Blacks Research Articles

Effects of Social Determinants of Health on Acute Stroke Care Among Patients With Acute Ischemic Stroke: A Retrospective Cohort Study.

Social determinants of health (SDOH) are important contributors to poor stroke-related outcomes. While some have suggested that this association is driven by the increased incidence of stroke observed with poor SDOH, others have raised concerns regarding disparities in acute stroke care. This study aimed to determine the association between SDOH and the administration of thrombolytic therapy and mechanical thrombectomy among patients with acute ischemic stroke. A retrospective cohort analysis was conducted using Texas Emergency Department Public Use Data (2016-2019), including adult patients diagnosed with acute ischemic stroke. The risk ratios (RRs) of administering thrombolysis and thrombectomy based on variables representing SDOH and a collective measure (Social Vulnerability Index [SVI]) were computed using mixed-effects Poisson regression models accounting for the nested nature of patients in hospitals and neighborhoods. The Charlson comorbidity score was considered as a covariate. Of the 139,852 patients with ischemic stroke (female, 51.7%; White, 67.2%; Black, 16.6%; Hispanic, 25.1%), 16,831 (12.3%) received thrombolytic therapy and 5,951 (4.3%) received mechanical thrombectomy. Age older than 65 years (RR 0.578 [0.537-0.621]) vs 18-45 years, Black (RR 0.801 [0.761-0.844]) vs White, Hispanic (RR 0.936 [0.895-0.98]) vs non-Hispanic, Medicare/Medicaid/Veterans Affairs (VA) (RR 0.917 [0.882-0.954]) or uninsured (RR 0.883 [0.833-0.935]) vs private insurance, and rural (RR 0.782 [0.723-0.845]) vs urban dwelling were less likely to be associated with thrombolysis. Patients in the highest quintile based on the SVI were less likely to receive thrombolysis than those in the lowest quintile (RR 0.926 [0.867-0.989]). Patients were less likely to receive thrombectomy if they were 65 years and older (RR 0.787 [0.691-0.895]), belonged to the Black race (RR 0.745 [0.679-0.818]) or Hispanic ethnicity (RR 0.919 [0.851-0.992]), had Medicare/Medicaid/VA insurance (RR 0.909 [0.851-0.971]), or were from a rural area (RR 0.909 [0.851-0.971]). Similarly, SVI decreased the likelihood of undergoing mechanical thrombectomy (RR 0.842 [0.747-0.95]). Despite many improvements in stroke management, SDOH continue to be a significant driver of treatment access for acute ischemic stroke. While our findings are limited to Texas, our results should raise awareness and promote more studies regarding the effects of these SDOH at the national and international levels.

EPID-05. THE INCREASED RISK OF MENINGIOMA AMONG INDIVIDUALS WHO ARE NON-HISPANIC BLACK IS MAGNIFIED AMONG MALES AND AMONG THOSE DIAGNOSED WITH GRADE 2-3 TUMORS

