Asian Ethnic Backgrounds Research Articles

Developmental differences in bystander behavior toward intergroup and intragroup exclusion.

This study examined prosocial bystander behavior in an online ball-throwing game (Cyberball), toward the exclusion of immigrants and nonimmigrant peers within intergroup and intragroup contexts. Participants were British children (8- to 10-year-olds) and adolescents (13- to 15-year-olds, N = 292; female N = 144). They were an ethnically diverse low-to-middle SES sample from a South Asian, White, Black, or mixed ethnic background. Participants played the game and witnessed a victim being excluded by peers. The victim's and excluders' group membership and status were highlighted in a prototypical (i.e., majority status peers excluding a minority status victim) or nonprototypical (i.e., minority status peers excluding a majority status victim) intergroup context. In intragroup contexts exclusion involved peers from the same group (i.e., majority status peers excluding a majority status victim or minority status peers excluding a minority status victim). Prosocial bystander behavior and "verbal" reactions to the exclusion were measured. Adolescents showed more prosocial bystander behavior than children when it was an intergroup context but not when it was an intragroup context. Only adolescents showed more prosocial bystander behavior when the intergroup context was prototypical compared to nonprototypical. Verbal reactions were related to prosocial bystander behavior and, with age, individuals increasingly verbally challenged the exclusion and the motivation behind it. The findings support the Social Reasoning Developmental (SRD) approach to social exclusion by showing that from late childhood into midadolescence bystander behavior is increasingly related to group membership and group status of the excluders and victim. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Dysphonia and dysphagia consequences of paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS)

ImportancePaediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 (PIMS-TS) is a novel disease first identified in 2020. Recent cohort studies have described the complex presentation and symptomatology. This paper provides detailed description of the dysphagia and dysphonia symptoms, management, and outcome. ObjectiveTo describe dysphagia and dysphonia in PIMS-TS. DesignRetrospective cohort study. SettingSingle tertiary and quaternary children's hospital. ParticipantsAll 50 children treated for paediatric multisystem inflammatory disease between April and June 2020 were included in this study. Main Outcome(s) and Measure(s)Dysphonia: GRBAS Perceptual Severity Scores, Vocal Handicap Index scores and the Vocal Tract Discomfort Scale. Dysphagia: Functional Oral Intake Scale. ResultsFifty children met the diagnostic criteria for PIMS-TS. 33 (66%) were male. Median age was 10 years (range: 1–17). 36 (72%) were of Black, Asian or minority ethnic background. Nine (18%) required specialist assessment and management of dysphagia and/or dysphonia. Five (55%) were male with a median age of 9 years 7 months (range: 1–15 years). Symptoms typically resolved within three months. Two children presented with persisting dysphonia three months post-presentation. Neurological, inflammatory, and iatrogenic causes of dysphagia and dysphonia were identified. Conclusions and RelevanceDysphonia and dysphagia are present in children with PIMS-TS. Further data is required to understand pathophysiology, estimate incidence, and determine prognostic factors. This preliminary data highlights the need for dysphagia and dysphonia screening and timely referral for specialist, multidisciplinary assessment and treatment to ensure short-term aspiration risk is managed and long-term, functional outcomes are optimised.

My journey into mental healthcare as an international medical graduate (IMG).

Over half of doctors who joined the General Medical Council's (GMC) medical register in the UK in 2020 were from Black, Asian and minority ethnic (BAME) background, and I am one of them. Having experienced clinical settings across three different countries, I think my journey deserves to be shared with others as a unique experience. My story will help medical students and early career doctors have a general idea of different clinical settings and hopefully will encourage them to chase their dreams. I hope to inspire people.

Uptake of COVID-19 vaccination in a medium secure psychiatric hospital population.

Patients in medium secure hospitals may be at particularly increased risk of coronavirus disease 2019 (COVID-19) infection and complications. We undertook a service evaluation involving all current in-patients within a single, English medium secure hospital to describe the uptake of the COVID-19 vaccine among this population. Data regarding capacity to consent to the vaccine, acceptance/refusal of this (and reasons for refusal) and demographics was retrospectively collected from the patients' clinical records and analysed. In total, 85 patients (92.4% of eligible patients) had capacity to decide if they wanted the COVID-19 vaccine. Of these 68 (80.0%) consented and 17 (20.0%) declined to consent. A similar proportion of patients aged under and over 40 years old consented to have the vaccine. Those from a Black Asian minority ethnic background were more likely to decline the vaccine than White British patients. The reasons for capacitous refusal appeared similar to those seen in the general population.

