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The present study aimed to use CBCT to compare the influence of White and Black ethnicity on gingival and bone thickness. A total of 84 individuals of both genders, aged between 18 and 59 years old, were divided into Black (BG; n = 42) and White (WG; n = 42) groups and were analyzed from June 2020 to April 2021. The gingival thickness (GT) and buccal bone plate thickness (BBPT) were measured using CBCT in all maxillary anterior teeth. Mann-Whitney, t test, chi-square, Pearson correlation, and Spearman correlation were used for comparisons and correlations with a 5% significance level. Black individuals had mean GT (1.45 ± 0.29 mm) and BBPT (1.07 ± 0.21 mm) significantly thicker (gingival: P < .0001; bone: P = .0002) than White individuals (1.17 ± 0.28 mm and 0.91 ± 0.17 mm, respectively). The variables presented greater values for men. A positive correlation between the BBPT and GT was found in two teeth in the WG (left and right central incisors) and one tooth in the BG (left canine). Moreover, a correlation between BBPT and GT immediately below the alveolar bone crest (0 mm) was found in four teeth in the WG (left and right lateral and central incisors) and the BG (left and right canine, left lateral and central incisors). Black race was shown to significantly influence the GT and BBPT, with Black patients presenting thicker structures than White patients. [ABSTRACT FROM AUTHOR]

IMPORTANCE: There are consistent data demonstrating that socioeconomic disadvantage is associated with risk of premature mortality, but research on the relationship between neighborhood socioeconomic factors and premature mortality is limited. Most studies evaluating the association between neighborhood socioeconomic status (SES) and mortality have used a single assessment of SES during middle to older adulthood, thereby not considering the contribution of early life neighborhood SES. OBJECTIVE: To investigate the association of life course neighborhood SES and premature mortality. DESIGN, SETTING, AND PARTICIPANTS: This cohort study included Black and White participants of the multicenter Atherosclerosis Risk in Communities Study, a multicenter study conducted in 4 US communities: Washington County, Maryland; Forsyth County, North Carolina; Jackson, Mississippi; and the northwestern suburbs of Minneapolis, Minnesota. Participants were followed up for a mean (SD) of 18.8 (5.7) years (1996-2020). Statistical analysis was performed from March 2023 through May 2024. EXPOSURE: Participants residential addresses during childhood, young adulthood, and middle adulthood were linked with US Census-based socioeconomic indicators to create summary neighborhood SES scores for each of these life epochs. Neighborhood SES scores were categorized into distribution-based tertiles. MAIN OUTCOMES AND MEASURES: Premature death was defined as all-cause mortality occurring before age 75 years. Multivariable-adjusted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS: Among 12 610 study participants, the mean (SD) age at baseline was 62.6 (5.6) years; 3181 (25.2%) were Black and 9429 (74.8%) were White; and 7222 (57.3%) were women. The lowest, compared with the highest tertile, of neighborhood SES score in middle adulthood was associated with higher risk of premature mortality (HR, 1.28; 95% CI, 1.07-1.54). Similar associations were observed for neighborhood SES in young adulthood among women (HR, 1.25; 95% CI, 1.00-1.56) and neighborhood SES in childhood among White participants (HR, 1.25; 95% CI, 1.01-1.56). Participants whose neighborhood SES remained low from young to middle adulthood had an increased premature mortality risk compared with those whose neighborhood SES remained high (HR, 1.25; 95% CI, 1.05-1.49). CONCLUSIONS AND RELEVANCE: In this study, low neighborhood SES was associated with premature mortality. The risk of premature mortality was greatest among individuals experiencing persistently low neighborhood SES from young to middle adulthood. Place-based interventions that target neighborhood social determinants of health should be designed from a life course perspective that accounts for early-life socioeconomic inequality.

BackgroundTo examine long-term retinal nerve fibre layer thickness (RNFLT) variability and associated clinical factors in African (AD) and European descent (ED) individuals with glaucoma.MethodsThis retrospective cohort study included glaucoma eyes of AD and ED from Diagnostic Innovations in Glaucoma Study/The African Descent and Glaucoma Evaluation Study with ≥4 visits/2 years of follow-up. We calculated optic nerve head RNFLT variability per-examination/visit as the absolute error of its residuals across follow-up. Full, baseline and parsimonious linear-mixed models were fit to evaluate the effects of clinical factors (demographics and ocular characteristics, prior/intervening glaucoma surgeries and cataract extraction (CE), RNFLT thinning rate, scan quality, visit/testing frequency, etc) on RNFLT variability in both races.ResultsThere were 376 and 625 eyes (226 and 349 participants) of AD and ED, and the mean (95% CI) RNFLT variability was 1.62 (1.52, 1.71) µm and 1.42 (1.34, 1.50) µm, respectively (p=0.002). AD and ED had some shared predictors of RNFLT variability, including intraocular pressure fluctuation and scan quality, although the effects varied (p

BACKGROUND AND AIMS: Despite the substantial impact of environmental factors, individuals with a family history of liver cancer have an increased risk for HCC. However, genetic factors have not been studied systematically by genome-wide approaches in large numbers of individuals from European descent populations (EDP). APPROACH AND RESULTS: We conducted a 2-stage genome-wide association study (GWAS) on HCC not affected by HBV infections. A total of 1872 HCC cases and 2907 controls were included in the discovery stage, and 1200 HCC cases and 1832 controls in the validation. We analyzed the discovery and validation samples separately and then conducted a meta-analysis. All analyses were conducted in the presence and absence of HCV. The liability-scale heritability was 24.4% for overall HCC. Five regions with significant ORs (95% CI) were identified for nonviral HCC: 3p22.1, MOBP , rs9842969, (0.51, [0.40-0.65]); 5p15.33, TERT , rs2242652, (0.70, (0.62-0.79]); 19q13.11, TM6SF2 , rs58542926, (1.49, [1.29-1.72]); 19p13.11 MAU2 , rs58489806, (1.53, (1.33-1.75]); and 22q13.31, PNPLA3 , rs738409, (1.66, [1.51-1.83]). One region was identified for HCV-induced HCC: 6p21.31, human leukocyte antigen DQ beta 1, rs9275224, (0.79, [0.74-0.84]). A combination of homozygous variants of PNPLA3 and TERT showing a 6.5-fold higher risk for nonviral-related HCC compared to individuals lacking these genotypes. This observation suggests that gene-gene interactions may identify individuals at elevated risk for developing HCC. CONCLUSIONS: Our GWAS highlights novel genetic susceptibility of nonviral HCC among European descent populations from North America with substantial heritability. Selected genetic influences were observed for HCV-positive HCC. Our findings indicate the importance of genetic susceptibility to HCC development.

The purpose of this study was to test the reliability and validity of the UMOVE Mobility Screen in older adults living with dementia using a Rasch analysis and hypothesis testing. The UMOVE Mobility Screen (UMOVE) focuses on nine activities: following commands, muscle strength, and basic functional mobility tasks. Trained evaluators completed assessments on 244 patients, the majority of whom were female (62%), and White (71%). Based on Rasch Analysis, there was evidence of good item and person reliability (indexes > 0.80), good INFIT statistics, and only one item fitting the model based on OUTFIT statistics. Validity was supported based on hypothesis testing. There was no evidence of Differential Item Functioning between races and genders. Item mapping raised concerns about the spread of the items across the full spectrum of mobility assessed in the UMOVE Mobility Screen. Future testing should consider adding some easier and some more difficult items. [ABSTRACT FROM AUTHOR]

Associations of total testosterone (T) and calculated free T with cardiovascular disease (CVD) remain poorly understood. Particularly how these associations vary according to race and ethnicity in a nationally representative sample of men. Data included 7058 men (≥20 years) from NHANES. CVD was defined as any reported diagnosis of heart failure (HF), coronary artery disease (CAD), myocardial infarction (MI), and stroke. Total T (ng/mL) was obtained among males who participated in the morning examination. Weighted multivariable-adjusted logistic regression models were conducted. We found associations of low T (OR = 1.57, 95% CI = 1.17-2.11), low calculated free T (OR = 1.53, 95% CI = 1.10-2.17), total T (Q1 vs Q5), and calculated free T (Q1 vs Q5) with CVD after adjusting for estradiol and SHBG. In disease specific analysis, low T increased prevalence of MI (OR = 1.72, 95% CI = 1.08-2.75) and HF (OR = 1.74, 95% CI = 1.08-2.82), but a continuous increment of total T reduced the prevalence of CAD. Similar inverse associations were identified among White and Mexican Americans, but not Blacks (OR = 0.93, 95% CI = 0.49-1.76). Low levels of T and calculated free T were associated with an increased prevalence of overall CVD and among White and Mexican Americans. Associations remained in the same direction with specific CVD outcomes in the overall population.

