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Fia'Ali'i J, Law M, O'Donovan C, Skinner JR, Broadbent E. Perspectives and experiences of Māori and Pasifika peoples living with cardiac inherited disease: a qualitative study. Psychol Health 2024; 39:728-748. [PMID: 35912632 DOI: 10.1080/08870446.2022.2105336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 06/25/2022] [Accepted: 07/17/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE Cardiac inherited diseases can have considerable psychosocial effects, including lifestyle limitations, anxiety and depression. Most research to date on patient experiences of CID has been conducted with people from Western cultures, yet culture can shape patient views and experiences of health. The aim of this research was to explore the experiences and perspectives of Māori and Pasifika living with a cardiac inherited disease (CID). METHODS AND MEASURES Semi-structured interviews were conducted with 14 Māori and 14 Pasifika patients living with a cardiac inherited disease and seven of their family members, using Talanoa and Kaupapa Māori methodologies. Themes from the interviews were identified using interpretative phenomenological analysis. RESULTS Three common themes were identified as important in shaping participants' perceptions and experiences of CID: (1) difficulty in understanding the disease as separate from symptoms, (2) considering ancestors and future generations and (3) the role of spirituality and religion. CONCLUSION This study highlights a gap between indigenous patients' understanding of CID and the western biomedical approach. Patients' understanding and treatment behaviours depend on symptoms, familial ties and spirituality. The findings support the need for transparency and culturally appropriate practices in healthcare. Considering these aspects may help to reduce health inequities for these populations.
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Affiliation(s)
- Jessee Fia'Ali'i
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Mikaela Law
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Claire O'Donovan
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jonathan R Skinner
- Cardiac Inherited Disease Group New Zealand, Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Qi R, Qureshi M, Gire N, Chaudhry IB, Vass V, McIntyre JC, Barlow K, Bentall RP, White RG, Husain N. Ethnic density and first episode psychosis in the British Pakistani population: findings from the East Lancashire Early Intervention Service. Br J Psychiatry 2024:1-6. [PMID: 38634312 DOI: 10.1192/bjp.2024.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND Elevated risk of psychosis for ethnic minority groups has generally been shown to be mitigated by high ethnic density. However, past survey studies examining UK Pakistani populations have shown an absence of protective ethnic density effects, which is not observed in other South Asian groups. AIMS To assess the ethnic density effect at a local neighbourhood level, in the UK Pakistani population in East Lancashire. METHOD Data was collected by the East Lancashire Early Intervention Service, identifying all cases of first episode psychosis (FEP) within their catchment area between 2012 and 2020. Multilevel Poisson regression analyses were used to compare incidence rates between Pakistani and White majority groups, while controlling for age, gender and area-level deprivation. The ethnic density effect was also examined by comparing incidence rates across high and low density areas. RESULTS A total of 455 cases of FEP (364 White, 91 Pakistani) were identified. The Pakistani group had a higher incidence of FEP compared to the White majority population. A clear effect of ethnic density on rates of FEP was shown, with those in low density areas having higher incidence rates compared to the White majority, whereas incidence rates in high density areas did not significantly differ. Within the Pakistani group, a dose-response effect was also observed, with risk of FEP increasing incrementally as ethnic density decreased. CONCLUSIONS Higher ethnic density related to lower risk of FEP within the Pakistani population in East Lancashire, highlighting the impact of local social context on psychosis incidence.
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Affiliation(s)
- Robert Qi
- Institute of Population Health, University of Liverpool, UK
| | - Masood Qureshi
- Early Intervention Service, Lancashire South Cumbria NHS Foundation Trust, Accrington, UK
| | - Nadeem Gire
- School of Medicine, The University of Central Lancashire, Preston, UK
- Global Centre for Research on Mental Health Inequalities, Mersey Care NHS Foundation Trust, Prescot, UK
| | - Imran B Chaudhry
- Department of Psychiatry, Ziauddin Hospital, Karachi, Pakistan
- Division of Psychology and Mental Health, University of Manchester, UK
| | - Victoria Vass
- Institute of Population Health, University of Liverpool, UK
| | | | - Kaylee Barlow
- Early Intervention Service, Lancashire South Cumbria NHS Foundation Trust, Accrington, UK
| | | | - Ross G White
- School of Psychology, Queen's University Belfast, UK
| | - Nusrat Husain
- Global Centre for Research on Mental Health Inequalities, Mersey Care NHS Foundation Trust, Prescot, UK
- Division of Psychology and Mental Health, University of Manchester, UK
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Arab JP, Dunn W, Im G, Singal AK. Changing landscape of alcohol-associated liver disease in younger individuals, women, and ethnic minorities. Liver Int 2024. [PMID: 38578107 DOI: 10.1111/liv.15933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 03/06/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024]
Abstract
Alcohol use is the most important determinant of the development of alcohol-associated liver disease (ALD) and of predicting long-term outcomes in those with established liver disease. Worldwide, the amount, type, and pattern of use of alcohol vary. Alcohol use and consequent liver disease have been increasing in certain ethnic groups especially Hispanics and Native Americans, likely due to variations in genetics, cultural background, socio-economic status, and access to health care. Furthermore, the magnitude and burden of ALD have been increasing especially in the last few years among females and young adults who are at the prime of their productivity. It is critical to recognize the problem and care for these patients integrating cultural aspects in liver clinics. At the federal level, a societal approach is needed with the implementation of public health policies aiming to reduce alcohol consumption in the community. By addressing these challenges and promoting awareness, we can strive to reduce the burden of ALD, especially in high-risk demographic groups to improve their long-term health outcomes. Finally, we need studies and quality research examining these changing landscapes of demographics in ALD as a basis for developing therapeutic targets and interventions to reduce harmful drinking behaviours in these high-risk demographic groups.
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Affiliation(s)
- Juan P Arab
- Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University & London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine, Western University, London, Ontario, Canada
- Departamento de Gastroenterologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Winston Dunn
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Gene Im
- Division of Gastroenterology and Hepatology, Department of Medicine, Mount Sinai Medical School, New York, New York, USA
| | - Ashwani K Singal
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Louisville, Louisville, Kentucky, USA
- Health Research, VA Medical Center, Sioux Falls, South Dakota, USA
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Buresh M, Buchheit BM, Wason K, Northup R, Bratberg J, Finnell DS. Advocacy for Equity Around Evidence-Based Treatments: Overview and Proceedings of the AMERSA 2023 Conference. Subst Use Addctn J 2024; 45:156-162. [PMID: 38288714 DOI: 10.1177/29767342241228101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
This commentary provides an overview of the 2023 Association of Multidisciplinary Education and Research in Substance use and Addiction (AMERSA) annual conference: Advocacy for Equity Around Evidence-Based Treatments, held from November 1 to 4, 2023, in Washington, DC. The conference featured 9 interactive workshops, 106 oral abstract presentations, and 130 posters. From the preconference workshop to plenary sessions, paper, and poster presentations, there was a focus on addressing imbalanced social systems and structures underlying disparities. In the face of increasing drug overdose deaths, diminished access to prevention, intervention, treatment, and recovery supports for racial and ethnic minorities, there is a pressing need for advocacy for equity around evidence-based treatments.
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Affiliation(s)
- Megan Buresh
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Bradley M Buchheit
- School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Kristin Wason
- Chobanian and Avedisian School of Medicine, Boston University, Boston, MA, USA
| | | | - Jeffrey Bratberg
- University of Rhode Island College of Pharmacy, Kingston, RI, USA
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Doyle DM, Barreto M. Stigma salience increases loneliness among ethnic minorities. Br J Soc Psychol 2024. [PMID: 38558020 DOI: 10.1111/bjso.12742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024]
Abstract
Research shows that ethnic minorities are at increased risk of loneliness compared to the general population of the United Kingdom. We hypothesized that stigma salience increases loneliness among ethnic minorities, conducting two experimental studies with ethnic minorities (Study 1: N = 134, Study 2: N = 267) in which participants were randomly assigned to a stigma salience (recalling a personal experience of discrimination based on ethnicity) or control condition (recalling a past meal in Study 1 and the experience of reading a book in Study 2). Across these two studies, we demonstrated that stigma salience consistently increased self-reported loneliness relative to the control conditions. Study 1 additionally showed evidence for an indirect effect of stigma salience on loneliness through feelings of anxiety. Study 2 replicated the effect of self-relevant (but not non-self-relevant) stigma salience on loneliness and provided suggestive evidence for a more specific indirect effect through identity-related social anxiety.
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Ullah N, Martin S, Poduval S. A Snapshot of COVID-19 Vaccine Discourse Related to Ethnic Minority Communities in the United Kingdom Between January and April 2022: Mixed Methods Analysis. JMIR Form Res 2024; 8:e51152. [PMID: 38530334 DOI: 10.2196/51152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Existing literature highlights the role of social media as a key source of information for the public during the COVID-19 pandemic and its influence on vaccination attempts. Yet there is little research exploring its role in the public discourse specifically among ethnic minority communities, who have the highest rates of vaccine hesitancy (delay or refusal of vaccination despite availability of services). OBJECTIVE This study aims to understand the discourse related to minority communities on social media platforms Twitter and YouTube. METHODS Social media data from the United Kingdom was extracted from Twitter and YouTube using the software Netlytics and YouTube Data Tools to provide a "snapshot" of the discourse between January and April 2022. A mixed method approach was used where qualitative data were contextualized into codes. Network analysis was applied to provide insight into the most frequent and weighted keywords and topics of conversations. RESULTS A total of 260 tweets and 156 comments from 4 YouTube videos were included in our analysis. Our data suggests that the most popular topics of conversation during the period sampled were related to communication strategies adopted during the booster vaccine rollout. These were noted to be divisive in nature and linked to wider conversations around racism and historical mistrust toward institutions. CONCLUSIONS Our study suggests a shift in narrative from concerns about the COVID-19 vaccine itself, toward the strategies used in vaccination implementation, in particular the targeting of ethnic minority groups through vaccination campaigns. The implications for public health communication during crisis management in a pandemic context include acknowledging wider experiences of discrimination when addressing ethnic minority communities.
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Affiliation(s)
- Nazifa Ullah
- Research Department of Primary Care & Population Health, University College London, London, United Kingdom
| | - Sam Martin
- Vaccines and Society Unit, Oxford Vaccine Group, University of Oxford, Oxford, United Kingdom
| | - Shoba Poduval
- Institute of Health Informatics, University College London, London, United Kingdom
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Hasmath R. The operations of contemporary Han Chinese privilege. China Inf 2024; 38:3-23. [PMID: 38434490 PMCID: PMC10906100 DOI: 10.1177/0920203x231193086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
This article discusses the conceptual underpinnings and performance of Han Chinese privilege in the People's Republic of China. It suggests that Han Chinese privilege has gained salience from specific public policies and philosophies of governance. This is aptly viewed across a range of sites, including the labour market and media, and involves state institutions and micro-level everyday interactions between the Han Chinese and the ethnic minority populations. Finally, the article theorizes why a robust Han Chinese privilege discourse has not emerged, and remains largely an unacknowledged concept.
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Affiliation(s)
- Reza Hasmath
- Reza Hasmath, 10-10 HM Tory Building, Department of Political Science, University of Alberta, Edmonton, AB T6G 2H4 Canada.
