Ethno-racial Backgrounds Research Articles

Two- and three-year-olds prefer mastery-oriented over outcome-oriented help

It has been shown that school-aged children often turn to others for help with the motive to learn and expand on their knowledge or skills (so-called “mastery-oriented” help-seeking, Nelson-Le Gall, 1985). Although help-seeking in problem-solving contexts is increasingly studied in preschoolers, there is so far no experimental evidence that young children show a preference for mastery- as opposed to outcome-driven help. In two online experiments (N = 144, 72 female), 2- and 3-year-olds from diverse ethno-racial backgrounds living in the United States (68 % White; 16 % Latine) watched an agent failing at a task (e.g., pouring water into a cup) before they selected one of two helpers for the agent: one who demonstrated how to perform the task (mastery-oriented helper) or one who completed the task without demonstration (outcome-oriented helper). Children of both ages selected mastery-oriented helpers to assist the struggling agent (Experiments 1 and 2) but chose helpers randomly in a control condition in which the agent succeeded at the task and therefore needed no mastery-oriented help (Experiment 2). The findings indicate that young children recognize that furthering one’s abilities is a core motive of help-seeking.

Examining sleep characteristics in Canada through a diversity and equity lens

ObjectiveTo examine specific sleep characteristics of adults living in Canada according to sex, gender, ethnoracial background, socioeconomic status, immigration status, sexual orientation, and language spoken at home. MethodsThis cross-sectional and nationally representative study used self-reported data from the 2021 Canadian Community Health Survey (n = 39,346 adults aged 18 years and older). Sleep characteristics (sleep duration, nighttime insomnia symptoms, unrefreshing sleep, and difficulty staying awake) were assessed and compared across groups. ResultsFemales were more likely than males to report nighttime insomnia symptoms (23.1% vs. 14.8%) and unrefreshing sleep (17.2% vs. 13.5%). The same was also observed for gender identity. Although White respondents were more likely to meet sleep duration recommendations (58.3%), they had the highest prevalence of nighttime insomnia symptoms (20.9%) compared to respondents with other ethnoracial backgrounds. Respondents coming from lower socioeconomic backgrounds were more likely to report poorer sleep compared to those coming from higher socioeconomic backgrounds. Insomnia symptoms were lower among immigrants (13.9%) compared to nonimmigrants (21.1%). Respondents with a sexual orientation not classified as heterosexual, gay, or lesbian reported poorer sleep. Finally, for language spoken at home, those who responded “French only” were more likely to meet sleep duration recommendations (64.1%) and were less likely to report unrefreshing sleep (8.8%). Nighttime insomnia symptoms were the lowest among those who reported speaking a language other than French or English at home (9.5%). ConclusionThis study highlights important sleep disparities among Canadians. Future intervention strategies should aim to reduce sleep health disparities.

Income is not an equalizer: health development inequities by ethnoracial backgrounds in California kindergartners

BackgroundEarly childhood health development is positively associated with income, but the strength of this relationship with ethnoracial background remains unclear. This study examined the extent of health development inequities among California kindergarteners based on ethnoracial backgrounds and neighborhood-level income.MethodsThis cross-sectional study assessed health development inequities by analyzing neighborhood-level income, ethnoracial background, and health development data for California kindergarteners. Student-level data (n = 106,574) were collected through teacher report between 2010–2020 across 52 school districts and 964 schools. Student addresses were geocoded and linked to American Community Survey neighborhood income levels. Health development was measured using the Early Development Instrument, a population-level measure which includes physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge domains. Outcomes included being “on-track” in each domain as well as overall health development.ResultsUsing a Generalized Estimation Equation with a log-link function, while accounting for interactions between ethnoracial background, income, and income-squared, we found significant health development inequities by ethnoracial background and neighborhood-level income. Regarding overall health development, as well as the physical, social and emotional domains, Black students had a lower likelihood of being on-track compared to the weighted average across income levels, whereas Asian students surpassed the weighted average. White students exhibited the steepest slope, and at the lowest income levels, their health development scores were akin to their Black and Hispanic/Latino/a low-income counterparts but resembled their Asian counterparts at higher income levels. For the general knowledge and communication domain, white students consistently had the highest likelihood of being on-track, while Hispanic/Latino/a students had the lowest likelihood across all income levels.ConclusionThis study examines health development inequities among California kindergarteners in diverse communities. Our analysis shows that the relationship between neighborhood-level income and kindergartners’ health development varies by domain and is weaker for students of color. Given the scarcity of population-level data on health development outcomes, these analyses offer valuable insights for identifying ecosystems necessitating support in promoting equitable early childhood health development.