Abstract BACKGROUND Demographic factors associated with elevated meningioma incidence include older age, female sex, and Black race. There are limited data exploring how meningioma risk in Black persons varies across the lifespan, interacts with sex, and differs by tumor grade. METHODS The Central Brain Tumor Registry of the United States (CBTRUS) is a population-based registry combining data from the CDC’s National Program of Cancer Registries and NCI’s Surveillance, Epidemiology and End Results Program, covering the entire U.S. population. Meningioma diagnoses from CBTRUS (2004-2019) were used to calculate incidence rate ratios (IRRs) for non-Hispanic Black individuals (NHB) as compared to non-Hispanic White individuals (NHW) across 10-year age intervals, and stratified by sex and WHO tumor grade (grade 1 versus grades 2/3, combined). RESULTS From 2004-2019, a total of 53,890 NHB individuals and 322,373 NHW individuals were diagnosed with a primary meningioma. The NHB to NHW IRR was elevated, beginning in the third decade of life (IRR=1.19; 95%CI: 1.11-1.28), peaking in the seventh decade (IRR=1.29; 95%CI: 1.26-1.31), and persisting throughout the lifespan. The IRR peaked in the seventh decade of life across strata of tumor grade, but, within this age group, NHB race/ethnicity was associated with substantially higher risk of grade 2/3 tumors (IRR=1.59; 95%CI: 1.48-1.70) than grade 1 tumors (IRR=1.27; 95%CI: 1.24-1.29). Meningioma risk was elevated in NHB females compared to NHW females (IRR=1.16; 95%CI: 1.15-1.18) and among NHB males compared to NHW males (IRR=1.22; 95%CI: 1.19-1.25), revealing synergistic interaction between NHB race/ethnicity and male sex (PInteraction=0.001). CONCLUSIONS This study identifies an elevated risk of meningioma in NHB relative to NHW, beginning shortly after puberty and continuing across the lifespan. NHB race/ethnicity conferred higher risk of meningioma among men than among women, and higher risk of developing WHO grade 2/3 than grade 1 tumors. These results highlight meningioma as a major potential source of racial disparities in neuro-oncology.

DISP-10. RACIAL AND SOCIOECONOMIC DIFFERENCES IN CLINICAL AND ACCESS TO CARE OUTCOMES IN NEUROSURGICAL-ONCOLOGY PATIENTS

Abstract BACKGROUND Large database studies have identified racial and socioeconomic differences in neurosurgical-oncologic outcomes. For clearer insights and understanding, more detailed and prospective evaluation is needed. METHODS We retrospectively analyzed a database of 1475 patients undergoing surgery for CNS tumors over 5 years. Multivariate analysis, specific to various pathologies, was conducted to identify demographic and socioeconomic factors (including age, sex, racial identity, primary language, insurance status, and income estimate) associated with access to care and clinical outcomes. Additionally, prospective patient-centered interviews were conducted on neuro- oncology patients to qualitatively explore reasons for disparities in healthcare. RESULTS Significant associations were found between racial identities (White n=911; Hispanic n=285; Asian n=206; Black n=74) and sex (ANOVA p 0.0043), age (p<0.0001), income estimate (p<0.0001), primary language (p<0.0001), and insurance status (p<0.0001). Among different pathologies, presentation to the ED, rather than outpatient setting, was consistently associated with a non- English primary language (p=0.0312) and Medi-Cal insurance (p=0.0029). Time from imaging diagnosis to neurosurgical consultation was associated with non- English primary language (p=0.0262) and Medi-Cal (p=0.0030). Delay between recommendation for surgery and date of surgery was significant in Black patients (p=0.0112). A non- English primary language was negatively associated with having a gross total resection (p=0.0087). Notably, adjuvant treatments were less likely for those with non-English primary language (p=0.0203), Black race (p=0.0049), and Medi-Cal coverage (p=0.0014). Cox regression analysis identified only age (p<0.0001) as a predictor of poorer overall survival in oncologic cases. Prospective interviews identified cultural, economic (work- related), and healthcare navigation issues as reasons for differences in access to care. CONCLUSIONS Across the spectrum of neurosurgical oncology diagnoses, racial and socioeconomic factors independently associate with access to care but not clinical outcome variables. Further investigation is needed, particularly in patients with non- English primary languages and cultural attitudes towards chemotherapy and radiation therapy.

