Ethnic Groups Research Articles

Prevalence of visual impairment and estimation of refractive errors among school children in Kakamega, Kenya

AIM: To investigate the prevalence of visual impairment (VI) and provide an estimation of uncorrected refractive errors in school-aged children, conducted by optometry students as a community service. METHODS: The study was cross-sectional. Totally 3343 participants were included in the study. The initial examination involved assessing the uncorrected distance visual acuity (UDVA) and visual acuity (VA) while using a +2.00 D lens. The inclusion criteria for a subsequent comprehensive cycloplegic eye examination, performed by an optometrist, were as follows: a UDVA<0.6 decimal (0.20 logMAR) and/or a VA with +2.00 D ≥0.8 decimal (0.96 logMAR). RESULTS: The sample had a mean age of 10.92±2.13y (range 4 to 17y), and 51.3% of the children were female (n=1715). The majority of the children (89.7%) fell within the age range of 8 to 14y. Among the ethnic groups, the highest representation was from the Luhya group (60.6%) followed by Luo (20.4%). Mean logMAR UDVA choosing the best eye for each student was 0.29±0.17 (range 1.70 to 0.22). Out of the total, 246 participants (7.4%) had a full eye examination. The estimated prevalence of myopia (defined as spherical equivalent ≤-0.5 D) was found to be 1.45% of the total sample. While around 0.18% of the total sample had hyperopia value exceeding +1.75 D. Refractive astigmatism (cil<-0.75 D) was found in 0.21% (7/3343) of the children. The VI prevalence was 1.26% of the total sample. Among our cases of VI, 76.2% could be attributed to uncorrected refractive error. Amblyopia was detected in 0.66% (22/3343) of the screened children. There was no statistically significant correlation observed between age or gender and refractive values. CONCLUSION: The primary cause of VI is determined to be uncorrected refractive errors, with myopia being the most prevalent refractive error observed. These findings underscore the significance of early identification and correction of refractive errors in school-aged children as a means to alleviate the impact of VI.

The interlink between thyroid autoimmunity and type 1 diabetes and the impact on male and female fertility.

The aim of this review is to discuss the several interconnections between thyroid autoimmunity and type 1 diabetes in terms of epidemiology, immunoserology, genetic predisposition, and pathogenic mechanisms. We will also analyze the impact of these conditions on both male and female fertility. A literature search was carried out using the MEDLINE/PubMed, Scopus, Google Scholar, ResearchGate, and Clinical Trials Registry databases with a combination of keywords. It was found that the prevalence of thyroid autoantibodies in individuals with type 1 diabetes (T1DM) varied in different countries and ethnic groups from 7 to 35% in both sexes. There are several types of autoantibodies responsible for the immunoserological presentation of autoimmune thyroid diseases (AITDs) which can be either stimulating or inhibiting, which results in AITD being in the plus phase (thyrotoxicosis) or the minus phase (hypothyroidism). Different types of immune cells such as T cells, B cells, natural killer (NK) cells, antigen presenting cells (APCs), and other innate immune cells participate in the damage of the beta cells of the islets of Langerhans, which inevitably leads to T1D. Multiple genetic and environmental factors found in variable combinations are involved in the pathogenesis of AITD and T1D. In conclusion, although it is now well-known that both diabetes and thyroid diseases can affect fertility, only a few data are available on possible effects of autoimmune conditions. Recent findings nevertheless point to the importance of screening patients with immunologic infertility for AITDs and T1D, and vice versa.

Negative life events and suicidality among adolescents in Western China: the mediating effect of depressive symptoms and the moderating effect of self-esteem.