Fit-testing of respiratory protective equipment in the UK during the initial response to the COVID-19 pandemic

BackgroundPublic Health England guidance stipulates the use of filtering facepiece (FFP3) masks for healthcare workers engaged in aerosol-generating procedures. Mask fit-testing of respiratory protective equipment is essential to protect healthcare workers from aerosolized particles.AimTo analyse the outcome of mask fit-testing across National Health Service (NHS) hospitals in the UK during the first wave of the coronavirus disease 2019 (COVID-19) pandemic.MethodsUsing the Freedom of Information Act, 137 NHS hospitals were approached on May 26th, 2020 by an independent researcher to provide data on the outcome of fit-testing at each site.FindingsNinety-six hospitals responded to the request between May 26th, 2020 to October 29th, 2020. There was a total of 86 mask types used across 56 hospitals, 13 of which were used in at least 10% of these hospitals; the most frequently used was the FFP3M1863, used by 92.86% of hospitals. Overall fit-testing pass rates were provided by 32 hospitals with mean pass rate of 80.74%. The most successful masks, in terms of fit-test failure rates, were the Alpha Solway 3030V and the Alpha Solway S–3V (both reporting mean fit-test failures of 2%). Male- and female-specific pass and failure rates were provided by seven hospitals. Across the seven hospitals, 20.1% of men tested failed the fit-test for all masks used, whereas 19.9% of women tested failed the fit-test for all masks used. Failure rates were significantly higher in staff from Black, Asian, and Minority Ethnic (BAME) backgrounds 644/2507 (25.69%) across four hospitals.ConclusionTwenty percent of healthcare workers tested during the first response to the pandemic failed fit-testing for masks. A small sample revealed that this was most prominent in staff from BAME backgrounds.

Learning from the experiences of Black, Asian and Minority Ethnic (BAME) university students who withdraw from their undergraduate degree

Students from a Black, Asian and Minority Ethnic (BAME) background are more likely to withdraw from their undergraduate degree in the United Kingdom (UK). It is therefore important to explore withdrawal experiences and perspectives that relate to this population of students to increase both student retention and success. Thirteen UK-domiciled, full-time undergraduate, first-degree entrants from a BAME background, who had withdrawn from a post-1992 university in the West Midlands, took part in a semi-structured interview. The present study explored BAME student experiences of withdrawal which covered personal, academic and social concerns. Using a thematic analysis approach, five themes were developed: (a) academic issues, (b) does anybody even care? (c) balancing part-time employment alongside HE, (d) family perception and pressure and (e) the importance of social integration. Participants often discussed withdrawal as a holistic experience whereby although certain aspects were more prominently spoken about, generally withdrawal was a materialisation of more than one problematic area. There is a need for institutions to further understand the challenges faced by BAME students in order to provide more localised support and intervention to improve BAME retention, success and experiences within higher education (HE).

A Systematic Review and Meta-Analysis of Gestational Diabetes and Mental Health Among BAME Populations

Backgrounds: Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with an increased risk of mental health (MH) disorders. These include both antenatal and postnatal depression (PND), anxiety, psychological distress and post-traumatic-stress-disorder (PTSD). Both GDM and MH disorders have been shown to disproportionately affect individuals from Black, Asian and Minority Ethnic (BAME) backgrounds. Methods: A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863). Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis and sensitivity analysis. These were used to determine odds ratio (OR) and 95% confidence intervals (CI) to establish prevalence. Findings: Sixty studies were finalised from the 20,040 data pool. Forty-six studies were included systematically with 14 used to meta-analyse GDM and MH outcomes. A second meta-analysis was conducted using 7 studies to determine GDM risk among BAME women with pre-existing MH disorders. The results indicate an increased risk with pooled adjusted OR for both reflected at 1.23, 95% CI of 1.00-1.50 and 1.29, 95% CI of 1.11-1.50 respectively. Interpretation: The available studies suggest a MH sequalae with GDM as well as a sequalae of GDM with MH among BAME populations. These findings warrant further exploration to better manage these patients clinically. Funding Statement: Not applicable Declaration of Interests: PP has received research grant from Novo Nordisk, and other, educational from Queen Mary University of London, other from John Wiley & Sons, other from Otsuka, outside the submitted work. SR reports other from Janssen, 691 Lundbeck and Otsuka outside the submitted work. All other authors report no conflict of interest.

A Smartphone App Designed to Empower Patients to Contribute Toward Safer Surgical Care: Qualitative Evaluation of Diverse Public and Patient Perceptions Using Focus Groups.