CTNI-75. TRIALS IN PROGRESS: REGISTRY OF SAFETY & EFFICACY IN ADULTS WITH PRIMARY & METASTATIC INTRACRANIAL TUMORS TREATED WITH START (GAMMATILES (CS-131 SOURCE BRACHY-THERAPY)): NCT04427384

Abstract INTRO This is the first observational registry study of R+STaRT, delivered by Cs-131 sources in permanently implanted resorbable collagen tile carriers, for patients with intracranial tumors. METHODS Since October 2020, 37 sites to-date have enrolled 359 patients with primary & metastatic intracranial tumors into the R+STaRT registry to assess the safety & efficacy of the addition of Gamma Tile to medically needed resection. Local control, overall survival, QOL, neurocognition, functional decline, and surgical and radiation associated AE’s are collected at 1, 3, 6, 9,12, 18 and 24 months, then every 6 months through 5 years. RESULTS Demographics include 359 patients, avg. age 57 y.o.. 162 malignant gliomas, 125 metastatic tumors, 38 meningiomas, and 34 rare other tumors. 197 Males (163 White, 23 Black, 5 Asian, and other races) and 157 Females (White 121, 28 Black, 0 Asian, and 8 other races). No unexpected outcomes reported in the hands of experienced providers have occurred, although close clinical-radiographic follow-up, to ensure early detection of possible treatment-effects, is paramount. Steroid-use, and above endpoints, continue to be collected. CONCLUSIONS In this observational registry of Gamma Tiles (Cs-131 source brachy-therapy) added to medically needed resections for patients with primary and metastatic intracranial tumors continues. Data will be used to benchmark clinical outcomes of R+STaRT therapy and allow for comparisons to existing standard-of-care treatments. The outcome measures captured will allow for evaluation of the potential risks and benefits of this treatment approach for patients in a real-world setting.

Race, Neighborhood Disadvantage, and Prehospital Law Enforcement Handcuffing in Children With Behavioral Health Emergencies

ImportanceMinoritized youth and children in resource-limited neighborhoods rely on emergency medical services (EMS) for accessing care, including during behavioral health emergencies (BHEs). Law enforcement (LE) officers sometimes use forceful tactics in such settings. Assessing LE actions is needed to ensure safe and equitable care for vulnerable populations.ObjectiveTo examine whether race and ethnicity, neighborhood disadvantage, sex, and age are associated with LE handcuffing during pediatric BHEs.Design, Setting, and ParticipantsThis cross-sectional study analyzed LE handcuffing, demographic factors, and neighborhood disadvantage in Alameda County, California. The study population included children younger than 18 years who were evaluated by EMS for BHEs between January 1, 2012, and June 30, 2019. Data analysis was completed between January 1, 2022, and August 30, 2023.ExposuresPrimary exposures included race and ethnicity and Area Deprivation Index (ADI) rank as ADI I (1-3 [lowest]), ADI II (4-6 [moderate]), and ADI III (7-10 [highest]).Main Outcome and MeasureThe primary outcome was LE handcuffing during BHEs. The study calculated handcuffing proportions stratified by race and ethnicity, ADI, and sex.ResultsThe final dataset consisted of 6759 pediatric BHE encounters with complete data. Among these, 3864 encounters (57.2%) were with females. The median age was 14.9 (IQR, 13.4-16.2) years. Overall, LE handcuffing occurred in 517 encounters (7.6%); Black children had higher odds than their White peers (adjusted odds ratio [AOR], 1.80; 95% CI, 1.39-2.33). Compared with low neighborhood disadvantage, moderate neighborhood disadvantage was independently associated with increased odds of handcuffing (ADI II: AOR, 1.51; 95% CI, 1.21-1.88), as was highest neighborhood disadvantage (ADI III: AOR, 1.54; 95% CI, 1.19-1.99). Male sex (AOR, 2.31; 95% CI, 1.91-2.79) and age (AOR per 1-year increase, 1.15; 95% CI, 1.10-1.21) were also associated with increased odds of handcuffing. In moderately disadvantaged neighborhoods, the odds were higher for Black children (AOR, 2.52; 95% CI, 1.65-3.86). When stratified by sex, the odds of handcuffing were significantly higher for Black females compared with White females (AOR, 2.59; 95% CI, 1.69-3.98).Conclusions and RelevanceThe findings of this cross-sectional study suggest that accessing EMS for BHEs may expose Black children and youth in disadvantaged neighborhoods to LE use of handcuffing. Emergency medical services should reconsider the role of LE officers in these settings.

