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STUDY OBJECTIVE: African Americans (AAs) show early signs of vascular dysfunction paired with elevated blood pressure (BP) and total peripheral resistance (TPR), which is thought to underlie their increased rates of cardiovascular health complications relative to European Americans (EAs). AAs paradoxically have higher cardiac vagal tone, indexed by heart rate variability (HRV), which is cardio-protective. This paradox has been termed the Cardiovascular Conundrum. The physiological mechanism underlying this phenomenon is not well understood. We examined race differences in baroreflex function, which might be an important mechanism underlying the Cardiovascular Conundrum. DESIGN: Participants completed a 5-minute baseline period where resting cardiac metrics were assessed. SETTING: Laboratory. PARTICIPANTS: 130 college-aged individuals (54 women, 57 AAs). MAIN OUTCOME MEASURES: Baroreflex function was indexed as baroreflex sensitivity (BRS; the magnitude of changes in cardiovascular activity in accordance with BP changes) and effectiveness (BEI; the ratio of BP changes that elicit changes in cardiovascular activity) in the cardiac, vascular, and myocardial limbs. RESULTS AND CONCLUSIONS: Results showed AAs to have higher HRV and cardiac BRS in comparison to EAs, suggesting the baroreflex is more sensitive to correcting the heart period for changes in BP among AAs compared to EAs. However, AAs showed lower vascular BEI relative to EAs, suggesting less effective control of TPR. In sum, lower BEI in the vascular branch might be an important mechanism underlying the Cardiovascular Conundrum (i.e., higher HRV and BP) and by extension, health disparities in cardiovascular diseases between AAs and EAs.

Introduction: National data reveal that the age-adjusted prevalence of leisure-time physical inactivity is higher among Blacks and Hispanics compared with Whites. However, these estimates do not consider nonleisure physical activity (PA). Also, race/ethnicity in these findings may by confounded by socioeconomic status disparities in PA. Here, we examine racial/ethnic differences in multiple measures of PA within a lower socioeconomic status sample. Methods: Participants in the current cross-sectional study (n = 1526 adults, aged ≥ 18 y) were recruited from Supplemental Nutrition Assistance Program-Education classes (nutrition education classes that target low-income people) in Texas. Self-report data were obtained using survey questionnaires in spring and fall 2018. PA outcomes of 4 different intensities were assessed: mean daily time spent walking, engaging in moderate and vigorous PA, and sitting. Additional PA-related measures included use and awareness of community PA resources. Linear regression models examined racial/ethnic differences in the 4 PA outcomes after adjusting for participant gender, age, household composition measures, and various socioeconomic status measures. Results: In this low-income sample, Hispanic and Black participants spent 6 to 9 more minutes per day walking and engaging in moderate and vigorous PA compared with White/other participants (P <.05 for each measure). Conversely, White/other participants reported spending 82 more minutes sitting per day than Black and Hispanic participants (P <.01). Overall, Black participants were most likely to utilize community PA resources and report ease of engaging in exercise. Discussion: Together, these results reveal greater engagement in PA by racial/ethnic minorities in low-income communities compared with Whites. Our results have implications for tailoring PA programming to these communities. [ABSTRACT FROM AUTHOR]

Background and Objectives: As overdose rates rise among non‐White Americans, understanding barriers to substance use disorder (SUD) treatment access by race and ethnicity is important. This study explores self‐reported barriers to SUD treatment by race and ethnicity in emergency department (ED) populations. Methods: We conducted a secondary, exploratory analysis of a randomized trial of patients not seeking SUD treatment who endorsed active drug use at six academic EDs. Responses to the Barriers to Treatment Inventory were compared by race, ethnicity, and drug severity, using χ2 tests (N = 858), followed by adjusted logistic regression models. Results: Absence of a perceived drug problem (39% non‐Hispanic Black, 38% Hispanic, 50% non‐Hispanic White; p ≤.001) was the most prevalent barrier to SUD treatment. Non‐Hispanic Black participants were less likely to state that they could handle their drug use on their own (OR = 0.69, CI = 0.50–0.95), and were more likely to report disliking personal questions than non‐Hispanic White participants (OR = 1.49, CI = 1.07–2.09). Non‐Hispanic Black participants were less likely than Hispanic participants to agree that treatment availability (OR = 0.46, CI = 0.28–0.76) and family disapproval (OR = 0.38, CI = 0.16–0.91) were treatment barriers. Discussion and Conclusions: Screening and counseling may help address the barrier, common to all groups, that drug use was not seen as problematic. Expanding access to diverse treatment options may also address the range of barriers reported by our study population. Scientific Significance: Our study is one of the first in the U.S. to examine both individual and structural barriers to accessing treatment and to examine the association with drug use severity by race/ethnicity. [ABSTRACT FROM AUTHOR]

Background Very few studies have evaluated the global prevalence of pruritus. Objectives To assess its prevalence according to age, sex, ethnicity and geographic region. Methods An international cross-sectional study was conducted in 20 countries from January to April 2023. Participants were asked to complete a questionnaire on sociodemographics, and to confirm the presence or absence of a skin disease in the last 12 months and the presence or absence of pruritus in the last 7 days. Results The studied sample included 50 552 individuals. The worldwide prevalence of pruritus was 39.8%. The age group ≥ 65 years had the highest prevalence (43.3%). The prevalence was 40.7% among women and 38.9% among men (P < 0.001). There was no significant difference between ethnicities (P = 0.14). Compared with North America (41.2%), the prevalence of pruritus was significantly lower in Europe (35.9%, P < 0.001), Australia (38.4%, P = 0.017), East Asia (40.2%, P = 0.04) and Latin America (36.5%, P < 0.001), and higher in Africa (45.7%, P = 0.007). No significant difference was found with the Middle East (40.2%, P = 0.36). The prevalence of pruritus in BRICS countries (40.3%) was significantly higher than that in developed countries (38.7%) (P < 10– 3 ). Conclusions Out analysis is limited because there is no information about the severity or type (acute, chronic) of pruritus. The global prevalence of pruritus revealed age, sex and geographic region differences, with no ethnic differences. [ABSTRACT FROM AUTHOR]

Since the creation of Pakistan in 1947, the state has been struggling in nation-building efforts because of mainly ethnic differences in the country. This is most evident in Balochistan, Pakistan's largest province, which has been suffering from insurgency since the late 1950s. Being home to the Gwadar Port, there is a growing Baloch resistance to the China-Pakistan Economic Corridor (CPEC) since 2015. This situation necessitates a thorough examination of how the locals view and have reacted to the CPEC. This research investigates Baloch reactions to the CPEC and how the federal and provincial governments as well as Beijing have tried to address these challenges. China's investment is seen by the Baloch as neo-colonialism—something they must fight at all costs. Therefore, the CPEC, and particularly projects like the Gwadar Port, have added to the locals' grievances against the state, reflected through an increasing number of terrorist attacks in Balochistan. [ABSTRACT FROM AUTHOR]

Purpose: Elective induction of labor (IOL) has been increasingly performed since growing data suggesting its safety and potential improved maternal and neonatal outcomes. Recommendations of elective IOL for patients from racial or ethnic minority backgrounds given the data showing increased risk of stillbirth for some populations has been met with criticism. This scoping review aims to determine if there are racial disparities in access to elective IOL and maternal and neonatal outcomes. Methods: A review of the literature on IOL that appeared in English journals was performed using MEDLINE and EMBASE. The search strategy included the combination of key terms "induction of labour" and "race" or "ethnicity" in titles, abstracts, or keywords. Results: A total of 8 studies were identified and included. The articles were heterogenous in the race or ethnicity distinctions they used for analysis. Three out of 4 studies that analyzed the rate of elective IOL by race found that White patients were more likely to receive the intervention. Three out of 4 studies that analyzed outcomes of IOL found no difference, while one study found Black patients benefit most from IOL at 38 weeks compared to other races that had the lowest risk of complications with IOL at 39 weeks. Conclusion: Racial and ethnic disparities exist with White patients being most likely to access this intervention. The majority of data points to similar outcomes, suggesting no increased harm to elective IOL for a particular group. However, the optimal timing of elective IOL given disproportionate stillbirth risk remains to be elucidated. [ABSTRACT FROM AUTHOR]

Firearm suicides among adolescents have increased in the US and rates vary across racial and ethnic groups. In this study, we examined contextual information around adolescent firearm suicides and analyzed how incident characteristics vary across racial and ethnic groups. We analyzed firearm suicides among adolescents (ages 10–18 years) from 2004 to 2020 using data from the National Fatality Review-Case Reporting System (NFR-CRS). There were 4,153 firearm suicides during that period. Suicides often involved males, older adolescents (15–18 years), and handguns. Most firearms belonged to the primary caregiver and incidents frequently occurred at home. However, we found that characteristics varied substantially across racial and ethnic groups. Overall, we provide new information on firearm suicides among adolescents in the US using a larger dataset than previous studies and found significant differences in characteristics and demographics across racial and ethnic groups. This finding suggests the need for tailored prevention strategies. [ABSTRACT FROM AUTHOR]

