Ethnic Representation Research Articles

Brain-phenotype predictions of language and executive function can survive across diverse real-world data: Dataset shifts in developmental populations

Predictive modeling potentially increases the reproducibility and generalizability of neuroimaging brain-phenotype associations. Yet, the evaluation of a model in another dataset is underutilized. Among studies that undertake external validation, there is a notable lack of attention to generalization across dataset-specific idiosyncrasies (i.e., dataset shifts). Research settings, by design, remove the between-site variations that real-world and, eventually, clinical applications demand. Here, we rigorously test the ability of a range of predictive models to generalize across three diverse, unharmonized developmental samples: the Philadelphia Neurodevelopmental Cohort (n=1291), the Healthy Brain Network (n=1110), and the Human Connectome Project in Development (n=428). These datasets have high inter-dataset heterogeneity, encompassing substantial variations in age distribution, sex, racial and ethnic minority representation, recruitment geography, clinical symptom burdens, fMRI tasks, sequences, and behavioral measures. Through advanced methodological approaches, we demonstrate that reproducible and generalizable brain-behavior associations can be realized across diverse dataset features. Results indicate the potential of functional connectome-based predictive models to be robust despite substantial inter-dataset variability. Notably, for the HCPD and HBN datasets, the best predictions were not from training and testing in the same dataset (i.e., cross-validation) but across datasets. This result suggests that training on diverse data may improve prediction in specific cases. Overall, this work provides a critical foundation for future work evaluating the generalizability of brain-phenotype associations in real-world scenarios and clinical settings.

Trends in Gender, Racial, and Ethnic Representation Among US Neurology Faculty

This cross-sectional study assesses changes in gender, racial, and ethnic representation among US neurology faculty from 1972 to 2021.

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

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

A meta-analysis on racial discrimination and alcohol use among Asian Americans.

Racial discrimination has been identified as a contributing risk factor for alcohol use among racially minoritized individuals. The aims of this study were to quantify the relationship between racial discrimination and alcohol use among Asian Americans, examine gender, age and generational status as moderators, and characterize ethnic group representation across the literature. A systematic literature search was conducted using PsycINFO, CINAHL, Web of Science, PubMed, Embase, and OpenDissertations. A random effects model using Pearson's r effect sizes was conducted on separate alcohol outcomes. Meta-regression analyses tested for moderating effects, and heterogeneity was examined by identifying outliers and subgroup differences. Risk of bias was assessed using a funnel plot and Egger's regression test. Twenty-two effect sizes were extracted from 18 studies, representing 8926 participants. A significant positive association was found between racial discrimination and alcohol consumption (k = 9, r = 0.13, 95% CI = [0.07, 0.19], I2 = 80.7%, p = 0.002) and problematic alcohol use (k = 12, r = 0.27, 95% CI = [0.12, 0.40] I2 = 93.7%, p = 0.002), but not binge use (k = 3, r = 0.08, 95% CI = [-0.49, 0.60], I2 = 95.0%, p = 0.64). Age, gender, and generational status were not significant moderators (p's > 0.10). When ethnic groups were reported, Chinese Americans were most represented (36.9%), while Indian Americans were notably underrepresented (1.18%). There is a small positive association between racial discrimination and alcohol consumption and problematic alcohol use among Asian Americans. Research should seek to fill gaps identified by this review, including the dearth of longitudinal work needed to establish temporal precedence, the limited understanding of racial discrimination on binge use and underrepresented ethnic groups in this field of research, and reducing heterogeneity between studies.

The Missing Voices, an exploration of what healthcare-related research would matter to Global Ethnic Majority Women in Aberdeenshire, Scotland