Controversial Cartoon at Central University

This fictional case study provides a summary of events that took place at Central University after the campus newspaper published a controversial political cartoon mocking media coverage of the killing of an unarmed Black man. The cartoon and lack of administrative response led to the formation of a student activist group. The case highlights the conflict some campus administrators perceive in protecting student expression, which may harm other students’ feelings of safety and belonging. Discussion questions and suggested class activities are included.

Toponymic renaming as a reflection of social cohesion and social justice in the City of Tshwane

ABSTRACT Recently, the concept of social cohesion has been increasingly used in the South African government and policy circles when discussing the challenges of social cohesion in a society deeply divided by race, class, and nationality. Related to this concept is the practice of naming and renaming places, precisely after regime change. Also known as a toponymic purge, new rulers change exisiting names to gian political legitimacy for their political values and to reflect the new socio-political order, rendering place names of the previous regime obsolete in the process. As a result, this paper analyses toponymic renaming as a reflection of social cohesion in the street renaming process of the City of Tshwane, South Africa. The paper uses a qualitative research approach and a case study design. A sample of 14 participants were puposively selected and data were technically analysed. The findings of the study revealed that the street renaming process accomodated Black people who had previously been marginalized. Therefore, Coloureds and Black participants believed that social cohesion and social justice had been accomplished through the process of renaming the streets. White participants, on the other hand, held a different perspective that the process did not contribute to social cohesion.

Racial and Ethnic Disparities in Referral Rejection from Postacute Care Facilities among People with Opioid Use Disorder in Massachusetts

Objectives The aim of the study was to examine the association between Black, White, and Hispanic or Latino race and ethnicity and referral rejection from private postacute care facilities among hospitalized individuals with opioid use disorder (OUD). Methods In this retrospective cohort study, we linked electronic postacute care referrals from Boston Medical Center in 2018 to electronic medical record data, which we used to ascertain OUD status and race and ethnicity. Using multivariable logistic regression, we examined the association between Black, White, and Hispanic or Latino race and ethnicity and referral rejection, adjusting for individual-level characteristics including medication for opioid use disorder treatment type and for facility-level factors using facility random effects. Results We identified 159 hospitalizations from 141 individuals with OUD referred to private postacute medical care, corresponding to 1272 referrals to 244 facilities. Hospitalizations comprised 53 (33%) non-Hispanic Black, 28 (18%) Hispanic or Latino, and 78 (49%) non-Hispanic White individuals. In adjusted analyses, referrals for non-Hispanic Black individuals had significantly higher odds of rejection compared to referrals for non-Hispanic White individuals (adjusted odds ratio 1.83, 95% confidence interval [1.24, 2.69], P = 0.002). There were no significant differences between referrals for Hispanic or Latino individuals and non-Hispanic White individuals (adjusted odds ratio 1.11, 95% confidence interval [0.67, 1.84], P = 0.69). Conclusions Among people with OUD referred to private postacute care in Massachusetts, non-Hispanic Black individuals were more likely to be rejected compared to non-Hispanic White individuals, demonstrating racism in postacute care admissions. Efforts to address discrimination against people with OUD in postacute care admissions must also address racial equity.

A preliminary investigation into the relationship between municipal debt and the financial viability of waterboards in South Africa

ABSTRACT The provision of water and sanitation services in South Africa is complex due to historical apartheid spatial planning whose remnants are still evident in the democratic country. The rural areas which are mostly occupied by black Africans still, on average, have water services backlog compared to urban areas. At a national level for South Africa to achieve the Sustainable Developmental Goal 6, the country must decisively deal with the backlog and a staggering more than R14 billion debt that the municipalities owe to the waterboards. The current study used the Municipal Strategic Self-Assessment and financial health (FH) check-up tools to determine if there is a causal relationship between the vulnerability of municipalities and the financial viability of waterboards. A linear regression was computed using the SPSS statistical programme to assess the relationship between the FH of the waterboards and the vulnerability index (VI) of the municipalities. It was found that a high VI was more prevalent in the rural municipalities than in the urban municipalities, pointing to a need to develop a differentiated financial framework for these rural municipalities. The study recommended that municipalities should implement remedial actions waterboards should perform FH check-ups, and there must be consequence management.

