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Aims The literature review aimed to identify the barriers the Punjabi and/or Sikh community have in accessing support for alcohol addiction. Method A systematic review of the literature was undertaken of four scholarly databases, Google Scholar and grey literature on UK-based research conducted after 1980 into alcohol addiction in the Punjabi and/or Sikh community. Fourteen papers met the inclusion criteria outlined in the paper and were included in the review. Results Ten main barriers to accessing support were found; stigma, religion, lack of understanding of addiction, over reliance on a medical model of treatment and disregard of therapy, cultural implications of being a member of the Punjabi and/or Sikh community and the addiction community, gender and generational differences and a lack of government commitment to alcohol support for BME communities with a lack of culturally specific services. Conclusion Despite the many barriers explored, the role of stigma remained a powerful theme throughout often underpinning other barriers. A key recommendation across many papers was the need for culturally sensitive support services. Several areas for future research were identified. [ABSTRACT FROM AUTHOR]

Background In primary care, health professionals use blood tests to investigate nonspecific presentations to inform referral decisions. Reference ranges for the commonly used blood tests in western countries were developed in predominately White populations, and so may perform differently when applied to non-White populations. Knowledge of ethnic variation in blood test results in healthy/general populations could help address ethnic inequalities in cancer referral for diagnosis and outcomes. Objective This systematic review explored evidence of ethnic differences in the distribution of selected blood test results among healthy/general populations to inform future research aimed at addressing inequalities in cancer diagnosis. Methods We searched PubMed and EMBASE to identify studies reporting measures of haemoglobin, MCV, calcium, albumin, platelet count, and CRP in nondiseased adults from at least 2 different ethnic groups. Two reviewers independently screened studies, completed data extraction and quality assessment using an adapted Newcastle-Ottawa scale. Participants were stratified into White, Black, Asian, Mixed, and Other groups. Data were synthesised narratively and meta-analyses were conducted where possible. Results A total of 47 papers were included. Black men and women have lower average values of haemoglobin, MCV, and albumin, and higher average values of CRP relative to their White counterparts. Additionally, Black men have lower average haemoglobin than Asian men, whereas Asian women have lower average CRP values when compared with White women. Conclusions There is evidence of ethnic differences in average values of haemoglobin, MCV, CRP, and albumin in healthy/general populations. Further research is needed to explore the reasons for these differences. Systematic review registration: CRD42021274580 [ABSTRACT FROM AUTHOR]

The phenomenon of widespread genetic ancestry testing has raised questions about its social impact, particularly on issues of race. Some accounts suggest testing can promote bridging social capital – connections between racial groups. In this multi-method paper, we ask whether (1) taking genetic ancestry tests (GATs) and (2) receiving results of African, Asian, or Native American ancestry increases network racial diversity for White Americans. We use a randomized controlled trial of 802 White, non-Hispanic Americans, half of whom received GATs. Unexpected findings show that test-takers' network racial diversity decreases after testing. Using 58 follow-up interviews, we develop and test a possible theory, finding initial evidence that test-takers' network racial diversity declines because they reconsider their racial appraisals of others in their networks. [ABSTRACT FROM AUTHOR]

This paper examines how an Asian candidate's national origin background affects their perceived ability to represent different constituents. Would Asian voters prefer any Asian candidate over someone who is non-Asian? Using a series of survey experiments that randomly emphasize the national origin backgrounds of two real politicians and a hypothetical politician, I find that politicians who are East or Southeast Asian are viewed as more representative of Asian American interests than those who are South Asian. Nonetheless, respondents agree that Asian politicians, regardless of national origin, will represent Asian Americans more than a non-Asian politician. While national origin background matters, there is still potential for an electoral advantage based on shared Asian panethnicity. These results contribute to our understanding of the salience of panethnic identities in electoral contexts. [ABSTRACT FROM AUTHOR]

The paper presents findings from the first-ever study of kinship care in the UK using census micro data. We show that, in 2001, over 173,000 children in the UK were living with relatives, without their parents. The majority of these children were living in poor and deprived circumstances. There were significant differences in the likelihood of a child being in kinship care between socio-economic groups and geographic areas. The paper presents the first reliable, nationally representative estimates of kinship care and its patterning, which will form a baseline for future studies and for comparisons with international data. The findings presented have important implications for policy, particularly with regard to the needs of kinship carers for financial, emotional, practical and other support. [ABSTRACT FROM AUTHOR]

Giardia duodenalis is one of the major causes of diarrhea among children. We performed a systematic review and meta-analysis to assess the prevalence of G. duodenalis and associated risk factors among Asian children. We searched online databases (PubMed, Scopus and Web of Science) and Google Scholar search engine for studies published from 1 January 2000 to 15 March 2022 that measured the prevalence of G. duodenalis among Asian children. Accordingly, the pooled prevalence and 95% CIs were estimated using a random-effects meta-analysis model for the included studies. A total of 182 articles from 22 Asian countries met the inclusion criteria. The pooled prevalence of G. duodenalis infection among Asian children was estimated as 15.1% (95% CI 14.1 to 16%). The highest and lowest pooled prevalence values of G. duodenalis infection were estimated for Tajikistan and China as 26.4% (95% CI 22.9 to 30%) and 0.6% (95% CI 0.001 to 1.02%), respectively. The infection had a higher prevalence in males than in females (OR=1.24; 95% CI 1.16 to 1.31; p<0.001), which was statistically significant. Giardiasis is common among Asian children, hence, a prevention and control scheme of this protozoan in children should be considered by health officials and health policymakers, especially in Asian countries where the prevalence is highest. [ABSTRACT FROM AUTHOR]

Coconut oil is being heavily promoted as a healthy oil, with benefits that include support of heart health. To assess the merits of this claim, the literature on the effect of coconut consumption on cardiovascular risk factors and outcomes in humans was reviewed. Twenty-one research papers were identified for inclusion in the review: 8 clinical trials and 13 observational studies. The majority examined the effect of coconut oil or coconut products on serum lipid profiles. Coconut oil generally raised total and low-density lipoprotein cholesterol to a greater extent than cis unsaturated plant oils, but to a lesser extent than butter. The effect of coconut consumption on the ratio of total cholesterol to high-density lipoprotein cholesterol was often not examined. Observational evidence suggests that consumption of coconut flesh or squeezed coconut in the context of traditional dietary patterns does not lead to adverse cardiovascular outcomes. However, due to large differences in dietary and lifestyle patterns, these findings cannot be applied to a typical Western diet. Overall, the weight of the evidence from intervention studies to date suggests that replacing coconut oil with cis unsaturated fats would alter blood lipid profiles in a manner consistent with a reduction in risk factors for cardiovascular disease. [ABSTRACT FROM AUTHOR]

