Ethnic Backgrounds Research Articles

Worldwide Clinical and Real-World Exposure to Baricitinib

Introduction: Baricitinib (BARI), an oral selective JAK inhibitor, is approved in many geographies for adults with rheumatoid arthritis or alopecia areata and for patients as young as age 2 years with atopic dermatitis or juvenile idiopathic arthritis. It is also approved in the US for hospitalized patients with COVID-19 infection. We report the worldwide clinical trial and real-world exposure to BARI across a range of diseases, ages and racial backgrounds. Methods: Real-world patient exposure estimates were calculated based on total mg sold, average daily dose, and average length of therapy as reported to regulatory agencies through the cumulative timeframe ending Jan. 31, 2024. Clinical trial exposures were based on actual exposures from completed trials through Feb. 13, 2024, and estimates were made for ongoing blinded trials based on the enrolment/randomization schemes Results: In the real-world setting, an estimated 1,836,600 patients have been exposed to the following BARI doses: 1 mg, ~2,000 (0.1%); 2 mg, ~524,900 (28.6%); 4 mg, ~1,309,600 (71.3%). Of these estimated exposures, ~ 57% were for COVID-19 with the remaining for all other indications combined. Across 59 clinical trials (completed and ongoing), an estimated 14,660 subjects (548 healthy volunteers and 14,112 patients) have received BARI since June 2008. Exposures from completed studies include 10,276 patients (62% female), 399 of whom were <18 yrs of age (≤1 month, N=4; 1 month - ≤2 yrs, N=24; >2 - ≤12 yrs, N=111; >12 - ≤18 yrs, N=260), 8820 were >18 to ≤65 yrs, 1027 were >65 yrs, and 30 had age unknown. An additional 467 adolescent and pediatric patients down to the age of 2 have been treated with BARI for atopic dermatitis in an ongoing clinical trial, bringing the total number of patients <18 years of age to 866 across dermatologic, rheumatologic, other autoimmunologic, and acute infectious diseases (excluding alopecia areata for which there is an ongoing pediatric trial). Clinical trial exposures by racial and ethnic background are as follows: Asian, N=2,491; Black, N=450; Caucasian, N=6,237; other, N=496; multiple, N=135; unknown, N=467. Conclusion: There has been extensive real-world exposure to BARI across indications and populations, and BARI is a well-studied molecule in clinical trials, across varied disease states, racial populations and ages. Since average daily dose and length of therapy may vary over time, real-world exposures are only an estimate of total patients receiving BARI. Exposures in clinical trials include patients as young as less than 1 month of age up to patients over the age of 65 years. While these exposures do not indicate efficacy or safety, they provide data to establish the overall profile of the drug and can inform on its performance over time across a variety of populations.

Self-Reported Unfair Police Stops and Skin Tone, Ethnic Origin, and Citizenship Status among Latino Adults

While a growing literature has documented vast ethnoracial inequalities tied to the occurrence and outcomes of police contact, less research has examined the patterning of perceived unfair police stops among Latino populations. The present study relies on insights from tri-racial stratification theory to examine associations between perceived unfair police stops and skin tone, ethnic origin, and citizenship status among Latino adults. Data come from the Pew Research Center’s nationally representative 2021 National Survey of Latinos ( n = 3,019). We regress whether a respondent perceived being stopped unfairly by police in the past year on the Yadon-Ostfeld Skin Color Scale (i.e., 1–10, 10 = Darkest), ethnic origin (i.e., Puerto Rican, Cuban, Dominican, Salvadoran, Spaniard, Central American, South American, or other), and citizenship status (i.e., U.S. citizen or not). Results showed that having a darker skin tone and U.S. citizenship were associated with higher odds of experiencing a police stop perceived as unfair. Latinos with the darkest skin tones had nearly a one in five chance of a perceived unfair police stop. Average probabilities of a perceived unfair stop were higher for Puerto Ricans, Cubans, and Salvadorans than others followed by Mexicans/Chicanos. Dominicans’ probability was lower than five of the eight other groups. Findings identify heterogeneity among Latino populations such that variation in skin tone, citizenship status, and ethnic origin independently factor into self-reported unfair police stops. Research examining ethnoracial disparities in criminal legal contact and its consequences would benefit from more fully disaggregating panethnic groups.

