Ethnic Factors Research Articles

What factors are considered in hospital funding models? A review of the literature on health services funding in organisation for economic co-operation and development countries.

One of the most difficult challenges in healthcare involves equitable allocation of resources. Our review aimed to identify international funding models in Organisation for Economic Co-operation and Development (OECD) countries for government-funded public hospitals and evidence underpinning their efficacy, via review of the peer-reviewed and grey literature. Ovid-Medline, Ovid Embase, Scopus, and PubMed were searched for peer-reviewed literature. Advanced Google searches and targeted hand searches of relevant organisational websites identified grey literature. Inclusion criteria were: English language, published between 2011 and 2022, and that the article: (1) focused on healthcare funding; (2) reported on or identified specific factors, indexes, algorithms or formulae associated with healthcare funding; and (3) referred to countries that are members of the OECD, excluding the United States (US). For peer-reviewed literature 1189 abstracts and 35 full-texts were reviewed; six articles met the inclusion criteria. For grey literature, 2996 titles or abstracts and 37 full-texts were reviewed; five articles met the inclusion criteria. Healthcare funding arrangements employed in 15 OECD countries (Australia, Belgium, Canada, Finland, France, Germany, Israel, Italy, the Netherlands, New Zealand, Norway, Spain, Sweden, Switzerland, and the United Kingdom [UK; specifically, England, Scotland, Wales and Northern Ireland]) were identified, but papers reported population-based funding arrangements for specific regions rather than hospital-specific models. While some models adjusted for deprivation and ethnicity factors, none of the identified documents reported on health systems that adjusted funding allocation for social determinants such as health literacy levels.

Early emergence of racial and ethnic differences in sleep health among toddlers living in low-income families

ObjectivesEmerging evidence suggests racial and ethnic and socioeconomic differences in children’s sleep health, yet few have examined these differences among very young children. The purpose of this study is to identify potential racial, ethnic, and sociodeomographic factors associated with multiple dimensions of sleep health in toddlers living in very low-income families. ParticipantsSample included 110 racially and ethnically diverse dyads with toddlers aged 12-15 months living in low-income families. MethodsActigraph data (9 days and nights), caregiver completed sleep diaries, Brief Infant Sleep Questionnaire—extended, and caregiver-reported socioeconomic characteristics were collected. ResultsToddlers’ average sleep duration (10.25 hours; SD = 0.76) was less than the age-based recommendations. There were significant race and ethnic differences in toddler’s actigraph-measured bedtime (p < .001) and variability in bedtimes (p = .004). Non-LatinX White toddlers had earlier bedtimes and less variability than Black and LatinX children. These between-group differences remained statistically significant after controlling for measured socioeconomic variables (p’s < 0.001). Within racial and ethnic group differences in bedtime and bedtime variability by education, employment, and marital status were identified with medium to large effect sizes. ConclusionsRacial and ethnic between-group differences in sleep occurred as early as 12 months of age and were not explained by sociodemographic variables (eg, income-to-needs, education, housing). Further research is necessary to determine structural and contextual factors that explain the racial and ethnic differences in sleep health in early childhood. Identifying these factors may inform the development of socially and culturally tailored interventions to reduce sleep health disparities.

Nasopharyngeal Carcinoma (NPC) in Russia and Epstein - Barr Virus Types: Analysis of the Influence of Gender, Ethnic and Age Factors on the Virus Types Spread in NPC Patients