Type 2 diabetes is highly prevalent among South Asian origin groups around the world. Not only is prevalence higher than in other ethnic groups, age at presentation is lower and these groups are more likely to experience complications. Evidence suggests that lifestyle interventions may prevent or delay the onset of diabetes. However, little is known about diabetes prevention in South Asians (SA). DH!AAN is a diabetes prevention program designed for Surinamese SA in The Netherlands. In this paper, we describe the theoretical frameworks and formative research that guided the development and cultural adaptation of DH!AAN. Cultural adaptation was based on analysis of the determinants of diet and physical activity, including socio-cultural factors, within our study population. This led to the incorporation of surface and deep structure elements in the intervention. One-to-one counseling by dieticians using motivational interviewing (MI) was the basis for the intervention. Additionally, we aimed to generate social support by including family members in parts of the intervention and group sessions to address issues relating to traditional food habits. We discuss our reflections on the development process and the choices made in developing this intervention. The results of DH!AAN will provide insight into the use of MI for this population group. Moreover, DH!AAN will provide evidence regarding the feasibility of diabetes prevention among South Asian populations. [ABSTRACT FROM AUTHOR]

Background: South Asians experience higher rates of cardiovascular disease than any other ethnic group. South Asians may be less adherent with a cardiac medication regimen than Caucasians. The factors contributing to adherence are important to discover to assist South Asians to optimize their cardiac health. Data sources: CINAHL, Medline (Ovid), PsychINFO, EMB Reviews-(Cochrane), and EMBASE were accessed using the key words: ‘South Asian’, ‘Asia’, ‘East India’, ‘India’, ‘Pakistan’, ‘Bangladesh’, ‘Sri Lanka’, ‘medication compliance’, ‘medication noncompliance’ and ‘medication adherence’. English language papers published from January 1980 to January 2013 were eligible for inclusion. Review methods: Abstracts were reviewed for redundancy and eligibility by the primary author. Manuscripts were then retrieved and reviewed for eligibility and validity by the first and last authors. Content analysis strategies were used for the synthesis. Results: Thirteen papers were in the final data set; most were conducted in India and Pakistan. Medication side-effects, cost, forgetfulness and higher frequency of dosing contributed to non-adherence. South Asian immigrants also faced language barriers, which contributed to non-adherence. Knowledge regarding the medications prescribed was a factor that increased adherence. Conclusion: South Asians’ non-adherence to cardiac medications is multifaceted. How South Asians who newly immigrate to Western countries make decisions regarding their cardiac medication adherence ought to be explored in greater detail. [ABSTRACT FROM AUTHOR]

Transnational adoption requires adoptive parents to negotiate complexities concerning difference and belonging within the family. Transnational adoption is mediated through societal and governmental prescriptions of suitability that include willingness and competency to raise children to maintain connections to their birth heritages. Tensions in the formation of parental identities are located in different racial, ethnic, cultural and class-based backgrounds to the children they adopt. This contrasts against dominant models of family where constructions of belonging are based on biological ties. A qualitative study of thirty-five Australian adoptive parents explored reflections on adoption processes and how the complex task of performing suitability was negotiated. Theoretical understandings were developed using a grounded theory approach. Contemporary social theory with a focus on race, cosmopolitanism and families further developed emergent theoretical understandings during analysis. Tensions in identity formation are discussed. The paper concludes that issues of race in identity formation are marginalised. [ABSTRACT FROM AUTHOR]

Objectives. In this paper, we explored the association between direct and indirect measures of intergenerational ambivalence, making comparisons by generational position and child’s gender; furthermore, we examined whether these measures were similarly strong predictors of depressive symptoms and positive affect. Methods. Data for the analysis were collected from 254 mothers aged 72–82 years and a randomly selected adult child as part of a larger study of within-family differences in parent–adult child relations. Results. The findings provided evidence that direct and indirect measures were strongly associated among mothers but only weakly associated among adult children, particularly sons. The two measures were similarly strong predictors of mothers’, but not children’s, depressive symptoms and positive affect. The most pronounced differences in congruence between direct and indirect measures were found when comparing mothers and sons. Discussion. The analyses presented here suggest that direct and indirect measures of intergenerational ambivalence may not be tapping the same underlying construct, particularly in the case of adult children and especially sons. Furthermore, direct measures may have an advantage over indirect measures when including sons in the study design. We conclude that direct and indirect measures cannot be used interchangeably across the combination of generation and gender. [ABSTRACT FROM PUBLISHER]

This paper describes body composition and dietary intakes of the three major ethnic groups residing in Singapore and how these are related to cardiovascular risk factors in these groups. When the relationship between body mass index (BMI, kg/m[SUP2]) and body fat percentage was studied, Singaporeans were found to have higher percentage of body fat compared with Caucasians with the same BMI. At BMIs that are much lower than WHO-recommended cut-off values for obesity, both the absolute and relative risks of developing cardiovascular risk factors are markedly elevated for all three ethnic groups. The excessive fat accumulation and increased risks at lower BMIs signal a need to re-examine cut-off values for obesity among Chinese, Malays, and Indians. [ABSTRACT FROM AUTHOR]

Background Starting in 2018, national death certificates included a new racial classification system that accounts for multiple-race decedents and separates Native Hawaiian and Pacific Islander (NHPI) individuals from Asian individuals. We estimated cancer death rates across updated racial and ethnic categories, sex, and age. Methods Age-standardized US cancer mortality rates and rate ratios from 2018 to 2020 among individuals aged 20 years and older were estimated with national death certificate data by race and ethnicity, sex, age, and cancer site. Results In 2018, there were approximately 597 000 cancer deaths, 598 000 in 2019, and 601 000 in 2020. Among men, cancer death rates were highest in Black men (298.2 per 100 000; n = 105 632), followed by White (250.8; n = 736 319), American Indian/Alaska Native (AI/AN; 249.2; n = 3376), NHPI (205.6; n = 1080), Latino (177.2; n = 66 167), and Asian (147.9; n = 26 591) men. Among women, Black women had the highest cancer death rates (206.5 per 100 000; n = 104 437), followed by NHPI (192.1; n = 1141), AI/AN (189.9; n = 3239), White (183.0; n = 646 865), Latina (128.4; n = 61 579), and Asian (111.4; n = 26 396) women. The highest death rates by age group occurred among NHPI individuals aged 20-49 years and Black individuals aged 50-69 and 70 years and older. Asian individuals had the lowest cancer death rates across age groups. Compared with Asian individuals, total cancer death rates were 39% higher in NHPI men and 73% higher in NHPI women. Conclusions There were striking racial and ethnic disparities in cancer death rates during 2018-2020. Separating NHPI and Asian individuals revealed large differences in cancer mortality between 2 groups that were previously combined in vital statistics data. [ABSTRACT FROM AUTHOR]