BackgroundCervical and other vaccine-preventable HPV-associated cancers disproportionately impact Hispanic/Latinos in the USA. HPV vaccine uptake may be impacted by community agreement with common HPV vaccine misperceptions. It is unknown whether Hispanics/Latinos have a greater agreement with these misperceptions relative to non-Hispanic whites.MethodsHPV vaccine misperceptions were assessed through a 12-item Likert scale included in a population health assessment mailed to households in the southwest United States. Linear regression models assessed the association between identifying as Hispanic/Latino and summed misperception score.ResultsAmong the 407 individuals in the analytic sample, 111 (27.3%) were Hispanic/Latino and 296 (72.7%) were non-Hispanic white. On average, Hispanics/Latinos had a 3.03-point higher HPV vaccine misperception sum score relative to non-Hispanic whites, indicating greater agreement with misperceptions (95% confidence interval: 1.16-4.88; p

PurposeWe investigated racial disparities in survival by histology in cervical cancer and examined the factors contributing to these disparities.MethodsNon-Hispanic Black and non-Hispanic White (hereafter known as Black and White) patients with stage I-IV cervical carcinoma diagnosed between 2004 and 2017 in the National Cancer Database were studied. Survival differences were compared using Cox modeling to estimate hazard ratio (HR) or adjusted HR (AHR) and 95% confidence interval (CI). The contribution of demographic, socioeconomic and clinical factors to the Black vs White differences in survival was estimated after applying propensity score weighting in patients with squamous cell carcinoma (SCC) or adenocarcinoma (AC).ResultsThis study included 10,111 Black and 43,252 White patients with cervical cancer. Black patients had worse survival than White cervical cancer patients (HR = 1.40, 95% CI = 1.35-1.45). Survival disparities between Black and White patients varied significantly by histology (HR = 1.20, 95% CI = 1.15-1.24 for SCC; HR = 2.32, 95% CI = 2.12-2.54 for AC, interaction p

IntroductionDepressive symptoms are associated with higher risk of dementia, but how they impact cognition in diverse populations is unclear.MethodsAsian, Black, Latino, or White participants (n = 2227) in the Kaiser Healthy Aging and Diverse Life Experiences (age 65+) and the Study of Healthy Aging in African Americans (age 50+) underwent up to three waves of cognitive assessments over 4 years. Multilevel models stratified by race/ethnicity were used to examine whether depressive symptoms were associated with cognition or cognitive decline and whether associations differed by race/ethnicity.ResultsHigher depressive symptoms were associated with lower baseline verbal episodic memory scores (-0.06, 95% CI: -0.12, -0.01; -0.15, 95% CI: -0.25, -0.04), and faster decline annually in semantic memory (-0.04, 95% CI: -0.07, -0.01; -0.10, 95% CI: -0.15, -0.05) for Black and Latino participants. Depressive symptoms were associated with lower baseline but not decline in executive function.DiscussionDepressive symptoms were associated with worse cognitive outcomes, with some evidence of heterogeneity across racial/ethnic groups.HighlightsWe examined whether baseline depressive symptoms were differentially associated with domain-specific cognition or cognitive decline by race/ethnicity. Depressive symptoms were associated with worse cognitive scores for all racial/ethnic groups across different domains examined. Higher depressive symptoms were associated with faster cognitive decline for semantic memory for Black and Latino participants. The results suggest a particularly harmful association between depressive symptoms and cognition in certain racial/ethnic groups.

This study explored the association between socioecological factors and outdoor physical activity (PA) and play in children with disabilities during the COVID-19 pandemic. Parents (N = 133) completed a survey to report changes in their child's outdoor PA and play during the pandemic (from prepandemic levels), and child, household, and neighborhood environment factors. Children with a PA-supporting parent and from multichild and White households had lower odds of reporting decreased outdoor PA. Children from multichild, higher income, married couple households and a PA-supporting parent had lower odds of decreased outdoor play. Living in neighborhoods with higher urbanization (i.e., high dwelling density, street intersections, and land-use mix) was associated with greater odds of decreased outdoor PA and play. Future research that uses larger and more representative samples of children with disabilities is needed to test for the multivariate effects of socioecological variables on outdoor PA and play. [ABSTRACT FROM AUTHOR]

Multiple myeloma (MM) is twice as common in Black individuals compared with in White individuals, and diabetes mellitus (DM) disproportionately affects Black patients. Although numerous studies have shown a correlation between DM and MM, this has not been studied in the context of race and in vivo mechanisms. We conducted a retrospective clinical study of 5383 patients with MM of which 15% had DM (White, 12% and Black, 25%). Multivariable Cox models showed reduced overall survival (OS) for patients with DM (hazard ratio, 1.27; 95% confidence interval, 1.11-1.47; P < .001). This appeared to be driven by a marked difference in OS between White patients with and without DM but not in Black patients. In contrast, obesity was associated with better OS in Black patients but not in White patients. To complement this analysis, we assessed MM growth in a genetically engineered immunocompromised nonobese diabetic (Rag1-/-/muscle creatinine kinase promoter expression of a human IGF1R [M] with a lysine [K] to arginine [R] point mutation) mouse model to evaluate the mechanisms linking DM and MM. MM.1S xenografts grew in more Rag1-/-/MKR mice and grew more rapidly in the Rag1-/-/MKR mice compared with in controls. Western blot analysis found that MM1.S xenografts from Rag1-/-/MKR mice had higher phosphorylated S6 ribosomal protein (Ser235/236) levels, indicating greater activation of the mammalian target of rapamycin pathway. Our study is, to our knowledge, the first to evaluate racial differences in DM prevalence and survival in MM, as well as the effect of DM on tumor growth in mouse models. Our results suggest that DM may contribute to the higher incidence of MM in Black patients; and to improve survival in MM, DM management cannot be ignored.

Genetic variants and epigenetic features both contribute to the risk of Alzheimer's disease (AD). We studied the AD association of CpG-related single nucleotide polymorphisms (CGS), which act as a hub of both the genetic and epigenetic effects, in Caribbean Hispanics (CH) and generalized the findings to Non-Hispanic Whites (NHW). First, we conducted a genome-wide, sliding-window-based association with AD, in 7,155 CH and 1,283 NHW participants. Next, using data from the dorsolateral prefrontal cortex in 179 CH brains, we tested the cis- and trans-effects of AD-associated CGS on brain DNA methylation to mRNA expression. For the genes with significant cis- and trans-effects, we investigated their enriched pathways. We identified six genetic loci in CH with CGS dosage associated with AD at genome-wide significance levels: ADAM20 (Score = 55.19, P = 4.06 × 10-8), the intergenic region between VRTN and SYNDIG1L (Score = - 37.67, P = 2.25 × 10-9), SPG7 (16q24.3) (Score = 40.51, P = 2.23 × 10-8), PVRL2 (Score = 125.86, P = 1.64 × 10-9), TOMM40 (Score = - 18.58, P = 4.61 × 10-8), and APOE (Score = 75.12, P = 7.26 × 10-26). CGSes in PVRL2 and APOE were also significant in NHW. Except for ADAM20, CGSes in the other five loci were associated with CH brain methylation levels (mQTLs) and CGSes in SPG7, PVRL2, and APOE were also mQTLs in NHW. Except for SYNDIG1L (P = 0.08), brain methylation levels in the other five loci affected downstream mRNA expression in CH (P