Is Love (Skin Color) Blind?: Skin Color and Interdating across Ethnoracial Groups1

The role skin color plays in shaping cross‐ethnoracial relationships is not well understood despite its implications for the trajectory of U.S. ethnoracial relations. Using the National Longitudinal Study of Freshmen, I investigate two questions: Among ethnoracial minorities, how does a person's skin color relate to the likelihood of dating individuals from another ethnoracial group? Does this relationship vary by the combination of ethnoracial backgrounds of the individuals who are dating? The results indicate that the influence of skin color on interdating may depend on the status levels of partners' ethnoracial groups. A person from a lower status group with a darker skin color—relative to other similar group members with lighter skin color—is less likely to date someone from a higher status group, but darker skin color is associated with a greater likelihood of interdating when a darker‐skinned member of a higher status group dates a member of a lower status group. Further, the results point to a complex relationship between two intermediate groups, Asians and Latinos, which seems dependent on Latino respondents' gender.

A Person-Centered Analysis of Adolescent Multicultural Socialization Niches and Academic Functioning.

Despite the growing cultural diversity worldwide, there is scarce research on how socialization processes prepare youth to respond to increasing multicultural demands and the degree to which these socialization opportunities inform youth academic functioning. This study used a person-centered approach to identify profiles or niches based on the degree and consistency of multicultural socialization experiences across school, peer, and family settings and to examine the associations between identified niches and markers of academic functioning (i.e., emotional and behavioral academic engagement, academic aspirations and expectations) in a sample of adolescents (N = 717; Mage = 13.73 years). Participants (49.9% girls) were from the U.S. Southwest and represented multiple ethno-racial backgrounds (31.8% Hispanic/Latinx, 31.5% Multiethnic, 25.7% White, 7.3% Black or African American, 1.4% Asian American or Pacific Islander, 1.4% American Indian or Alaska Native, and 1% Arab, Middle Eastern, or North African). Six distinct multicultural socialization niches were identified. Three niches had similar patterns across school-peer-family but ranged in the degree of socialization. The cross-setting similar higher socialization niche (Niche 6) demonstrated greater socialization than the cross-setting similar moderate (Niche 5) and lower socialization (Niche 4) niches, which had moderate and lower socialization, respectively. Three niches demonstrated cross-setting dissimilarity which ranged in the type of cross-setting contrast and the degree of socialization. The cross-setting dissimilar school contrast socialization niche (Niche 3) had greater dissimilarities between socialization opportunities in the school setting compared to the peer and family settings and demonstrated the lowest levels of socialization of all niches. The other two niches, the cross-setting dissimilar peer contrast (Niche 1) and greater peer contrast socialization (Niche 2) niches had larger dissimilarities between socialization opportunities in the peer setting than the school and family settings. In the former, however, the contrast was lower, and socialization ranged between very low to low. In the latter, the contrast was higher and socialization ranged from very low to moderate. Most adolescents were in the cross-setting similar lower socialization niche or in the cross-setting dissimilar niches. Adolescents in the cross-setting similar higher multicultural socialization demonstrated greater emotional and behavioral academic engagement than adolescents in most of the other niches. Adolescents in the cross-setting dissimilar school contrast niches demonstrated lower emotional and behavioral academic engagement and lower academic expectations than adolescents in some of the other niches. The results emphasize the collective role of school, peer, and family multicultural socialization on emotional and behavioral academic engagement.

Preliminary Reporting Patterns of Suicide Ideation and Attempt Among Native American Adolescents in Two Samples