BackgroundMySurgery is a smartphone app designed to empower patients and their caregivers to contribute toward safer surgical care by following practical advice to help reduce susceptibility to errors and complications.ObjectiveThe aim of this study is to evaluate service users’ perceptions of MySurgery, including its perceived acceptability, the potential barriers and facilitators to accessing and using its content, and ideas about how to facilitate its effective implementation. The secondary aim is to analyze how the intended use of the app might differ for diverse patients, including seldom-heard groups.MethodsWe implemented a diversity approach to recruit participants from a range of backgrounds with previous experience of surgery. We aimed to achieve representation from seldom-heard groups, including those from a Black, Asian, and minority ethnic (BAME) background; those with a disability; and those from the lesbian, gay, bisexual, transgender, queer (LGBT+) community. A total of 3 focus groups were conducted across a 2-month period, during which a semistructured protocol was followed to elicit a rich discussion around the app. The focus groups were audio recorded, and thematic analysis was carried out.ResultsIn total, 22 individuals participated in the focus groups. A total of 50% (n=11) of the participants were from a BAME background, 59% (n=13) had a disability, and 36% (n=8) were from the LGBT+ community. There was a strong degree of support for the MySurgery app. The majority of participants agreed that it was acceptable and appropriate in terms of content and usability, and that it would help to educate patients about how to become involved in improving safety. The checklist-like format was popular. There was rich discussion around the accessibility and inclusivity of MySurgery. Specific user groups were identified who might face barriers in accessing the app or acting on its advice, such as those with visual impairments or learning difficulties and those who preferred to take a more passive role (eg, some individuals because of their cultural background or personality type). The app could be improved by signposting further specialty-specific information and incorporating a calendar and notes section. With regard to implementation, it was agreed that use of the app should be signposted before the preoperative appointment and that training and education should be provided for clinicians to increase awareness and buy-in. Communication about the app should clarify its scientific basis in plain English and should stress that its use is optional.ConclusionsMySurgery was endorsed as a powerful tool for enhancing patient empowerment and facilitating the direct involvement of patients and their caregivers in maintaining patient safety. The diversity approach allowed for a better understanding of the needs of different population groups and highlighted opportunities for increasing accessibility and involvement in the app.

Identifying targets for interventions to support public adherence to government instructions to reduce transmission of SARS-CoV-2

BackgroundSARS-CoV-2 lacks sentience and can only be spread through human behaviour. Government instructions to the general public include: (a) limiting time spent outside the home, (b) staying more than 1 m away from people outside the household at all times, and (c) maintaining hand hygiene. Current evidence suggests high rates of adherence to such instructions, but interventions to sustain adherence to government instructions in the long term can only be developed if we know why people do or do not adhere to them. The aims were to assess levels of public adherence to government instructions to reduce transmission of SARS-CoV-2, but more importantly to gauge why people were or were not adhering to instructions.MethodsCross-sectional survey of 2252 adults who were representative of the UK population. Data were analysed descriptively, and using one-sample t-tests, within-participants ANOVA and multiple linear regression.ResultsThe sample reported mostly adhering to UK government instructions to reduce SARS-CoV-2 transmission, with 5% or fewer people reporting active resistance to instructions. People generally reported high levels of capability, opportunity and motivation to follow the instructions, but perceived relatively few physical and social opportunities. Multiple linear regression analyses showed that better adherence was associated with older age, being a woman, having a white ethnic background, and with perceiving greater levels of capabilities, opportunities and motivations.ConclusionsInterventions targeted at people with black, Asian and minority ethnic backgrounds, men and younger people that focus on increasing capabilities, providing greater opportunities and boosting motivations are needed to support continued adherence to government instructions to reduce SARS-CoV-2 transmission. Further research is required to track changes in people’s capabilities, opportunities, motivations and behaviours in response to the ongoing emergency, any changes in government instructions, and to adapt the present procedures to other emergency situations.

Ethnic inequalities in older adults bowel cancer awareness: findings from a community survey conducted in an ethnically diverse region in England

BackgroundTo date, research exploring the public’s awareness of bowel cancer has taken place with predominantly white populations. To enhance our understanding of how bowel cancer awareness varies between ethnic groups, and inform the development of targeted interventions, we conducted a questionnaire study across three ethnically diverse regions in Greater London, England.MethodsData were collected using an adapted version of the bowel cancer awareness measure. Eligible adults were individuals, aged 60+ years, who were eligible for screening. Participants were recruited and surveyed, verbally, by staff working at 40 community pharmacies in Northwest London, the Harrow Somali association, and St. Mark’s Bowel Cancer Screening Centre. Associations between risk factor, symptom and screening awareness scores and ethnicity were assessed using multivariate regression.Results1013 adults, aged 60+ years, completed the questionnaire; half were of a Black, Asian or Minority ethnic group background (n = 507; 50.0%). Participants recognised a mean average of 4.27 of 9 symptoms and 3.99 of 10 risk factors. Symptom awareness was significantly lower among all ethnic minority groups (all p’s < 0.05), while risk factor awareness was lower for Afro-Caribbean and Somali adults, specifically (both p’s < 0.05). One in three adults (n = 722; 29.7%) did not know there is a Bowel Cancer Screening Programme. Bowel screening awareness was particularly low among Afro-Caribbean and Somali adults (both p’s < 0.05).ConclusionAwareness of bowel cancer symptoms, risk factors and screening varies by ethnicity. Interventions should be targeted towards specific groups for whom awareness of screening and risk factors is low.

