Ethnic Categories Research Articles

Unity in Diversity: Federalism in Multiethnic Country Nepal

Federalism, in general and multiethnic federalism, in particular is supposed to be a device to create unity in diversity in multiethnic country. Multiethnic federalism, a form of federalism, in which the territorial government or state is carved out based on nation or ethnic category to enable national minorities to exercise indigenous and ethnic minority rights like self-rule and autonomy is supposed to be a device to create unity in diversity in multiethnic country like Nepal. In Nepal, indigenous nationalities, and Madhesi communities who, historically, have been excluded in state’s institutions, have demanded multiethnic federalism, identity-based federalism on their own term, as an institutional device for their inclusion in the state. They have argued that it is a device to generate unity in diversity through accommodating diversity in the state. But there was no consensus on this issue while making the constitution through the constituent assembly. Some have argued that it would be a 'castist' (Jatiya) state if ethnic-based federalism is adopted. In this article, I have argued that multiethnic federalism is a device to end the nature of the age-old exclusionary Nepali state and an institutional mechanism of healing the inter-ethnic rupture of Nepali society. Indigenous nationalities in Nepal have demanded separation within a state to protect and promote their identity based on democratic values rather than separate from a state of their own. For this purpose, I have reviewed theoretical articles and critically analyze how it creates unity in diversity in a multiethnic country like Nepal.

Prostate cancer genetic alterations in Hispanic men.

Differences in DNA alterations in prostate cancer among White, Black, and Asian men have been widely described. This is the first description of the frequency of DNA alterations in primary and metastatic prostate cancer samples of self-reported Hispanic men. We utilized targeted next-generation sequencing tumor genomic profiles from prostate cancer tissues that underwent clinical sequencing at academic centers (GENIE 11th). We decided to restrict our analysis to the samples from Memorial Sloan Kettering Cancer Center as it was by far the main contributor of Hispanic samples. The numbers of men by self-reported ethnicity and racial categories were analyzed via Fisher's exact test between Hispanic-White versus non-Hispanic White. Our cohort consisted of 1412 primary and 818 metastatic adenocarcinomas. In primary adenocarcinomas, TMPRSS2 and ERG gene alterations were less common in non-Hispanic White men than Hispanic White (31.86% vs. 51.28%, p = 0.0007, odds ratio [OR] = 0.44 [0.27-0.72] and 25.34% vs. 42.31%, p = 0.002, OR = 0.46 [0.28-0.76]). In metastatic tumors, KRAS and CCNE1 alterations were less prevalent in non-Hispanic White men (1.03% vs. 7.50%, p = 0.014, OR = 0.13 [0.03, 0.78] and 1.29% vs. 10.00%, p = 0.003, OR = 0.12 [0.03, 0.54]). No significant differences were found in actionable alterations and androgen receptor mutations between the groups. Due to the lack of clinical characteristics and genetic ancestry in this dataset, correlation with these could not be explored. DNA alteration frequencies in primary and metastatic prostate cancer tumors differ among Hispanic-White and non-Hispanic White men. Notably, we found no significant differences in the prevalence of actionable genetic alterations between the groups, suggesting that a significant number of Hispanic men could benefit from the development of targeted therapies.

Students’ Perception of Anti-Academic Norms in Flanders: The Role of Ethnicity, Peer Discrimination and Ethnic Belonging

Anti-academic norms have proven to affect the educational strategies of adolescents. The determinants related to the experience of anti-academic norms and especially its link to ethnic inequality within the educational system have not received sufficient attention in European educational research. Hence, this study examines which students perceive anti-academic norms by investigating the role of students’ ethnic group categorization, their experiences with (non-) ethnic discrimination, and the role of ethnic belonging. A quantitative analysis of 2,728 students from 45 secondary schools in Flanders showed that majority students perceive more anti-academic norms than students who are descendants from labor migrants. Both ethnic and non-ethnically discriminated students experience more anti-academic norms compared to non-discriminated students. Overall, students’ ethnic identity belonging is a promotive factor and thus associated with lower anti-academic norms. Furthermore, the results also indicate that students from both high and low status ability groups (tracks) are more at risk of perceiving anti-academic norms.

Increasing ethnicity reporting to better understand cultural needs accessing a primary care talking therapy service.

