Mental health outcomes among U.S. healthcare workers before, during, and after the 2019 global respiratory pandemic: A population-based study.

Epilepsy affects 22.2% of people with intellectual disability compared with 1% of the general population. This study aims to identify characteristics associated with epilepsy-caused deaths in adults with intellectual disability and epilepsy in England. We conducted a retrospective population-based analysis of all deaths of adults with intellectual disability and epilepsy reviewed by the English Learning from Lives and Deaths programme (2016-2021). Deaths were classified by whether epilepsy was the primary cause or not. Demographic, clinical and care-related variables were analysed using multivariable Cox regression for associations with age at death and factors linked to epilepsy-related mortality. Epilepsy was the primary cause of death in 1584 (16.2%) of 9756 deaths of people with intellectual disability and epilepsy. These individuals died at a significantly younger median age than those who died of other causes (56 vs 62 years; p<0.001). Epilepsy and non-epilepsy-related deaths in this population were more common among people with moderate-to-profound intellectual disability (p<0.001) and those of African or Asian ethnicity (p<0.001). Risk factors included poor quality of care, service gaps and lack of annual health checks (p<0.001). Psychiatry and speech and language therapy (SALT) input was protective. Epilepsy-related deaths in intellectual disability may cause earlier mortality because of pervasive health inequalities and missed prevention opportunities. Targeted interventions, including annual health checks, improved multidisciplinary care access, improved inclusion of ethnic minorities, and integration of specialist psychiatric and SALT support may increase length of life. Systemic service redesign is required to reduce avoidable epilepsy-related mortality.

The escalating global burden of Alzheimer's disease (AD), projected to reach $16.9 trillion by 2050 with disproportionate impacts on low- and middle-income countries and racial minorities, underscores an urgent need for accessible early detection tools. Current therapies offer limited symptomatic relief but fail to halt neurodegeneration. Serum exosomal lipids, which reflect brain pathophysiology through blood-brain barrier crossing vesicles, present promising minimally invasive biomarkers. However, a standardized framework for their systematic development is lacking. We propose a structured three-phase approach comprising discovery, analytical validation, and clinical utility assessment. The discovery phase employs nontargeted lipidomics of serum exosomes from AD patients and controls integrated with machine learning to identify dysregulated pathways and prioritize candidate biomarkers. Analytical validation involves targeted quantification using UPLC-MS/MS to optimize sensitivity and specificity within complex matrices, with rigorous performance evaluation via receiver operating characteristic (ROC) curve analysis and area under the curve (AUC) analysis in independent case-control cohorts establishing preliminary diagnostic cut-offs. Clinical utility assessment requires longitudinal evaluation in treated AD cohorts to correlate biomarker dynamics with disease progression or therapeutic response, refine diagnostic thresholds, and explore presymptomatic risk prediction. Implementing this framework demands multidisciplinary collaboration and strict ethical adherence. This strategy paves the way for clinically validated serum exosomal lipid biomarkers to enable presymptomatic detection and personalized risk stratification, ultimately mitigating AD's devastating socioeconomic impact.

Media influences on ethnic majority attitudes toward ethnic minorities: A systematic review and meta-analysis

This article aims to analyze the formative tactics and conceptual categories of storytelling as an educational tool to improve marketing processes in rural communities and ethnic minorities in Colombia. The methodology consisted of a systematic bibliographic review of a descriptive-qualitative nature, based on academic documents published since 2019, located in university repositories and databases such as Google Scholar and Scopus.The results were organized according to the literature into two categories: "Marketing Education" and "Storytelling", with their respective subtopics, based on the central question: How does marketing education through storytelling impact peasant and minority groups in Colombia?The study identified that storytelling, in its digital, interactive formats and through social media, emerges as a potential strategy to empower rural and ethnic communities in Colombia. It adds value to their products and helps connect with broader markets without losing the distinctive narrative of each group.It was concluded that although there is growing interest in the topic, gaps remain in the literature regarding the concrete application and impact measurement of these tactics in rural and ethnic contexts in Colombia, highlighting a valuable area for future research.