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Mattei J, Caballero-González A, Maafs-Rodríguez A, Zhang A, O’Neill HJ, Gago C. Lessons learned by adapting and implementing LUCHA: a deep-structure culturally tailored healthy eating randomized pilot intervention for ethnic-diverse Latinos. Front Public Health 2024; 11:1269390. [PMID: 38445250 PMCID: PMC10912621 DOI: 10.3389/fpubh.2023.1269390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/20/2023] [Indexed: 03/07/2024] Open
Abstract
Objectives To report the adaptation and implementation of LUCHA (Latinos United for a Culturally Healthy Alimentation), a pilot intervention to improve dietary quality and behaviors (primary outcomes) of Latinos in Massachusetts, US, and the lessons learned during the process, including disruptions during the COVID-19 pandemic, to help shape future programs. Methods The cultural adaptation process was pre-planned using a framework, grounded in the Theory of Reasoned Action/Planned Behavior, and informed by formative mixed-methods research. A projected 75 self-identifying Latino adults (25-65y) were recruited with community-wide strategies and randomized to receive, in parallel, daily healthy eating text messages for 2 months, reinforced for 2 subsequent months, to either control (i.e., surface-level messages based on USDA MyPlate in Spanish), or intervention (i.e., deep-structure messages). The intervention messages were ethnically tailored to Caribbean or non-Caribbean heritages specifically, grounded in entrenched cultural attitudes, norms, and preferences. Trained research assistants administered questionnaires and clinical measurements at baseline, 2-months, and 4-months, in person (pre-pandemic) or via online video calls (at-pandemic). Clinicaltrials.gov registration #NCT04724382. Results LUCHA faced challenges and opportunities that conveyed lessons for future cultural adaptation and implementation of healthy eating programs. Recommendations are provided to improve digital programs for diverse ethnicities, such as widening language capabilities in texting services, using familiar video call applications, and instructing participants to measure their own clinical metrics at home using guided standardized protocols. Conclusion Tailoring nutrition programs with deep-structure cultural messages is essential when promoting healthy eating in diverse Latino heritages. LUCHA can inform programs for similar ethnic groups.
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Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | | | - Ana Maafs-Rodríguez
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Amelia Zhang
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - H. June O’Neill
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - Cristina Gago
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, United States
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Mahmood B, Adu P, McKee G, Bharmal A, Wilton J, Janjua NZ. Ethnic Disparities in COVID-19 Vaccine Mistrust and Receipt in British Columbia, Canada: Population Survey. JMIR Public Health Surveill 2024; 10:e48466. [PMID: 38363596 PMCID: PMC10896316 DOI: 10.2196/48466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/16/2023] [Accepted: 12/15/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Racialized populations in the United States, Canada, and the United Kingdom have been disproportionately affected by COVID-19. Higher vaccine hesitancy has been reported among racial and ethnic minorities in some of these countries. In the United Kingdom, for example, higher vaccine hesitancy has been observed among the South Asian population and Black compared with the White population, and this has been attributed to lack of trust in government due to historical and ongoing racism and discrimination. OBJECTIVE This study aimed to assess vaccine receipt by ethnicity and its relationship with mistrust among ethnic groups in British Columbia (BC), Canada. METHODS We included adults ≥18 years of age who participated in the BC COVID-19 Population Mixing Patterns Survey (BC-Mix) from March 8, 2021, to August 8, 2022. The survey included questions about vaccine receipt and beliefs based on a behavioral framework. Multivariable logistic regression was used to assess the association between mistrust in vaccines and vaccine receipt among ethnic groups. RESULTS The analysis included 25,640 adults. Overall, 76.7% (22,010/28,696) of respondents reported having received at least 1 dose of COVID-19 vaccines (Chinese=86.1%, South Asian=79.6%, White=75.5%, and other ethnicity=73.2%). Overall, 13.7% (3513/25,640) of respondents reported mistrust of COVID-19 vaccines (Chinese=7.1%, South Asian=8.2%, White=15.4%, and other ethnicity=15.2%). In the multivariable model (adjusting for age, sex, ethnicity, educational attainment, and household size), mistrust was associated with a 93% reduced odds of vaccine receipt (adjusted odds ratio 0.07, 95% CI 0.06-0.08). In the models stratified by ethnicity, mistrust was associated with 81%, 92%, 94%, and 95% reduced odds of vaccine receipt among South Asian, Chinese, White, and other ethnicities, respectively. Indecision, whether to trust the vaccine or not, was significantly associated with a 70% and 78% reduced odds of vaccine receipt among those who identified as White and of other ethnic groups, respectively. CONCLUSIONS Vaccine receipt among those who identified as South Asian and Chinese in BC was higher than that among the White population. Vaccine mistrust was associated with a lower odds of vaccine receipt in all ethnicities, but it had a lower effect on vaccine receipt among the South Asian and Chinese populations. Future research needs to focus on sources of mistrust to better understand its potential influence on vaccine receipt among visible minorities in Canada.
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Affiliation(s)
- Bushra Mahmood
- Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - Prince Adu
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- Department of Social Medicine, Heritage College of Osteopathic Medicine, Ohio University, Dublin, OH, United States
| | - Geoffrey McKee
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Aamir Bharmal
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - James Wilton
- British Columbia Center for Disease Control, Vancouver, BC, Canada
| | - Naveed Zafar Janjua
- British Columbia Center for Disease Control, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, BC, Canada
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Chen Q, Liang L, Shi Y, Lu F. Epidemiological and clinical characteristics of open globe injuries in Southwest China. Front Med (Lausanne) 2024; 11:1303683. [PMID: 38384411 PMCID: PMC10879276 DOI: 10.3389/fmed.2024.1303683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Background Open globe injuries (OGIs) are one of the leading causes of monocular vision loss, and the clinical characteristics of OGIs are region specific. The features and patterns of OGIs in Southwest China are poorly known and not well studied. Our study aimed to review the epidemiological and clinical characteristics of patients hospitalized for OGIs in Southwest China. Methods A retrospective study of OGI patients admitted to the West China Hospital from January 1st, 2015, to December 31st, 2019, was performed. Demographic characteristics and injury details were recorded. The Birmingham Eye Trauma Terminology system and the ocular trauma score (OTS) were used. Results A total of 3,014 patients were included. The male-to-female ratio was 5.2:1, and the mean age was 35.6 ± 19.1 years. 15.2% of patients were from the ethnic groups. The highest-risk occupation was the farmer (30.3%), followed by the worker (28.5%). OGIs occurred more frequently in people with middle (37.0%) and primary school (33.1%) education levels. Types of injuries included 46.8% penetration, 21.2% rupture, 2.9% perforation, and 29.1% intraocular foreign body (IOFB). The injuries types differed between age and occupation groups (p < 0.001). IOFBs had a higher risk of causing endophthalmitis, retinal detachment, and traumatic cataracts (p < 0.001). The most common injuries resulted from sharp objects (72.7%). The causes of the injuries were significantly associated with age, ethnicity, and occupation (p < 0.001). Explosion injuries and attacks by animals were more common among people of Tibetan and Yi ethnicities. Blunt trauma, vehicle crashes, falls and age older than 60 years were risk factors for a lack of light perception and lower OTS scores prognosis. Conclusion OGIs in Southwest China mainly affected working-aged males, especially workers or farmers. Severe vision loss and IOFBs are more common findings. OGIs in older patients and ethnic minorities requires additional attention.
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Affiliation(s)
| | | | | | - Fang Lu
- The Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Bess C, Ferdinand D, Underwood P, Ivy D, Albert MA, Onwuanyi A, McCullough C, Brewer LC. Promoting Cardiovascular Health Equity: Association of Black Cardiologists Practical Model for Community-Engaged Partnerships. J Am Coll Cardiol 2024; 83:632-636. [PMID: 38296407 DOI: 10.1016/j.jacc.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/06/2023] [Accepted: 11/28/2023] [Indexed: 02/08/2024]
Affiliation(s)
- Courtney Bess
- Division of Cardiology, University of Texas Southwestern, Dallas, Texas, USA
| | - Daphne Ferdinand
- Healthy Heart Community Prevention Project, Inc, New Orleans, Louisiana, USA
| | | | - Donnell Ivy
- Association of Black Cardiologists, Inc, Washington, DC, USA
| | - Michelle A Albert
- Center for the Study of Adversity and Cardiovascular Disease (NURTURE Center), Division of Cardiology, University of California-San Francisco, San Francisco, California, USA
| | - Anekwe Onwuanyi
- Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA
| | | | - LaPrincess C Brewer
- Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota, USA; Center for Health Equity and Community Engagement Research, Rochester, Minnesota, USA.
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Huang SY, Ye GB, He YJ, Bin XY, Zhou M, Huang XF. [Progress in Gene Polymorphisms Associated With Osteoporosis Susceptibility in Zhuang Ethnic Group in Guangxi]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2024; 46:82-87. [PMID: 38433636 DOI: 10.3881/j.issn.1000-503x.15501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
The purpose of this paper is to systematically summarize the gene polymorphisms associated with osteoporosis(OP)susceptibility in Zhuang ethnic group in Guangxi.These genes mainly encode vitamin D receptor,estrogen receptor,calcitonin receptor,and adiponectin.The genotype and allele distribution frequency were compared between Zhuang ethnic group and other ethnic groups,which can clarify the existing genes and the potential gene polymorphism associated with OP in Zhuang ethnic group.The findings provide a representative solution for the subsequent research on the genes associated with OP susceptibility in ethnic minorities.
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Affiliation(s)
- Si-Yu Huang
- School of Basic Medical Sciences,YouJiang Medical University for Nationalities,Baise,Guangxi 533000,China
| | - Guang-Bin Ye
- School of Basic Medical Sciences,YouJiang Medical University for Nationalities,Baise,Guangxi 533000,China
| | - Yu-Jia He
- School of Basic Medical Sciences,YouJiang Medical University for Nationalities,Baise,Guangxi 533000,China
| | - Xiao-Yun Bin
- School of Basic Medical Sciences,YouJiang Medical University for Nationalities,Baise,Guangxi 533000,China
| | - Min Zhou
- School of Public Health and Management,YouJiang Medical University for Nationalities,Baise,Guangxi 533000,China
| | - Xiu-Feng Huang
- School of Basic Medical Sciences,YouJiang Medical University for Nationalities,Baise,Guangxi 533000,China
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Merritt MA, Lim U, Lampe JW, Kaenkumchorn T, Boushey CJ, Wilkens LR, Shepherd JA, Ernst T, Le Marchand L. Dietary intake and visceral adiposity in older adults: The Multiethnic Cohort Adiposity Phenotype study. Obes Sci Pract 2024; 10:e734. [PMID: 38259353 PMCID: PMC10802887 DOI: 10.1002/osp4.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/01/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
Background There are established links between the accumulation of body fat as visceral adipose tissue (VAT) and the risk of developing obesity-associated metabolic disease. Previous studies have suggested that levels of intake of specific foods and nutrients are associated with VAT accumulation after accounting for total energy intake. Objective This study assessed associations between a priori selected dietary factors on VAT quantified using abdominal magnetic resonance imaging. Methods The cross-sectional Multiethnic Cohort Adiposity Phenotype Study included n = 395 White, n = 274 Black, n = 269 Native Hawaiian, n = 425 Japanese American and n = 358 Latino participants (mean age = 69 years ± 3 SD). Participants were enrolled stratified on sex, race, ethnicity and body mass index. General linear models were used to estimate the mean VAT area (cm2) for participants categorized into quartiles based on their dietary intake of selected foods/nutrients adjusting for age, sex, racial and ethnic groups, the total percentage fat from whole-body dual energy X-ray absorptiometry and total energy. Results There were significant inverse associations with VAT for dietary intake of total vegetables, total fruits (including juice), cereals, whole grains, calcium, copper and dietary fiber (p-trend ≤0.04). Positive trends were observed for VAT for participants who reported higher intake of potatoes, total fat and saturated fatty acids (SFA) (p-trend ≤0.02). Foods/nutrients that met the multiple testing significance threshold were total fruits, whole grains, copper, dietary fiber and SFA intake. Conclusions These results highlight foods and nutrients including SFA, total fruit, whole grains, fiber and copper as potential candidates for future research to inform dietary guidelines for the prevention of chronic disease among older adults.