ABSTRACT Objective Native American adolescents are disproportionately burdened by suicidality. Here, we examine patterns of reporting of suicide ideation and suicide attempt among Native American youth compared to those from other ethnoracial backgrounds, as this data is important for grounding commonly subscribed to frameworks of suicide risk (e.g., ideation-to-action). Method Data are from the Youth Risk Behavior Surveillance Survey (N = 54,243; grades 9–12; 51.0% female) and Minnesota Student Survey (N = 335,151; grades 8, 9, 11; 50.7% female). Comparing Native American youth to peers from other ethnoracial backgrounds, we examined two suicide reporting patterns: 1) odds of reporting suicide attempt among those who reported ideation and 2) odds of reporting suicide ideation among those who reported an attempt. Results Across both samples, when reporting suicide ideation, youth from other ethnoracial backgrounds were 20–55% less likely than Native American youth to also report attempt. While few consistent differences were observed between Native American youth and those from other racial minority backgrounds in patterns of co-reporting suicide ideation and attempt across samples, White youth were between 37% and 63% less likely than Native American youth to report a suicide attempt without also reporting ideation. Conclusions The increased odds of engaging in a suicide attempt with or without reporting ideation question the generalizability of widely held frameworks of suicide risk to Native American youth and have important implications for suicide risk monitoring. Future research is needed to illuminate how these behaviors unfold over time and the potential mechanisms of risk for engaging in suicide attempts in this disproportionately burdened group. Abbreviations: YRBSS: Youth Risk Behavior Surveillance Survey; MSS: Minnesota Student Survey

Demographic differences in services utilization across in-person (2019), telehealth (2020), and hybrid (2021) outpatient substance use services in New York

ObjectivesMany outpatient substance use programs have experienced in-person, remote/telehealth, and hybrid models of care since the 2020 Covid-19 Pandemic. Changes in treatment models naturally affect service utilization and may affect treatment trajectories. Currently, limited research examines the implications of different health care models on service utilization and patient outcomes in substance use treatment. Here, we reflect on the implications of each model from a patient-centered care approach and review the implications on service utilization and outcomes. MethodsWe employed a retrospective, observational, longitudinal, cohort design to explore differences in demographic characteristics and service utilization among patients receiving in-person, remote, or hybrid services across four substance use clinics in New York. We reviewed admission (N = 2238) and discharge (N = 2044) data from four outpatient SUD clinics within the same health care system across three cohorts (2019, in-person; 2020, remote; 2021, hybrid). ResultsPatients discharged in 2021 (hybrid) had significantly more median total treatment visits (M = 26, p ≤ 0.0005), a longer course of treatment (M = 154.5 days, p ≤ 0.0001), and more individual counseling sessions (M = 9, p ≤ 0.0001) compared to the other two cohorts. Demographic analyses indicate more ethnoracial diversity (p = 0.0006) among patients admitted in 2021, compared to the other two cohorts. Over time, the proportion of individuals being admitted with a co-existing psychiatric disorder (2019, 49 %; 2020; 55.4 %, 2021, 54.9 %) and no prior mental health treatment (2019, 49.4 %; 2020, 46.0 %; 2021, 69.3 %) increased (p = 0.0001). Admissions in 2021 were more likely to be self-referred (32.5 %, p < 0.0001), employed full-time (39.5 %, p = 0.01), and have higher educational attainment (p = 0.0008). ConclusionDuring hybrid treatment in 2021, patients from a wider range of ethnoracial backgrounds were admitted and retained in care, patients with higher socioeconomic status (who were previously less likely to enter treatment) were admitted, and fewer individuals left against clinical advice (compared to the remote 2020 cohort). More patients successfully completed treatment in 2021. Service utilization, demographic, and outcome trends support a hybrid model of care.

Dysregulation profile in children of ethnoracially diverse at-risk families: Factor structure and longitudinal correlates.

The present work sought to confirm the factor structure and examine longitudinal strengths-based and mental health correlates of the dysregulation profile (DP) in children of at-risk fragile families of diverse ethnoracial backgrounds. The data came from the Fragile Families and Child Wellbeing Study (N = 2125 families). Mothers (Mage = 25.3) were mostly unmarried (74.6%), and children (51.4% boys) were identified as Black (47.0%), Hispanic (21.4%), White (16.7%), or multiracial or other backgrounds. Childhood DP was constructed using mother reports of the Child Behavior Checklist at age 9. Mothers' in-home parent-child interactions and depressive symptoms were assessed at child age 5. At age 15, children responded about their own mental health, social skills, and other strengths-focused outcomes. A bifactor DP structure fit well to the data, with the DP factor representing difficulties in self-regulation. Using SEM, we found that mothers who were more depressed and used less warm parenting at child age 5 had children who presented with higher DP at age 9. DP was in turn associated with less social skills, perseverance, optimism, and more anxiety, depression, and impulsivity at adolescence. Childhood DP appears to be relevant and applicable for at-risk, diverse families, and may also impede on children's future positive functioning.

