Blacks Research Articles

Sociodemographic Factors Correlate with Late Stage Pediatric Hodgkin Lymphoma and Rhabdomyosarcoma: A Report from the Children's Oncology Group Registries.

We examined association between late stage diagnosis and individual- and community-level characteristics among pediatric Hodgkin lymphoma (HL) and rhabdomyosarcoma (RMS) patients. We obtained Children's Oncology Group (COG) data from 1999-2021 including summary stage (local (L), regional (R), distant (D)), tumor subtype, demographics, and ZIP code at diagnosis. We linked ZIP codes to county-level redlining scores (C,D=greatest redlining), Child Opportunity Index (COI), and measures of segregation (racial dissimilarity indices (DI)). Logistic regressions calculated odds ratios for late stage diagnosis, and by race within tumor subtype. 5,933 HL and 2,800 RMS patients were included. Late stage diagnosis of HL was correlated with Black race (ORDistant(D) vs regional/local(R&L)=1.38 [1.13-1.68]), being uninsured (ORD vs R&L=1.38 [1.09-1.75]), and subtype (Nodular sclerosis vs Other HL: ORD vs R&L=1.64 [1.34-2.01], Untyped: ORD vs R&L=1.30 [1.04-1.63]). Late stage rhabdomyosarcoma was correlated with bilingual households (ORDistant/regional(D&R) vs local(L)=2.66 [1.03-6.91]) and tumor type (Alveolar vs Embryonal ORD vs R&L=6.16 [5.00-7.58]. Community-level factors associated with late stage HL were greater Black (OR80-100%=1.83; 95% CI=1.11-3.02) and Hispanic (OR60-79%=1.30; 95%CI=1.05-1.60) DI. Late stage diagnosis for RMS was associated with more redlined census tracts within counties (OR=1.54; 95% CI =1.02-2.35) and low/very low COI (OR=1.21; 95% CI=1.02-1.45). Novel markers of community deprivation, such as redlining and racial segregation, likely affect cancer outcomes for children with HL and RMS in this first disparities study using COG registries. The interplay of multilevel risk factors provides important consideration for efforts to improve early detection of pediatric cancer diagnosis.

An In-Depth Look at the Trip-Deprived People of the United States

Social equity is fundamental to achieving sustainability. However, the social dimension of sustainability has received less attention than the environmental and economic dimensions. In the United States, policies mandate equitable distribution of benefits from transportation investments among all people, including the underserved populations consisting of people with disabilities, poor people, minorities, and older adults. These populations were historically considered transportation-disadvantaged because of their inability to travel like others. However, until the release of the 2022 National Household Travel Survey (NHTS) data in November 2023, there were no national data to comprehensively examine the validity of the assumptions about people’s inability to travel. By including a special-topic question on equity for the first time that enquires about people taking fewer-than-planned trips in a 30-day period for certain reasons, the 2022 NHTS makes it possible to take a deeper look at the trip-deprived Americans. This research uses logit models and confirmatory factor analysis with a national sample of more than 11,000 NHTS respondents to examine the personal, household, and geographic area characteristics of the trip deprived. The models controlled for variations in travel need. The results show that people with disabilities, unemployed people, people with low income, Black people, and people without cars are at a higher risk of being trip-deprived. Similar evidence was not found for older adults. Geographic area characteristics are not as important as the personal and household characteristics, but they also provide important insights for transportation planning purposes.

Acne Keloidalis Nuchae: A Multicenter Retrospective Study of 142 Hispanic Patients

Introduction: Acne keloidalis nuchae (AKN) is a primary cicatricial alopecia with mixed infiltrate. It is more common in African or persons of African descent. Objectives: Our objective was to describe the epidemiology and clinical and trichoscopic presentations of AKN in a large series of Hispanic patients. Methods: This was a retrospective study from 10 different dermatological centers in Argentina, Colombia, Mexico, and Peru. Patients with a clinical diagnosis of AKN treated by 12 dermatologists experienced in trichology from 2018 to 2022 were included. The Umar classification system was used to determine severity. Results: We identified 142 patients with AKN: 98% were male (n=140) with a mean age of 32 years; 108 patients had a previous history of trauma to the nuchal area (76%, p<0.001); and 48 were positive for a history of acne (33.8%, p=0.021). Patients with >50 months of evolution were mainly classified in classes III and IV compared to patients with an evolution of <50 months (30%, n=9 vs. 14%, n=15; p=0.019; respectively). Conclusion: AKN should be considered in the differential diagnosis in the Hispanic population. Advanced stages of the disease are correlated with chronic evolution.