Background: Elder mistreatment (EM) prevalence varies greatly according to definitional criteria. However, little is known regarding the significance of different EM definitions with respect to health outcome. This paper explores the association between different definitions of EM and their subtypes and suicidal ideation (SI) in an U.S. Chinese aging population.Methods: The Population Study of ChINese Elderly in Chicago Study was conducted from 2011 to 2013 of 3157 community-dwelling Chinese older adults aged 60 years. Psychological, physical mistreatment (PM), caregiver neglect (CN), financial exploitation (FE), and overall EM were measured by different definitional approaches varying in the strictness. SI in the past 2 weeks and 12 months were assessed.Results: After adjusting for confounders, the least restrictive EM definition (odds ratio [OR], 2.10 [1.34-3.28]; OR, 2.43 [1.66-3.55]), moderately restrictive EM definition (OR, 2.87 [1.80-4.56]; OR, 2.71 [1.82-4.04]), and most restrictive EM definition (OR, 2.24 [1.36-3.66]; OR, 2.34 [1.54-3.56]) were associated with increased risk for 2-week and 12-month SI. For subtypes of EM, psychological mistreatment (the least and most restrictive definitions, 2-week SI: OR, 2.83 [1.71-4.68]; OR, 3.13 [1.10-8.91]; 12-month SI: OR, 2.43 [1.56-3.78]; OR, 2.88 [1.10-7.54]), PM (2-week SI: OR, 5.12 [1.83-14.29]; 12-month SI: OR, 3.45 [1.30-9.13]), and FE was not associated with 2-week SI, only the broadly defined FE (OR, 1.73 [1.01-2.96]) was associated with higher odds of reporting 12-month SI. CN was only associated with higher odds of reporting 12-month SI (OR, 2.17 [1.19-3.96]; OR, 1.94 [1.24-3.04]) but not 2-week SI.Conclusion: EM and its subtypes were significantly associated with SI; some associations varied by definitions and subtypes. [ABSTRACT FROM AUTHOR]

How is sexual racism maintained in an organization that claims to resist it? This article applies the concept of sexual racism to an organizational case study of a friendship group of gay Asian and white men that aims to uplift Asian men's erotic capital, but which actually upholds white desirability. Through ethnographic observations and interviews, the author first compares Asian and white men's unequal positions on the gay sexual hierarchy before joining the group. The author unpacks four dimensions of organizational experience in which sexual racism is reproduced and white desirability is maintained: (1) a group monitoring practice that reproduces interracial stereotypes; (2) the normalized Asian-white pairing norm and the necessity of whiteness in romantic formation; (3) Asians vs. whites' personal experiences of change in sexual capital that stabilize white desirability while Asians' desirability increase with a cost; and (4) the reproduction of anti-Blackness in group-level constraints against non-white, non-Asian members. These findings contribute to sociological understandings of the racialization of sexuality and the sexualization of race by showing how an alternative space of desire for minority groups can still manifest sexual racism on individual and organizational levels. [ABSTRACT FROM AUTHOR]

This study investigates the size of the initial wage disadvantage and the patterns of subsequent labor-market assimilation for immigrant workers in South Korea. We find that immigrants to Korea earn 17–29 percent less upon arrival than natives with similar characteristics, and the wage gap diminishes by 1.55 percent per year spent in the country. The patterns of assimilation differ by both gender and country of origin. Males and Asian immigrants generally follow the patterns of all foreign workers. However, females experience a smaller initial wage difference and no convergence, while immigrants from non-Asian countries and Japan initially earn higher wages than natives, but they then experience a relative decline in wages over time. The results of our out-migration analysis suggest that the negative assimilation of non-Asian and Japanese immigrants may be due to positively selected out-migration. [ABSTRACT FROM AUTHOR]

In this article, we explore how historical patterns of identity construction shape today's attitudes towards immigrants in Mexico. Immigrants in Mexico constitute a very small percentage of the country's population. Yet some immigrants, in particular those of Asian origin, face a strong anti-immigrant sentiment as measured in terms of opinions and opposition to their social and political incorporation. We trace contemporary anti-Chinese sentiment back to historical processes of Mexican colonisation, which resulted in a particular politics of Chinese incorporation at the turn of the 19th century. This incorporation was violently contested during and after the revolution, leading to a construction of a national identity based on openly excluding the Chinese community. Using experimental evidence, we show that anti-Asian prejudice today is well explained by looking at ethnic traits and civic norms that are endorsed by natives as being constitutive of Mexican national identity. [ABSTRACT FROM AUTHOR]

Background Racial disparities in survival of patients with cancer motivate research to quantify treatment disparities and evaluate multilevel determinants. Previous research has not evaluated cardiac radiation dose in large cohorts of breast cancer patients by race nor examined potential causes or implications of dose disparities. Methods We used a statewide consortium database to consecutively sample 8750 women who received whole breast radiotherapy between 2012 and 2018. We generated laterality- and fractionation-specific models of mean heart dose. We generated patient- and facility-level models to estimate race-specific cardiac doses. We incorporated our data into models to estimate disparities in ischemic cardiac event development and death. All statistical tests were 2-sided. Results Black and Asian race independently predicted higher mean heart dose for most laterality-fractionation groups, with disparities of up to 0.42 Gy for Black women and 0.32 Gy for Asian women (left-sided disease and conventional fractionation: 2.13 Gy for Black women vs 1.71 Gy for White women, P  < .001, 2-sided; left-sided disease and accelerated fractionation: 1.59 Gy for Asian women vs 1.27 Gy for White women, P  = .002). Patient clustering within facilities explained 22%-30% of the variability in heart dose. The cardiac dose disparities translated to estimated excesses of up to 2.6 cardiac events and 1.3 deaths per 1000 Black women and 0.7 cardiac events and 0.3 deaths per 1000 Asian women vs White women. Conclusions Depending on laterality and fractionation, Asian women and Black women experience higher cardiac doses than White women. This may translate into excess radiation-associated ischemic cardiac events and deaths. Solutions include addressing inequities in baseline cardiac risk factors and facility-level availability and use of radiation technologies. [ABSTRACT FROM AUTHOR]

Background There are limited renal replacement therapy (RRT) prediction models with good performance in the general population. We developed a model that includes lifestyle factors to improve predictive ability for RRT in the population at large. Methods We used data collected between 1996 and 2017 from a medical screening in a cohort comprising 442 714 participants aged 20 years or over. After a median follow-up of 13 years, we identified 2212 individuals with end-stage renal disease (RRT, n : 2091; kidney transplantation, n : 121). We built three models for comparison: model 1: basic model, Kidney Failure Risk Equation with four variables (age, sex, estimated glomerular filtration rate and proteinuria); model 2: basic model + medical history + lifestyle risk factors; and model 3: model 2 + all significant clinical variables. We used the Cox proportional hazards model to construct a points-based model and applied the C statistic. Results Adding lifestyle factors to the basic model, the C statistic improved in model 2 from 0.91 to 0.94 (95% confidence interval: 0.94, 0.95). Model 3 showed even better C statistic value i.e. 0.95 (0.95, 0.96). With a cut-off score of 33, model 3 identified 3% of individuals with RRT risk in 10 years. This model detected over half of individuals progressing to RRT, which was higher than the sensitivity of cohort participants with stage 3 or higher chronic kidney disease (0.53 versus 0.48). Conclusions Our prediction model including medical history and lifestyle factors improved the predictive ability for end-stage renal disease in the general population in addition to chronic kidney disease population. [ABSTRACT FROM AUTHOR]

