, General Hospital of Southern Theater Command of PLA, The First School of Clinical MedicineSouthern Medical UniversityGuangzhouChina
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De Jesus O. Degenerative Cervical Disc Herniation: Prevalence of Affected Cervical Level in a Hispanic Population in Puerto Rico. World Neurosurg 2024; 181:e776-e779. [PMID: 37914080 DOI: 10.1016/j.wneu.2023.10.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/03/2023]
Abstract
BACKGROUND In the literature, degenerative cervical disc herniation is considered to occur more frequently at the C5-C6 and C6-C7 levels. This study aimed to evaluate the operated cervical level prevalence among patients with degenerative cervical disc herniation in a Hispanic Puerto Rico population. METHODS The University of Puerto Rico Neurosurgery database was used to identify patients who underwent anterior cervical discectomy for degenerative cervical disc herniation during a 15-year period from January 1, 2006 until December 31, 2020. Operated cervical levels for each patient were analyzed. RESULTS During the study period, 409 patients were operated on for degenerative cervical disc herniation. Two hundred-eight patients (50.8%) had disc herniations at more than 1 cervical level for 663 treated levels. The most prevalent cervical levels in this Hispanic population were C5-C6 (34.8%) and C4-C5 (28.1%). The C6-C7 level was involved in 18.9% of the operated levels, and the C3-C4 level in 17.3%. The C7-T1 level was involved in only 0.6% of the operated levels, and the C2-3 level in 0.3%. The cohort included 51.3% of men and 48.7% of women, with a men-to-women ratio of 1.05:1. The median age of females was 56.5 (range 26-82) and 59.0 (range 31-85) for males. Operated cervical discs were most common between the ages of 48 and 66 years for either sex. CONCLUSIONS In a Hispanic Puerto Rico population, the most prevalent operated degenerative cervical disc levels were C5-C6 and C4-C5.
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Affiliation(s)
- Orlando De Jesus
- Department of Surgery, Section of Neurosurgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico, USA.
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Kondo J, Tempaku PF, D'Almeida V, Kakazu VA, Andersen ML, Tufik S, Poyares D. Sleep patterns according to genetically determined ethnicity in the population of São Paulo, Brazil. Sleep Med 2024; 113:242-248. [PMID: 38064796 DOI: 10.1016/j.sleep.2023.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 01/07/2024]
Abstract
Sleep is a behavior expressed differently for each individual. However, studies have shown that some ethnic groups express common sleep patterns, which can be observed in different ethnic groups. Previous studies have shown the existence of sleep disparities in populations of different ethnicities. Most of these studies have considered self-reported ethnicity and assessed sleep subjectively. Therefore, the aim of this study was to evaluate sleep disparities in different ethnic groups based on an analysis of genetic ancestry and the use of objective sleep evaluation. To do this, we used data from the São Paulo Epidemiologic Sleep Study (EPISONO), which was undertaken in Brazil, a country that is known for its ethnic/racial diversity. All individuals completed a series of questionnaires, underwent full polysomnography and had their blood collected for DNA extraction. After genotyping and identifying samples with high-quality DNA suitable for genetic analysis, 31 ancestry-informative markers (AIMs) were selected. These markers exhibited substantial allelic frequency differences, enabling the characterization of the three primary founding populations of modern Brazil - Europeans, West-Africans, and Native Americans. Through this analysis, the genetic contribution of each of these ancestral groups was identified in respect of each participant. Based on this, a latent class cluster analysis (LCCA) was performed to define the three clusters that best classified the sample according to ethnic group: African (n = 255), Caucasian (n = 668) and Native American (n = 83). Applying the adjusted model for the confounding variables (age, socio-economic class and sex), statistically significant differences in sleep variables between ethnicities were found. Africans had higher sleep latency compared to the other groups (β = 4.46, CI = 1.18 to 7.74 and β = 7.83, CI = 3.50 to 12.15), while Caucasians had longer total sleep time (β = -16.47, CI = -29.94 to -2.99) and better sleep efficiency (β = -2.19, CI = -4.35 to -0.02) compared to Africans. Regarding the respiratory arousals index (β = -1.11, IC = -2.07 to -0.16) and periodic leg movements index (β = -7.48, CI = -12.08 to -2.88), both were higher among Caucasians compared to Africans. We were able to conclude that genetic ancestry might modulate sleep structure and the occurrence of sleep disorders.