Socioeconomic deprivation and perinatal anxiety: an observational cohort study.

Women from areas of social deprivation and minority ethnic groups are more likely to experience poor physical health and have higher rates of mental health problems relative to women from less socially disadvantaged groups. However, very little research has examined this in relation to perinatal anxiety. The current study aims to determine prevalence, risk factors and desire for treatment for perinatal anxiety in three regions of the UK with diverse regional characteristics. Women completed measures of anxiety in early, mid-, late-pregnancy and postpartum. Participants were included from three regions of the UK: Region 1 = North East England & North Cumbria n = 512; Region 2 = London North Thames n = 665; Region 3 = West Midlands n = 705. Prevalence of perinatal anxiety was lower in Region 1 (OR 0.63 95% CI 0.45 to 0.89) and Region 2 (OR 0.72 95% CI 0.52 to 0.98) relative to Region 3. Analysis showed the effect of neighbourhood socioeconomic deprivation on perinatal anxiety differed by region. In more affluent regions, living in a deprived neighbourhood had a greater impact on perinatal anxiety than living in a deprived neighbourhood in a deprived region. Other factors associated with risk of anxiety in the perinatal period included physical health problems and identifying as being from 'mixed or multiple' ethnic groups. Neighbourhood deprivation relative to regional deprivation is a better predictor of perinatal anxiety than either regional deprivation or neighbourhood deprivation alone. Women of mixed ethnic backgrounds and women with physical health problems may warrant more attention in terms of screening and support for perinatal anxiety. Self-reported desire for treatment was found to be low.

Experiences of using Electronic Medical Records among Patients from Ethnic Minority Backgrounds: A Rapid Review

Experiences of using Electronic Medical Records among Patients from Ethnic Minority Backgrounds: A Rapid Review

Racial/ethnic differences in survival and treatment response with PD-1/PD-L1 inhibitors in resectable non-small cell lung cancer: a meta-analysis of randomized controlled trials.

The optimal treatment for resectable Non-Small Cell Lung Cancer (NSCLC) remains under investigation, particularly about its effectiveness across different ethnicities. This meta-analysis aims to investigate the potential benefits of adding PD1/PD-L1 inhibitors for treatment, stratified by ethnicity. We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCTs) that investigated the use of PD1/PD-L1 inhibitors to treat patients with resectable NSCLC. The outcomes evaluated were disease-free survival/event-free survival (DFS/EFS), major pathological response (MPR), and pathological complete response (pCR). Hazard ratios (HRs) or risk ratios (RRs) with 95% confidence intervals (CIs) were computed for all endpoints using DerSimonian and Laird random-effects models. Statistical analyses were performed with R Software, version 4.2.3. A total of six RCTs comprising 3,827 patients with NSCLC were included. In populations of Asian descent, PD1/PD-L1 significantly improved DFS/EFS (HR 0.59; 95% CI 0.44-0.78), MPR (RR 5.76; 95% CI 3.58-9.28), and pCR (RR 25.00; 95% CI 6.17-101.36). Similarly, patients of European ancestry experienced significantly improved DFS/EFS (HR 0.77; 95% CI 0.65-0.90), MPR (RR 2.75; 95% CI 2.00-3.77), and pCR (RR 4.53; 95% CI 2.69-7.6) with PD1/PD-L1 therapy. Notably, patients with mixed ethnicity also demonstrated significant improvement in MPR (RR 4.05; 95% CI 2.60-6.33) and pCR (RR 8.44; 95% CI 3.75-19.00) when receiving PD1/PD-L1 inhibitors. This comprehensive meta-analysis suggests that incorporating PD1/PD-L1 inhibitors into treatments offers a promising benefit for patients with resectable NSCLC, regardless of ethnicity. Future studies with in-depth molecular characterization of patients can further refine these findings and potentially guide the development of personalized treatment strategies based on individual ethnic backgrounds.