The COVID-19 pandemic highlighted the under-utilisation of statutory mental health care services by minority ethnic groups in the United Kingdom (UK). To improve ethnicity reporting to better understand the needs of patients accessing a primary care talking therapies service. We conducted a clinical audit to observe outcomes from pre-COVID (2019), first wave of COVID-19 (2020) and 2021 for three broad ethnic categories: black African/Caribbean, Asian and white British. Intervention was conducted on staff to improve data recording of ethnicity. A patient survey was sent to those identified as dropped out from treatment from May 2020 to April 2021. A total of 229 patients responded to the survey. The survey asked for reasons that impacted on not continuing with sessions. Quantitative analysis showed a statistically significant difference on discharge outcome between white British and black African/Caribbean (p=<0.0001), with black African/Caribbean patients most likely to drop out of treatment, and in 2020 the Asian population was below the recovery target of 50%. Qualitative analysis revealed therapist factors included lack of confidence in therapist and not being listened to, patient factors included neurodiversity, being unsure whether it would be helpful and confidentiality concerns, and service factors included being notified of discharge from the service, remote delivery of therapy, treatment options, and treatment materials. Services must work towards improving service provision by capturing hidden disparities and socialising treatment to meet the needs of minority ethnic groups in the UK. The present study recommends culturally adapted treatment and co-producing therapy materials.

RACIAL AND ETHNIC REPRESENTATION IN LARGE B‐CELL LYMPHOMA TRIALS AND REAL‐WORLD DATABASES

Introduction: In large B-cell lymphoma (LBCL) trials, racial and ethnic representation is difficult to determine due to underreporting in some regions, or because some patients may not provide data. It is difficult to understand the full extent of any underrepresentation of specific races or ethnicities in these trials relative to the prevalence of LBCL in clinical practice. The objective of this study was to characterize racial and ethnic representation in LBCL real-world databases and recently published LBCL studies. Methods: Analyses of the distribution of different racial and ethnic categories were conducted across 6 real-world clinical practice databases from the United States (US): SEER-Medicare, COTA, Medicare, Optum Market Clarity, Optum CDM, and Concert AI RWD. In addition, a targeted review of recently published studies in patients with LBCL was conducted to identify reported race and ethnicity distributions. Distributions were described using counts and percentages for each race (Asian, Black, White, and other/unknown/not reported) and ethnicity (Hispanic, non-Hispanic, and other/unknown/not reported) category. Results: Patients with LBCL from the databases included: COTA (N = 5848), SEER-Medicare (N = 102,548), Medicare (N = 136,466), Optum Market Clarity (N = 19,649), Optum CDM (N = 22,175), and Concert AI (N = 1828). Race and ethnicity distributions are reported in Table 1. Across databases, Asian (2%–6%) and Black (5%–8%) races were substantially lower than White race (69%–88%). Across various lines of therapy, distributions were similar: 3%–5% Asian, 3%–5% Black, and 78%–82% White. Hispanic ethnicity (5%–22%) was substantially lower than non-Hispanic ethnicity (70%–91%). In the targeted review, 14 publications of LBCL therapies were identified; of these, 10 did not report racial/ethnic composition. In 4 publications (Salles et al., 2020; Sehn et al., 2020; Bannerji et al., 2022; and a real-world study by Shenoy et al., 2011), Asian, Black, White, and other/unknown/not reported represented 2%–13%, 0%–7%, 71%–89%, and 1%–11%, respectively. Conclusions: Information on racial and ethnic distributions in LBCL studies is underreported, particularly in global trials. If this information was reported and reflective of LBCL in clinical practice in the US, the numbers of Asian and Black patients would be low at ≤8%, and most patients would be expected to be White and non-Hispanic. Encore Abstract—previously submitted to ASCO 2023 The research was funded by: Genmab A/S and AbbVie Keywords: aggressive B-cell non-Hodgkin lymphoma, cancer health disparities Conflicts of interests pertinent to the abstract J. Munoz Consultant or advisory role Pharmacyclics/AbbVie, Bayer, Gilead/Kite Pharma, Pfizer, Janssen, Juno/Celgene, BMS, Kyowa, Alexion, Fosunkite, Innovent, Seattle Genetics, Debiopharm, Karyopharm, Genmab, ADC Therapeutics, Epizyme, Beigene, Servier, Novartis, MorphoSys/Incyte, Secura Bio, TG Therapeutics, MEI, Lilly/Loxo Honoraria: Targeted Oncology, OncView, Curio, Kyowa, Physicians’ Education Resource, Seattle Genetics Research funding: Bayer, Gilead/Kite Pharma, Celgene, Merck, Portola, Incyte, Genentech, Pharmacyclics, Seattle Genetics, Janssen, Millennium Other remuneration: Speaker’s Bureau: Gilead/Kite Pharma, Kyowa, Bayer, Pharmacyclics/Janssen, Seattle Genetics, Acrotech/Aurobindo, BeiGene, Verastem, AstraZeneca, Celgene/BMS, Genentech/Roche. A. Mutebi Employment or leadership position: Genmab T. Wang Employment or leadership position: Genmab G. Zhang Employment or leadership position: Genmab J. Yu Employment or leadership position: AbbVie J. He Employment or leadership position: Genmab A. Chibber Employment or leadership position: Genmab R. Kamalakar Employment or leadership position: AbbVie M. Jun Employment or leadership position: Genmab K. Adejumo Employment or leadership position: AbbVie S. Yang Employment or leadership position: Genmab A. Kalsekar Employment or leadership position: Genmab