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Affiliation(s)
- Julia Kondo
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Priscila F Tempaku
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Vânia D'Almeida
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Viviane A Kakazu
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Dalva Poyares
- Departamento de Psicobiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
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Dulaney A, Virostko J. Disparities in the Demographic Composition of The Cancer Imaging Archive. Radiol Imaging Cancer 2024; 6:e230100. [PMID: 38240671 PMCID: PMC10825717 DOI: 10.1148/rycan.230100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 10/31/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024]
Abstract
Purpose To characterize the demographic distribution of The Cancer Imaging Archive (TCIA) studies and compare them with those of the U.S. cancer population. Materials and Methods In this retrospective study, data from TCIA studies were examined for the inclusion of demographic information. Of 189 studies in TCIA up until April 2023, a total of 83 human cancer studies were found to contain supporting demographic data. The median patient age and the sex, race, and ethnicity proportions of each study were calculated and compared with those of the U.S. cancer population, provided by the Surveillance, Epidemiology, and End Results Program and the Centers for Disease Control and Prevention U.S. Cancer Statistics Data Visualizations Tool. Results The median age of TCIA patients was found to be 6.84 years lower than that of the U.S. cancer population (P = .047) and contained more female than male patients (53% vs 47%). American Indian and Alaska Native, Black or African American, and Hispanic patients were underrepresented in TCIA studies by 47.7%, 35.8%, and 14.7%, respectively, compared with the U.S. cancer population. Conclusion The results demonstrate that the patient demographics of TCIA data sets do not reflect those of the U.S. cancer population, which may decrease the generalizability of artificial intelligence radiology tools developed using these imaging data sets. Keywords: Ethics, Meta-Analysis, Health Disparities, Cancer Health Disparities, Machine Learning, Artificial Intelligence, Race, Ethnicity, Sex, Age, Bias Published under a CC BY 4.0 license.
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Affiliation(s)
- Aidan Dulaney
- From the Department of Diagnostic Medicine (A.D., J.V.), Livestrong
Cancer Institutes (J.V.), and Department of Oncology (J.V.), Dell Medical
School, University of Texas at Austin, 210 E 24th St, Austin, TX 78712; and Oden
Institute for Computational Engineering and Sciences, University of Texas at
Austin, Austin, Tex (J.V.)
| | - John Virostko
- From the Department of Diagnostic Medicine (A.D., J.V.), Livestrong
Cancer Institutes (J.V.), and Department of Oncology (J.V.), Dell Medical
School, University of Texas at Austin, 210 E 24th St, Austin, TX 78712; and Oden
Institute for Computational Engineering and Sciences, University of Texas at
Austin, Austin, Tex (J.V.)
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Jacobs BM, Tank P, Bestwick JP, Noyce AJ, Marshall CR, Mathur R, Giovannoni G, Dobson R. Modifiable risk factors for multiple sclerosis have consistent directions of effect across diverse ethnic backgrounds: a nested case-control study in an English population-based cohort. J Neurol 2024; 271:241-253. [PMID: 37676298 PMCID: PMC10769990 DOI: 10.1007/s00415-023-11971-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Multiple sclerosis is a leading cause of non-traumatic neurological disability among young adults worldwide. Prior studies have identified modifiable risk factors for multiple sclerosis in cohorts of White ethnicity, such as infectious mononucleosis, smoking, and obesity during adolescence/early adulthood. It is unknown whether modifiable exposures for multiple sclerosis have a consistent impact on risk across ethnic groups. AIM To determine whether modifiable risk factors for multiple sclerosis have similar effects across diverse ethnic backgrounds. METHODS We conducted a nested case-control study using data from the UK Clinical Practice Research Datalink. Multiple sclerosis cases diagnosed from 2001 until 2022 were identified from electronic healthcare records and matched to unaffected controls based on year of birth. We used stratified logistic regression models and formal statistical interaction tests to determine whether the effect of modifiable risk factors for multiple sclerosis differed by ethnicity. RESULTS We included 9662 multiple sclerosis cases and 118,914 age-matched controls. The cohort was ethnically diverse (MS: 277 South Asian [2.9%], 251 Black [2.6%]; Controls: 5043 South Asian [5.7%], 4019 Black [4.5%]). The age at