INTRODUCTION: Non-Hispanic Black (NHB) Americans have a higher incidence of colorectal cancer (CRC) and worse survival than non-Hispanic white (NHW) Americans, but the relative contributions of biological versus access to care remain poorly characterized. This study used two nationwide cohorts in different healthcare contexts to study health system effects on this disparity. METHODS: We used data from the Surveillance, Epidemiology, and End Results (SEER) registry as well as the United States Veterans Health Administration (VA) to identify adults diagnosed with colorectal cancer between 2010 and 2020 who identified as non-Hispanic Black (NHB) or non-Hispanic white (NHW). Stratified survival analyses were performed using a primary endpoint of overall survival, and sensitivity analyses were performed using cancer-specific survival. RESULTS: We identified 263,893 CRC patients in the SEER registry (36,662 (14%) NHB; 226,271 (86%) NHW) and 24,375 VA patients (4,860 (20%) NHB; 19,515 (80%) NHW). In the SEER registry, NHB patients had worse OS than NHW patients: median OS of 57 months (95% confidence interval (CI) 55-58) versus 72 months (95% CI 71-73) (hazard ratio (HR) 1.14, 95% CI 1.12-1.15, p = 0.001). In contrast, VA NHB median OS was 65 months (95% CI 62-69) versus NHW 69 months (95% CI 97-71) (HR 1.02, 95% CI 0.98-1.07, p = 0.375). There was significant interaction in the SEER registry between race and Medicare age eligibility (p

Cerebrovascular and α-synuclein pathologies are frequently observed alongside Alzheimer disease (AD). The heterogeneity of AD necessitates comprehensive approaches to postmortem studies, including the representation of historically underrepresented ethnic groups. In this cohort study, we evaluated small vessel disease pathologies and α-synuclein deposits among Hispanic decedents (HD, n = 92) and non-Hispanic White decedents (NHWD, n = 184) from three Alzheimer's Disease Research Centers: Columbia University, University of California San Diego, and University of California Davis. The study included cases with a pathological diagnosis of Intermediate/High AD based on the National Institute on Aging- Alzheimer's Association (NIA-AA) and/or NIA-Reagan criteria. A 2:1 random comparison sample of NHWD was frequency-balanced and matched with HD by age and sex. An expert blinded to demographics and center origin evaluated arteriolosclerosis, cerebral amyloid angiopathy (CAA), and Lewy bodies/Lewy neurites (LBs/LNs) with a semi-quantitative approach using established criteria. There were many similarities and a few differences among groups. HD showed more severe Vonsattel grading of CAA in the cerebellum (p = 0.04), higher CAA density in the posterior hippocampus and cerebellum (ps = 0.01), and increased LBs/LNs density in the frontal (p = 0.01) and temporal cortices (p = 0.03), as determined by Wilcoxon's test. Ordinal logistic regression adjusting for age, sex, and center confirmed these findings except for LBs/LNs in the temporal cortex. Results indicate HD with AD exhibit greater CAA and α-synuclein burdens in select neuroanatomic regions when compared to age- and sex-matched NHWD with AD. These findings aid in the generalizability of concurrent arteriolosclerosis, CAA, and LBs/LNs topography and severity within the setting of pathologically confirmed AD, particularly in persons of Hispanic descent, showing many similarities and a few differences to those of NHW descent and providing insights into precision medicine approaches.

OBJECTIVE: We sought to examine trends in diagnosed behavioral health (BH) conditions [mental health (MH) disorders or substance use disorders (SUD)] among pregnant and postpartum individuals between 2008-2020. We then explored the relationship between BH conditions and race/ethnicity, acknowledging race/ethnicity as a social construct that influences health disparities. METHODS: This study included delivering individuals, aged 15-44 years, and continuously enrolled in a single commercial health insurance plan for 1 year before and 1 year following delivery between 2008-2020. We used BH conditions as our outcome based on relevant ICD 9/10 codes documented during pregnancy or the postpartum year. RESULTS: In adjusted analyses, white individuals experienced the highest rates of BH conditions, followed by Black, Hispanic, and Asian individuals, respectively. Asian individuals had the largest increase in BH rates, increasing 292%. White individuals had the smallest increase of 192%. The trend remained unchanged even after adjusting for age and Bateman comorbidity score, the trend remained unchanged. CONCLUSIONS: The prevalence of diagnosed BH conditions among individuals in the perinatal and postpartum periods increased over time. As national efforts continue to work toward improving perinatal BH, solutions must incorporate the needs of diverse populations to avert preventable morbidity and mortality.

Leadership coaching—a relational process by which a professional coach works with a leader to support their development—is a common component of learning and development portfolios in organizations. Despite broad agreement about the importance of the coaching relationship, relational processes remain undertheorized, failing to account for the growth and intertwining of coach‐leader self‐concepts as they engage in a generative and co‐creative coaching process. To address these shortcomings, we reconceptualize the relational process within coaching as one of relational self‐expansion and theorize that the communication channel and communication quality impact relational self‐expansion which, in turn, influences coaching effectiveness. Our hypotheses are tested in a field experiment featuring random assignment to experimental conditions (communication channels) in which a coaching intervention was deployed in five organizations. Using structural equation modeling, we demonstrated that communication quality and relational self‐expansion during the coaching process positively predicted coaching effectiveness. Contrary to expectations, communication quality did not differ by channel (phone, videoconference, face‐to‐face) nor did it predict relational self‐expansion. [ABSTRACT FROM AUTHOR]

Background: Festivals play an important role in improving death and grief literacy, enabling members of the public to engage with these often-sensitive topics. Good Grief Weston festival was co-designed and delivered with the community in Weston-super-Mare, a coastal town in South-West England with high levels of socioeconomic disadvantage but rich community assets. It was held in person over 8 days in May 2023. Objectives: To evaluate the reach and impact of Good Grief Weston festival and gather data to inform future festivals. Design: Mixed methods evaluation (survey and focus groups). Methods: Online and paper surveys assessing participants' characteristics and experiences were administrated during and after the festival. Survey participants who indicated their willingness to participate were invited to attend a focus group. Focus groups were recorded, transcribed and analysed using thematic analysis. Data were collected by trained community co-researchers. Results: Approximately 3000 people attended the festival. Of 204 completed surveys, 64.5% were from women, age range ⩽15 to ⩾75 years; 88.2% identified as White; 14.9% deaf, disabled/with a chronic condition; 18.9% neurodivergent; 9.0% gay, bisexual or queer. Festival participants were entertained (70.9%), inspired (68.5%), felt part of a like-minded community (54.3%), talked to someone new (49.2%), learnt about grief/bereavement (34.3%), shared or expressed experiences (30.3%) and found out about local support (19.7%). 71.3% reported that they felt more confident talking about grief after attending. Median experience rating was 5 (IQR 0; possible range 1 = poor to 5 = excellent). In free-text comments, participants expressed appreciation for the festival and described benefits in attending. Two focus groups were conducted (n = 8 participants, all women), lasting c.1.5 h. Focus groups added rich descriptions of the festival's value, and data to inform the next festival. Conclusion: Findings suggest festivals of this nature can play a central role in a public health approach. Plain language summary: What was the impact of Good Grief Weston festival? Why was the study done? Previous studies have shown that many people feel unsupported by their community after the death of a loved one. We designed a festival to improve knowledge and support for bereaved people. We did this study to assess how the festival affected the people who attended. What did the researchers do? The team included researchers and people and organisations from the local community. Together, we designed and ran a festival on the topic of death, grief and bereavement in Weston-super-Mare, a coastal town with areas of high deprivation. The festival took place over an eight-day period in May 2023 and included creative, interactive and educational events. The team collected feedback on attendees' experiences of the festival. We did this using online and paper feedback forms, postcards, and focus groups to collect as many opinions as possible. What did the researchers find? We found that a wide range of people attended the festival. Most people who took part in the research rated the festival as 'excellent'. They told us they learnt about grief and bereavement and found out about local support services. Attendees met new people, shared their experiences, and felt that the festival built community spirit. They also made suggestions to improve any future festivals. What do the findings mean? The findings show that in-person festivals can effectively engage the public on the topic of death, grief and bereavement. They can also help develop connections between people and organisations in communities. These connections and learning opportunities may help communities to support their members through bereavement. [ABSTRACT FROM AUTHOR]