Racial and ethnic representation in large B-cell lymphoma trials and real-world databases.

e19530 Background: In large B-cell lymphoma (LBCL) trials, racial and ethnic representation is difficult to determine due to underreporting in some regions, or because some patients may not provide data. It is difficult to understand the full extent of any underrepresentation of specific races or ethnicities in these trials relative to the prevalence of LBCL in clinical practice. The objective of this study was to characterize racial and ethnic representation in LBCL real-world databases and recently published LBCL studies. Methods: Analyses of the distribution of different racial and ethnic categories were conducted across 6 real-world clinical practice databases from the United States (US): SEER-Medicare, COTA, Medicare, Optum Market Clarity, Optum CDM, and ConcertAI RWD. In addition, a targeted review of recently published studies in patients with LBCL was conducted to identify reported race and ethnicity distributions. Distributions were described using counts and percentages for each race (Asian, Black, White, and other/unknown/not reported) and ethnicity (Hispanic, non-Hispanic, and other/unknown/not reported) category. Results: Patients with LBCL from the databases included: COTA (N=5848), SEER-Medicare (N=102,548), Medicare (N=136,466), Optum Market Clarity (N=19,649), Optum CDM (N=22,175), and ConcertAI (N=1828). Race and ethnicity distributions are reported in the table. Across databases, Asian (2–6%) and Black (5–8%) races were substantially lower than White race (69–88%). Across various lines of therapy, distributions were similar: 3–5% Asian, 3–5% Black, and 78–82% White. Hispanic ethnicity (5–22%) was substantially lower than non-Hispanic ethnicity (70–91%). In the targeted review, 14 publications of LBCL therapies were identified; of these, 10 did not report racial/ethnic composition. In 4 publications (Salles et al, 2020; Sehn et al, 2020; Bannerji et al, 2022; and a real-world study by Shenoy et al, 2011), Asian, Black, White, and other/unknown/not reported represented 2–13%, 0–7%, 71–89%, and 1–11%, respectively. Conclusions: Information on racial and ethnic distributions in LBCL studies is underreported, particularly in global trials. If this information was reported and reflective of LBCL in clinical practice in the US, the numbers of Asian and Black patients would be low at ≤8%, and most patients would be expected to be White and non-Hispanic. [Table: see text]

US Cigarette Smoking Disparities by Race and Ethnicity - Keep Going and Going!

Although current cigarette smoking among US adults decreased from 42.4% in 1965 to 12.5% in 2020, prevalence is higher among certain racial and ethnic groups, including non-Hispanic American Indian and Alaska Native (AIAN) adults. We examined trends in current cigarette smoking prevalence, population estimates, and relative disparity among US adults (aged ≥18 y) between 2011 and 2020 by using data from the National Health Interview Survey. SAS-callable SUDAAN was used to obtain prevalence and population estimates, and relative disparity was calculated on the basis of findings in the literature. Trends were significant at P < .05. From 2011 to 2020, linear decreases in prevalence and population estimates were observed for non-Hispanic White (20.6% to 13.3%; 32.1 million to 20.7 million), non-Hispanic Black (19.4% to 14.4%; 5.1 million to 4.0 million), and Hispanic (12.9% to 8.0%; 4.2 million to 3.3 million) adults. For non-Hispanic AIAN adults, prevalence remained around 27%, and a linear increase in the population estimate was observed from 400,000 to 510,000. Relative disparity did not change across racial and ethnic categories. Linear decreases have occurred between 2011 and 2020 for non-Hispanic White, non-Hispanic Black, and Hispanic adults who smoke, but the number of non-Hispanic AIAN adults who currently smoke has increased by 110,000, and relative disparities persist. To reduce racial and ethnic disparities in smoking, understanding how factors at multiple socioecologic levels impact smoking and helping to inform paths to equitable reach and implementation of tobacco control interventions for all population groups are needed.

