Ethnic Minority Backgrounds Research Articles

Abstract IA033: The impact of race, ethnicity, culture, and well-being among childhood cancer survivors and their parent caregivers

Abstract The number of childhood cancer survivors (CCS) has increased over the past 30 years due to improvements in the treatment of cancers affecting this population; however, most CCS experience late adverse effects from their cancer treatment. In many cases, when a child is diagnosed with cancer, parents serve as primary caregivers throughout their child's cancer journey by providing them with medical, informational, and emotional support. Even when CCS become young adults, parents often remain involved with medical care and help CCS transition from pediatric to adult-focused survivorship care. Unfortunately, the proportion of young adult CCS engaged in survivorship follow-up care rapidly declines with increasing age and time since treatment. Disengagement in follow-up care results in inadequate medical surveillance for late effects and a missed opportunity for survivorship-focused care, including psychosocial screening and supportive care referral. The decline in long-term follow-up care is multifactorial and includes patient, provider, and system-related barriers to care. This session will present a brief overview of CCS and parents from racial and ethnic minority backgrounds who experience significant health disparities, including inequities in cancer treatment and access to care compared to non-Hispanic whites. This session will also highlight the work from the Center for Young Adult Cancer Survivorship Research; a dual institutional center focused on survivorship care and quality of life among multi-ethnic survivors (predominantly Hispanic). Recent research examining racial/ethnic disparities included other related factors such as socioeconomic status, language preference, nativity, and acculturation, which provided insight into how to best address these multifactorial aspects of racial/ethnic disparities in this population. Lastly, this session will review a recent report by Mobley et al., 2021 that described systematic barriers to CCS survivorship care and discussed new opportunities to address these health care barriers. Citation Format: Carol Y. Ochoa. The impact of race, ethnicity, culture, and well-being among childhood cancer survivors and their parent caregivers [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr IA033.

Abstract B085: Shifting sociodemographic characteristics of a phase 1 oncology clinical trial population at an NCI-designated Comprehensive Cancer Center in the Southeast in comparison to its catchment area

Abstract Background: Racial and ethnic minority populations are consistently under-represented in oncology clinical trials despite comprising a disproportionate share of cancer burden. Due in part to difficulties associated with participation, phase 1 (P1) oncology trials pose a unique challenge and opportunity for minority inclusion. Here we examine the sociodemographics of P1 cancer clinical trial patients at an NCI-designated Comprehensive Cancer Center compared to all patients treated at the center, patients with new cancer diagnoses in metropolitan Atlanta (ATL), and the state of Georgia (GA). Methods: Patients enrolled on P1 trials at the Winship Cancer Institute (WCI) from 2015- 2020, identified from a data warehouse, were compared to new patient registrations at WCI from 2015-2020. Patients with cancer in metro ATL and GA were identified from the SEER Nov 2018 Submission. Covariates for the P1 and WCI institutional cohorts included sex, race, insurance, zip code. Covariates for SEER patients included sex and race. Median income by zip code per Census 2020 data was divided in quartiles per Census 2020 GA income distribution. Summary statistics are reported for categorical variables using frequencies and percentages. Comparisons between groups were conducted using one-sample proportion tests. Trends were assessed using the Cochran-Armitage test. Results: From 2015-2020, 2325 patients (43.4% F, 56.6% M) signed consent for P1 trials. Grouped race distribution was 70.3% White, 26.2% Black, 3.5% Other. Insurance distribution was 42.9% private, 48% government, 9.1% uninsured/other. Of new patient registrations at WCI from 2015-2020 (N=107497) (50.0% F, 50.0% M), grouped race distribution was 63.3% W, 32.0% B, 4.7% O. ATL 2015 SEER patients (N=31101) (50.3%F, 49.7%M) showed grouped race distribution 58.4% W, 37.2% B, 4.3% O. GA 2015 SEER patients (N=99487) (48.6%F, 51.4%M) showed grouped race distribution 71.2% W, 26.7% B, 2.1% O. Race and sex distribution of P1 patients was significantly different than WCI and ATL SEER patients (p< 0.001). Comparing the P1 and WCI groups from 2015-2020, percent female did not change over time in either group (p=0.54 P1; p=0.063 WCI). Percentage of white patients did decrease over time in both groups (p=0.009 P1; p<0.001 WCI). Percent of P1 patients with private insurance was higher than the WCI group (p<0.001). Percent of P1 and WCI patients living in zip codes with lower median household income (Q1 & Q2) were 19.6% and 20.4%, respectively (p=0.41). Conclusions: Although P1 patients at WCI were more likely to be white, male, and privately insured, from 2015-2020, the percentage of white patients in P1 oncology clinical trials and amongst all new cancer patients treated at WCI decreased significantly. This data serves to initially characterize the existing racial disparities in oncology clinical trials in metro ATL and GA, and will lead to further understanding to ultimately improve representation of patients from racial and ethnic minority backgrounds in P1 clinical trials in our catchment area. Citation Format: Chloe S. Lalonde, Jeffrey M. Switchenko, Madhusmita Behera, Mehmet A. Bilen, Taofeek K. Owonikoko, Colleen M. Lewis, Elise Hitron, Hannah Collins, Tracy B. Goodale, Emma C. Judson, Ludimila Cavalcante, R. Donald Harvey, Jennifer W. Carlisle. Shifting sociodemographic characteristics of a phase 1 oncology clinical trial population at an NCI-designated Comprehensive Cancer Center in the Southeast in comparison to its catchment area [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B085.