EDI&S SO02 The Aspire Initiative: A Community-Based Intervention to Champion Equality, Diversity and Inclusion in the Future Surgical Workforce

Abstract Background In March 2021, the Royal College of Surgeons of England published The Kennedy Report, an independent and powerful review addressing the critical issues surrounding equality, diversity and inclusion within the surgical profession. Chapter 5 of the review states that aspirations to become a surgeon can begin whilst at secondary school, yet students from diverse ethnic and social backgrounds felt discouraged by teachers who doubted their potential. We describe the development and implementation of a strategic careers outreach initiative across the state-funded secondary schools in our diverse community, aiming to engage and support aspiring surgeons early in their journey. Method In June 2023, The Aspire Initiative was launched as an independent entity supported by surgeons from the local Hepato-Pancreato-Biliary Unit and sponsorship from the Royal College of Surgeons of England. Targeting students aged 13 to 17, the initiative offers community open events, inspiring video content, surgical work experience for those over 16, and outreach careers assemblies. Between November 2023 and March 2024, 13 assemblies were delivered at various state-funded secondary schools across Leicester. These sessions were led by surgeons reflecting ethnic, gender, and socio-economic diversity. Students were invited to complete surveys before and after the assembly to assess their impact. Results The pre-session survey, completed by 874 students from Years 8-11, revealed that 149 aspired to be doctors or surgeons, while 243 were considering this (n=392). Of the 392 students, 57% reported that their parents had not attended university. Only 19% had a good understanding of the medical school application process, and 21% knew about the support available. Furthermore, 31% felt knowledgeable about the daily responsibilities and training pathways of medical professionals. The post-session survey, with 420 responses, showed significant improvements: 91% gained a better understanding of a surgical career and 52% felt more inspired and motivated to pursue their aspirations. Conclusion The Kennedy Report recommended that careers outreach to diverse communities should be planned for as a strategic priority. This study highlights the impact of such initiatives in state-funded secondary schools, showing how they provide students from diverse social backgrounds with crucial insights into surgical careers. These programs help students make informed decisions and inspire them to pursue their aspirations by connecting with relatable role models. We propose that engaging with students at the secondary school level offers an ideal opportunity for surgeons to foster and sustain professional relationships with a diverse future workforce, laying foundations for continued support and mentorship.

Abstract 4137770: Development of a User-Friendly Self-Screening Tool for Assessing Metabolic Syndrome Risk in young adults from economically challenged regions

Background: Metabolic syndrome is a cluster of conditions that increase the risk of heart disease and diabetes. Early identification and management are crucial, particularly in economically challenged regions where access to healthcare may be limited. Research Questions/Hypothesis: User-friendly self-report data accurately predict metabolic outcomes. Aims: To develop and validate nomograms for individualized estimation of metabolic syndrome risk. Methods: Data from 521 college students (60.1% aged 17-20 years; 68.7% female; 28.0% white) were collected in 2022/2023 from two Brazilian cities. These cities are located in the country's poorest states, with Gini indices of 0.56 and 0.43. The potential predictors include demographic and economic variables, school-related factors, behaviors, and body weight. Based on predictors for abdominal obesity identified through multilevel logistic regression, we created a nomogram model. We performed the Hosmer-Lemeshow test to assess model calibration and used a bootstrapping approach (B = 150) for internal validation. To evaluate external validity, we assessed metabolic syndrome in a subset of 375 students. The area under the receiver operating characteristic curve (AUROC), with a threshold of 0.70, was used to evaluate the model's discrimination accuracy. Results: We identified 114 (23.0%) college students who were abdominally obese. We found ten variables associated with the primary outcome: age, biological sex, physical education facilities, enrollment in sports competition (during elementary school); grade retention, preferred subject, physical education classes per week; enrollment in sports training (during secondary school); adherence of 24-hour movement behaviors and body weight. The proposed nomogram showed acceptable performance in the AUROC (0.94 [95% CI: 0.92-0.96). The calibration assessment indicated reasonable consistency of our model (p > 0.05). In the internal validation, we observed a decreased predictive capability (AUROC = 0.86). Conclusion: The 24h-MESYN risk score offers an effective self-screening tool for college students from diverse racial and ethnic backgrounds in economically challenged regions to assess their risk of developing metabolic syndrome.

