Black Racial Groups Research Articles

Racial, ethnic and sex disparity in acute heart failure patients with COVID-19: A nationwide analysis

BackgroundPatients with acute heart failure (AHF) exacerbation are susceptible to complications in the setting of COVID-19 infection. Data regarding the racial/ethnic and sex disparities in patients with AHF and COVID-19 remains limited. ObjectiveWe aim to evaluate the impact of race, ethnicity, and sex on the in-hospital outcomes of AHF with COVID-19 infection using the data from the National Inpatient Sample (NIS). MethodsWe extracted data from the NIS (2020) by using ICD-10-CM to identify all hospitalizations with a diagnosis of AHF and COVID-19 in the year 2020. The associations between sex, race/ethnicity, and outcomes were examined using a multivariable logistic regression model. ResultsWe identified a total of 158,530 weighted AHF hospitalizations with COVID-19 infection in 2020. The majority were White (63.9 %), 23.3 % were Black race, and 12.8 % were of Hispanic ethnicity, mostly males (n = 84,870 [53.5 %]). After adjustment, the odds of in-hospital mortality were lowest in White females (aOR 0.83, [0.78–0.98]) and highest in Hispanic males (aOR 1.27 [1.13–1.42]) compared with White males. Overall, the odds of cardiac arrest (aOR 1.54 [1.27–1.85]) and AKI (aOR 1.36 [1.26–1.47] were higher, while odds for procedural interventions such as PCI (aOR 0.23 [0.10–0.55]), and placement on a ventilator (aOR 0.85 [0.75–0.97]) were lower among Black males in comparison to White males. ConclusionMale sex was associated with a higher risk of in-hospital mortality in white and black racial groups, while no such association was noted in the Hispanic group. Hispanic males had the highest odds of death compared with White males.

Digital Variation of Machine Learning Through Basic Diagnostic Test Application Approach: an Integrative Literature Review

Electronic Medical Records (EMRs) are digital applications of machine learning models that function to receive and store clinical data related to medical information for the purposes of basic clinical diagnostic tests. The integrative review aims to provide a synthesis of new findings from several articles on EMRs for the early detection of basic clinical diagnoses with a variety of existing populations. Using four databases, we reviewed 11 articles. All authors involved review abstracts and full text according to predetermined criteria. The selected articles are then integrated into the publication quality assessment matrix, further included in machine learning algorithms for diagnostic determination of the disease. Reviewed articles are excluded in the form of artificial intelligence. The PRISMA flowchart identified 1962 articles and the final selection found 11 articles. Circulating system networks dominate machine learning models (66.6%). The study netted an average population of 490.5 and the artificial intelligence system managed to detect 9 body systems from different body systems. A total of 11 articles were selected, more than half of which were Caucasian (80.90%) and white (72.95%), but only 1 article was represented by Caucasian ethnicity, while white race was almost in every article. African-American and Black racial groups were in the middle position at 29.95% and 17.50%. The racial representation with the least percentage below 10% was Hispanic and Asian (6.10% and 2.17%). This machine learning has proven to be very accurate for detecting disease diagnoses in hospital, other health clinics. Therefore, the further development of this application for the purpose of establishing clinical diagnosis precisely and accurately.

Prevalence and predictors of colorectal cancer screening in the United States: evidence from the HINTS database 2018 to 2020.

The incidence of colorectal cancer (CRC) and CRC-related mortality among young adults (< 50years) has been on the rise. The American Cancer Society (ACS) reduced the CRC screening age to 45 in 2018. Few studies have examined the barriers to CRC screening among young adults. Analyses were conducted using data from 7,505 adults aged 45-75years who completed the 2018 to 2020 Health Information National Trends Survey. We examined the sociodemographic characteristics associated with CRC screening overall and by age group using separate multivariable logistic regression models. 76% of eligible adults had received screening for CRC. Increasing age, Black racial group [OR 1.45; 95% CI (1.07, 1.97)], having some college experience, a college degree or higher [OR 1.69; 95% CI (1.24, 2.29)], health insurance coverage [OR 4.48; 95% CI (2.96, 6.76)], primary care provider access [OR 2.48; 95% CI (1.91, 3.22)] and presence of a comorbid illness [OR 1.39; 95% CI (1.12, 1.73)] were independent predictors of CRC screening. Current smokers were less likely to undergo CRC screening [OR 0.59; 95% CI (0.40, 0.87)]. Among adults aged 50-64years, being of Hispanic origin [OR 0.60; 95% CI (0.39, 0.92)] was associated with a lower likelihood of CRC screening. CRC screening rates among adults 45-49years are low but are increasing steadily. Odds of CRC screening among Blacks is high which is encouraging while the odds among current smokers is low and concerning given their increased risk of developing CRC.