RACISMO X NEGRO NA GESTÃO PÚBLICA

The presence of black people in public administration is a crucial and complex issue that is intertwined with the history of racism in Brazil. The fight for more black representation in spaces of power is a direct confrontation with the racist structures that permeate our society. The slave system, which lasted for centuries in Brazil, left deep marks on society, establishing racial hierarchies that persist to this day. For more than three centuries, slavery denied black people citizenship and any kind of political participation. This historical legacy perpetuates inequalities and prejudices, affecting the Brazilian social structure to this day. This article, through bibliographical research, seeks to understand the relationship between racism and low black representation in the Brazilian political system, analyzing how racism contributes directly to the under-representation of black people in other spheres of power and social prestige. However, this study only reinforces how fundamental it is to tackle structural racism so that, through affirmative policies, the inclusion of black people in Brazilian society can take place in a more equal way in the context of public management, enabling institutions to be more diverse and plural.

State Divorce Laws, Reproductive Care Policies, and Pregnancy-Associated Homicide Rates, 2018-2021

ImportanceBarriers to divorce and reproductive health care can threaten the health and safety of pregnant and recently pregnant females.ObjectiveTo examine state laws about divorce, reproductive health care (access to contraception, family planning services, and abortion), and pregnancy-associated homicide rates in US states over a 4-year period (2018-2021).Design, Setting, and ParticipantsIn this cross-sectional study, bivariate tests and regressions were used to analyze crude rates of pregnancy-associated homicide from the National Violent Death Reporting System in 181 state-years for calendar years 2018 to 2021, with analyses conducted on September 8, 2024.ExposuresAccess to divorce while pregnant and reproductive health care over a 4-year period in the US.Main Outcomes and MeasuresPrimary outcomes (pregnancy-associated homicide by intimate partners vs non–intimate partners and rates among younger Black, Hispanic, and White females) were assessed using the National Violent Death Reporting System. Negative binomial regression was used to test 2 hypotheses: access to divorce while pregnant and reproductive health care are associated with pregnancy-associated homicide rates.ResultsIndividual level data, including exact sample size, were not available in this study of state-level homicide rates. Negative binomial regression analysis showed that, where finalizing divorce during pregnancy is prohibited, intimate partner homicide rates (incidence rate ratio [IRR], 2.11; 95% CI, 1.09-4.08; P = .03) and rates among younger (age 10-24 years) White females (IRR, 2.39; 95% CI, 1.12-5.09; P = .02) were significantly higher. In state-years with greater access to reproductive health care, rates were significantly lower for non–intimate partner homicide (IRR, 0.92; 95% CI, 0.87-0.98; P = .01) and for younger Black females (IRR, 0.91; 95% CI, 0.87-0.96; P < .001) and younger Hispanic females (IRR, 0.87; 95% CI, 0.79-0.96; P = .007).Conclusions and RelevanceIn this cross-sectional study of pregnancy-associated homicide rates, barriers to divorce were associated with higher homicide rates and access to reproductive health care was associated with lower homicide rates. This study highlights the association between state legislation and pregnancy-associated homicide in the US, which is important information for policymakers.