Introduction: The discovery of two molecular types of Epstein-Barr virus, EBV-1 and EBV-2, with different biological properties, stimulated the search for new neoplasms associated with each type of the virus. Objective: The aim of this study was to analyze the prevalence of EBV-1 and EBV-2 in NPC patients from different climatic and geographical regions of Russia, representatives of different gender, ethnic and age groups of patients. Materials and Methods: Using nested PCR EBV types were determined in blood plasma of NPC and other non-EBV-associated tumors of the oral cavity (OTOC/EBV-) patients from the North Caucasus (NCFD) and the Central (CFD) Federal Districts of Russia. IgG and IgA antibody titers to viral capsid antigen (VCA) were determined by indirect immunofluorescence. Results: The studies carried out have shown that NPC and OTOC/EBV- patients were infected with both EBV types in roughly the same ratio. There were also no statistically significant differences in serological activities of NPC patients infected with EBV-1 or EBV-2. The prevalence of EBV-2 types 1 and 2 was not influenced by gender or ethno-geographic affiliation of NPC patients. The only difference was EBV-2 predominance in NPC patients under 60, and EBV-1 predominance in those over 60 years old. Conclusion: The absence of a predominance of one of the EBV types in NPC patients indicates that neither EBV-1 nor EBV-2 is strictly NPC-associated in Russia, and that different ethnic and climatic-geographical factors in the spread of virus types in NPC patients are not playing an essential role.

Bone metastatic cancer of unknown primary at initial presentation.

Cancer of unknown primary (CUP) is a challenging malignancy. The purpose of this study was to investigate the clinical characteristics and prognosis of bone metastatic CUP using the population-based Surveillance, Epidemiology, and End Results (SEER) database. From the SEER database, we identified 1908 patients with bone metastatic CUP at initial presentation between 2010 and 2018. Histology was subdivided following International Classification of Diseases for Oncology codes as Adenocarcinoma, Squamous cell, Neuroendocrine, or Carcinoma not otherwise specified (NOS). Cox proportional hazard modeling was applied using factors of age, sex, ethnicity, histological subtype, and therapeutic intervention. Among the 1908 patients, histology was Neuroendocrine in 240 patients, Squamous cell in 201 patients, Adenocarcinoma in 810 patients and NOS in 657 patients. In each subtype, patients tended to be predominantly male and white. Chemotherapy was introduced for 28% of patients and radiation for 34% in the entire cohort. Survival in patients with bone metastatic CUP was unfavorable, with a median survival of 2months. Among the histological subtypes, Adenocarcinoma showed shorter survival than the other groups. In addition, treatment interventions such as chemotherapy and radiation therapy prolonged survival, particularly for Squamous cell, Adenocarcinoma and NOS, but not for Neuroendocrine. Bone metastatic CUP showed extremely poor prognosis, but treatment interventions such as chemotherapy and radiation generally offered survival benefits. Further randomized clinical research is needed to confirm the present results.

The Presence of Diglossia in American-Based Talk Shows

This study aims to find the types of diglossia and the factors of the use of language variations in the videos of “Steve Tv show, Netflix is a Joke, ABC, The Tonight Show Starring Jimmy Fallon” on the YouTube channel. Diglossia is defined as a situation where two language variations occur at the same time. This is a content analysis and the data were taken from conversations in the video analyzed using Trudgill's theory. Further, factors of the occurrence of diglossia in the use of language variations are based on Yule's theory of diglossia. Using observation as main instrument of collecting data, all diglossia occurring in the selected videos are classified into high, medium, and low classes to be tallied to come to the final findings. The findings highlight that diglossia is found in six of the eight videos. The writers identified standard English as dominant on the Tonight Show Starring Jimmy Fallon's YouTube channel. While the use of non-standard English is more dominant in videos on the Steve Tv Show, Netflix is a Joke and ABC channel. The factor that causes a lot of language variation is the ethnic background where this factor is found on 3 YouTube channels, the age factor on 2 YouTube channels, the speech community factor on 2 YouTube channels, and the gender factor on 1 YouTube channel. From the two types of language variation and four of the five factors of diglossia found in the videos, high language variation and ethnic background factors are language variations and dominating factors

Distribution characteristics and results of allergens in patients with allergic rhinitis in Ningxia area