Abstract 4144525: An Observation Of Racial Disparities In Patients Admitted With St Segment Elevated Myocardial Elevation

introduction: This sudy explores the multifaceted nature of racial disparities among patients admitted with STEMI, shedding light on the complex interplay of social, economic, and healthcare factors that contribute to differential outcomes among diverse populations. Methods: we examined the national inpatient sample 2017-2020 for adult admitted with st segment myocardial infarction,we compared the clincal outcome based on racial distribution.STATA 18th edition was used for analyses. Age, gender, race, hypertension, diabetes, obesity, dyslipidemia, and Elixhauser comorbidity index were identified as confounders by univariate analyses and tested further with multivariate logistic regression models. The primary outcome was mortality. Secondary outcomes were the need for intubation, cardiac arrest, length of stay (LOS), and total hospital charges. Results: There were 826315 hospitalizations with STEMI. Mean age was 64 yrs and 62% were male. Among the admitted patients, Caucasians were 593575 (72%), Blacks were 75025(9.1%),Hispanics were 69605(8.4%), Asians were 23734(2.9%). All-cause mortality in patients admitted with STEMI was 88125 where subgroup Analysis with Caucasians, Blacks ,Hispanics and Asians had 60074(10.1%) vs 9135 (12.1%) vs 7645(10.9%) and 2999(12.6%) respectively. Further subgroups analysis revealed that Blacks (13.9%, aOR 1.37 CI 1.28-1.47,P value<0.001) were more likely to require intubation,followed by Asians(13.5% aOR 1.59 CI 1.43--1.76, p value <0.001) ,then Hispanic (13% aOR 1.45,CI 1.35-1.56 P vale <0.001)and caucasians were least likely to require intubation(9.7% ) Finally, racial subgroup showed significant primary andsecondary outcomes that are presented in Table 1. Conclusion: All obtained results revealed statistical significance and we considered Caucasian population as baseline. Mortality waa highest amongst Asians,followed by Blacks then Hispanics and least in the caucasian subgroup. Understanding these disparities is essential for improving healthcare equity and ensuring that all patients receive appropriate and equitable care regardless of their racial or ethnic background.

Abstract 4137516: Disparities in Participation: Analyzing Age, Sex, Race, and Ethnicity in Atrial Fibrillation Clinical Trials in the United States

Introduction: Atrial fibrillation (AF) is a prevalent cardiovascular disease that significantly impacts public health in the United States. Although numerous clinical trials aim to optimize AF management, concerns about demographic disparities in trial participation persist. This study assesses the representation of age, sex, race, and ethnicity among participants in AF trials conducted in the US, highlighting potential biases that could affect the generalizability of trial outcomes. Methods: An extensive review of clinical trials registered on ClinicalTrials.gov involving patients with AF up to April 2024 was performed. The search was filtered to include all completed interventional trials across phases 2 to 4 without restrictions on the initiation or completion dates. Data were extracted concerning mean age, age distribution, sex, and the racial and ethnic composition of the trial participants. Results: From the 173 trials analyzed, a total of 1,355,239 participants were included, with an average age of 64.7 years. The demographic breakdown revealed a participant pool consisting predominantly of older adults (>65 years: 70.8%), with a significant underrepresentation of the younger age group (18-65 years: 29.2%). Males constituted 65.2% of the trial population, highlighting a gender imbalance. Racially, 74.1% of participants were White, while African Americans (7.7%) and Asians (5.9%) and other racial groups were notably underrepresented. Ethnic disparities were also evident, with Hispanic participants making up only 11.5% of the study population. Conclusion: The findings demonstrate significant disparities in the age, sex, race, and ethnic backgrounds of AF clinical trial participants in the US. These imbalances could potentially limit the applicability of trial results across the broader, diverse population. Efforts to enhance the diversity of clinical trial cohorts are essential to ensure more equitable health outcomes and the universal applicability of clinical research findings. Future strategies should focus on targeted recruitment and inclusive study designs to address these disparities.