Aim: To examine the hypothesis that there would be ethnic differences in the relationship between ectopic fat and tissue‐specific insulin resistance (IR) across a spectrum of glucose tolerance in Black African (BA) and White European (WE) men. Materials and Methods: Fifty‐three WE men (23/10/20 normal glucose tolerance [NGT]/impaired glucose tolerance [IGT]/type 2 diabetes [T2D]) and 48 BA men (20/10/18, respectively) underwent a two‐step hyperinsulinaemic‐euglycaemic clamp with infusion of D‐[6,6‐2H2]‐glucose and [2H5]‐glycerol to assess hepatic, peripheral and adipose tissue IR. Magnetic resonance imaging was used to measure subcutaneous adipose tissue, visceral adipose tissue (VAT) and intrahepatic lipid (IHL). Associations between ectopic fat and IR were assessed using linear regression models. Results: There were no differences in tissue‐specific IR between ethnic groups at any stage of glucose tolerance. VAT level was consistently lower in the BA population; NGT (p = 0.013), IGT (p = 0.006) and T2D (p = 0.015). IHL was also lower in the BA compared with the WE men (p = 0.013). VAT and IHL levels were significantly associated with hepatic IR in the BA population (p = 0.001) and with peripheral IR in the WE population (p = 0.027). Conclusions: The present study suggests that BA and WE men exhibit the same degree of IR across a glucose tolerance continuum, but with lower VAT and IHL levels in the BA population, suggesting that IR may be driven by a mechanism other than increased ectopic fat accumulation in BA men. [ABSTRACT FROM AUTHOR]

Summary Objective Methods Results Conclusion The relationship between ethnicity, obesity and health‐related quality of life outcomes in a multi‐ethnic population remains poorly understood. We aim to investigate the relationship between ethnicity, body mass index (BMI), obesity‐associated diseases, as well as determinants of quality of life (QoL) in Southeast Asian patients with obesity. We aim to develop and validate a simple objective score to identify patients with obesity at high risk for major depression.Associations between ethnicity, obesity‐associated diseases, BMI and determinants of QoL (Patient Health Questionnaire‐9 and 36‐Item Short Form Survey) were analysed using multivariate logistic regression in a prospective cohort of 1501 patients with obesity. Multivariate regression and receiver operating characteristics curves were used to develop and validate a novel scoring system to identify patients at risk of major depression.Patients of Chinese, Malay and Indian ethnicity had increased risk of hypertension (odds ratio [OR]: 1.51 [95% confidence interval [CI]: 1.19–1.92, p < .001]), BMI Class 4 (OR: 17.89 [95% CI: 9.53–33.60, p < .001]) and major depression (OR: 1.71 [95% CI: 1.23–2.39, p = .002]), respectively. Factors associated with major depression (gender, ethnicity, age, obstructive sleep apnoea, Physical Component Score and Mental Component Score scores) were used to create and validate a novel scoring system with an area under curve of 0.812 (95% CI: 0.787–0.837). A cutoff of 4 of 7 points was identified with a sensitivity of 70%, specificity of 81%, positive predictive of 53% and negative predictive value of 90%.The prevalence of metabolic complications from obesity significantly varies with ethnicity. We developed a novel and simple scoring tool combining objective demographic and patient‐reported outcomes to screen and triage patients at risk of major depression. [ABSTRACT FROM AUTHOR]

Purpose: The prevalence of armed conflicts in Africa seems commonplace, with little possibility to their end. This study aims to challenge a narrative that seem to consider ethnicity, or ethnic differences as the main causes of armed civil conflicts in Africa. This study argues that while ethnicity might play a role in conflict formation, ethnicity is simply a Trojan horse that is impishly presented as the main cause of armed conflicts in Africa.Design/Methodology: Data were collected from both primary and secondary sources. To evaluate the ethnicity vs. conflict nexus more conscientiously, this study provided two case examples: Ethiopia and Kenya, each providing distinct political trajectories.Findings: The study finds that ethnicity is not the main cause of armed conflicts in Africa; rather, the main causal factors are embedded in bad governance practices by political elites and their cronies. Notable is the practice of politics of power grab and marginalisation of certain groups to achieve Machiavellian ends. The additional causal factor is tied to external imperial exploitative motives of looting Africa’s natural resources, often using African puppets, bagmen and traitors of their own homeland. Thus, a combination of bad local governance practices and external economic interests is mainly what has led to a surge in armed civil conflicts in Africa.Originality/Value: The novelty of this study is that it challenges conventional political standpoints on the causes of ethnic-related conflicts and the solutions needed to end/reduce them. The study has achieved this by pushing the cloak of appreciating the scope and scale of Africa’s armed conflicts by advancing the argument that conflict management solutions lie inward rather than outward through the utilisation of local or homegrown conflict resolution mechanisms. Such local mechanisms must focus on addressing bad governance practices. The current penchant of relying on international or foreign mediatory systems as solutions is done merely at the behest of global politicking and, as such, only provides cosmetic solutions, hence themselves responsible for those protracted ethnic-related conflicts. [ABSTRACT FROM AUTHOR]

Background: The research community has historically failed to enroll diverse groups of participants in dementia clinical trials. A unique aspect of dementia care research is the requirement of a study partner, who can attest to the care recipient's clinical and functional capacity. The aim of this study is to assess racial and ethnic differences and the importance of various trial considerations among dementia caregivers, in their decision to participate in clinical research as study partners. Method: We embedded a vignette about a hypothetical dementia clinical trial in a nationally representative survey of U.S. dementia caregivers, oversampling non-Hispanic Black and Hispanic caregivers. Dementia caregivers were asked about their willingness to participate in the trial with their care recipient and rated the importance of nine considerations in hypothetical decisions to participate. Caregiver demographic characteristics were analyzed as predictors of trial participation in a base demographic model. In a second reasons model caregiver demographic characteristics and the rated importance of the nine considerations were separately analyzed as predictors; both models used survey-weighted logistic regression. Result: The sample consisted of 610 dementia caregivers, including 156 non-Hispanic Black and 122 Hispanic caregiver participants. In the base demographic model, hypothetical trial participation was negatively associated with older caregiver age (OR (odds ratio) = 0.72, p = < 0.001). In the reasons model, the rated importance of a social responsibility to help others by participating in research was significantly associated with participation (OR = 1.56, p = 0.049), while the importance of the possibility of the care recipient experiencing serious side effects was negatively associated with participation (OR = 0.51, p = 0.003). In both models there was no significant difference in hypothetical participation between non-Hispanic Black and non-Hispanic White caregivers, or between Hispanic and non-Hispanic White caregivers. Conclusion: Hispanic and non-Hispanic Black dementia caregivers were not less likely than non-Hispanic White dementia caregivers to participate in a hypothetical dementia clinical trial. Our study suggests that failures to recruit diverse populations in dementia clinical research are not attributable to less willingness among members of underrepresented groups but may instead reflect structural barriers and historic exclusion from trial participation. [ABSTRACT FROM AUTHOR]

Objective Methods Results Significance Little is known about the incidence of late onset epilepsy (LOE) across different racial/ethnic groups in the USA, particularly in the Hispanic population. Stroke, a strong predictor of LOE, is more common in non‐Hispanic Blacks (NHBs) and Hispanics than in non‐Hispanic Whites (NHWs). We assessed the incidence of LOE across racial/ethnic groups and examined whether the associations of stroke with LOE risk differ by race/ethnicity.The Northern Manhattan Study is a population‐based longitudinal study of older adults enrolled between 1993 and 2001. Participants free of history of stroke or epilepsy at baseline (n = 3419) were followed prospectively for incidence of LOE. We estimated LOE incidence per 1000 person‐years in each racial/ethnic group. We used Cox proportional hazards regression to assess the association of race/ethnicity with LOE and multiplicative interactions of race/ethnicity with incident stroke in relation to LOE, adjusting for demographics and comorbid diagnoses.During 51 176 person‐years of follow‐up, 183 individuals developed LOE. Incidence of LOE was significantly higher in NHBs (6.2 per 1000 person‐years) than in NHWs (3.3 per 1000 person‐years, p = .004). There was no significant difference in LOE incidence between NHWs (3.3 per 1000 person‐years) and Hispanics (2.6 per 1000 person‐years, p = .875). However, following incident stroke, the risk of LOE differed across racial/ethnic groups. Incident stroke was associated with 2.55 times the risk of LOE among NHWs (95% confidence interval [CI] = .88–7.35), 8.53 times the risk of LOE among Hispanics (95% CI = 5.36–13.57, p = .04 for stronger association than that in NHWs), and 6.46 times the risk of LOE among NHBs (95% CI = 3.79–11.01, p = .12 for stronger association than that in NHWs).We found a stronger association of incident stroke with LOE risk in Hispanics and NHBs than in NHWs, offering some insight into the racial/ethnic disparities of LOE incidence. [ABSTRACT FROM AUTHOR]