Background: The Covid Connected Care Center (C4), a low-barrier telephone nurse hotline, was developed at an academic medical center to increase access to healthcare information and services across the state of Oregon, including to those without a usual source of care. Other studies have demonstrated that telephone triage services can positively influence health behaviors, but it is not known how this effect is maintained across racial/ethnic groups. The objective of this study was to show that the C4 reached throughout the state of Oregon, was valuable to callers, and that recommendations given affected callers' subsequent health-related behaviors. Methods: This mixed-methods study, informed by the RE-AIM (Reach, Effectiveness, Addoption, Implementation and Maintenance) framework, assessed caller demographics and clinical care from March 30 2020 until September 8, 2021. Descriptive statistics, multivariable risk models and Zou's modified Poisson modeling were applied to electronic health record and call system data; An inductive approach was used for patient and staff experience surveys and semi-structured interviews. Approval was obtained from the OHSU Institutional Review Board (Study 00021413). Results: 145,537 telephone calls and 92,100 text-based contacts (61% and 39%, respectively) were included. Callers tended to not have a usual source of primary care and utilized recommended services. Emergency department utilization was minimal (1.5%). Racial or ethnic disparities were not detected in the recommendations, but Black (RR 0.92, CI 0.86–0.98) and Multiracial (RR 0.90 CI 0.81–0.99) callers were less likely than non-Hispanic white callers to receive a COVID-19 test. Participants in the post-call survey (n = 50) would recommend this service to friends or family. Interviews with callers (n = 9) revealed this was because they valued assistance translating general recommendations into a personalized care plan. C4 staff interviewed (n = 9) valued the opportunity to serve the public. The C4 was a trusted resource to the public and reached the intended audiences. However, disparities in access to COVID-19 testing persisted. Conclusions: Nursing triage hotlines can guide caller behavior and be an effective part of a robust public health information infrastructure. [ABSTRACT FROM AUTHOR]

Background: U.S. firearm sales surged during the COVID-19 pandemic, with many purchases by first-time firearm owners. The 2023 National Survey of Gun Policy sought to understand the public health implications of this surge by comparing the purchasing motivations and firearm policy views of pandemic-era first-time purchasers to prior gun owners. Methods: We fielded a nationally representative public opinion survey of U.S. adults (n = 3096) from 1/4/23 to 2/6/23. We oversampled for gun owners and Black, Hispanic, and Asian Americans. Survey weights were applied to generate representative estimates. New gun owners were identified through affirmative responses to: "Have you bought any guns since January 1, 2020?" and "Did you buy your first gun after January 1, 2020?" Recent purchasers were additionally asked whether concerns of 1) political or 2) racial violence motivated their purchase. Purchase motivations and gun policy support were examined among new and prior gun owners (n = 1002) and compared using logistic regression and predictive probabilities. Results: Overall, 11% of respondents reported purchasing a gun since 1/1/20, 35% for the first time. Among recent purchasers, larger proportions of Democrat, Black, Asian, and Hispanic respondents were new gun owners than Republican or white respondents. Compared to prior owners, odds were 4.5-times higher that new gun owners' recent purchase was motivated by racial violence and 3.2-times higher for political violence. Majority support was found for protective gun policies, with few differences by purchase recency or motivations. The only policy for which support by new and prior gun owners differed significantly was the permit-to-purchase policy (76% v. 63%, respectively). Similarly, few significant differences in support were observed when stratifying by purchase motivation. Notably, both those who reported recent purchase motivations of racial violence and of political violence expressed significantly higher support for a "stand-your-ground" policy compared to those who did not report such motivations. Conclusions: Racial and political violence appear to be larger concerns among new gun owners, motivating purchasing among demographic groups with traditionally lower gun ownership rates. These findings suggest a need for safety assurances amid racial and political tensions and growing gun ownership. Gun owners' support for such policies remains strong. [ABSTRACT FROM AUTHOR]

This article examines the phenomenon of white individuals donning blackface to commit crimes and shift the blame onto African Americans. This practice, dating from the post-Reconstruction era through the Jim Crow period, involved white criminals disguising themselves as Black to evade justice and manipulate racial biases in law enforcement and society. The article traces the historical roots of this tactic, citing figures like Frederick Douglass and W.E.B. Du Bois, and highlights its pervasive impact on racial violence and criminal justice. Through case studies, including Asa Wright’s 1932 blackface robbery, the author reveals how this racial deception not only framed Black individuals for crimes but also contributed to broader systemic racial oppression.

This article examines how Black Americans utilized tort law during the Jim Crow era to seek justice for white violence, even when criminal courts failed to protect them. It focuses on cases where Black plaintiffs sued white individuals and companies for acts of violence, particularly in public spaces such as train stations. The article argues that civil courts offered Black Americans a legal path to hold white perpetrators accountable and to financially penalize entities that supported Jim Crow, emphasizing the untold history of Black legal resistance through damage suits during this period.

Limited data exist on racial-ethnic differences in the application of restraints for patients visitng the emergency department (ED). This study examines whether there is an association between race and patient ED visit type with the application of four-point mechanical restraints in a high acuity safety-net urban academic hospital. The study retrospectively reviewed 198,610 visits to the ED at Boston Medical Center made by patients between 18 and 89 years old between May 1, 2014 and May 1, 2019. ED visit type was categorized based on primary billing code for the visit as either medical or behavioral; behavioral visits were further categorized into 5 groups based on corresponding primary psychiatric billing code category. The relationships between race/ethnicity and four-point mechanical restraints were analyzed using binary logistic regression models in SPSS. 1.4% of unique visits involved the use of four-point mechanical restraints. Patients with a behavioral visit were significantly over 16 times more likely to be restrained than those with a medical visit. Black patients were significantly more likely to be restrained than white patients for behavioral visits but less likely for medical visits. Black and Hispanic patients were also significantly more likely to be restrained for a behavioral visit regardless of psychiatric diagnosis. Asian patients were less likely to be restrained regardless of ED visit type. Significant racial differences in restraints for White patients with medical visits and Black and Hispanic patients with behavioral visits prompts further investigation on the role of clinician bias when managing acute patients. [ABSTRACT FROM AUTHOR]

Objective: Disorders of glucose metabolism in children with obesity are less common than in adults. There is also evidence that they may be transient. The aims of this study were to determine the prevalences of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes mellitus (DM2) and its reversibility in pediatric patients with obesity and to define the factors determining the reversibility of prediabetes or progression to diabetes. Methods: Retrospective analysis included of young patients with obesity. Patients presented and were treated between 2000-2022 at a single center. Results: The study included 573 (316 girls; 55.15%) Caucasian patients with median body mass index (BMI) Z-score of 3.95 (range 2.0-9.9) and median age 13.9 (2.9-17.1) years old. OGTT results were normal in 90.8% (n=520) and signs of prediabetes occurred in 9.2% (n=53); IFG 17%, IGT 88.7%, DM 0%. Among those who underwent OGTT twice (n=53), impaired glucose regulation was present in 9.3% (n=5) (IFG 40%, IGT 80%, DM 0%) at baseline and in 14.8% subject (n=8) (IFG 25%, IGT 50%, DM 25%) at follow-up after lifestyle modification only. After 12-36 months of follow up, in those with a history of IGT, 60% reverted to normal glucose tolerance, while IFG and IGT persisted in 20% and 20%, respectively, and none progressed to DM. The risk factors for progression of glucose metabolism disorders were increase of BMI Z-score, higher insulin levels and elevated homeostatic model assessment-insulin resistance. Conclusion: IFG and IGT are common in pediatric patients with obesity, while the progression to DM2 is rare. Disorders of glucose metabolism have reversible character. [ABSTRACT FROM AUTHOR]