Surprise Billing Is Common in Total Joint Arthroplasty and Negatively Impacts Patient Satisfaction.

Patients undergoing total joint arthroplasty (TJA) may receive unexpected medical bills. Such "surprise" bills may cause financial hardship for patients, which prompted policymakers to pass the No Surprises Act. The purpose of this study was to determine the incidence of surprise bills for patients undergoing TJA and the effect of surprise billing on patient satisfaction. This was a retrospective study of patients who underwent a primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) at a large multi-state institution. Patients completed a questionnaire regarding the incidence of surprise bills after their surgery, details of those bills, and how the bills affected their surgical satisfaction. Independent predictors for receiving a surprise bill were assessed through a multivariate regression analysis. Twelve percent of participants received at least one surprise bill after their TJA. The most common surprise bill came from the surgical facility (48%), followed by anesthesia (36%). Multivariate logistic regression analysis identified older age and Black race to be independent predictors of surprise billing. Furthermore, surgery occurring after the No Surprises Act bill enforcement on January 1, 2022, was found to increase a patient's likelihood of receiving a surprise bill (P=.039, effect size=0.18). Patients who received a surprise bill reported being significantly less satisfied with their surgery (P=.002, effect size=0.45). Forty-nine percent of patients with a surprise bill felt their billing negatively affected their surgical satisfaction. Surprise billing continues to occur after TJA and can negatively affect patient satisfaction. Although surgeons may be unable to limit the amount of bills patients receive postoperatively, increased communication and education regarding the perioperative billing process may prove to be beneficial for both patient satisfaction and the physician-patient relationship. [Orthopedics. 20XX;4X(X):XXX-XXX.].

Rethink Recovery: A Qualitative Approach to Exploring Messaging for Medication-Assisted Recovery (MAR).

Similar to national trends, in Illinois, fatal opioid overdoses have risen. Black men (35+) outrank all other racial subgroups for the highest rate of fatal opioid overdoses in the state. To address this, Prevention First and the Illinois Department of Human Services developed a public health education campaign to support increasing enrollment in recovery services, with a focus on Black men (35+). Self-reported Black participants with opioid use disorder (OUD) made up the analytic sample. Study goals were to understand lived experiences of the campaign audience; investigate knowledge, attitudes, and beliefs regarding OUD and treatment; explore perceived barriers and facilitators to treatment; and evaluate messaging that showcased medication-assisted recovery (MAR) as a viable tool for treatment and recovery. Interviews were recorded and transcribed for thematic analysis. Participants shared long and cyclical journeys of use and recovery. Participants had low levels of knowledge of available treatment options and struggled to imagine themselves in recovery because of the fear of cravings and withdrawal. Messaging that was realistic about the cyclical nature of recovery, showed the varying options for MAR, and addressed cravings and withdrawals were well received. These findings illustrate the importance of understanding an audience and involving them in campaign development to create messaging that promotes behavior change and sustained health. Through the Decision Blocks strategic framework, we discovered information gaps, barriers to treatment, and practical solutions to increase access to treatment for Black men with OUD that has been limited due to inequities caused by structural racism.

Feasibility and Acceptability of a Prospective Syphilis Sexual Network Study for Sexual Minority Men.