Racial Disparities in Obesity-Related Cardiovascular Mortality in the United States: Temporal Trends From 1999 to 2020.

Background Obesity is a major risk factor for cardiovascular disease, with differential impact across populations. This descriptive epidemiologic study outlines trends and disparities in obesity-related cardiovascular mortality in the US population between 1999 and 2020. Methods and Results The Multiple Cause of Death database was used to identify adults with primary cardiovascular death and obesity recorded as a contributing cause of death. Cardiovascular deaths were grouped into ischemic heart disease, heart failure, hypertensive disease, cerebrovascular disease, and other. Absolute, crude, and age-adjusted mortality rates (AAMRs) were calculated by racial group, considering temporal trends and variation by sex, age, and residence (urban versus rural). Analysis of 281 135 obesity-related cardiovascular deaths demonstrated a 3-fold increase in AAMRs from 1999 to 2020 (2.2-6.6 per 100 000 population). Black individuals had the highest AAMRs. American Indian or Alaska Native individuals had the greatest temporal increase in AAMRs (+415%). Ischemic heart disease was the most common primary cause of death. The second most common cause of death was hypertensive disease, which was most common in the Black racial group (31%). Among Black individuals, women had higher AAMRs than men; across all other racial groups, men had a greater proportion of obesity-related cardiovascular mortality cases and higher AAMRs. Black individuals had greater AAMRs in urban compared with rural settings; the reverse was observed for all other races. Conclusions Obesity-related cardiovascular mortality is increasing with differential trends by race, sex, and place of residence.

Effects of Women's Body Satisfaction, Emotional Eating, and Race on Short-, Mid-, and Long-term Weight Loss

ObjectiveTo improve understanding of psychosocial factors, their changes, and racial differences with implications for behavioral obesity treatments. MethodsWomen with obesity of White (n = 64) and Black (n = 33) racial groups participated in cognitive-behavioral community-based obesity treatment and were assessed on body satisfaction, emotional eating, and weight changes over 3, 6, 12, and 24 months via mixed-model repeated-measures analysis of variance and stepwise multiple regression analyses. ResultsBaseline body satisfaction scores were significantly higher (P < 0.001) in Black participants. White participants had significantly higher (P = 0.04) emotional eating scores. Significant overall improvements (P < 0.001) in body satisfaction, emotional eating, and weight were found, with weight reduction significantly greater (P = 0.05) among the White women. Weight reductions were significantly predicted by changes in body satisfaction and emotional eating (R2 = 0.12–0.20, P < 0.01). When racial group was entered into the analyses, the explained variance in weight change over 6 and 12 months significantly increased (P < 0.05). Conclusions and ImplicationsFindings suggest addressing body satisfaction, emotional eating, and racial differences by adjusting obesity treatment targets could improve outcomes. Research-to-practice needs include a control group and further identification/elucidation of other psychosocial and economic factors that might affect outcomes.

Work-place diversity climate: Its association with racial microaggressions and employee work-place well-being

The study examined the role of work-place diversity climate in relation to employees’ experiences of racial microaggressions (RMAs), their organisational commitment, turnover intentions, job satisfaction, and organisational citizenship behaviour (OCB) in selected South African organisations. The employees (n = 262; male = 52.9%; white = 47.1%) completed the Diversity Perception Scale (DPS), the Daily Life Experience Scale (DLE), and measures for organisational commitment, turnover intentions, job satisfaction, and OCB. Following standardised regression analysis, the results indicated that an inclusive diversity climate was associated with lower employee perceptions of RMAs, reduced turnover intentions, improved job satisfaction, and improved OCB. Experiences of RMA’s was directly associated with lower diversity climate, higher turnover intentions, lower job satisfaction, and decreased OCBs. Diversity climate indirectly influenced the relationships between RMA’s and employee organisational commitment, turnover intentions, job satisfaction, and OCBs. Female gender and black racial group membership was associated with a lower sense of diversity climate and increased experiences of RMAs. The current findings suggest a need for diversity climate management for enhancing employee work-place well-being.