Constructing non-hegemonic entrepreneurial masculinity: the case of Black men doing entrepreneurship in a predominantly white context

PurposeThe literature on entrepreneurial masculinity has primarily focused on how hegemonic masculinity is constructed and performed in entrepreneurship. Little is known about how non-hegemonic masculinity is performed by male entrepreneurs who do not fit the dominant and traditional form of masculinity in a specific context. Focusing on a cohort of Black male entrepreneurs who practised entrepreneurship in a predominantly white context, this paper explores how non-hegemonic entrepreneurial masculinity is constructed.Design/methodology/approachThe study uses Interpretative Phenomenological Analysis (IPA) to analyse qualitative data collected through semi-structured interviews with nine Black male entrepreneurs living and doing business in the Northeast of England.FindingsThe study found that Black male entrepreneurs construct a distinct form of entrepreneurial masculinity by leveraging the identity of White women to construct a respectable entrepreneurial masculinity. The form of masculinity the men engaged in is theorised as transactional masculinity. This is enacted through relationships with White women which is seen as a symbol of respect and social acceptance, and as a “rite of passage” in entrepreneurship. The study presents a model of entrepreneurial masculinity to explain how transactional masculinity is constructed in relation to femininity and other forms of masculinity.Originality/valueThe study theorises how non-hegemonic entrepreneurial masculinity is enacted through the concept of transactional masculinity. It presents a model of entrepreneurial masculinity and gives voice to the experiences of male entrepreneurial actors with non-hegemonic masculinity.

The racialisation of AIDS in Denmark: Tabloid media scandals of sex, race and contagion

In 1992, a Danish tabloid newspaper published the picture, name and address of a Black man on its front page under the title ‘He is the AIDS killer’. The outing marked the beginning of a controversial public scandal in Denmark directly leading to the introduction of a new law criminalising HIV in 1994. Centring questions of race and nationality in connection with HIV/AIDS, we examine in what ways the discursive framing of this, and two other public scandals, became tools of interpellation calling into existence ‘problematic’ and ‘dangerous’ groups like the racialised immigrant. Drawing on theories of race and racialisation through the work of Michel Foucault and Alexander G. Weheliye, we understand racism as structurally constituted within biopower and the violent expulsion of racialised people as a form of structural racism integrated in the state apparatus. Thinking about race in this way allows us to investigate how the figure of the racialised immigrant is represented vis-à-vis a racialised regime of representation as well as within a specific economy of fear and white paranoia. Our analysis shows that the racialisation of AIDS in Denmark, through which the control and disciplining of racialised bodies were made possible, worked in tandem with the cultural production of a national health crisis narrative that – put together – enabled, produced and pushed for particular political reactions and interventions culminating with the passing of the HIV Act in 1994.

Governance of the Black Experience on Reddit: r/BlackPeopleTwitter as a Case Study in Supporting Sense of Virtual Community for Black Users

Despite frequent efforts to combat racism, almost no research has explored how to cultivate positive experiences of thriving Black culture on Reddit. In this case study, we surveyed users of r/BlackPeopleTwitter (BPT)--a large, popular subreddit that showcases screenshots of hilarious or insightful social media posts made by Black people (mainly from Black Twitter). Our research questions seek to understand users' motivations for visiting BPT, how they experience a sense of virtual community (SOVC) and membership in BPT, and how BPT's governance influences these experiences. We find that that users come to BPT primarily for excellent humor and entertainment, sociopolitical context on issues relevant to Black people, and/or partaking in the shared Black experience. Black users are more likely to report higher SOVC and to identify as members, whereas non-Black users are more likely to identify as guests or visitors to the community. To protect Black expression, the BPT moderation team implemented a governance strategy for verifying racial identity and limiting participation to only verified users in certain threads. Our data suggest that this policy is a contentious but influential aspect of SOVC that simultaneously constructs and challenges the sense of the subreddit existing as a safe space for Black people. We synthesize these results by discussing how: differing platform affordances across Twitter and Reddit combine to cultivate a thriving Black community on Reddit; the need for Black authenticity on an otherwise anonymous platform can guide future research in identity verification; and the limitations of this study motivate future work to support all marginalized communities online.