To investigate the mediating role of depressive symptoms in the relationship between negative life events (NLEs) and suicidality, as well as to test the moderating effect of self-esteem in the mediation model. A total of 3,003 adolescents from Han, Tibetan, and Yi ethnic groups living in Western China were included in this study. Utilizing the structural equation model, a mediation model and a moderated mediation model were constructed. The presence of NLEs was positively associated with suicidality (β = 0.17, p < 0.001). Depressive symptoms partially mediated the relationship between NLEs and suicidality (indirect effect β = 0.19, p < 0.001). Self-esteem moderated both the antecedent and subsequent segments of the mediating paths of "NLEs → depressive symptoms → suicidality" and the direct relationship between NLEs and suicidality. Among adolescents with a low level of self-esteem, the mediating effect coefficient of depressive symptoms was higher at 0.18 (95% confidence interval (CI): 0.14-0.23), in contrast to adolescents with a high level of self-esteem, where the mediating effect coefficient of depressive symptoms was 0.04 (95% CI: 0.02-0.07). NLEs are directly associated with an increased risk of suicidality and indirectly related to suicidality by increasing the risk of depressive symptoms among adolescents. Self-esteem can moderate the mediating effect of depressive symptoms and the relationship between NLEs and suicidality. The intervention strategy for preventing suicidality among adolescents who have experienced NLEs should focus on reducing depressive symptoms and improving self-esteem.

The mathematics pipeline in England: inclusion and the excellence stream

Abstract In England, there is currently heightened political interest in increasing mathematics attainment and maximizing post-16 participation. The latter is not merely an issue for upper secondary but requires a long-view of students’ mathematical progress. This paper reports such a system-level overview of the mathematics education pipeline in England based on analysis of linked data from the National Pupil Database (NPD) and Higher Education Statistics Agency (HESA). A sequence of mixed-effect logistic regression models at each phase of the education pipeline are developed to predict attainment in General Certificate of Secondary Education (GCSE), A level and undergraduate mathematics and participation in post-16 and university mathematics. In particular, we focus on the impact of prior attainment and student demographics: gender, ethnicity and socio-economic status. The analysis identifies four important findings. Firstly, female participation and attainment in A level Mathematics and Further Mathematics is lower than that of male students, which impacts their representation in undergraduate mathematics, despite them marginally outperforming male students at both GCSE and degree level. Secondly, the attainment and participation of students of Asian ethnicity in GCSE and A level Mathematics is striking in its positive divergence from the trends of other ethnic groups, whereas White students have higher attainment than other ethnic groups at university. Thirdly, many students from poorer backgrounds fall behind their peers during years 7 to 11, and their participation and attainment in A level Mathematics is also reduced compared to their more affluent peers. Lastly, students who study A level Further Mathematics are more likely to study undergraduate mathematics, but they are no more likely to achieve a first-class degree, compared to those who haven’t studied Further Mathematics. The findings should be informative to policymakers and other stakeholders who can put in place enhancements and interventions to improve the outcomes for underrepresented groups.

Digital memory construction in Lijiang

Purpose The ancient town of Lijiang is a representative place of ethnic minorities in China’s southwest border area jointly built by many ethnic groups. Its rich and diversified history, culture and architecture as well as its artistic and spiritual values need to be better retained and explored.Design/methodology/approach The protection and inheritance of Lijiang’s cultural heritage will be improved through the construction of digital memory resources. To guide Lijiang’s digital memory construction, this study explores strategies of digital memory construction by analyzing four case studies of well-known memory projects from China and America.Findings From the case studies analysis, factors of digital memory construction were identified and compared. Factors led to the discussion of strategies for constructing the digital memory of Lijiang within its design, construction and service phases.Originality/value The ancient town of Lijiang is a famous historical and cultural city in China, and it is also a representative place of ethnic minorities in the border area jointly built by many ethnic groups. The rich culture should be preserved and digitalized to offer better use for the whole nation.

Genetic Diversity and Haplogroup Distribution of Three Ethnic Groups Tay, Thai, and Nung

Genetic Diversity and Haplogroup Distribution of Three Ethnic Groups Tay, Thai, and Nung

Larger spleens and greater splenic contraction during exercise may be an adaptive characteristic of Nepali Sherpa at high-altitude.

