Degree Of Underrepresentation Research Articles

Racial/Ethnic Representation Among American Board of Family Medicine Certification Candidates from 1970 to 2020.

Because improved patient outcomes and experiences have been associated with health care workforce diversity, efforts to create a diverse family physician workforce have increased. However, a metric that could properly measure family physician representation in various contexts has seldom been studied. The goal of this study is to propose a new metric logRQ and use it to examine the diversification progress of American Board of Family Medicine (ABFM) certification candidates relative to national, state, and historic populations, as well as medical school matriculants. We obtained race/ethnicity for certification candidates from the 2014 to 2020 ABFM Certification Examination Registration questionnaire and examined racial/ethnic representation relative to various populations via logRQs. The total sample comprised 26,368 initial certification candidates and 55,347 continuing certification candidates. Asian, Hispanic, and Black's logRQ increased by 0.51, 0.42, and 0.41, respectively, in initial certification candidates compared with continuing certification candidates. In addition, logRQ standard deviation ranged from 0.19 to 0.87 across States, indicating state-level variation. Although Black and Hispanic remained underrepresented, the degree of underrepresentation had improved substantially across the past 5 decades, with logRQ increasing from -2.12 (Black) and -1.16 (Hispanic) in the 1970s to -0.46 (Black) and -0.68 (Hispanic) in the 2010s. The race/ethnicity logRQs of 2020 initial certification candidates relative to 2013 to 2014 medical school matriculants were all near 0, reflecting equitable representation. We utilized the proposed metric logRQ to quantify the advancement in representation among ABFM certification candidates in different contexts. The proposed logRQ may serve as a useful tool to monitor representation progress systematically.

Distribution of age and apnea-hypopnea index in diagnostic sleep tests in West Texas

Obstructive sleep apnea (OSA) is a disease characterized by the collapse of the upper airway during sleep. It is debated whether increasing age is associated with an increased severity based on the apnea-hypopnea index (AHI) in OSA patients. To better characterize the distribution of age and AHI in OSA patients, a large, retrospective analysis of diagnostic sleep test results in West Texas was performed. This study analyzed 3993 adult patients (aged ≥18 years) who had either a full or a split night sleep study performed at Alpha Sleep Labs between July 1, 2009, and September 1, 2020. The distribution of age approximates a normal distribution with a mean age of 52.6 and standard deviation of 14.4 years. Compared to the US population, the study population is overrepresented by those 40 to 60 years of age and underrepresented by those 20 to 40 and ≥60 years. The degree of underrepresentation was greater for young patients than the elderly. The number of subjects vs. AHI approximated an exponential decay. Although prevalence probably contributes to the observed distributions of age and AHI, we cannot conclude that our data represent either the prevalence of OSA or AHI. The population of people undergoing diagnostic sleep testing is not representative of the total population. Interdependencies are observed between age and AHI, but the basis for these interdependencies is unclear. Future studies will need to examine these effects in greater detail.

Faith Binckes, Kathryn Laing, Hannah Lynch (1859-1904): Irish Writer, Cosmopolitan, New Woman

She wrote with a passion for perfection. (p. 1) The recent decade in Irish literature has been marked by a boom in critical research that seeks to restore fairness to the canon’s gender inequality. Although there is always a risk of exclusion, in the case of Ireland, women writers have suffered from a serious degree of under-representation in Irish critical discourse. The change is detectable by a new wave of inspiring critics who challenge previous traditions, showing the cultural richness o...

Confidence in Law Enforcement When African-Americans are Underrepresented on the Force: An Exploratory Study

Confidence in Law Enforcement When African-Americans are Underrepresented on the Force: An Exploratory Study, Charles E. MacLean, 2019: Dissertation, Nova Southeastern University, Abraham S. Fischler College of Education and School of Criminal Justice. This dissertation explores the prediction that when African-Americans are underrepresented among sworn officers in a community’s local law enforcement agencies compared to the African-American proportions in that community’s overall population, African-American civilians’ confidence in their local law enforcement agencies may suffer, leading to impaired respect for law, reduced civilian cooperation with law enforcement, and civilian impressions of weakened procedural justice and fairness. With low civilian confidence, the argument goes, one could expect an enhanced sense of disenfranchisement among the underrepresented sub-populations. The purpose of this study is to consider the impact of underrepresentation of African-Americans among sworn officers serving a local community, explore the key correlates of civilian confidence viewed through the lens of African-American perceptions and attitudes, and confront the superordinate roles that procedural justice and police effectiveness play in forming African-American civilian attitudes of confidence, trust, and satisfaction in local law enforcement. To quantify representativeness, this study expresses relative racial compositions of the police and the policed as a Racial Mirror Index (“RMI”). If the percent of a community’s police, who are African-American, exactly matches the percent of the policed in that community, who are African-American, the RMI-AA (“Racial Mirror Index-African-American”) would equal 100. RMI-AAs over 100 indicate African-Americans are overrepresented on the local law enforcement agency compared to the African-American share of the general population; RMI-AAs under 100 indicate African-Americans are underrepresented among sworn officers on the force. Despite expectations, as this study makes clear, RMI-AA is not a significant predictor of African-American civilian confidence, trust, and satisfaction in local law enforcement. Instead, African-American attitudes about local law enforcement are overwhelmingly driven by African-American perceptions of procedural justice and police effectiveness. African-American confidence, trust, and satisfaction in law enforcement remains far lower than for Whites regardless of RMI-AA and the degree of underrepresentation on the force. Thus, law enforcement agencies cannot hire their way out of this confidence gap through minority recruitment. Instead, improving African-American confidence in local law enforcement will require the agencies to engage with the far more substantive work of ensuring their officers deliver both procedural justice and effective policing.