A IMPORTÂNCIA DO ALEITAMENTO MATERNO PARA ESTREITAR O VÍNCULO AFETIVO ENTRE MÃE E FILHO

Breastfeeding plays a crucial role in strengthening the bond between mother and child. In addition to providing vital nutrition in the first months and years of a child's life, breastfeeding also promotes a healthy, affectionate relationship. Exclusive practice in the first months is the best form of nutrition, intensifying the emotional bond and contributing to healthy development. Adequate guidance on breastfeeding techniques during the prenatal and postpartum period is essential to ensure the effectiveness of this process. Furthermore, breastfeeding offers benefits for both the baby and the mother, helping with postpartum recovery and protecting against diseases such as breast cancer. However, challenges persist in promoting breastfeeding, with rates below recommendations in some regions due to social and cultural factors. It is essential that health policies and professionals offer support and education to mothers, regardless of their ethnic origin or financial situation. Childcare consultations play a crucial role in monitoring a child's growth and promoting child health. Therefore, the active involvement of health professionals, public policies and society in general is necessary to create an environment favorable to breastfeeding. Breastfeeding is essential for promoting healthy relationships between mothers and children, contributing to the physical and emotional health of both.

Exploring the Impact of Workforce Diversity on Employee Attitudes and Organizational Performance: An Empirical Study of Perceptions and Outcomes

Background: As modern organizations increasingly prioritize workforce diversity, understanding its influence on employee performance and organizational effectiveness is crucial. This study investigates the impact of diversity dimensions, including gender, age, ethnicity, and educational background, on employee attitudes and workplace outcomes. Objectives: The primary aim is to assess employees' perceptions of diversity within organizational contexts, exploring their attitudes toward diversity initiatives, personal impacts, and the broader effects on organizational success. Methods: A quantitative survey approach was employed, with a structured questionnaire administered to capture responses from a diverse participant sample. The survey examined agreement or disagreement across statements related to diversity's benefits, costs, and effects on organizational harmony and personal satisfaction. Findings: Results reveal a strong, positive perception of diversity among respondents, with the majority indicating that diversity fosters harmony, organizational effectiveness, and personal enrichment. While 91.4% express enthusiasm for diversity, 100% agree that diversity initiatives are worthwhile and support continued organizational efforts. Negative sentiments were minimal, indicating broad acceptance and positive attitudes toward diversity. Conclusion: The findings highlight diversity as a strategic asset that enhances innovation, inclusivity, and organizational performance. The study underscores the value of fostering a diverse workplace culture where employees feel appreciated, engaged, and motivated to contribute unique perspectives. Novelty: This research adds to the growing body of literature by providing empirical evidence from a varied demographic context, reinforcing diversity’s role in strengthening organizational cohesion and performance. The insights contribute to a deeper understanding of how positive diversity perceptions can be leveraged as a driver of organizational success.

Exploring patients’ views and experiences of side-effects and how they are reported, a focus group study