‘It’s been quite a poor show’ – exploring whether practitioners working for Improving Access to Psychological Therapies (IAPT) services are culturally competent to deal with the needs of Black, Asian and Minority Ethnic (BAME) communities

Abstract Cultural competency is a core clinical skill. Yet, psychological therapists may be inadequately trained to deal with the needs of service users from Black, Asian and Minority Ethnic (BAME) backgrounds. This can lead to dissatisfaction with mental health services, disengagement from therapy, and poorer treatment outcomes when compared to the White British population. The aim of this study was to explore whether practitioners working for Improving Access to Psychological Therapies (IAPT) services are culturally competent to deal with the needs of diverse communities. Semi-structured interviews were carried out with a range of practitioners, from early career psychological wellbeing practitioners (PWPs) to senior cognitive behavioural therapists (n=16). Reflexive thematic analysis (RTA) was used to analyse the data, guided by a six-phase process to produce a robust pattern-based analysis. Overall, three themes were generated: (1) encountering cultural dissonance within therapy; (2) challenges in making cultural adaptations to therapy; and (3) identifying cultural competency needs. Out of sixteen participants, only nine therapists received one-day formal training throughout their therapeutic career, whilst seven reported receiving no cultural competence training at all. Overall, it appears that there is an urgent need and desire for therapists to be offered cultural competency training so that they can better serve BAME communities. Clinical implications and future recommendations are made. Key learning aims (1) To briefly introduce cross-cultural theoretical models that may assist mental health professionals to think critically about Western notions of therapy and whether they are suited to the needs of ethnic minority communities. (2) To consider challenges IAPT practitioners encounter during therapy and identify examples of good practice. (3) To explore to what extent IAPT practitioners feel culturally competent to deal with the needs of BAME communities. (4) To encourage IAPT services and decision makers (e.g. training bodies and commissioners) to enhance cultural competence training so that practitioners can better serve ethnic minority communities.

Making the invisible visible: using national surveillance data to identify people experiencing homelessness in England with COVID-19.

Persons experiencing homelessness (PEH) or rough sleeping are a vulnerable population, likely to be disproportionately affected by the coronavirus disease 2019 (COVID-19) pandemic. The impact of COVID-19 infection on this population is yet to be fully described in England. We present a novel method to identify COVID-19 cases in this population and describe its findings. A phenotype was developed and validated to identify PEH or rough sleeping in a national surveillance system. Confirmed COVID-19 cases in England from March 2020 to March 2022 were address-matched to known homelessness accommodations and shelters. Further cases were identified using address-based indicators, such as NHS pseudo postcodes. In total, 1835 cases were identified by the phenotype. Most were <39 years of age (66.8%) and male (62.8%). The proportion of cases was highest in London (29.8%). The proportion of cases of a minority ethnic background and deaths were disproportionality greater in this population, compared to all COVID-19 cases in England. This methodology provides an approach to track the impact of COVID-19 on a subset of this population and will be relevant to policy making. Future surveillance systems and studies may benefit from this approach to further investigate the impact of COVID-19 and other diseases on select populations.