The diversity of Central Asians has been shaped by multiple migrations and cultural diffusion. Although ancient DNA studies have revealed the demographic changes of the Central Asian since the Bronze Age, the contribution of the ancient populations to the modern Central Asian remains opaque. Herein, we performed high-coverage sequencing of 131 whole genomes of Indo-European-speaking Tajik and Turkic-speaking Kyrgyz populations to explore their genomic diversity and admixture history. By integrating the ancient DNA data, we revealed more details of the origins and admixture history of Central Asians. We found that the major ancestry of present-day Tajik populations can be traced back to the admixture of the Bronze Age Bactria–Margiana Archaeological Complex and Andronovo-related populations. Highland Tajik populations further received additional gene flow from the Tarim mummies, an isolated ancient North Eurasian–related population. The West Eurasian ancestry of Kyrgyz is mainly derived from Historical Era populations in Xinjiang of China. Furthermore, the recent admixture signals detected in both Tajik and Kyrgyz are ascribed to the expansions of Eastern Steppe nomadic pastoralists during the Historical Era. [ABSTRACT FROM AUTHOR]

Findings from these oral health-related studies show many health disparities within Asian American populations. Keywords: Asian; Immigrants; Aging; Model Minority; Health Disparities EN Asian Immigrants Aging Model Minority Health Disparities 105 111 7 08/23/22 20220701 NES 220701 Asian Americans were the fastest-growing population segment in the United States in the last two decades. Asian American Health Status: Pictures Incomplete Much of our knowledge of Asian American health has been determined by studies in which investigators have either grouped Asian American subjects together or examined one subgroup alone (e.g. Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese; [13]). [Extracted from the article]

Introduction: Identifying genetic factors associated with smoking cessation could inform precision cessation interventions. Of major interest is genetic variation in nicotine metabolism, largely predicted by CYP2A6 variations.Aims and Methods: We conducted a systematic literature review to summarize the population-based evidence of the association between CYP2A6 and smoking cessation. In the 12 studies meeting the inclusion criteria, the known functional metabolic effect of CYP2A6 variants was used to classify nicotine metabolism as normal (>75% metabolic activity), intermediate (50.1%-75% activity), slow (25%-50% activity), and poor (<25% activity). Summary odds ratios of smoking cessation were calculated across metabolic groups, stratified by ancestry and whether participants received pharmacotherapy or placebo/no treatment.Results: Among untreated people of European ancestry (n = 4 studies), those with CYP2A6 reduced metabolism were more likely to quit smoking than those with normal metabolism (Summary OR = 2.05, 95% CI 1.23 to 3.42) and the likelihood of cessation increased as nicotine metabolism decreased. Nicotine replacement therapy attenuated the association at end-of-treatment, while bupropion modified the association such that intermediate/slow metabolizers were less likely to quit than normal metabolizers (Summary OR = 0.86, 95% CI 0.79 to 0.94). Among untreated Asian people (n = 3 studies), results differed compared with those with European ancestry: those with slow metabolism were less likely to have quit smoking than normal metabolizers (Summary OR = 0.52, 95% CI 0.38 to 0.71). Evidence for people of African ancestry (n = 1 study) suggested the CYP2A6 association with cessation may differ compared with those of European ancestry.Conclusions and Implications: Most studies included in this review were of European ancestry populations; these showed slower nicotine metabolism was associated with increased likelihood of smoking cessation in a dose-related manner. Pharmacotherapy appeared to attenuate or modify this association among people of European ancestry, but it is unclear whether the change in the association remains consistent after treatment ceases. This finding has implications for precision medicine cessation interventions. Based on only a few studies of people of Asian or African ancestry, the association between CYP2A6 variants and cessation may differ from that observed among those of European ancestry, but more evidence is needed. [ABSTRACT FROM AUTHOR]

Legg-Calvé-Perthes’ disease (Perthes’ disease) is a childhood osteonecrosis of the hip for which the disease determinants are poorly understood. In this review, the authors identify studies of Perthes’ disease incidence published up to December 2010 and make denominator populations comparable in order to allow meaningful between-study evaluation. Incidence rates and confidence intervals were determined, and, where appropriate, denominator populations were obtained from national statistical offices. Poisson regression was used to determine the influence of race and geography. The review included 21 studies that described 27 populations in 16 countries, with 124 million person-years of observation. The annual incidence among children under age 15 years ranged from 0.2 per 100,000 to 19.1 per 100,000. Race was a key determinant, with East Asians being least affected and whites most affected, though data were insufficient to consider incidence among blacks (for South Asians vs. East Asians, incidence rate ratio = 2.9, 95% confidence interval (CI): 2.4, 3.5; for whites vs. East Asians, incidence rate ratio = 8.8, 95% CI: 8.2, 9.6). Latitude was a strong predictor of disease, even after adjustment for race. Each 10° increase in latitude was associated with an incidence increase of 1.44 (95% CI: 1.30, 1.58) times. While much of the international variation appears to be a function of race, latitude demonstrates a strong association. This observation may offer new epidemiologic insights into the determinants of Perthes’ disease. [ABSTRACT FROM PUBLISHER]

Purpose: There is a fundamental knowledge gap regarding the experience of dementia within minority ethnic groups in the United Kingdom and elsewhere. The present study examined the subjective reality of living with dementia from the perspective of people with dementia within the 3 largest ethnic groups in the United Kingdom. Design and Methods: This was a qualitative study in which in-depth individual interviews were conducted with 11 Black Caribbean, 9 south Asian, and 10 White British older people with dementia. The lack of information in this area prompted the use of a grounded theory approach. Results: The main theme to emerge from the interviews with the people with dementia was “threat to valued elements of life.” Participants engaged in a process of appraisal in which they assessed the degree to which their condition and support needs interfered with valued elements of life. The analysis revealed that each element of this process was culturally informed. Implications: There is potential for modifying beliefs to reduce the perceived threat of dementia and for family and professional carers to promote the roles, relationships, and activities that each person with dementia values. The findings outlined in this paper can inform the development of a culturally sensitive approach. [ABSTRACT FROM PUBLISHER]

The disease burden of typhoid fever remains high in endemic areas in Asia and Africa, especially in children. Recent clinical trials conducted by the Typhoid Vaccine Acceleration Consortium show typhoid conjugate vaccine (TCV) to be safe, immunogenic, and efficacious at preventing blood culture-confirmed typhoid fever in African and Asian children. Pakistan, Liberia, and Zimbabwe recently introduced TCV through campaigns and routine childhood immunizations, providing protection for this vulnerable population. It is essential to continue this momentum while simultaneously filling data gaps-including typhoid complications-to inform decision-making on TCV introduction. A multidisciplinary approach including surveillance, water, sanitation, and hygiene investments, and large-scale TCV introduction is needed to decrease the burden and mortality of typhoid fever. [ABSTRACT FROM AUTHOR]

Background: Little is known about the time course of mortality reduction following smoking cessation in Asians who have smoking behaviours distinct from their Western counterparts. We evaluated the level of reduction in all-cause, cardiovascular disease (CVD) and lung cancer mortality by years since quitting smoking, in Asia.Methods: Using Cox regression, we analysed individual participant data (n = 709 151) from 16 prospective cohorts conducted in China, Japan, Korea/Singapore, and India/Bangladesh, separately by cohorts. Cohort-specific hazard ratios (HRs) were combined using a random-effects meta-analysis.Results: During a mean follow-up of 12.0 years, 108 287 deaths were ascertained-35 658 from CVD and 7546 from lung cancer. Among Asian men, a dose-response relationship of risk reduction in deaths from all causes, CVD and lung cancer was observed with an increase in years after smoking cessation. Compared with never smokers, however, all-cause and CVD mortality among former smokers remained elevated 10-14 years after quitting [multivariable-adjusted HR (95% confidence interval (CI) = 1.25 (1.13-1.37) and 1.20 (1.02-1.41), respectively]. Lung cancer mortality stayed almost 2-fold higher than among never smokers 15-19 years after smoking cessation [1.97 (1.41-2.73)], particularly among former heavy smokers [2.62 (1.71-4.00)]. Women who quitted for ≥5 years retained a significantly elevated mortality from all causes, CVD and lung cancer. Overall patterns of the cessation-mortality associations were similar across countries.Conclusions: Our findings suggest that adverse effects of tobacco smoking persist for an extended time period, even for more than two decades, which is beyond the time windows defined in current clinical guidelines for risk assessment of lung cancer and CVD. [ABSTRACT FROM AUTHOR]