Objective:To investigate the distribution of allergens in patients with allergic rhinitis （AR） in Ningxia, and provide theoretical data for the prevention and treatment of AR in this region. Methods:A total of 1664 patients diagnosed with AR in the Otorhinolaryngology Head and Neck Surgery Department of Yinchuan First People's Hospital Outpatient Clinic from January 2018 to December 2021 were retrospectively collected. Use the allergen sIgE antibody detection kit （immunoblotting method） to detect inhalation and ingestion allergens in patients.Results: ①Among all AR patients, 1 158 cases were detected positive, resulting in the detection rate was 69.59%; ②The detection rate of inhalation allergen was 65.87%, and the detection rate of ingestion allergen was 19.83%; ③Mugwort was the most sensitive allergen, and 76.32% of the patients having a positive grade ≥3; ④Out of the patients, 294 cases （25.39%） were allergic to only one allergen, 244 cases （21.07%） were allergic to two allergens, and 620 cases （53.54%） were allergic to three or more allergens; ⑤During different seasons, the highest number of positive allergens detected was in the summer, with 968 cases （83.59%）. Mugwort was the main allergen during this season （69.01%）. After the COVID-19 epidemic, the total positive rate of sIgE tests in AR patients decreased compared to before, and the difference was statistically significant （P<0.001）; ⑥Mugwort, dog epithelium, mold combination, egg, peanut, soybean, Marine fish combination and fruit combination all showed statistically significant differences between different gender groups （P<0.05）; ⑦Common ragweed, mugwort, dust mite combination, cockroach, egg, milk, Marine fish combination, shrimp, fruit combination and nut combination all showed statistically significant differences among different age groups （P<0.05）; ⑧There were statistically significant differences in hay dust among different ethnic groups （P<0.05）. Conclusion:Artemisia argyi is the main allergen in Ningxia, and the distribution characteristics of different allergens are influenced by treatment season, the COVID-19 epidemic, gender, age, ethnicity, and other factors, showing certain distribution patterns and rules.

Academic Performance of Preclinical Medical Students in Association with Gender, Ethnicity and Entry Qualification

Various qualifications are accepted as the entry requirement into the Medical School of Universiti Putra Malaysia (UPM) including Sijil Tinggi Persekolahan Malaysia (STPM), matriculation and Asasi Sains Pertanian (ASPER). We aim to determine the relationship between academic performance of preclinical medical students with sociodemographic factors of gender, ethnicity and entry qualification. A retrospective cohort study was conducted using secondary data from the Deputy Dean’s Office (Academic of Medicine) of the Medical School of UPM. Information was obtained on three cohorts of preclinical medical students (n = 308), which includes gender, ethnicity, entry qualification and examination results of Packages 1 to 9 and the Professional Examination I. Their identities and year of enrolment were kept anonymous. Data were analysed using IBM Statistical Package for the Social Science (SPSS) v26.0 using chi-square or Fisher’s exact test (significant if p &lt; 0.05). No significant association was seen between gender and the academic performances of the preclinical medical students. The Chinese ethnic group had a significant association with good academic performance, whereas the Malay ethnic group had an association with poor academic performance. There were significant associations between STPM intake and good academic performance for Cohort 1 in Package 1 (p = 0.007); 2 (p &lt; 0.001); 5 (p = 0.007); 6 (p = 0.012); 7 (p = 0.006); 8 (p = 0.002) and for Cohort 2 in Package 1 (p = 0.049), 6 (p = 0.031) and 9 (p = 0.049) but no significant association for Cohort 3. In conclusion, academic performance is significantly associated with Chinese and Malay ethnicity. Furthermore, STPM graduates outperformed students from other entry qualifications in the Medical School of UPM.

Violent and Unethical Non-Violent Abuse of Faith and Ethnoreligious Sentiments in Southeast Europe: Religious Peace-Building?