Background: Within-breath analysis of oscillometry parameters is a growing research area since it increases sensitivity and specificity to respiratory pathologies and conditions. However, reference equations for these parameters in White adults are lacking and devices using multiple sinusoids or pseudorandom forcing stimuli have been underrepresented in previous studies deriving reference equations. The current study aimed to establish reference ranges for oscillometry parameters, including also the within-breath ones in White adults using multi-sinusoidal oscillations. Methods: White adults with normal spirometry, BMI ≤30 kg/m2, without a smoking history, respiratory symptoms, pulmonary or cardiac disease, neurological or neuromuscular disorders, and respiratory tract infections in the previous 4 weeks were eligible for the study. Study subjects underwent oscillometry (multifrequency waveform at 5–11–19 Hz, Resmon PRO FULL, RESTECH Srl, Italy) in 5 centers in Europe and the USA according to international standards. The within-breath and total resistance (R) and reactance (X), the resonance frequency, the area under the X curve, the frequency dependence of R (R5–19), and within-breath changes of X (ΔX) were submitted to lambda-mu-sigma models for deriving reference equations. For each output parameter, an AIC-based stepwise input variable selection procedure was applied. Results: A total of 144 subjects (age 20.8–86.3 years; height 146–193 cm; BMI 17.42–29.98 kg/m2; 56% females) were included. We derived reference equations for 29 oscillatory parameters. Predicted values for inspiratory and expiratory parameters were similar, while differences were observed for their limits of normality. Conclusions: We derived reference equations with narrow confidence intervals for within-breath and whole-breath oscillatory parameters for White adults. [ABSTRACT FROM AUTHOR]

Background: Women are three times more likely to be diagnosed with thyroid cancer than men, with incidence rates per 100,000 in the United States of 20.2 for women and 7.4 for men. Several reproductive and hormonal factors have been proposed as possible contributors to thyroid cancer risk, including age at menarche, parity, age at menopause, oral contraceptive use, surgical menopause, and menopausal hormone therapy. Our study aimed to investigate potential reproductive/hormonal factors in a multiethnic population. Methods: Risk factors for thyroid cancer were evaluated among female participants (n = 118,344) of the Multiethnic Cohort Study. The cohort was linked to Surveillance, Epidemiology, and End Results cancer incidence and statewide death certificate files in Hawaii and California, with 373 incident papillary thyroid cancer cases identified. Exposures investigated include age at menarche, parity, first pregnancy outcome, birth control use, and menopausal status and type. Multivariable Cox proportional hazards models were used to obtain relative risk (RR) of papillary thyroid cancer and their 95% confidence intervals (CI). Covariates included age, race and ethnicity, reproductive history, body size, smoking, and alcohol consumption. Results: We observed a statistically significant increased risk of papillary thyroid cancer for oophorectomy (adjusted RR 1.58, 95% CI: 1.26, 1.99), hysterectomy (adjusted RR 1.65, 95% CI: 1.33, 2.04), and surgical menopause (adjusted RR 1.55, 95% CI: 1.22, 1.97), and decreased risk for first live birth at ≤20 years of age versus nulliparity (adjusted RR 0.66, 95% CI: 0.46, 0.93). These associations did not vary by race and ethnicity (p het > 0.44). Conclusion: The reproductive risk factors for papillary thyroid cancer reported in the literature were largely confirmed in all racial and ethnic groups in our multiethnic population, which validates uniform obstetric and gynecological practice. [ABSTRACT FROM AUTHOR]

Objective: To examine racial/ethnic disparities in severe maternal morbidity (SMM) and adverse pregnancy outcomes (APOs) among pregnant patients with substance use disorder (SUD) compared to individuals without SUD. Materials and Methods: We conducted a cross-sectional analysis of inpatient hospitalizations of pregnant people from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) from 2016 to 2019. ICD-10 codes were used to identify the frequency of SMM and/or APO between those with and without SUD by race/ethnicity. Multilevel logistic regression analyses were performed to identify the effect of race/ethnicity as an independent predictor and as an effect modifier of SMM and APO in patients with SUD. Results: From 2,508,259 hospitalizations, SUD was identified in 6.7% admissions with the highest rate in White patients (8.2%) followed by Black (7.7%) and Hispanic (2.2%) patients. Rate of SMM and APO were increased in patients with SUD in all racial/ethnic groups compared to those without SUD, increasing by 1% and 10%, respectively. Among all patients, Black race was an independent predictor of SMM (adjusted odds ratio [aOR] 2.09; 95% confidence interval [CI]: 2.05–2.13) and APO (aOR 1.58; 95% CI: 1.56–1.59). Hispanic ethnicity was also an independent risk factor for predicting SMM (aOR 1.40; 95% CI: 1.37–1.43). Among Hispanic patients, SUD was associated with an ∼90% increased likelihood of SMM and APO. Conclusion: Although higher rates of SMM and APO are seen among hospitalizations of pregnant people with SUD, racial/ethnic disparities also exist among this population. This warrants further attention and presents an opportunity for intervention and for addressing the root causes of racial and ethnic disparities. [ABSTRACT FROM AUTHOR]

Informed by the social ecological model, which asserts that health behaviors and beliefs are the result of multiple levels of influence, we examined factors related to parents' support for in-school COVID-19 mitigation strategies. Using data from a survey of 567 parents/caregivers of public elementary and middle school students in eight Maryland counties, we employed regression models to examine relationships between parent-, child-, family-, school-, and community-level factors and acceptability of mitigation strategies. Acceptance of COVID-19 mitigation strategies was positively correlated with child- and family-level factors, including child racial identity (parents of Black children were more accepting than those of White children, odds ratio [ OR ]: 2.5, 95% confidence interval [CI] = [1.5, 4.1]), parent receipt of the COVID-19 vaccine (OR : 2.4, 95% CI = [1.5, 3.7]), and parent Democrat or Independent political affiliation (compared with Republican affiliation, OR : 4.2, 95% CI = [2.6, 6.7]; OR : 2.2, 95%CI = [1.3, 3.8], respectively). Acceptance was also positively associated with parents' perceptions of their school's mitigation approach, including higher school mitigation score, indicating more intensive mitigation policies (OR : 1.1, 95% CI = [1.0, 1.1]), better school communication about COVID-19 (OR : 1.7, 95% CI = [1.4, 1.9]) and better school capacity to address COVID-19 (OR : 1.9, 95% CI = [1.5, 2.4]). Community-level factors were not associated with acceptance. Child- and parent-level factors identified suggest potential groups for messaging regarding mitigation strategies. School-level factors may play an important role in parents' acceptance of in-school mitigation strategies. Schools' capacity to address public health threats may offer an underappreciated and modifiable setting for disseminating and reinforcing public health guidance. [ABSTRACT FROM AUTHOR]

Limited estimates exist on risk factors for epithelial ovarian cancer (EOC) in Asian, Hispanic, and Native Hawaiian/Pacific Islander women. Participants in this study included 1734 Asian (n  = 785 case and 949 control participants), 266 Native Hawaiian/Pacific Islander (n  = 99 case and 167 control participants), 1149 Hispanic (n  = 505 case and 644 control participants), and 24 189 White (n  = 9981 case and 14 208 control participants) from 11 studies in the Ovarian Cancer Association Consortium. Logistic regression models estimated odds ratios (ORs) and 95% CIs for risk associations by race and ethnicity. Heterogeneity in EOC risk associations by race and ethnicity (P  ≤ .02) was observed for oral contraceptive (OC) use, parity, tubal ligation, and smoking. We observed inverse associations with EOC risk for OC use and parity across all groups; associations were strongest in Native Hawaiian/Pacific Islander and Asian women. The inverse association for tubal ligation with risk was most pronounced for Native Hawaiian/Pacific Islander participants (odds ratio (OR) = 0.25; 95% CI, 0.13-0.48) compared with Asian and White participants (OR = 0.68 [95% CI, 0.51-0.90] and OR = 0.78 [95% CI, 0.73-0.85], respectively). Differences in EOC risk factor associations were observed across racial and ethnic groups, which could be due, in part, to varying prevalence of EOC histotypes. Inclusion of greater diversity in future studies is essential to inform prevention strategies. This article is part of a Special Collection on Gynecological Cancers. [ABSTRACT FROM AUTHOR]