Welcome the Unwelcoming: Exploring Social Justice in School Pedagogies

This article emphasizes looking for social justice in school pedagogies and practices to welcome students coming from other than the mainstream cultural background. The article utilizes the qualitative research design under which the narrative interview was carried outwith a single student coming from an ethnic minority background in one of the rural schools situated in the Kathmandu district. The goal was to explore their experiences about the mainstream school’s practices in which Nepali language as a medium of instruction, uniformed pedagogy, and centralized curriculum are the dominant approach. To understand the experiences of children with diverse socio-cultural backgrounds, the article employs the multicultural perspective as a lens.The article argues that most of the classroom management, teachers’ teaching skills and manners, school culture, and subject matters in the curricula and text are the most unwelcoming aspects to welcome children coming from different socio-cultural, linguistic, and ethnic backgrounds. The article explores many unexplored areas that concern the several gaps between entire schooling processes and ethnic/indigenous students’ socio-cultural backups. School culture, pedagogy, and classroom management have not well fostered thewillingness to nurture and support cultural competence, interconnectedness, inter-reciprocity, and mutual understanding to welcome the unwelcoming in school. The article, therefore, warrants an immediate initiation to bringing an entire improvement in school culture in a way that addresses every need and expectation of linguistically, culturally, ethnically, economically, geographically, and religiously diverse children.

Understanding Intimate Partner Violence Among Ethnic and Sexual Minorities: Lived Experiences of Queer Women in Norway.

Drawing upon in-depth, semi-structured interviews, this study explored how queer women from ethnic minority backgrounds in Norway understand and experience intimate partner violence (IPV). Based on an intersectional approach, the study highlights and discusses how having multiple minority positions may inform and affect the way participants experience IPV. The analysis shows that participants' experiences of IPV are shaped by their multiple minority statuses in Norwegian society. A discussion is provided that revolves around how being a sexual as well as an ethnic minority generates a significant power imbalance for the participants in their relationships.

SARS-CoV-2 seroprevalence in children worldwide: a systematic review and meta-analysis

The higher hospitalisation rates of those aged 0-19 years (referred to herein as 'children') observed since the emergence of the immune-evasive SARS-CoV-2 Omicron variant and subvariants, along with the persisting vaccination disparities highlighted a need for in-depth knowledge of SARS-CoV-2 sero-epidemiology in children. Here, we conducted this systematic review to assess SARS-CoV-2 seroprevalence and determinants in children worldwide. In this systematic review and meta-analysis study, we searched international and preprinted scientific databases from December 1, 2019 to July 10, 2022. Pooled seroprevalences were estimated according to World Health Organization (WHO) regions (at 95% confidence intervals, CIs) using random-effects meta-analyses. Associations with SARS-CoV-2 seroprevalence and sources of heterogeneity were investigated using sub-group and meta-regression analyses. The protocol used in this study has been registered in PROSPERO (CRD42022350833). We included 247 studies involving 757,075 children from 70 countries. Seroprevalence estimates varied from 7.3% (5.8-9.1%) in the first wave of the COVID-19 pandemic to 37.6% (18.1-59.4%) in the fifth wave and 56.6% (52.8-60.5%) in the sixth wave. The highest seroprevalences in different pandemic waves were estimated for South-East Asia (17.9-81.8%) and African (17.2-66.1%) regions; while the lowest seroprevalence was estimated for the Western Pacific region (0.01-1.01%). Seroprevalence estimates were higher in children at older ages, in those living in underprivileged countries or regions, and in those of minority ethnic backgrounds. Our findings indicate that, by the end of 2021 and before the Omicron wave, around 50-70% of children globally were still susceptible to SARS-CoV-2 infection, clearly emphasising the need for more effective vaccines and better vaccination coverage among children and adolescents, particularly in developing countries and minority ethnic groups. None.