Speaker demographics at the Society for Healthcare Epidemiology of America (SHEA) Spring Conference, 2019–2022

Background: The Society for Healthcare Epidemiology of America (SHEA) serves as a national platform for infection prevention and antibiotic stewardship. Like many professional healthcare societies over the last decade, the SHEA has pledged to provide equitable opportunities to individuals in the organization. The impact of these efforts remains undetermined. This study evaluated trends in speaker demographics at the annual SHEA Spring Conference from 2019 to 2022. Methods: SHEA leadership or staff provided demographic information on SHEA members and Spring conference speakers (excluding poster sessions) from 2019 to 2022. We excluded 2020 due to conference cancellation. Data were summarized using descriptive statistics, and χ2 analysis was used to evaluate changes over time. Individual speakers were compared with member demographics. Self-reported SHEA speaker and member demographics were available for sex, race or ethnicity, age, primary practice setting, and professional degrees. Speaker professional degree was not available for 2022. Results: In total, 447 speaker slots were filled by 218 unique speakers over the 3-year period. The SHEA average annual membership between 2019 and 2022 with self-reported demographics included 55.2% female and 44.8% male members, with race reported as follows: 69.3% White, 21.4% Asian, 6.0% Hispanic or Latino, 2.9% Black, 0.4% American Indian/Alaska Native/Native Hawaiian/Pacific Islander (AIAN/NHPI). However, almost half of the members did not report a race or ethnicity. The SHEA speakers during the same period were 63.5% female and 36.5% male, with 68.2% White, 13.3% Asian, 3.8% Black, 3.4% Hispanic/Latino, and 0.8% AIAN/NHPI. Only 13.4% of speakers did not report race or ethnicity. Every year, there were fewer than 6 speakers in each of the Black, Hispanic or Latino, AIAN/NHPI race or ethnicity categories. In 2019, 49.2% of speakers were aged 41–50 years, compared with 28.6% of members in that age group (P = 0.0029). By 2022, 35.6% of speakers were aged 41–50 years, compared with 29.3% of members in that age group (P = .074). In 2021, pharmacists represented 11.9% of speakers compared with 2.9% of members, and members with nondoctoral degrees represented 11.1% of speakers compared with 21.4% of members (P &lt; .0001). In each year, there was a statistically significant association between primary practice setting and speaker or member representation, with underrepresentation of community or private-practice speakers relative to their proportion of membership: 2019 (7.5% speakers vs 14.3% members), 2021 (6.5% speakers vs 15.2% members), 2022 (4.3% speakers vs 15.7% members) (P &lt; .05) . Conclusions: Although there has been more equitable speaker age representation and an increase in pharmacist speakers at the SHEA Spring Conference over time, practitioners from community settings and those with nondoctoral degrees remain underrepresented relative to the SHEA membership. Racial or ethnic minoritized individuals remain underrepresented as members and speakers compared with the general US population. Intentional interventions are needed to consistently achieve equitable speaker representation across multiple demographic groups at the SHEA Spring Conference.Disclosures: None

“Mine from ’33; Yours from ’41”

AbstractAt many points in modern history, Ukrainian identity has been bound up with the Ukrainian language, Ukrainian forms of Christianity, and specific collective experiences of trauma as Ukrainians. This sense of national identity was particularly felt in the immediate post-Soviet period; for although Soviet nationalities policy attempted to eradicate dangerous forms of nationalism and ethnic prejudice, these policies often had the reverse effect, creating a heightened sense of competition between individual ethnic groups, which persisted into the post-1991 reconstruction of East European borders. In the wake of the 2013–14 Euromaidan protests, poets in Ukraine have sought to correct the failures of both Soviet nationalities policy and post-Soviet Ukrainian national-identity formation by weaving Jewish, Ukrainian, and Crimean Tatar histories of collective trauma into their writing. This article focuses on the recent work of the poet Marianna Kiyanovska, whose attempt to bridge seemingly irreconcilable histories can be read as part of what scholars have identified as a recent shift from viewing Ukrainian identity as an ethnic category to a civic one. Reading Kiyanovska in the context of other recent Ukrainian poems and songs, the author argues that this “civic turn” in Ukrainian identity formation is both a direct response to conversations taking place about the meaning of the Maidan, and part of a global conversation about privilege, erasure, and culpability.

Enrollment representation of age, race, and ethnicity in ovarian cancer registrational clinical trials (2010-2020): An evaluation by the U.S. Food and Drug Administration.