Dementia incidence is lower among Asian Americans than among Whites, despite higher prevalence of type 2 diabetes, a well-known dementia risk factor. Determinants of dementia, including type 2 diabetes, have rarely been studied in Asian Americans. We followed 4846 Chinese, 4129 Filipino, 2784 Japanese, 820 South Asian, and 123 360 non-Latino White members of a California-based integrated health-care delivery system from 2002 to 2020. We estimated dementia incidence rates by race/ethnicity and type 2 diabetes status, and we fitted Cox proportional hazards and Aalen additive hazards models for the effect of type 2 diabetes (assessed 5 years before baseline) on age of dementia diagnosis, controlling for sex/gender, educational attainment, nativity, height, race/ethnicity, and a race/ethnicity × diabetes interaction. Type 2 diabetes was associated with higher dementia incidence in Whites (hazard ratio [HR] = 1.46; 95% CI, 1.40-1.52). Compared with Whites, the estimated effect of diabetes was larger in South Asians (HR = 2.26; 95% CI, 1.48-3.44), slightly smaller in Chinese (HR = 1.32; 95% CI, 1.08-1.62) and Filipino (HR = 1.31; 95% CI, 1.08-1.60) individuals, and similar in Japanese individuals (HR = 1.44; 95% CI, 1.15-1.81). Heterogeneity in this association across Asian subgroups may be related to type 2 diabetes severity. Understanding this heterogeneity may inform prevention strategies to prevent dementia for all racial and ethnic groups. [ABSTRACT FROM AUTHOR]

U.S. citizens are debating whether slavery and white supremacy are core constituents of the United States, whether white children should be troubled by learning the brutalities of slavery and life under Jim Crow laws, and whether racial reparations are due to African Americans for the centuries of economic, political, and social oppression they have endured. While many white folks prefer to ignore or demean calls for reparations, others have turned to reparative genealogy. They are inquiring deeply into their ancestors' relationships to chattel slavery and white supremacy, committed to reckoning with their own and their ancestors' racial debts. They seek to develop what sociologist W. E. Du Bois called "double consciousness." In order to protect themselves, African Americans had to try and see through the eyes of white people, as well as their own. But white folks too rarely attempt to see themselves through the eyes of Black people. During slavery, how were whites seen by Blacks? Philosopher George Yancy urges white people to engage in the work of developing double consciousness so they can see, as most people of color do, the pernicious white and class advantages that haunt us. My ancestors were enslavers in North Carolina. I turned to slave narratives from Black North Carolinians to distill what they observed about white people. Their descriptions point to individual and cultural pathologies: dehumanizing, pathological narcissism, authoritarian character, greed, cruelty, sadism, the policing of racial borders, paranoia, absence of deserved shame and moral injury. These understandings underline some of the psychosocial tasks before us as white people. [ABSTRACT FROM AUTHOR]

The postdisaster experiences of 167 social work students in the aftermath of the Great Flood of 2016 were examined. Using a cross-sectional survey design and validated self-report measures, the current study examined the association between students' protective factors (hope, altruism, spiritual support; at 8, 20, and 12 items, respectively) and six adaptive coping mechanisms, and further sought to determine whether such associations varied according to students' race (white vs. African American). Six hierarchical multiple linear regression analyses were conducted using each of the adaptive coping strategies (acceptance, active coping, positive reframing, self-distraction, planning, and venting). Results showed that students' race moderated the associations between altruism and active coping, spiritual support and active coping, spiritual support and self-distraction, altruism and planning, spiritual support and planning, and altruism and venting. The decomposition of the significant interactions indicated that the effect of altruism on active coping, planning, and venting was greater among white than among African American participants; the effect of spiritual support on active coping, self-distraction, and planning was greater among African American than among white participants. Recommendations include educating all students about risks incurred when working with traumatized populations. Research examining postdisaster coping responses of social workers can inform culturally responsive supervision approaches. [ABSTRACT FROM AUTHOR]

Purpose: Currently, body weight-based dosing of rifampicin is recommended. But lately, fat-free mass (FFM) was reported to be superior to body weight (BW). The present evaluation aimed to assess the influence of body mass-related covariates on rifampicin's pharmacokinetics (PK) parameters in more detail using non-linear mixed effects modeling (NLMEM). Methods: Twenty-four healthy Caucasian volunteers were enrolled in a bioequivalence study, each receiving a test and a reference tablet of 600 mg of rifampicin separated by a wash-out period of at least 9 days. Monolix version 2023R1 was used for NLMEM. Monte Carlo simulations (MCS) were performed to visualize the relationship of body size descriptors to the exposure to rifampicin. Results: A one-compartment model with nonlinear (Michaelis–Menten) elimination and zero-order absorption kinetics with a lag time best described the data. The covariate model including fat-free mass (FFM) on volume of distribution (V/F) and on maximum elimination rate (Vmax/F) lowered the objective function value (OFV) by 56.4. The second-best covariate model of sex on V/F and Vmax/F and BW on V/F reduced the OFV by 51.2. The decrease in unexplained inter-individual variability on Vmax/F in both covariate models was similar. For a given dose, MCS showed lower exposure to rifampicin with higher FFM and accordingly in males compared to females with the same BW and body height. Conclusion: Our results indicate that beyond BW, body composition as reflected by FFM could also be relevant for optimized dosing of rifampicin. This assumption needs to be studied further in patients treated with rifampicin. [ABSTRACT FROM AUTHOR]

This study investigated stressors and strains, resources, and well-being among Black working caregivers (BWC) and White working caregivers (WWC) who participated in the Midlife in the United States study (Black: n = 49, White: n = 250). Comparisons were made between BWC and WWC for primary caregiving stressors, secondary strains, resources, and well-being, and hierarchical regression models tested associations among these factors. BWC reported less negative work-to-family spillover, more perceived control and religious/spiritual coping, and higher positive affect than WWC, complementing existing evidence of greater resilience among BWC. Secondary strains stemming from the workplace had stronger associations with well-being than primary caregiving stressors, confirming that the workplace deserves greater attention in stress research and interventions for working caregivers. Finally, perceived control, optimism, and family support were important resources for well-being for both BWC and WWC, substantiating their valuable role in interventions for working caregivers. [ABSTRACT FROM AUTHOR]

Research on skin tone bias (i.e., bias against members of the same racial group with different skin tones) has been conducted mostly with Black/White targets. We tested skin tone bias with East Asian (Korean) targets and investigated its possible mechanisms. In Study 1, comparisons of impressions between targets with different skin tones (darker‐, medium‐, and lighter‐skinned) showed statistically significant differences in warmth, competence, morality, cleanliness, dangerousness, strongness, and social status. Study 2 revealed that lighter‐skinned Koreans were perceived to be more similar to Whites (vs. Blacks or South Asians), but this perceived similarity did not explain the effect of skin tone on impression ratings. In Study 3, participants showed associations of darker (vs. lighter) skin with rural (vs. urban) areas and with blue‐collar (vs. white‐collar) jobs. However, these associations explained only the skin tone effects on dangerousness. This research demonstrated skin tone bias with East Asian participants and targets. [ABSTRACT FROM AUTHOR]