Paired tumor/normal sequencing to overcome racial differences in tumor mutational burden (TMB).

3138 Background: TMB is routinely reported in cancer patients tested with broad-panel next generation sequencing and has become a predictive biomarker associated with response to checkpoint inhibitor (CPI) therapy. Sequencing of paired tumor and normal specimens allows correction of TMB estimates with patient-specific germline variants. When a paired normal specimen is unavailable, TMB estimates are corrected using germline variant annotations derived from population-scale germline variant surveys. Germline variants do not generate neoantigens, which is the putative target of the immune response in CPI treated patients. To evaluate TMB differences in paired sequencing (PS) and tumor-only sequencing (TOS), we compared TMB assessments—stratified by race—in two common malignancies. Methods: Using de identified records from the Tempus clinico-genomic database, cohorts of patients with non-small cell lung cancer (NSCLC) and breast cancer sequenced using the Tempus xT NGS platform (DNA-seq of 595-648 genes at 500x coverage, whole exome capture RNA-seq) and noted to not have microsatellite instability, were identified for analyses. The Kruskall-Wallis test was used to compare TMB distributions. Results: Among 4,817 NSCLC patients with race information (13% Black (B), 5% Asian (A), 82% White (W), 3,052 had PS, and 1,765 had TOS performed. Median TMB for B, A, and W patients was 5.8, 2.6, and 4.7 (within group p &lt; 0.0001), respectively in patients with PS, and 9.5, 6, and 7.4 (within group p &lt; 0.0001), in patients with TOS. Comparisons across PS and TOS were highly significant (p &lt; 0.0001). The absolute difference in median TMB was 3.7, 3.4, and 2.5, respectively. Among 3,191 patients with breast cancer (17% B, 4% A, 78% W), 2,220 had PS, and 971 had TOS. Median TMB for B, A, and W patients was 2.6, 2.1, and 2.6 (within group p = 0.11), respectively, in patients with PS, and 6.3, 5.8, and 4.7 (within group p &lt; 0.0001) in patients with TOS. Comparisons across PS and TOS were highly significant (p &lt; 0.0001). The absolute difference in median TMB was 3.7, 3.7, and 2.1, respectively. Conclusions: PS reduces estimated TMB compared to TOS across all racial groups with a pronounced difference in Black and Asian racial groups. This is expected as population databases of germline variation are based on cohorts predominantly from individuals of European ancestry, leading to artifactually high TMB in minorities tested with TOS. As a result, artifactually elevated TMB estimates from TOS may promote treatment with CPI in patients with a low probability of response which could exacerbate known race-based outcome disparities. PS provides a more accurate estimate of TMB regardless of race and could reduce the use of CPI in patients with a low likelihood of response.

1256-P: Lower Diabetes Technology Adoption and Worse Glycemic Control in Minorities with Type 1 Diabetes

Introduction: Poorer outcomes in acute and late complications of type 1 diabetes (T1D) persist among racial/ethnic minorities, and technology adoption may be lower in these groups. Technologies such as continuous glucose monitors (CGM) and insulin pumps (CSII) enhance diabetes management and improve glycemic control. We examined differences in use of diabetes technology by race/ethnicity among patients 12 and older followed at the Barbara Davis Center who had T1D for at least 1 year. Methods: Use of CGM and/or CSII vs. neither was examined in 5,539 patients by racial/ethnic groups: Non-Hispanic White (NHW, n=3,945) , Black (n=161) , Hispanic (n=719) and Other racial groups (OR, n=714) . General liner models compared HbA1c and technology use by race/ethnicity. Results: Black, Hispanic and OR patients were younger, had shorter T1D duration, higher HbA1c and less use of technology. In linear models adjusted for age, diabetes duration and visits over the past year, use of technology was associated with lower HbA1c in each race/ethnic group. However, among technology users, minority patients had higher HbA1c compared to NHW patients. Conclusion: HbA1c was highest and diabetes technology use lowest among Blacks and Hispanics. Efforts to increase technology use for diabetes management in these populations may result in greater glycemic control and ultimately the reduction of acute and late complications of diabetes. Disclosure B.Conway: None. V.Shah: Advisory Panel; Medscape, Sanofi, Consultant; Dexcom, Inc., Research Support; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk. C.Geno rasmussen: None. A.Gerard gonzalez: n/a. J.K.Snell-bergeon: Stock/Shareholder; GlaxoSmithKline plc. Funding NIH grant P30-DK116073