The article presents a theoretical and conceptual examination of religious violent and unethical non-violent behaviors, ethnopolitical and clerical synergism, and religious peace-building capacity. I argue that the phenomenon of religious/ethnic violent and non-violent interchangeability adopted by national political unethical behavior has adverse consequences on the post-Yugoslav social behavior and reconciliation process; religions should be a moral peace-building agency. The multiethnic/multireligious socialist Yugoslav society has been violently transformed into influential ethical and clerical cultures, producing antagonistic ethnonational societies sustaining pastoralism as potent identity manifestations of the social capital. War-period visual violence and emotions influenced violent behavior and policy within the discourse "our vs. their sacred ethnic land," creating an unbearable ease of creating fear and motivating violent antagonism and war crimes. The post-war antagonistic media rhetoric, visual antagonism, and abuse of faith adversely impact peaceful coexistence. Ethnic, religious, ideological, and political contextual factors are challenging to generate in post-conflict, divided Balkan societies. Fear of others, religiously distinct, is a category that's difficult to determine and prevent. Western-Balkan societies possess victimological and political mythical conventions, honoring ethnoreligious war victories, defeats, and agonies, maintaining hostility and revenge discourse. Historically, religions were misused to justify violence and maintain non-violence, unethical sociopolitical order, and negative peace. The ideologies of religious superiority intertwine with intensely dominant national perceptions, so belonging to the Serb, Croat, or Bosniak people is equated with Orthodoxy, Catholicism, or Islam. This entanglement is the groundwork for despondency and a hostile peace climate. Current clerical and ethnopolitical policies lead further away from conflict transformation, directing toward the renewal of monotheistic spirituality, cognition, and violence. Political involvement affects "authentic" religion. We should engage in all-inclusive theological and consensus approaches to demonstrate that religions are peace-building agencies, retrieving and revitalizing authentic morality criteria. Religious sentiments mobilize people more rapidly than other identities.

Urolithiasis: Modern Approaches to Classification, Diagnosis and Treatment

Urinary stone disease (USD) is the most common and progressive disease of the urinary system, which is characterized by frequent exacerbations and a severe course. This is a complex disease caused by various causes, in which several biochemical processes are involved, occurring not only in the urinary system, but also in the whole organism. USD depends on geographical, climatic, ethnic, dietary and genetic factors. Over the past 20 years there has been an increase prevalence of this disease. The course of USD is characterized by the acute and chronic pyelonephritis and frequent recurrence, which leads to the development of renal failure, disability and fatal consequences. Calculus can form de novo anywhere in the urinary tract. The pathophysiology of USD differs depending on the place of stone formation and depends on endogenous and exogenous factors. Urinary tract stones are classified depending on etiology, location, size, number, frequency of occurrence, and radiopacity. The main symptoms of USD are pain of various nature; microscopic hematuria; dysuria, which most often indicates the presence of a stone in the urinary bladder or a low location in the ureters; discharge of crystals of urinary salts or concretions; increased body temperature. The diagnosis of USD is based on a carefully history taking and physical examination, which allows to determine the correct direction of diagnostic approach, which include laboratory and instrumental methods of diagnosis. Ultrasound diagnosis is used as the main method for visualization of calculi, but recently non contrast-enhanced computed tomography has become the standard for the diagnosis of acute low back pain, replacing intravenous urography. The choice of treatment is based on many parameters, such as the number, size, morphology, shape, volume, mobility, hardness and location of the stones and is individualized for each patient. There are two main approaches: conservative treatment and surgic al one. Medicinal treatment of USD is used primarily to prevent the repeated formation of new stones or to increase those inclusions that are already present in the organs. Drug therapy is carried out with the aim of normalizing processes in the body, the failure of which leads to the development of pathology. However, conservative treatment has its limitations and is most often used as a symptomatic treatment. Open laparoscopic interventions are rarely used recently, minimally invasive methods are more popular: extracorporeal shock-wave lithotripsy; ureterorenoscopy; percutaneous nephrolithotomy. Taking into account the increase in the prevalence of USD in Ukraine and disability (the third place among the general spectrum of causes of disability in urological practice), the article analyzes and reviews modern approaches to classification, early and accurate diagnosis, and choosing a timely and correct method of treatment.

Sex, Racial, and Ethnic Disparities in Acute Coronary Syndrome: Novel Risk Factors and Recommendations for Earlier Diagnosis to Improve Outcomes.

In this review, sex, racial, and ethnic differences in acute coronary syndromes on a global scale are summarized. The relationship between disparities in presentation and management of acute coronary syndromes and effect on worse clinical outcomes in acute coronary syndromes are discussed. The effect of demographic, geographic, racial, and ethnic factors on acute coronary syndrome care disparities are reviewed. Differences in risk factors including systemic inflammatory disorders and pregnancy-related factors and the pathophysiology underlying them are discussed. Finally, breast arterial calcification and coronary calcium scoring are discussed as methods to detect subclinical atherosclerosis and start early treatment in an attempt to prevent clinical disease.