Evaluation of independent risk factors associated with surgical site infections from caesarean section

BackgroundThe present study assessed factors associated with the risk of surgical site infections (SSI) after a caesarean section (C-section).MethodsData were collected in 1682 women undergoing elective (53.9%) and emergency (46.1%) C-sections between 1st August 2020, and 30th December 2021, at a National Health Service hospital (Surrey, UK).ResultsAt the time of C-section, the mean age was 33.1 yr (SD ± 5.2). Compared to women with BMI < 30 kg/m2, those with a BMI ≥ 35 kg/m2 had a greater risk of SSI, OR 4.07 (95%CI 2.48–6.69). Women with a history of smoking had a greater risk of SSI than those who had never smoked, OR 1.69 (95%CI 1.05–2.27). Women with a BMI ≥ 30 kg/m2 and had a smoking history or emergency C-section had 3- to tenfold increases for these adverse outcomes. Ethnic minority, diabetes or previous C-section did not associate with any of the outcomes.ConclusionsHigh BMI, smoking, and emergency C-section are independent risk factors for SSI from C-section. Women planning conception should avoid excess body weight and smoking. Women with diabetes and from ethnic minority backgrounds did not have increased risks of SSI, indicating a consistent standard of care for all patients.

INCLUSION OF ETHNICALLY DIVERSE POPULATIONS IN CLINICAL TRIALS OF HEALTHSPAN: IMPLICATIONS FROM THE SALSA STUDY

Abstract Background Geroscience-guided clinical trials focused on healthspan may seek to enroll older adults initially free of chronic diseases and disability. Here we examine healthspan in the San Antonio Longitudinal Study of Aging (SALSA), a cohort of 749 community-dwelling older (65+ years) Mexican Americans (MA) and European Americans (EA), and describe prevalence and characteristics associated with poor healthspan. Methods Poor healthspan was defined at the SALSA baseline exam as presence of any one of: 1) chronic disease (diabetes, myocardial infarction, congestive heart failure, stroke, chronic obstructive pulmonary disease, or cancer); 2) dependence in basic or instrumental activities of daily living; or 3) mini mental state exam score &amp;lt; 18. Frailty was defined by Fried phenotype criteria. The association of poor healthspan with age, sex, ethnic group, socioeconomic status (SES), and frailty was assessed using chi-square or t-tests. Results 544 (72.6%) participants met criteria for poor healthspan, which was associated with older age (69.6 ±3.4 vs. 69.3 ±3.4, p&amp;lt; 0.05), male sex (77.3% vs. 69.2%, p&amp;lt; 0.05), MA ethnicity (77.4% vs. 67.3%, p&amp;lt; 0.05), lower income (11.3 ±3.1 vs. 12.2 ±2.9, p&amp;lt; 0.001 and education (10.4 ±4.6 vs. 12.7 ±3.2, &amp;lt; 0.0001), and frailty (95.5% vs. 4.6%, p&amp;lt; 0.001). Conclusion Poor healthspan was highly prevalent (&amp;gt;70%) in SALSA and associated with MA ethnicity, low SES, and frailty. Geroscience-guided clinical trials of potential interventions to improve healthspan by preventing chronic diseases and disability may under-represent individuals of ethnic minority background and lower SES and, thereby, jeopardize generalizability of the findings to the broader population.

Exploring barriers to tobacco smoking cessation in minority ethnic patients in the UK

While the role of the dental team in promoting smoking cessation is well described, the nuances of counselling on tobacco use in individuals from ethnic minority backgrounds are less well understood. Beliefs and cultural practices require consideration when discussing the benefits of stopping smoking, an important consideration in a country with the great ethnic diversity prevalent in the UK. This article discusses culturally related barriers to patients stopping smoking. Recommendations for members of the dental team to consider next time they have a conversation with a patient from an ethnic minority background regarding their smoking habits are presented. CPD/Clinical Relevance: This article provides advice on how the dental team can help patients from ethnic minorities stop smoking.

Training on cultural competency for perinatal mental health peer supporters

Background Women from migrant or minority ethnic backgrounds are particularly vulnerable to perinatal mental ill health. Peer support can be beneficial for those with perinatal mental ill health. This study's aim was to evaluate a training package combining perinatal mental health and the impact of migration to enable better support for women from ethnic minorities with perinatal mental ill health. Methods Peer supporters who undertook training completed a survey immediately afterwards and interviews were conducted 3 months later. A total of 10 peer supporters were trained. Results The participants all rated the training as ‘excellent’ or ‘very good’ and reported increased awareness of perinatal mental ill health, cultural issues and women's vulnerability. More complex scenarios were requested, given the multi-factorial nature of many women's needs. Conclusions The combined training provided participants from different backgrounds with opportunities to learn from one another. Further evaluation among participants new to peer supporting is required.