Background Knowledge of decision-making preference of patients and caregivers is needed to facilitate deprescribing. This study aimed to assess the perspectives of caregivers and older adults towards deprescribing in an Asian population. Secondary objectives were to identify and compare characteristics associated with these attitudes and beliefs. Method A cross-sectional survey of two groups of participants was conducted using the Revised Patients' Attitudes Towards Deprescribing questionnaire. Descriptive results were reported for participants' characteristics and questionnaire responses from four factors (belief in medication inappropriateness, medication burden, concerns about stopping, and involvement) and two global questions. Correlation between participant characteristics and their responses was analyzed. Results A total of 1,057 (615 older adults; 442 caregivers) participants were recruited from 10 institutions in Singapore. In which 511 (83.0%) older adults and 385 (87.1%) caregivers reported that they would be willing to stop one or more of their medications if their doctor said it was possible, especially among older adults recruited from acute-care hospitals (85.3%) compared with older adults in community pharmacies (73.6%). Individuals who take more than five medications and those with higher education were correlated with greater agreement in inappropriateness and involvement, respectively. Conclusions Clinicians should consider discussing deprescribing with older adults and caregivers in their regular clinical practice, especially when polypharmacy is present. Further research is needed into how to engage older adults and caregivers in shared decision making based on their attitudes toward deprescribing. [ABSTRACT FROM AUTHOR]

Yellow Peril ideology has long cast Chinese as cruel, deceitful, incompetent disease vectors. Many US elites now tie such notions to China's response to Covid-19. Their racialized framing of the drive to condemn and sue China however exemplifies a Chinese idiom—"big thunder, little rain" (雷声大, 雨点小)—which means noisy, yet ineffective. There are empirical obstacles to convincing the world of Chinese responsibility for the pandemic, such as that the virus spread much more from Europe and the US than from China, many Western states failed against the virus, and pandemic-related agitation against China has resulted in many anti-Asian actions. The ongoing claims are thus unlikely to be convincing beyond the Anglosphere, but still spread racism and advance a US-led anti-China mobilization. [ABSTRACT FROM AUTHOR]

In contemporary cultural scenes saturated by 'intermediality' and 'transmediality', adaptation studies have challenged the distinction and hierarchy between the source and its adaptation, the author and the reader-spectator, and a variety of genres and media. While early critics of adaptation studies centred on fidelity criticism, recently Linda Hutcheon breaks free from literary elitism and emphasizes how stories, 'like genes', adapt to new environments 'by virtue of mutation'. Hutcheon argues, 'the fittest [stories] do more than survive; they flourish' in today's fierce competition for 'cultural selection'. This postmodernist notion of adaptation as proliferation, however, remains curiously reticent about the 'value' of such proliferation. My article argues that in the era of textual proliferation, adaptation has an ethical responsibility to voice the story of the socially and sexually 'unfit'. I then analyse The Handmaiden as a failed attempt at this ethical project. Directed by Chan-wook Park, a South Korean auteur, The Handmaiden borrows from Sarah Waters' Fingersmith (2002), a novel about female romantic friendship in nineteenth-century England. Although Park's visually stunning film epitomizes the indigenization of the 'fittest' story, its graphic portrayal of lesbian sex and change of setting leaves the question of sexual objectification of Asian women and Japanese colonization unanswered. [ABSTRACT FROM AUTHOR]

Institute of International Education (Open doors report on international educational exchange: International student enrollment trends, 1948/49–2017/18) data indicated that during the 2017–2018 academic year, 1,094,792 international students were studying at a college or university in the United States, of which 62% came from Asian countries such as China, Indonesia, Japan, Malaysia, South Korea, Taiwan, and Vietnam. Recognizing the importance of a diverse student body, universities have developed programs to assist international students in adapting to the U.S. culture and education system. Music therapy programs, particularly at the graduate level, continue to attract students from Asian countries, although the exact number of students is unknown. Furthermore, little is known about the extent to which music therapy programs provide support for Asian international students, or how Asian international students themselves adjust to, and experience, the first few years of their academic training. Within this context, the purpose of this study was to interview Asian international students studying in graduate music therapy programs in order to understand their experiences during their first 3 years in the United States, particularly the cultural and educational challenges they encountered. Six students and five new professionals were interviewed, with interview transcripts analyzed using methods consistent with qualitative content analysis. Results indicated that almost all the Asian international students interviewed experienced challenges associated with cultural and academic adjustment. Recommendations for students and educators suggest ways to support Asian students as they adapt and integrate into U.S. cultural and academic environments. [ABSTRACT FROM AUTHOR]

This article examines how minority leaders articulate emergent group boundaries. We provide the first systematic comparison of the Asian and Hispanic panethnic movements of the 1970s, assessing how pioneering publications developed claims about panethnicity before the identities became widely institutionalized. The findings indicate that despite referring to communities with different histories, discussions about Asian and Hispanic panethnicity displayed strikingly similar discursive patterns. We identify three such analytical patterns – broad definitions, prototypes, and group comparison – and theorize about how they helped to make new Asian and Hispanic boundaries recognizable. In doing so, we develop a new analytical framework for understanding the role of cultural and discursive resources in boundary construction and suggest how it may be applied beyond the cases examined here. [ABSTRACT FROM AUTHOR]

This article analyses the historical circumstances that linked physician manpower and immigration policy in the United States. The Hart–Celler Immigration and Nationality Act of 1965 facilitated the first large-scale migration of Foreign Medical Graduates (FMGs) from predominantly postcolonial Asian nations. FMGs were invited into the nation to staff hospitals in communities lacking physicians in exchange for legal status. During the Cold War, transnational physician migration was considered an expedient mechanism to address the inadequate supply of US physician manpower, and believed to be a tactical, foreign policy strategy. This arrangement, which was initiated as a short-term solution in a moment of 'crisis', has since become a permanent feature of US health care. Foreign physicians have become the numerical supplement of the medical system, the global reserve labour force instrumentalised to address doctor shortages in marginalised communities across the country. [ABSTRACT FROM AUTHOR]