The Role of Racial–Ethnic Identity in Understanding Depressive Symptoms in the Context of Racial Discrimination Among African American Youth

Objective: The current study tested the individual associations of three dimensions of racial–ethnic identity (i.e., private regard, public regard, and racial centrality) on depression and their moderation effects on the relationship between racial discrimination and depression. Method: We conducted secondary data analysis using a large, nationally representative cross-sectional sample of African American youth in the United States (N=810; mean age =15, SD=1.44; 52% female). We used hierarchical multiple regression modeling to test the moderation effects of racial–ethnic identity dimensions on the relationship between racial discrimination and depression, controlling for demographics and parental support. Results: Of participants, 86% reported experiencing at least one of the racial discrimination experiences on the Everyday Discrimination Scale. Consistent with prior research, racial discrimination was associated with depressive symptoms; higher levels of emotional support from parents were significantly and negatively associated with depression. Most importantly, whereas the racial–ethnic identity dimensions were positively correlated to one another, we found they have unique associations with depression. In particular, public regard (i.e., participants’ evaluation of how society views the Black racial group) moderated the association between racial discrimination and depression. Conclusions: Although it is important to understand the independent effects of the racial–ethnic identity dimensions, the current study also suggests the need to understand their interactive effects on depression in the context of racial discrimination among African American youth.

The significance and meaning of racial identity in consumer research: A review and call for research

AbstractThis article uses the Multidimensional Model of Racial Identity (MMRI) as a framework to broaden the current understanding of racial identity, structure our review of consumer psychological research on racial identity, and identify future research opportunities, thereby answering calls for efforts to foreground the perspectives of Black consumers and present frameworks that advance understanding of Black consumers. Building on the conceptualization of racial identity involving both the significance and meaning that individuals attribute to their membership within the Black racial group, we note that prior consumer psychological research has focused on the former while ignoring the latter. We identify opportunities to leverage aspects of the MMRI in future research on marketplace discrimination, marketplace stigma, and support for minority‐owned businesses. We also highlight opportunities to better understand the impact of the meaning of racial identity.

Legal Determinants of Health: Historic Housing Policy and Modern Day Surgical Outcomes

Research ObjectiveIn 1933 the United States Government Home Owners Loan Corporation used racial composition of neighborhoods to determine creditworthiness and labeled them “Best”, “Still Desirable”, “Definitely Declining” and “Hazardous.” Although efforts have been made to reverse these racist policies that structurally disadvantage Black Americans, the lasting legacy on modern day healthcare outcomes is uncertain. The objective of this study was to evaluate the association of historical racist housing policies and modern day healthcare outcomes.Study DesignCross‐sectional retrospective review of Medicare beneficiaries' who underwent one of five of common surgical procedures across neighborhoods historically labeled by the Home Owners Loan Corporation. Outcomes were risk‐adjusted using a multivariable logistical regression model accounting forpatient factors (age, sex, Elixhauser comorbidities), admission type (elective, urgent, emergency), and type of operation.Population Studied525,690 Medicare beneficiaries' admissions between 2012 and 2016 who underwent one of five of common surgical procedures ‐ coronary artery bypass, appendectomy, colectomy, cholecystectomy and hernia repair – across neighborhoods historically labeled by the Home Owners Loan Corporation.Principal FindingsOverall, 473,732 Medicare beneficiaries (mean age, 74.6 years; 49.8% women) underwent 520,690 operations within neighborhoods that had been historically graded by the Home Owners Loan Corporation. Mortality increased in a stepwise fashion across neighborhoods. Overall, 30‐day postoperative mortality was 4.3% in “Best” neighborhoods, 4.7% in “Still Desirable”, 4.8% in “Definitely Declining” and 5.1% in “Hazardous” (Best vs. Hazardous Odds Ratio = 1.21 [1.16–1.26]; P &lt; 0.001). The same stepwise increase was present for each procedure individually across the following ranges: coronary artery bypass (2.8% to 3.3%), appendectomy (2.8% to 3.3%), colectomy (8.0% to 9.3%), cholecystectomy (3.1% to 3.7%) and hernia repair (3.7% to 4.4%). Mortality rates also increased significantly in a stepwise manner across neighborhoods for White (4.6% to 5.2%, p &lt; 0.001) and Black (5.3% to 6.0%, p = 0.002) racial groups. Black Medicare Beneficiaries had higher mortality rates compared to non‐Blacks overall (5.8% vs 5.0%; absolute difference + 0.8%) with persistent disparity across neighborhoods from 5.3% vs 4.6% (+0.7%) in “Best” neighborhoods to 6.0% vs 5.2% (+0.8%) in “Hazardous” neighborhoods.ConclusionsDiscriminatory housing policy was associated with increasing rates of post‐operative mortality across neighborhoods for all racial groups, with Black Medicare beneficiaries being disproportionately affected.Implications for Policy or PracticeThese findings underscore the long term sequelae of housing policies and raise concern about policies that reward or penalize hospitals based on their outcomes without taking into account possible structural disadvantages within certain communities.Primary Funding SourceNational Institutes of Health.