To explore how patient characteristics related to health care disparities are associated with access to care and clinical outcomes among patients receiving surgical treatment for pelvic floor disorders in the United States. We searched MEDLINE, EMBASE, and ClinicalTrials.gov through March 25, 2024. Patient characteristics related to health care disparities included race, ethnicity, geographic location, and insurance status, among others. Outcomes included access to surgery, surgical outcomes, and patient-reported outcomes. Eligible studies reported multivariable regression analyses that included at least one patient characteristic related to health care disparities and an included study outcome. For each outcome, we describe the consistency (in direction), strength of association, and number of studies of the patient characteristic related to health care disparities. Meta-analysis was not performed because of study heterogeneity. This review was conducted by the Systematic Review Group of the Society of Gynecologic Surgeons. Of 6,853 abstracts screened, 42 studies with a total of 84 multivariable analyses were included. Characteristics associated with decreased access to apical suspension during prolapse surgery included being from a rural area or of Hispanic ethnicity, and Black racial identity was associated with decreased access to mesh augmentation. Black racial identity and Hispanic ethnicity were also associated with decreased access to reconstructive prolapse repair compared with obliterative procedures and hemorrhage during prolapse repair; older age and having Medicare insurance were associated with increased risk of overall complications. Not being from the Northeast was associated with increased risk of overall complications after prolapse surgery. Patients from a minority race were less likely to undergo reoperation after stress urinary incontinence (SUI) surgery. Black race was not associated with complications after SUI surgery. Patients in minoritized groups in the United States, those with Medicare insurance, and those not from the Northeast were more likely to have health care disparities related to surgical treatment for pelvic floor disorders. PROSPERO, CRD42021234511.

Childhood obesity disproportionately affects priority populations, including racial and ethnic minority groups and those with lower socio-economic backgrounds. These groups often encounter barriers to accessing public health services and may benefit from targeted interventions. This scoping review aimed to identify the characteristics of populations involved in interventions to prevent early childhood obesity and to understand whether and how existing interventions targeted and reached priority populations. Databases and trial registries were systematically searched until 4 October 2024, for planned, ongoing, and completed randomised controlled trials evaluating parent-focussed, behavioural interventions for childhood obesity prevention, starting within the first year of life. Two reviewers independently extracted data using a customised tool. Of the 11 960 articles identified, 82 trials were eligible. Most trials (87%) were conducted (or planned) in high-income countries, 11% in upper middle-income countries, and 2% in lower middle-income countries. Priority populations included parent-child dyads from specific ethnic or racial groups facing psychological, social, and/or economic disadvantages. Among the completed trials, 54% targeted priority populations, yet only 33% exclusively enrolled participants from these groups. Additionally, less than a quarter of the trials involved priority populations in the design of interventions (17%) and developed tailored interventions for these groups (21%). Current interventions do not sufficiently target, reach and engage priority populations. To achieve health equity in early childhood obesity prevention, it is essential to include underserved and at-risk populations in research and intervention design.

A Cohort Study of Statin Prescribing Among the Uninitiated Before and After the 2013 ACC/AHA Guideline Change by Race, Ethnicity and Language.

Association of Covid-19 vaccination uptake with recorded self-harm, neurodevelopmental disorders and mental health conditions during the Covid-19 pandemic: A nationwide e-cohort study in Wales, UK.

Health Inequality Aversion in the United States.

Digital divide in social media use among cancer survivors and the moderation role of offline social support.

ABSTRACT Ethnic minorities in Indonesia have long experienced marginalization through state policies, everyday practices, and public discourses that reproduce unequal power relations. One of the discursive tools that sustains such marginalization is humor, which reinforces and normalizes negative stereotypes about minority groups. Beneath its entertaining surface, ethnic humor conveys stigmas that operate through three underlying dimensions: experiential, relational, and expressive. Speakers and media producers construct these jokes through textual structures that depict minorities as abnormal, unintelligent, or uncivilized. The persistent reproduction of such humor perpetuates ethnic prejudices that have been deeply embedded in Indonesian society since the Dutch colonial period. By normalizing exclusionary views under the guise of amusement, ethnic humor sustains discriminatory attitudes that hinder the development of an anti-discriminatory society. This paper argues that ethnic humor in Indonesia functions as a discursive mechanism that perpetuates the marginalization of minority ethnic groups by encoding ideological meanings that normalize ethnic hierarchy.