e18527 Background: Ovarian cancer is the fifth leading cause of cancer mortality among U.S. women. Because clinical trials have historically not been demographically representative of real-world patients, an understanding of the extent of disparities is an important step in addressing them. We aimed to evaluate the representation of older adults and racial and ethnic minorities in trials for ovarian cancer drugs. Methods: We conducted a pooled analysis of all trials that were submitted to the U.S. Food and Drug Administration (FDA) from January 1, 2010 to December 31, 2020 in support of marketing applications for epithelial ovarian, fallopian tube, or primary peritoneal indications. Demographic data (age, race, and ethnicity) for adult participants were analyzed alongside incident ovarian cancer case data (diagnosis between 2010 and 2019) from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) Program. Enrollment to Incidence Ratio (EIR) is reported and defined as the percentage of participants divided by percentage of U.S. incident ovarian cancer cases. An EIR between 0.80-1.20 indicates adequate representation; &lt;0.80 or &gt;1.20 indicates underrepresentation or overrepresentation, respectively. Participants with race or ethnicity categories reported as unknown or missing, or insufficient for calculation were not included in this analysis. A sensitivity analysis was conducted to evaluate the exclusion of trials enrolling only BRCA+ participants. Results: The analysis included 8,211 participants enrolled across 15 clinical trials. Age was available for all participants; race/ethnicity was not reported for 16.3% of participants. With increasing age, EIR decreased (Table). Non-Hispanic (NH) White participants had the highest EIR of all racial/ethnic groups, while NH Black and Hispanic participants had the lowest EIR. Results were similar when excluding trials enrolling only BRCA+ participants. Conclusions: Adults aged ≥75, NH Black, and Hispanic participants were underrepresented in registrational trials for new ovarian cancer therapies. To enhance understanding of the correlation between age, race, and ethnicity, further analyses are necessary. Prospective measures are essential, as discussed in recent FDA guidances, to enroll an adequately representative population in ovarian cancer clinical trials.[Table: see text]

The Relationship of Os. Femur with Height influenced by Gender, Race, and Nutrition for Medical Student In Faculty of Medicine University Wijaya Kusuma Surabaya

Height is an important identity in forensics. Several long bones are known to be used for size estimation, one of which is the femur (Os. Femur). Personal height growth is affected by many factors, including gender, breed, and diet. This study aimed to analyze the correlation of Os length. Thigh height in UWKS medical students is influenced by gender, ethnicity and diet. This study used an observational descriptive analysis approach to conduct a cross-sectional study. Forty-four students from the UWKS School of Medicine participated in the study. Height measurement using Microcotoise, Os. Femoral New Deland with sliding calipers and weights with scales. Data were analyzed using normality test, Pearson correlation test, and simple linear regression test. The results show that there is a positive and very strong correlation between the Os lengths. Femur size, non-Javanese ethnicity, and normal, obese, and obese dietary categories in a male sample. There is now a strong positive relationship between femur length and height in the female sample. Meanwhile, the Os length has no correlation. Keywords: l ength os femur, height, gender, e thnicity, nutrition

Questioning Identity: How a Diverse Set of Respondents Answer Standard Questions About Ethnicity and Race

Ethnoracial identity refers to the racial and ethnic categories that people use to classify themselves and others. How it is measured in surveys has implications for understanding inequalities. Yet how people self-identify may not conform to the categories standardized survey questions use to measure ethnicity and race, leading to potential measurement error. In interviewer-administered surveys, answers to survey questions are achieved through interviewer–respondent interaction. An analysis of interviewer–respondent interaction can illuminate whether, when, how, and why respondents experience problems with questions. In this study, we examine how indicators of interviewer–respondent interactional problems vary across ethnoracial groups when respondents answer questions about ethnicity and race. Further, we explore how interviewers respond in the presence of these interactional problems. Data are provided by the 2013–2014 Voices Heard Survey, a computer-assisted telephone survey designed to measure perceptions of participating in medical research among an ethnoracially diverse sample of respondents.

Race and Ethnicity and Fracture Prediction Among Younger Postmenopausal Women in the Women’s Health Initiative Study

The best approach to identify younger postmenopausal women for osteoporosis screening is uncertain. The Fracture Risk Assessment Tool (FRAX), which includes self-identified racial and ethnic information, and the Osteoporosis Self-assessment Tool (OST), which does not, are risk assessment tools recommended by US Preventive Services Task Force guidelines to identify candidates for bone mineral density (BMD) testing in this age group. To compare the ability of FRAX vs OST to discriminate between younger postmenopausal women who do and do not experience incident fracture during a 10-year follow-up in the 4 racial and ethnic groups specified by FRAX. This cohort study of Women's Health Initiative participants included 67 169 women (baseline age range, 50-64 years) with 10 years of follow-up for major osteoporotic fracture (MOF; including hip, clinical spine, forearm, and shoulder fracture) at 40 US clinical centers. Data were collected from October 1993 to December 2008 and analyzed between May 11, 2022, and February 23, 2023. Incident MOF and BMD (in a subset of 4607 women) were assessed. The area under the receiver operating characteristic curve (AUC) for FRAX (without BMD information) and OST was calculated within each racial and ethnic category. Among the 67 169 participants, mean (SD) age at baseline was 57.8 (4.1) years. A total of 1486 (2.2%) self-identified as Asian, 5927 (8.8%) as Black, 2545 (3.8%) as Hispanic, and 57 211 (85.2%) as White. During follow-up, 5594 women experienced MOF. For discrimination of MOF, AUC values for FRAX were 0.65 (95% CI, 0.58-0.71) for Asian, 0.55 (95% CI, 0.52-0.59) for Black, 0.61 (95% CI, 0.56-0.65) for Hispanic, and 0.59 (95% CI, 0.58-0.59) for White women. The AUC values for OST were 0.62 (95% CI, 0.56-0.69) for Asian, 0.53 (95% CI, 0.50-0.57) for Black, 0.58 (95% CI, 0.54-0.62) for Hispanic, and 0.55 (95% CI, 0.54-0.56) for White women. For discrimination of femoral neck osteoporosis, AUC values were excellent for OST (range, 0.79 [95% CI, 0.65-0.93] to 0.85 [95% CI, 0.74-0.96]), higher for OST than FRAX (range, 0.72 [95% CI, 0.68-0.75] to 0.74 [95% CI, 0.60-0.88]), and similar in each of the 4 racial and ethnic groups. These findings suggest that within each racial and ethnic category, the US FRAX and OST have suboptimal performance in discrimination of MOF in younger postmenopausal women. In contrast, for identifying osteoporosis, OST was excellent. The US version of FRAX should not be routinely used to make screening decisions in younger postmenopausal women. Future investigations should improve existing tools or create new approaches to osteoporosis risk assessment for this age group.