MS diagnosis was earlier in the Black (40.5 [SD 10.9]) and Asian (37.2 [SD 10.0]) groups compared with White cohort (46.1 [SD 12.2]). There was a female predominance in all ethnic groups; however, the relative proportion of males was higher in the South Asian population (proportion of women 60.3% vs 71% [White] and 75.7% [Black]). Established modifiable risk factors for multiple sclerosis-smoking, obesity, infectious mononucleosis, low vitamin D, and head injury-were consistently associated with multiple sclerosis in the Black and South Asian cohorts. The magnitude and direction of these effects were broadly similar across all ethnic groups examined. There was no evidence of statistical interaction between ethnicity and any tested exposure, and no evidence to suggest that differences in area-level deprivation modifies these risk factor-disease associations. These findings were robust to a range of sensitivity analyses. CONCLUSIONS AND RELEVANCE Established modifiable risk factors for multiple sclerosis are applicable across diverse ethnic backgrounds. Efforts to reduce the population incidence of multiple sclerosis by tackling these risk factors need to be inclusive of people from diverse ethnicities.
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Affiliation(s)
- Benjamin M Jacobs
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University London, London, EC1M 6BQ, UK
- Department of Neurology, Royal London Hospital, London, UK
| | - Pooja Tank
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University London, London, EC1M 6BQ, UK
| | - Jonathan P Bestwick
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University London, London, EC1M 6BQ, UK
| | - Alastair J Noyce
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University London, London, EC1M 6BQ, UK
- Department of Neurology, Royal London Hospital, London, UK
| | - Charles R Marshall
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University London, London, EC1M 6BQ, UK
- Department of Neurology, Royal London Hospital, London, UK
| | - Rohini Mathur
- Centre for Primary Care, Wolfson Institute of Population Health, Queen Mary University London, London, UK
| | - Gavin Giovannoni
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University London, London, EC1M 6BQ, UK
- Department of Neurology, Royal London Hospital, London, UK
- Blizard Institute, Queen Mary University London, London, UK
| | - Ruth Dobson
- Centre for Preventive Neurology, Wolfson Institute of Population Health, Queen Mary University London, London, EC1M 6BQ, UK.
- Department of Neurology, Royal London Hospital, London, UK.
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Naamneh-Abuelhija B, Yogev-Seligmann G, Kafri M. Does affiliation with a minority group affect patient activation? Patient Educ Couns 2024; 118:108011. [PMID: 37866072 DOI: 10.1016/j.pec.2023.108011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 09/04/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To systematically review published studies assessing associations between ethnicity and patient activation (PA) among people with chronic conditions. METHODS A systematic review (PROSPERO-CRD42022320793) was performed by searching in PubMed, CINAHL, Scopus, and Google Scholar. Studies were included according to the following criteria: age > 18, diagnosis of at least one chronic condition, assessment of PA, report of ethnic minority group, and statistical analyses of PA scores include between-group comparisons or correlation or regression with ethnic group affiliation. Two reviewers conducted independent screening of records and full-text articles published until July 2021. Quality was evaluated using the National Institutes of Health study quality assessment tool. RESULTS From 197 records identified, 12 studies were included. The majority of studies focused on participants of White, Black and Hispanic ethnicity. Seven studies establish a significant association between ethnicity and PA, while the remainder of the studies found no association or inconclusive results. CONCLUSIONS The findings indicate that ethnicity is related to PA although additional, multiple explanatory variables other than ethnicity to PA were identified. Practice implications Programs to promote PA should be adjusted to participants' ethnic affiliation but consider differences in the barriers to PA and their magnitude that may differ across different ethnicities.
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Affiliation(s)
- Badera Naamneh-Abuelhija
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 3498838, Israel
| | - Galit Yogev-Seligmann
- Department of Occupational Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 3498838, Israel
| | - Michal Kafri
- Department of Physical Therapy, Faculty of Social Welfare & Health Sciences, University of Haifa, Mount Carmel, Haifa 3498838, Israel.