Investigating racial differences in mortality and survival outcomes following radical prostatectomy: a systematic review and meta-analysis

BackgroundNotable variations in cancer rates, survival rates, mortality exist among certain populations in the US. We aim to examine how prostate cancer prognosis differs among black and white men from various ethnic backgrounds undergoing radical prostatectomy.MethodsWe performed a comprehensive search across MEDLINE and Google Scholar databases from inception to March 2023 for observational studies including black and white men undergoing radical prostatectomy. Outcomes of interest included either overall survival, prostate cancer survival, biochemical recurrence, or all-cause mortality. Studies were pooled using hazard ratios (HR) with 95% confidence intervals (CIs) using Review Manager (RevMan) version 5.4.1.ResultsIn patients undergoing radical prostatectomy, the risk of all-cause mortality was significantly greater in blacks in comparison to whites ([HR] 1.16, 95% CI 1.12–1.21; I2 = 51%; p < 0.00001). Pooled analysis shows higher rate of prostate-specific mortality in blacks treated compared to whites ([HR]: 1.08, 95% CI 0.86–1.37; I2 = 81%; p = 0.50). The risk of biochemical recurrence was significantly higher in blacks undergoing radical prostatectomy than in whites (HR: 1.27; 95% CI 1.11–1.45; I2 = 58%; p = 0.0007). On regional subgroup analysis, the mid-west and multi-institutional centers revealed a higher rate of biochemical recurrence in blacks than in whites. No significant difference was noted between blacks and whites for overall survival.ConclusionsOur research demonstrated elevated rates of all-cause mortality, prostate-specific mortality, and biochemical recurrence, with no significant differences in overall survival between blacks and whites. Further research is warranted to assess ethnic and geographic differences at a large scale.

Race and Privacy in Broadcast Police Communications

Radios are essential for the operations of modern police departments, and they function as both a collaborative communication technology and a sociotechnical system. However, little prior research has examined their usage or their connections to individual privacy and the role of race in policing, two growing topics of concern in the US. As a case study, we examine the Chicago Police Department's (CPD's) use of broadcast police communications (BPC) to coordinate the activity of law enforcement officers (LEOs) in the city. From a recently assembled archive of 80,775 hours of BPC associated with CPD operations, we analyze human-generated text transcripts of radio transmissions broadcast 9:00 AM to 5:00 PM on August 10th, 2018 in one majority Black, one majority White, and one majority Hispanic area of the city (24 hours of audio) to explore four research questions: (1) Do BPC reflect reported racial disparities in policing? (2) How and when is gender, race/ethnicity, and age mentioned in BPC? (3) To what extent do BPC include sensitive information, and who is put at most risk by this practice? (4) To what extent can large language models (LLMs) heighten this risk? We explore the vocabulary and speech acts used by police in BPC, comparing mentions of personal characteristics to local demographics, the personal information shared over BPC, and the privacy concerns that it poses. Analysis indicates (a) policing professionals in the city of Chicago exhibit disproportionate attention to Black members of the public regardless of context, (b) sociodemographic characteristics like gender, race/ethnicity, and age are primarily mentioned in BPC about event information, and (c) disproportionate attention introduces disproportionate privacy risks for Black members of the public. This study shows BPC can provide a novel window into disproportionate attention (i.e., via radio communications) by law enforcement officers to specific racial groups, leading to increased privacy vulnerability for those groups, particularly Black males.

Book Review: Brotherhood University: Black Men’s Friendships and the Transition to Adulthood, By Brandon A. Jackson

Book Review: <i>Brotherhood University: Black Men’s Friendships and the Transition to Adulthood</i>, By Brandon A. Jackson

Children’s beliefs about Black and White men’s and women’s scientific knowledge: An intersectional approach.

Children’s beliefs about Black and White men’s and women’s scientific knowledge: An intersectional approach.