The Sherpa ethnic group living at altitude in Nepal may have experienced natural selection in response to chronic hypoxia. We have previously shown that Sherpa in Kathmandu (1400 m) possess larger spleens and a greater apnea-induced splenic contraction compared to lowland Nepalis. This may be significant for exercise capacity at altitude as the human spleen responds to stress-induced catecholamine secretion by an immediate contraction, which results in transiently elevated hemoglobin concentration ([Hb]). To investigate splenic contraction in response to exercise at high-altitude (4300 m; Pb = ~450 Torr), we recruited 63 acclimatized Sherpa (29F) and 14 Nepali non-Sherpa (7F). Spleen volume was measured before and after maximal exercise on a cycle ergometer by ultrasonography, along with [Hb] and oxygen saturation (SpO2). Resting spleen volume was larger in the Sherpa compared with Nepali non-Sherpa (237 ± 62 vs. 165 ± 34 mL, p < .001), as was the exercise-induced splenic contraction (Δspleen volume, 91 ± 40 vs. 38 ± 32 mL, p < .001). From rest to exercise, [Hb] increased (1.2 to 1.4 g.dl-1), SpO2 decreased (~9%) and calculated arterial oxygen content (CaO2) remained stable, but there were no significant differences between groups. In Sherpa, both resting spleen volume and the Δspleen volume were modest positive predictors of the change (Δ) in [Hb] and CaO2 with exercise (p-values from .026 to .037 and R2 values from 0.059 to 0.067 for the predictor variable). Larger spleens and greater splenic contraction may be an adaptive characteristic of Nepali Sherpa to increase CaO2 during exercise at altitude, but the direct link between spleen size/function and hypoxia tolerance remains unclear.

Documentation of social determinants of health across individuals from different racial and ethnic groups in home healthcare.

Home healthcare (HHC) enables patients to receive healthcare services within their homes to manage chronic conditions and recover from illnesses. Recent research has identified disparities in HHC based on race or ethnicity. Social determinants of health (SDOH) describe the external factors influencing a patient's health, such as access to care and social support. Individuals from racially or ethnically minoritized communities are known to be disproportionately affected by SDOH. Existing evidence suggests that SDOH are documented in clinical notes. However, no prior study has investigated the documentation of SDOH across individuals from different racial or ethnic backgrounds in the HHC setting. This study aimed to (1) describe frequencies of SDOH documented in clinical notes by race or ethnicity and (2) determine associations between race or ethnicity and SDOH documentation. Retrospective data analysis. We conducted a cross-sectional secondary data analysis of 86,866 HHC episodes representing 65,693 unique patients from one large HHC agency in New York collected between January 1, 2015, and December 31, 2017. We reported the frequency of six SDOH (physical environment, social environment, housing and economic circumstances, food insecurity, access to care, and education and literacy) documented in clinical notes across individuals reported as Asian/Pacific Islander, Black, Hispanic, multi-racial, Native American, or White. We analyzed differences in SDOH documentation by race or ethnicity using logistic regression models. Compared to patients reported as White, patients across other racial or ethnic groups had higher frequencies of SDOH documented in their clinical notes. Our results suggest that race or ethnicity is associated with SDOH documentation in HHC. As the study of SDOH in HHC continues to evolve, our results provide a foundation to evaluate social information in the HHC setting and understand how it influences the quality of care provided. The results of this exploratory study can help clinicians understand the differences in SDOH across individuals from different racial and ethnic groups and serve as a foundation for future research aimed at fostering more inclusive HHC documentation practices.

Risk perception and use of personal care products by race and ethnicity among a diverse population

Personal care products can contain phthalates, parabens and other endocrine-disrupting chemicals. However, information on perception of risks from personal care product use and how use varies by race and ethnicity is limited. We evaluated differences in personal care product use and risk perception in a diverse sample of participants recruited from a US college campus and online. A self-administered questionnaire captured information on sociodemographic factors, personal care product use trends and perception of risk associated with them. Pearson’s chi-square and Fisher’s exact tests were used to determine differences in personal care product use and risk perception by race and ethnicity. Ordered logistic regressions were performed to measure associations between personal care product use frequency across racial/ethnic categories. Participant (n = 770) mean age was 22.8 years [standard deviation ± 6.0]. Daily use of make-up (eye = 29.3%; other = 38.0%; all = 33.7%) and skincare products (55%) was most frequently reported among Middle Eastern and North African participants. Non-Hispanic Black participants reported the highest daily use of hairstyling products (52%) and lotion (78%). Daily make-up use was more frequently reported among females (41%) than males (24.6%). Levels of agreement were similar across racial and ethnic groups, that personal care product manufacturers should be required to list all ingredients (≥87%). There were significant associations between the frequency of use of some personal care products and racial/ethnic categories when the use frequencies of participants from other racial/ethnic categories were compared to the use frequency of non-Hispanic White participants. There were significant differences in daily use frequency, levels of trust, perception of safety and health risks associated with personal care products by race and ethnicity, underscoring that there may be different sources of exposure to chemicals in personal care products by race and ethnicity.