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Affiliation(s)
- Melissa A. Merritt
- The Daffodil CentreThe University of Sydney, a Joint Venture with Cancer Council NSWSydneyNew South WalesAustralia
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterUniversity of HawaiiHonoluluHawaiiUSA
| | - Unhee Lim
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterUniversity of HawaiiHonoluluHawaiiUSA
| | - Johanna W. Lampe
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWashingtonUSA
| | - Tanyaporn Kaenkumchorn
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsSeattle Children's HospitalSeattleWashingtonUSA
| | - Carol J. Boushey
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterUniversity of HawaiiHonoluluHawaiiUSA
| | - Lynne R. Wilkens
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterUniversity of HawaiiHonoluluHawaiiUSA
| | - John A. Shepherd
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterUniversity of HawaiiHonoluluHawaiiUSA
| | - Thomas Ernst
- Department of Diagnostic Radiology and Nuclear MedicineUniversity of MarylandBaltimoreMarylandUSA
| | - Loïc Le Marchand
- Cancer Epidemiology ProgramUniversity of Hawaii Cancer CenterUniversity of HawaiiHonoluluHawaiiUSA
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14
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Torkpoor R, Frolich K, Londos E, Nielsen TR. Diagnostic Accuracy of the Swedish Version of the Multicultural Cognitive Examination for Cognitive Assessment in Swedish Memory Clinics. J Alzheimers Dis 2024; 97:715-726. [PMID: 38143364 PMCID: PMC10836550 DOI: 10.3233/jad-230998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Cognitive assessment for foreign-born individuals is suboptimal. The Multicultural Cognitive Examination (MCE) was developed for use in culturally, linguistically and educationally diverse populations. The MCE includes the Rowland Universal Dementia Assessment Scale (RUDAS) and performs assessment of memory, verbal fluency, and visuospatial function. OBJECTIVE To compare the psychometric properties of the Swedish version of the Multicultural Cognitive Examination (MCE-S) with the Swedish versions of the RUDAS (RUDAS-S), the Mini-Mental State Examination (MMSE-SR), and the Clock Drawing Test (CDT), and to explore the ability of the MCE-S test to differentiate patients with and without dementia in a multicultural population. METHODS 117 outpatients at four memory clinics were tested using the MCE-S to complement the routine cognitive assessment. RESULTS Significant differences between patients with and without dementia were observed for all MCE-S components. There were significant differences between foreign-born and Swedish-born patients in the MMSE-SR, but not in the MCE-S or the RUDAS-S. The MCE-S, had good diagnostic performance for detecting dementia (AUC, 0.82), and was at least as good as the RUDAS-S alone (AUC, 0.79). The MCE-S also distinguished Alzheimer's disease (AD) from non-AD dementia. Contrary to expectations, the MCE-S was also at least as good as the MMSE-SR among the Swedish-born patients. CONCLUSIONS The MCE-S is adequate for detecting dementia in both foreign-born and Swedish-born populations. Based on the cultural diversity of general society, adapted cognitive tests that can be used for everyone are practical and beneficial for both patients and health-care professionals. Further studies are needed within primary care.
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Affiliation(s)
- Rozita Torkpoor
- Department of Clinical Sciences Malmö, Cognitive Disorder Research Unit, Lund University, Malmö, Sweden
- Memory Clinic, Skane University Hospital, Malmö, Sweden
| | - Kristin Frolich
- Department of Clinical Sciences Malmö, Cognitive Disorder Research Unit, Lund University, Malmö, Sweden
| | - Elisabet Londos
- Department of Clinical Sciences Malmö, Cognitive Disorder Research Unit, Lund University, Malmö, Sweden
- Department of Neurobiology, Division of Clinical Geriatrics, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - T. Rune Nielsen
- Danish Dementia Research Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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15
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Wong NE, Hagan MJ, Holley SR. Childhood Maltreatment and Suicidal Thoughts and Behaviors in Young Adults. Crisis 2024; 45:26-32. [PMID: 37337753 DOI: 10.1027/0227-5910/a000909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Background: Childhood maltreatment strongly predicts suicidality in young adulthood, which is increasingly common among Latina/o and Asian Americans. However, greater attention to modifiable explanatory factors is needed, particularly in ethnically minoritized populations. Aims: The current study evaluated whether the association between childhood maltreatment and suicidality may be accounted for by emotion regulation difficulties among a sample of young adults attending a large, minority-serving state university. Methods: Young adults (n = 853 participants; Mage = 22.43 years; 76.2% female) completed validated measures of suicidality, childhood maltreatment, depression, and emotion regulation difficulties. A multiple indirect effect analysis was conducted in a structural equation modeling framework. Results: Greater childhood maltreatment was associated with significantly greater emotion regulation difficulties across all six types and greater endorsement of overall suicidality. An indirect effect was found for limited access to regulation strategies only. Unexpectedly, lack of emotional awareness was associated with lower levels of ideation/attempts or threats of engaging in suicidal behavior. Limitations: The study was cross-sectional, precluding conclusions regarding causality. Conclusions: The findings suggest that, for individuals who have experienced childhood maltreatment, it is particularly important to address deficits in access to emotion regulation strategies to reduce the risk of suicidal ideation and behavior.
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Affiliation(s)
- Natalie E Wong
- Department of Psychology, San Francisco State University, CA, USA
| | - Melissa J Hagan
- Department of Psychology, San Francisco State University, CA, USA
| | - Sarah R Holley
- Department of Psychology, San Francisco State University, CA, USA
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16
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Henley P, Martins T, Zamani R. Assessing Ethnic Minority Representation in Fibromyalgia Clinical Trials: A Systematic Review of Recruitment Demographics. Int J Environ Res Public Health 2023; 20:7185. [PMID: 38131736 PMCID: PMC10742509 DOI: 10.3390/ijerph20247185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
The under-representation of non-White participants in Western countries in clinical research has received increased attention, due to recognized physiological differences between ethnic groups, which may affect the efficacy and optimal dosage of some treatments. This review assessed ethnic diversity in pharmaceutical trials for fibromyalgia, a poorly understood chronic pain disorder. We also investigated longitudinal change to non-White participant proportions in trials and non-White participants' likelihood to discontinue with fibromyalgia research between trial stages (retention). First, we identified relevant trials conducted in the United States and Canada between 2000 and 2022, by searching PubMed, Web of Science, Scopus, and the Cochrane Library databases. In trials conducted both across the United States and Canada, and exclusively within the United States, approximately 90% of participants were White. A longitudinal analysis also found no change in the proportion of non-White participants in trials conducted across the United States and Canada between 2000 and 2022. Finally, we found no significant differences in trial retention between White and non-White participants. This review highlights the low numbers of ethnic minorities in fibromyalgia trials conducted in the United States and Canada, with no change to these proportions over the past 22 years. Furthermore, non-White participants were not more likely to discontinue with the fibromyalgia research once they were recruited.
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Affiliation(s)
| | | | - Reza Zamani
- Medical School, College of Medicine and Health, University of Exeter, Exeter EX1 2LU, UK (T.M.)
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17
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He S, Shi Y, Wang F, Li C, Kang J, Zhang G, Zhou K, Yu Z, Yao Y, Peng H. Short-term prognosis of very-preterm infants of ethnic minorities and Han nationality at high altitude: a single-center, retrospective study. J Matern Fetal Neonatal Med 2023; 36:2228455. [PMID: 37380346 DOI: 10.1080/14767058.2023.2228455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/31/2023] [Accepted: 06/18/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE We aimed to analyze the perinatal care of very-preterm infants (VPIs) in plateau areas of China and to explore any differences in short-term outcomes between ethnic minorities and Han nationality. METHODS VPIs with gestational age (GA) <32 weeks admitted to Qinghai Red Cross Hospital from 1 January 2018 to 31 December 2020 were enrolled. Maternal information, neonatal information, perinatal care and discharge outcomes were retrospectively collected and analyzed. RESULTS A total of 302 VPIs were examined, including 143 (47.4%) ethnic minority infants and 159 (52.6%) Han infants. Mothers of ethnic minority infants were significantly younger than those of Han infants (27 y vs. 30 y, p < .001). There were no differences in the incidence of assisted reproduction, multiple pregnancies, maternal hypertension, clinical chorioamnionitis or premature rupture of membranes >18 h between ethnic minority mothers and Han mothers. Lower proportions of cesarean section and incidence of maternal diabetes were observed in ethnic minority mothers than in Han mothers [(9.1 vs.17.6%, p < .05) and (42.7 vs. 57.9%, p < .05, respectively)]. Meanwhile, fewer antenatal steroids were used in minority group than Han group (65.7 vs. 81.1%, p < .05). No significant differences in rates of death, active treatment, necrotizing enterocolitis stage ≥2, moderate-to-severe BPD, and incidence of severe retinopathy of prematurity in VPIs were found between the two groups and in all GA subgroups. Severe neurological injury was significantly less common in the minority newborns than in the Han infants (1.2 vs. 6.1%, p < .05). Compared with Han group, no excess risk of death, death or major morbidity, death despite active treatment, death or major morbidity despite active treatment was observed in ethnic minorities, with or without adjusting for gestational age and prenatal steroids. CONCLUSIONS Short-term prognosis of VPIs of ethnic minorities were similar to those of Han nationality.
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Affiliation(s)
- Shengnan He
- Department of Neonatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Yanling Shi
- Department of Neonatology, Qinghai Red Cross Hospital, Xining, China
| | - Fei Wang
- Department of Neonatology, Qinghai Red Cross Hospital, Xining, China
| | - Cungui Li
- Department of Neonatology, Qinghai Red Cross Hospital, Xining, China
| | - Jing Kang
- Department of Neonatology, Qinghai Red Cross Hospital, Xining, China
| | - Guofei Zhang
- Department of Neonatology, Qinghai Red Cross Hospital, Xining, China
| | - Kanghua Zhou
- Department of Neonatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Zhangbin Yu
- Department of Neonatology, Shenzhen People's Hospital, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Yanli Yao
- Department of Neonatology, Qinghai Red Cross Hospital, Xining, China
| | - Haibo Peng
- Department of Neonatology, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
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18
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Adebiyi AAMO, Ghezae FT, Mustafa J. Amplifying the voices of young people from Black, Asian and other minority ethnic backgrounds in mental health research. J Ment Health 2023; 32:1020-1021. [PMID: 33966572 DOI: 10.1080/09638237.2021.1898564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/01/2021] [Indexed: 10/21/2022]
Abstract
A commentary on the Mental Health Research Goals paper, emphasising the importance of the involvement of young people at all stages of mental health research pertaining to their demographic. Examples are highlighted from the UKRI Emerging Minds Network's research challenge on the impact of racism on young people's mental health in the UK, which has implications for research on racism and youth mental health specifically but also mental health research generally.
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19
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Vashisht A, Gutman G, Kaur T. ACP Conversations with Chinese and South Asian Patients: Physicians' Perspectives of Barriers and Facilitating Factors. Can Geriatr J 2023; 26:486-492. [PMID: 38045880 PMCID: PMC10684305 DOI: 10.5770/cgj.26.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Introduction/Objective Advance Care Planning (ACP) discussions are infrequently conducted with physicians, even fewer among minorities. We explored physicians' experiences in engaging Chinese (CH) and South Asian (SA) patients in ACP conversations to understand initiation and participation patterns, topics covered, and barriers and facilitating factors. Method Twenty-two physicians with 15%+ SA patients aged 55+ and 19 with 15%+ CH patients aged 55+ were interviewed. Results SA- and CH-serving physicians described similar initiation patterns, cultural context, and need for standardized ACP routines. However, the SA-serving physicians described greater involvement of family members, while CH-serving physicians described more communication barriers and family members' desire to hide the diagnosis from patients. Conclusion Cultural taboos surrounding discussion around death and dying appear to influence CH older adults and families strongly. Lack of familiarity with ACP amongst the SA population accounts more for their limited engagement in ACP discussions.
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Affiliation(s)
- Avantika Vashisht
- Gerontology Research Center, Simon Fraser University, Vancouver, BC
- Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC
| | - Gloria Gutman
- Gerontology Research Center, Simon Fraser University, Vancouver, BC
| | - Taranjot Kaur
- Gerontology Research Center, Simon Fraser University, Vancouver, BC
- Biological Studies, Simon Fraser University, Burnaby, BC,
Canada
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20
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Manyimo P, de Vries K. End-of-life care in the patient's home. Int J Palliat Nurs 2023; 29:528-536. [PMID: 38039125 DOI: 10.12968/ijpn.2023.29.11.528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND Providing end-of-life care in a patient's home is challenging, especially if the nurse is from a different ethnic background from the patient. Evidence shows that people from an ethnic minority background often experience poorer end-of-life care due to care providers not understanding their care needs. AIM To explore the experiences of community nursing staff caring for patients with an ethnic minority background at the end of their life. METHOD Using a qualitative descriptive approach, 16 semi-structured interviews were conducted and the data was thematically analysed. FINDING Participants dealt with large tight-knit families, paternalism and controlling behaviours. There was a mistrust of Western palliative medicine. Language barriers and challenges were faced by the nursing staff, resulting in difficult conversations with the families. Different levels of the nursing staff's spiritual/cultural competencies were also identified. The COVID-19 pandemic intensified the challenges. CONCLUSION This research has shed light on the challenges of individualising end-of-life care in a culturally diverse community in the UK. The nursing staff's cultural/spiritual competencies were challenged.