This article examines financial capability among low-income older Asian immigrants, using data from in-depth interviews with 13 participants in a subsidized employment program in Los Angeles. Overall, respondents present a portrait of economic insecurity. Qualitative analyses indicate that respondents perceived little need to improve their financial knowledge and management skills because they had "no money to manage. " Most respondents lacked either financial knowledge or financial management skills, which resulted in substantial financial losses among some respondents. Mistrust of financial institutions ("Banks are always vampires") and other financial barriers (for example, lack of credit history) blocked respondents' access to formal financial services. In some cases, ethnic financial resources (for example, ethnic banks) reduced the effects of such barriers. There is evidence that respondent financial knowledge and management skills may improve after opening a bank account, suggesting a potential role for financial access in expanding financial capability. Findings demonstrate the importance of financial capability–building interventions for low-income older Asian immigrants. Social workers should be equipped with financial literacy and in-depth understanding of financial needs, perceptions, values, behaviors, and resources of this population. [ABSTRACT FROM AUTHOR]

Aims Prior studies suggested that the risks of ischaemic stroke and bleeding in patients of Asian race with atrial fibrillation (AF) may be higher than that of non-Asians. In the analysis of ENGAGE AF-TIMI 48 trial, we compared clinical outcomes, edoxaban concentration, and anti-factor Xa (anti-FXa) activity, between Asian and non-Asian races. Methods and results There were 2909 patients of Asian race and 18 195 non-Asian race in the ENGAGE AF-TIMI 48 trial. The risks of thromboembolism and bleeding events were compared for Asians and non-Asians treated with warfarin. The trough levels of edoxaban concentration and anti-FXa activity were also compared and correlated with the efficacy and safety of edoxaban vs. warfarin. Compared to non-Asian patients, the Asian population was on average 2 years younger and 20 kg lighter. In the warfarin group, the adjusted risk of ischaemic stroke did not differ significantly for patients of Asian and non-Asian race [adjusted hazard ratio (aHR) = 1.12, P  = 0.56). Asians treated with warfarin had a higher-adjusted risk of intracranial haemorrhage (ICH: aHR 1.71, P  = 0.03) compared with non-Asians. The trough edoxaban concentration and anti-FXa activity were 20–25% lower for Asians compared with non-Asians. Compared to warfarin, higher dose edoxaban significantly reduced ICH while preserving the efficacy of stroke prevention in both Asians and non-Asians. Two of three net clinical outcomes appeared to be more favourably reduced with edoxaban in Asians compared with non-Asians (P int = 0.063 for primary, 0.037 for secondary, and 0.032 for third net clinical outcomes, respectively). Conclusion Compared to warfarin, higher dose edoxaban preserved the efficacy for stroke prevention and was associated with a favourable safety profile for Asians, which may be due to the lower trough edoxaban concentration and anti-FXa activity achieved in patients of Asian race. [ABSTRACT FROM AUTHOR]

US Asian/Pacific Islander (API) communities experience high air pollution levels. APIs may be predisposed to pancreatic β-cell dysfunction and have the highest prevalence of gestational diabetes mellitus (GDM) compared with other racial/ethnic groups. Exposure to high levels of volatile organic compounds (VOCs) impairs pancreatic β-cell function, leading to insulin resistance, but racial/ethnic differences in this association are unexamined. We analyzed singleton deliveries (n = 220,065) from the Consortium on Safe Labor (2002–2008). Exposure to 14 VOCs in each hospital referral region was based on modified Community Multiscale Air Quality models. Logistic regression estimated odds ratios for GDM associated with high (≥75th percentile) versus low (<75th percentile) VOC exposure 3 months before conception and during the first trimester of pregnancy. Preconception and first-trimester exposure to high VOC levels was associated with increased odds of GDM among whites and APIs. GDM risk was significantly higher for APIs than whites for most VOCs. Preconception benzene exposure was associated with 29% (95% confidence interval: 12, 47) increased odds of GDM among whites compared with 45% (95% confidence interval: 16, 81) increased odds among APIs. These findings highlight environmental health disparities affecting pregnant women. Increased focus on GDM risk in US API communities is warranted. [ABSTRACT FROM AUTHOR]

The determinants of buyer-seller negotiations in four cultures are investigated in a laboratory simulation. One hundred thirty-eight American, 54 Chinese, 42 Japanese, and 38 Korean business people participated in a two-person, buyer-seller, intracultural negotiation simulation. In negotiations between Americans, the use of more problem-solving bargaining strategies positively influenced negotiation outcomes. In negotiations between Chinese, more competitive strategies led to better results. In Japanese and Korean negotiations, buyers achieved higher economic rewards than sellers. In all four cultures, bargainers were more satisfied with negotiation outcomes when partners were rated more attractive. The primary purpose of the study is to determine if face-to-face, buyer-seller negotiation processes vary across three Asian cultures. Specifically, the validity of generalizations about Oriental behavior are called to question by comparing simulated negotiations of Japanese, Korean, and Chinese (Taiwanese) business people. American buyer-seller negotiation processes are also examined and discussed in relation to the three Asian cultures. [ABSTRACT FROM AUTHOR]

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Path analysis was used to assess direct and mediating relationships of an a priori mediation model. Data were collected from 210 black, Hispanic/Latino, and Asian undergraduate college students. Authors found that microaggression was positively associated with ethnic identity. Microaggression had a significant positive association with psychological distress but no other direct relationships with the outcome variables. Ethnic identity was negatively associated with psychological distress but positively associated with self-esteem and academic self-efficacy. A positive effect was found between ethnic identity and substance abuse. Ethnic identity mediated the effect of microaggression on psychological distress. Moreover, including ethnic identity in the equation revealed that microaggression has a positive effect on self-esteem and academic self-efficacy through participants' reported degree of ethnic identity. The results suggest that racial microaggressions have damaging impacts on the emotional health of racial and ethnic minority young adults. However, microaggressive experiences may also elicit stronger ethnic identity, which appears to serve as a protective factor to the negative influence of microaggression on psychological well-being. Post hoc exploratory multigroup analysis revealed some differential findings for each group. The article concludes with a discussion of the implications for social work practice, education, and research. [ABSTRACT FROM AUTHOR]

Purpose: Ankylosing spondylitis (AS), inflammatory bowel disease and Crohn's disease (CD) often coexist in the same patient and these diseases have remarkably strong overlaps in genetic association. The association between Unc51like kinase 1 (ULK1) gene polymorphisms and CD has been reported, and the aim of the current study was to investigate whether ULK1 polymorphisms are also associated with susceptibility to AS in the Chinese Han population.Methods: Five tagging single nucleotide polymorphisms in the ULK1 gene (rs9652059, rs11616018, rs12303764, rs4964879 and rs7300908) were genotyped by the improved multiplex ligase detection reaction method in a cohort of patients with AS (n=649) and controls (n=628). Various genetic models were performed and haplotypes were constructed after linkage disequilibrium analysis.Results: A statistically significant difference was found in the dominant model of the rs9652059 polymorphism (OR (95% CI) = 0.796 (0.638 to 0.994), χ2 = 4.064, p= 0.044). Haplotypes were conducted between rs9652059 and rs11616018, rs11616018 and rs4964879, rs9652059 and rs4964879 based on D' ≥0.9 and r2 ≥ 0.6. Ht5 (rs9652059C-rs4964879G) haplotype was associated with AS (OR (95% CI) = 0.834 (0.706 to 0.985), χ2=4.555, p= 0.0328) and other two haplotypes were marginally correlated with AS (ht2 (rs9652059C-rs11616018T): OR (95% CI) = 0.846 (0.717 to 1.000), χ2= 3.864, p= 0.0493); ht3 (rs9652059T-rs11616018T): OR (95% CI) = 1.440 (0.999 to 2.076), χ2 = 3.849, p = 0.0498).Conclusions: Our findings suggest that rs9652059 variation (C→T) could increase AS susceptibility and haplotypes of rs9652059C-rs4964879G, rs9652059C-rs11616018T and rs9652059T-rs11616018T may be associatd with AS. [ABSTRACT FROM AUTHOR]