Abstract Introduction In multicultural communities, such as the UK, published evidence has indicated that patients from marginalised backgrounds experience healthcare inequality and inequity with regards to accessibility and safety.1 The lack of appropriate ethnic representation in healthcare-related research, has been identified as a potential causation of some of these disparities and poorer health outcomes.2,3 The focus of this project was the marginalised communities identified by the NIHR to have poorer health outcomes, such as Global Ethnic Majority (GEM) women. Aim To explore what healthcare research matters to marginalised communities with a focus on lived and perceived experiences on access to healthcare for GEM women in Aberdeen city and Aberdeenshire, Scotland. Methods This pilot project captured real world data through an inclusive community engagement approach of reaching within rather than reaching out. A framework of 5Cs (Connect, Collaborate, Consult, Co-create and Circulate) was used to establish a diverse panel of ten GEM women. All panel members had a passion for equality and wellbeing as well as diverse lived experiences. The method used to establish the panel is presented elsewhere. Based on a review of literature, open-ended, flexible, thought-provoking questions for the discussions were developed and circulated to all panel members for approval. These questions were used to guide both in-person and virtual open discussions with aforementioned stakeholders to capture narratives and perspectives around barriers and facilitators to equitable healthcare access in the area. As the public members were research partners and not participants, no ethical approval was required as advised by a professor of pharmacy research and the school’s ethics convenor. The project had three main objectives. This submission will only report on objective three that aimed to Identify and prioritise research questions relating to equitable access to healthcare and the needs of marginalised minority ethnic communities. Results The objective was met. A list of emergent themes from the pre-panel questions and a list of panel-approved research questions were devised with a focus on access to healthcare. The emergent themes were around accessibility and equity of maternal/reproductive healthcare, lack of early screening for high-risk GEM groups and culturally appropriate approaches to mental healthcare. Solution focused recommendations included the design of an inclusive healthcare curriculum, compulsory EDI and cultural competency training for healthcare professionals who practice in diverse communities, additional screening programmes tailored to specific GEM groups based on prevalence and risk factors and the development of localised culturally appropriate and inclusive community programmes, especially for those who support new immigrants. Mistrust and lack of inclusive language were mentioned as potential barriers to participating in research. Discussion / Conclusion This pilot offered the historically under-represented and usually silent communities an equal voice within a trusting and collaborative environment. Over ten years after the enaction of the UK Equality Act (2010) inequity in healthcare access and poor outcomes are still evident. The outcomes of this small pilot study highlight that GEM-specific projects should be driven by that community.

11825 Race, Ethnicity, and Sex Representation Trends Among Minimally Invasive Gynecologic Surgery Fellowship Trainees and Graduates

11825 Race, Ethnicity, and Sex Representation Trends Among Minimally Invasive Gynecologic Surgery Fellowship Trainees and Graduates

A cross sectional analysis of residents by race/ethnicity and specialty from 2020-2023

BackgroundMinorities are underrepresented in all areas of medical education relative to the United States general population, and minority physicians are more likely to practice in disadvantaged areas and in primary care settings. Many individual and structural factors contribute to this discrepancy. We aimed to demonstrate how resident race/ethnicity representation differs across the various resident specialties. MethodsWe used publically available data from the Association of American Medical College's Report on Residents data series and averaged the four academic years from 2019 to 2020 through 2022-2023. We then calculated the odds ratio (OR) of self-reported race/ethnicity (alone and in combination) in thirty-four specialties. ResultsAcross the four-year study period, there were, on average, 147026 unduplicated resident trainees. The average number of duplicated residents by self-identified ethnic category (alone and in combination) include: American Indian or Alaska Native (839, 0.6%), Asian (31627, 21.5%), Black or African American (7935, 5.4%), Hispanic, Latino, or of Spanish Origin (10900, 7.4%), Native Hawaiian or Other Pacific Islander (296, 0.2%), White (76289, 51.9%), Other (4879, 3.3%), Unknown (522, 0.4%), and Non-US Citizens (23914, 16.3%). Across race/ethnicity, there are differences in ORs of representation in different specialties. Key findings include high representation in Public Health and Preventative Medicine by Black and African American (OR=3.7) and Native Hawaiian (OR=2.6) residents, and Family Medicine in Native Americans (OR=1.9), Native Hawaiian (OR=1.7), Black (OR=1.5), and Hispanic (OR=1.3) residents. Psychiatry also had high ORs of representation in minority residents. ConclusionThis study illustrates relative resident ethnic representation across training specialties. Minorities ethnicities were more likely to be represented in primary care and public health domains. This has implications for creating a physician workforce suitable to serve the United States Population.

The diabetes cardiovascular outcomes trials and racial and ethnic minority enrollment: impact, barriers, and potential solutions.