Background: To estimate and compare the association between metabolically healthy overweight/obesity (MHO) and the risk of type 2 diabetes (T2DM) among different ethnic groups in southwest China, while also exploring possible ethnic differences. Methods: This is a prospective cohort study of 6,820 participants in Southwest China. MHO was defined as body mass index (BMI) ≥ 24 kg/m2 and the presence of ≤ 1 component of metabolic syndrome. Cox proportional risk models were utilized to analyze the association between MHO and the risk of T2DM. Results: The median follow-up time was 6.58 years, during which 708 new cases of T2DM were diagnosed. In the total population, after adjusting for confounding factors, MHO was found to increase the risk of T2DM compared to metabolically healthy normal weight (MHNW) individuals (HR = 1.49, 95% CI: 1.15–1.93). Subgroup analysis by ethnicity revealed that, MHO increased the risk of T2DM in the Han population (HR = 1.64, 95% CI: 1.21–2.23), however, the difference was not statistically significant in the ethnic minority population.The results of sensitivity analysis further supported the robustness of these findings. Meanwhile, stratified by sex, age, and urban/rural, it was found that ethnic differences in the association between MHO and T2DM still existed, however, it is important to note that the association between MHO and T2DM was not statistically significant in the Han population subgroup aged ≥ 45 years (p > 0.05). Conclusion: MHO was associated with an increased risk of T2DM compared to MHNW, and there are ethnic differences. Future interventions need to be strengthened for Han Chinese key populations to reduce the risk of T2DM. [ABSTRACT FROM AUTHOR]

Background: SHR-1707 is a novel humanized anti-Aβ IgG1 monoclonal antibody that binds to Aβ fibrils and monomers to block the formation of Aβ plaques or to promote the microglial phagocytosis of Aβ. Preclinical studies showed that SHR-1707 reduced brain Aβ deposition in 5xFAD transgenic mice. Herein, we conducted two phase 1 studies to evaluate the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of a single intravenous dose of SHR-1707 in healthy adult subjects. Methods: Two randomized, double-blind, single-ascending-dose, phase 1 studies were conducted in China (Study CHN) and Australia (Study AUS). Study CHN consisted of 2 parts. In Part 1, eligible healthy young adults (18–45 years) were sequentially randomized 8:2 to receive SHR-1707 (five cohorts: 2, 6, 20, 40, and 60 mg/kg) or placebo in each cohort; in Part 2, elderly subjects (55–80 years) were randomized 8:4 to receive SHR-1707 (20 mg/kg) or placebo. A similar design was used in Study AUS, but with only healthy young adults enrolled across three dosing cohorts (2, 20, and 60 mg/kg). Results: Sixty-two (part 1/2, n = 50/12; age range, 18–42/55–63 years) and 30 subjects (age range, 18–42 years) received SHR-1707 or placebo in Study CHN and Study AUS, respectively. In Study CHN, all treatment-related adverse events (TRAEs) were mild, with the most common being transient laboratory abnormalities. In Study AUS, TRAEs were mostly mild (1 moderate event each with SHR-1707/placebo); the most common TRAEs with SHR-1707 were dysgeusia and fatigue (8.3% each). In both studies, the exposure of SHR-1707 increased in a slightly greater than dose-proportional manner over the dose range of 2–60 mg/kg in young adults; there was a dose-dependent increase in plasma Aβ42 concentration following SHR-1707 administration compared with the placebo group. The safety and PK and PD profiles of SHR-1707 in the elderly subjects were consistent with the younger counterpart at the same dose level. No ethnic difference in safety, PK and PD of SHR-1707 was observed. Conclusions: A single intravenous dose of SHR-1707 at 2–60 mg/kg was safe and well tolerated in healthy young adult and elderly subjects. The PK and PD profiles are supportive for further clinical development. Trial registration: NCT04973189 (retrospectively registered on Jul.21, 2021) and NCT04745104 (registered on Feb.6, 2021) on clinicaltrials.gov. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusions To determine the regional and ethnic differences in ocular axial elongation and refractive error progression in myopic and non‐myopic children.A retrospective analysis of 15 longitudinal clinical and population‐based studies was conducted in the UK, Sweden, Australia (classified as European), China, and Vietnam (classified as East Asian) between 2005 and 2021. A total of 14,593 data points from 6208 participants aged 6–16 years with spherical equivalent from +6 to −6 D were analysed. Progression was annualised from longitudinal axial length and cycloplegic spherical equivalent (SE) refraction. Generalised estimating equation models including main effects and interactions were used for model building. Age and region‐specific estimates for myopes and non‐myopes and confidence intervals are reported.Factors affecting axial elongation and SE progression in children included being myopic, followed by age, region/ethnicity and sex. The magnitude of regional/ethnic differences was dependent on myopia and age. Axial elongation and SE progression were lower in European compared with East Asian children, but differences were reduced with increasing age and differences in axial elongation were larger in myopes than non‐myopes. Age‐specific regional/ethnic differences indicated that axial elongation for a 6‐year‐old East Asian myopic child was greater than a European child by 0.15 mm/year (0.58 vs. 0.43 mm/year) and by 0.09 mm/year (0.35 vs. 0.26 mm/year) for a 10‐year‐old myope. SE progression was lower in a 6‐year‐old European myope by 0.48 D/year and at 10 years of age by 0.34 D/year compared with an East Asian myope.There are regional/ethnic differences in age‐specific refractive and axial growth patterns in both myopic and non‐myopic eyes, with more marked differences in younger East Asian children who demonstrated a higher axial growth and greater negative SE shift than their non‐Asian peers. Regional/ethnic differences in progression reflect environmental and ethnic variations. Age and region/ethnicity‐specific estimates could contribute as a reference for future comparisons. [ABSTRACT FROM AUTHOR]

This article analyses the image of the Arab 'uncertain body' by introducing two theoretical tools: first, the practice of sojourner passing: that is, an abrupt and temporary event limited in space and time in order to gain access to sexual, financial or militarised goals; second, the uncertainty of the Muslim male body. In the Israeli context, the fear of the Arab 'uncertain body' manifests itself in two main ways: (1) the fear of Arab sojourner passers who threaten sites of nationhood; and (2) Arabs who try to assimilate are blamed for passing as civilised, disguising their true monstrous nature. The Israel–Palestine context is unique in that it offers intriguing insights into passing in a non-western society, where the ethnic differences are blurred and hence anxiety is more pronounced. [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]

Background: Tourette syndrome (TS) is a neurodevelopmental disorder. The prevalence of TS in 2016–2017 has been reported; however, little is known about the current prevalence and trend in children and adolescents with TS. This study aimed to estimate the prevalence and trend of Tourette syndrome (TS) among US children and adolescents aged 0–17 years from 2016 to 2022. Methods: We analyzed data from a nationally representative sample of 278,472 children and adolescents aged 0–17 years who participated in the 2016–2022 National Survey of Children's Health (NSCH), a nationwide, population-based, cross-sectional survey of US children and adolescents. TS was defined as the affirmative response in the questionnaire completed by a parent or guardian. Results: Among the 278,472 children and adolescents enrolled, 754 had been diagnosed with TS, with an overall prevalence of 0.23% in all children and adolescents aged 0-17 years. The weighted prevalence by age group was lower than 0.01% in children aged 0–2 years, 0.05% in children aged 3–5 years, 0.28% in children aged 6–11 years, and 0.38% in adolescents aged 12–17 years. There were significant sex and racial/ethnic differences in the overall prevalence of diagnosed TS (i.e., 0.35% in boys and 0.11% in girls, 0.22% in Hispanics, 0.28% in non-Hispanic whites and 0.16% in non-Hispanic blacks). There was no significant change in the estimated prevalence of TS from 2016 to 2022. Conclusion: Based on nationally representative data, this study found that the national prevalence of TS among the US children and adolescents differed by sex and race/ethnicity but remained stable from 2016 to 2022. [ABSTRACT FROM AUTHOR]