In preparation for a prospective syphilis network study of sexual minority men, we conducted a mixed-methods formative study with the following objectives: a) assess acceptability of respondent driven sampling (RDS), b) assess acceptability of study procedures, c) social network seed selection, and d) pilot an ecological momentary assessment (EMA) study to assess social networking, sexual and substance use behavior. We conducted in-depth interviews with eight providers serving sexual minority men and five focus group discussions with 34 sexual minority men, prioritizing four target populations: young Black sexual minority men, 2) on PrEP, 3) living with HIV, 4) not engaged in care. The 4-week EMA pilot was conducted with 40 sexual minority men. EMA survey responses were analyzed to evaluate how different compensation levels influenced response rates. Brief exit surveys were used to assess EMA app acceptability. Primary themes identified through qualitative data collection: 1) importance of developing trust and maintaining confidentiality during proposed recruitment activities, 2) importance of compensating participants appropriately for study activities, and 3) cultural considerations for increasing visibility and participation of young Black sexual minority men. All EMA participants reported being "completely comfortable" reporting sexual behavior through the app. Most (78%) preferred the app to in-person interviews. Several participants identified technical issues with the app, including not receiving push notifications and spontaneous closure. This mixed-methods formative study allowed for adjustments to and tailoring of the planned network study, including recruitment protocols, compensation type and amount, and EMA survey wording and response items.

Fatal and Nonfatal Firearm Injury Rates by Race and Ethnicity in the United States, 2019 to 2020.

Racial disparities in firearm injury death in the United States are well established. Less is known about the magnitude of nonfatal and total firearm injury. To combine health care data with death certificate data to estimate total firearm injuries in various racial and ethnic groups. Retrospective, cross-sectional study. Fatal injury data were collected from the Centers for Disease Control and Prevention. Data on nonfatal injuries were collected from the Nationwide Emergency Department Sample (NEDS), a 20% stratified sample of U.S. emergency department visits, weighted to provide national estimates for the United States, 2019 to 2020. All firearm injuries and deaths in the United States. Race and ethnicity were classified into 5 mutually exclusive categories: Asian or Pacific Islander, Black, Hispanic, Native American, and White. International Classification of Diseases, 10th Revision codes were used to classify firearm injury intent. Incidence of fatal and nonfatal injury in the U.S. population and case-fatality ratios (CFRs). There were 252 376 total firearm injuries, including 84 908 deaths from firearm injures. Of all firearm injuries, 37.8% were unintentional, 37.3% were assault related, 21.0% were self-harm, and 1.3% were law enforcement associated. Self-harm had the highest CFRs (90.9% overall). Unintentional injuries accounted for just 1021 (1.2%) deaths but 94 433 (56.4%) of nonfatal injuries. Rates of self-harm were highest among White persons (11.0 per 100 000 population in 2020) followed by Native Americans (8.6 per 100 000). Rates of assault were highest among Black persons (70.1 per 100 000), as were unintentional injuries (56.1 per 100 000). Findings are limited by the accuracy of discharge coding in NEDS, particularly regarding injury intent and patient race and ethnicity. From 2019 to 2020, the total burden of firearm injuries amounts to an average of 1 injury every 4 minutes and 1 death every 12 minutes in the United States. Racial disparities in firearm injury death are mirrored in nonfatal injury. None.

An Empirical Analysis of Avoidable Medicare Payments and Medicare Payment Variations

This study investigates the determinants of average Medicare payments, focusing on the impact of secondary diagnoses, demographic factors, and regional disparities. Our model reveals that major complications and comorbidities (MCCs) significantly increase average Medicare payments compared to less severe complications (CCs), with coefficients of 7674.13 and 1542.67, respectively. Higher percentages of the elderly living in poverty correlate with increased payments, highlighting the influence of social determinants on healthcare costs. Demographic analysis shows that counties with higher populations of Black, Hispanic, Asian, or other races receive higher Medicare payments, indicating potential racial disparities in healthcare access and quality. Political affiliation also plays a role, with Democrat-voting counties incurring higher Medicare costs. Surprisingly, larger populations served correlate with decreased payments, possibly due to cost-containment programs like Medicare’s Competitive Bidding. State-level analysis reveals significant regional variations, with states like Oregon and Wyoming showing higher payments, while Mississippi and Georgia have the lowest. Our findings underscore the complexity of Medicare funding and the need for targeted policy interventions to address health disparities and ensure sustainable healthcare delivery.