The UK physician workforce: one-third at increased risk of death from COVID-19

21% of NHS staff are from Black, Asian and minority ethnic (BAME) backgrounds yet account for a disproportionately high number of medical-staff deaths from COVID-19. Using data from the published OpenSAFELY Collaborative, we analysed consultant physicians to determine those at increased risk of COVID-19 related death. Data from 13,500 consultant physicians collected by the Royal College of Physicians were analysed to determine those at an increased risk of death from COVID-19, assuming no comorbidities. The data reveal a picture in which a third of consultant physicians have a hazard ratio (HR) >1 for dying from COVID-19; one in five have HR >2; one in 11, HR >3; and one in 40, HR >4. Of concern are the risks to male physicians aged ≥60 with HR >3.8. Sub-specialties including cardiology, endocrine and diabetes, gastroenterology, haematology, neurology and rheumatology have a greater risk profile due to high proportion of men, physicians of older age, and proportion of BAME individuals. A third of consultant physicians have an increased risk of a COVID-19-related death, and one in five have a higher relative risk (HR >2). The risk is mainly driven by age, gender, and ethnicity, the risk is highest in male consultant physicians over 60, especially from BAME backgrounds.

Examining How Socialization Affects People Who Are Either Immigrants or First-Generation U.S. Citizens

This paper focuses on the relationship between theupbringing of first-generation Americans andimmigrants, and how their cultural ties influencedtheir political philosophy or ideology. I willexplore different factors such as how an individual'sideology contrasts with their parents. Thestudy mostly focused on students from the Universityof California, Merced (UC Merced), andpeople who are physically and financially independent.Factors such as age, gender, politicalparty affiliation, political philosophy, and countryof origin or country of parents’ origin wereconsidered in this study. While there is an emphasison students of Latino or Hispanic origin,other backgrounds like Asian ethnic groups were alsoconsidered. Students of Asian ethnicbackgrounds were relevant in this study as they similarlywent through periods of assimilation toWestern culture. This paper also compares my findingsto the conclusions of Uhlaner &amp; Garcia’s(2016) essay on Latino partisan preference, Sapiro’s(2004) study on how socialization&nbsp;affectspolitical identity, and Kinefuchi’s (2010) researchon how assimilation affects political and socialattachments. This paper looks at how parental influence,or the lack thereof, leads to thedevelopment of their children’s political views whileminding sociocultural and socioeconomicfactors. This paper will consider how knowledge on socialization and political philosophy can influence current events like the&nbsp; political campaigns during the 2020 United States presidential election.

COVID Intensive Care Unit Through the Eyes of Ophthalmologists.

Description The disproportionate impact of COVID on the mortality and morbidity of people of black, Asian and minority ethnic (BAME) backgrounds has been recognised and is under investigation. Here we present a different impact: that on the psyche. As three doctors of BAME heritage, we shared an experience of being redeployed from ophthalmology to the COVID Intensive Care Unit. We share our reflections on the experience and lessons learned.

Women, wellbeing and the city: A model of participatory health research exploring physical activity in Black, Asian and minority ethnic communities

Objective: The aim of this project was to document a partnership working process from a cross-sectoral and cross-cultural participatory health research study focused on promoting physical activity among women from Black, Asian and minority ethnic (BAME) backgrounds. Design: A participatory health research paradigm was used to support this pilot feasibility study into partnership working for health promotion. Action research and community development principles underpinned the design, delivery and interpretation of findings from a community-based survey, data from four focus groups and bespoke interventions. Setting: Community groups from education, leisure, health and religious community sectors, and charity sectors, in the City of Liverpool, met in different venues representing those sectors. Method: Reflection on the process of community engagement in a research study guided by socio-ecological model, community development and action research principles. Results: Seven emerging collaborative processes based on effective partnership working, capacity-building practice and sustaining health and wellbeing evolved from a partnership between a Community Researchers Advisory Group and a Partners Advisory Group. BAME ‘community connectors’ were key to obtaining feedback from 213 women from 16 ethnic groups, which influenced the development of bespoke interventions and local sport and physical activity long-term policy, as one means of reducing social inequalities for women from BAME backgrounds. Conclusion: This feasibility study demonstrates the effectiveness and limitations of partnership working as a public health tool. The local Sport and Physical Activity Alliance and council department worked together to promote the sustainability of BAME-focused programmes as part of their governance and policy frameworks.