Understanding vaccine hesitancy: The role of fear and message framing in COVID-19 vaccination intention in adults in the UK.

Clinical studies have shown that outcomes of patients with prostate cancer could vary depending on race. In this study, the authors sought to determine if the treatment effect of apalutamide, an androgen receptor pathway inhibitor (ARPI), on overall survival (OS) varies depending on the race of the patient. This pooled analysis includes individual patient data from two phase 3 trials, TITAN and SPARTAN, which randomized patients to androgen deprivation therapy (ADT)±apalutamide in metastatic hormone-sensitive and nonmetastatic castration-resistant prostate cancer, respectively. Race was self-identified and categorized as Asian, Black, White, and Others categories. The authors applied a stratified (stratification for the trial) multivariable Cox proportional hazards regression model to determine heterogeneity of treatment effect on OS after adjustment for age, performance status, body mass index, T- and N-stage, Gleason score, comorbidities, and exposure to statins and metformin. Overall, 2190 patients were included: 16.9% patients were Asian, 3.7% were Black, 67.4% were White, and 12.0% were from the Others category. The authors did not find any significant heterogeneity of treatment effect from apalutamide on OS across racial groups (interaction-p=.46). Among ADT plus apalutamide-treated patients, there was no association of race with OS (hazard ratio for Asian, 0.77 [95% CI, 0.56-1.06]; Black, 0.82 [95% CI, 0.49-1.37]; and Others, 1.00 [95% CI, 0.75-1.34], all compared to White). In this study, the authors did not find any evidence of difference in the treatment effect of apalutamide on OS across patients of different races, although interpretation remains limited by poor representation of racial minorities. Among apalutamide-treated patients, there was no association of race with OS.

Persistent Racial Disparities in Chronic Limb-Threatening Ischemia Outcomes and Utilization Among US Medicare Patients.

The article examines the situation in the southeast of Turkey, primarily in the Tur Abdin region, where religious minorities belonging to various branches of Christianity currently reside. The main Christian denominations present in Turkey today are outlined. The historical trajectory of Christianity on the territory of modern Turkey is analyzed. The principal religious minorities living in Turkey at present are identified. Special attention is given to the largest religious minorities in the region under consideration — the Syriac Jacobites and the Assyrians. Accordingly, the article examines the status of the Syriac Orthodox Church and the Assyrian Church of the East in Turkey. The study analyzes the position of Christians within the modern Turkish state, key historical changes and trends, as well as the problems and specific features of the legal regulation of Christian minorities. It addresses issues concerning the rights of communities as religious and ethnic minorities, including matters of property. The article reviews Turkey’s domestic situation and the influence of its religious policy on the international stage. A perspective is offered on the future development of the situation, particularly regarding the role and status of Turkish Christians in the context of Turkey–EU relations. The article also outlines the characteristics of the area inhabited by Christians in southeastern Turkey, the rich history of Tur Abdin, its major towns, and its cultural, historical, and religious landmarks. It examines the history and significance of monastic complexes, churches, and religious monuments associated with the Syriac Jacobites and Assyrians on Turkish territory. Contemporary scholarly research is used to determine the current condition of these sites, many of which are threatened by destruction or disappearance due to various factors. The most affected sites of religious heritage are identified, and an assessment is given of the conditions for their preservation and the need for state intervention and archaeological restoration work. Finally, the general situation of Christians in modern Turkey is evaluated, considering the challenges and risks faced by this religious minority.