To assess associations of ACEs with depression and anxiety, with special emphasis on potential racial and ethnic disparities. Data were from the National Survey of Children's Health (NSCH), 2021 –2022, a large, cross-sectional, nationally representative, population-based study of United States children aged 0–17. The associations of cumulative ACEs with depression and anxiety among 104,205 children and adolescents were assessed via multivariable logistic regression, including adjustment for age, sex, race, household income, and parental educational attainment. ACEs were associated with depression and anxiety in a linear, dose-dependent manner. After adjustment for covariates, compared to no ACE exposures, participants with exposures to one, two, and three ACEs exhibited significantly higher odds of depression (fully-adjusted ORs and 95 % CIs = 2.18 [2.03, 2.35], 4.95 [4.55, 5.39], and 11.39 [10.18, 12.75], respectively). For anxiety, compared to no ACEs exposures, participants with exposure to one, two, and three ACEs had significantly higher odds of anxiety (fully-adjusted ORs and 95 % CIs = 1.90 [1.81, 2.00], 3.66 [3.44, 3.90], and 6.91 [6.30, 7.58], respectively). Notably, stratified analyses indicated potential effect modification by race, wherein the associations of ACEs with depression and anxiety were strongest in Black and White participants. ACEs were robustly associated with depression and anxiety in a national sample of U.S. children and adolescents, with differential impacts of ACES on mental health observed across racial and ethnic groups. These findings underscore the need for urgent government and healthcare interventions and policies to ameliorate ACEs' health effects, especially among disproportionately impacted minority groups. • ACEs were associated with elevated depression and anxiety in U.S. youths • Black and White youth were most vulnerable, indicating disparities in ACE impact • NSCH 2021–2022 data capture the effect of the COVID-19 pandemic • Critical need for mental health interventions designed for minority groups [ABSTRACT FROM AUTHOR]

This research studies factors affecting the rapid spread of a donor-driven, Feeding America BackPack (weekend food assistance) program at schools in northwestern North Carolina. Foodbank data are matched with census tract, administrative-school, and GIS data for places of worship (PWs), facilitating analyses of the role of need, religion, and race/ethnicity. Our conceptual model yields a new hybrid fragmentation index that captures racial/ethnic differences between the school and community. Consistent with the model, discrete-time survival estimates suggest that schools with a racial/ethnic composition different from the surrounding community were less likely to get a program, especially if no other program-eligible schools were nearby. The GIS-created PWs bring new information, but yield results only weakly suggestive of a positive relationship. Results withstand falsification and robustness checks. A descriptive update reveals that most high-need schools eventually offered weekend food assistance but that race/ethnicity may still play a role for those that do not. [ABSTRACT FROM AUTHOR]

We review ethnic group differences on high-stakes General Mental Ability (GMA) tests based on 21st century UK data. Thereafter, we meta-analyse scores on 23 occupational, public sector, educational, military, or general-public selection tests, with a sample size exceeding two million. Relative to White GMA, the grand meta-analytic effect sizes (Cohen's d) by major ethnic groups were: Mixed d =.14 (k = 24, N = 67,114), Blacks d =.65 (k = 32, N = 112,975), Asians d =.33 (k = 32, N = 311,695), and Other d =.49 (k = 24, N = 42,846). Further, although Chinese residents outscored White British residents (d = −.15, k = 20, N = 18,897), all other Asian ethnic groups scored slightly to substantially lower. For example, South Asians as a whole averaged d =.37; k = 13, N = 67,566. By subgroups, these averages were: Indians (d =.17, k = 10, N = 28,236), Pakistanis (d =.49, k = 9, N = 19,371), and Bangladeshi (d =.55, k = 7, N = 19,772). Implications for practice and theory are discussed. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionsGrowing research suggests that adversity experienced early in life can affect young children’s development, with implications for health-related outcomes years later. This study explored long-term associations between early life adversity before age 5 (ELA) and later substance use outcomes, and racial and ethnic differences in associations.Data are from children born 1984–2000 to female participants in the U.S. National Longitudinal Study of Youth-1979 cohort (N = 4582 children nested within 2683 mothers, with 1.4–1.8 outcome observations on average for each child in each age period). ELA at ages 0–4 was measured through home observations and maternal surveys, and included high parental conflict and maternal hazardous drinking/drug use (threat-related exposures), and low cognitive stimulation, low emotional support, and household poverty (deprivation-related exposures). Alcohol and cannabis use frequency were measured in biennial adolescent and young adult surveys through 2016. Analyses involved multilevel regression and interactions accounting for demographics, birth cohort, and family history of alcoholism.ELA-threat exposure was associated with greater alcohol and cannabis use frequency in mid-adolescence and at ages 22–25 and 26–32 [exp(β^)’s = 1.05 to 1.13, p’s < 0.05]. Associations of ELA-deprivation with substance use were either null or negative. There were pronounced racial and ethnic inequities in ELA exposure but no evidence of racial and ethnic differences in associations between ELA and later substance use.Broadening substance use research to focus on early childhood conditions appears warranted. Studies that identify intervening pathways to outcomes could inform early, targeted substance use prevention. Efforts are needed to eliminate racial and ethnic inequities in early life conditions. [ABSTRACT FROM AUTHOR]

Background Study Design and Methods Results Discussion Pediatric patients from minoritized racial and ethnic groups receive red blood cell (RBC) transfusions more frequently while undergoing major surgical procedures. Our objective was to identify the contribution of preoperative anemia to racial and ethnic differences in RBC transfusion rates in adolescent spine surgery.This is a multicenter, retrospective cohort study of the National Surgical Quality Improvement Program Pediatric database, 2016 to 2021 for patients in the United States and Canada.Adolescents identifying as non‐Hispanic Black, Hispanic, and other race/ethnicity presented with higher rates of preoperative anemia than non‐Hispanic White adolescents (16.3%, 10.6%, and 9.9%, vs. 7.8%, respectively; p < .0001) and were transfused at higher rates (14.4%, 11.9%, 16.5%, vs. 10.0%, respectively; p < .0001). Minoritized groups demonstrated higher adjusted odds of RBC transfusion compared with non‐Hispanic Whites (non‐Hispanic Black: aOR 1.45 95% CI 1.26–1.65, Hispanic: aOR 1.17 95% CI 0.96–1.41, other race/ethnicity: aOR 1.63 95% CI 1.26–2.09). Of the total effect of minoritized race and/or ethnicity on RBC transfusion, 13.9% was attributed to the indirect effect through preoperative anemia.In this cohort study, patients from minoritized racial and ethnic groups received RBC transfusions at a higher rate than non‐Hispanic White patients, and the difference was partially mediated by preoperative anemia. Future efforts to minimize transfusions and improve health equity should target this modifiable risk factor alongside other sources of disparity and discrimination. [ABSTRACT FROM AUTHOR]

Background: Understanding the burden of aortic stenosis (AS) across diverse racial and ethnic populations is important to ensure equitable resource allocation. This study explored whether severe AS rate varies by race and ethnicity. Methods: The rates of severe AS, stratified by race and ethnicity, were calculated among 615,038 adults with a transthoracic echocardiogram. Logistic regression analysis was performed to identify factors associated with severe AS. Results: Severe AS rates ranged from 0.08% in adults < 50 years old to 3.8% in those = 90 years old. Compared to non-H ispanic White and Asian American [adjusted odds ratio (aOR) = 0.47, 95% confidence interval (CI): 0.42-0.53] and non-H ispanic Black (aOR = 0.44, 95% CI: 0.39-0.50) patients were less likely to have severe AS, whereas Hispanic patients (aOR = 0.91, 95% CI: 0.87-0.98) had near similar likelihood. Age was the strongest risk factor for severe AS (compared to age < 50 years, aOR = 21.8, 95% CI: 17.8-26.6 for age 80-89 years, and aOR = 43.8, 95% 35.5-54.0 for age = 90 years). Additional factors associated with severe AS included male sex (aOR = 1.38, 95% CI: 1.30-1.46) and diabetes (aOR = 1.23, 95% CI: 1.15-1.31). Conclusions: Asian American and non-H ispanic Black adults had lower rates of severe AS compared to White and Hispanic patients. The rate of severe AS progressively increases with age in all racial and ethnic groups, with higher rates in men compared with women. With a demographic shift toward an aging and more diverse population, the burden of AS is anticipated to rise. Ensuring adequate allocation of resources to meet the evolving needs of a diverse population remains a shared health care imperative. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine differences in music engagement across immigration generations among different racial/ethnic groups for adults living in the United States. I conducted secondary analysis of two 2018 nationally representative surveys, the February Current Population Survey (CPS) and the Self-Perceptions of Creativity and Arts Participation (SPCAP). CPS questions for music engagement included formalised operations of performing and practicing instruments and singing, whereas the questions in the SPCAP study used expanded/informal language. Initial descriptive and bivariate analyses demonstrated differences in music engagement by immigration generation and race. However, multivariate logistic regression results indicated that substantive differences between immigration generations and racial and ethnic groups were mostly diminished, though the specific ways in which members of different immigrant and cultural groups engage with music may differ. Implications for culturally sustaining pedagogy in K-12 music education and suggestions for future research are discussed. [ABSTRACT FROM AUTHOR]