Demographic Factors as Disparities in Sabah Values ​​of Patriotism

The main challengesof nation -building is to manage and organize the social differences of society, isby sharing the same values of patriotism. The value of patriotism that can be shared without differentiating between ethnic and religious identities will make it easier to cultivate and maintain harmonious relations in a society that is complex. Therefore, the purpose of this paper is to examine the practice of the Kadazan-Dusun, Bajau and Murut communities on the value of patriotism as theiridentity asMalaysian citizens. The values of patriotism in this study are based on six values, namely loyalty, sacrifice, pride, sense of belonging, discipline, striving and productivity. The domain of practicing the value of patriotism is based on five frequency scales. The finding scores of this section are divided into three levels, namely high, moderateand low. The study involves500 respondents consisting of Kadazan-Dusun, Bajau and Murut ethnic groups. This study is based on a quantitative research approach and uses the Probability Proportional to Size (PPS) sampling method. Study data were obtained through survey methodwith the distribution of questionnaires to respondents fromselected districts in Sabah. The findings of this study were analyzed descriptively and inferentially. The results of the study found that the respondents' practice of patriotism values is high and there is a significant difference between ethnic and religious factors on the practice of patriotism values. It can be concluded that the society in Sabah is a patriotic society,butethnic and religious factors also determine the differences inpatriotic practicesbetween the Kadazan-Dusun, Bajau and Murut ethnic groups.

Factors affecting the selection of Kadazandusun ethnic foods among students of Universiti Malaysia Sabah, Malaysia

Ethnic food refers to food originating from a specific ethnic group. The study identifies the knowledge and factors in Kadazandusun ethnic food selection among students at the Universiti Malaysia Sabah (UMS). A total of 410 students from Universiti Malaysia Sabah were recruited as respondents through the snowball method. This quantitative study used questionnaires to collect data. The closed-ended questionnaire has four parts: demographics, knowledge, factors affecting food selection, and Kadazandusun ethnic food consumption intention. Data were analyzed using descriptive statistics and presented as frequencies, percentages, and mean values to address the study aims. In this study, 46.8% of the respondents had low knowledge (scale of 0–50) about Kadazandusun ethnic food. As factors that influence food selection, the health factor with an average value of x= 3.39 ± 1.095 received a neutral response toward agreeing compared with the convenience factor (x= 3.17 ± 1.086), taste/sense of food (x= 3.12 ± 1.170), price(x= 3.17 ± 1.134), and habit (x= 2.55 ± 1.164). Therefore, awareness and ethnic food selection factors among students are still low. A mechanism that can promote ethnic food, especially among IPTA students, for sustainability, information dissemination, and consumption of traditional ethnic food, is needed so that it does not disappear.

Lessons From Canadian Judgments: The Consideration of Culture in Intimate Partner Violence Legal Cases Involving Asian Canadians.

Despite the pervasiveness of intimate partner violence (IPV) in Canada, research examining IPV in the context of Asian Canadians is scarce. Our study examined whether and how Canadian judges consider culture when determining a sentence in IPV cases involving an Asian offender and/or an Asian victim. We systematically searched for publicly published cases through CanLII. A total of 50 cases met the inclusion criteria. Cultural themes were identified using a direct content analysis approach to capture a priori themes in the literature, as well as identify any other factors considered. Our findings indicated culture was most often considered in only a superficial way (n = 31, 62.0%), where judges only made statements that simply identified the ethnicity of the offender and not how culture may have impacted the case. When examining cases where culture was meaningfully considered there were no prominent culture themes identified (all themes present in <14% of cases). We suggest this may not only reflect the heterogeneity of Asian Canadians, but could also reflect the lack of cultural consideration by the judges. Cultural factors were also rarely considered explicitly as an aggravating or mitigating factor in a case (n = 2; 4.0% and n = 7; 14.0% of the total sample, respectively). The findings reveal the current lack of meaningful consideration of culture in IPV legal cases involving Asian Canadians. We outline how this contrasts the increased attention to the meaningful consideration of culture in the Canadian legal arena and prompt all professionals involved in assessing and managing IPV risk to consider racial, ethnic, and cultural factors in these cases.