Identity affirmation is associated with adaptive cardiovascular flexibility in response to stress among sexual and gender minority people of color

BackgroundResearch with sexual and gender minority (e.g., lesbian, gay, bisexual, queer, asexual, trans, non-binary) people of Color (SGM-PoC) has largely focused on risk and negative health outcomes. The existing strengths-based mental health research suggests that identity affirmation may be associated with psychological resilience and good mental health among SGM-PoC, but little is known about predictors of physiological resilience and biomarkers of physical health in this population. Adaptive cardiovascular flexibility is an indicator of physiological resilience and physical health in that it enables the body to mobilize resources to adapt to challenges. This study explored the association between identity affirmation and physiological resilience, observed through cardiovascular flexibility in response to stress among SGM-PoC. MethodsParticipants were 95 SGM-PoC of varying ethnoracial backgrounds, sexual orientations, and gender identities, residing in Canada. Participants completed questionnaires on sociodemographic and psychosocial variables, including a measure of identity affirmation, the Queer People of Color Identity Affirmation Scale (QPIAS). In a laboratory setting, we induced stress using the Trier Social Stress Test and measured heart rate variability (HRV) over time using wearable electrocardiogram devices. ResultsResults from multilevel modeling analyses revealed that high QPIAS scores were associated with adaptive cardiovascular flexibility, as evidenced by reduced HRV during stress exposure, followed by HRV increase during recovery. As QPIAS scores increased, the shape of HRV trajectory increasingly reflected our predicted pattern of adaptive cardiovascular flexibility. Meanwhile, low QPIAS scores were not associated with this pattern and appeared to predict a more flatlined HRV activity during the experiment. ConclusionsFindings indicate that Queer People of Color identity affirmation may be related to physiological resilience, observed through a more adaptive cardiovascular profile when responding to stress. Identity affirmation may thus be a protective factor for SGM-PoC, pointing to the critical importance of affirming resources and strengths-based health research.

Anti-Asian discrimination and antiracist bystander behaviors amid the COVID-19 outbreak.

Anti-Asian racism is a public health concern, and it has escalated during the coronavirus disease 2019 (COVID-19) outbreak. Bystanders-individuals who directly witness or become aware of acts of racism-can help by discouraging perpetrations of discrimination (and other forms of violence), offering help and support to victims, and reinforcing antiracist prosocial norms. Yet, little is known about who engages in antiracist bystander interventions in response to discriminatory events, and who engages in proactive bystander behaviors to discourage future acts of racism. In the present study, 456 U.S. community adults of diverse ethnoracial backgrounds (18-85 years, Mage = 48.8, 52.0% women, 212 Asian Americans) reported on their experiences with discrimination, attitudes about the acceptability of discrimination, and engagement in proactive and reactive bystander behaviors. About 40% of the Asian American participants experienced discrimination during a 1-week period in early months of the COVID-19 pandemic. Among individuals who witnessed anti-Asian discrimination during the study period, 45% of them engaged in antiracist reactive bystander interventions. Controlling for ethnicity, gender, and attitudes about the acceptability of discrimination, individuals who reported more frequent experiences with everyday discrimination prior to the pandemic were more likely to engage in reactive bystander behaviors in response to anti-Asian discrimination. Lifetime experiences with discrimination may contribute to individuals' active engagement in antiracist bystander behaviors. Future research directions on antiracist bystander actions and allyship are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement Using data collected during the COVID-19 pandemic, we found that bystander behaviors responding to anti-Asian discrimination could manifest in reactive bystander interventions and proactive antiracism. People with greater lifetime experiences with discrimination were more likely to intervene when witnessing anti-Asian racism incidents. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Similar response to biologic therapy across racial and ethnic groups among patients with psoriasis enrolled in the CorEvitas Psoriasis Registry

To the Editor: Psoriasis impacts 7 million Americans of all ethnoracial backgrounds. Racial/ethnic differences in response to biologic therapy for psoriasis have been described in clinical trials1; yet, these findings do not reflect real-world outcomes.2 Data from clinical practice are needed to further our understanding of potential variability in the effectiveness of biologics. We used data from the CorEvitas Psoriasis Registry,3 an observational cohort of patients evaluated in dermatology clinics, to better understand the response to biologics across racial/ethnic groups.