AbstractBackground: Although health anxiety is broadly related to the overutilization of healthcare, limited research has examined this relation among individuals with substance use disorders (SUDs), or the extent to which racial/ethnic differences influence this relationship. Objectives: The purpose of the current study is to examine the moderating role of racial/ethnic minoritized background in the relationship between health anxiety and treatment utilization among individuals with SUDs. In the present study, patients with SUDs receiving residential treatment in Mississippi (N=118; 62% racial/ethnic minoritized status, 35.6% White) completed a measure of health anxiety and answered questions about past mental health, physical health, and substance use treatment. Regression models examined whether racial/ethnic minoritized status (White vs. racial/ethnic minoritized status) moderated the relation of health anxiety to treatment utilization among patients with SUDs. Treatment utilization was examined by asking whether participants had seen a doctor or mental health provider, engaged in substance use treatment, or alcohol treatment prior to their current treatment (dichotomous), as well as the number of times they had engaged in each treatment (physical health, mental health, substance use, and alcohol treatment) in the past year (continuous). Results: Results revealed that the facets of health anxiety involving concerns about pain and disease phobia were positively associated with treatment utilization, but only among racial/ethnic minoritized participants, with concerns about pain positively associated with self-reported physical health treatment utilization (OR=0.70, 95% CI=0.50; 0.97) and disease phobia positively associated with past mental health (B = 0.36, p = 0.023) and alcohol use treatment (B=-0.23, p=.009). Conversely, disease phobia was related to less prior alcohol use treatment among White participants (B=-0.23, p=.009). Conclusions: Overall, among patients in residential treatment for SUDs, racial/ethnic minoritized participants with SUDs reported more health anxiety compared to white participants, and certain facets of health anxiety (i.e., concerns about pain and worry about severe illness) were linked to heightened treatment utilization among racial/ethnic minoritized individuals. [ABSTRACT FROM AUTHOR]

This study investigates structural inequalities in educational enjoyment in a contemporary cohort of United Kingdom (UK) primary school children. Foundational studies in the sociology of education consistently indicate that the enjoyment of education is stratified by social class, gender, and ethnicity. Analysing data from the UK Millennium Cohort Study, which is a major cohort study that tracks children born at the start of the 21st century, we examine children's enjoyment of both school and individual academic subject areas. The overarching message is that at age 11 most children enjoy their education. The detailed empirical analyses indicate that educational enjoyment is stratified by gender, and there are small differences between ethnic groups. However, there is no convincing evidence of a social class gradient. These results challenge orthodox sociological views on the relationship between structural inequalities and educational enjoyment, and therefore question the existing theoretical understanding of the wider role of enjoyment in education. [ABSTRACT FROM AUTHOR]

This article explores the racial and ethnic disparities in healthcare access and satisfaction among older adults in the United States. It specifically focuses on the impact of Medicare Advantage (MA) compared to Traditional Medicare (TM) on healthcare equity. The study finds that Black and Hispanic older adults face challenges in obtaining necessary care and experience more hospitalizations for chronic conditions compared to White older adults. The research also reveals disparities in satisfaction with care, access, and costs between different racial and ethnic groups in MA and TM. The findings emphasize the importance of addressing these disparities and improving healthcare experiences for Black and Hispanic beneficiaries in Medicare. [Extracted from the article]

Background: Prior research documented racial and ethnic disparities in health care experiences within the Veterans Health Administration (VA). Little is known about such differences in VA-funded community care programs, through which a growing number of Veterans receive health care. Community care is available to Veterans when care is not available through the VA, nearby, or in a timely manner. Objective: To examine differences in Veterans' experiences with VA-funded community care by race and ethnicity and assess changes in these experiences from 2016 to 2021. Design: Observational analyses of Veterans' ratings of community care experiences by self-reported race and ethnicity. We used linear and logistic regressions to estimate racial and ethnic differences in community care experiences, sequentially adjusting for demographic, health, insurance, and socioeconomic factors. Participants: Respondents to the 2016–2021 VA Survey of Healthcare Experiences of Patients-Community Care Survey. Measures: Care ratings in nine domains. Key Results: The sample of 231,869 respondents included 24,306 Black Veterans (mean [SD] age 56.5 [12.9] years, 77.5% male) and 16,490 Hispanic Veterans (mean [SD] age 54.6 [15.9] years, 85.3% male). In adjusted analyses pooled across study years, Black and Hispanic Veterans reported significantly lower ratings than their White and non-Hispanic counterparts in five of nine domains (overall rating of community providers, scheduling a recent appointment, provider communication, non-appointment access, and billing), with adjusted differences ranging from − 0.04 to − 0.13 standard deviations (SDs) of domain scores. Black and Hispanic Veterans reported higher ratings with eligibility determination and scheduling initial appointments than their White and non-Hispanic counterparts, and Black Veterans reported higher ratings of care coordination, with adjusted differences of 0.05 to 0.21 SDs. Care ratings improved from 2016 to 2021, but differences between racial and ethnic groups persisted. Conclusions: This study identified small but persistent racial and ethnic differences in Veterans' experiences with VA-funded community care, with Black and Hispanic Veterans reporting lower ratings in five domains and, respectively, higher ratings in three and two domains. Interventions to improve Black and Hispanic Veterans' patient experience could advance equity in VA community care. [ABSTRACT FROM AUTHOR]

Racial/ethnic differences exist in the prevalence of adverse childhood experiences (ACEs). However, few studies have examined racial/ethnic differences in the association between ACEs and poor mental health outcomes in young adulthood. Data on 10 self-reported, recalled ACEs (prior to age 18) and current symptoms of depression, anxiety, post-traumatic stress disorder, and sleep problems in early adulthood were collected from 2,020 young adults (age 20–23 years) between January and June 2021 enrolled in a Southern California prospective community-based cohort. Logistic regression models run in 2022–2023 evaluated the association of cumulative (0, 1, 2, 3, 4+ ACEs), grouped (abuse, neglect, household dysfunction), and individual ACE exposure with mental health outcomes; interaction models tested for differences by race/ethnicity. All ACE exposures (cumulative, grouped, individual ACEs) were associated with increased odds of most mental health symptoms. Significant differences by race/ethnicity emerged for individual and grouped (but not cumulative) ACEs. For example, associations of any abuse-related ACE and emotional and physical abuse with depressive symptoms were greater for Hispanic participants than for those of another race/ethnicity. Further, associations of emotional abuse with sleep problems were greater for Hispanic participants than for Asian American and Pacific Islander participants (interaction p s<0.05). Though not significant, the association of familial incarceration with depression symptoms was higher for AAPI participants than for other racial/ethnic groups (interaction p -value=0.06). Evaluation of individual and grouped ACEs reveals important racial/ethnic heterogeneity in associations with mental health outcomes. Findings have implications for targeted prevention efforts for racial/ethnic groups at higher risk for poor mental health. [ABSTRACT FROM AUTHOR]

Background and Objectives: Loneliness is a major public health concern; however, limited research has examined the mechanisms contributing to racial/ethnic inequities in loneliness. Race/ethnicity has been hypothesized to be a distal factor influencing loneliness, and racial/ethnic inequities in loneliness may be attributable to socioeconomic factors (e.g., income and education). Our study seeks to confirm these hypotheses by examining mechanisms that contribute to racial/ethnic inequities in loneliness. In other words, if racial/ethnic differences in loneliness among older adults are mediated by income and education. Research Design and Methods: Data came from the Health and Retirement Study Leave-Behind Questionnaire, 2014–2016. Loneliness was measured by the UCLA 3-item loneliness scale. Race/ethnicity categories were White, Black, and Hispanic/Latino. The mediator variables were household income and education. Multivariable linear regression models were used to determine differences in loneliness by race/ethnicity. The Karlson–Holm–Breen (KHB) mediation method was used to determine if income and education mediated racial/ethnic differences in loneliness. Results: In models examining income and education together, a complete mediation was found between White and Black older adults, in that income and education completely mediated differences in loneliness between these groups. A partial mediation was found between White and Hispanic, and Black and Hispanic older adults. When examining income and education separately, we found that income solely accounted for racial/ethnic differences in loneliness compared to education. Discussion and Implications: Our study is the first to explicitly determine if socioeconomic factors mediate race/ethnicity differences in loneliness among a national sample of older adults. These findings illustrate that income may have greater proximate effects for loneliness among older adults in comparison to education. Additionally, these findings can inform evidence-based interventions to reduce loneliness among older adults. Interventions that enhance quality of life and provide opportunities for socialization for racialized low-income older adults may help decrease racial/ethnic inequities in loneliness. [ABSTRACT FROM AUTHOR]