Sociodemographic predictors of perceived weight discrimination.

Perceived weight discrimination is associated with increased risk for chronic diseases and reduced life expectancy. Nevertheless, little is known about perceived weight discrimination in racial, ethnic, and sexual minority groups or in individuals at the intersections of those groups. The goal of this study was to identify sociodemographic predictors of perceived weight discrimination. A diverse sample of adults (37% Black/African American, 36% Latino, 29% sexual minority) with a body mass index (BMI) ≥ 18.5 kg/m2 were recruited from a national US panel to complete an online survey (N = 2454). Perceived weight discrimination was assessed with the Stigmatizing Situations Survey-Brief (SSI-B). Using hierarchical linear regression analysis, SSI-B scores were predicted from the four sociodemographic characteristics of interest (gender, race, ethnicity, and sexual orientation) while controlling for BMI, age, education, and income (Step 1). At Step 2, all two-way interactions between the four sociodemographic characteristics were added to the model. At Step 1, higher SSI-B scores were observed for Latino (vs. non-Latino) adults, sexual minority (vs. heterosexual) adults, younger (vs. older) adults, adults with higher (vs. lower) levels of education, and adults with higher (vs. lower) BMI. At Step 2, race interacted with gender, ethnicity, and sexual orientation to predict SSI-B scores such that relatively higher scores were observed for non-Black women, Black men, adults who identified as Black and Latino, and non-Black sexual minority adults. Perceived weight discrimination varied across sociodemographic groups, with some subgroups reporting relatively high frequency. Black race appeared to be protective for some subgroups (e.g., Black women), but risk-enhancing for others (e.g., Black men, individuals who identified as Black and Latino). Additional research is needed to identify specific factors that cause certain sociodemographic groups -and indeed, certain individuals-to perceive higher levels of weight discrimination than others.

Forging Romanitas: The Intersection of Urbanization and Identity in Mérida

This paper aims to explore the role of urbanization in the formation of a shared Roman identity during the time of the Roman Empire. By examining the physical features of urban settlements and the economic opportunities that arose from them, it seeks to understand how these factors contributed to the development of a cohesive identity across the empire’s vast and diverse territory. This paper will use examples from cities in the western regions of the empire, such as Pompeii and Mérida, to demonstrate how urbanization and the economic opportunities it brought forth helped create a sense of Romanness among diverse ethnic groups. It will also investigate the impact of building projects and intervention from wealthy elites in the fostering of a Roman identity through urbanization. This idea will then be tied into the role of Roman architecture and urban planning in the development of said identity, exemplified by the similarities and differences between settlements across the empire. At the same time, this paper will also consider the historical context in which these urban settlements emerged, examining how the broader geopolitical situation might have impacted urbanization. By analyzing the intersection between physical structures and economic opportunities brought about within Roman urban settlements, this paper hopes to shed light on the significance of urbanization as a driving force behind the formation of a shared Roman identity. This research will contribute to the broader understanding of cultural identity formation in ancient societies and the role of urbanization in shaping the collective consciousness of diverse populations.

Olympism and Chinese humanism: a critical analysis of the opening ceremony of the 2022 Beijing Winter Olympic Games

ABSTRACT The purpose of this study is to examine China’s discourse on uniting all ethnic groups internally and conveying the human community to the world in the opening ceremony of the 2022 Beijing Winter Olympics (BWO), reflecting the different Olympism of the East and the West and the intersection of Chinese humanism discourse to form the core concept of this study. In terms of research methods, this study took the opening ceremony of the BWO as the research object, collected the content of the opening ceremony of the 2022 BWO, media reports, and related academic research, and analyzed the discussion of the 2022 BWO at the opening ceremony. The results have shown that the BWO opening ceremony continues the Chinese humanism concept of the 2008 Beijing Olympics, showing the connotation of people-oriented patriotism and emphasizing the ideal of a community with a shared future for humanity in the world. This study concludes that the BWO opening ceremony emphasizes Chinese tradition, culture, and patriotism. At the same time, the opening ceremony’s theme is set as the concept of “One World, One Family.” This discourse has formed a contrast between cosmopolitanism and patriotism, which not only shows the contradiction in the internal discourse of Chinese humanism but also shows the dialogue’s dilemma between the Asian value thinking advocated by Chinese humanism and the universal values of individualism and human rights emphasized by Western concepts.