The quest for a reconciled South Africa : political transformation in Zakes Mda's The Madonna of Excelsior

This article explores the quest for political transformation in South Africa as depicted in Zakes Mda's The Madonna of Excelsior (2002). It is underpinned by the Immorality and Prohibition of Marriage Act as a legislative framework that adversely impacted both black and white racial groups during apartheid rule. The article further traces aspects of reconciliation from the apartheid era to the democratic dispensation as portrayed in the novel. It presents how Mda applies a retrospective nation-building narrative that fuses historical descriptions with fiction to satirise and subvert colonial nationalism for a prospective South African political unity. Similarly, he deconstructs manifestations of corruption of state resources by the black elite. The narrative of transition in South Africa does not only pertain to historical accounts, it also serves as an instrument to contrast the two administrations as they resume duty in the new South Africa, fictionalised as Excelsior, shortly after the elections. This article, thus, examines political transition in retrospect in order to project an inclusive future. It excavates historical accounts that can contribute to a deeper understanding of current events to assist South Africa re-imagine a transformed and peaceful future.

Abstract 12667: Racial Disparities in Emergency Care of Patients With Suspected ACS Undergoing Cardiac CT Angiography: Insights From Romicat II and ACRIN-PA

Introduction: A disparity in health outcomes between black and white patients with coronary artery disease (CAD) has also been reported with pathophysiological differences in CAD and racial disparities in providing health care as potential explanations. Hypothesis: To determine racial disparity in emergency care of patients with suspected acute coronary syndrome (ACS) undergoing cardiac CT angiography (cCTA), which provides knowledge of underlying CAD status. Methods: We combined patient level data of the ACRIN-PA 4005 (American College of Radiology Imaging Network, Pennsylvania) and ROMICAT II (Rule Out Myocardial Infarction using Computer Assisted Tomography) trials, which enrolled patients presenting with suspicion of ACS who were randomized to cCTA as a first diagnostic test at 14 US sites. Sample was restricted to subjects with known CAD status based on cCTA. Self-reported race while the race ‘Black’ were defined as “a person having origins in any of the black racial groups of Africa” and the race ‘white’ as “a person having origins in any of the original peoples of Europe, the Middle East, or North Africa”. Results: We included 1,191 patients (53% white, 47% black). Pretest probability for ACS was similar (TIMI score, p=0.77) between black and white patients, while black patients had lower presence and extent of CAD (calcium score: 39.3±189.3 vs. 88.2±292.1, p&lt;0.001; obstructive CAD 8.3% vs. 17.5%, p&lt;0.001) and ACS (4.0% vs 6.9%, p=0.03). After accounting for the underlying CAD, black patients were more likely admitted to the hospital (β: 0.29 [95%CI: 0.05-0.54-]) and were more likely to undergo additional testing (β: 0.47 [95%CI: 0.09-0.85]) while remaining management showed no significant differences. Conclusions: After adjustment for underlying CAD, among patients in the ED with suspicion of ACS, those who are black received more downstream testing and were more frequently admitted to hospital than white patients.