Treatment of nevus of Ota and Ito and epidermal nevus syndrome

Nevus of Ota, nevus of Ito and nevus of Hori are special melanocytic nevi that have aslate-brown or blue/grey coloring. They are pigmented disorders characterized by its heterotopic melanocytic dermal location and by blue/brown unilateral and sometimes bilateral facial patch in case of nevus of Ota, and in the supraclavicular, scapular, and deltoid region in case of nevus of Ito. It is more common in patients with Asian and dark-skinned ethnic backgrounds. Histologically, elongated, dendritic melanocytes are seen scattered mainly throughout the upper third of reticular dermis. An acquired variant is called Hori's nevus with more bilateral facial distribution, similar to melasma. Dermal melanocytosis can also occur elsewhere on the body, including inside the mouth. Despite its benign nature, patients frequently seek therapy because of its facial involvement. QS lasers are used effectively to treat these lesions. The number of treatment sessions correlates with clinical improvement. Post laser hypo- and hyperpigmentation are common side effects mainly affecting patients with darker skin.

Retrospective cohort study of admission timing and mortality following COVID-19 infection in England

ObjectivesWe investigated whether the timing of hospital admission is associated with the risk of mortality for patients with COVID-19 in England, and the factors associated with a longer interval between...

Mémoires et records: réflexions sur &lt;i&gt;The Vaccine Archive&lt;/i&gt;

Vicki Sung-yeon Kwon, an art historian and curator, and Lathika Sritharan, a public health researcher, discuss their collaborative project Memories and Records: The Vaccine Archive, an archive display of vaccine-related memories and immunization records of people from various parts of the world. They share challenges and accomplishments of collaborating with multidisciplinary participants and mounting an art exhibition at the UNAIDS building. As Canadians of Asian ethnic and cultural background, Kwon and Sritharan contemplate how vaccines are differently remembered in the Global North and the Global South.

Racism Matters 2: Disparities in COVID-19 Outcomes

This article, the second in the series ‘Racism matters’, looks at the impact of COVID-19 on maternity care in the UK and more specifically how this affects women from a Black, Asian and Minority Ethnic (BAME) background, with a focus on Black mothers. What are the challenges these women face in maternity daily? What can midwives learn from the findings of The Mothers and Babies Reducing Risk through Audit and Confidential Enquiries (MBRRACE) report?

Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study

BackgroundData for front-line health-care workers and risk of COVID-19 are limited. We sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk.MethodsWe did a prospective, observational cohort study in the UK and the USA of the general community, including front-line health-care workers, using self-reported data from the COVID Symptom Study smartphone application (app) from March 24 (UK) and March 29 (USA) to April 23, 2020. Participants were voluntary users of the app and at first use provided information on demographic factors (including age, sex, race or ethnic background, height and weight, and occupation) and medical history, and subsequently reported any COVID-19 symptoms. We used Cox proportional hazards modelling to estimate multivariate-adjusted hazard ratios (HRs) of our primary outcome, which was a positive COVID-19 test. The COVID Symptom Study app is registered with ClinicalTrials.gov, NCT04331509.FindingsAmong 2 035 395 community individuals and 99 795 front-line health-care workers, we recorded 5545 incident reports of a positive COVID-19 test over 34 435 272 person-days. Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93–12·33). To account for differences in testing frequency between front-line health-care workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test (adjusted HR 3·40, 95% CI 3·37–3·43). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors.InterpretationIn the UK and the USA, risk of reporting a positive test for COVID-19 was increased among front-line health-care workers. Health-care systems should ensure adequate availability of PPE and develop additional strategies to protect health-care workers from COVID-19, particularly those from Black, Asian, and minority ethnic backgrounds. Additional follow-up of these observational findings is needed.FundingZoe Global, Wellcome Trust, Engineering and Physical Sciences Research Council, National Institutes of Health Research, UK Research and Innovation, Alzheimer's Society, National Institutes of Health, National Institute for Occupational Safety and Health, and Massachusetts Consortium on Pathogen Readiness.

UK allergy and immunology in a post‐COVID‐19 era

UK allergy and immunology in a post‐COVID‐19 era