Classical assimilation theories hold that immigrant groups will slowly integrate economically over time over multiple generations, which implies that the (grand)children of immigrants will improve their housing market position compared to their (grand)parents and transition from rental housing to owner-occupation. This study uses unique data on the children and grandchildren of immigrants and native Dutch ('third generation') in 2018 to assess whether and how the descendants of large immigrant groups from the postwar era have attained ownership. The generational perspective is two-fold. First, we are interested in how individuals from various generations compare within and between origin groups (generational comparison). Second, the study also assesses the role of parental wealth and tenure in intergenerational transfers, i.e., ethnic and generational differences in the effects of these parental background variables. Our estimates from logistic regression models show that Surinamese-Dutch and Turkish-Dutch see higher predicted owner-occupation rates over generations, with some Turkish-Dutch groups having higher rates than native-Dutch. The parental background variables partly predict owner-occupation rates and explain group differences, which indicates the importance of generational transfers. [ABSTRACT FROM AUTHOR]

Objective To evaluate and compare the root canal morphology of mandibular premolars in Saudi and Sudanese subpopulations and between males and females within each group using cone-beam computed tomography (CBCT). Materials and Methods A cross-sectional study was done between May 2022 and July 2023. Six hundred premolars from Saudi and Sudanese subpopulations were evaluated using CBCT for their number of roots, type of root canal configuration based on Vertucci's classification, and average canal length measured from the buccal cusp tip to the root end. Statistical Analysis Statistical comparisons were made between males and females within each subpopulation and the two subpopulations using the chi-square test for root number and type of root canal configuration and an independent sample t -test for the canal length. Results Most mandibular premolars in both subpopulations had a single root, with type I root canal configuration. However, Sudanese showed various canal configurations (I, II, III, IV, and V) compared with Saudis, which was statistically significant in the first canal of the first mandibular premolar (p < 0.05). Also, there were statistically significant differences in canal length between Saudi males and females (p < 0.05) and between Saudis and Sudanese (p < 0.05) in the first and second premolars. Conclusion Although most mandibular premolars in Saudi and Sudanese subpopulations exhibited a single root and type I canal configuration, variations exist between and within the groups, highlighting ethnic and gender differences and emphasizing the need for dentists' attention. [ABSTRACT FROM AUTHOR]

Paid parental leave has become a part of family policies in an increasing number of Western societies. Parental leave benefits may create varying incentives which can lead to heterogeneous fertility responses. The aim of this study is to examine whether and how the changes in second- and third-order fertility associated with the 2004 parental leave reform in Estonia vary depending on mothers' education and ethnic background. The study draws on data from Estonian administrative registers on women born between 1960 and 1999, who had their first or second child between 1993 and 2014. Mixture cure models are estimated for the transitions to second and third births. We find that women with high educational attainment exhibit a stronger response, both in terms of accelerating the tempo and increasing the quantum of fertility, to the introduction of earnings-related parental leave benefits, than their counterparts with less schooling. In terms of fertility quantum, Estonian women show a stronger response than women from other ethnic groups. Regarding the tempo of childbearing, the results pertaining to ethnic differences are mixed. The study suggests that changes in fertility behavior associated with the introduction of earnings-related parental leave benefits are more pronounced among women with higher opportunity costs. [ABSTRACT FROM AUTHOR]

Abstract Glucagon‐like peptide‐1 receptor (GLP‐1R) agonists induce weight loss in patients with type 2 diabetes mellitus (T2DM), but the underlying mechanism is unclear. Recently, the mechanism by which metformin induces weight loss could be explained by an increase in growth differentiation factor 15 (GDF15), which suppresses appetite. Therefore, we aimed to investigate whether the GLP‐1R agonist liraglutide modifies plasma GDF15 levels in patients with T2DM. GDF15 levels were measured in plasma samples obtained from Dutch Europids and Dutch South Asians with T2DM before and after 26 weeks of treatment with daily liraglutide (n = 44) or placebo (n = 50) added to standard care. At baseline, circulating GDF15 levels did not differ between South Asians and Europids with T2DM. Treatment with liraglutide, compared to placebo, decreased body weight, but did not modify plasma GDF15 levels in all patients, or when data were split by ethnicity. Also, the change in plasma GDF15 levels after treatment with liraglutide did not correlate with changes in body weight or HbA1c levels. In addition, the dose of metformin used did not correlate with baseline plasma GDF15 levels. Compared to placebo, liraglutide treatment for 26 weeks does not modify plasma GDF15 levels in Dutch Europid or South Asian patients with T2DM. Thus, the weight loss induced by liraglutide is likely explained by other mechanisms beyond the GDF15 pathway. Highlights What is the central question of this study? Growth differentiation factor 15 (GDF15) suppresses appetite and is increased by metformin: does the GLP‐1R agonist liraglutide modify plasma GDF15 levels in patients with type 2 diabetes mellitus (T2DM)? What is the main finding and its importance? Plasma GDF15 levels did not differ between South Asians and Europids with T2DM and were not modified by 26 weeks of liraglutide in either ethnicity. Moreover, there was no correlation between the changes in plasma GDF15 levels and dosage of metformin administered, changes in body weight or HbA1c levels. The appetite‐suppressing effect of liraglutide is likely exerted via pathways other than GDF15.

Background Methods Results Conclusions Unmet need for home and community‐based services (HCBS) may disparately impact older adults from racial and ethnic minoritized groups. We examined racial and ethnic differences in unmet need for HCBS among consumers ≥65 years using publicly funded HCBS.We analyzed the National Core Indicators‐Aging and Disability survey data (2015–2019) from 21,739 community‐dwelling HCBS consumers aged ≥65 years in 23 participating states. Outcome measures included self‐reported unmet need in six service types (i.e., personal care, homemaker/chore, delivered meals, adult day services, transportation, and caregiver support). Racial and ethnic groups included non‐Hispanic Black, Asian, non‐Hispanic White, Hispanic, and multiracial groups. Logistic regression models examined associations between race and ethnicity and unmet need, adjusting for sociodemographic, health, and HCBS program (i.e., Medicaid, Older Americans Act [OAA], Program for All‐Inclusive Care for the Elderly [PACE]) characteristics, and use of specific service types.Among 21,739 respondents, 23.3% were Black, 3.4% were Asian, 10.8% were Hispanic, 58.8% were non‐Hispanic White, and 3.7% were multiracial or identified with other races/ethnicities. Asian and Black consumers had higher odds of reporting unmet need in personal care than White consumers (adjusted odds ratio [aOR], 1.45, p value < 0.01; and aOR, 1.25, p < 0.001, respectively). Asian and Black consumers had significantly higher odds of unmet need in adult day services versus White consumers (aOR, 1.94, p < 0.001 and aOR, 1.39, p < 0.001, respectively). Black consumers had higher odds of unmet need versus non‐Hispanic White consumers in meal delivery and caregiver support services (aOR, 1.29; p < 0.01; and aOR 1.26, p < 0.05, respectively). Race and ethnicity were not significantly associated with experiencing unmet need for homemaker/chore or transportation services.Future research should identify driving forces in disparities in unmet need to develop culturally appropriate solutions. [ABSTRACT FROM AUTHOR]