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Affiliation(s)
- Pretty Manyimo
- Specialist Palliative Care Nurse, Leicestershire Partnership Trust, UK
| | - Kay de Vries
- Professor of Old Peoples Health, Health and Life Sciences, De Montfort University, UK
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21
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Bilodeau A, White SE, Ma C, Turgeon L, Henderson A. Marginalized, but not demobilized: Ethnic minority protest activity when facing discrimination. Int Polit Sci Rev 2023; 44:627-644. [PMID: 37933326 PMCID: PMC10625494 DOI: 10.1177/01925121231156633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
In a context of backlash against diversity in many countries, we know little about how ethnic minorities respond politically when they personally experience discrimination. Moving beyond the study of electoral participation, this research investigates whether experiences of discrimination push ethnic minorities toward an alternate political pathway for those who feel sidelined by the political community: protest activity. The study also examines whether the context of discrimination (i.e. public or private sphere) has different consequences for protest participation, and whether intragroup contact enhances the effects of discrimination on protest participation. Relying on a survey of 1647 respondents from racialized backgrounds in Canada, our findings indicate that discriminatory experiences increase participation in protest activities irrespective of its context, and that the positive relationship between discriminatory experiences and protest activity is stronger among respondents with greater intragroup contact.
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Affiliation(s)
| | - Stephen E White
- Department of Political Science, Carleton University, Canada
| | - Clayton Ma
- Department of Political Science, Concordia University, Canada
| | - Luc Turgeon
- School of Political Studies, University of Ottawa, Canada
| | - Ailsa Henderson
- School of Social and Political Science, University of Edinburgh, UK
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22
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Rosenberg KL, Burns A, Caplin B. Effect of ethnicity and socioeconomic deprivation on uptake of renal supportive care and dialysis decision-making in older adults. Clin Kidney J 2023; 16:2164-2173. [PMID: 37915922 PMCID: PMC10616494 DOI: 10.1093/ckj/sfad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Indexed: 11/03/2023] Open
Abstract
Background Renal supportive care has become an increasingly relevant treatment option as the renal patient population ages. Despite the prevalence of kidney disease amongst ethnic minority and socioeconomically deprived patients, evidence focused on supportive care and dialysis decision-making in these groups is limited. Methods This retrospective study selected older patients referred to a low clearance or supportive care service between 1 January 2015 and 31 December 2019. A descriptive analysis of clinical and socioeconomic characteristics according to treatment choice was produced and multivariate logistic regression models used to identify predictive factors for choosing supportive care. Surrogate markers for the success of decision-making processes were evaluated, including time taken to reach a supportive care decision and risk of death without making a treatment decision or within 3 months of starting kidney replacement therapy (KRT). Finally, the association between ethnicity and socioeconomic status and hospital admission rates was compared between treatment groups. Results Amongst 1768 patients, 515 chose supportive care and 309 chose KRT. Predictive factors for choosing supportive care included age, frailty and a diagnosis of cognitive impairment. However, there was no association with ethnicity or deprivation. Similarly, these factors were not associated with time taken to make a supportive care decision or the mortality outcome. Amongst those on KRT, more socially advantaged patients had decreased rates of hospital admissions compared with those less advantaged (incident rate ratio 0.96, 95% confidence interval 0.92-0.99). Conclusion Predictive factors for choosing supportive care were clinical, rather than socioeconomic. Lower socioeconomic status was associated with increased rates of hospitalization in the KRT group. This is a possible signal that these groups experienced greater morbidity on KRT versus supportive care, an association not demonstrated amongst higher socioeconomic groups.
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Affiliation(s)
| | - Aine Burns
- Department of Renal Medicine, University College London, London, UK
| | - Ben Caplin
- Department of Renal Medicine, University College London, London, UK
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23
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Europa RT, Eide K, Hjern A, Manhica H, Dunlavy A. Narcotic offences and drug use disorders among young refugees in Norway. Scand J Public Health 2023:14034948231201895. [PMID: 37795672 DOI: 10.1177/14034948231201895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
AIMS We examined the patterns of healthcare utilisation for drug use disorders (DUDs) and charges related to narcotics among young refugees in Norway considering the role of sex, country of origin and condition of arrival (accompanied versus unaccompanied minors). METHODS Based on national registers, sex-stratified Cox regression models were used to estimate hazard ratios to assess the risk of being charged with a narcotics offence and the use of healthcare services related to DUDs. The sample consisted of 15,068 young refugees and 573,241 young Norwegians born in Norway to two Norwegian-born parents. All of the young people in the sample were born between 1983 and 1994. The follow-up period was from January 2008 to December 2015. RESULTS Compared with their Norwegian peers, both male and female refugees showed either a similar or lower risk of receiving healthcare for DUDs. However, male refugees showed an increased risk of being charged with a narcotic offence, except those from Afghanistan and the former Yugoslavia. Accompanied male refugees were at a higher risk of being charged, while unaccompanied male refugees showed a lower risk. CONCLUSIONS Young male refugees generally had a higher risk of being charged for narcotic offences while showing a similar risk of receiving healthcare for DUDs compared to Norwegian-born young people. However, young men from Afghanistan and the former Yugoslavia deviated from this pattern. This may be partially explained by the length of time spent in Norway. The results add support to previous qualitative studies suggesting that punitive drug policies may disproportionately affect men from minority groups. Further research controlling for parental household-level factors is warranted.
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Affiliation(s)
- Ryan T Europa
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Norway
| | - Ketil Eide
- Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Norway
| | - Anders Hjern
- Department of Medicine, Clinical Epidemiology, Karolinska Institutet, Sweden
- Centre for Health Equity Studies, Department of Public Health Sciences, Stockholm University, Sweden
| | - Helio Manhica
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Andrea Dunlavy
- Centre for Health Equity Studies, Department of Public Health Sciences, Stockholm University, Sweden
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24
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Fakkel M, Peeters M, Branje S, Stevens GWJM, Vollebergh WAM. Decline in positive future orientations among adolescents during covid-19: The role of socioeconomic status, parental support, and sense of control. J Adolesc 2023; 95:1321-1332. [PMID: 37321963 DOI: 10.1002/jad.12204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 05/15/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Before coronavirus disease (covid-19), adolescents from a lower socioeconomic status (SES) background tend to have less positive future orientations, receive less parental support, and have a weaker sense of control than adolescents from a higher SES background. The covid-19 pandemic has potentially increased the socioeconomic gaps in positive future orientations, parental support, and sense of control among adolescents who are currently in vocational education. As societies are aiming to return back to precovid norms, certain groups of adolescents might require more attention for ensuring a stable future than others. METHODS Two-wave questionnaire data of 689 Dutch adolescents (Mage = 17.8; 56% female) from the Youth Got Talent project was analyzed. Latent Change Score models are a relatively novel approach that allows two-wave data to estimate associations between precovid predictor variables and changes in outcome variables from before to during covid-19 (e.g., SES, positive future orientations, parental support, and sense of control). Analyses were preregistered. RESULTS The precovid socioeconomic differences in adolescent's positive future orientations and sense of control remained stable during covid-19, whereas the socioeconomic difference in parental support decreased during covid-19. A decline in parental support, an increase in sense of control, and more covid-19 hardships were associated with an increase in future orientations. CONCLUSION The covid-19 situation has not substantially increased socioeconomic differences in positive future orientations and sense of control, but did decrease socioeconomic differences in parental support among adolescents. Short-term policies should aim to facilitate parental support and positive future orientations to all adolescents who experienced a decline, while also long-term focusing on the more consistent socioeconomic difference in sense of control among adolescents.
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Affiliation(s)
- Matthijs Fakkel
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Margot Peeters
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Susan Branje
- Department of Youth & Family, Utrecht University, Utrecht, The Netherlands
| | - Gonneke W J M Stevens
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Wilma A M Vollebergh
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
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25
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Grossi AA, Puoti F, Maggiore U, Cardillo M. Refusal Rates to Organ Donation in Intensive Care Units Among Immigrant Populations in Italy. Transpl Int 2023; 36:11674. [PMID: 37745641 PMCID: PMC10513101 DOI: 10.3389/ti.2023.11674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/14/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Alessandra Agnese Grossi
- Center for Clinical Ethics, Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
- Department of Human Sciences, Innovation and Territory, University of Insubria, Como, Italy
| | - Francesca Puoti
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Umberto Maggiore
- Nephrology Unit, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Massimo Cardillo
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
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26
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Marchio A, Sitbounlang P, Deharo E, Paboriboune P, Pineau P. Concealed for a Long Time on the Marches of Empires: Hepatitis B Virus Genotype I. Microorganisms 2023; 11:2204. [PMID: 37764048 PMCID: PMC10535388 DOI: 10.3390/microorganisms11092204] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023] Open
Abstract
Genotype I, the penultimate HBV genotype to date, was granted the status of a bona fide genotype only in the XXIst century after some hesitations. The reason for these hesitations was that genotype I is a complex recombinant virus formed with segments from three original genotypes, A, C, and G. It was estimated that genotype I is responsible for only an infinitesimal fraction (<1.0%) of the chronic HBV infection burden worldwide. Furthermore, most probably due to its recent discovery and rarity, the natural history of infection with genotype I is poorly known in comparison with those of genotypes B or C that predominate in their area of circulation. Overall, genotype I is a minor genotype infecting ethnic minorities. It is endemic to the Southeast Asian Massif or Eastern Zomia, a vast mountainous or hilly region of 2.5 million km2 spreading from Eastern India to China, inhabited by a little more than 100 million persons belonging primarily to ethnic minorities speaking various types of languages (Tibeto-Burman, Austroasiatic, and Tai-Kadai) who managed to escape the authority of central states during historical times. Genotype I consists of two subtypes: I1, present in China, Laos, Thailand, and Vietnam; and I2, encountered in India, Laos, and Vietnam.
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Affiliation(s)
- Agnès Marchio
- Institut Pasteur, Université Paris Cité, Unité “Organisation Nucléaire et Oncogenèse”, INSERM U993, 75015 Paris, France;
| | - Philavanh Sitbounlang
- Centre d’Infectiologie Lao-Christophe Mérieux (CILM), Vientiane 3888, Laos; (P.S.); (P.P.)
| | - Eric Deharo
- MIVEGEC, Université Montpellier, CNRS, IRD, 34394 Montpellier, France;
| | - Phimpha Paboriboune
- Centre d’Infectiologie Lao-Christophe Mérieux (CILM), Vientiane 3888, Laos; (P.S.); (P.P.)
| | - Pascal Pineau
- Institut Pasteur, Université Paris Cité, Unité “Organisation Nucléaire et Oncogenèse”, INSERM U993, 75015 Paris, France;
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Liu N, Chen T, Peng Y, Xie Y. Cantonese media promotes Chinese cultural identification: structural equation modeling based on Malaysian Chinese. Front Psychol 2023; 14:1217340. [PMID: 37691799 PMCID: PMC10483222 DOI: 10.3389/fpsyg.2023.1217340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Language media from one's hometown is an important means of maintaining cultural identification, especially for minorities. Cantonese media plays an active role in shaping the Chinese cultural identification of ethnic Chinese all over the world. To date, few researchers have undertaken quantitative empirical analyses of the mechanism through which Cantonese media influences cultural identification. Methods Using data from 642 Malaysian Chinese, this study established a structural equation model with the partial least squares method. Results We found that the emotional affinity of ethnic Chinese to Cantonese media can influence identification with Chinese culture through the perceived value of Cantonese media and cognition of Chinese culture. The perceived value of Cantonese media (IE = 0.208) and cognition of Chinese culture (IE = 0.068) play partial mediation roles. Meanwhile, emotional affinity to Cantonese media influences cognition of Chinese culture (IE = 0.069) through the chain mediation of perceived value of Cantonese media and cognition of Chinese culture. Age has a partial moderating effect in the structural equation model. Compared with minors, adults' emotional affinity to Cantonese media can eventually influence identification with Chinese culture (TEdiff = 0.126) more strongly through several mediation paths. Discussion The study suggests a need to cultivate the emotional affinity of ethnic Chinese to Cantonese media, improve the multidimensional values of Cantonese media, and endow Cantonese media with functions of cultural dialog and knowledge transmission. The international transmission of Cantonese media could play a vital role in building a cultural community for ethnic Chinese globally.