People with SCI From Racial/Ethnic Minority Backgrounds Are At Increased Risk For Wheelchair Breakdowns

<h3>Research Objectives</h3> To determine whether people from racial and ethnic minority backgrounds are at increased risk for wheelchair breakdowns and their negative consequences. <h3>Design</h3> Cross-sectional survey. <h3>Setting</h3> Eight SCI Model Systems (SCIMS) Centers. <h3>Participants</h3> Full-time wheelchair users (≥16 years old) with chronic SCI (duration of injury ≥1 year). Of the 734 survey respondents, n=541 had complete data on key measures and were included in this analysis. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The dependent variable, wheelchair breakdowns within the past 6 months, was measured with the following nominal categories: breakdowns, breakdowns without consequences, and breakdowns with consequences. The focal independent variable, race/ethnicity, included non-Hispanic Black, non-Hispanic White, and Hispanic subgroups. Multinomial regression models were used to estimate differences in risk of breakdown by race/ethnicity, controlling for financial strain (negative strain, no negative strain), employment (unemployed, employed), wheelchair type (manual, power), and wheelchair payer (private, self-pay, government). <h3>Results</h3> Individuals who were Hispanic reported more breakdowns without consequences relative to those who were non-Hispanic Whites (RRR: 2.4, 95%CI: 1.2-4.8, p=.015). Non-Hispanic Black (RRR: 2.1, 95%CI: 1.1-4.2, p=.033) and Hispanic participants (RRR: 2.6, 95%CI: 1.2-6.2, p=.028) reported more breakdowns with negative consequences relative to non-Hispanic White participants. <h3>Conclusions</h3> Wheelchair breakdowns are a frequent occurrence among people with spinal cord injury (SCI) and often lead to several immediate, negative consequences, such as injury; being stranded; and/or missing work, school, or medical appointments.1, 2 Previous studies have found disparities in wheelchair prescription based on race/ethnicity; namely, people with SCI from minority group backgrounds were less likely to receive higher-end, customizable chairs or have backup wheelchairs.3, 4 In this sample of wheelchair users with SCI, Hispanic and non-Hispanic Black participants had greater risk of one or more wheelchair breakdowns, and negative consequences from those breakdowns. Prior research has found that consequences from breakdowns is associated with poorer health outcomes.5 Further research is needed to determine why these relationships were observed and methods of preventing wheelchair breakdowns and their negative consequences. <h3>Author(s) Disclosures</h3> N/A

Communication is crucial: Lessons from COVID-19 vaccination and pregnancy.

The morbidity and mortality from COVID-19 infection are higher in pregnant women compared to their nonpregnant counterparts. As real-world evidence accumulates demonstrating there is no increased risk of adverse maternal and neonatal outcomes associated with COVID-19 vaccination during pregnancy, guidelines have evolved from a case-by-case benefit-risk decision through to clear recommendation in April 2021 for COVID-19 vaccination in pregnancy. However, vaccine hesitancy is a barrier to uptake, especially among the younger population and individuals of ethnic minority backgrounds; pregnant women have additional concerns. Trust in the importance and effectiveness of the vaccine, trust in public health agencies and science, together with good communication methods regarding the safety of COVID-19 vaccines are strong factors for vaccination acceptance in pregnancy. Lack of trust in the health system was worsened by initial knowledge gaps in the information provided about COVID-19 infection and the safety and immunogenicity of COVID-19 vaccines. This was exacerbated by access to incorrect information and misinformation to fill in those knowledge gaps, especially with the increased use of social media. To provide advice and reassurance on COVID-19 vaccine safety to pregnant women, healthcare professionals involved in their care should have the knowledge and skills to provide risk-benefit communication and would benefit from access to training in science communication. Clinical pharmacologists have the expertise to appraise and synthesize emerging pharmacovigilance data, which can inform and support risk-benefit communication by other clinicians. Information should be strategically directed at individual audiences, taking their perspectives and foundational belief systems into consideration.