Treatment courts have played a key role in criminal justice reform by offering an alternative to incarceration for individuals who have substance use and mental health disorders. The treatment court model requires programs to complete evaluations, as well as measure potential racial and ethnic disparities in outcomes. This study contributes to literature by using the Racial and Ethnic Disparities (RED) Program Assessment Tool to see if treatment courts (n = 151) have fidelity to the model by completing regular evaluation and to assess for racial and ethnic disparities in graduation rates. Treatment courts in this study, for the most part, were not faithful to the model by completing regular evaluation. Specifically, only 34% of the programs regularly examined graduation outcomes by race and ethnicity. Additionally, racial and ethnic disparities did exist where white participants were more likely than African American and Hispanic participants to graduate treatment court. Implications for policy advocacy, treatment court practice, and future research are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To determine how pre-existing conditions contribute to racial disparities in adverse maternal outcomes and incorporate these conditions into models to improve risk prediction for racial minority subgroups. Study design: We used data from the "Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b)" observational cohort study. We defined multimorbidity as the co-occurrence of two or more pre-pregnancy conditions. The primary outcomes of interest were severe preeclampsia, postpartum readmission, and blood transfusion during pregnancy or up to 14 days postpartum. We used weighted Poisson regression with robust variance to estimate adjusted risk ratios and 95% confidence intervals, and we used mediation analysis to evaluate the contribution of the combined effects of pre-pregnancy conditions to racial/ethnic disparities. We also evaluated the predictive performance of our regression models by racial subgroup using the area under the receiver operating characteristic curve (AUC) metric. Results: In the nuMoM2b cohort (n = 8729), accounting for pre-existing conditions attenuated the association between non-Hispanic Black race/ethnicity and risk of severe preeclampsia. Cardiovascular and kidney conditions were associated with risk for severe preeclampsia among all women (aRR, 1.77; CI, 1.61–1.96, and aRR, 1.27; CI, 1.03–1.56 respectively). The mediation analysis results were not statistically significant; however, cardiovascular conditions explained 36.6% of the association between non-Hispanic Black race/ethnicity and severe preeclampsia (p = 0.07). The addition of pre-pregnancy conditions increased model performance for the prediction of severe preeclampsia. Conclusions: Pre-existing conditions may explain some of the association between non-Hispanic Black race/ethnicity and severe preeclampsia. Specific pre-pregnancy conditions were associated with adverse maternal outcomes and the incorporation of comorbidities improved the performance of most risk prediction models. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Progressive supranuclear palsy (PSP) is a progressive atypical parkinsonian condition that results in severe disability. There are few studies of PSP in patients of non‐white European ancestry.We aim to perform deep phenotyping in a South Asian PSP cohort to uncover possible ethnic differences in disease characteristics.Consecutive PSP patients had their clinical records reviewed for clinical features operationalized in the Movement Disorder Society (MDS)‐PSP diagnostic criteria and relevant investigations, including imaging and genetic tests. Clinical variables were summarized by descriptive statistics and Kaplan–Meier curves were generated for survival analysis.Twenty‐seven patients, comprising Indians (78%), Pakistanis (11%) and Sri Lankans (11%) were included. Mean age of symptom onset was 63.8 ± 7.0 years and 22% of patients had an early age of onset (<60 years). The most common presenting symptom was parkinsonism (56%), followed by cognitive dysfunction (37%), falls (33%) and dysarthria (26%). The predominance types at final review were distributed across PSP‐RS (67%), PSP‐PGF (15%), PSP‐P (15%) and PSP‐F (4%). Atypical clinical features like cerebellar signs (33%), REM‐sleep behavior disorder (RBD) (55%), visual hallucinations (22%), and a family history of parkinsonism (20%) were evident in a proportion of patients.We present a South Asian cohort of PSP patients with a higher than previously reported percentages of early‐onset disease, family history and atypical clinical manifestations. These patients do not fit easily into the PSP phenotypes defined by the current MDS criteria. Dedicated clinicopathological and genetic tests are needed in this population to dissect the pathogenesis of clinically‐defined PSP. [ABSTRACT FROM AUTHOR]

Losing a beloved pet can be difficult on the human psyche. In Western societies, many bereaved pet owners often suffer alone and in private, due to the unease or embarrassment surrounding their grief expression, as is especially the case among Asian Americans because of various sociocultural reasons. Incorporating the Reasoned Action Approach (RAA), a well-known theory in Health Communication, this study surveyed 600 Asian American adults and identified theory-driven and empirically tested intervention strategies that aim to increase Asian Americans' intention to seek counseling upon pet loss. Our study found that age and ethnic differences were significantly associated with counseling intention. We also identified three salient control beliefs under the RAA (e.g., the ability to make appointments online, participating in counseling/therapy over the phone, and the immediate availability of counselors/therapists) that significantly heighten Asian Americans' counseling intention upon pet loss through self-efficacy. Theoretical implications and practical contributions of this study are also discussed. [ABSTRACT FROM AUTHOR]

Whiteness in the US is often conceptualized largely as the absence of a meaningful cultural identity. Research from my own lab suggests that overlooking the nuances inherent in White identity (e.g., differences between ethnic groups) can induce feelings of threat and backlash against multiculturalism among dominant group members. Based on this research, I argue that conceptualizing Whiteness as multifaceted—for example, by acknowledging not only interethnic but also religious and socioeconomic differences—may mitigate dominant group members' threat perceptions and increase their comfort amidst growing discussions of diversity, equity, and inclusion in institutions and organizations. Further, attending to the complexities of White identity may produce more positive intergroup outcomes, such as reduced racial/ethnic prejudice and greater perceived personal contributions to diversity, and may benefit groups that are classified as "White" on demographic forms but often do not perceive themselves as such (e.g., Middle Eastern and North African Americans, Hispanic/Latino[a] Americans). [ABSTRACT FROM AUTHOR]

Introduction- Doppler ultrasonography is used to evaluate uteroplacental circulation by analysing the systolic and diastolic waveforms. Given the ethnic and geographical differences in PIH and IUGR, it is crucial to comprehend the methods used to predict it in different populations. The aim of present study was to assess the role of level 2 doppler waveforms (at the time of anomaly scan) in assessing abnormal trophoblastic invasion and predicting adverse pregnancy outcomes in the form of PIH and IUGR. Material and methods- The present prospective study was conducted in department of obstetrics and gynaecology at SMGS Hospital among 100 pregnant females visiting the OPD during the study period of one year. As detailed level 2 anomaly scan is mandatory in our settings at 18-22 weeks, the required data on doppler study at 18-22 weeks could easily be extracted from the study patients, thus being economical on the part of patients in low resource settings.The doppler study was performed on all cases throughout the 18-22 weeks period of pregnancy and the two Indices like Pulsatility Index and Diastolic notch of uterine artery were recorded. The patients were followed up for the development of PIH and IUGR. Results- Out of 100 cases, pregnancy induced hypertension was found in 20 cases while 80 cases did not show pregnancy induced hypertension.30 cases developed IUGR and 70 remained non IUGR cases. Diastolic notch was found in 16 of PIH and 22 of nonPIH patients. 8 of PIH cases had a pulsatility index (PI) of greater than 1.71, compared to 10 of non PIH cases, which had a PI of greater than 1.71 (p=0.01). The sensitivity of diastolic notch in diagnosis of PIH was 65.3% whereas, that of PI was 53.48%. Similarly, diastolic notch was present in 19 of IUGR cases and 10 of non IUGR cases.8 of IUGR patients had PI of >1.7 and 20 of non IUGR cases had PI of > 1.7 giving the statistically significant results. Thus, second trimester doppler changes in the uterine artery has a role in prediction of IUGR too. Conclusion– Uterine artery doppler is a potentially effective method for predicting the occurrence of PIH and IUGR by examining both the pulsatility index (PI) and the presence of a diastolic notch in the uterine artery. The Doppler technique demonstrated a high level of diagnostic accuracy in detecting preeclampsia. [ABSTRACT FROM AUTHOR]

Youth of color are often exposed to racism at both systemic and individual levels. Interpersonal racial/ethnic discrimination is the behavioral manifestation of individual racism.1,2 While direct individual experiences of racism (eg, comments directed at the individual) have deleterious effects for the socioemotional well-being of youth of color,3 research also points to the negative effects of broader exposure to racism (eg, viewing racist comments, images, or videos online1,2) that is not experienced directly. Now that social media (SM) has become a prominent and ubiquitous source of social interactions for adolescents, research on the influence of racism on youth must contend with this new medium. This is especially the case for youth of color, particularly Black and Hispanic/Latine youth, who report more SM use than White youth who do not identify as Hispanic/Latine.4 The unique features of SM, including its permanence, publicness, and personalized algorithms, may increase both direct and indirect experiences of online racism for youth of color, particularly due to its constant availability and highly visual nature, which likely expose and re-expose youth of color to a variety of online racist experiences. Approximately 20% of all Black adolescents sampled in a large national survey reported that they were the target of online bullying or harassment because of their racial or ethnic identity.4 Indeed, exposure to direct and indirect online racism is associated with negative mental health outcomes for youth of color,5,6 including posttraumatic symptoms, depression, and anxiety. [ABSTRACT FROM AUTHOR]

Higher self‐reported rumination, a common form of trait perseverative cognition, is linked with lower resting heart rate variability (HRV), which indicates poorer cardiac function and greater disease risk. A meta‐analysis and systematic review indicated that in samples with fewer European Americans, the association of rumination with both heart rate and blood pressure was stronger. Thus, trait rumination may be more strongly associated with resting HRV among ethnically minoritized populations. The current study investigated whether differences in the association of self‐reported rumination with resting HRV varied by ethnicity in a sample (N = 513; Mage = 19.41; 226 Women) of self‐identified African Americans (n = 110), Asian Americans (n = 84), and European Americans (n = 319). Participants completed a five‐minute baseline period to assess resting HRV, followed by the Ruminative Responses Scale, which contains three facets of rumination including brooding, depressive, and reflective rumination. On average, Asian Americans reported higher levels of rumination relative to European Americans. African Americans had higher resting HRV than Asian Americans. Adjusting for covariates, higher self‐reported rumination was significantly associated with lower resting HRV in both African and Asian Americans, but not significantly so in European Americans. This finding was consistent for brooding and reflective, but not depressive rumination. Overall, this study lends insight into a psychological mechanism—rumination—that may impact health disparities among ethnically minoritized individuals, contributing to an understanding of how stress gets under the skin among such minoritized populations. [ABSTRACT FROM AUTHOR]