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145
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El-Gamel A, Raman J. Outcomes of Valvular Heart Disease-How Can We Close the Gap for Indigenous Patients? Heart Lung Circ 2024; 33:7-8. [PMID: 38342562 DOI: 10.1016/j.hlc.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2024]
Affiliation(s)
- Adam El-Gamel
- Wollongong Cardiothoracic Unit, Wollongong, NSW, Australia; Faculty of Medical and Health Sciences, The University of Auckland, New Zealand; and, University of Waikato Medical Research Centre, The University of Waikato, Hamilton, New Zealand.
| | - Jai Raman
- Department of Cardiothoracic Surgery, St Vincent's Hospital, Melbourne, Vic, and Department of Cardiothoracic Surgery, Austin Hospital, Melbourne, Vic, Australia.
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146
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Chaudhry UAR, Carey IM, Critchley JA, DeWilde S, Limb ES, Bowen L, Panahloo A, Cook DG, Whincup PH, Harris T. A matched cohort study evaluating the risks of infections in people with type 1 diabetes and their associations with glycated haemoglobin. Diabetes Res Clin Pract 2024; 207:111023. [PMID: 37984487 DOI: 10.1016/j.diabres.2023.111023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 11/22/2023]
Abstract
AIMS People with type 1 diabetes (T1D) have raised infection rates compared to those without, but how these risks vary by age, sex and ethnicity, or by glycated haemoglobin (HbA1c), remain uncertain. METHODS 33,829 patients with T1D in Clinical Practice Research Datalink on 01/01/2015 were age-sex-ethnicity matched to two non-diabetes patients. Infections were collated from primary care and linked hospitalisation records during 2015-2019, and incidence rate ratios (IRRs) were estimated versus non-diabetes. For 26,096 people with T1D, with ≥3 HbA1c measurements in 2012-2014, mean and coefficient of variation were estimated, and compared across percentiles. RESULTS People with T1D had increased risk for infections presenting in primary care (IRR = 1.81, 95%CI 1.77-1.85) and hospitalisations (IRR = 3.37, 3.21-3.53) compared to non-diabetes, slightly attenuated after further adjustment. Younger ages and non-White ethnicities had greater relative risks, potentially explained by higher HbA1c mean and variability amongst people with T1D within these sub-groups. Both mean HbA1c and greater variability were strongly associated with infection risks, but the greatest associations were at the highest mean levels (hospitalisations IRR = 4.09, 3.64-4.59) for >97 versus ≤53 mmol/mol. CONCLUSIONS Infections are a significant health burden in T1D. Improved glycaemic control may reduce infection risks, while prompter infection treatments may reduce hospital admissions.
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Affiliation(s)
- Umar A R Chaudhry
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom.
| | - Iain M Carey
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Julia A Critchley
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Stephen DeWilde
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Elizabeth S Limb
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Liza Bowen
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Arshia Panahloo
- St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London SW17 0QT, United Kingdom
| | - Derek G Cook
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
| | - Tess Harris
- Population Health Research Institute, St George's, University of London, London SW17 0RE, United Kingdom
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147
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Mallawaarachchi G, Rog DJ, Das J. Ethnic disparities in the epidemiological and clinical characteristics of multiple sclerosis. Mult Scler Relat Disord 2024; 81:105153. [PMID: 38043364 DOI: 10.1016/j.msard.2023.105153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/13/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Multiple Sclerosis (MS) is a neuroinflammatory disorder which affects 2.8 million people world-wide. A growing body of evidence shows ethnic disparities in MS. This review aims to evaluate differences, based upon ethnic background, in the incidence, prevalence, disease course, and efficacy of disease-modifying therapies (DMTs) among people with MS (PwMS). METHOD Ethnicities were classified as White, Black, Hispanic, Asian, and Middle Eastern and North African (MENA). A literature search was conducted using the PubMed search engine to identify articles on MS and ethnicity that were published in the English language between 01/01/2005 and 31/05/2022. RESULTS 101 studies met all inclusion criteria. Although the incidence and prevalence of MS varied among ethnicities, findings were inconsistent and depended on the continent of the study. Ethnicity may have an impact on the disease course. PwMS from Black, Hispanic, and MENA, but not Asian ethnicities, appeared to accumulate physical disability at a faster rate than those from White ethnicity. Although there was a lack of studies evaluating the relative safety and efficacy of DMTs among various ethnicities, interferon-beta was found to be less efficacious in PwMS from Black ethnicity. CONCLUSIONS Further studies, with more uniform definitions of ethnicity are required to comprehensively understand ethnic disparities in MS, in particular to identify underlying causes, to facilitate the delivery of personalised medical care and avoid inequity.