This study was aimed to explore the level of psychological distress and posttraumatic stress among female burn survivors in Pakistan. It was also intended to study the kind of social support available to these burn survivors in a society where women right violation is common. The sample consisted of 35 female burn victims selected from two hospitals. General Health Questionnaire, posttraumatic stress disorder Checklist-Specific, and Social Support Scale were used to measure study variables in addition to a short open-ended questionnaire to identify coping strategies of these burn survivors. Consistent with the hypothesis, results found a high level of psychological reaction among female burn survivors. About one-quarter of the sample (23%) presented severe symptoms of psychological distress whereas 20% of the sample reported to experience severe posttraumatic stress disorder symptoms. There was a significant inverse relationship between psychological reactions and social support as hypothesized. Majority of female burn victims found to use emotion-focused coping (EFC) mainly including prayers, emotional discourse, and using drugs. The findings of the study would be helpful to plastic surgeons, dermatologists, psychologists, and social workers to understand the patient's psychological reactions, their copying styles, and the role of social support in the rehabilitation program for these survivors. [ABSTRACT FROM AUTHOR]

Second-hand smoke (SHS) exposure is high among UK Bangladeshi and Pakistani populations, reflecting higher male smoking prevalence and fewer home smoking restrictions than the general population. The Muslim Communities Learning About Second-hand Smoke (MCLASS) study explored the feasibility and acceptability of implementing SHS education in 14 UK mosques. Religious teachers (RTs) in seven intervention mosques were trained and provided with a culturally appropriate educational package. After the intervention, mosque leaders, RTs and congregants' experiences and perceptions of the intervention were explored through interviews and focus group discussions. Delivery of the intervention varied across mosques. Facilitators and barriers included: mosque diversity (congregation size, organizational structure, educational activities, women's role and involvement); degree of trust between researchers and personnel; and views on SHS. Most participants thought mosques' involvement in SHS health promotion was appropriate, but the perceived importance of SHS differed. We found that a health promotion programme delivered within Islamic religious settings that engages RTs in the process of facilitation, can be acceptable and feasible, but care must be taken to explore the culture and ethos of the institution, including its organizational structure, management committee, RTs and congregation. [ABSTRACT FROM AUTHOR]

Background: Chicago's Chinatown is home to a sizeable community of first-generation Chinese American immigrants. This qualitative study seeks to describe the attitudes toward, and barriers and facilitators of, breast cancer screening among Chinese women in Chicago's Chinatown to inform strategies for future interventions.Methods: We conducted six focus groups among Chinese-speaking adult women aged 45 and older. Focus groups were transcribed, coded, and analyzed for emergent themes.Results: Forty-seven women participated in focus groups; 10 (21%) had received a breast cancer diagnosis in their lifetime, all participants were foreign-born, and 80% have resided in the United States for over 10 years. Participants expressed a range of breast cancer beliefs, attitudes toward screening, barriers encountered, and facilitators. Some differences were noted between women with cancer and those without. Barriers described include language, time, not wanting to burden their adult children, and transportation. Navigation services and physician recommendation were suggested facilitators to screening.Conclusions: Our findings have important implications for development of interventions and policies to bolster breast cancer screening among Chinese women. We highlight the need to connect Chinese older adults with resources to navigate the health care system and present opportunities for community stakeholders, researchers, health professionals, and policy makers to improve the health of Chinese Americans. [ABSTRACT FROM AUTHOR]

Soyfoods have been intensely researched, primarily because they provide such abundant amounts of isoflavones. Isoflavones are classified as both plant estrogens and selective estrogen receptor modulators. Evidence suggests that these soybean constituents are protective against a number of chronic diseases, but they are not without controversy. In fact, because soyfoods contain such large amounts of isoflavones, concerns have arisen that these foods may cause untoward effects in some individuals. There is particular interest in understanding the effects of isoflavones in young people. Relatively few studies involving children have been conducted, and many of those that have are small in size. While the data are limited, evidence suggests that soy does not exert adverse hormonal effects in children or affect pubertal development. On the other hand, there is intriguing evidence indicating that when soy is consumed during childhood and/or adolescence, risk of developing breast cancer is markedly reduced. Relatively few children are allergic to soy protein, and most of those who initially are outgrow their soy allergy by 10 years of age. The totality of the available evidence indicates that soyfoods can be healthful additions to the diets of children, but more research is required to allow definitive conclusions to be made. [ABSTRACT FROM AUTHOR]

Study Question: Do the rates at which women transition among different intensities of pregnancy planning vary with age, marital status and race/ethnicity?Summary Answer: Rates of transition from low or moderate pregnancy probability groups (PPGs) to higher PPGs vary by age, marital status and race/ethnicity.What Is Known Already: The design of prospective studies of the effects of pre- and peri-conception exposures on fecundity, pregnancy and children's health is challenging because at any specific time only a small percentage of reproductive age women is attempting to conceive. To our knowledge, there has been no population-based, prospective study that repeatedly assessed pregnancy planning, which included women who were not already planning pregnancy at enrollment and whose ages spanned the female reproductive age range.Study Design, Size, Duration: A longitudinal study was carried out that repeatedly assessed pregnancy probability in 12 916 women for up to 21 months from January 2009 to September 2010.Participants/materials, Setting, Method: We analyzed data from the National Children's Study Vanguard Study, a pilot study for a large-scale epidemiological birth cohort study of children and their parents. During the Vanguard Study, investigators followed population-based samples of reproductive age women in each of seven geographically dispersed and diverse study locations over time to identify when they sought to become pregnant, providing a unique opportunity to prospectively assess changes in pregnancy planning in a large sample of US women. At study entry and each follow-up contact, which occurred at 1, 3 or 6 month intervals depending on PPG, a questionnaire was used to assess behavior dimensions of pregnancy planning to assign women to low, moderate, high non-tryer and high tryer PPGs.Main Results and the Role Of Chance: Crude rates of pregnancy increased with higher assigned PPG, validating the utility of the instrument. The initial PPG and probabilities of transitioning from low or moderate PPG to higher PPG or pregnancy varied with age, marital status and race/ethnicity. Women aged 25 to <35 years had shorter times to transition to higher PPGs or to pregnant compared with women <25 years. Women who were not currently married had longer times to transition from any initial PPG to pregnant, high tryer or high non-tryer status than currently married women. Non-Hispanic Black (NHB) and Hispanic women had shorter time to transition from low or moderate to high non-tryer than non-Hispanic White (NHW) women. NHB women also had shorter time to transition from low to high tryer than NHW women. High tryers are more likely to be aged 25 to <30 years, to be married, and to be Hispanic, NHB or other race/ethnicity than women in the low PPG.Limitations, Reasons For Caution: Loss to follow-up varied by age, marital status and race/ethnicity. Although weights were not developed for the Vanguard study, the self-weighting design minimizes the bias of unweighted analysis. Nonetheless, the SEs for some estimates may be under-estimated.Wider Implications Of the Findings: Our results show that demographic characteristics are strong predictors of women's behaviors toward pregnancy. The results further show that frequent follow-up assessments of pregnancy planning behavior in large numbers of women are required to recruit an unbiased sample of preconception women. These findings will be useful to investigators designing prospective studies of fecundability, pregnancy outcomes and children's health.Study Funding/competing Interests: National Institutes of Health (contracts N01-HD53414, N01-HD63416, N01-HD53410, N01-HD53415, N01-HD53396, N01-HD53413 and N01-HD-53411; grant R21 ES016846) and by the University of California Irvine Center for Occupational and Environmental Health. No competing interests.Trial Registration Number: None. [ABSTRACT FROM AUTHOR]