Climate action has been deemed as fundamental to counteract the impacts of rising global temperatures on health which will disproportionately affect low-income populations, racial and ethnic minorities, women, and other historically marginalized groups. Along with poverty reduction, inequality mitigation, gender equality promotion, and public health protection, climate action has been recognized as a fundamental goal for achieving Sustainable Development Goals (SDGs). However, despite growing recognition of the need to align climate action with development goals, there is a knowledge gap regarding how the implementation of climate change mitigation and adaptation policies impacts social inequalities. To address this knowledge gap, this document proposes a scoping review protocol aimed at identifying and synthesizing research that examines the impacts of climate policies on inequalities at the subnational scales, within the transport, infrastructure and health. The objective of this review is to map existing evidence, identify conceptual and empirical gaps and inform policy strategies that promote climate action in line with values of social justice and equality.

This study meticulously examines the racial and cultural ramifications associated with Thailand’s 2013 Dunkin’ Donuts “Charcoal Donut” advertisement, which incited international indignation due to its visual resemblance to blackface. This study utilizes Fairclough’s Three-Dimensional Model of Critical Discourse Analysis (CDA) to investigate the visual representation of race and identity, and the ways in which these representations either uphold or challenge dominant social constructs. Data were obtained from the advertisements and augmented by secondary sources, including international news reports, scholarly analyses, and audience reactions on social media. The analysis shows that the advertising uses language that is both inclusive and nationalistic, but its visual design focuses on light-skinned images and follows traditional Thai beauty standards for colourists. Audience views show a difference between how people in different cultures saw the picture: some thought it was stylish or original, while others thought it was racist because it used blackface. At the macro social practice level, the advertisement reinforces the concept of "Thainess," which promotes unity and a shared identity while obscuring the systemic disadvantages experienced by ethnic minorities. The study contributes to the existing academic discourse on global advertising by illustrating how multicultural narratives are selectively adapted to align with local contexts, thereby negotiating and normalizing prevailing power dynamics. It emphasizes the importance of culturally informed and ethically sound representation methods in international marketing.

As one of the significant revolutionary sites where the Red Army operated after entering northwestern Sichuan during the Long March, Zhuokeji preserves a wealth of distinctive red cultural heritage. This heritage not only documents the historical process of contact, communication, and solidarity between the Red Army and ethnic minorities but also bears witness to the unwavering revolutionary spirit under extremely challenging conditions. With the advancement of cultural confidence and the rural revitalization strategy, the red cultural heritage in Zhuokeji has increasingly become a vital element for local cultural and tourism development. However, issues such as simplistic cultural interpretation, homogenized tourism products, inadequate activation of resources, and weak capacity for transforming cultural value persist during the development process. Based on categorizing the types and historical connotations of Zhuokeji’s red cultural heritage and aligning with the development trends of cultural and tourism integration in ethnic regions, this paper proposes systematic strategies from multiple perspectives. The study argues that Zhuokeji’s red cultural heritage serves not only as an important medium for revolutionary history education but also as a cultural resource for fostering a sense of community for the Chinese nation in ethnic regions. Therefore, efforts should be made to promote the integration of culture and tourism on the basis of scientific conservation, enabling it to become a significant force for narrating China’s stories effectively, promoting ethnic unity, and driving local revitalization in the new era.

In this study, through Artificial Intelligence Generated Content (AIGC) for the local ethnic minority Pumi people's dress patterns of China's local culture as a carrier, we mainly extract the dress patterns characterized by the Lonicera pattern, combining AIGC technology and the Lonicera pattern to further generate the IP image with national characteristics. Using the stable diffusion model, based on the dataset of a complete Lonicera pattern, the LoRA (Low Rank Adaptation) model is trained for the Pumi dress pattern, and an IP series of image designs based on the Chinese Pumi ethnic group is innovatively designed. This ultimately achieves the purpose of integrating traditional culture and technology, publicizing the local characteristics of the dresses, and passing down the excellent traditional dress patterns of this ethnic group. This research provides reference value for the integration of the Pumi ethnic minority and promotes the digital transformation and innovative development of national culture.