Epidemiology and demographic risk factors for myopia in Ghana: a 5-year retrospective study

PurposeTo explore the epidemiology and demographic risk factors for myopia among a clinical sample.MethodsIn a hospital-based retrospective study, eligible subjects were grouped into either myopia or non-myopia. Demographic data, including age, sex, occupation, area of residence, region of residence, and ethnicity, were analysed. Other clinical information analysed included the degree of myopia and intervention provided for the myopia.ResultsOverall, the medical records of 15807 patients were retrieved between January 2015 and December 2019, with 50.9% being males. The mean ± SD age of the patients was 42.81 ± 18.99 years. A total of 44.4% of the patients were myopic. Age, type of ethnic group, occupation, and area of residence were associated with myopia. Demographic risk factors for myopia included occupations such as professionals (OR: 2.93; 95% CI 2.44–3.52), technicians and associated workers (OR: 6.71; 95% CI 5.15–8.74), service workers (OR: 11.74; 95% CI 9.62–14.33), skilled agriculture and fishery (OR: 1.88; 95% CI 1.41–2.50), craft workers (OR: 3.41; 95% CI 2.75–4.25), armed forces (OR: 10.26; 95% CI 7.54–13.97), students (OR: 3.49; 95% CI 2.76–4.42), the unemployed (OR: 6.64; 95% CI 5.44–8.11), as well as Ewe (OR: 1.46; 95% CI 1.17–1.82) and Ga-Adangbe (OR: 1.28; 95% CI 1.05–1.54) ethnicities.ConclusionEwe and Ga-Adangbe ethnicities, and specific occupations are risk factors for myopia.

Trajectories of State-Level Sepsis-Related Mortality by Race and Ethnicity Group in the United States

Background: Recent reports on the national temporal trends of sepsis-related mortality in the United States (US) suggested improvement of outcomes in several race and ethnicity groups. However, it is unknown whether national data reflect state-level trajectories. Methods: We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death data set to identify all decedents with sepsis in the US during 2010–2019. Negative binomial regression models were fit to estimate national and state-level trends of age-adjusted sepsis-related mortality rates within race and ethnicity groups. Results: There were 1,852,610 sepsis-related deaths in the US during 2010–2019. Nationally, sepsis-related mortality rates decreased among Blacks and Asians, were unchanged among Hispanics and Native Americans, and rose among Whites. The percent of states with similar trends were 30.0% among Blacks, 32.1% among Asians, 74.3% among Hispanics, 75.0% among Native Americans, and 66.7%% among Whites, while trending in opposite direction from 3.6% among Asians to 15.0% among Blacks. Conclusions: National trends in sepsis-related mortality in the US did not represent state-level trajectories in race ethnicity groups. Gains in sepsis outcomes among race and ethnicity groups at the national level were not shared equitably at the state level.