Abstract C020: Racial differences in the risks of second primary gynecologic cancers following chemotherapy for malignant ovarian tumors: Asian subgroups in the United States, 2000-2016

Abstract Objective: The incidence of ovarian cancer in the United States varies by race with the highest rates among white women but lower survival observed among black women and other racial and ethnic groups. These disparities in outcomes among women with ovarian cancer are not well understood, including the differential occurrence of second primary cancers according to race. Our objective was to measure racial differences in incidence of second primary gynecologic cancers (SPGC) among women with malignant ovarian tumors following treatment with chemotherapy. Specifically, we aimed to determine differences in SPGC incidence by Asian ethnic subgroups in the United States. Methods: We conducted a retrospective cohort study of women ages 20 years and older diagnosed with first primary malignant ovarian tumors treated with definitive surgery and chemotherapy between 2000 and 2016 from 18 population-based registries in the Surveillance, Epidemiology and End Results (SEER) Program. We collected demographic and clinical information on ovarian histologic subtypes, laterality, tumor grade, type of surgery and treatment with radiotherapy. Census tract-level sociodemographic characteristics of women were also described. The incidence of SPGC in our cohort was compared to expected incidence rates in the general population using age-and region-standardized incidence ratios (SIRs) and 95% confidence intervals (CI) for individual racial/ethnic groups. Results: Among 34,081 women with ovarian cancer, 74% were white, 6% were black, 8% were Asian/Pacific Islander (API) and 11% were Hispanic. Median age at diagnosis was lower among API and Hispanic women (54 years) compared to white (60 years) and black women (58 years). Most ovarian tumors were serous or endometrioid, although API women had a higher proportion of clear cell ovarian tumors (15%) compared to white (6%), black (5%) and Hispanic women (6%). Subgroups of API women also differed in distribution of ovarian tumor histology, grade, and age at diagnosis. Whereas incidence of SPGC was observed to be lower than expected among white women (SIR 0.72 CI 0.59-0.87), estimates were suggestive of higher than expected incidence among black (SIR 1.61, CI 0.88-2.71) and API women (SIR 1.64, CI 0.96-2.63), although confidence intervals included 1.0. Increased risk of vaginal cancers was observed among all women, although risk estimates were highest among API women (SIR 23.90, CI 4.93-69.84) and were also significant for risk of uterine cancers (SIR 2.28 CI 1.21-3.90). Among API women, only Filipinas had significantly increased incidence of SPGC overall including both uterine and vaginal cancers. Conclusions: Risk of SPGC following treatment of ovarian cancer differs by race. The increased incidence of secondary gynecological cancers observed in Asian women is driven largely by increased rates of uterine and vaginal cancers among Filipina women. Further research is warranted to understand the possible mechanism(s) underlying this observed disparity. Citation Format: Nita H Mukand, Ashwini N Zolekar, Naomi Y Ko, Gregory S Calip. Racial differences in the risks of second primary gynecologic cancers following chemotherapy for malignant ovarian tumors: Asian subgroups in the United States, 2000-2016 [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C020.

Lessons from Foreign Owned Spaza Shops in South African Townships

In 2014, the World Bank pronounced how the informal sector is probably responsible for half of the GDP in developing countries. This sector can no longer be ignored as it is embedded in most developing countries’ economies. In a country like South Africa, the informal sector is a gateway to economic freedom where the historically deprived groups were left behind and could not participate in the formal economic sectors, as they would have liked. This was due to racially skewed policies of the apartheid regime. The country saw black racial groups marginalised from acquiring appropriate skills, education and resources to allow them to participate in the formal economy. The barrier to entry into formal economies resulted in the significant rise of the informal economy. One of the most prevalent business forms in this sector has been Spaza Shops. In fact, in South Africa, Spaza Shops have become synonymous with the informal sector. Post-apartheid, with the opening of the country’s borders over the years, there has been an increase in foreign owned Spaza Shops both legally and illegally, at the expense of locally owned ones. Using an exploratory research design, this paper sought to uncover various practices and procedures that have been accredited to the success of foreign owned Spaza’s in townships. Through qualitative engagement with relevant literature published over a period of six years, a relationship between foreign owned businesses and locally owned businesses in the townships of South Africa was investigated. The study outcomes identified motives for increased and successful foreign owned businesses in townships. These are Networking and Economies of Scales; Socio-Economic Motivators; Geographic Location; Financial Management, Entrepreneurial Orientation and Business practice. All of these motives are seen as equally important and can be used to upskill and motivate local informal traders to be as competitive within the township economy.