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Affiliation(s)
- Nian Liu
- School of Public Administration, Guangzhou University, Guangzhou, China
| | - Tongyu Chen
- School of Arts (Journalism), Monash University, Melbourne, VIC, Australia
| | - Yuqing Peng
- School of Journalism and Communication, Guangzhou University, Guangzhou, China
| | - Ying Xie
- School of Public Administration, Guangzhou University, Guangzhou, China
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Benidir A, Levert MJ, Bilodeau K. The Role of Islamic Beliefs in Facilitating Acceptance of Cancer Diagnosis. Curr Oncol 2023; 30:7789-7801. [PMID: 37754480 PMCID: PMC10530149 DOI: 10.3390/curroncol30090565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/14/2023] [Accepted: 08/20/2023] [Indexed: 09/28/2023] Open
Abstract
Although survival rates for patients with cancer have increased, this disease continues to affect couples significantly. Religion and culture seem to be part of the therapeutic process for people with cancer. Despite the abundance of the Arab Muslim community in Western countries, there is a lack of documented data on Arab Muslim couples experiencing cancer. A simple exploratory qualitative study was conducted through semi-structured interviews on six married couples (n = 12) identifying with the Arab Muslim culture and being affected by cancer. An iterative data analysis was performed. Results were reported under the following themes: accepting illness through coping strategies provided by Muslim religious beliefs and practices, experiencing problems with the expression of needs and feelings within the couple, experiencing closeness within the family, and experiencing illness in the hospital setting as Muslims. Our results show that Islamic beliefs can facilitate acceptance of a cancer diagnosis. It is also noted that religion seems to unite spouses in supporting each other and maintaining hope in a difficult context. Communication issues may persist between a couple due to stressors related to cancer. The results of this study could raise awareness about the importance of exploring religious and spiritual beliefs when supporting couples affected by cancer.
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Affiliation(s)
- Amina Benidir
- Faculty of Nursing, University of Montreal, Station Centre-Ville, Montreal, QC H3C 3J7, Canada; (M.-J.L.); (K.B.)
| | - Marie-Josée Levert
- Faculty of Nursing, University of Montreal, Station Centre-Ville, Montreal, QC H3C 3J7, Canada; (M.-J.L.); (K.B.)
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, 6363, Hudson Road, Montreal, QC H3S 1M9, Canada
| | - Karine Bilodeau
- Faculty of Nursing, University of Montreal, Station Centre-Ville, Montreal, QC H3C 3J7, Canada; (M.-J.L.); (K.B.)
- Maisonneuve-Rosemont Hospital Research Centre, 5415 Boul. Assomption, Montreal, QC H1T 2M4, Canada
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Grossi AA, Puoti F, Masiero L, Troni A, Cianchi T, Maggiore U, Cardillo M. Inequities in Organ Donation and Transplantation Among Immigrant Populations in Italy: A Narrative Review of Evidence, Gaps in Research and Potential Areas for Intervention. Transpl Int 2023; 36:11216. [PMID: 37636900 PMCID: PMC10450150 DOI: 10.3389/ti.2023.11216] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/19/2023] [Indexed: 08/29/2023]
Abstract
Immigrants from outside Europe have increased over the past two decades, especially in Southern European countries including Italy. This influx coincided with an increased number of immigrants with end-stage organ diseases. In this narrative review, we reviewed evidence of the gaps between native-born and immigrant populations in the Organ Donation and Transplantation (ODT) process in Italy. Consistent with prior studies, despite the availability of a publicly funded health system with universal healthcare coverage, non-European-born individuals living in Italy are less likely to receive living donor kidney transplantation and more likely to have inferior long-term kidney graft function compared with EU-born and Eastern European-born individuals. While these patients are increasingly represented among transplant recipients (especially kidney and liver transplants), refusal rates for organ donation are higher in some ethnic groups compared with native-born and other foreign-born referents, with the potential downstream effects of prolonged waiting times and inferior transplant outcomes. In the process, we identified gaps in relevant research and biases in existing studies. Given the Italian National Transplant Center's (CNT) commitment to fighting inequities in ODT, we illustrated actions taken by CNT to tackle inequities in ODT among immigrant communities in Italy.
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Affiliation(s)
- Alessandra Agnese Grossi
- Center for Clinical Ethics, Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
- Department of Human Sciences, Innovation and Territory, University of Insubria, Como, Italy
| | - Francesca Puoti
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Lucia Masiero
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Alessia Troni
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Tiziana Cianchi
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
| | - Umberto Maggiore
- Nephrology Unit, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy
| | - Massimo Cardillo
- Italian National Transplant Center (CNT), Istituto Superiore di Sanità, Rome, Italy
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Grossi AA, Randhawa G, Jansen NE, Paredes-Zapata D. Taking a "Care Pathway/Whole Systems" Approach to Equality Diversity Inclusion (EDI) in Organ Donation and Transplantation in Relation to the Needs of "Ethnic/Racial/Migrant" Minority Communities: A Statement and a Call for Action. Transpl Int 2023; 36:11310. [PMID: 37600748 PMCID: PMC10437067 DOI: 10.3389/ti.2023.11310] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023]
Abstract
International evidence shows variation in organ donation and transplantation (ODT) based upon a range of patient characteristics. What is less well understood is the impact of patient "ethnicity/race/immigration background," as these terms are defined and intended differently across countries. We also know that these characteristics do not operate in isolation but intersect with a range of factors. In this paper, we propose a framework that seeks to clarify the definition of the key terms "ethnicity/race/migrant" and to review how these communities are operationalized across European studies about inequities in ODT. Further, patients and the public wish to see Equality Diversity Inclusion (EDI) approaches in their everyday lives, not just in relation to ODT. We propose a 'care pathway/whole-systems' approach to ODT encompassing culturally competent public health interventions for a) the prevention and management of chronic diseases, b) improvements in public engagement for the promotion of the culture of ODT and enhancements in end-of-life care, through to c) enhanced likelihood of successful transplant among migrant/ethnic minority communities. Our framework recognizes that if we truly wish to take an EDI approach to ODT, we need to adopt a more social, human and holistic approach to examining questions around patient ethnicity.
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Affiliation(s)
- Alessandra Agnese Grossi
- Center for Clinical Ethics, Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy
- Department of Human Sciences, Innovation and Territory, University of Insubria, Como, Italy
| | - Gurch Randhawa
- Institute for Health Research, University of Bedfordshire, Luton, United Kingdom
| | | | - David Paredes-Zapata
- Donation and Transplant Coordination Section, Hospital Clínic, Barcelona, Spain
- Surgical Department, University of Barcelona, Barcelona, Spain
- Donation and Transplantation Institute Foundation, Barcelona, Spain
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Ahmed A, Winterbottom A, Ahmed S, Stoves J, Daga S. Decisional Needs of People From Minority Ethnic Groups Around Living Donor Kidney Transplantation: A UK Healthcare Professionals' Perspective. Transpl Int 2023; 36:11357. [PMID: 37554318 PMCID: PMC10405286 DOI: 10.3389/ti.2023.11357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/04/2023] [Indexed: 08/10/2023]
Abstract
Despite improved patient and clinical outcomes, living donor kidney transplantation is underutilized in the United Kingdom, particularly among minority ethnic groups, compared to deceased donor kidney transplantation. This may in part be due to the way in which kidney services present information about treatment options. With a focus on ethnicity, semi structured interviews captured the views of 19 kidney healthcare professionals from two renal centres in West Yorkshire, about the decisional needs and context within which people with advanced kidney disease make transplant decisions. Data were analysed using thematic analysis. Themes were categorized into three groups: 1) Kidney healthcare professionals: language, cultural awareness, trusted personnel, and staff diversity, 2) Patient information resources: timing and setting of education and suitability of patient-facing information and, 3) People with advanced kidney disease: knowledge, risk perception, and cultural/religious beliefs. To our knowledge, this is the first study in the United Kingdom to investigate in depth, healthcare professionals' views on living donor kidney transplantation decision making. Six recommendations for service improvement/delivery to support decision making around living donor kidney transplantation among minority ethnic groups are described.
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Affiliation(s)
- Ahmed Ahmed
- Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
- Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Anna Winterbottom
- Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
- Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Shenaz Ahmed
- Division of Psychological and Social Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - John Stoves
- Department of Renal Medicine, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Sunil Daga
- Department of Renal Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
- Leeds Institute of Medical Research, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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Ekezie W, Connor A, Gibson E, Khunti K, Kamal A. A Systematic Review of Behaviour Change Techniques within Interventions to Increase Vaccine Uptake among Ethnic Minority Populations. Vaccines (Basel) 2023; 11:1259. [PMID: 37515074 PMCID: PMC10386142 DOI: 10.3390/vaccines11071259] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
COVID-19 caused significant morbidity and mortality amongst ethnic minority groups, but vaccine uptake remained lower than non-minoritised groups. Interventions to increase vaccine uptake among ethnic minority communities are crucial. This systematic review synthesises and evaluates behaviour change techniques (BCTs) in interventions to increase vaccination uptake in ethnic minority populations. We searched five databases and grey literature sources. From 7637 records identified, 23 studies were included in the review. Interventions were categorised using the Behaviour Change Wheel (BCW) and Behaviour Change Taxonomy v1. Vaccines included influenza, pertussis, tetanus, diphtheria, meningitis and hepatitis. Interventions were primarily delivered in health centres/clinics and community settings. Six BCW intervention functions and policy categories and 26 BCTs were identified. The main intervention functions used were education, persuasion and enablement. Overall, effective interventions had multi-components and were tailored to specific populations. No strong evidence was observed to recommend specific interventions, but raising awareness and involvement of community organisations was associated with positive effects. Several strategies are used to increase vaccine uptake among ethnic minority communities; however, these do not address all issues related to low vaccine acceptance. There is a strong need for an increased understanding of addressing vaccine hesitancy among ethnic minority groups.
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Affiliation(s)
- Winifred Ekezie
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, UK
- Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, UK
| | - Aaisha Connor
- School of Social Sciences, Birmingham City University, Birmingham B4 7BD, UK
| | - Emma Gibson
- School of Social Sciences, Birmingham City University, Birmingham B4 7BD, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester LE5 4PW, UK
- Centre for Ethnic Health Research, University of Leicester, Leicester LE5 4PW, UK
| | - Atiya Kamal
- School of Social Sciences, Birmingham City University, Birmingham B4 7BD, UK
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Teodorowski P, Rodgers SE, Fleming K, Tahir N, Ahmed S, Frith L. Exploring how to improve the involvement of Polish and South Asian communities around big data research. A qualitative study using COM-B model. Int J Popul Data Sci 2023; 8:2130. [PMID: 37670958 PMCID: PMC10476635 DOI: 10.23889/ijpds.v8i1.2130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023] Open
Abstract
Introduction Involving public contributors helps researchers to ensure that public views are taken into consideration when designing and planning research, so that it is person-centred and relevant to the public. This paper will consider public involvement in big data research. Inclusion of different communities is needed to ensure everyone's voice is heard. However, there remains limited evidence on how to improve the involvement of seldom-heard communities in big data research. Objectives This study aims to understand how South Asians and Polish communities in the UK can be encouraged to participate in public involvement initiatives in big data research. Methods Forty interviews were conducted with Polish (n=20) and South Asian (n=20) participants on Zoom. The participants were living in the United Kingdom and had not previously been involved as public contributors. Transcribed interviews were analysed using reflexive thematic analysis. Results We identified eight themes. The 'happy to reuse data' theme sets the scene by exploring our participants' views towards big data research and under what circumstances they thought that data could be used. The remaining themes were mapped under the capability-opportunity-motivation-behaviour (COM-B) model, as developed by Michie and colleagues. This allowed us to discuss multiple factors that could influence people's willingness to become public contributors. Conclusions Our study is the first to explore how to improve the involvement and engagement of seldom-heard communities in big data research using the COM-B model. The results have the potential to support researchers who want to identify what can influence members of the public to be involved. By using the COM-B model, it is possible to determine what measures could be implemented to better engage these communities.