Spirituality is an important aspect of treatment and recovery for substance use disorders (SUDs), but ambiguities in measurement can make it difficult to incorporate as part of routine care. We evaluated the psychometric properties of an adapted short-form version of the Spirituality Scale (the Spirituality Scale–Short-Form; SS-SF) for use in SUD treatment settings. Participants were adult patients (N = 1,388; Mage = 41.23 years, SDage = 11.55; 68% male; 86% White) who entered a large, clinically mixed inpatient SUD treatment program. Factor analysis supported the two-dimensional structure, with factors representing Self-Discovery and Transcendent Connection. Tests of measurement invariance demonstrated that the scale was invariant across age and gender subgroups. The SS-SF exhibited convergent and concurrent validity via associations with participation in spiritual activities, hopefulness, life satisfaction, 12-step participation, and depressive symptoms. Finally, scores on the SS-SF were significantly higher at discharge compared to admission, demonstrating short-term sensitivity to change. These findings support use of the SS-SF as a concise, psychometrically sound measure of spirituality in the context of substance use treatment. [ABSTRACT FROM AUTHOR]

We examined how potential job candidates react to a hiring organization that requests diversity, equity and inclusion (DEI) statements, which conservatives in the United States and elsewhere have criticized as being unrelated to job function and inappropriately political or ideological. Across three studies (two of which were pre‐registered), we compared reactions to requests for DEI (vs. teamwork or conservative values) statements as a function of race (Black vs. White), political conservatism and symbolic racism (Total N = 1108). When a DEI (vs. teamwork or politically conservative values) statement was requested, participants who were more (vs. less) conservative perceived the organization as less just, expressed less interest in the job, and expected poorer person‐organization fit, even when a job‐related rationale was provided. Further, participants who were more (vs. less) conservative evaluated a request for a statement consistent with conservative values more favourably. Thus, criticisms that DEI statements are overly political are not applied to other statements that might elicit similar concerns. Moreover, an internal meta‐analysis suggested that the relationships of conservatism to justice and interest (but not person‐organization fit) in response to requests for DEI (vs. teamwork) statements were not independent of racism. Findings were consistent with social dominance theory; racism may underlie seemingly race‐neutral backlash to DEI statements. [ABSTRACT FROM AUTHOR]

In non-endemic countries, surveillance of non-travel cases of enteric fever is important to identify carriers and reduce secondary transmission. We characterised these cases in England between 2012 and 2021 and assessed potential sources of infection to inform guidance revision. Retrospective case–case. We identified enteric fever cases from the national surveillance dataset. Non-travel cases were defined as no travel to an endemic country or travel but onset of >60 days after return. Multivariable logistic regression was used to identify factors associated with non-travel cases. We reviewed the case records of cases with unknown source of infection. Compared to travel cases, non-travel cases (7%; 225/3075) were older (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.02–1.04), asymptomatic (OR = 9.3: 95% CI: 4.3–20.3), and confirmed with Salmonella typhi infection (OR = 1.74, 95% CI: 1.26–2.4). Non-travel cases had lower odds of being of Indian (OR = 0.27, 95% CI: 0.16–0.45) or Pakistani ethnicity (OR = 0.34, 95% CI: 0.16–0.45) than White British. Surveillance questionnaires identified a possible infection source for 53%: case records review identified a further 23%: 33% secondary transmission, mostly household; 21% had overseas visitors, or travelling family; 12% were carriers (cases with enteric fever in the past), 12% travelled to endemic country outside of the 60-day window, and 22% had other possible sources. Case records differentiated between travel 60–90 days (5%) vs travel years prior to onset (7%), suggesting carrier status. Not all possible carriers were identified through the surveillance questionnaire. Therefore, we recommend additional questions to systematically capture travel history beyond 60 days to assist in classifying carrier status and to updating the source of infection. [ABSTRACT FROM AUTHOR]

Objectives: Targeting is a communication strategy in which a message is designed to address a particular group. It has been postulated that targeting increases message relevance; however, researchers are still explicating relevance and its impact on downline cognitive processes (e.g. message quality, cognitive cost). The current study addresses both gaps by evaluating the impact of targeted materials for White and African American audiences. Design: Adult women (N = 266) aged 18-74 (Mage = 47.12, SD = 1.40) were recruited to participate in a 2 (targeting: multiracial, African American) × 2 (race: White participants, African American participants) × 2 (topic: Hypertension, Environmental Breast Cancer) message experiment. Results: Across both topics, African American participants in the African American condition had reduced cognitive costs, increased message clarity, and increased message relevance. An indirect serial mediation model was supported wherein the relationship between targeting and behavioral intention was mediated by perceived relevance and perceived message quality. Conclusion: Targeting enhances perceived message relevance which, in turn, impacts behavioral intentions via perceived message quality. This model is consistent with the postulates of relevance theory and informs both intervention design and evaluation. [ABSTRACT FROM AUTHOR]

While many cancer patients who use tobacco try to quit post-diagnosis, some prefer to quit without using tobacco treatment, despite evidence against unassisted quit attempts. This study aimed to understand the rationale for some cancer patients' desire to quit tobacco without assistance. Thirty-five adult cancer patients who currently used tobacco and declined tobacco treatment because of the desire to quit unassisted provided data via a standardized questionnaire and a semi-structured interview. The sample was predominately White, non-Hispanic (85.71%) and female (68.57%). The most common cancer site was gynecological. Key themes that emerged from the interviews were: self-reliance, willpower, social norms, and negative attitudes toward tobacco treatment. The most frequently endorsed barrier to tobacco treatment was " I know others who have quit without tobacco treatment" (82.86%). This study with cancer patients identified affective, cognitive, and personality factors related to quitting unassisted, and social and systemic reasons to not use tobacco treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: Contralateral prophylactic mastectomy (CPM) remains a personal decision, influenced by psychosocial factors, including cosmesis and peace of mind. Although use of CPM is disproportionately low among Black patients, the degree to which these disparities are driven by patient- vs hospital-level factors remains unknown. STUDY DESIGN: Patients undergoing mastectomy for nonmetastatic ductal or lobular breast cancer were tabulated using the National Cancer Database from 2004 to 2020. The primary endpoint was receipt of CPM. Multivariable logistic regression models were constructed with interaction terms between Black-serving hospital (BSH) status and patient race to evaluate associations with CPM. Cox proportional hazard models were used to evaluate long-term survival. RESULTS: Of 597,845 women studied, 70,911 (11.9%) were Black. After multivariable adjustment, Black race (adjusted odds ratio 0.65, 95% CI 0.64 to 0.67) and treatment at BSH (adjusted odds ratio 0.84, 95% CI 0.83 to 0.85) were independently linked to lower odds of CPM. Although predicted probability of CPM was universally lower at higher BSH, Black patients faced a steeper reduction compared with White patients. Receipt of CPM was linked to improved survival (hazard ratio [HR] 0.84, 95% CI 0.83 to 0.86), whereas Black race was associated with a greater HR of 10-year mortality (HR 1.14, 95% CI 1.12 to 1.17). CONCLUSIONS: Hospitals serving a greater proportion of Black patients are less likely to use CPM, suggestive of disparities in access to CPM at the institutional level. Further research and education are needed to characterize surgeon-specific and institutional practices in patient counseling and shared decision-making that shape disparities in access to CPM. [ABSTRACT FROM AUTHOR]