A Dynamic Analysis of Maternal Fertility Choices and Child Health in South Africa

The relationship between household size and future health outcomes for children is of immense interest to economists, demographers and policy-makers especially in developing countries. One reason for this is that child health is a key determinant of future human capital. This is particularly important in South Africa with high levels of unemployment, poverty and gross income inequality. Moreover, the quantity-quality model of fertility indicates a trade-off of children’s welfare with increasing family size. However, despite the forgoing, relatively little empirical research has been done regarding this nexus, especially in developing countries. Furthermore, while the few studies have mainly relied on cross-sectional data, this study takes advantage of the availability of the recent National Income Dynamic Study (NIDS) panel data set to empirically assess this link. We make use of both the Generalized Method of Moments (GMM) and the Control Function (CF) approaches to account for econometric issues such as heterogeneity and endogeneity. These results suggest fertility choices has a significant association with child health. Moreover, younger children are more likely to be affected by increased household size. These results are concordant with theoretical expectations. From a policy perspective, these findings indicate that intensified child support is likely to improve child health outcomes in South Africa, particularly among the black racial group where fertility is comparatively higher. Moreover, family planning programs especially in the rural areas of the country, should be promoted. In addition, the empowerment of women through provision of funding for schooling and skills development could also contribute to better child health outcomes.

The Pharmacy Student Population: Applications Received 2017-18, Degrees Conferred 2017-18, Fall 2018 Enrollments

This report presents data that describe the 2017-18 pharmacy application pool, degrees conferred in 2017-18, and fall 2018 pharmacy program enrollments. Data for this report were requested from 143 US colleges and schools of pharmacy recognized by the Accreditation Council for Pharmacy Education (ACPE) using five separate survey instruments. There were previously two professional education programs at US colleges and schools of pharmacy: one leading to a baccalaureate in pharmacy, and the other leading to the Doctor of Pharmacy (PharmD) degree. However, June 30, 2005 marked the official expiration of the ACPE standards to the baccalaureate in pharmacy (BS Pharmacy) degree programs in accordance with the transition to the Doctor of Pharmacy (PharmD) degree as the sole professional degree program in the US Some colleges and schools of pharmacy conferred degrees in the BS Pharmacy program until 2004-05. For the purpose of this report, students in Doctor of Pharmacy programs are categorized under PharmD1 when the program leads to a Doctor of Pharmacy degree conferred as the first professional degree. Students who have already received a baccalaureate in pharmacy and are enrolled in a Doctor of Pharmacy degree program are categorized under PharmD2. The following definitions refer to the race/ethnicity groups as used in this report. White refers to US citizens or permanent residents having origins in any of the original peoples of Europe, the Middle East, or North Africa. Black or African American refers to US citizens or permanent residents having origins in any of the black racial groups of Africa. Hispanic or Latino refers to US citizens or permanent residents of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. Asian refers to US citizens or permanent residents having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. Native Hawaiian or Other Pacific Islander refers to US citizens or permanent residents having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. Prior to 2011, these students were included in the Asian category. American Indian or Alaska Native refers to US citizens or permanent residents having origins in any of the original peoples of North and South America (including Central America) who maintains cultural identification through tribal affiliation or community attachment. Two or More Races refers to US citizens or permanent residents who are not Hispanic or Latino and identify themselves by more than one race. Unknown refers to US citizens or permanent residents whose race and ethnicity are not known. Prior to 2011, this category was labeled Other/Unknown and students that were of two or more races were included in this category. Finally, International/Foreign refers to citizens of a foreign country/permanent residents of a country other than the US.