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Affiliation(s)
- Piotr Teodorowski
- Department of Public Health, Policy & Systems, University of Liverpool
| | - Sarah E. Rodgers
- Department of Public Health, Policy & Systems, University of Liverpool
| | - Kate Fleming
- National Disease Registration Service, NHS England
| | | | | | - Lucy Frith
- Centre for Social Ethics and Policy, University of Manchester
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Iqbal K, Modood T. Students' educational drive and ethnic capital. J Community Psychol 2023; 51:2083-2097. [PMID: 36752415 DOI: 10.1002/jcop.23011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/16/2022] [Accepted: 01/22/2023] [Indexed: 06/14/2023]
Abstract
Class has been central to European sociology and especially to sociology of education. Class origins (through one's parents) do indeed largely determine one's educational attainments and through them, with further support from one's class origins, determine one's class destination. And the cycle continues in one's own children. However, class does not affect all ethnic groups in the same manner, given that different groups bring different resources to any given situation, in this case, education, through their ethnic capital. Ethnic capital is the social capital that may be distinctive to a particular ethnic group and so can vary across groups. It can motivate, support and channel the behaviour of members of a group. This article focuses on the ethnic capital of one set of parents and the wider community. It is based on qualitative research undertaken with a small group of British Kashmiris who have been educationally successful. The investigation explored the contribution of their parents and the wider community to their education: how the parents and the wider family communicated their expectations on education and the support and encouragement they provided to the young people. The findings showed that in a socioeconomically disadvantaged context the ethnic capital of the parents and the community can be a driving factor in their children's education.
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Affiliation(s)
| | - Tariq Modood
- Centre for the Study of Ethnicity and Citizenship, University of Bristol, Bristol, UK
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Siu JYM, Cao Y, Shum DHK. Stigma and health inequality experienced by ethnic minorities during the COVID-19 pandemic in a Chinese community: an implication to health policymakers. Front Public Health 2023; 11:1184209. [PMID: 37304108 PMCID: PMC10248003 DOI: 10.3389/fpubh.2023.1184209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/11/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Ethnic minorities are considered one of the most vulnerable groups during the COVID-19 pandemic. However, the explanatory pathway of how their disadvantaged experiences during epidemics are related to the embedded and longstanding stigmas against them and how these embedded stigmas can affect their resilience in disease outbreaks are not well understood. This study investigated the experiences of ethnic minorities in the COVID-19 pandemic, and how their experiences were related to the embedded stigma toward them. Methods This study adopted a qualitative approach, interviewed 25 individuals (13 women and 12 men) from ethnic minority groups residing in Hong Kong from August 2021 to February 2022 in a semi-structured format. Thematic analysis was conducted to analyze the data. Results The participants were isolated and stereotyped as infectious during the COVID-19 pandemic at community and institutional levels. Their experiences did not occur suddenly during the pandemic but were embedded in the longstanding segregation and negative stereotypes toward ethnic minorities in different aspects of life before the pandemic. These negative stereotypes affected their resilience in living and coping with the pandemic. Conclusion The participants' experiences during the COVID-19 pandemic were mostly disadvantageous and predominantly initiated by the mainstream stigmatization toward them by the local Chinese residents and government. Their disadvantaged experiences in the pandemic should be traced to the embedded social systems, imposing structural disparities for ethnic minorities when accessing social and medical resources during a pandemic. Because of the preexisting stigmatization and social seclusion of ethnic minorities in Hong Kong, the participants experienced health inequality, which stemmed from social inequality and the power differential between them and the Chinese locals. The disadvantaged situation of the participants negatively affected their resilience to the pandemic. To enable ethnic minorities better cope with future epidemics, merely providing assistance to them during an epidemic is barely adequate, but a more supportive and inclusive social system should be established for them in the long run.
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Affiliation(s)
- Judy Yuen-Man Siu
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- Interdisciplinary Centre for Qualitative Research and Training, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- International Research Centre for the Advancement of Health Communication, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Yuan Cao
- Interdisciplinary Centre for Qualitative Research and Training, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- Research Institute for Intelligent Wearable Systems, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - David H. K. Shum
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Wiśniowski A, Allen R, Aparicio-Castro A, Olsen W, Islam M. The economic impact of the COVID-19 pandemic on ethnic minorities in Manchester: lessons from the early stage of the pandemic. Front Sociol 2023; 8:1139258. [PMID: 37274606 PMCID: PMC10237338 DOI: 10.3389/fsoc.2023.1139258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 05/02/2023] [Indexed: 06/06/2023]
Abstract
This review summarizes the economic impacts of the pandemic on ethnic minorities, focusing on the city of Manchester. It utilizes multiple reporting sources to explore various dimensions of the economic shock in the UK, linking this to studies of pre-COVID-19 economic and ethnic composition in Manchester and in the combined authority area of Greater Manchester. We then make inferences about the pandemic's short-term impact specific to the city region. Greater Manchester has seen some of the highest rates of COVID-19 and as a result faced particularly stringent "lockdown" regulations. Manchester is the sixth most deprived Local Authority in England, according to 2019 English Indices of Multiple Deprivation. As a consequence, many neighborhoods in the city were always going to be less resilient to the economic shock caused by the pandemic compared with other, less-deprived, areas. Particular challenges for Manchester include the high rates of poor health, low-paid work, low qualifications, poor housing conditions and overcrowding. Ethnic minority groups also faced disparities long before the onset of the pandemic. Within the UK, ethnic minorities were found to be most disadvantaged in terms of employment and housing-particularly in large urban areas containing traditional settlement areas for ethnic minorities. Further, all Black, Asian, and Minority ethnic (BAME) groups in Greater Manchester were less likely to be employed pre-pandemic compared with White people. For example, people of Pakistani and Bangladeshi ethnic backgrounds, especially women, have the lowest levels of employment in Greater Manchester. Finally, unprecedented cuts to public spending as a result of austerity have also disproportionately affected women of an ethnic minority background alongside disabled people, the young and those with no or low-level qualifications. This environment has created and sustained a multiplicative disadvantage for Manchester's ethnic minority residents through the course of the COVID-19 pandemic.
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Affiliation(s)
- Arkadiusz Wiśniowski
- Social Statistics Department, The University of Manchester, Manchester, United Kingdom
| | - Ruth Allen
- Social Statistics Department, The University of Manchester, Manchester, United Kingdom
| | | | - Wendy Olsen
- Social Statistics Department, The University of Manchester, Manchester, United Kingdom
| | - Maydul Islam
- Policy@Manchester, The University of Manchester, Manchester, United Kingdom
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Vuong TN, Dang CV, Jagals P, Toze S, Gallegos D, Gatton M. Household Food Insecurity Negatively Impacts Diet Diversity in the Vietnamese Mekong Delta: A Cross-Sectional Study. Asia Pac J Public Health 2023; 35:276-283. [PMID: 37070630 PMCID: PMC10262329 DOI: 10.1177/10105395231166544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Healthy, diverse diets are vital for life. In low/middle-income countries, however, the focus is more on food quantity rather than diet quality. This study assessed household diet diversity (HDD) in the Vietnamese Mekong Delta and its associations with household food insecurity (HFI) and household food availability (HFA) controlling for socioeconomic factors. Primary food-preparers in 552 randomly selected households in two rural provinces were interviewed about socioeconomic factors, HDD, HFI, and HFA. More than 80% of households predominantly consumed energy-dense foods, whereas less than 20% consumed nutrient-dense foods. Lower HDD was associated with HFI, lower HFA, for the Khmer ethnic minority, and low livelihood capitals (landlessness, low expenditure, debt) and low utensil scores. The study highlighted the need to provide improved food and nutrition policies that increase availability and access to diverse and healthy foods as well as reduce poverty and increase incomes for at-risk rural and ethnic minority groups.
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Affiliation(s)
- Thuy Ngoc Vuong
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
- Institute of Public Health in Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Chinh Van Dang
- Institute of Public Health in Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Paul Jagals
- Children’s Health and Environment Program, Child Health Research Centre, The University of Queensland Centre for Children’s Health Research, South Brisbane, QLD, Australia
| | - Simon Toze
- Urban Water Futures, The Gap, Brisbane, QLD, Australia
| | - Danielle Gallegos
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Kelvin Grove, QLD, Australia
- Woolworths Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, QLD, Australia
| | - Michelle Gatton
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
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Ricci F, Torales J, Bener A, Castaldelli-Maia JM, Chumakov E, Bellomo A, Ventriglio A. Mental health of ethnic minorities: the role of racism. Int Rev Psychiatry 2023; 35:258-267. [PMID: 37267026 DOI: 10.1080/09540261.2023.2189951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 06/03/2023]
Abstract
Racism and racial discrimination heavily impact on health and mental health of ethnic minorities. In this conceptual paper and narrative review, we aim to report on relevant evidence from the international literature describing the prevalence and the qualitative aspects of mental illness due to racism and ethnic- discrimination in different settings and populations. Some variables related to racism, such as cultural, institutional, interpersonal factors, as well as the concepts of perceived and internalised racism will be described and discussed. These are relevant characteristics in the explanatory model of the relationship between racism and mental health. Epidemiological data on the prevalence of depressive and psychotic symptoms as well as substance abuse/misuse among ethnic minorities in large catchment areas, such as United States and United Kingdom, will be represented. We conclude that anti-racism policies are essential in order to address racism and racial discrimination around the world. Pluralistic societies should be promoted in order to understand mental illnesses among ethnic and cultural minorities. Also, anti-racism programs should be delivered in the educational and health-care settings and their impact evaluated.
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Affiliation(s)
- Fabiana Ricci
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción, Paraguay
| | - Abdulbari Bener
- Department of Biostatistics and Public Health, Schools of Medicine, Dentistry and Pharmacy, Istanbul Medipol University, İstanbul, Turkey
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil
| | - Egor Chumakov
- Department of Psychiatry and Addiction, St. Petersburg State University, St. Petersburg, Russia
| | - Antonello Bellomo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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Barello S, Acampora M, Grimaldi L, Maccacaro C, Dell'Acqua S, Spina B, Giangreco D. "Health without Borders": Early Findings and Lessons Learned from a Health Promotion Program for Ethnic Minorities Living in Italy. Int J Environ Res Public Health 2023; 20:ijerph20095646. [PMID: 37174165 PMCID: PMC10178414 DOI: 10.3390/ijerph20095646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
In multicultural contexts, health promotion can be challenging due to people's differences in beliefs, values, and practices regarding health and healthcare. Using the prototypical case scenario offered by the "Health without Borders" program, this study was generally aimed at summarizing the lessons learned and suggesting implications that are hopefully relevant to future culturally competent health promotion programs. This exploratory study used in-depth interviews, focus groups, and document analyses as primary methodological tools to gather data. A qualitative approach was chosen because it has the potential to explore, in depth, the main characteristics (values, operational domains, and action strategies) behind this prototypical case. The study findings suggest that the multicultural health promotion program under study is characterized by four main intertwined core values (i.e., empowerment; peer education; social embeddedness; tailor-made). In turn, these values are expressed in the ten main operational domains (i.e., proactive approach to health promotion; fostering interculturality in health promotion; fostering multidisciplinarity in health promotion; measuring the impact of initiatives; identifying, training, and activating key community members in the role of peer educators; promoting community engagement; fostering a "domino effect"; building institutional links with the organization of the territory; continuous training of the professionals involved in the initiatives; flexibility and a constant focus on projects' continuous redesign) that orient specific strategies of action. This program is based on a tailor-made principle for intervention design and delivery. This feature allows intervention providers to flexibly incorporate the target population's values in delivering health promotion activities. Therefore, the value of this prototypical case lies in the design of "adjustable" initiatives that fit the "program-as-designed" with the cultural characteristics of target populations involved in the intervention.