‘De-ethnicization’ in New Englishes: Perception and recognition of ethnicity in Namibian English

Do New Englishes develop ethnically neutral forms? This study showcases a combined perceptual and variationist approach to this question, using the case of Namibian English. It seeks to locate ‘de-ethnicized’ Namibian English varieties in mismatches between variety perception and auditory variety recognition, assessed via an experiment involving 244 young Namibian respondents. Namibian voices are used as playback material as part of an ethnic recognition task. These voices are selected from a sample of 94 ethnically diverse informants from both government and private schools in Namibia’s capital city following a phonetic characterization of all sampled individual varieties. While the respondents are sometimes unsure as to whether some specific Namibian ethnic groups speak a distinctive English variety, they generally endorse the notion that there is a ‘racial’ continuum of Namibian English varieties comprising ‘Black’, ‘White’, and ‘Coloured’ varieties. Meanwhile, vowel variation patterns among the informants, which I treat as a potential indicator of ethnoracial backgrounds, reveal an ethnoracially heterogenous variety cluster. This cluster is located in between a White cluster and a (mostly) Black cluster and displays combined Coloured, female, and private school associations. The auditory variety recognition task suggests that this cluster tends to be ethnically misrecognized by the respondents, as are women's voices in general, and non-White private school women's voices in particular. Still, the Black respondents largely recognize the Black informants’ voices as Black, irrespective of these voices’ ethnic background. The findings offer joint variationist and perceptual suggestions that Non-White women are gradually de-ethnicizing Namibian English across social classes. This trend possibly results in Black and Coloured varieties amalgamating into a local high-status English variety.

Negotiating Belonging: Race, Class, and Religion in the Brazilian Quest for “Becoming American”

Abstract This study examines how members of a majority second-generation Brazilian church in South Florida perceive their English-speaking, “American” congregation compared to the Portuguese-speaking Brazilian congregation from which they originated. Data for this research are drawn from in-depth, open-ended interviews with 32 members from different ethnoracial backgrounds, participant observation, and content analysis of the congregations’ social media. Findings show that the discourse of church differences portrays the two congregations in racialized and classist ways. Combining boundary-making and identity work theories, I argue that the perceptions espoused by members of the American congregation come from a place of pressure to assimilate to U.S. White middle-class culture, consequently reinforcing and legitimizing stereotypes in an effort to distance themselves from Brazilian immigrants.

شناسایی عوامل مؤثر بر تحقق الگوی برنامهریزی شهری تنوعگرا در شهر رشت با استفاده از روش نظریۀ زمینهای نظاممند

Society today is made up of diverse individuals of varying ages, sexes, ethno-racial backgrounds, physical abilities, and faiths. Planning theory and practice has become more conscious in recent times of the need to cater for a diverse range of needs and preferences. Planning for diversity is an approach which takes into account the needs of different groups of people. A few studies around the world have addressed to introduce the approach of planning for diversity and difference and identify the factors affecting its application and realization. In our country, we are facing a vacuum of academic studies in this field. Therefore, the purpose of this study is to introduce this approach and identify the factors affecting its realization in Rasht based on the views of the planning experts of this city.According to the type of research problem and its statistical population, the grounded theory method has been used. To collect data, first a semi-structured questionnaire based on literature review was developed and then in-depth interviews were conducted with 10 planning experts of this city using targeted sampling method. In this study, the systematic approach of grounded theory method has been used. The systematic approach emphasizes the use of data analysis steps including open, axial, and selective coding and the development of a logical model or a visual description of the generated theory. After conducting interviews and collecting textual data, analysis and coding begin along with sampling. The textual data from the interviews were analyzed using the coding process and line-by-line analysis method in MAXQDA software. In the grounded theory, the researcher by performing multiple coding steps will extract the sub-categories, main categories and core category from the data and will continue the analysis.Finally, the factors affecting the realization of the diversity-oriented urban planning approach including 17 main categories and 59 sub-categories and the relationships between them were identified. These factors include the thinking governing the urban planning mechanism, macro-urban planning policies, changing the approach of preparing urban development plans, modifying the content of urban development plans, public demand, type of urban planning system, national laws protecting the rights of various social groups, law enforcement, cultural and social characteristics of citizens, financial strength of municipalities, structure and organization of implementing plans, inter-organizational coordination, teaching urban planning students, knowledge and experience of providers of urban development plans, City Council approvals, needs assessment, improving urban environment quality/ diversity-oriented urban environment. In this step, we select the category of using and realizing the diversity-oriented approach from the open coding stage and place it in the center of the process we are studying, as the central phenomenon and then relate the other categories to it. These other categories include causal conditions, strategies, contextual and intervening conditions, and consequences. This step involves drawing a diagram called a coding pattern. The coding pattern illustrates the relationships between causal conditions, strategies, contextual and intervening conditions, and consequences. In this stage of coding, we write a theory of the relationships between the categories in the axial coding pattern. This theory provides an abstract description of the process studied in this study, namely the application and realization of the diversity-oriented urban planning approach. The results show that a wide range of intellectual, policy, instrumental, organizational, legal, financial, educational and socio-cultural infrastructures are effective in realizing this approach. Identifying and explaining these factors is a guide for future decisions and practices of our country's urban planning authorities to recognize diverse social groups, respond to their different needs in the city and combat discrimination in urban planning practices.