Type 2 diabetes (T2D) affects millions of individuals worldwide and is a well-documented risk factor for cardiovascular (CV) disease and chronic kidney disease, both of which are leading causes of mortality. Racial and ethnic minority groups in the US, including but not limited to Hispanic/Latino, non-Hispanic Black, and Southeast Asian individuals, are disproportionately burdened by both T2D and its adverse outcomes. In recent years, there have been numerous cardiovascular outcomes trials (CVOTs) on novel antidiabetic therapies, including the dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), and sodium-glucose cotransporter-2 (SGLT2) inhibitors. CVOTs's initial aim was to demonstrate the cardiovascular safety of these drugs. Unexpected CV and kidney protective effects were found, specifically among the GLP-1 RAs and the SGLT2 inhibitors. These benefits informed the new paradigm of the management of patients with T2D. However, some experts argued that the lack of racial and ethnic minority group representation in these trials represented a challenge. While the downstream effects of this lack of representation must be further elucidated, it is clear and recognized that efforts need to be made to include a more representative sample in future CVOTs, specifically including individuals from those groups most burdened by T2D and its complications, if clinicians are to have an accurate picture of the benefits and potential pitfalls of utilizing these drugs in a real-world setting. In this comprehensive review, we briefly summarize the significant findings from the CVOTs, report the lack of representation of Hispanic/Latino, non-Hispanic Black, and Southeast Asian individuals in the CVOTs, investigate the barriers to recruiting racial and ethnic minority groups into clinical trials, and suggest potential solutions to overcome these obstacles at the patient-, provider-, and sponsor/system-level in future trials.

The Prevalence of Specific Learning Difficulties in Higher Education: A Study of UK Universities Across 12 Academic Years.

Specific learning and attention difficulties are often first identified in childhood, but they can cause lifelong academic and occupational challenges. We explored the prevalence of these difficulties and the representation of sex and ethnicity amongst all first-year students in UK higher education across 12 years-almost 5.7 million students-and compared course preferences and University destinations of those with and without difficulties. Students declaring learning/attention difficulties were more likely to be White or of Mixed ethnicity and least likely to be Asian. They were more likely to attend specialist HE institutions or newer universities, and more likely to study courses in creative arts and design, agriculture and architecture than law, languages, computer science, and mathematical sciences. The number of students declaring difficulties has increased year on year, in actual terms and as a proportion of the student body, suggesting that efforts to increase diversity and inclusion have been successful. However, differences remain between students with and without learning/attention difficulties in terms of ethnicity, subjects studied, and HE institutions attended, so more needs to be done to identify and address reasons for this. While this paper reports data from UK students, it addresses an international question and invites similar explorations of other national datasets.

Who gets to be an ELT course book author? Native speakerism in English for specific purposes and business English course books

IntroductionNative speakerism has a profound influence on many aspects of ELT, for example negatively affecting job opportunities of those perceived as ‘non-native speakers’. Nevertheless, little is known about the effect of native speakerism on the recruitment of course book authors (CBAs).MethodsTherefore, this study analysed the linguistic and ethnic representation of 161 CBAs of 77 business English business English and English for specific purposes English for Specific Purposes course books (CBs) published globally by Pearson, OUP, CUP, Macmillan and NGL.ResultsThe data clearly show that publishers tend to hire white ‘native speakers’ from the UK as CBAs. More specifically, 90% of all CBA slots were taken by ‘native speakers’, 95% by white CBAs, and 78% by CBAs from the UK.DiscussionThis indicates a profound native speakerist bias among publishers against not only ‘non-native speakers’, but also those ‘native speakers’ who are not white or do not come from the UK. It is thus suggested that business English and English for Specific Purposes publishers pay greater attention to the diversity of the author teams they hire.

Race and ethnicity representation in phase 2/3 oncology clinical trial publications in the United States: A systematic review.