Effect of the Teacher-student Relationships on Feedback Literacy of High School Students in Tibetan areas of China: Mediating Effect of Emotional Intelligence and Moderating Effect of Ethnicity Category

Effect of the Teacher-student Relationships on Feedback Literacy of High School Students in Tibetan areas of China: Mediating Effect of Emotional Intelligence and Moderating Effect of Ethnicity Category

81 Post-Burn Psychosocial Outcomes in Pediatric Minority Patients: A Burn Database Cross-sectional Study

Abstract Introduction Racial and ethnic minority burn patients often face barriers to longitudinal psychosocial support after injury. Studies utilizing the Burn Model System (BMS) National Database show adult minority patients report worse psychosocial outcomes during burn recovery in domains such as body image or social re-integration. No study to date has investigated differences in psychosocial outcomes by racial or ethnic category in the pediatric population using the BMS database. This study examines eight outcomes in minority pediatric patients to better characterize potential differences in the pediatric patient population. Methods Patients under 18 years old treated for burn injury between 2009 and 2019 consented to participate in a multi-center longitudinal study were included in the current sample. We analyzed eight outcomes using the National Institute of Health Toolbox and PROMIS-25 measures with higher reported scores indicating worse symptom severity. Multi-level, linear mixed effects, regression modeling analyzed associations between race/ethnicity and outcomes at three time points (discharge after index hospitalization, 6- and 12- month post-injury. Results The total cohort of 277 patients were 81% male (n = 182) and on average 8.78 years old (range: 3-18 years at time of injury). When surveyed 12 months after injury, pediatric Hispanic patients reported a mean fatigue score of 45.8 (95% confidence interval (CI): 41.6, 49.9) compared to pediatric non-Hispanic patient score of 43.0 (95% CI: 37.1, 48.9). At 12 months, Hispanic patients reported a mean anxiety score of 46.1 (95% CI: 42.7, 49.5), compared to 41.4 (95% CI: 25.8, 47.1) reported by non-Hispanic patients. At 12 months after injury, Hispanic patients reported a mean peer relationship score of 51.1 (95% CI: 47.2, 55.1) compared to non-Hispanic patients' score of 55.5 (95% CI: 50.3, 60.6). Hispanic patients also reported a mean pain interference score of 44.7 (95% CI: 42.3, 47.0) compared to non-Hispanic patients' score of 38.3 (95% CI: 34.9, 41.6) at 12 months after injury. Conclusions Following burn injury, pediatric Hispanic patients report worse outcomes in several psychosocial domains compared to pediatric non-Hispanic patients, although differences were not statistically significant. However, as significant differences in outcomes exist in adult Hispanic/Latino patients, this study supports the need for further evaluation into potential factors that lead to worse outcomes in Hispanic populations. Applicability of Research to Practice Although pediatric Hispanic patients do not report significantly worse outcomes than non-Hispanic patients in short term burn recovery, these patients may benefit from further counseling and psychosocial support after injury.

