Non-white Subjects Research Articles

“Little Boats” in the Storm: Racial Ambiguity and Gender in Two Postemancipation Adoptions

Exactly what transgression Mary Ann Lamb committed is unknown, but adoptive parents, Loren and Nancy Thompson, considered them serious things we had to reprove for. Lamb, young black woman of about 20, had visited city of Kingston, Jamaica, to bid Thompsons farewell as they departed for their native home in United States (Thompson 1858b). They left behind and did not return for more than year. Perhaps Thompsons caught Lamb drinking rum with friends. Perhaps she flirted. Or perhaps she rebuked Thompsons for leaving her (Kenny 2010,192). Whatever she did, it clearly contravened gendered etiquette by which Thompsons, white emissaries of American Missionary Association in postemancipation Jamaica, lived and that they sought to cultivate among their congregants.In 1875, another daughter rebelled. Writing to guardian, radical Republican carpetbagger Albion Tourgee, nineteen-year-old Adaline Pattillo announced intention to withdraw from Hampton Institute, where she had been enrolled for four years. She would instead return to Yanceyville, North Carolina, where biological mother, Louisa, and sister, Mary, remained. Motivated by guilt and loyalty, Pattillo had decided to devote time to them. Tourgee had envisioned very different path for Ada, as he called her. Although Pattillo was born slave, Tourgee expected that formal education would provide middle-class respectability, and perhaps limited, gender-appropriate public role, joining white reformers in uplifting (Elliott 2006). Tourgee had moved Pattillo into his North Carolina home in 1869, directed his wife, Emma, to educate her, and sent to Hampton, with this result in mind (Elliott 2006; Woods 2013). Pattillo had other plans for both herself and blood relatives. do want, she stressed with an underline, in an unequivocal expression of insistence, a home of our own & I will not feel content until I get one (Pattillo 1875).Although separated by seventeen years and nearly two thousand miles, these two acts of rebellion reveal what was possibly common outcome of transracial adoption in postemancipation societies. Historically, family has been primary site in which racial and gender ideologies of its members, including children, are formed. The phenomenon holds true for end of slavery in Anglophone Atlantic (Scully and Paton 2005). Concepts of race in nineteenth century partly relied on notion that the filiation of individuals transmits from generation to generation substance both biological and spiritual and thereby inscribes them in temporal community known as 'kinship' (Balibar 1991, 100). Thus, disruption of this genealogical scheme by transfer of nonwhite subjects from black households to those of white reformers raises questions concerning how racial and gender subjectivities of freedchildren were affected.1 Transracial adoptees lived on cusp of two families, included fully in neither. By examining these arrangements from perspectives of children, adopters, and, where sources allow, biological mothers who sought to reclaim their offspring, present essay will show that result for children in question manifested in conflicted identities and an ambiguous sense of place within race and gender categories.The early decades of freedom provide fruitful sites of examination for these phenomena. Before emancipation, abolitionists frequently criticized effects of bondage on enslaved families (Dixon 1997) but had little to no power to directly intervene. Slavery's demise provided reformers like Tourgees and Thompsons degree of access to governance of black children that property rights of slaveholders had hitherto largely prevented. Moreover, adoptions occurred when racial hierarchies that many had once assumed stable were undone. Transracial adoption, Mark Jerng argues, was most common when national traumas focused on formation of. …

Changes in peanut allergy prevalence in different ethnic groups in 2 time periods

Changes in peanut allergy prevalence in different ethnic groups in 2 time periods

Bonny Ibhawoh. Imperial Justice: Africans in Empire's Court.

Administrators of the British Empire lived with a tension between racial distinctions and the universalist premises of British ideals. Nowhere was this tension more persistent than in the empire's courts of law. Imperial law was continually pulled between a localism, whose flexibility gave room for tolerance of native culture and, also, European racism, and a universalism which conversely constrained both. Bonny Ibhawoh has written a most valuable study of how such tensions expressed themselves in the twentieth century through the workings of the two appeals courts for colonial Africa and the Judicial Committee of the Privy Council (JCPC). The JCPC has been neglected by historians, in part because of the difficulty of using its archives, until very recently inconveniently housed in the basement of the former home of the JCPC at Number 9 Downing Street. Yet as the empire's highest “court,” it played a key role in shaping imperial justice. Closely examining the Privy Council's archives along with those of the East African and West African Courts of Appeal, Ibhawoh describes how some nonwhite subjects were able to use these courts to challenge imperial inequities, and how the legal universalism represented by the JCPC conflicted with both the pragmatism and the racism of local magistrates and other Europeans. A single legal universe for all the king's subjects or a flexible legal “multiverse,” adapted to local circumstances and racial hierarchies? This question, never resolved, underlay much activity in these courts.