Patients, Pride, and Prejudice: Exploring Black Ontarian Physicians' Experiences of Racism and Discrimination.

Black physicians' and trainees' experiences of racism are not well documented in Canada, reflecting a knowledge gap needing correction to combat racism in Canadian health care. The authors undertook a descriptive study of Black physicians and trainees in the Canadian province of Ontario. The goal of this study was to report upon racism experienced by participant Ontarian physicians to challenge the purported rarity of racism in Canadian health care. An anonymous online survey of physicians and trainees who self-identify as Black (African/Afro-Canadian/African American/Afro-Caribbean) was administered in March and April 2018 through the Black Physicians' Association of Ontario (BPAO) listserv. The survey was modeled on qualitative interview guides from American studies. Snowball sampling was employed whereby BPAO members forwarded the survey to eligible colleagues (non-BPAO members) to maximize responses. Survey data were analyzed and key themes described. Survey participants totalled 46, with a maximal response rate of 38%. Participants reported positive experiences of collegiality with Black colleagues and strong bonds with Black patients. Negative discrimination experiences included differential treatment and racism from peers, superiors, and patients. Participants reported race as a major factor in their selection of practice location, more so than selection of career. Participants also expressed a lack of mentorship, and there was a strong call for increased mentorship from mentors with similar ethno-racial backgrounds. This study challenges the notion that racism within Canadian health care is rare. Future systematic collection of information regarding Black physicians' and trainees' experiences of racism will be key in appreciating the prevalence and nature of these experiences.

Factors That Limit Hispanic Representation in Medical Education: A Review of Hispanic Underrepresentation in Medical Education

The underrepresentation of Hispanics in medical education poses a looming problem for the United States. The inability to produce a physician population that mirrors their patients leads to inadequate healthcare for individuals of all ethno‐racial backgrounds. By 2045, Hispanics are projected to make up the majority of the population. The U.S. is 30% Hispanic but only 4% of all current medical students are Hispanic. The objectives of this research were to: [1] analyze key academic, socioeconomic, and psychosocial factors that hinder Hispanics in entering medical schools, and [2] highlight the benefits of increasing Hispanic representation within medical education. A library research using electronic databases such as JSTOR, Proquest, and Medline was conducted. Fifty peer‐reviewed articles were selected, analyzed, and evaluated for their relevance. Relevancy was judged based on how well the articles addressed our objectives. The identification of key factors was done by surveying how often frequently these occurred in the literature.Our review identified multiple key factors. In terms of academics, Hispanics were limited by low GPA, MCAT scores, and gateway courses. In terms of socioeconomic factors, Hispanics were limited by household income and the high cost of obtaining a medical education. Lastly, key psychosocial‐related factors identified were a lack of Hispanic mentors, negative stereotype, stigmatization, micro aggression, and limited exposure to real life role models and to health careers. Our review shows that at any point in time, one or more of these factors play a limiting role in Hispanic students gaining admission into a medical school. To counter these hindrances, the following recommendations are in order: [1] create mentoring programs supported by medical schools for students in primary, secondary, and undergraduate levels; [2] devote resources to socially and economically disadvantaged areas by running summer internship programs, [3] create pipeline programs that are focused on URMs, and [4] encourage institutional change within medical education itself by seamlessly integrating cultural competency aspects into programs, curricula, courses, student orientation programs, and faculty training.Support or Funding InformationThis research was funded by the Texas A&amp;M International University College of Arts and Sciences and ACT On IDEAS.