Abstract TP206: Prevalence and Predictors of Cerebral Microbleeds Among Racial Minorities With Ischemic Stroke and Transient Ischemic Attack

Background: Cerebral microbleeds (CMB) are associated with dementia and stroke. CMB are attributed to cerebral amyloid angiopathy (lobar CMB), and hypertensive angiopathy (deep CMB). Racial minorities (RM) have a higher prevalence and poorer control of vascular risk factors, thus CMB may differ in prevalence and distribution in RM. We determined the prevalence, burden and vascular risk factors of CMB across racial groups in patients with stroke and transient ischemic attack, and CMB influence in short term outcomes. Methods: We included 2001 consecutive (year 2009-2018) patients with a readable T2*gradient-echo MRI sequence. CMB rating followed standardized guidelines and grouped topographically into lobar, deep or infratentorial. Race was self-reported based on U.S. census procedures and categorized as White, Black or Other racial groups (ORG). Univariate analyses were done to compare vascular risk factors between CMB groups, and multivariate logistic regression analyses were used to relate CMB and short term functional (modified Ranking scale score &lt;3 vs. higher) and adverse hospital outcomes (pneumonia, UTI, DVT, death), across racial groups. Results: We observed CMB in 679 (34%) patients. The respective distribution in lobar, deep and infratentorial regions were: Whites (n=174; 67.2%, 20.7% and 12%); Blacks (n=374; 53%, 28.4% and 18.5%); ORG (n=131; 45.5%, 25.3% and 29.3%). Blacks and ORG with CMB were younger than Whites (66 and 66 vs 70; p&lt;0.01); and had higher prevalence of diabetes (44% and 41% vs 28%, p&lt;0.01). Blacks had higher prevalence of previous stroke when compared with Whites (36% vs 27%, p&lt;0.05). Patients with 10+ CMB, compared with no CMB and 1-9 CMB, had higher in-hospital pneumonia (8% vs 2.1% and 2.4% respectively; p=0.02) and were less likely to have mRS 0-2 at discharge (44.8% vs 55.3% and 48.7%; p=0.06). No difference was observed in mortality and other hospital adverse events. Conclusion: Racial minorities had higher proportion of CMB in non-lobar regions, suggesting that RM are more likely to have hypertensive angiopathy. RM with CMB were younger and differed in several risk factors compared to Whites. High CMB burden affected adversely outcomes. Further studies are needed to better characterize the clinical impact of CMB in RM.

A Comparative Analysis of Black Racial Group Consciousness in the United States and Britain

AbstractExtant scholarship on black politics has demonstrated the mobilizing effect that racial group consciousness can have on African American political participation. Few studies, however, test for or compare the political impact of group consciousness across national contexts. This paper presents an empirical comparison of group consciousness and its relationship with political behavior among black Americans and black Britons. Mobilizing two nationally representative surveys from the United States and Britain and a multi-dimensional measure of group consciousness, the findings presented here suggest that while elements of racial group consciousness are present among blacks in both societies, racial group consciousness is generally more prevalent and politically significant among blacks in the United States. For example, blacks in Britain are less likely to view blacks as occupying a fundamentally marginalized structural position and less likely to endorse race specific interventions that might address that marginalization. Results from regression analysis further suggest that while strong racial (rather than national) group attachment negatively affects the likelihood that blacks will vote in both countries, other elements of group consciousness are more strongly associated with participation among blacks in the United States than in Britain.

Sexually Dimorphic Faciometrics in Black Racial Groups From Early Adulthood to Late Middle Age.

An increasing body of research focusing on gender-related traits has utilized faciometrics in order to consider sexual dimorphism: Aspects as diverse as social heuristics, facial attractiveness, sexual orientation, aggression, and trustworthiness have all been investigated. However, the majority of these studies have tended to focus on White or Caucasian student populations and have paid little regard to either older populations or racial background. The current study therefore investigated sexual dimorphism in 450 participants (225 women) from a Black population across four age groups (20s, 30s, 40s, and 50s). In line with much previous research using White or Caucasian faces, the expected sexual dimorphism was seen in the younger age-group in three of the four indices (cheekbone prominence, facial width to lower facial height, and lower face height to full face height). However, consistent with more recent literature, the facial width to height ratio (fWHR) was not found to be significantly different between men and women in this age-group. Contrary to previous research, when considering broader age groups, the three established measures of facial sexual dimorphism, when looked at independently, remained static over time, but this was not true for fWHR. It is concluded that facial structure does not follow the same aging trajectory in all populations and care should be taken in choice of facial metric, depending on the nature of the sample under investigation.