Https://www.shdisj.com/index.php/shdisj/article/view/110

A person lives nowadays in a multicultural world, and transformations of the conditions of social life lead to the changes in the sphere of values and worldview of both the indigenous population and the representatives of national minorities. Family values of Ukrainian and Crimean Tatar youth living in mainland Ukraine after the occupation of the Crimea, were investigated. The purpose of the research is a cross-cultural study of family values and parental attitudes of Ukrainian and Crimean youth. Methodology. Sample: N=220 (110 Ukrainians (55 boys and 55 girls) and 110 Crimean Tatars (55 boys and 55 girls) aged 17-24. Methods: Schwartz's value questionnaire, PARI questionnaire, "Family atom" by E. Eidemiller, "Role expectations and harassment in marriage" by A. Volkova, questionnaire "Development of a complete personality in the conditions of modern changes" by O. Vlasova, V. Shcherbina, "Scales of multicultural identification" by A. Mambetova, "Emotional self-awareness" test by O. Vlasova, M. Berezyuk. Results. The majority of Ukrainian youth demonstrate the values of stimulation, which are pronouncedly expressed in the form of the desire for novelty, the need for changes and deep experience, the value of a life full of thrills, new impressions and complicated tasks, as well as universalism (tolerance, protection of human well-being and natural environment). Among the Crimean Tatar youth the values of safety, achievement, universalism and conformity are expressed at a high level (in ½ and more of the respondents). In the course of this research common (nuclear) parental attitudes of the respondents were revealed, which serve as the basis for the formation of transcultural values. Both ethnic groups are characterized by avoiding conflict, developing the activity of a child, partnership relationship, suppression of aggressiveness, verbalization.

Food ethnobotany of forest resource in the high-altitude Himalaya Mountains: Enhancing the food sovereignty of ethnic groups

The vital knowledge of traditional foraging techniques used in indigenous peoples' cuisines may be preserved through gastronomical field studies before it is lost forever. Certain plants are appreciated for their gastronomic, social, economic and ecological importance in the High Himalaya because they play such a significant role in the daily life of the local indigenous populations. To determine the plant cultural indicators for each ethnic group, the data were analyzed using an indicator species analysis. Semi-structured interviews of 167 participants, focus group discussion, and field observations were used to gather information from February 2019 to August 2022 for a comprehensive and systematic gastronomical survey. Across four ethnic groups, a total of (N = 99) wild edible plant species and (N = 9) fungi species from 38 families were documented. Tender leaves were the most commonly used, while tubers were the least commonly used. The majority of the species reported were used as vegetables, followed by species used as fruits and herbal tea. For the first time, we examined cross-cultural similarity and dissimilarity for gastronomic usage: vegetables and savoring plants,fruits, and herbal tea across the cultures studied from the perspective of food ethnobotany. We discovered a clear difference in how different cultures used forest resources, with Gujjar and Pahari showing the most species similarity. This is because these ethic groups are culturally linked with one another and share a common social structure, geography, and language. We calculated plant cultural markers for each species, and 19 of them had significant p-values among the four ethnic groups. The findings revealed a positive relationship between the Gujjar and Pahari ethnic groups and the gastronomical indicator values, while the Kashmiri ethnic group had a negative relationship. The Kashmiri ethnic group experienced the loss of traditional knowledge because of the economic transition that caused people to prefer purchasing vegetables from the market rather than foraging for them in the wild. Traditional knowledge was also dwindling between the Gujjar and Pahari ethnic groups because of social changes brought on by developmental activities that changed their way of life. The identified plant cultural markers were significant to local residents and frequently had adaptations to extremely harsh climatic and environmental conditions. Our finding that 47% of species had market value suggests that these species have a sizable market demand and a promising economic value. They have the potential to boost food security, local community sovereignty, and people's living standards. Food production systems may become more resilient and sustainable by incorporating these indicator species into conventional agriculture. The current study raises awareness about forest resources and enables ethnic groups to live in a natural environment without food scarcity.

Ethnic stereotypes and prejudices of modern Russian youth

The article examines the theoretical foundations of the analysis of ethnic stereotypes and prejudices that have developed in modern sociological and socio-psychological science. The patterns of this phenomenon characteristic of modern society are highlighted. The results of the authors’ own empirical study of ethnic stereotypes and prejudices of modern Russian youth are presented that made it possible to identify the regional specificity of the manifestation of this phenomenon among Perm youth and to compared it with the Moscow youth. The specificity was identified according to behavioural (behaviour in the process of interethnic conflict; existence of interpersonal relationships with representatives of another ethnic group; orientation towards a certain type of relationship with representatives of another ethnic group), cognitive (knowledge about representatives of their own and other ethnic groups; trust in services provided by representatives of different ethnic groups and by migrants; trust in representatives of different ethnic groups) and emotional parameters (emotional attitude to the culture and traditions of another ethnic group; emotional attitude to interethnic conflict). The main factors influencing the formation of ethnic stereotypes and prejudices among Perm and Moscow youth are clarified. These results can be used for further study of regional characteristics of interethnic relations and ethnic stereotypes, prejudices, their dynamics and effective interaction of ethnophors as well as to optimise the process of interethnic relations.