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Affiliation(s)
- Serena Barello
- EngageMinds HUB-Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Marta Acampora
- EngageMinds HUB-Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Lorenzo Grimaldi
- Italian League Against Cancer, Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Cecilia Maccacaro
- Italian League Against Cancer, Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Sara Dell'Acqua
- EngageMinds HUB-Consumer, Food & Health Engagement Research Center, Department of Psychology, Università Cattolica del Sacro Cuore, Milano and Cremona, L.Go Gemelli 1, 20123 Milan, Italy
| | - Barbara Spina
- Italian League Against Cancer, Via Giacomo Venezian 1, 20133 Milan, Italy
| | - Daniela Giangreco
- Italian League Against Cancer, Via Giacomo Venezian 1, 20133 Milan, Italy
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Khattak HM, Woof VG, French DP, Donnelly LS, Ruane H, Ulph F, Qureshi N, Khan N, Evans DG, Robb KA. The role of knowledge, primary care and community engagement to improve breast-screening access for Pakistani women in the United Kingdom: A secondary analysis of a qualitative study. J Health Serv Res Policy 2023:13558196231155824. [PMID: 37039238 PMCID: PMC10363928 DOI: 10.1177/13558196231155824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Breast cancer incidence is rising among Pakistani women in the United Kingdom. However, uptake of breast screening remains low. This study aimed to improve access to breast screening for British-Pakistani women by exploring their knowledge of breast cancer and the role of primary care and community networks to support screening access amongst British-Pakistani women. METHODS We undertook a secondary qualitative analysis of 18 semi-structured interviews with British-Pakistani women from East Lancashire in the United Kingdom. Anonymized transcripts of the interviews were used for a thematic analysis. RESULTS Three themes were identified in the interviewees' responses: (i) 'Women's knowledge of breasts and breast cancer', which described how a cultural taboo exists around Pakistani women's bodies and around breast cancer; (ii) 'Role of primary care', which detailed how General Practitioners can support informed decisions and offer a trusted and valued information source; (iii) 'Community engagement', which described the potential to disseminate breast-screening information through the whole community, including primary care providers, all family members and mosques. CONCLUSIONS Our analysis suggested three main targets for future interventions to improve access to breast screening for British-Pakistani women: (i) co-produced strategies to increase knowledge of breasts and breast screening; (ii) greater collaboration with local General Practitioners to support women to make informed choices about screening; and (iii) community engagement involving General Practitioners and community leaders, to inform everyone - not just screening-age women - about breast cancer and screening.
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Affiliation(s)
- Hooran M Khattak
- School of Social and Political Sciences, University of Glasgow, UK
| | - Victoria G Woof
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, UK
| | - David P French
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, UK
| | - Louise S Donnelly
- Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust, UK
| | - Helen Ruane
- Nightingale & Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust, UK
| | - Fiona Ulph
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, UK
| | - Nadeem Qureshi
- NIHR School of Primary Care, School of Medicine, University Park, UK
| | - Nasaim Khan
- Department of Genomic Medicine, MAHSC, Manchester University NHS Foundation Trust, UK
| | - D Gareth Evans
- Nightingale and Prevent Breast Cancer Research Unit, Manchester University NHS Foundation Trust, UK and Medical Genetics and Cancer Epidemiology, Department of Genomic Medicine, MAHSC, University of Manchester, Manchester University NHS Foundation Trust, UK
| | - Kathryn A Robb
- School of Health and Wellbeing, University of Glasgow, UK
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Almoussa M, Mattei J. Cardiovascular health and risk factors in African refugees and immigrants in the United States: a narrative review. Ethn Health 2023; 28:399-412. [PMID: 35306946 DOI: 10.1080/13557858.2022.2052712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Refugees and immigrants often experience challenges pre- and post-settlement that expose them to risk factors of cardiovascular disease (CVD). Literature on CVD among the growing population of African refugees and immigrants in the United States (US) is scant. This narrative review aimed to evaluate existing studies reporting on CVD and its risk factors among African refugees and immigrants in the US, and to recognize limitations in the current research, policy, and healthcare for adequate CVD-related care for African refugees and immigrants. DESIGN Articles on African refugee and/or immigrant health were searched on PubMed using multiple key search terms. Studies conducted between 1995 and 2020 and reporting on CVD-related measures in individuals from African countries of origin were included. Six articles were found discussing refugee health only and seven articles discussed refugee and immigrant health together. RESULTS Overall, the studies showed the varying prevalence of CVD risk factors, mostly depending on the country of origin. Worsening cardiometabolic health with longer residency in the US was generally reported. Refugee-only studies relied mostly on medical records data, while refugee and immigrant studies used both medical records and primary data collection. Limitations in data pertain to the geographical representation of both African countries (predominantly from Somalia despite migrants arriving from diverse African countries) and of regions of settling in the US (predominantly the north/northeast), scarce longitudinal studies, and lack of distinction between refugees and immigrants. Multiple social and structural barriers to cardiovascular health were identified, mostly related to cultural and linguistic challenges and to inadequate or complex health insurance and healthcare systems. CONCLUSION The cardiovascular health of African refugees and immigrants remains understudied and underserved. Further research and interventions to alleviate barriers and improve cardiovascular health in African refugees and immigrants in the US should be developed using culturally appropriate, accessible, flexible, and multifaceted strategies.
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Affiliation(s)
- Maya Almoussa
- Department of Molecular and Cellular Biology, Harvard College Faculty of Arts and Sciences, Cambridge, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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van Apeldoorn JAN, Roozekrans AK, Harskamp RE, Richard E, Agyemang C, Moll van Charante EP. General practitioners' views on cardiovascular prevention for ethnic minorities-a qualitative study in the Netherlands. Fam Pract 2023:7095192. [PMID: 36994852 DOI: 10.1093/fampra/cmad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES While ethnic minorities in Europe are disproportionally affected by cardiovascular disease (CVD), little is known about how general practitioners (GPs) perceive differences in risk or care needs across ethnic minority groups. Therefore, we explored GPs' views on whether ethnicity influences cardiovascular risk, whether a culturally sensitive approach is warranted, on potential barriers in the provision of such care, and to find potential opportunities to improve cardiovascular prevention for these groups. METHODS We conducted a qualitative study by interviewing GPs practising in The Netherlands. The interviews were semistructured, audio-recorded, and analysed by 2 researchers using thematic analysis. RESULTS We interviewed 24 Dutch GPs (50% male). GPs' views on the impact of ethnicity on CVD risk varied widely, yet it was generally recognized as a relevant factor in cardiovascular prevention for most minority groups, prompting earlier case-finding of high-risk patients. While GPs were aware of sociocultural differences, they emphasized an individualized approach. Perceived limitations were language barriers and unfamiliarity with sociocultural customs, leading to a need for continuing medical education on culturally sensitive care and reimbursement of telephone interpreting services. CONCLUSION Dutch GPs have differing views on the role of ethnicity in evaluating and treating cardiovascular risk. Despite these differences, they emphasized the importance of a personalized and culturally sensitive approach during patient consultations and expressed a need for continuing medical education. Additional research on how ethnicity influences CVD risk may strengthen cardiovascular prevention in increasingly diverse primary care populations.
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Affiliation(s)
- Joshua A N van Apeldoorn
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
- Department of General Practice, Amsterdam Public Health Research Institute and Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Alet K Roozekrans
- Department of General Practice, Amsterdam Public Health Research Institute and Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ralf E Harskamp
- Department of General Practice, Amsterdam Public Health Research Institute and Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Edo Richard
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
- Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Eric P Moll van Charante
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Meibergdreef 9, Amsterdam, The Netherlands
- Department of General Practice, Amsterdam Public Health Research Institute and Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Binkowski S, Roberts A, Fried L, Nicholas JA, Frearson K, Davis EA, Cherian S, Abraham MB. Perspectives of culturally and linguistically diverse families in the management of children with type 1 diabetes in Western Australia. Ethn Health 2023:1-14. [PMID: 36935189 DOI: 10.1080/13557858.2023.2190063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES Children with Type 1 diabetes (T1D) from different ethnic backgrounds are growing in proportion in clinical practice and tend to have a higher risk of poor health outcomes. The study aimed to investigate the perspectives of culturally and linguistically diverse families in the management of children with T1D in Western Australia. DESIGN A generic qualitative approach was used. Families of children and adolescents with T1D with first-generation African, Asian or Middle Eastern background were invited to participate in a semi-structured interview. The interviews were audio-recorded, transcribed and analysed thematically. Demographic, clinical and socio-economic data were collected from all participants. RESULTS Fifteen families (27% African, 33% Middle Eastern, 40% Asian) participated in the study. The mean (SD) age of the child with T1D was 10.2 (5.1) years, had diabetes for 2.9 (1.6) years and an average HbA1c of 67 (15) mmol/mol. Four main themes were identified through qualitative analysis. 'Dietary challenges': lack of adequate food resources posed a barrier to determine carbohydrate amount in traditional meals; 'Linguistic challenges': inadequate reading and language skills affected comprehension of written information and the desire for pictorial resources was reported; 'Limited Support': absence of extended family made management of T1D difficult; and 'Knowledge': a key facilitator, which was acquired through clinic education, enabled families to develop skills to effectively manage T1D. CONCLUSION The study highlights the need to consider cultural diversity, psychosocial needs, English proficiency and health literacy when assessing and planning diabetes education. These findings will be useful to formulate a more culturally sensitive approach to diabetes education to improve care and outcomes for young people with T1D from culturally and linguistically diverse families.
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Affiliation(s)
- Sabrina Binkowski
- Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Alison Roberts
- Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Australia
| | - Leanne Fried
- Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Jennifer A Nicholas
- Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Australia
- Discipline of Paediatrics, The University of Western Australia, Perth, Australia
| | - Kingsley Frearson
- Discipline of Paediatrics, The University of Western Australia, Perth, Australia
| | - Elizabeth A Davis
- Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Australia
- Discipline of Paediatrics, The University of Western Australia, Perth, Australia
| | - Sarah Cherian
- Discipline of Paediatrics, The University of Western Australia, Perth, Australia
- Refugee Health Service, Department of General Paediatrics, Perth Children's Hospital, Perth, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Australia
| | - Mary B Abraham
- Children's Diabetes Centre, Telethon Kids Institute, The University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Australia
- Discipline of Paediatrics, The University of Western Australia, Perth, Australia
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Glasofer A, Dingley C, Kim J, Colosimo R, Gordon HRD. Medication Decision Making in Low-Income Families of Black Children With ADHD: A Mixed Methods Study. J Atten Disord 2023; 27:847-858. [PMID: 36879501 DOI: 10.1177/10870547231158382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVES The purpose of this study was to explore how and why some low-income Black caregivers seek medication treatment for their children with ADHD. METHODS Using a sequential exploratory mixed method design, Phase 1 comprised an indepth case study design of seven low-income Black caregivers of children receiving medication for ADHD. Based on findings from Phase 1, the second phase involved a secondary analysis of data on Black uninsured or publicly insured children age 6 to 17 with ADHD (n = 450). RESULTS Factors influencing medication decision-making included child safety and volatility, caregiver mental health, caregiver aggravation, family centered care (FCC), shared decision making (SDM), sole caregiver status, and school involvement. After adjusting for ADHD severity, previous receipt of special education services and experiences of FCC and SDM were independently associated with receipt of a medication for ADHD. CONCLUSIONS Clinicians and school personnel can intervene to decrease disparities in the treatment of ADHD.
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Affiliation(s)
- Amy Glasofer
- University of Nevada Las Vegas, Voorhees, NJ, USA
| | | | - Jinyoung Kim
- University of Nevada Las Vegas, Las Vegas, NV, USA
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Carew Tofani A, Taylor E, Pritchard I, Jackson J, Xu A, Kotera Y. Ethnic Minorities' Experiences of Cardiac Rehabilitation: A Scoping Review. Healthcare (Basel) 2023; 11. [PMID: 36900762 DOI: 10.3390/healthcare11050757] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/11/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Cardiac rehabilitation (CR) can improve cardiovascular risk factors, decrease cardiac mortality, and promote healthy lifestyle behaviours. However, services remain underutilized by groups of ethnic minorities. The purpose of the study was to identify patients' personal CR experiences to identify the differences CR makes towards minorities' lifestyle. An initial electronic search was performed in 2021 for papers ranging from 2008-2020 across specific databases, including PubMed, EMBASE, APA PsycINFO, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Medline. Google Scholar was also used to supplement the search process and to identify studies performed within grey literature. A total of 1230 records were screened, of which 40 were assessed for eligibility. The final sample consisted of seven qualitative design studies that were identified for inclusion in this review. Based on patient personal experiences, this review identified that ethnic minorities continue to remain disadvantaged when accessing healthcare interventions, primarily as a result of cultural behaviours, linguistic barriers, socioeconomic status, religious and fatalistic beliefs, and low physician referral rates. More research is needed to elucidate this phenomenon and address these factors faced by ethnic minorities.