Abstract Introduction Adverse drug reactions (ADRs) are an increasing health concern, causing considerable physical, psychological and economic impacts1,2. The yellow card scheme (YCS) is the UK’s spontaneous reporting system, allowing patients and healthcare professionals to report ADRs (3). Research has shown that patient reports could provide a beneficial insight into real-world situations and are a key aspect of pharmacovigilance2. Despite this, under-reporting by patients remains a significant issue that needs to be addressed1. Aim This study aimed to explore views and experiences of the public regarding ADR reporting. Methods Following approval from Cardiff University School of Pharmacy and Pharmaceutical Sciences Research Ethics Committee, adult members of the South Wales public who had experienced an ADR (“side-effect”) were invited via social media outlets such as Facebook and WhatsApp to participate in an online (Zoom) focus group to discuss their ADR experience (including whether they reported) and knowledge and views on the YCS. Healthcare professionals were excluded from the study. Written informed consent and demographic information via a short online survey were obtained prior to the focus group. The focus groups were audio and video recorded via Zoom and discussions were transcribed verbatim. A thematic analysis was executed to identify fundamental themes. Results Four focus groups, involving 11 participants took place. The sample consisted mostly of females between 18-30 years of age from an ethnic minority background. Themes identified were lack of knowledge of ADRs and the YCS; support and barriers to reporting ADRs and strategies for improving YCS reporting. There was a lack of knowledge of ADRs with uncertainty over the concept of “side-effect” and varying degrees of understanding on the topic. All participants had suffered side-effects that were severe in nature, affecting them physically, psychologically or cosmetically. None of the participants had any concept of the YCS and side-effect reporting. Despite this, participants felt reporting of side-effects was vital to ensure the safety of medications and prevention of patient harm. The majority of participants sought support for side-effects from a General Practitioner (GP) or community pharmacist, although difficulties accessing GP appointments was a barrier. Strategies suggested for increasing awareness of YCS to increase ADR reporting were use of posters, social media, QR codes, online prompts, coffee mornings and letters sent home to parents from schools. Discussion / Conclusion If patients are unsure around the concept of a side-effect and don’t know about the YCS, reporting rates will continue to fall. Although it is recognised that the sample is not fully representative of the Welsh population, this small-scale exploratory study has nevertheless identified some possible concerns but also some opportunities to engage patients in ADR reporting. Patient education by healthcare professionals on side-effects, alongside increased promotion of the YCS via social media and advertisements in healthcare settings are key opportunities to increase patients’ awareness and understanding of ADRs and ADR reporting. Further research is essential to understand the extent of these issues and also to investigate how healthcare professionals can facilitate this process. Follow-up studies are planned.

ASSESSMENT OF THYROID FUNCTION DISORDERS AMONG THE SUBJECTS ATTENDING CENTRAL LABORATORY OF A TERTIARY CARE HOSPITAL: AN OBSERVATIONAL, CROSS-SECTIONAL STUDY

Objective: Thyroid disorders are the most common endocrine disorders worldwide and India is not an exception. Several factors may determine the prevalence of thyroid dysfunction including age, gender, geographical and ethnic background, and most importantly iodine intake. Therefore, data related to thyroid disorders from one population cannot be extrapolated to another. In this study, we aimed to assess the disorders of thyroid function among the subjects attending the central laboratory of a tertiary care hospital. Methods: This observational, cross-sectional study was conducted in the Department of Pharmacology and the Department of Biochemistry of the same institute over a period of 3 months. All subjects of either sex attending the central laboratory of the institute for estimating thyroid function on their outpatient visit during the study period were included. Subjects who were on any medications known to alter the thyroid hormone status or diagnosed with a thyroid disorder and/or on therapy were excluded. A pre-designed and pre-tested data collection form was used for taking interviews to collect relevant data including sociodemographic characteristics, comorbid conditions, thyroid illness, and investigational reports. Results: A total of 132 subjects were included in the study. The majority of them were female (72.27%) and residents of urban areas (52.27%). The most common comorbid conditions and presenting symptoms were hypertension (25.76%) and fatigue (46.97%), respectively. The majority of the subjects were found to be euthyroid (81.81%). About 18.19% of the study subjects were having thyroid disorders, most commonly subclinical hypothyroidism (SCH) (13.64%), followed by primary hypothyroidism (2.27%), secondary hyperthyroidism (1.52%), and subclinical hyperthyroidism (0.76%). Thyroid disorders were mainly found in females, such as primary hypothyroidism (66.67%), SCH (66.67%), and subclinical hyperthyroidism (100%). The majority of the thyroid disorders were found in the age group of 26–50 years (20.27%), where females were found to have more primary hypothyroidism (3.17%), and SCH (12.70%). Conclusion: The findings of our study call for a review of current practices regarding thyroid disorders to include active screening of thyroid function among the subjects at greater risks and an emphasis on regular monitoring of the thyroid status.

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.