The association between race and Crohn's disease phenotype in the Western Cape population of South Africa, defined by the Montreal Classification System.

BackgroundInter-racial differences in disease characteristics and in the management of Crohn's disease (CD) have been described in African American and Asian subjects, however for the racial groups in South Africa, no such recent literature exists.MethodsA cross sectional study of all consecutive CD patients seen at 2 large inflammatory bowel disease (IBD) referral centers in the Western Cape, South Africa between September 2011 and January 2013 was performed. Numerous demographic and clinical variables at diagnosis and date of study enrolment were identified using an investigator administered questionnaire as well as clinical examination and patient case notes. Using predefined definitions, disease behavior was stratified as ‘complicated’ or ‘uncomplicated’.ResultsOne hundred and ninety four CD subjects were identified; 35 (18%) were white, 152 (78%) were Cape Coloured and 7(4%) were black. On multiple logistic regression analysis Cape Coloureds were significantly more likely to develop ‘complicated’ CD (60% vs. 9%, p = 0.023) during the disease course when compared to white subjects. In addition, significantly more white subjects had successfully discontinued cigarette smoking at study enrolment (31% vs. 7% reduction, p = 0.02). No additional inter-racial differences were found. A low proportion of IBD family history was observed among the non-white subjects.ConclusionsCape Coloured patients were significantly more likely to develop ‘complicated’ CD over time when compared to whites.

EPIDEMIOLOGY AND COURSE OF UNIPOLAR MANIA: RESULTS FROM THE NATIONAL EPIDEMIOLOGIC SURVEY ON ALCOHOL AND RELATED CONDITIONS (NESARC)

Unipolar mania (UM), in which only manic episodes occur during the course of illness, may be an important clinical manifestation of bipolar disorder that is under-recognized and understudied. The aim of this study is, for the first time, to examine the prevalence of UM and its clinical characteristics in the community. Among a total of 1,411 subjects with bipolar I disorder, we evaluated the prevalence of UM using three different criteria proposed in previous studies. We compared the clinical characteristics of subjects with UM to those with a more classic bipolar presentation with mania and lifetime major depressive episode (MDE). We additionally explored the proportion of subjects with UM who later experience at least one MDE during a 3-year follow-up period and determined risk factors for converting from UM to classic bipolar disorder. The prevalence rate of UM among those with bipolar disorder ranged from 5.0 to 7.2% depending on the criteria. UM was more common in male and nonwhite subjects. About half of individuals with UM experienced subthreshold depression. Individuals with UM had lower rates of comorbid anxiety disorders or attention deficit hyperactivity disorder (ADHD). During the follow-up, about 18% of subjects with UM experienced MDEs. Male, nonwhite, comorbid generalized anxiety disorder and ADHD predicted an increased transition from UM to classic bipolar disorder. Subthreshold depression was not associated with the risk of the transition. UM is an infrequent but clinically distinct subtype of bipolar I disorder. Further research delineating the characteristics of UM is warranted.

Quantitative MRI analysis in children with multiple sclerosis: a multicenter feasibility pilot study.

BackgroundPediatric multiple sclerosis (MS) is a rare disorder with significant consequences. Quantitative MRI measurements may provide significant insights, however multicenter collaborative studies are needed given the small numbers of subjects. The goal of this study is to demonstrate feasibility and evaluate lesion volume (LV) characteristics in a multicenter cohort of children with MS.MethodsA common MRI-scanning guideline was implemented at six member sites of the U.S. Network of Pediatric MS Centers of Excellence. We included in this study the first ten scans performed at each site on patients meeting the following inclusion criteria: pediatric RRMS within 3 years of disease onset, examination within 1 month of MRI and no steroids 1 month prior to MRI. We quantified T2 number, T2-LV and individual lesion size in a total of 53 MRIs passing quality control procedures and assessed gadolinium-enhancing lesion number and LV in 55 scans. We studied MRI measures according to demographic features including age, race, ethnicity and disability scores, controlling for disease duration and treatment duration using negative binomial regression and linear regression.ResultsThe mean number of T2 lesions was 24.30 ± 19.68 (range:1–113) and mean gadolinium-enhancing lesion count was 1.85 ± 5.84, (range:0–32). Individual lesion size ranged from 14.31 to 55750.60 mm3. Non-white subjects had higher T2–LV (unadjusted pT2-LV = 0.028; adjusted pT2-LV = 0.044), and maximal individual T2-LV (unadjusted pMax = 0.007; adjusted pMax = 0.011) than white patients. We also found a trend toward larger mean lesion size in males than females (p = 0.07).ConclusionAssessment of MRI lesion LV characteristics is feasible in a multicenter cohort of children with MS.