Population-Based Estimates for the Prevalence of Multiple Sclerosis in the United States by Race, Ethnicity, Age, Sex, and Geographic Region

Racial, ethnic, and geographic differences in multiple sclerosis (MS) are important factors to assess when determining the disease burden and allocating health care resources. To calculate the US prevalence of MS in Hispanic, non-Hispanic Black (hereafter referred to as Black), and non-Hispanic White individuals (hereafter referred to as White) stratified by age, sex, and region. A validated algorithm was applied to private, military, and public (Medicaid and Medicare) administrative health claims data sets to identify adult cases of MS between 2008 and 2010. Data analysis took place between 2019 and 2022. The 3-year cumulative prevalence overall was determined in each data set and stratified by age, sex, race, ethnicity, and geography. The insurance pools included 96 million persons from 2008 to 2010. Insurance and stratum-specific estimates were applied to the 2010 US Census data and the findings combined to calculate the 2010 prevalence of MS cumulated over 10 years. No exclusions were made if a person met the algorithm criteria. Prevalence of MS per 100 000 US adults stratified by demographic group and geography. The 95% CIs were approximated using a binomial distribution. A total of 744 781 persons 18 years and older were identified with MS with 564 426 cases (76%) in females and 180 355 (24%) in males. The median age group was 45 to 54 years, which included 229 216 individuals (31%), with 101 271 aged 18 to 24 years (14%), 158 997 aged 35 to 44 years (21%), 186 758 aged 55 to 64 years (25%), and 68 539 individuals (9%) who were 65 years or older. White individuals were the largest group, comprising 577 725 cases (77%), with 80 276 Black individuals (10%), 53 456 Hispanic individuals (7%), and 33 324 individuals (4%) in the non-Hispanic other category. The estimated 2010 prevalence of MS per 100 000 US adults cumulated over 10 years was 161.2 (95% CI, 159.8-162.5) for Hispanic individuals (regardless of race), 298.4 (95% CI, 296.4-300.5) for Black individuals, 374.8 (95% CI, 373.8-375.8) for White individuals, and 197.7 (95% CI, 195.6-199.9) for individuals from non-Hispanic other racial and ethnic groups. During the same time period, the female to male ratio was 2.9 overall. Age stratification in each of the racial and ethnic groups revealed the highest prevalence of MS in the 45- to 64-year-old age group, regardless of racial and ethnic classification. With each degree of latitude, MS prevalence increased by 16.3 cases per 100 000 (95% CI, 12.7-19.8; P < .001) in the unadjusted prevalence estimates, and 11.7 cases per 100 000 (95% CI, 7.4-16.1; P < .001) in the direct adjusted estimates. The association of latitude with prevalence was strongest in women, Black individuals, and older individuals. This study found that White individuals had the highest MS prevalence followed by Black individuals, individuals from other non-Hispanic racial and ethnic groups, and Hispanic individuals. Inconsistent racial and ethnic classifications created heterogeneity within groups. In the United States, MS affects diverse racial and ethnic groups. Prevalence of MS increases significantly and nonuniformly with latitude in the United States, even when adjusted for race, ethnicity, age, and sex. These findings are important for clinicians, researchers, and policy makers.

Ethnic Identity in Social and Political Domains: A New Conceptual Model

In this paper, I attempt to build on and improve a significant conceptual innovation, made by Rogers Brubaker, between the terms ethnic category and ethnic group. This conceptual distinction problematizes groupist approaches and takes ethnic groupness as a variable to explore processes and dynamics of ethnic group formation. In this study, I improve and develop Brubaker’s conceptual distinction in two ways. First, I propose indicators for measuring ethnic category and ethnic group in the phenomenal world. Second, I develop a conceptual model based on the aforementioned conceptual distinction. I propose that ethnic identity can take four forms on the bases of how ethnic category members perform their ethnic identities in social and political domains: (1) socially and politically active ethnic identity, (2) socially active but politically dormant ethnic identity, (3) socially dormant but politically active ethnic identity, (4) socially and politically dormant ethnic identity. I suggest that these identity forms help us better understand the implications of the terms ethnic category and ethnic group at individual level by applying it to the Kurdish case in Turkey.

Chances of Early School Leaving—With Special Regard to the Impact of Roma Identity

Early school leaving rates among Roma are higher than in the majority population, as confirmed by several studies, but the descriptions are often two-dimensional. Intersectionality is described as a persistent situation formed by several social dimensions, and this specific position can be advantageous or disadvantageous from the aspect of educational inequalities. This study aims to explore what type of intersectional position can raise the chance of early school leaving and what is the role of the Roma ethnic identity in this. Earlier empirical analyses are rather two-dimensional, and these intersectional situations cannot be identified with them. The Hungarian Youth Survey databases provided an opportunity to conduct this type of multiple approaches. With the help of our results, the intersectional position can be described in which the chance of early school leaving is higher. The elements of this situation are embedded in economic, educational, geographical and ethnic categories at the same time. The effect of Roma ethnic identity is significant but not the strongest in our model. With the help of a comparison of the two waves of the research project, we can state that the patterns of this intersectional and disadvantageous situation are stable but not unchanged.

Racial and ethnic disparities in obstetric anesthesia: a scoping review.