The Myth of Maghrib Prohibition in "Sandekala" Film: Reception Analysis Toward Indonesian Audiences

This study aims to find out the meaning of student audiences in Jakarta and Tangerang on the mythical message of prohibiting going out at sunset (Maghrib) in the film "Sandekala".The research approach used the qualitative approach with the reception analysis method by Stuart Hall. Stuart Hall's Reception Analysis Theory (Encoding-Decoding) has a model with three categories: Dominant Position, Negotiated Position, and Oppositional Position. The data collection technique in this research used in-depth interviews with ten informants. The research results show the shared meaning of the mythical messages about the Maghrib exit ban in the film Sandekala is different. It happens because the decoding that informants produce varies according to factors of gender, age, religion, ethnicity and culture. There are other factors, such as the level of individual beliefs in myths in society, especially the Maghrib exit ban. The study concludes that ten informants and eight questions in this research obtained thirty-six shared meanings of Dominant Position, seventeen of Negotiated Position and twenty-seven of Oppositional position to the mythical messages of the Maghrib exit ban in the film Sandekala. In this study, as a whole, the most shared meaning is found in the dominant position. In other words, Jakarta and Tangerang students, as active audiences, can interpret the content and messages of the myth about the Maghrib exit ban in the Film Sandekala following what the text producer gave in the film.

Severe ocular complications of SJS/TEN and associations among pre-onset, acute, and chronic factors: a report from the international ophthalmology collaborative group.

We formed an international research collaboration that included Japan, South Korea, Brazil, Thailand, Taiwan, the UK, and the US (682 patients from 13 hospitals between 2005 and 2020), to better evaluate the role of race, ethnicity, and other risk factors in the pathophysiology of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Ophthalmologists often see SJS/TEN patients with severe ocular complications (SOC; frequency 50% SJS/TEN patients) when the patients are referred to them in the chronic stage after the acute stage has passed. Global data were collected using a Clinical Report Form, capturing pre-onset factors, as well as acute and chronic ocular findings. Key conclusions of this retrospective observational cohort study were as follows: (1) Ingestion of cold medications [acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs)] was significantly and positively correlated with trichiasis, symblepharon, and/or conjunctivalization of the cornea in the chronic stage; (2) common cold symptoms prior to onset of SJS/TEN were significantly and positively correlated with acute conjunctivitis and ocular surface erosions in the acute stage and with trichiasis and symblepharon and/or conjunctivalization of the cornea in the chronic stage; (3) patients with SJS/TEN who presented with SOC tended to be female; (4) patients less than 30 years of age are more likely to develop SOC in the acute and chronic stages of SJS/TEN; (5) patients with acute severe conjunctivitis with ocular surface erosion and pseudomembrane formation in the acute stage are more likely to develop ocular sequelae in the chronic stage; and (6) onychopathy in the acute stage was positively correlated with ocular sequelae in the chronic stage. Our findings show that the ingestion of cold medications, common cold symptoms prior to the onset of SJS/TEN, and a young age might strongly contribute to developing the SOC of SJS/TEN.

COVID-19 Vaccine Decision-Making Among Black Pregnant and Postpartum Women.

The history of biomedical research is marred by racially discriminatory and abusive practices that impacted Black/African Americans. Medical racism impacts the trust and utilization of new medical interventions, such as the COVID-19 vaccine. This study aimed to understand Black pregnant and postpartum women's perspectives and decision-making about the COVID-19 vaccine. We used a qualitative descriptive design and recruited 23 pregnant and postpartum Black women aged 18 years and above. Data was collected using a semi-structured interview guide. Data were analyzed using content analysis. The participants described factors influencing their decision to receive or not receive the COVID-19 vaccines. These factors included individual, cultural, ethnicity, religious, and family-related factors (individual-personal beliefs influenced decisions about the vaccine; ethnicity, culture, and religion influenced vaccine decision-making; group-family and friends played a role in decision-making), vaccine or vaccination-related issues (concerns about vaccination and pregnancy outcomes and mistrust in the vaccine information), and contextual influence (sources of vaccine information influenced decision-making and healthcare providers influenced decision-making). Understanding the vaccine decision-making process of underserved populations likely to decline vaccination due to pregnancy, postpartum, and breastfeeding status will help design tailored interventions to improve vaccine acceptance in minority communities, especially for pregnant and postpartum women.