Ethnicity and suicide attempt: analysis in bipolar disorder and schizophrenia

BackgroundEvidence is mixed as to whether White Europeans are at a higher risk for suicide attempts or completions compared to other ethnic groups. The present analysis assessed whether risk for suicide attempt was associated with White European ethnicity in 907 subjects with schizophrenia or bipolar disorder.MethodsSubjects were diagnosed using the Structured Clinical Interview for DSM-IV, and ethnicity was determined by self-report. Subjects were recruited from psychiatric care centers in Toronto, Canada. Logistic regression correcting for clinical covariates like age, gender and diagnosis, was used in this study.ResultsWe found no difference in suicide attempter status in white and non-white subjects who were diagnosed with schizophrenia and bipolar disorder.ConclusionOur study does not support the evidence that White-European patients in North America are at higher risk for suicide attempt compared to non-European descent subjects. However, this result has to be replicated in larger studies in patients with these disorders.

Validation of a Four-Point Photographic Scale for the Assessment of Midface Volume Loss and/or Contour Deficiency

Soft-tissue augmentation with injectable fillers is commonly performed in the malar area. A four-point scale, the Medicis Midface Volume Scale, was developed and validated as an objective measure of the severity of midface volume loss. Using a separate photographic guide, four investigators rated photographs (front and right and left sides, to provide a full view of the face) of 60 untreated subjects in random order during two sessions 2 or more weeks apart. Both sides of the midface were scored separately as follows: 1, fairly full; 2, mild loss of fullness; 3, moderate loss, slight hollowing; and 4, substantial loss, clearly apparent hollowing. Most subjects (mean age, 45.7 years; range, 23 to 80 years) were women (72 percent) and white (87 percent). Intraobserver agreement between sessions was "almost perfect" (weighted kappa scores) for the right (0.918; 95 percent CI, 0.887 to 0.949) and left (0.911; 95 percent CI, 0.878 to 0.943) sides. Intraobserver exact agreement between sessions was 87.1 percent (range, 76.7 to 95.0 percent) for the right side and 86.3 percent (range, 76.7 to 95.0 percent) for the left. Interobserver agreement was "substantial" to "almost perfect" (weighted kappa scores) for the right (0.759 to 0.893) and left (0.758 to 0.888) sides. Interobserver exact agreement was 72.5 to 87.5 percent for the right side and 72.5 to 86.7 percent for the left. Overall, results were similar in nonwhite and white subjects. Consistent agreement by different evaluators and the same evaluator at different times validates the four-point Medicis Midface Volume Scale as suitable to objectively measure the severity of midface volume loss. Diagnostic IV.

Eradication of factor viii inhibitors in patients with mild and moderate hemophilia A

In hemophilia A, up to 25% of new antifactor VIII (FVIII) inhibitory antibodies (inhibitors) occur in patients with mild or moderate disease. Once the inhibitor develops, options for management include observation, immune modulation, and immune tolerance induction (ITI). Currently, there is little data to guide a clinician's management decisions. In a case series, eight of the 26 subjects with mild or moderate hemophilia complicated by an inhibitor underwent ITI; two were successful, two were unsuccessful, and four were partially successful. In a systematic review of the literature, 12 of the 16 patients with mild or moderate hemophilia responded to rituximab for treatment to eradicate the inhibitor. To increase our understanding of treatment options for inhibitor eradication in patients with mild or moderate hemophilia A complicated by an inhibitor, a secondary analysis of clinical and treatment characteristics in a cohort of 36 patients with mild or moderate hemophilia A and inhibitor was undertaken. In multivariate analyses, rituximab alone (n = 6) and other immune-modulating treatments alone (n = 2) were significantly associated with an increased likelihood of inhibitor clearance [hazard ratio (HR) = 4.4 (95% CI = 1.06–20.03) and 10.21 (95% CI = 1.17–78.28), respectively], whereas ITI alone (n = 9) was not [HR = 1.35 (95% CI = 0.44–4.07)].