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Affiliation(s)
| | - David J Rog
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford, United Kingdom M6 8HD
| | - Joyutpal Das
- University of Manchester, Oxford Rd, Manchester, United Kingdom M13 9PL; Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford, United Kingdom M6 8HD.
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148
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Agerström J, Andréll C, Bremer A, Strömberg A, Årestedt K, Israelsson J. All Else Being Equal: Examining Treatment Bias and Stereotypes Based on Patient Ethnicity and Socioeconomic Status With In-Hospital Cardiac Arrest Clinical Vignettes. Heart Lung 2024; 63:86-91. [PMID: 37837719 DOI: 10.1016/j.hrtlng.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/08/2023] [Accepted: 09/27/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Research on ethnic and socioeconomic treatment differences following in-hospital cardiac arrest (IHCA) largely draws on register data. Due to the correlational nature of such data, it cannot be concluded whether detected differences reflect treatment bias/discrimination - whereby otherwise identical patients are treated differently solely due to sociodemographic factors. To be able to establish discrimination, experimental research is needed. OBJECTIVE The primary aim of this experimental study was to examine whether simulated IHCA patients receive different treatment recommendations based on ethnicity and socioeconomic status (SES), holding all other factors (e.g., health status) constant. Another aim was to examine health care professionals' (HCP) stereotypical beliefs about these groups. METHODS HCP (N = 235) working in acute care made anonymous treatment recommendations while reading IHCA clinical vignettes wherein the patient's ethnicity (Swedish vs. Middle Eastern) and SES had been manipulated. Afterwards they estimated to what extent hospital staff associate these patient groups with certain traits (stereotypes). RESULTS No significant differences in treatment recommendations for Swedish versus Middle Eastern or high versus low SES patients were found. Reported stereotypes about Middle Eastern patients were uniformly negative. SES-related stereotypes, however, were mixed. High SES patients were believed to be more competent (e.g., respected), but less warm (e.g., friendly) than low SES patients. CONCLUSIONS Swedish HCP do not seem to discriminate against patients with Middle Eastern or low SES backgrounds when recommending treatment for simulated IHCA cases, despite the existence of negative stereotypes about these groups. Implications for health care equality and quality are discussed.
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Affiliation(s)
- Jens Agerström
- Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Växjö 391 3232, Sweden.
| | - Cecilia Andréll
- Department of Clinical Sciences Lund, Anesthesiology and Intensive Care, Center for Cardiac Arrest, Faculty of Medicine, Lund University, Lund, Sweden
| | - Anders Bremer
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Växjö, Sweden
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences and Department of Cardiology, Linköping University, Linköping, Sweden
| | - Kristofer Årestedt
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Växjö, Sweden; Department of Research, Region Kalmar County, Kalmar, Sweden
| | - Johan Israelsson
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Växjö, Sweden; Department of Internal Medicine, Division of Cardiology, Kalmar County Hospital, Kalmar, Sweden
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149
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Schmidt L, Kanichy M, Njau G, Schmidt M, Stepanov A, Anderson R, Stiffarm A, Williams A. Adverse Childhood Experiences, Interpersonal Violence, and Racial Disparities in Early Prenatal Care in North Dakota (ND PRAMS 2017-2019). J Interpers Violence 2024; 39:237-262. [PMID: 37644756 DOI: 10.1177/08862605231195802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
In North Dakota (ND), American Indian women are more likely to be exposed to adverse childhood experiences (ACEs) and interpersonal violence, and receive late prenatal care (PNC) compared to other racial groups. In a sample of 1,849 (weighted n = 26,348) women from the 2017 to 2019 North Dakota Pregnancy Risk Assessment Monitoring System, we performed a series of logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for AI and Other Racial Identity women compared to White women regarding risk of late PNC (initiated after week 13) and dissatisfaction of PNC timing. Models were adjusted for interpersonal violence (from husband/partner, family member, someone outside of family, ex-husband/partner, or any) to determine if violence accounts for racial/ethnic disparities in PNC. AI women experienced two-fold higher risk of late PNC (OR: 2.25, 95% CI: 1.55, 3.26) and dissatisfaction of PNC timing (OR: 2.34, 95% CI: 1.61, 3.40) than White women. In the analyses for the association between joint ACEs (Higher: ≥4; Lower: <4)/Race and PNC outcomes, odds of late PNC were two-fold among AI women with Higher ACEs (OR: 2.35, 95% CI: 1.41, 3.94) and Lower ACEs (OR: 2.73, 95% CI: 1.69, 4.41), compared to White women with Lower ACEs. Results were similar for dissatisfaction of PNC timing. Accounting for violence did not significantly change odds ratios in any analyses. Thus, interpersonal violence surrounding pregnancy does not explain racial disparities in PNC in ND. To understand disparities in PNC among AI women, risk factors like historic trauma and systemic oppression should be examined.