Developing and testing Advance Choice Document implementation resources for Black African and Caribbean people with experience of compulsory psychiatric admission

BackgroundAdvance Choice Documents (ACDs) have been recommended for use in England and Wales based on evidence from trials that show that they can reduce involuntary hospitalisation, which disproportionately affects Black African and Caribbean people. Our aim was therefore to develop and test ACD implementation resources and processes for Black people who have previously been involuntarily hospitalised and the people that support them.MethodsResource co-production workshops were held to inform the development of the ACD template and two types of training for all stakeholders, comprising a Recovery College course and simulation training. An ACD facilitator then used the ACD template developed through the workshops to create personalised ACDs with service users and mental health staff over a series of meetings. Interviews were then conducted with service user and staff participants and analysed to document their experience of the process and opinions on ACDs. Other implementation strategies were also employed alongside to support and optimise the creation of ACDs.ResultsNine ACDs were completed and were largely reported as appropriate, acceptable, and feasible to service users and staff. Both reported it being an empowering process that encouraged hope for better future treatment and therefore better wellbeing. Uncertainty was also expressed about the confidence people had that ACDs would be adhered to/honoured, primarily due to staff workload. The information provision training and the skills training were generally considered to be informative by trainees.ConclusionsThe project has developed an ACD creation resource that was reported as agreeable to all stakeholders; however, the generalisability of the findings is limited due to the small sample size. The project also highlights the importance of staff and ACD facilitator capacity and good therapeutic relationships in ACD completion. Further research is needed to determine the adjustments needed for large scale use, including for those under age 18 and those under the care of forensic mental health services; and how to include carers/supporters more in the process.

Postmarketing Surveillance of Inferior Vena Cava Filters Among US Medicare Beneficiaries

Inferior vena cava filters (IVCFs) are commonly used to prevent pulmonary embolism in selected clinical scenarios, despite limited evidence to support their use. Current recommendations from professional societies and the US Food and Drug Administration endorse timely IVCF retrieval when clinically feasible. Current IVCF treatment patterns and outcomes remain poorly described. To evaluate temporal trends and practice patterns in IVCF insertion and retrieval among older US patients and report the incidence of periprocedural and long-term safety events of indwelling and retrieved IVCFs. Prespecified, retrospective, observational cohort of Medicare Fee-for-Service (FFS) beneficiaries, leveraging 100% of samples of inpatient and outpatient claims data from January 1, 2013, to December 31, 2021. First-time IVCF insertion while insured by Medicare FFS. The primary safety outcome was the composite of all-cause death, filter-related complications (eg, fracture, embolization), operating room visits following filter-related procedures, or new diagnosis of deep vein thrombosis (DVT). Events were considered periprocedural if they occurred within 30 days of IVCF insertion or retrieval and long-term if they occurred more than 30 days after. Among 270 866 patients with IVCFs placed during the study period (mean age, 75.1 years; 52.8% female), 64.9% were inserted for first-time venous thromboembolism (VTE), 26.3% for recurrent VTE, and 8.8% for VTE prophylaxis. Of these patients, 63.3% had major bleeds or trauma within 30 days of IVCF insertion. The volume of insertions decreased from 44 680 per year in 2013 to 19 501 per year in 2021. The cumulative incidence of retrieval was 15.3% at a median of 1.2 years and 16.8% at maximum follow-up of 9.0 years. Older age, more comorbidities, and Black race were associated with a decreased likelihood of retrieval, whereas placement at a large teaching hospital was associated with an increased likelihood of retrieval. The incidence of caval thrombosis and DVT among patients with nonretrieved IVCFs was 2.2% (95% CI, 2.1%-2.3%) and 9.2% (95% CI, 9.0%-9.3%), respectively. The majority (93.5%) of retrieval attempts were successful, with low incidence of 30-day complications (mortality, 0.7% [95% CI, 0.6%-0.8%]; filter-related complications, 1.4% [95% CI, 1.2%-1.5%]). In this large, US real-world analysis, IVCF insertion declined, yet retrievals remained low. Strategies to increase timely retrieval are needed, as nonretrieved IVCFs may have long-term complications.