Role of ethnicity in thrombotic and hemorrhagic complications of myeloproliferative neoplasms.

e18555 Background: Philadelphia-chromosome negative myeloproliferative neoplasms (MPN) are a group of hematologic malignancies with known complications of hemorrhage and thrombosis. Age and a previous history of thrombosis are well-documented risk factors for future vascular events. Variations in the rates of these complications among ethnicities and sexes have not been extensively explored. Methods: Our retrospective analysis included 301 adult patients with a diagnosis of MPN without a history of thrombosis or hemorrhagic event seen at the Indiana University Simon Cancer Center between 1992 and 2019. Relationships between ethno-racial backgrounds and vascular complications and disease outcomes were evaluated using multivariate logistic regression analysis and Cox regression models. Results: Two hundred seventy-one patients (90.0%) were Caucasian and 30 patients (10.0%) were non-Caucasian. Non-Caucasian patients were comprised of African America, Asian, and Middle Eastern ethnicities. Median age at diagnosis was 56 years, and 43.9% were male. No association was found between the incidence of thrombotic complications and ethnicity using the log-rank test ( p 0.68). The incidence of hemorrhagic events was significantly increased in non-Caucasian patients (OR = 4.33; 95% CI [1.15 – 16.36], p 0.03). Patients with higher hemoglobin concentration at diagnosis were at a significantly lower risk of bleeding complications (OR = 0.79; 95% CI [0.65 – 0.95], p 0.01). Non-Caucasian patients were at 2.98 times (95% CI [1.19 – 7.44], p 0.02) higher risk when vascular complications were pooled together. Our models also showed that male sex (OR = 0.14; 95% CI [.02 – .98], p 0.048) and a higher platelet count at the time of diagnosis (OR = 0.99; 95% CI [.993 –.999], p 0.03) had a marginally significant association with decreased rate of progression to acute myeloid leukemia. Conclusions: This study suggests that in patients without a history of thrombosis or bleeding, non-Caucasian ethnicity was associated with an increased adjusted risk of hemorrhagic complications in patients with MPN. This observation may inform future studies to further characterize those disparities in outcomes at the genetic or socioeconomic level.

The Difference a Job Makes: Licit and Illicit Work Experiences and Aspirations at a Transitional Housing Facility for Women Leaving the Sex Industry

This investigation establishes a baseline understanding of how women exiting the sex industry understand the economic options available to them by reviewing their work experiences in the legal economy, histories of sex industry involvement, and their aspirations for legal work upon entering a yearlong residential program offered at a transitional housing facility. Specifically, it explores how prior work experience, type of sex industry involvement, and demographic characteristics such as race and age intersect with women’s legal work aspirations upon leaving the sex industry. Analysis indicates that women’s occupational choices are limited by prior experiences within the formal and informal economies and that women of color and poor women of all ethno-racial backgrounds are particularly likely to face disadvantages in both economic sectors. Findings accordingly indicate that rehabilitative settings must consider whether the career pathways they create lead to economic self-sufficiency and reduce the likelihood that women will return to life situations they express a desire to leave.

Changing characteristics of forensic psychiatric patients in Ontario: a population-based study from 1987 to 2012.

To quantify the demand for forensic psychiatric services in Ontario over the past 25years and investigate whether the sociodemographic, clinical and offense-based characteristics of forensic patients have changed over time. We investigated all forensic admissions from 1987 to 2012 resulting in a disposition of Not Criminally Responsible on account of Mental Disorder (N = 2533). We present annual proportions of patients with specified sociodemographic, clinical and offense characteristics, and investigate whether the duration of forensic system tenure varies as a function of admission year, psychiatric diagnosis, or index offense. There has been a steady increase in forensic admissions over this time period, particularly individuals with comorbid substance use disorders and individuals of non-Caucasian ethno-racial background. The proportion of persons committing severe violence has remained low and has decreased over time. Having a comorbid personality, neurological, or substance use disorder significantly increased forensic system tenure, as did committing a violent offense. Individuals who came into the system in earlier years had slower rates of discharge compared to more recent admissions. Defining the trends characterizing the growth of the forensic population has important policy implications, as forensic services are costly and involve a significant loss of liberty. The current results indicate that young, substance abusing individuals of diverse ethno-racial backgrounds and who commit relatively low-level violence comprise an increasing proportion of Ontario's forensic population, and suggest that treatment must be optimized to best serve the needs of these individuals.

The Practice of Islam in America: An Introduction

The Practice of Islam in America: An Introduction