Socio-economic geography and the land rights of indigenous peoples in Paraguay

AbstractThe article investigates the long-term tendencies of Paraguayan political-economy, in particular the mounting impacts of export-oriented agribusiness on its indigenous peoples. The analysis is based on the theorisation of the geographical force of subtraction, that is, the evanescent properties of capitalist development, in which economic growth takes place via an interconnected elimination of rights, opportunities and alternatives. The discussion is focussed on the land struggle of the Paĩ Tavyterã in the northeast of Paraguay and members of the same ethnic group who live in Brazil (called Guarani-Kaiowa). It is a relational narrative that draws insights from various actors, communities and situations. The main conclusions are that, despite the fact that Paraguay is now a major exporter of agribusiness commodities, what has prevailed is the accumulation of multiple forms of political, environmental, social and economic violence. At the same time, the decolonising reaction of indigenous peoples, in alliance with other sectors of the working class, aims at reverting the deficit caused by systemic socio-economic subtraction and in pursuit of transformative additions.

Active Direction: A new observational measure of African American parenting

A new observational measure of a culturally salient, supportive African American parenting style, Active Direction, was developed. Ratings were compared to standard qualitative ratings and across two ethnic groups. Active Direction represents the provision of structure to interactions in the form of corrective direction with clear and concise feedback that is assessed for supportiveness rather than simple content or tone. The 7-point rating item was examined in observations of African American (n = 172) and Hispanic American (n = 196) mother-child interactions collected at age 2.5 years in families from low-income households. Ratings were compared and associations to previously reported ratings of the interactions were examined. Active Direction was often observed among the African American mothers (81%) but rarely observed among the Hispanic mothers (16%), with a large effect size difference, supporting the hypothesis that Active Direction may represent a culturally specific approach to parenting for African American parents. Maternal behavior correlations of Active Direction with cognitive stimulation, intrusiveness, scaffolding, and calm authority and with child affiliative obedience and dyadic routines and rituals were significantly higher and detachment significantly lower in the African American compared to the Hispanic sample. The new measure of Active Direction, centered around culturally salient values and differences in both historical and lived experiences, addresses characteristics of parenting in African American families that are supportive of their children’s development and provides a fruitful direction for future research.

What Explains Inequalities in Telehealth Utilization Among North Carolina Medicaid Beneficiaries?

Background: Increased availability of telehealth can improve access to health care. However, there is evidence of persistent disparities in telehealth usage, as well as among people from minoritized racial and ethnic groups and rural residents. The objective of our work was to explore the degree to which disparities in telehealth use for behavioral health (BH) and musculoskeletal (MSK) related services during the COVID-19 pandemic are explained by observed beneficiary- and area-level characteristics. Methods: Using North Carolina Medicaid claims data of Medicaid beneficiaries with BH or MSK conditions, we apply nonlinear regression-based decomposition analysis-based models developed by Kitagawa, Oaxaca, and Blinder to determine which observed variables are associated with racial, ethnic, and rural inequalities in telehealth usage. Results: In the BH cohort, we found statistically significant differences in telehealth usage by race in the adult population, and by race, Hispanic ethnicity, and rurality in the pediatric population. In the MSK cohort, we found significant inequities by Hispanic ethnicity and rurality among adults, and by race and rurality among children. Inequalities in telehealth use between groups were small, ranging from 0.7 percentage points between urban and rural adults with MSK conditions to 3.8 percentage points between white adults and people of color among those with BH conditions. Overall, we found that racial and ethnic inequalities in telehealth use are not well explained by the observed variables in our data. Rural disparities in telehealth use are better explained by observed variables, particularly area-level broadband internet use. Conclusions: For inequalities between rural and urban residents, our analysis provides observational evidence that infrastructure such as broadband internet access is an important driver of differences in telehealth use. For racial and ethnic inequalities, the pathways may be more complex and difficult to measure, particularly when relying on administrative data sources in place of more detailed data on individual-level socioeconomic factors.