20 Background: The five 1997 Office of Management and Budget (OMB) races in the US include American Indian or Alaskan Native (AI/AN), Asian, Black or African American, Native Hawaiian or Other Pacific Islander (NHPI), and White, with Hispanic ethnicity. Despite the Affordable Care Act (ACA) mandating OMB-based collecting/reporting standards, race and ethnicity publishing in medical journals is inconsistent, despite being necessary to achieve health equity. We aimed to quantify race and ethnicity reporting rates and calculate representation quotients (RQs) in published oncology clinical trials. Methods: In this systematic review, PubMed/Embase were queried for phase 2/3 clinical trials of the 6 most common noncutaneous solid malignancies, published between 2012-2022, in 4 high-impact journals. Trial characteristics were recorded. The RQs for each race and ethnicity were calculated by dividing the percent of representation in clinical trial publications by the percent of year-matched, site-specific incident cancers in the US, compared with Kruskal-Wallis tests with Bonferroni Correction (BC). Reporting was compared between journal publications and ClinicalTrials.gov. Results: Among 1,202 publications evaluated, 364 met inclusion criteria: 16 JAMA , 241 JCO , 19 Lancet , and 88 NEJM . Publications included 268,209 patients (171,132 women [64%]), with a median of 356 (IQR, 131-800) patients per publication. Reported race and ethnicity included AI/AN in 52 (14%) publications, Asian in 196 (54%), Black or African American in 215 (59%), Hispanic in 67 (18%), NHPI in 28 (8%), and White in 254 (70%). Median RQ varied across race (P < .001 BC) with 1.04 (IQR, 0.09-4.77) for Asian, 0.98 (IQR, 0.86-1.06) for White, 0.42 (IQR, 0.12-0.75) for Black or African American, and 0.00 (IQR, 0.00-0.00) for both AI/AN and NHPI patients. Sensitivity analyses showed similar findings upon subset analysis for US-only clinical trials. There was significantly less race and ethnicity reporting in the clinical trial publications compared with ClinicalTrials.gov documentation for AI/AN (14% vs 45%, P < .001 per McNemar χ 2 with continuity correction [MC]) and NHPI (7.7% vs 43%; P < .001 MC). Conclusions: While most phase 2/3 oncology clinical trials published in high-impact journals report race and ethnicity, most did not report AI/AN and NHPI racial categories. Our findings support a call to action for consistent journal policies and transparent race and ethnicity reporting, in alignment with ACA-concordant race and ethnicity federal reporting requirements.

S1251 Clinical Trial Characteristics of Inflammatory Bowel Disease Trials Influencing Reporting and Representation of Race and Ethnicity on ClinicalTrials.gov

S1251 Clinical Trial Characteristics of Inflammatory Bowel Disease Trials Influencing Reporting and Representation of Race and Ethnicity on ClinicalTrials.gov

Evaluating the Performance and Bias of Natural Language Processing Tools in Labeling Chest Radiograph Reports.

Background Natural language processing (NLP) is commonly used to annotate radiology datasets for training deep learning (DL) models. However, the accuracy and potential biases of these NLP methods have not been thoroughly investigated, particularly across different demographic groups. Purpose To evaluate the accuracy and demographic bias of four NLP radiology report labeling tools on two chest radiograph datasets. Materials and Methods This retrospective study, performed between April 2022 and April 2024, evaluated chest radiograph report labeling using four NLP tools (CheXpert [rule-based], RadReportAnnotator [RRA; DL-based], OpenAI's GPT-4 [DL-based], cTAKES [hybrid]) on a subset of the Medical Information Mart for Intensive Care (MIMIC) chest radiograph dataset balanced for representation of age, sex, and race and ethnicity (n = 692) and the entire Indiana University (IU) chest radiograph dataset (n = 3665). Three board-certified radiologists annotated the chest radiograph reports for 14 thoracic disease labels. NLP tool performance was evaluated using several metrics, including accuracy and error rate. Bias was evaluated by comparing performance between demographic subgroups using the Pearson χ2 test. Results The IU dataset included 3665 patients (mean age, 49.7 years ± 17 [SD]; 1963 female), while the MIMIC dataset included 692 patients (mean age, 54.1 years ± 23.1; 357 female). All four NLP tools demonstrated high accuracy across findings in the IU and MIMIC datasets, as follows: CheXpert (92.6% [47 516 of 51 310], 90.2% [8742 of 9688]), RRA (82.9% [19 746 of 23 829], 92.2% [2870 of 3114]), GPT-4 (94.3% [45 586 of 48 342], 91.6% [6721 of 7336]), and cTAKES (84.7% [43 436 of 51 310], 88.7% [8597 of 9688]). RRA and cTAKES had higher accuracy (P < .001) on the MIMIC dataset, while CheXpert and GPT-4 had higher accuracy on the IU dataset. Differences (P < .001) in error rates were observed across age groups for all NLP tools except RRA on the MIMIC dataset, with the highest error rates for CheXpert, RRA, and cTAKES in patients older than 80 years (mean, 15.8% ± 5.0) and the highest error rate for GPT-4 in patients 60-80 years of age (8.3%). Conclusion Although commonly used NLP tools for chest radiograph report annotation are accurate when evaluating reports in aggregate, demographic subanalyses showed significant bias, with poorer performance in older patients. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Cai in this issue.