Trust in the Provider and Glaucoma-Related Blindness

Purpose. We hypothesized that lower trust in the physician is associated with worse visual outcomes in glaucoma. Methods. Subjects completed the Trust in Provider Scale (TPS) and performed visual field tests at least two years apart. The primary outcome was glaucoma-related blindness. Results. Subjects with glaucoma-related blindness scored lower on the TPS (74.9 ± 7.4, n = 21) than subjects without blindness (78.8 ± 6.9, n = 39; P = 0.04). In white subjects, TPS scores were similar for blind (77.1 ± 7.7, n = 12) versus not blind subjects (76.4 ± 6.7, n = 10; P = 0.82). For nonwhite subjects, TPS scores were lower for blind (72.0 + 6.2, n = 9) versus not blind subjects (79.6 ± 6.9, n = 29; P = 0.005). In multiple regression models, the interaction between race and trust was significant (P = 0.007), indicating that the increase in odds for blindness with each unit decrease in TPS score was different for white versus nonwhite subjects. Discussion. Glaucoma patients' trust in the physician is associated with glaucoma-related blindness in this study. The association between lower trust in the physician with blindness in patients of nonwhite race deserves further attention as we strive to reduce disparities in visual outcomes.

Playing through differences: black–white racial logic and interrogating South Asian American identity

This article examines how South Asian American communities ascribe meaning to the category of ‘race’ while adding their own sensibilities to racial categories of ‘black’ and ‘white’. Drawing upon ethnographic methods, I analyse leisure spaces of basketball to demonstrate how racial formation in the US for non-white ethnic American subjects engages the black–white racial binary while simultaneously critiquing this racial logic. Racial categories provide a lexicon for comprehending South Asian American difference, while South Asian idioms perpetuate racializing discourses.

Australian Responses to the Indian Famine, 1876–78: Sympathy, Photography and the British Empire

This article analyses Australian efforts on behalf of victims of the 1876–8 Indian famine as complex articulations of colonial identity and loyalty in the British imperial world. Focused on the Victorian Famine Relief Fund, which made extensive use of vivid photographic images of sufferers, the article also examines the public campaigns on behalf of Indian famine victims in other colonial cities and towns. It suggests that the language of filial duty most commonly associated with later military commitments had a humanitarian pedigree, and that the settler colonial ability to express empathy for non-white British subjects was enhanced by the capacity to see photographic images of them. Despite their promise of drawing the viewer closer to witnessing suffering, photographs of famine victims served rather to emphasise the distance between the viewer and the viewed, in ways that were productive for the fund-raising effort.

Review of Symptom Experiences in Children and Adolescents With Cancer

Inadequate symptom relief in children and adolescents with cancer leads to unnecessary suffering. This review assesses research on children and adolescents with cancer that had been published from 2002 to 2010. The review identifies the symptom experiences of children and adolescents undergoing treatment and describes the progress that has been made since Docherty's 2003 systematic review of nurse researcher published studies from 1990 to 2002, which identified gaps in research on the symptoms of pediatric oncology patients. A computerized search of medical and nursing literature produced 50 published studies and 2 dissertations that addressed the symptom experiences of children and adolescents receiving treatment for cancer. Pain from cancer-related procedures and fatigue were the most frequently identified symptoms, followed closely by nausea and vomiting. More preschool-aged subjects and nonwhite subjects need to be assessed, distinctions between age groups and gender should be explored, and instrumentation for the prereading group must be developed. Research on symptoms experienced by children and adolescents has gained momentum within the last 10 years, and some of the gaps identified by Docherty have been addressed. Multicenter trials would increase sample sizes and decrease enrollment time. By synthesizing research completed from 2002 to 2010 on symptoms of children who had cancer, new ideas can be generated and shared with clinical nursing staff to improve patient care. Gaps to further direct research are also identified.

The Transatlantic Indian, 1776–1930

The Transatlantic Indian, 1776–1930

Clinical and Radiographic Predictors of GOLD–Unclassified Smokers in the COPDGene Study