Beyond challenges and enrichment: a qualitative account of cross-cultural experiences of nursing patients with an ethnic minority background in Norway

BackgroundSubstantial mass migrations to the Scandinavian countries have made them heterogeneous and multicultural societies. Migration has also influenced the workforce, especially the healthcare system that has had to accommodate a culturally diverse population. This qualitative study aimed to explore nurses’ experiences in caring for patients with an ethnic minority background.MethodsFocus group interviews with a total of 21 nurses were conducted. Thematic analysis was performed on the transcribed and translated interviews.ResultsThe findings of this study revealed three major themes: various experiences concerning language barriers and the use of interpreters, the impact of religious and cultural values, and caring for patients with an ethnic minority background is professionally interesting but demanding.ConclusionsCaring for culturally diverse patients offers both challenges and opportunities to enhance cultural competence and cultural sensitivity among nurses. Various culturally divergent needs of patients such as family visits, food preferences, expression of pain, and gender sensitivity are interlinked and depend on effective communication during encounters with nurses and the healthcare system at large.

The role of colleges for advanced studies in Roma undergraduates’ adjustment to college in Hungary from a social network perspective

ABSTRACT Adapting to the expectations of educational institutions can be difficult for any students, but it is particularly difficult for disadvantaged, first-generation college students with a minority ethnic background. Our case study, employing a social network perspective, examines the role of small peer-communities in the academic adjustment of underrepresented minority students, namely Roma young people in Hungary. Using a social network approach, the study aims to evaluate what the exact role of ‘colleges for advanced studies’ communities is in the everyday life of Roma students, characteristically first-generation intellectuals, and how such communities contribute to academic adjustment. Furthermore, this study examines the main dilemmas concerning the operation of such colleges for advanced studies. The results show that institutions with fewer students and those operating in separate buildings (spatial segregation) provide an opportunity for much stronger connections and more interactions for the students. However, the analysis also showed that the predominance of RCASN ties may hinder the formation of host connections, and this way hampers the stronger bonding to the university.

Demographic and Clinical Presentation of Hospitalised Patients with SARS-CoV-2 During the First Omicron Wave

Introduction: The objectives of this retrospective study were to describe clinical presentations and mortality outcomes of hospitalised patients with the COVID-19 Omicron variant within two acute district general hospitals, and to evaluate demographic factors associated with these presentations and mortality. Methods: Data was obtained over a month in 2021–2022 from multi-ethnic patients who were hospitalised and detected to have severe acute respiratory syndrome coronavirus 2 Omicron infection. Details included socio-demographic characteristics, vaccination, and mortality. Patients were subdivided into three groups: Group 1 were admitted with true COVID-19 pneumonitis, Group 2 had incidental COVID-19 on admission screening, and Group 3 were negative on admission but developed COVID-19 over 7 days post-admission. Results: Of 553 patients, only 24.1% (133/553) were in Group 1, 58.2% (322/553) in Group 2, and 17.7% (98/553) in Group 3. Patients in Group 1 and Group 3 were significantly older than those in Group 2 (p&lt;0.001). Thirty percent of patients from Black, Asian, and minority ethnic backgrounds had COVID-19 pneumonitis compared with 19% of those with White ethnicity (p=0.002). Twenty percent of patients were admitted within nonmedical specialties, i.e., surgical specialties, paediatrics, and obstetrics. Of 36 requiring critical care, 21 were in Group 1. Of those patients, 20/21 (95%) were unvaccinated and seven of the 21 who died were all unvaccinated (100%). Common COVID-19 presentations included delirium, falls, seizures, chronic obstructive pulmonary disease, and antenatal problems. Overall, 13.7% (76/553) patients died and 4.7% (26/553) were directly attributable to COVID-19. Conclusions: This large, multi-ethnic study has described clinical presentations and mortality of hospitalised patients with Omicron. It has determined socio-demographic factors associated with these presentations, including ethnicity and vaccination rates. The study provides useful information for future COVID-19 studies examining outcomes and presentations of Omicron and future COVID-19 variants.

PDCM Finder: an open global research platform for patient-derived cancer models.

PDCM Finder (www.cancermodels.org) is a cancer research platform that aggregates clinical, genomic and functional data from patient-derived xenografts, organoids and cell lines. It was launched in April 2022 as a successor of the PDX Finder portal, which focused solely on patient-derived xenograft models. Currently the portal has over 6200 models across 13 cancer types, including rare paediatric models (17%) and models from minority ethnic backgrounds (33%), making it the largest free to consumer and open access resource of this kind. The PDCM Finder standardises, harmonises and integrates the complex and diverse data associated with PDCMs for the cancer community and displays over 90 million data points across a variety of data types (clinical metadata, molecular and treatment-based). PDCM data is FAIR and underpins the generation and testing of new hypotheses in cancer mechanisms and personalised medicine development.