Race, Ethnicity, and Gender Representation Among US Academic Spine Surgeons.

Although diversity has improved across certain orthopaedic subspecialties, enhancing diversity within spine surgery has remained a challenge. We aimed to investigate the current state of sex, racial, and ethnic diversity among academic orthopaedic spine surgeons in the United States. In January 2024, a cross-sectional analysis of orthopaedic spine surgery faculty in the United States was conducted using the Doximity database to identify eligible surgeons. Fellowship-trained orthopaedic spine surgeons (professor, associate professor, and assistant professor) who graduated residency between 1990 and 2022 were included. Race, sex, academic rank, residency year of graduation, and H-Index scores were recorded using publicly available information from faculty profile pages and the Doximity database. Four hundred fifty-two spine faculty were included in the analysis: 95.1% men and 4.84% women. Across race and ethnicity, 315 surgeons (69.7%) were White, 111 (24.6%) Asian, 15 (3.32%) Black or African American, and 11 (2.43%) Hispanic or Latino or of Spanish origin. Of the 101 professor-level surgeons, 3 (2.97%) were Black men. Among female professors, none were Black, Asian, or Hispanic/Latino. No Hispanic or Latino female professors, associate professors, or assistant professors were identified. The sex and race/ethnicity demographics that have increased in percentage over time include White women (0.92% to 6.08%), Asian men (11.0% to 26.5%), Asian women (0% to 1.66%), and Hispanic/Latino men (1.83% to 3.87%). The surgeon demographic groups that demonstrated minimal fluctuations over time included Black men, Black women, and Hispanic/Latino women. Our findings demonstrate that underrepresentation among academic spine surgeons remains an ongoing challenge that warrants increased attention. Enhancing the representation of Black and Hispanic men, as well as Black, Asian, and Hispanic women, in spine surgery requires a deliberate effort at every level of orthopaedic training.

Racial and ethnic representation of youth in type 1 diabetes interventional trials

BackgroundUnderrepresentation of racial and ethnic groups in clinical trials can limit generalizability of research findings and equitable access to treatment. This study evaluates racial and ethnic representation of youth in US-based interventional trials on childhood type 1 diabetes (T1D). MethodsThis cross-sectional study examined interventional trials of T1D conducted in the US and registered on ClinicalTrials.gov. Trials were included if completed as of June 6, 2023, began between years 2010 and 2022, and exclusively enrolled youth ≤19 years old. We assessed representation of racial and ethnic groups in T1D trials, estimated using the enrollment-prevalence difference (EPD). ResultsA total of 106 trials were eligible for inclusion. Of those eligible, 62 (58 %) trials reported participant race or ethnicity and were included in the analyses. Significant disparities in enrollment were observed for American Indian/Alaska Native, Asian/Pacific Islander, Black, and Hispanic youth compared to their respective contribution to disease burden among youth in the US. Disparities in trial enrollment were greatest for Black (EPD, −10.2; 95 % confidence interval [CI], −14.4 to −7.9) and Hispanic (EPD, −7.7; 95 % CI, −12.6 to −4.8) youth. EPDs of trials conducted prior to year 2017 did not differ significantly from those conducted as of year 2017. ConclusionsHistorically marginalized racial and ethnic youth were underrepresented in T1D trials. Strategies to improve recruitment of these populations are needed to reduce inequities in diabetes treatment and outcomes.

Disparities in the Representation of Sex, Race and Ethnicity in Tension-Type Headache Clinical Trials.

While tension-type headache (TTH) is the most common primary headache disorder, its effect according to sex, race and ethnicity remains unclear. We investigated disparities in sex, racial and ethnic representation in TTH clinical trials with comparison to global disease burdens. In this cross-sectional analysis, TTH clinical trials had female overrepresentation and racial and ethnic minority underrepresentation, which may affect understanding of the impact of TTH on different populations and personalized treatment development. Trial enrollment that is diverse and reflective of global disease burdens is crucial for improving study generalizability, understanding of diverse clinical presentations, and ensuring healthcare equity.