‘People of the barracks’: Meta-beliefs of a migrant community in West Kalimantan, Indonesia

Literature discussing contents of meta-beliefs, or beliefs about other beliefs, and what effects they have on intergroup relationships, specifically among disadvantaged groups are rare. Our study aims to explore meta-beliefs among the resettled Sambas Madurese community, in West Kalimantan, Indonesia, who were affected by the 1999 Sambas Conflict. We adopted an ethnographic approach, with a three-month live-in duration, conducting interviews, casual conversations, and taking part in community activities. Our findings reveal two important contents of meta-belief held by the Sambas Madurese migrants: ‘people of the barracks’, and ‘evil and criminal’. As a disadvantaged group, the Sambas Madurese resort to more covert and subtle forms of resistance, mainly through reappropriation and daily life changes to disprove meta-beliefs. Here, reappropriation of those negative meta-beliefs, mainly linked to moral superiority, is employed. It is observed that the contents of meta-belief go beyond cognitive aspects, including strong emotive components and behavioral responses. Our study hopes to contribute to a discussion on intergroup relationships among host and disadvantaged migrant communities from ethnic conflict backgrounds.

Educational outcomes of children with major congenital anomalies: Study protocol for a population-based cohort study using linked hospital and education data from England

Background Major congenital anomalies (CAs) affect around 2% of live births and are a primary cause of infant mortality, childhood morbidity and long-term disability, often requiring hospitalisation and/or surgery. Children with CAs are at greater risk of lower educational attainment compared with their peers, which could be due to learning disabilities, higher rates of ill-health and school absences, or lack of adequate educational support. Our study will compare the educational attainment of children with CAs to those of their peers up to age 11 in England, using linked administrative health and education data. Methods We will analyse data from the ECHILD (Education and Child Health Insights from Linked Data) database. Children born in NHS-funded hospitals from 1st September 2003 to 31st August 2008 whose hospital records were linked to their educational records at three Key Stages (ages 4/5, 6/7 and 10/11 years) will be included. Children with different CAs, indicated by recorded hospital diagnosis codes, will be compared to children without CAs. We will compare the proportions of enrolled children who take the assessment, the proportions who reached national expected levels of attainment, and the mean standardised attainment scores for Maths and English at each Key Stage. We will describe variations in outcome by sex, ethnic minority background, region, and neighbourhood deprivation, and perform regression modelling to compare the attainment trajectories of children with and without CAs, controlling for sociodemographic factors. Ethics and dissemination Ethics approval has been obtained for the analyses of the ECHILD database. Our findings will provide information for parents regarding their children’s expected academic potential, and also enable the development of interventions to support those at risk of not doing well. We will disseminate our findings to academics, policy makers, service users and providers through seminars, peer-reviewed publications, conference abstracts and other media (lay summaries and infographics).

Reconciling British Values with Professional Identity: The Pursuit of Ontological Security Among Muslim Teachers in England

This article aims to investigate how the legal requirement to promote fundamental British values (FBVs) impacts Muslim teachers’ professional identity formation, utilising Interpretive Phenomenological Analysis. Semi-structured interviews were conducted with self-identified Muslim teachers, including both male and female individuals from diverse ethnic backgrounds, employed in secondary schools across England. This study seeks to interpret Muslim teachers’ experiences through Anthony Giddens’ ontological security theory. Firstly, Muslim teachers expressed pride in being British and their successful integration into society. Secondly, the meaning of Britishness was elucidated by the participants through references to the values described in the current government guidelines on promoting FBVs. Finally, the impact of the obligation to promote FBVs on the professional identity formation of Muslim teachers points to a degree of ambivalence rooted in seeking ontological security. Certain teachers adopted an uncritical stance towards FBV policy, prioritising ‘values’ within the debate and thereby normalising the discourse surrounding FBVs. In contrast, others engaged in a critical analysis of FBV rhetoric, highlighting its adverse impact on academic discussions and their professional identities. From the perspective of ontological security theory, Muslim teachers are situated in a fragile position; while the majority grapple with ontological insecurity, others exist in a realm between ontological security and insecurity.

Antidepressant prescribing inequalities in people with comorbid depression and type 2 diabetes: A UK primary care electronic health record study.