A significant proportion of smokers have lung function impairment characterized by a reduced FEV(1) with a preserved FEV(1)/FVC ratio. These smokers are a poorly characterized group due to their systematic exclusion from chronic obstructive pulmonary disease (COPD) studies. To characterize the clinical, functional, and radiographic features of Global Initiative for Chronic Obstructive Lung Disease (GOLD)-Unclassified (FEV(1)/FVC ≥ 0.7 and FEV(1) < 80% predicted) and lower limits of normal (LLN)-unclassified (FEV(1)/FVC ≥ LLN and FEV(1) < LLN) subjects compared to smokers with normal lung function and subjects with COPD. Data from the first 2,500 subjects enrolled in the COPDGene study were analyzed. All subjects had 10 or more pack-years of smoking and were between the ages of 45 and 80 years. Multivariate regression models were constructed to determine the clinical and radiological variables associated with GOLD-Unclassified (GOLD-U) and LLN-Unclassified status. Separate multivariate regressions were performed in the subgroups of subjects with complete radiologic measurement variables available. GOLD-U smokers account for 9% of smokers in COPDGene and have increased body mass index (BMI), a disproportionately reduced total lung capacity, and a higher proportion of nonwhite subjects and subjects with diabetes. GOLD-U subjects exhibit increased airway wall thickness compared to smoking control subjects and decreased gas trapping and bronchodilator responsiveness compared to subjects with COPD. When LLN criteria were used to define the "unclassified" group, African American subjects were no longer overrepresented. Both GOLD-U and LLN-Unclassified subjects demonstrated a wide range of lung function impairment, BMI, and percentage of total lung emphysema. Subjects with reduced FEV(1) and a preserved FEV(1)/FVC ratio are a heterogeneous group with significant symptoms and functional limitation who likely have a variety of underlying etiologies beyond increased BMI. Clinical trial registered with www.clinicaltrials.gov (NCT000608764).

Keratin Variants Predispose to Acute Liver Failure and Adverse Outcome: Race and Ethnic Associations

Keratins 8 and 18 (K8/K18) provide anti-apoptotic functions upon liver injury. The cytoprotective function of keratins explains the overrepresentation of K8/K18 variants in patients with cirrhosis. However, K8/K18 variant-associated susceptibility to acute liver injury, which is well-described in animal models, has not been studied in humans. We analyzed the entire coding regions of KRT8 and KRT18 genes (15 total exons and their exon-intron boundaries) to determine the frequency of K8/K18 variants in 344 acute liver failure (ALF) patients (49% acetaminophen-related) and 2 control groups (African-American [n = 245] and previously analyzed white [n = 727] subjects). Forty-five ALF patients had significant amino-acid-altering K8/K18 variants, including 23 with K8 R341H and 11 with K8 G434S. K8 variants were significantly more common (total of 42 patients) than K18 variants (3 patients) (P < .001). We found increased frequency of variants in white ALF patients (9.1%) versus controls (3.7%) (P = .01). K8 R341H was more common in white (P = .01) and G434S was more common in African-American (P = .02) ALF patients versus controls. White patients with K8/K18 variants were less likely to survive ALF without transplantation (P = .02). K8 A333A and G434S variants associated exclusively with African Americans (23% combined frequency in African American but none in white controls; P < .0001), while overall, K18 variants were more common in non-white liver-disease subjects compared to whites (2.8% vs 0.6%, respectively; P = .008). KRT8 and KRT18 are important susceptibility genes for ALF development. Presence of K8/K18 variants predisposes to adverse ALF outcome, and some variants segregate with unique ethnic and race backgrounds.

Patient reported outcomes in adults with type 2 diabetes on basal insulin randomized to addition of mealtime pramlintide or rapid-acting insulin analogs

Objective:To determine whether treatment satisfaction and quality of life were affected by adding mealtime pramlintide or rapid-acting insulin analogs (RAIAs) to basal insulin therapy for patients with inadequately controlled type 2 diabetes.Research design and methods:In this 24-week open-label, multicenter study of adults with type 2 diabetes, mealtime pramlintide (PRAM) (120 μg fixed dose; n = 56) or titrated RAIAs (n = 56) was added to basal insulin therapy with or without oral antidiabetic medications.Clinical trial registration:ClinicalTrials.Gov NCT00467649Main outcome measures:Quality of life (Diabetes Distress Scale – DDS, and Pittsburgh Sleep Quality Index – PSQI), and treatment satisfaction (Diabetes Treatment Satisfaction Questionnaire – DTSQ, and Pramlintide Treatment Satisfaction Questionnaire – PRAM-TSQ) were assessed at baseline and week 24. Mixed-effect models estimated mean group changes from baseline to week 24 (adjusted for baseline scores) in patient reported outcomes.Results:PRAM patients experienced significant improvement in total diabetes distress, while RAIA patients did not; both groups experienced significant improvement in regimen-related distress and physician-related distress. Between-group differences in DDS measures were not significant. PRAM patients experienced significant improvement in sleep latency and daytime dysfunction, while RAIA patients did not; the difference between groups was significant for daytime dysfunction. Both treatment groups experienced significant improvement in most individual DTSQ items and total diabetes treatment satisfaction, while only PRAM patients experienced significant improvement in perceived hypoglycemia. Between-group differences in DTSQ measures were not significant. Both treatment groups experienced significant improvement in most individual PRAM-TSQ items and total treatment satisfaction; RAIA patients experienced increased eating flexibility and reduced perceived weight control. PRAM patients experienced significantly better perceived weight and appetite control than RAIA patients.Limitations:The sample size was relatively small and there were few non-white subjects. The schedule for implementation of change in therapy may have affected study outcomes.Conclusions:Adding pramlintide on a background of basal insulin improved some aspects of treatment satisfaction and quality of life relative to adding rapid-acting insulin analogs.