Safe Harbors from Fair‐Cross‐Section Challenges? The Practical Limitations of Measuring Representation in the Jury Pool

The U.S. Constitution guarantees criminal defendants the right to an impartial jury selected from a jury pool that reflects the demographic composition of the geographic community served by the court. Yet there is little consensus in case law from state and federal courts about the most appropriate method of measuring demographic representation or the degree of underrepresentation that would violate the fair‐cross‐section requirement. Although the U.S. Supreme Court recently addressed these issues for the first time since Duren v. Missouri, its opinion in Berghuis v. Smith did little to settle the questions. In the present article, the authors use demographic information from the U.S. Census Bureau and information about jury operations in state courts from the National Center for State Courts to estimate the potential impact of competing proposals about how to measure demographic representation at different threshold levels of constitutional tolerance. Given the demographic composition of counties in the United States and the size of the jury pool in most courts, the authors find that a bright‐line rule using either of the two most common measures of representation (absolute disparity and comparative disparity) would create “safe harbors” in which the courts in a majority of jurisdictions across the country would become effectively immune from fair‐cross‐section challenges.

Safe Harbors from Fair Cross Section Challenges? The Practical Limitations of Measuring Representation in the Jury Pool

The US Constitution guarantees criminal defendants the right to an impartial jury selected from a jury pool that reflects the demographic composition of the geographic community served by the court. Yet there is little consensus in case law from state and federal courts about the most appropriate method of measuring demographic representation or the degree of underrepresentation that would violate the Fair Cross Section requirement. Although the US Supreme Court recently addressed these issues for the first time since Duren v. Missouri, its opinion in Berghuis v. Smith did little to settle the questions. In the present paper, the authors use demographic information from the US Census Bureau and information about jury operations in state courts from the National Center for State Courts to estimate the potential impact of competing proposals about how to measure demographic representation at different threshold levels of constitutional tolerance. The authors find that a bright-line rule using either of the two most common measures of representation (absolute disparity and comparative disparity) given the demographic composition of counties in the US and the size of the jury pool in most courts would create “safe harbors” in which the courts in a majority of jurisdictions across the country would become effectively immune from fair cross section challenges.

Underrepresentation of short palindromes in Selenomonas ruminantium DNA: evidence for horizontal gene transfer of restriction and modification systems?

Molecular analysis of isolates of the rumen bacterium Selenomonas ruminantium revealed a high variety and frequency of site-specific (restriction) endonucleases. While all known S. ruminantium restriction and modification systems recognize hexanucleotide sequences only, consistently low counts of both 6-bp and 4-bp palindromes were found in DNA sequences of S. ruminantium. Statistical analysis indicated that there is some correlation between the degree of underrepresentation of tetranucleotide words and the number of known restriction endonucleases for a given sequence. Control analysis showed the same correlation in lambda DNA but not in human adenovirus DNA. Based on the data presented, it could be proposed that there is a much higher historical occurrence of restriction and modification systems in S. ruminantium and (or) frequent horizontal gene transfer of restriction and modification gene complexes.

Participation of patients 65 years of age or older in cancer clinical trials.

Although 61% of new cases of cancer occur among the elderly, recent studies indicate that the elderly comprise only 25% of participants in cancer clinical trials. Further investigation into the reasons for low elderly participation is warranted. Our objective was to evaluate the participation of the elderly in clinical trials sponsored by the National Cancer Institute (NCI) and assess the impact of protocol exclusion criteria on elderly participation. We conducted a retrospective analysis using NCI data, analyzing patient and trial characteristics for 59,300 patients enrolled onto 495 NCI-sponsored, cooperative group trials, active from 1997 through 2000. Our main outcome measure was the proportion of elderly patients enrolled onto cancer clinical trials compared with the proportion of incident cancer patients who are elderly. Overall, 32% of participants in phase II and III clinical trials were elderly, compared with 61% of patients with incident cancers in the United States who are elderly. The degree of underrepresentation was more pronounced in trials for early-stage cancers than in trials for late-stage cancers (P <.001). Furthermore, protocol exclusion criteria on the basis of organ-system abnormalities and functional status limitations were associated with lower elderly participation. We estimate that if protocol exclusions were relaxed, elderly participation in cancer trials would be 60%. The elderly are underrepresented in cancer clinical trials relative to their disease burden. Older patients are more likely to have medical histories that make them ineligible for clinical trials because of protocol exclusions. Insurance coverage for clinical trials is one step toward improvement of elderly access to clinical trials. Without a change in study design or requirements, this step may not be sufficient.

The Underrepresentation of French Canadians on English Canadian NHL Teams

Using a comprehensive data set covering the entire modern era of the National Hockey League (NHL), this article finds evidence that French Canadians have been underrepresented on English Canadian NHL teams, relative to their representation on U.S.-based teams. This underrepresentation on English Canadian teams was found not only for French Canadian players but also for off-ice personnel such as general managers and coaches. None of the traditional arguments as to why French Canadians may face entry barriers in the NHL can adequately explain the results of this article. The findings of the article give support to the hypothesis that French-English tensions may be resulting in English Canadian teams discriminating against French Canadian players. This hypothesis is given more credence when it is found that the degree of underrepresentation of French Canadians is greater during those NHL seasons when sovereigntist political threats in Quebec are highest.