Obesity, obesities and gastrointestinal cancers

Obesity has been recognized to be increasing globally and is designated a disease with adverse consequences requiring early detection and appropriate care. In addition to being related to metabolic syndrome disorders such as type 2 diabetes, hypertension, stroke, and premature coronary artery disease. Obesity is also etiologically linked to several cancers. The non-gastrointestinal cancers are breast, uterus, kidneys, ovaries, thyroid, meningioma, and thyroid. Gastrointestinal (GI) cancers are adenocarcinoma of the esophagus, liver, pancreas, gallbladder, and colorectal. The brighter side of the problem is that being overweight and obese and cigarette smoking are mostly preventable causes of cancers.Epidemiology and clinical studies have revealed that obesity is heterogeneous in clinical manifestations. In clinical practice, BMI is calculated by dividing a person's weight in kilograms by the square of the person's height in square meters (kg/m2). A BMI above 30 kg/m2 (defining obesity in many guidelines) is considered obesity. However, obesity is heterogeneous. There are subdivisions for obesity, and not all obesities are equally pathogenic.Adipose tissue, in particular, visceral adipose tissue (VAT), is endocrine and abdominal obesity (a surrogate for VAT) is evaluated by waist-hip measurements or just waist measures. Visceral Obesity, through several hormonal mechanisms, induces a low-grade chronic inflammatory state, insulin resistance, components of metabolic syndrome, and cancers. Metabolically obese, normal-weight (MONW) individuals in several Asian countries may have BMI below normal levels to diagnose obesity but suffer from many obesity-related complications. Conversely, some people have high BMI but are generally healthy with no features of metabolic syndrome. Many clinicians advise weight loss by dieting and exercise to metabolically healthy obese with large body habitus than to individuals with metabolic obesity but normal BMI.The GI cancers (esophagus, pancreas, gallbladder, liver, and colorectal) are individually discussed, emphasizing the incidence, possible pathogenesis, and preventive measures.From 2005 to 2014, most cancers associated with overweight and Obesity increased in the United States, while cancers related to other factors decreased. The standard recommendation is to offer or refer adults with a body mass index (BMI) of 30 or more to intensive, multicomponent behavioral interventions. However, the clinicians have to go beyond. They should critically evaluate BMI with due consideration for ethnicity, body habitus, and other factors that influence the type of obesity and obesity-related risks. In 2001, the Surgeon General's ``Call to Action to Prevent and Decrease Overweight and Obesity'' identified obesity as a critical public health priority for the United States. At government levels reducing obesity requires policy changes that improve the food and physical activity for all. However, implementing some policies with the most significant potential benefit to public health is politically tricky. The primary care physician, as well as subspecialists, should identify overweight and Obesity based on all the variable factors in the diagnosis. The medical community should address the prevention of overweight and Obesity as an essential part of medical care as much as vaccination in preventing infectious diseases at all levels- from childhood, to adolescence, and adults.

The ethnic factor in international relations in the Middle East: a historical retrospective and the current state