In response to the data revolution, academic research and media attention have increasingly focused on the technological adaptation and innovation displayed by the far right. The greatest attention is paid to social media and how groups and organizations are utilizing technological advancement and growth in virtual networks to increase recruitment and advance radicalization on a global scale. As with most social and political endeavors, certain technologies are in vogue and thus draw the attention of users and regulators and service providers. This creates a technological blind spot within which extremist groups frequently operate older and less well regarded technologies without the oversight that one might expect. This article examines the less well-studied traditional and official websites of the Ku Klux Klan, the most established and iconic of American far-right organizations. By incorporating non-participant observation of online spaces and thematic analysis, this research analyzes the evolution of 26 websites, from their emergence in the early 1990s to the present day. We examine the ways in which traditional printed communications and other ephemera have progressed with advances in technology, focusing on the following central elements of Klan political activism and community formation: Klan identity, organizational history, aims and objectives; technology and outreach, including online merchandise and event organization; and the constructions of whiteness and racism. The results add value and insight to comparable work by offering a unique historical insight into the ways in which the Klan have developed and made use of Web 1.0, Web 2.0, and Web3 technologies. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study is to compare quality of diabetes care in people with type 2 diabetes by ethnicity, in Scotland. Methods: Using a linked national diabetes registry, we included 162,122 people newly diagnosed with type 2 diabetes between 2009 and 2018. We compared receipt of nine guideline indicated processes of care in the first‐year post‐diabetes diagnosis using logistic regression, comparing eight ethnicity groups to the White group. We compared annual receipt of HbA1c and eye screening during the entire follow‐up using generalised linear mixed effects. All analyses adjusted for confounders. Results: Receipt of diabetes care was lower in other ethnic groups compared to White people in the first‐year post‐diagnosis. Differences were most pronounced for people in the: African, Caribbean or Black; Indian; and other ethnicity groups for almost all processes of care. For example, compared to White people, odds of HbA1c monitoring were: 44% lower in African, Caribbean or Black people (OR 0.56 [95% CI 0.48, 0.66]); 47% lower in Indian people (OR 0.53 [95% CI 0.47, 0.61]); and 50% lower in people in the other ethnicity group (OR 0.50 [95% CI 0.46, 0.58]). Odds of receipt of eye screening were 30%–40% lower in most ethnic groups compared to the White group. During median 5 year follow‐up, differences in HbA1c monitoring and eye screening largely persisted, but attenuated slightly for the former. Conclusions: There are marked ethnic disparities in routine diabetes care in Scotland in the short‐ and medium‐term following diabetes diagnosis. Further investigation is needed to establish and effectively address the underlying reasons. [ABSTRACT FROM AUTHOR]

Background: Black patients with heart failure (HF) report worse quality of life (QoL) than White patients. Few investigators have examined mediators of the association between race and QoL, but depressive symptoms and sleep quality are associated with QoL. Objective: The aim of this study was to determine whether depressive symptoms and sleep quality are mediators of the relationship between race and QoL among patients with HF. Methods: This was a cross-sectional study. We included 271 outpatients with HF. Self-reported race (White/Black), depressive symptoms (Patient Health Questionnaire), sleep quality (Pittsburgh Sleep Quality Index), and QoL (Kansas City Cardiomyopathy Questionnaire) were collected at baseline. A serial multiple mediator analysis was conducted using the PROCESS macro for SPSS. Results: Ninety-six patients (35.4%) were Black. Black participants reported higher levels of depressive symptoms and poorer sleep quality than White participants. Race was not directly associated with QoL but indirectly associated with QoL through depressive symptoms and poorer sleep quality. Because of higher levels of depressive symptoms and poorer sleep quality, Black participants reported poorer QoL than White participants. Conclusions: Depressive symptoms and sleep quality together mediated the relationship between race and QoL. These findings suggest that screening for depressive symptoms and sleep quality could identify patients at risk for poor QoL, especially in Black patients. [ABSTRACT FROM AUTHOR]

Social determinants of health (SDOH) refer to social and economic factors that influence a patient's health status. The purpose of this study was to investigate the impact of SDOH on preoperative and postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores and postoperative resource utilization following primary shoulder arthroplasty (SA). This retrospective chart review evaluated data from all patients who underwent primary SA (including anatomic, reverse, and hemiarthroplasty) at a single health system between May 2020 and May 2022. Patients without at least 6-month postoperative PROMIS questionnaires and those undergoing revision surgeries were excluded. The electronic medical record was used to identify SDOH for each patient, and PROMIS scores for Upper Extremity (PROMIS-UE), Pain Interference (PROMIS-PI), and Depression (PROMIS-D) were completed electronically at respective preoperative and postoperative visits. Univariate analysis using independent 2-group t -tests and Chi-squared tests were used to analyze the mean difference between patient groups based on SDOH. Multivariate linear regressions were performed with all predictors used in the univariate model using the least squares method. The study included 248 patients who underwent SA, with a mean age of 67.9 years. Caucasian patients were over-represented in the highest quartile of median household income (MHI) compared to Black patients (35.1% vs. 17.2%) who were over-represented in the lowest MHI quartile (37.9% vs. 8.3%). At 6-month postoperative, black patients had significantly lower UE (33.8 ± 6.2 vs. 38.1 ± 9.0; P =.03) and greater PI scores (59.1 ± 6.1 vs. 55.6 ± 8.6; P =.145) compared to Caucasian patients. Similarly, at 6-month follow-up, the lowest MHI quartile had lower UE (33.8 ± 7.7 vs. 39.6 ± 8.8; P =.01) and higher PI scores (58.7 ± 6.5 vs. 54.3 ± 8.2; P <.01) compared to the highest MHI quartile, and females demonstrated lower UE (36.3 ± 7.9 vs. 38.6 ± 9.8; P =.04) and higher D scores (46.2 ± 9.1 vs. 42.0 ± 8.6; P =.046) compared to males. Government/public insurance demonstrated lower UE (36.8 ± 8.0 vs. 39.8 ± 10.4; P =.03) and higher D scores (45.9 ± 9.2 vs. 40.6 ± 7.6; P =.03) compared to private insurance. At 12-month follow-up, females demonstrated lower UE scores compared to males (36.0 ± 10.2 vs. 40.1 ± 11.3; P =.03). Black patients harbored lower UE, PI, and D scores compared to Caucasian patients, although not statistically significant. Several socioeconomic factors such as race, gender, and insurance status are associated with differential outcomes after SA. Patients who are Black, female, current smokers, and from the lowest income quartile are associated with inferior PROMIS function, pain, and depression outcomes following SA. [ABSTRACT FROM AUTHOR]

Comprehensive genomic profiling is highly recommended for treatment decision in nonsquamous, non-small cell lung cancer (NSCLC). However, rare genomic alterations are still being unveiled, with scarce data to guide therapy. Herein, we describe the treatment journey of a 56-year-old, never-smoker Caucasian woman with a metastatic NSCLC harboring a CD47-MET fusion, initially classified as a variant of unknown significance. She had undergone 3 lines of therapy over the course of 3 years, including chemotherapy, immunotherapy, and anti-angiogenic therapy. After reanalysis of her next-generation sequencing data in our service, the fusion was reclassified as likely oncogenic. The patient was started with fourth-line capmatinib, with a good tolerance so far and a complete metabolic response in the active sites of disease, currently ongoing for 18 months. In conclusion, we highlight the sensitivity of a novel MET fusion to capmatinib and emphasize the need for comprehensive panels in NSCLC and molecular tumor board discussions with specialized centers when rare findings arise. [ABSTRACT FROM AUTHOR]

Purpose: To understand perceived facilitators and barriers older adults experienced in accessing coronavirus disease 2019 (COVID-19) vaccines. Method: An electronic survey was distributed to older adults and those familiar with experiences of older adults accessing COVID-19 vaccines. Analysis included descriptive statistics and directed content analysis of open-ended responses, guided by the National Institute on Aging Health Disparities Research Framework. Results: Most participants (n = 294) identified as White (79.5%), 33.8% identified as Hispanic, 8.1% identified as Black, and 12.4% identified as Other. Two thirds of respondents were male (68.6%), and the median age was 67 years. Five key themes emerged: Availability and Accessibility, Information, Cost, Safety and Side Effects, and Sense of Security. Conclusion: Barriers and facilitators to accessing COVID-19 vaccines for older populations paralleled those seen in other demographics. Similar needs likely exist for access to other vaccines and health care in general. Vaccine rollouts, particularly in public health emergencies, must be carried out with care and an awareness of the barriers faced by vulnerable groups. [Journal of Gerontological Nursing, 50(9), 12–17.] [ABSTRACT FROM AUTHOR]