To compare the likelihood of being prescribed an antidepressant in depressed individuals with and without type 2 diabetes. We performed a matched cohort study using primary care record data from the UK Clinical Practice Research Datalink. We used multivariable logistic regression to compare antidepressant prescribing during the first five years of starting oral antidiabetic medication to a comparison group without type 2 diabetes, matched based on GP practice, age and sex. We performed subgroup analyses stratified by sex, age and ethnicity. People with type 2 diabetes and depression were 75% less likely to be prescribed an antidepressant compared to people with depression alone (odds ratio (OR) 0.25, 95% confidence interval (CI) 0.25 to 0.26). This difference was greater in males (OR 0.23, 95% CI, 0.22 to 0.24), people older than 56 years (OR 0.23, 95% CI, 0.22 to 0.24), or from a minoritised ethnic background (Asian OR 0.14, 95% CI 0.12-0.14; Black OR 0.12, 95% CI 0.09-0.14). There may be inequalities in access to antidepressant treatment for people with type 2 diabetes, particularly those who are male, older or from minoritised ethnic backgrounds.

Disparities in Patient Portal Activation and Usage at a Large Pediatric Academic Institution.

Access to personal medical information promotes patient understanding of health issues and enables patient self-advocacy of healthcare needs. The advent of electronic medical record systems and the 2016 21st Century CURES Act promoted and encouraged patient access to personal medical information, yet technology-dependent modalities have often disadvantaged certain communities. We sought to evaluate whether disparities existed in access to patient portals at our institution, the main pediatric care provider in an area serving one million children. We evaluated the activation of patient portal accounts at our institution over the past decade (2010-2021). Portal activation data were analyzed by ethnic background and language preference and income information available based on primary home access location. Further, we evaluated portal activation rates over time and across institutional interventions. A logistic regression model was used to identify important demographic associations with portal account status. Over 1 million patients were served at our pediatric institution over the study period with 47.7% having ever activated their patient portals. Univariate analyses and ultimately logistic regression modeling demonstrated significant differences in portal activation by ethnicity (odds ratio (confidence interval):1.36 (1.34, 1.37)), language preference (1.39 (1.37, 1.40)), and median household income (1.00001 (1.00001, 1.00001)). Interim interventions were successful in improving portal activation rates. Overall, electronic medical record portal activation was less prevalent among Hispanic, non-English speakers, and patients living in communities with lower median household income. Opportunities for interventions exist to reduce healthcare disparities in these underserved communities.

Professional Male Soccer Players' Perspectives of the Nutrition Culture Within an English Premier League Football Club: A Qualitative Exploration Using Bourdieu's Concepts of Habitus, Capital and Field.

Professional soccer players' self-reported dietary intakes often do not meet recommended sport nutrition guidelines. Although behaviour change models have previously explored barriers and enablers to nutritional adherence, the cultural factors influencing players' nutritional habits also warrant investigation. Accordingly, we aimed to explore players' perceptions of the nutrition culture within the professional soccer environment. An interpretivist paradigm, which emphasises that reality is subjectively and socially constructed, underpins this study. Qualitative, face-to-face semi-structured interviews (comprising open-ended questions) were conducted with purposively sampled male soccer players from the English Premier League (EPL) (five British, five migrant; mean age: 26 ± 6years; mean EPL appearances: 106 ± 129). Data were abductively analysed using thematic analysis according to Bourdieu's concepts of habitus, capital, field and doxa practices. This study revealed five key themes: (1) players' habitus, as shaped by familial, ethnic and religious backgrounds, influences their dietary habits; (2) social capital, via managers (head coaches), teammates and online influences, impact players' dietary practices; (3) the increase in both soccer clubs' and players' economic capitals has advanced nutrition provision; (4) an unequal distribution of economic capitals has led to hierarchical practice in the performance nutrition field with personalised nutrition being somewhat enacted at the higher levels; and (5) body composition measurement is a 'doxic' practice in professional soccer that warrants challenge. Soccer players' habitual nutritional practices are influenced by personal upbringing and the club context, including economic resources and social capital from managers. The performance nutrition field within professional soccer is also shaped by stakeholders' doxic beliefs surrounding the perceived optimal body composition of players, with managers exerting social capital.