The Middle East is one of the most hot spots of our time. The close interweaving of peoples, linguistic groups, and religions makes this region one of the most "explosive". Studying the problem of ethnic conflicts in the Middle East, special attention should be paid to the history of the emergence of statehood in the countries of the region. For several centuries, the Middle East region has been a European colony. It was only by the twentieth century that most of the peoples living in the Middle East gained independence. An important role in this was played by armed groups, often professing radical Islam and claiming not only their own country, but also the territory of their "neighbors". This article is also focused on the situation of ethnic minorities who have failed to establish their own State. The most striking example is the Kurds, separated by four borders at once and living in Turkey, Iraq, Iran and Syria. The object of this study is the relationship between the peoples of the Middle East. The research is based on the historical and systematic method. Within its framework, the development of the states of the Middle East in the XX and XXI centuries was considered, the relationship between historical prerequisites and the current situation in the region was assessed. Along with historical methods, general scientific methods (analysis and generalization) will be involved. When writing the article, the following tasks were set: 1) To analyze the historical component of international relations in the Middle East 2) To assess the current state of interactions between countries and peoples in the region 3) To assess the degree of influence on the policy of the Middle East countries by armed groups 4) To analyze the degree of involvement of Western states in the regional agenda. The novelty of this work lies in the analysis and study of the historical prerequisites for the formation of statehood of individual countries of the Middle East, dividing them into groups to identify signs that affect the ethnic factor in international relations in the Middle East.

Demographic and racial characteristics, and survival trends in pleural mesothelioma: A population based study.

e20543 Background: Mesothelioma is a rare and aggressive type of cancer that originates from the visceral and parietal pleura. Approximately 3,000 people are diagnosed with mesothelioma in the United States each year ( &lt; 0.03% of all cancers). The prognosis is poor, with a 5-year survival rate of only 7 to 10%. With a latency period of 30 to 60 years, mesothelioma is typically diagnosed at an advanced age. Our objective is to investigate the demographic and racial factors that affect prognosis and survival rates in patients with pleural mesothelioma. Methods: We conducted a retrospective analysis using the Surveillance, Epidemiology, and End Results (SEER) database. Socioeconomic and racial factors in 13,166 patients diagnosed with mesothelioma from 2000 to 2019 were analyzed using the Pearson chi-square test. Cancer-specific survival outcomes were compared across racial and ethnic factors using the Kaplan-Meier analysis. Results: The patients were predominantly male (78.3%) and White (91.3%). Gender-based differences were narrower among the Asian/Pacific Islander population (74.5% male vs. 25.5% female) and Black population (76.8% male vs. 23.2% female) compared to Whites (78.5% male vs. 21.5% female). In the Asian/Pacific Islander population, 59.7% of patients were diagnosed with mesothelioma after 2010, compared to 40.3% diagnosed before 2010 (p-value &lt; 0.001). Of the 12,029 new mesothelioma diagnoses in the White population, 51.6% occurred before 2010 and 48.4% after 2010. Distant disease was more prevalent in the Black population at 68%, compared to 64% in White patients and 62.3% in Asian/Pacific Islanders. Patients with a household income above $65,000 accounted for 60.8%. 57.9% of Black patients had an income below $65,000, compared to 38.9% of White patients and 23% of Asian/Pacific Islanders. At diagnosis, 51% of Black patients were married, compared to 69.5% of Asian/Pacific Islander patients and 64.5% of White patients. Chemotherapy was administered to 41.7% of patients (p-value &lt; 0.07), followed by surgery (24.5%, p-value &lt; 0.003) and radiation (10.4%, p-value &lt; 0.026). 75.8% of Black individuals did not receive treatment, compared to 71.6% of Asian/Pacific Islanders and 70.1% of White patients (p-value &lt; 0.001). The cumulative incidence of mesothelioma-related death was 70.2%. The 1-year, 3-year, and 5-year survival rates for Black patients were 29%, 5%, and 1% respectively; for White patients, the rates were 33.2%, 6.5%, and 2.1%; and for Asian/Pacific Islander patients, the rates were 31%, 6%, and 2%. Conclusions: Our study highlights the interplay of socioeconomic and racial factors that may impact survival trends. Black patients have a poorer survival rate compared to White and Asian/Pacific Islander populations. This disparity could be attributed to several factors such as later stage diagnosis, lower marital status, household income, and reduced access to treatment options.

HPR29 Health Equity Frameworks – Healthcare System Actions and Priorities

Health equity has been defined as attainment of the highest level of health for all people, regardless of race, ethnicity, disability, and/or other factors affecting access to care and health outcomes in healthcare delivery. Health equity is becoming a priority for payers and hospitals looking to improve patient outcomes. The objective of this research was to evaluate health equity frameworks currently used by payer and hospital organizations.