Social restitution: tools and actions to rehumanise and transform injustice

Restitution has predominantly been described as a legal rather than a social action in international law, as well as in South Africa’s history of truth, reconciliation and redress policies after the end of apartheid. Introducing the concept of ‘social restitution’ this paper argues for a reimagined and wider understanding of restitution to address the need for social justice in the spaces between the law court and individual acts of charity, and between policies for redress and personal antipathy against these. Social restitution can be defined as intentional voluntary actions and attitudes developed through dialogue based on a sense of moral obligation aimed at addressing the damage done to individuals and communities by unjust actions and legacies of the past. Drawing on international debates about and understandings of the meaning of restitution, social restitution is shown to be both continuous with legal restitution and distinguished from it through its voluntary nature, its potential to be forward-looking rather than punitive, generative rather than accusatory, and offering everyday opportunities to bridge the gap between ‘knowing’ about injustice and ‘acting’ to repair it. Following this discussion, the latter part of the paper outlines the need for new categories of actors in contexts of injustice beyond those of victim, perpetrator and bystander (the Hilberg triangle of actors), introducing the ideas of beneficiaries and resisters; argues for the potential social restitution has as a mechanism for rehumanising all actors; and offers recommendations for how engaged action-oriented dialogues might contribute to achieving this aim, while noting the limits and dangers of dialogue. It draws on an empirical study on the meaning and actions of restitution conducted with black and white adult South Africans in making some of its arguments.

Impact of Prostate-Specific Antigen Screening Pattern on Prostate Cancer Mortality Among Non-Hispanic Black and Non-Hispanic White Men: A Large, Urban Health System Cohort Analysis.

Randomized studies assessing the effect of PSA screening on mortality in non-Hispanic Black (NHB) men are lacking. We aimed to assess the association between PSA screening and survival among NHB men in comparison to non-Hispanic White (NHW) men in a racially diverse real-world North American population. The study cohort included 6378 men who self-identified as NHB or NHW and were diagnosed with prostate cancer (PCa). Patients received PSA screening and subsequent PCa treatment and follow-up at our institution. Patients were sorted based on PSA testing intensity for the 5 years prior to diagnosis, as follows: never, some (<1 test/y), and annual testing (1 test/y). The primary outcome was risk of prostate cancer-specific mortality (PCSM). Competing risk cumulative incidence curves estimated PCSM rates. Competing risk regression analyses examined the impact of PSA testing on PCSM. An interaction term was incorporated to assess the impact of race on the outcome. Median (IQR) age and PSA at diagnosis were 67 (60-73) years and 5.8 (4.4-9.6) ng/mL, respectively, and 2929 (46%) men were NHB (Kruskal-Wallis P values < .001). Annual PSA testing was more frequent in NHW (5%) than in NHB (3%) men (χ2 P value < .001). On cumulative incidence analysis, in the never, some, and annual PSA testing groups, the 10-year PCSM was respectively 12.3%, 5.8%, and 4.6% in NHW and 18.5%, 7%, and 1.2% in NHB patients (Gray's test P values < .001). At CCR, PSA screening rate was associated with more favorable PCSM rates (HR: 0.47; 95% CI 0.33-0.68; P < .001). The interaction term for race did not show statistical significance (P = .2). PSA testing was associated with a reduced risk of PCSM in both NHB and NHW men diagnosed with PCa. Additionally, the positive impact of the screening rate seemed to be independent of race.