Research Summary: On March 1, 2022, correspondence from the Los Angeles Police Department (LAPD) headquarters stated that officers can no longer use minor infractions (e.g., equipment violations) as a pretextual reason to further investigate drivers for criminal behavior. If LAPD officers are to execute a discretionary stop, they must activate their body‐worn cameras and reasonably articulate to the civilian why they are being investigated. The intent is to reduce racial/ethnic disparities in stops and build trust of the police within the community. Critics of the policy argue that elevated crime rates will result due to the crime suppression effect of such stops. This study examines racial differences in stops before and after the policy change, as well as whether Part 1 violent and property crimes increased. Descriptive findings show that while the counts of stops, arrests, and contraband seizures during stops decreased, the percentage of non‐White civilians stopped decreased only minimally following the intervention. Results from using Bayesian synthetic control methods indicate an increase in both violent and property crimes post‐intervention compared with the synthetic counterfactual. The increase in violent crimes has a low probability of being different from the counterfactual, whereas the increase in property crimes has a high probability, suggesting that the intervention led to a real change in property crimes compared with what would have been expected under the counterfactual. Policy Implications: This study provides preliminary evidence that emerging policies intended to restrict discretionary stops may not have the intended effect on racial disparities in police traffic stops. Instead, agencies passing similar policies may expect to see the potential unintended consequence of a spike in jurisdictional property crimes. We argue that such types of stops across a jurisdiction may have a general deterrent effect on more common and calculative crimes such as property crimes. To combat violent crimes, agencies should consider focusing discretionary stops in known hot spots. Further, our findings offer implications for research on the effects of de‐policing on crime. Police agencies should monitor potential unintended impacts of these policies if enacted and be prepared to deal with such consequences. [ABSTRACT FROM AUTHOR]

Objective: Investigation of serum bile acid profiles in pregnancies complicated by gestational diabetes mellitus (GDM) in a multi‐ethnic cohort of women who are lean or obese. Design: Prospective cohort study. Setting: UK multicentre study. Population: Fasting serum from participants of European or South Asian self‐reported ethnicity from the PRiDE study, between 23 and 31 weeks of gestation. Methods: Bile acids were measured using ultra‐performance liquid chromatography‐tandem mass spectrometry. Log‐transformed data were analysed using linear regression in STATA/IC 15.0. Main outcome measures: Total bile acids (TBAs), C4, fasting glucose and insulin. Results: The TBAs were 1.327‐fold (1.105–1.594) increased with GDM in European women (P = 0.003). Women with GDM had 1.162‐fold (1.002–1.347) increased levels of the BA synthesis marker C4 (P = 0.047). In South Asian women, obesity (but not GDM) increased TBAs 1.522‐fold (1.193–1.942, P = 0.001). Obesity was associated with 1.420‐fold (1.185–1.702) increased primary/secondary BA ratio (P < 0.001) related to 1.355‐fold (1.140–1.611) increased primary BA concentrations (P = 0.001). TBAs were positively correlated with fasting glucose (P = 0.039) in all women, and with insulin (P = 0.001) and the Homeostatic Model Assessment for Insulin Resistance (HOMA‐IR) (P = 0.001) in women with GDM. Conclusions: Serum BA homeostasis in late gestation depends on body mass index and GDM in ethnicity‐specific ways. This suggests ethnicity‐specific aetiologies may contribute to metabolic risk in European and South Asian women, with the relationship between BAs and insulin resistance of greater importance in European women. Further studies into ethnicity‐specific precision medicine for GDM are required. [ABSTRACT FROM AUTHOR]

Past research extensively documents inequalities in educational opportunity and achievement by students' race/ethnicity or socioeconomic status (SES). Less scholarship focuses on how race/ethnicity and SES interact and jointly contribute to educational inequalities. We advance this burgeoning line of scholarship by charting math achievement trajectories and school socioeconomic composition by both student race/ethnicity and SES in California from 2014–15 through 2017–18. Linked administrative data allow us to operationalize student SES more richly than point-in-time free meal eligibility, a measure commonly used in education research. We find evidence of considerable racial/ethnic disparities in math achievement and school socioeconomic composition among same-SES students. White and Asian students score substantially higher on math achievement tests and attend higher-SES schools than same-SES Hispanic and Black students. Achievement and contextual inequalities are related: differential exposure to school SES by student race/ethnicity is associated with racial/ethnic achievement disparities within SES groups. Our findings show that SES does not translate into the same contextual or achievement advantages for students of all racial/ethnic groups, demonstrating the importance of jointly considering student race/ethnicity and SES in future research and policy development. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic negatively impacted mental health in the general population in Britain. Ethnic minority people suffered disproportionately, in terms of health and economic outcomes, which may contribute to poorer mental health. We compare the prevalence of depression and anxiety across 18 ethnic groups in Britain during the COVID-19 pandemic. Secondary analysis of cross-sectional data (February–November 2021) from 12,161 participants aged 18–60 years old (N with data on outcomes = 11,540 for depression & 11,825 for anxiety), obtained from the Evidence for Equality National Survey (EVENS). Data were weighted to account for selection bias and coverage bias. Weighted regression models examined ethnic differences in depression (Centre for Epidemiologic Studies Depression Scale) and anxiety (Generalised Anxiety Disorder-7). Effect modification analyses explored whether ethnic differences in outcomes were consistent within age and sex sub-groups. Compared to White British people, greater odds of anxiety caseness (and greater anxiety symptoms) were observed for Arab (OR = 2.57; 95 % CI = 1.35–4.91), Mixed White and Black Caribbean (1.57; 1.07–2.30), any other Black (2.22, 1.28–3.87) and any other Mixed (1.58; 1.08–2.31) ethnic groups. Lower odds of depression caseness (and lower depressive symptoms) were identified for Chinese (0.63; 0.46–0.85), Black African (0.60; 0.46–0.79), and any other Asian (0.55; 0.42–0.72) ethnic groups. Cross-sectional data limits the opportunity to identify changes in ethnic inequalities in mental health over time. We have identified certain ethnic groups who may require more targeted mental health support to ensure equitable recovery post-pandemic. Despite finding lower levels of depression for some ethnic groups, approximately one third of people within each ethnic group met criteria for depression. • Cross-sectional analysis of the largest UK survey of ethnic minority people • Ethnic differences in depression and anxiety were compared against White British. • Arab and any other Black people had more than double the odds of reporting anxiety. • Mixed White and Black Caribbean and any other Mixed people also had greater odds. • Lower levels of depression observed for some ethnic minority groups. [ABSTRACT FROM AUTHOR]

History of childhood maltreatment (CM) is common and robustly associated with prenatal and postpartum (perinatal) depression. Given perinatal depression symptom heterogeneity, a transdiagnostic approach to measurement could enhance understanding of patterns between CM and perinatal depression. In two independently collected samples of women receiving care at perinatal psychiatry clinics (n = 523 and n = 134), we categorized longitudinal symptoms of perinatal depression, anxiety, stress, and sleep into transdiagnostic factors derived from the Research Domain Criteria and depression literatures. We split the perinatal period into four time points. We conducted a latent profile analysis of transdiagnostic factors in each period. We then used self-reported history of CM (total exposure and subtypes of abuse and neglect) to predict class membership. A three-class solution best fit our data. In relation to positive adaptive functioning, one class had relatively more positive symptoms (high adaptive), one class had average values (middle adaptive), and one class had fewer adaptive symptoms (low adaptive). More total CM and specific subtypes associated with threat/abuse increased an individual's likelihood of being in the Low Adaptive class in both samples (ORs: 0.90–0.97, p <.05). Generalizability of our results was curtailed by 1) limited racial/ethnic diversity and 2) missing data. Our results support taking a person-centered approach to characterize the relationship between perinatal depression and childhood maltreatment. Given evidence that increased exposure to childhood maltreatment is associated with worse overall symptoms, providers should consider incorporating preventative, transdiagnostic interventions for perinatal distress in individuals with a history of childhood maltreatment. • Women with a history of childhood maltreatment (CM) had worse transdiagnostic mood and anxiety symptoms. • The pattern of results was consistent across pregnancy and the first year postpartum. • Retrospective total CM and abuse (not neglect) increased a person's likelihood of displaying the maladptive symptom pattern. • Results replicated in two independently collected samples with varying clinical and demographic characteristics. [ABSTRACT FROM AUTHOR]