It’s ok to be different: Supporting black and minority ethnic nurses and midwives in their professional development in the UK

BackgroundA significant proportion of the United Kingdom’s (UK’s) healthcare workforce comprises people from Black and Minority Ethnic (BME) backgrounds. Evidence shows that this population is under-represented at senior management levels. A collaborative leadership development initiative for BME nurses and midwives, by involving their line managers and mentors, was designed and implemented in a Scottish Health Board. AimThis paper affirms the importance of a collaborative initiative that is targeted to support BME nurses and midwives for leadership development and career progression, and the promotion of an inclusive organisational culture to improve team work, and service standards. MethodThis initiative adopted an Action Research approach. The programme began with collectively exploring participants’ understanding of BME workforce development challenges, then planning and delivering a targeted leadership development training, and then evaluating it, in a cyclical way. FindingsWith support from the project facilitators, line managers and mentors, a significant number of BME participants have gone on to achieve career progression. Participating line-managers and mentors have gained an in-depth and nuance understanding of workforce diversity, individuals’ potentials, unconscious biases, and the importance of an inclusive organisational culture. All participants reported that they have learned to become more reflective in their professional practice, and more able to explore, embrace, and promote inclusive workplace culture. BME participants reported feeling that they were valued members of staff, and that this had led to a positive impact on team work and better patientcare outcome. ConclusionThe project has opened a new window into the world of the BME workforce. Findings highlight the value of a diverse workforce, and of an inclusive organisational culture being crucial for effective team work, and of overall benefit to workforce management. Finally, a collaborative initiative like this can successfully improve team work to deliver better patient care.

Exercise Self-efficacy Improvements During Cardiac Rehabilitation: IMPACT OF SOCIAL DISPARITIES.

The objective of this study was to determine exercise self-efficacy improvements during cardiac rehabilitation (CR) and identify predictors of exercise self-efficacy change in CR participants. Patients with coronary heart disease at four metropolitan CR sites completed the Exercise Self-efficacy Scale at entry and completion. A general linear model identified independent predictors of change in exercise self-efficacy. The mean age of patients (n = 194) was 65.9 ± 10.5 yr, and 81% were males. The majority (80%) were married or partnered, 76% were White, and 24% were from an ethnic minority background. Patients received CR in-person (n = 91, 47%) or remote-delivered (n = 103, 54%). Exercise self-efficacy mean scores improved significantly from 25.2 ± 5.8 at CR entry to 26.2 ± 6.3 points at completion ( P = .025). The majority of patients (59%) improved their self-efficacy scores, 34% worsened, and 7% had no change. Predictors of reduced exercise self-efficacy change were being from an ethnic minority (B =-2.96), not having a spouse/partner (B =-2.42), attending in-person CR (B =1.75), and having higher exercise self-efficacy at entry (B =-0.37) (adjusted R2 = 0.247). Confidence for self-directed exercise improves in most, but not all, patients during CR. Those at risk for poor improvement (ethnic minorities, single patients) may need extra or tailored support, and screening for exercise self-efficacy at CR entry and completion is recommended. Differences identified from CR delivery mode need exploration using robust methods to account for complex factors.

Does Fitzpatrick Score Predict Flap Loss? Microsurgical Breast Reconstruction Outcomes of Varying Skin Color.

This is a retrospective study conducted on patients who underwent any type of autologous flap breast reconstruction performed by the two senior authors at an academic center between January 2010 and December 2021. The sole primary outcome variable was flap loss. Patient skin tone was assessed using the Fitzpatrick scale on clinical photographs of patients. A total of 1115 pateints underwent autologous flap breast reconstruction, of which only 56 met both exclusion and inclusion criteria with 58 individual breasts being included in the final study population. The most common race of subjects was White (n = 33; 56.9%) while the most common Fitzpatrick score skin tone was type II (n = 22; 37.9%). The Cochran-Armitage test of trend showed a statistically significant linear trend, P = 0.006, with darker Fitzpatrick score skin tones associated with a higher proportion of flap loss in patients who had vascular compromise. A logistic regression showed that none of the predictor variables were significant. Patients with darker Fitzpatrick skin tones were associated with flap loss after vascular compromise. To prevent flap loss in patients who have darker Fitzpatrick score skin tones, more aggressive flap monitoring should be taken into consideration in the immediate postoperative setting.