Genetic predictors of blood pressure traits are associated with preeclampsia

Preeclampsia, a pregnancy complication characterized by hypertension after 20 gestational weeks, is a major cause of maternal and neonatal morbidity and mortality. Mechanisms leading to preeclampsia are unclear; however, there is evidence of high heritability. We evaluated the association of polygenic scores (PGS) for blood pressure traits and preeclampsia to assess whether there is shared genetic architecture. Non-Hispanic Black and White reproductive age females with pregnancy indications and genotypes were obtained from Vanderbilt University’s BioVU, Electronic Medical Records and Genomics network, and Penn Medicine Biobank. Preeclampsia was defined by ICD codes. Summary statistics for diastolic blood pressure (DBP), systolic blood pressure (SBP), and pulse pressure (PP) PGS were acquired from Giri et al. Associations between preeclampsia and each PGS were evaluated separately by race and data source before subsequent meta-analysis. Ten-fold cross validation was used for prediction modeling. In 3504 Black and 5009 White included individuals, the rate of preeclampsia was 15.49%. In cross-ancestry meta-analysis, all PGSs were associated with preeclampsia (ORDBP = 1.10, 95% CI 1.02–1.17, p = 7.68 × 10−3; ORSBP = 1.16, 95% CI 1.09–1.23, p = 2.23 × 10−6; ORPP = 1.14, 95% CI 1.07–1.27, p = 9.86 × 10−5). Addition of PGSs to clinical prediction models did not improve predictive performance. Genetic factors contributing to blood pressure regulation in the general population also predispose to preeclampsia.

2D:4D digit ratio as a potential marker for prostate cancer risk

BackgroundThe second-to-fourth digit ratio (2D:4D) is thought to reflect prenatal exposure to sex steroids. We investigated the relationship between 2D:4D and odds of prostate cancer. MethodData were collected in PROtEuS, a population-based case-control study conducted in Montréal, Canada (2005–2012), including 1931 incident prostate cancer cases aged < 76 years and 1994 population controls. In-person interviews elicited information on potential risk factors. Digit lengths were measured by interviewers applying a standard protocol. Odds ratios (OR) and 95 % confidence intervals (CI) were estimated using unconditional logistic regression adjusting for potential confounders. ResultsThe OR of prostate cancer for a standard deviation increase in 2D:4D was 0.91 (95 % CI: 0.85–0.98). For less and more aggressive cancers, ORs were 0.93 (95 % CI: 0.87–1.00) and 0.85 (95 % CI: 0.77–0.93), respectively. There was an interaction with ancestry (p=0.04), whereas the OR among men of African descent was 1.23 (95 % CI: 0.96–1.57, based on 128 cases). ConclusionFindings suggest an inverse association between 2D:4D and odds of overall prostate cancer, more pronounced for aggressive cancers. This supports the notion that high levels of testosterone in utero, estimated by a low 2D:4D ratio, are associated with a higher risk of prostate cancer. Contrastingly, a high digit ratio was associated with greater cancer odds among participants of African descent. Upon replication, 2D:4D could prove to be an easily measured marker of prostate cancer risk.

Race, Gender, Class, and Perceived Everyday Discrimination

Everyday discrimination has been studied for the last three decades, but there is a lack of quantitative research on the effects of race, gender, and class, and especially their intersectional effects, on perceived everyday discrimination for the U.S. population as a whole, despite a few studies at the local or group levels. Using new data from the 2018 General Social Survey and multiple regression, this study investigates how race, gender, and class independently and intersectionally shape everyday discrimination experiences in the United States. The results indicate that, holding other variables constant, Blacks self-claimed a significantly higher level of everyday discrimination than Whites, but other races did not differ significantly from Whites in such an experience; class was inversely associated with the level of everyday discrimination, and gender did not have an independent effect. However, while Black men self-reported a higher level of everyday discrimination than White men, Black women self-reported a lower level of everyday discrimination than White women; higher-class Blacks tended to report a significantly higher level of everyday discrimination experiences than lower-class Blacks. The findings have significant implications for research and practice in the area of everyday discrimination.

Revolutionary Art and the Creation of the Future: The Afrofuturist Texts of José Antonio Aponte and Martin R. Delany

Afrofuturism (an artistic perspective in which Black voices tell alternative narratives of culture, technology, and the future) and the Dark Fantastic (interrupting negative depictions of Black people through emancipatory interpretations of art) are two interrelated concepts used by Black artists in the Atlantic World to counter negative images and emphasize a story from a Black perspective. Likewise, these concepts have been used to recreate and re-narrate history with an eye towards subverting white supremacist historical narratives. By using Afrofuturism and the Dark Fantastic as lenses through which texts by authors from the African Diaspora in the Atlantic World are examined, an alternative narrative of Black histories and futures concerned with revolution, liberation, and justice can be seen. The two texts that are the subject of this research include José Antonio Aponte’s descriptions of his book of paintings under interrogation in 1812–1813, and Martin Delany’s novel Blake; or the Huts of America (1859–1862), providing images of enslavement that run counter to a white supremacist telling of history. They both imagine alternative pasts and futures for Africa and the Afro-Diaspora involving revolution and magic. These works, though produced at different times and locations in the nineteenth century, offer new ways in which to discuss liberation and freedom in the context of the artistic production of the Atlantic World.