Aims: Previous studies indicate that South Asians (SAs) may have a reduced risk of developing atrial fibrillation (AF) despite having a higher prevalence of traditional cardiovascular risk factors. This observational study was designed to explore the relative differences between SAs and Whites in a well-defined, multi-ethnic population with careful consideration of traditional cardiovascular risk factors that are thought to contribute to the development of AF.Methods and results: Anonymized data from 417 575 adults were sourced from primary care records within Bradford Metropolitan District, UK. Atrial fibrillation diagnosis was indicated by the presence on the AF Quality Outcomes Framework register. Self-reported ethnicity was mapped to census ethnic codes. The age-standardized prevalence rates of AF were calculated for comparison between the White and SA populations; our study sample presented relative proportions of 2.39 and 0.4%. Multivariable logistic regression analysis was performed to estimate the odds of developing AF given SA ethnicity. Adjustment for age, sex, and established risk factors found a 71% reduction in odds of AF in SAs when compared with Whites [odds ratio (OR): 0.29, 95% confidence interval (CI): 0.26-0.32]. When stratified by ethnicity, analyses revealed significantly different odds of AF for patients with diabetes; diabetes was not associated with the development of AF in the SA population (0.81, 95% CI: 0.63-1.05).Conclusion: This study, in a multi-ethnic population, presents ethnicity as a predictor of AF in which prevalence is significantly lower in SAs when compared with Whites. This is despite SAs having a higher frequency of established risk factors for the development of AF, such as ischaemic heart disease, heart failure, hypertension, and type 2 diabetes. These findings are consistent with previous literature and add weight to the need for further investigation, although this is the first study to investigate the differential associations of individual risk factors with development of AF. [ABSTRACT FROM AUTHOR]

Home foreclosures can precipitate declines in health among the individuals who lost their homes. Whether home foreclosures can "spillover" to affect the health of other neighborhood residents is largely unknown. Using longitudinal data from the Multi-Ethnic Study of Atherosclerosis that were linked to foreclosure data from 2005 to 2012, we assessed whether greater exposure to neighborhood foreclosures was associated with temporal changes in 3 objectively measured cardiometabolic risk factors: body mass index, systolic blood pressure, and fasting glucose level. We used fixed-effects models to estimate mean changes in cardiometabolic risk factors associated with changes in neighborhood foreclosures over time. In models in which we controlled for time-varying income, working status, medication use, neighborhood poverty, neighborhood unemployment, and interactions of age, sex, race, and state foreclosure laws with time, a standard-deviation increase in neighborhood foreclosures (1.9 foreclosures per quarter mile) was associated with increases in fasting glucose (mean = 0.22 mg/dL, 95% confidence interval: -0.05, 0.50) and decreases in blood pressure (mean = -0.27 mm Hg, 95% confidence interval: -0.49, -0.04). Changes in neighborhood foreclosure rates were not associated with changes in body mass index. Overall, greater exposure to neighborhood foreclosures had mixed associations with cardiometabolic risk factors over time. Given the millions of mortgages still in default, further research clarifying the potential health effects of neighborhood foreclosures is needed. [ABSTRACT FROM AUTHOR]

Ambient air pollution and temperature have been linked with cardiovascular morbidity and mortality. Metabolic syndrome and its components--abdominal obesity, elevated fasting blood glucose concentration, low high-density lipoprotein cholesterol concentration, hypertension, and hypertriglyceridemia--predict cardiovascular disease, but the environmental causes are understudied. In this study, we prospectively examined the long-term associations of air pollution, defined as particulate matter with an aerodynamic diameter less than or equal to 2.5 µm (PM2.5), and temperature with the development of metabolic syndrome and its components. Using covariate-adjustment Cox proportional hazards models, we estimated associations of mean annual PM2.5 concentration and temperature with risk of incident metabolic dysfunctions between 1993 and 2011 in 587 elderly (mean = 70 (standard deviation, 7) years of age) male participants in the Normative Aging Study. A 1-µg/m³ increase in mean annual PM2.5 concentration was associated with a higher risk of developing metabolic syndrome (hazard ratio (HR) = 1.27, 95% confidence interval (CI): 1.06, 1.52), an elevated fasting blood glucose level (HR= 1.20, 95% CI: 1.03,1.39), and hypertriglyceridemia (HR = 1.14, 95% CI: 1.00,1.30). Our findings for metabolic syndrome and high fasting blood glucose remained significant for PM2.5 levels below the Environmental Protection Agency's health-safety limit (12 µg/m³). A 1°C increase in mean annual temperature was associated with a higher risk of developing elevated fasting blood glucose (HR = 1.33, 95% CI: 1.14, 1.56). Men living in neighborhoods with worse air quality--with higher PM2.5 levels and/or temperatures than average--showed increased risk of developing metabolic dysfunctions. [ABSTRACT FROM AUTHOR]

Growing evidence has linked positive psychological attributes like optimism to a lower risk of poor health outcomes, especially cardiovascular disease. It has been demonstrated in randomized trials that optimism can be learned. If associations between optimism and broader health outcomes are established, it may lead to novel interventions that improve public health and longevity. In the present study, we evaluated the association between optimism and cause-specific mortality in women after considering the role of potential confounding (sociodemo-graphic characteristics, depression) and intermediary (health behaviors, health conditions) variables. We used prospective data from the Nurses' Health Study (n = 70,021). Dispositional optimism was measured in 2004; all-cause and cause-specific mortality rates were assessed from 2006 to 2012. Using Cox proportional hazard models, we found that a higher degree of optimism was associated with a lower mortality risk. After adjustment for sociode-mographic confounders, compared with women in the lowest quartile of optimism, women in the highest quartile had a hazard ratio of 0.71 (95% confidence interval: 0.66, 0.76) for all-cause mortality. Adding health behaviors, health conditions, and depression attenuated but did not eliminate the associations (hazard ratio = 0.91, 95% confidence interval: 0.85, 0.97). Associations were maintained for various causes of death, including cancer, heart disease, stroke, respiratory disease, and infection. Given that optimism was associated with numerous causes of mortality, it may provide a valuable target for new research on strategies to improve health. [ABSTRACT FROM AUTHOR]