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Affiliation(s)
| | | | - Grace Njau
- North Dakota Department of Health & Human Services, Bismarck, ND, USA
| | - Matthew Schmidt
- North Dakota Department of Health & Human Services, Bismarck, ND, USA
| | | | | | - Amy Stiffarm
- University of North Dakota, Grand Forks, ND, USA
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150
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Uhm SY, Do TP, Montoya RH, Lam B, Kheirkhah A. Comparison of corneal tomographic parameters between Hispanic and non-Hispanic patients. Graefes Arch Clin Exp Ophthalmol 2024; 262:143-148. [PMID: 37493776 DOI: 10.1007/s00417-023-06167-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 05/28/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023] Open
Abstract
PURPOSE To compare corneal tomographic parameters between Hispanic White and non-Hispanic White patients using Pentacam data. METHODS This retrospective study evaluated preoperative Pentacam data from 641 patients 50 years or older who underwent surgery for senile cataract and self-identified as Hispanic or non-Hispanic White. Patients of non-White race or multiethnic groups, or a history of surgery, trauma, or any abnormality of the cornea or anterior segment were excluded. Cornea and anterior segment parameters, as measured with Pentacam, were then compared between Hispanics and non-Hispanics. RESULTS There were 352 Hispanic White and 289 non-Hispanic White patients. These included 231 men and 410 women, with a mean age of 69.5 ± 8.2 years. There were no significant differences between Hispanics and non-Hispanics in front or back keratometry or amount of front astigmatism. However, Hispanics had a greater amount of back astigmatism (0.36 ± 0.19 vs 0.32 ± 0.17 diopter, P = 0.04). Moreover, there was a statistically significant difference in front steep axis of the left eyes between Hispanics and non-Hispanics (97.8 ± 47.9 vs 108.2 ± 48.9 deg, P = 0.01), and a marginally significant difference in front steep axis of the right eyes (81.0 ± 48.2 vs 73.5 ± 49.9 deg, P = 0.06). Hispanics also had a lower vertex pachymetry (548.1 ± 34.5 vs 553.4 ± 37.4 μm, P = 0.04) and a smaller anterior chamber volume (134.7 ± 39.0 vs 146.1 ± 39.9 mm3, P < 0.001). CONCLUSIONS There are some differences in cornea and anterior segment parameters between Hispanics and non-Hispanics 50 years or older who underwent surgery for senile cataract. However, such differences may not be clinically significant.
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Affiliation(s)
- So Yeon Uhm
- Department of Ophthalmology, UT Health San Antonio, San Antonio, TX, USA
| | - Trong Phat Do
- Department of Ophthalmology, UT Health San Antonio, San Antonio, TX, USA
| | | | - Brandon Lam
- Department of Ophthalmology, UT Health San Antonio, San Antonio, TX, USA
| | - Ahmad Kheirkhah
- Department of Ophthalmology, UT Health San Antonio, San Antonio, TX, USA.
- Medical Arts and Research Center, 8300 Floyd Curl Dr., San Antonio, TX, USA.
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