Racial and ethnic minority representation in dementia risk factor research: a scoping review of cohort studies

BackgroundDespite a potentially greater burden of dementia, racial and ethnic minority populations around the world may be more likely to be excluded from research examining risk factors for incident dementia....

Ethnicity in neuro-oncology research: How are we doing and how can we do better?

This study systematically reviews and meta-analyses the extent of ethnic minority representation in neuro-oncology Phase III and IV clinical trials, explores the effect of ethnicity on outcomes, and identifies predictors for the inclusion of ethnicity data in publications. Adhering to PRISMA guidelines, we conducted a comprehensive literature search across multiple databases, on Phase III and IV trials in neuro-oncology that reported on adult and/or paediatric subjects. Through meta-analysis, we synthesized information on overall survival, event-free survival, and the incidence of adverse outcomes across ethnicities. From 448 identified articles, a fraction reported ethnicity data, with an even smaller number providing outcome data stratified by ethnicity. Most study participants were identified as White, underscoring a significant underrepresentation of minorities. Our meta-analysis did not reveal significant outcome differences by ethnicity, which may be attributed to the limited and inadequate reporting of data. Predictors for including ethnicity data were identified, including trials in North America(OR2.39, 95%CI 1.18-5.12, p < 0.02),trials of drugs or biologic agents(OR 5.28, 95%CI 1.43-3.42, p < 0.05),and trials funded by charities(OR 2.28, 95% CI 1.04-5.27, p < 0.05) or pharmaceutical companies(OR 3.98, 95% CI 1.60-10.0, p < 0.005). The underrepresentation of minorities in neuro-oncology clinical trials and the inadequately characterized impact of ethnicity on treatment outcomes highlight a critical need for more inclusive recruitment strategies and improved reporting standards. Change is necessary to ensure trials reflect the diversity of the patient population, which is essential for developing tailored strategies and improving outcomes. Future research should prioritize understanding the role of ethnicity in neuro-oncology to facilitate personalized treatment approaches.

Этническое мифотворчество в киберпространстве как фактор репрезентации этничности чувашей

The article is devoted to the study of Chuvash ethnic myth-making in cyberspace. The aim of the work is to determine its role as one of the factors of ethnicity representation. The study is based on the analysis of the relevant content presented on popular web platforms and social networks YouTube, Rutube, Zen, VKontakte, Odnoklassniki. The study identifies a certain section of content offered by search algorithms as the most viewed and included in thematic collections and playlists. The author examines the myth-making components of the Internet space, characterizes formats and plots, identifies their authors, and studies the audience's reaction to the content. Data analysis showed that ethnic myth-making has a positive effect on the representation of the Chuvash culture. Despite some inaccuracies in the information, such material generally evokes positive emotions in users. Information in video and text format is published on popular Russian platforms, making ethno-myth-creating content accessible to a wide audience. The myths created by the authors reflect their desire to show the antiquity and significance of the Chuvash people, which helps the Chuvash people to understand their identity, place and role in the world. Ethno-myth-creating content on the Internet increases interest in the Chuvash culture, promoting its popularization and representation.

Exploring Smokers Perspectives on Health Status and Health Seeking Behavior: A Qualitative Exploration

Objective: Smokers might tend to ignore when communicating about smoking health risks. We used Bourdieu’s conceptual tool to guide and explore their perception of being healthy despite their smoking behavior and their health seeking practice. Material and Methods: A qualitative method, using a semi-structured interview as the main method of collecting the data, was used. This method was implemented because of its flexibility in the exploration, based on participant responses. Results: The findings are reported as per the thematic analysis of 15 purposively selected participants. The ages of the 15 participants varied from 20 to 55 years old, and they were selected from the quantitative study to participate voluntarily in this qualitative exploration. Among them, 14 were males and one was female. The ethnic representation in this qualitative part were Malays (n=14) and Chinese (n=1). The duration of smoking varied in the sample, with the majority smoking for more than five years. Conclusion: This study better understands smokers’ health perception and their health-seeking behavior. Firstly, the perception of the less harmful effects of smoking on the health of smokers was understood within the views of Bourdieu’s Theory of Cultural Health Capital, which, in turn poses challenges to smoking cessation programs and campaigns. This study reported that smokers perceived themselves as healthy, and thus continued their smoking habit despite knowing its side effects.