“If you do not have Black futures in mind…then what’s guiding the steps”: anti-racist recommendations for traumatic brain injury rehabilitations’ investments in hopeful Black futures

Purpose The need for specialized rehabilitation considerations to address racial health disparities and optimize functional outcomes such as participation in daily life for Black people with traumatic brain injury (TBI) has been acknowledged. This study uses anti-racism as an entry point for addressing institutional racism by examining what the experiences of Black survivors of TBI, rehabilitation providers, and family caregivers tell us about imagined possibilities for rehabilitation to promote Black futures. Material and methods A constructivist-informed narrative inquiry using critical race theory and in-depth narrative interviewing was applied across ten women and four men. Reflexive thematic analysis within and across groups of participants led to conceptualizing two main themes and five sub-themes. Results Conceptualized themes captured requirements for TBI rehabilitations’ investments in Black futures: (1) the need for critical information and specialized educational supports and particular requirements for supporting participation in meaningful life situations, and (2) responsibilities of delivering rehabilitation care for Black service users. Conclusion TBI rehabilitation must be tailored to the realities of living while being Black, integrate personal values, beliefs, interests, and equitable supports to maximize optimal functioning and participation if the goal of rehabilitation is community integration for all persons living with the impacts of TBI.

COVID-19 Related Knowledge, Attitudes, and Behaviors Among Black Men with Chronic Health Conditions: A Latent Profile Analysis

ABSTRACT Research indicates that Black communities experienced disproportionately higher numbers of confirmed cases and fatalities throughout the COVID-19 pandemic with Black men experiencing marked reductions in life expectancy. Inequities were further magnified by known COVID-19 such as hypertension, diabetes, obesity, and higher prevalence of cardiovascular disease. The current project aimed to assess the knowledge, attitudes, and behaviors related to COVID-19 among Black men with chronic conditions. Specifically, we sought to determine whether COVID-19-related perspectives and behaviors impacted cross-sectional health outcomes. A national sample of Black men (N = 312) who self-reported at least one chronic disease responded to survey questions about their knowledge, attitude, and preventative behaviors (KAP) related to COVID-19. Analyses suggest that unique latent profiles based on COVID-19-related KAP differentially impacted participants’ self-reported health and well-being for those low on KAP items. The discussion includes considerations on viral hygiene interventions, misinformation, stigma, and perceptions of discrimination.

Internalized Oppression: Exploring the Nuanced Experiences of Gender and Sexuality in Historically Black Colleges and Universities

In the American South at the turn of the twentieth century, quality education was scarce and legislative laws were put in place to ensure that African American individuals remained far away from Predominantly White Institutions (PWIs). As a result, Historically Black Colleges and Universities (HBCUs) became a catalyst for change in this “separate but equal” society. This article will explore the significance of HBCUs in elevating Black Americans throughout the twentieth century, while also assessing the conservative nature of the institutions and their inflexibility towards the various nuances of African American communities. While it is not particular to HBCUs, a tolerance of toxic masculinity and severe conservatism has resulted in starkly different Black experiences for cis-gendered heterosexual men, in contrast to cisgendered women and other members of the 2SLGBTQI+ community. By investigating various experiences within HBCUs, this article will explain the unifying and uplifting benefits for Black individuals in these institutions, as well as its many divisive components. My research will strive to analyze and properly convey the various nuanced experiences throughout HBCUs and assess the variety of factors that have led to these underrepresented interactions. This article will provide an understanding of how HBCUs have and continue to reflect American society but also demonstrate their role in various Black communities and their representation of non-dominant Black groups from the late nineteenth century to the present.