Health disparities continue to affect racial and ethnic marginalized obstetric patients disproportionally with increased risk of Cesarean delivery and pregnancy-related death. Yet, the literature on what influences such disparities in obstetric anesthesia service and its clinical outcomes is less well known. We set out to describe racial and ethnic disparities in obstetric anesthesia during the peripartum period in the USA via a scoping review of the recent literature. Using the Institute of Medicine's definition of disparities, we searched the National Library of Medicine's PubMed/Medline, Embase, Web of Science, APA PsycINFO, and Google Scholar for articles published between 1 January 2000 and 30 June 2022 to identify literature on racial and ethnic disparities in obstetric anesthesia. Out of 8,432 articles reviewed, 15 met our inclusion criteria. All but one study was observational. Seven studies were single-institutional while the remaining used multicentre data/databases. All studies compared two or more race and ethnicity classifications. Studies in this review described disparities in the use of labour epidural analgesia, labour epidural request timing, anesthesia for Cesarean deliveries, postpartum pain management, and epidural blood patch for postdural puncture headaches. Several studies reported disparities observed in the unadjusted models becoming no longer significant when adjusted for other covariates. Based on the findings of the present scoping review on racial and ethnic disparities in obstetric anesthesia, we present an evidence map identifying knowledge gaps and propose a future research agenda.

Cardiovascular Disease Risk Assessment Using Traditional Risk Factors and Polygenic Risk Scores in the Million Veteran Program

Primary prevention of atherosclerotic cardiovascular disease (ASCVD) relies on risk stratification. Genome-wide polygenic risk scores (PRSs) are proposed to improve ASCVD risk estimation. To determine whether genome-wide PRSs for coronary artery disease (CAD) and acute ischemic stroke improve ASCVD risk estimation with traditional clinical risk factors in an ancestrally diverse midlife population. This was a prognostic analysis of incident events in a retrospectively defined longitudinal cohort conducted from January 1, 2011, to December 31, 2018. Included in the study were adults free of ASCVD and statin naive at baseline from the Million Veteran Program (MVP), a mega biobank with genetic, survey, and electronic health record data from a large US health care system. Data were analyzed from March 15, 2021, to January 5, 2023. PRSs for CAD and ischemic stroke derived from cohorts of largely European descent and risk factors, including age, sex, systolic blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, smoking, and diabetes status. Incident nonfatal myocardial infarction (MI), ischemic stroke, ASCVD death, and composite ASCVD events. A total of 79 151 participants (mean [SD] age, 57.8 [13.7] years; 68 503 male [86.5%]) were included in the study. The cohort included participants from the following harmonized genetic ancestry and race and ethnicity categories: 18 505 non-Hispanic Black (23.4%), 6785 Hispanic (8.6%), and 53 861 non-Hispanic White (68.0%) with a median (5th-95th percentile) follow-up of 4.3 (0.7-6.9) years. From 2011 to 2018, 3186 MIs (4.0%), 1933 ischemic strokes (2.4%), 867 ASCVD deaths (1.1%), and 5485 composite ASCVD events (6.9%) were observed. CAD PRS was associated with incident MI in non-Hispanic Black (hazard ratio [HR], 1.10; 95% CI, 1.02-1.19), Hispanic (HR, 1.26; 95% CI, 1.09-1.46), and non-Hispanic White (HR, 1.23; 95% CI, 1.18-1.29) participants. Stroke PRS was associated with incident stroke in non-Hispanic White participants (HR, 1.15; 95% CI, 1.08-1.21). A combined CAD plus stroke PRS was associated with ASCVD deaths among non-Hispanic Black (HR, 1.19; 95% CI, 1.03-1.17) and non-Hispanic (HR, 1.11; 95% CI, 1.03-1.21) participants. The combined PRS was also associated with composite ASCVD across all ancestry groups but greater among non-Hispanic White (HR, 1.20; 95% CI, 1.16-1.24) than non-Hispanic Black (HR, 1.11; 95% CI, 1.05-1.17) and Hispanic (HR, 1.12; 95% CI, 1.00-1.25) participants. Net reclassification improvement from adding PRS to a traditional risk model was modest for the intermediate risk group for composite CVD among men (5-year risk >3.75%, 0.38%; 95% CI, 0.07%-0.68%), among women, (6.79%; 95% CI, 3.01%-10.58%), for age older than 55 years (0.25%; 95% CI, 0.03%-0.47%), and for ages 40 to 55 years (1.61%; 95% CI, -0.07% to 3.30%). Study results suggest that PRSs derived predominantly in European samples were statistically significantly associated with ASCVD in the multiancestry midlife and older-age MVP cohort. Overall, modest improvement in discrimination metrics were observed with addition of PRSs to traditional risk factors with greater magnitude in women and younger age groups.