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Pickering K, Galappaththi EK, Ford JD, Singh C, Zavaleta-Cortijo C, Hyams K, Miranda JJ, Arotoma-Rojas I, Togarepi C, Kaur H, Arvind J, Scanlon H, Namanya DB, Anza-Ramirez C. Indigenous peoples and the COVID-19 pandemic: a systematic scoping review. Environ Res Lett 2023; 18:033001. [PMID: 36798651 PMCID: PMC9923364 DOI: 10.1088/1748-9326/acb804] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/17/2022] [Accepted: 02/01/2023] [Indexed: 05/06/2023]
Abstract
Past influenza pandemics including the Spanish flu and H1N1 have disproportionately affected Indigenous Peoples. We conducted a systematic scoping review to provide an overview of the state of understanding of the experience of Indigenous peoples during the first 18 months of the COVID-19 pandemic, in doing so we capture the state of knowledge available to governments and decision makers for addressing the needs of Indigenous peoples in these early months of the pandemic. We addressed three questions: (a) How is COVID-19 impacting the health and livelihoods of Indigenous peoples, (b) What system level challenges are Indigenous peoples experiencing, (c) How are Indigenous peoples responding? We searched Web of Science, Scopus, and PubMed databases and UN organization websites for publications about Indigenous peoples and COVID-19. Results were analyzed using descriptive statistics and content analysis. A total of 153 publications were included: 140 peer-reviewed articles and 13 from UN organizations. Editorial/commentaries were the most (43%) frequent type of publication. Analysis identified Indigenous peoples from 19 different countries, although 56% of publications were centered upon those in Brazil, United States, and Canada. The majority (90%) of articles focused upon the general adult population, few (<2%) used a gender lens. A small number of articles documented COVID-19 testing (0.04%), incidence (18%), or mortality (16%). Five themes of system level challenges affecting exposure and livelihoods evolved: ecological, poverty, communication, education and health care services. Responses were formal and informal strategies from governments, Indigenous organizations and communities. A lack of ethnically disaggregated health data and a gender lens are constraining our knowledge, which is clustered around a limited number of Indigenous peoples in mostly high-income countries. Many Indigenous peoples have autonomously implemented their own coping strategies while government responses have been largely reactive and inadequate. To 'build back better' we must address these knowledge gaps.
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Affiliation(s)
- Kerrie Pickering
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Eranga K Galappaththi
- Department of Geography, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States of America
| | - James D Ford
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Chandni Singh
- School of Environment and Development, Indian Institute for Human Settlements, Bangalore, India
| | - Carol Zavaleta-Cortijo
- Unidad de Ciudadanía Intercultural y Salud Indígena (UCISI), Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Keith Hyams
- Department of Politics and International Studies, University of Warwick, Coventry, United Kingdom
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ingrid Arotoma-Rojas
- Priestley International Centre for Climate, University of Leeds, Leeds, United Kingdom
| | - Cecil Togarepi
- Department of Animal Production, Agribusiness and Economics, School of Agriculture and Fisheries Sciences, University of Namibia, Windhoek, Namibia
| | - Harpreet Kaur
- Indian Institute for Human Settlements, Bangalore, India
| | | | - Halena Scanlon
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Didacus B Namanya
- Ministry of Health, Uganda National Health Research Organisation, Entebbe, Uganda
| | - Cecilia Anza-Ramirez
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
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Brijnath B, Navarro Medel C, Antoniades J, Gilbert AS. Culturally Adapting Evidence on Dementia Prevention for Ethnically Diverse Communities: Lessons Learnt from co-design. Clin Gerontol 2023; 46:155-167. [PMID: 35894749 DOI: 10.1080/07317115.2022.2101968] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES 40% of dementia cases can be prevented by addressing 12 lifestyle factors. These risk factors have increased presence in ethnic minorities, yet dementia prevention messages have not reached these communities. This article investigates the experience of co-designing a dementia prevention animated film with 9 ethnic groups in Australia. METHODS Evidence-based recommendations were adapted through an iterative process involving workshops with a stakeholder advisory committee and nine focus groups with 104 participants from the Arabic-, Hindi-, Tamil-, Cantonese-, Mandarin-, Greek-, Italian-, Spanish-, and Vietnamese-speaking communities. Data were analyzed using the Normalization Process Theory. RESULTS Cultural adaptation involves consideration of the mode of delivery, imagery and tone of the resource being developed; ensuring cultural adequacy; anticipating the need of the end-users; and managing linguistic challenges associated with working across multiple languages. CONCLUSIONS Learnings from this co-design process offer valuable insights for researchers and program developers who work with ethnic minority groups. CLINICAL IMPLICATIONS • Adaptation across cultures and languages is a negotiation not a consensus building exercise• Linguistic adaptation requires consideration of the education levels, and linguistic and intergenerational preferences of community members• Co-designing across multiple languages and cultures risks "flattening out" key aspects of cultural specificity.
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Affiliation(s)
- Bianca Brijnath
- Division of Social Gerontology, National Ageing Research Institute
- School of Social Sciences, University of Western Australia
| | | | - Josefine Antoniades
- Division of Social Gerontology, National Ageing Research Institute
- School of Public Health and Preventive Medicine, Monash University
| | - Andrew S Gilbert
- Division of Social Gerontology, National Ageing Research Institute
- Department of Social Inquiry, La Trobe University
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Yu J, Wallace S, Kenkre J. A consensus approach: Understanding the support needs of women in Newport West, Wales, to participate in breast screening. Health Expect 2023; 26:1065-1080. [PMID: 36756775 PMCID: PMC10154802 DOI: 10.1111/hex.13720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 02/10/2023] Open
Abstract
INTRODUCTION Breast screening is an effective way to improve the early detection of breast cancer and reduce mortality. Unfortunately, low uptake of screening is often reported. This study aimed to explore the support needs of women residing in Newport West, Wales, to participate in breast screening. METHODS Group Concept Mapping, a structured participatory consensus approach, was used as the method. Participants completed three activities either online or offline: brainstorming to generate statements, sorting statements into themed categories; rating statements for perceived importance and accessibility (easy to get). RESULTS Thirty-seven participants from seven ethnic groups took part. Sixty-three statements (items of support) were generated and sorted into seven conceptually similar clusters (themes) (Trusting that I will be respected; Reassurance about my experience; Accessibility and convenience; Practical support; Addressing cultural diversity; Information tailored to individual needs; Raising awareness and understanding of breast screening). The 'Trusting that I will be respected' cluster was rated most important, while the 'Practical support' cluster was rated least accessible. Some disparity between responses was found based on ethnicity, language, disability and previous attendance of breast screening. CONCLUSIONS Women require a range of support to participate in breast screening. The results highlight the importance of ensuring women feel and are respected, instilling trust in the staff performing the screening, offering reassurance about positive experiences of breast screening and providing practical support, especially individualized/targeted support for people who do not speak and/or read English and those with a disability. PATIENT OR PUBLIC CONTRIBUTION The public contributed to the development of the information sheet, consent form, recruitment and data collection method.
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Affiliation(s)
- Juping Yu
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, Wales, UK
| | - Sarah Wallace
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, Wales, UK
| | - Joyce Kenkre
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, Wales, UK
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Irizarry Y, Monk EP, Cobb RJ. Race-shifting in the United States: Latinxs, Skin Tone, and Ethnoracial Alignments. Sociol Race Ethn (Thousand Oaks) 2023; 9:37-55. [PMID: 38152393 PMCID: PMC10752354 DOI: 10.1177/23326492221114813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
In the study, we engage the question of racial "fluidity" by examining patterns of ethnoracial identification in adolescence and, importantly, shifts in ethnoracial identification between adolescence and adulthood using two waves of data from a nationally representative, longitudinal study of adolescents who were in Grades 7 to 12 during the 1994 to 1995 school year. Our theoretical framework draws from social identity theory and brings together bodies of research in race and immigration to make a case for the importance of phenotype, ancestry, and sociocultural elements as potential mechanisms for patterns among Latinx youth, as shifts in ethnoracial identification are predominantly a Latinx phenomenon. The bulk of the findings suggest that both phenotype and immigration are important factors for ethnoracial self-identification among Latinx youth, as well as shifts in their ethnoracial identification in young adulthood. Given what we know about ethnoracial categorization and ascription, findings suggest that, overall, shifts in ethnoracial identification among Latinx youth are primarily about bringing their self-identification into alignment with how they think they tend to be (and most likely are) perceived by others, which we suggest represents a Sedimentation of the Color Line. We close by discussing the myriad implications of our findings for the U.S. racial order and the ongoing debate about how to "measure" the Latinx population.
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Wang Y, Fang J, Li B, Li C, Liu S, He J, Tao L, Li C, Yang Y, Li L, Xiao S. Clinical and genetic characterization of pediatric patients with Wilson's disease from Yunnan province where ethnic minorities gather. Front Genet 2023; 14:1142968. [PMID: 37020998 PMCID: PMC10067573 DOI: 10.3389/fgene.2023.1142968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/08/2023] [Indexed: 04/07/2023] Open
Abstract
Background: Wilson's disease (WD) is an autosomal recessive disease that is caused by mutations in the ATP7B (a copper-transporting P-type ATPase) gene. The disease has a low prevalence and is characterized by a copper metabolism disorder. However, various characteristics of the disease are determined by race and geographic region. We aimed to discover novel ATP7B mutations in pediatric patients with WD from Yunnan province, where there is a high proportion of ethnic minorities. We also performed a comprehensive analysis of ATP7B mutations in the different ethnic groups found in Southwest China. Methods: We recruited 45 patients who had been clinically diagnosed with WD, from 44 unrelated families. Routine clinical examinations and laboratory evaluations were performed and details of age, gender, ethnic group and symptoms at onset were collected. Direct sequencing of the ATP7B gene was performed in 39 of the 45 patients and their families. Results: In this study, participants came from seven different ethnic groups in China: Han, Bai, Dai, Zhuang, Yi, Hui and Jingpo. Three out of ten patients from ethnic minorities presented with elevated transaminases, when compared to the majority of the Han patients. Forty distinct mutations (28 missense, six splicing, three non-sense, two frameshift and one mutation of uncertain significance) were identified in the 39 patients with WD. Four of the mutations were novel and the most frequent mutation was c.2333G > T (p.R778L, allelic frequency: 15.38%). Using the phenotype-genotype correlation analysis, patients from ethnic minorities were shown to be more likely to have homozygous mutations (p = 0.035) than Han patients. The patients who carried the c.2310C > G mutation had lower serum ceruloplasmin levels (p = 0.012). In patients with heterozygous mutations, c.3809A > G was significantly associated with ethnic minorities (p = 0.042). The frequency of a protein-truncating variant (PTV) in Han patients was 34.38% (11/32), while we did not find PTV in patients from ethnic minorities. Conclusion: This study revealed genetic defects in 39 pediatric patients with WD from Yunnan province. Four novel mutations were identified and have enriched the WD database. We characterized the genotypes and phenotypes in different minorities, which will enhance the current knowledge on the population genetics of WD in China.
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Affiliation(s)
| | | | - Bin Li
- Kunming Children’s Hospital, Kunming, China
| | - Chongyang Li
- Department of Oncology, The Affiliated Hospital of Yunnan University, Kunming, China
| | - Shan Liu
- Yunnan Cancer Hospital, Kunming, China
| | - Juan He
- Kunming Children’s Hospital, Kunming, China
| | - Lvyan Tao
- Kunming Children’s Hospital, Kunming, China
| | - Cuifen Li
- Kunming Children’s Hospital, Kunming, China
| | - Ya Yang
- Kunming Children’s Hospital, Kunming, China
| | - Li Li
- Kunming Children’s Hospital, Kunming, China
- *Correspondence: Li Li, ; Shufang Xiao,
| | - Shufang Xiao
- Kunming Children’s Hospital, Kunming, China
- *Correspondence: Li Li, ; Shufang Xiao,
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