Black Bottom and Paradise Valley: The Intersection of Race, Class, and Memory in Twentieth Century Detroit

The Black Bottom community of Detroit, Michigan became an ethnic hub for African American’s due to the Great Migration of the early twentieth century. This was a vibrant community composed of a heterogeneous population from various backgrounds and social classes, though faced with ongoing issues regarding sanitary and housing conditions due to entrenched racial segregation within the city. By 1936, the neighbourhood was split by middle class entrepreneurs who wished to raise the cultural prominence of the community’s entertainment district. This research analyzes the intra-class relations that caused the fracturing of two communities: Black Bottom and Paradise Valley. Moreover, this work refutes historical debates, which wish to concretely bind these entities as separate. Through an overview of Detroit’s history, the memory of the community is assessed effectively creating an intersectional analysis encompassing African American intra-class relations, culture, the fluidity of space, and collective memory.

Content Analysis of Textbooks via Natural Language Processing

Purpose: Advanced methods from the field of data science have the potential to shed fresh light on basic concerns in the field of educational research. Natural language processing tools, such as lexicons, word embeddings, and topic models, are used in 15 United States history textbooks that were extensively used in Texas between the years 2015 and 2017. Material and Methods: This study aims to analyze these textbooks for their portrayal of historically oppressed populations. Latinx individuals are rarely mentioned, but renowned white men are almost always mentioned. People of African descent are characterized as behaving in ways that imply helplessness and lack of control, according to lexical methods. Women are most often addressed in the contexts of the home and the workplace, according to the word embeddings. Issues of a political rather than a social nature are highlighted by subject modeling. Findings: We also found that textbooks with a smaller representation of women and people of African heritage are more often purchased by conservative nations. Implications to Theory, Practice and Policy: Our computational toolkit has a rich history of textbook analysis and has recently been distributed as part of our efforts to support new fields of study.

Prevalence and predictors of long-term progression of chronic kidney disease in people with HIV in Ghana from 2003–2018

BackgroundHIV is associated with an increased risk of progression to chronic kidney disease (CKD), and this risk is higher in people of West African descent than many other ethnicities. Our study assessed the rates of eGFR change and predictors of rapid eGFR progression in patients receiving antiretroviral therapy (ART), including tenofovir disoproxil fumarate (TDF), in central Ghana between 2003 and 2018.MethodsThis single-centre retrospective study enrolled people with HIV (PWH) initiating ART in Ghana between 2003–2018. Demographics, hepatitis B (HBsAg) status, ART regimens and estimated glomerular filtration rate (eGFR) measurements were recorded, and analyses including multi-level model linear regression were performed to determine predictors of greater levels of eGFR decline and risk of rapid eGFR decline.ResultsSix hundred and fifty-nine adult participants were included in the study with a median follow-up time of 6 years (IQR 3.6–8.9). 149 participants (22.6%) also had confirmed HBV co-infection. eGFR mean values were lowest at the point of diagnosis and highest on the second measurement taken; mean eGFR slowly decreased over subsequent measures thereafter. TDF use was associated with the highest mean rate of eGFR decline of all nucleoside or nucleotide reverse transcriptase inhibitors (NRTIs) with a statistically significant greater annual decline of -1.08 mL/min/1.73m2/year (CI: -1.92, -0.24) compared with zidovudine. Nevirapine (-0.78mL /min/173m2/year; CI: -1.39, -0.17) and protease inhibitors (-1.55mL/mil/173m2/year; CI: -2.68, -0.41) were associated with greater eGFR declines compared with efavirenz. Negative HBsAg status was associated with greater eGFR decline compared with positive HBsAg status (-1.25mL/mil/173m2/year; CI 0.29. -2.20).ConclusionsIncreased rates of eGFR decline amongst PWH in Ghana were associated with TDF, nevirapine, and protease inhibitor use as well as negative HBsAg status. Additional research using mortality outcome data is needed to closely assess long-term predictors of eGFR decline in African populations.