Improving Global Vascular Risk Prediction With Behavioral and Anthropometric Factors: The Multiethnic NOMAS (Northern Manhattan Cohort Study)

This study sought to improve global vascular risk prediction with behavioral and anthropometric factors. Few cardiovascular risk models are designed to predict the global vascular risk of myocardial infarction, stroke, or vascular death in multiethnic individuals, and existing schemes do not fully include behavioral risk factors. A randomly derived, population-based, prospective cohort of 2,737 community participants free of stroke and coronary artery disease was followed up annually for a median of 9.0 years in the NOMAS (Northern Manhattan Study) (mean age 69 years, 63.2% women, 52.7% Hispanic, 24.9% African American, and 19.9% white). A global vascular risk score (GVRS) predictive of stroke, myocardial infarction, or vascular death was developed by adding variables to the traditional Framingham cardiovascular variables based on the likelihood ratio criteria. Model utility was assessed through receiver-operating characteristics, calibration, and effect on reclassification of subjects. Variables that significantly added to the traditional Framingham profile included waist circumference, alcohol consumption, and physical activity. Continuous measures for blood pressure and fasting blood sugar were used instead of hypertension and diabetes. Ten-year event-free probabilities were 0.95 for the first quartile of GVRS, 0.89 for the second quartile, 0.79 for the third quartile, and 0.56 for the fourth quartile. The addition of behavioral factors in our model improved prediction of 10-year event rates compared with a model restricted to the traditional variables. A GVRS that combines traditional, behavioral, and anthropometric risk factors; uses continuous variables for physiological parameters; and is applicable to nonwhite subjects could improve primary prevention strategies.

Response to Tim Barringer, A White Atlantic?

In my response to Tim Barringer’s piece, I emphasize the importance of extending one’s frame of reference when discussing transatlantic artistic connections to the consideration of as many different art forms as possible – including photography, and magazine and book illustrations – in order to get as full a picture as possible of the two-way flow in transatlantic artistic influences.This fuller picture notably extends the degree to which images of non-white subjects are seen to be in circulation. I also draw attention to the ways in which American and English artistic circles intersected outside as well as within these two countries, a point reinforced by looking at American women sculptors in Rome in the 1860s, paying particular attention to the work of the part African-American, part Native American sculptor, Edmonia Lewis. In her work can be seen a complex set of attitudes towards her subject matter that remind one forcefully of the many racial and cultural strands coming together in new American art.

An international compendium of mutations in the SCN5A-encoded cardiac sodium channel in patients referred for Brugada syndrome genetic testing

Brugada syndrome (BrS) is a common heritable channelopathy. Mutations in the SCN5A-encoded sodium channel (BrS1) culminate in the most common genotype. This study sought to perform a retrospective analysis of BrS databases from 9 centers that have each genotyped >100 unrelated cases of suspected BrS. Mutational analysis of all 27 translated exons in SCN5A was performed. Mutation frequency, type, and localization were compared among cases and 1,300 ostensibly healthy volunteers including 649 white subjects and 651 nonwhite subjects (blacks, Asians, Hispanics, and others) that were genotyped previously. A total of 2,111 unrelated patients (78% male, mean age 39 +/- 15 years) were referred for BrS genetic testing. Rare mutations/variants were more common among BrS cases than control subjects (438/2,111, 21% vs. 11/649, 1.7% white subjects and 31/651, 4.8% nonwhite subjects, respectively, P <10(-53)). The yield of BrS1 genetic testing ranged from 11% to 28% (P = .0017). Overall, 293 distinct mutations were identified in SCN5A: 193 missense, 32 nonsense, 38 frameshift, 21 splice-site, and 9 in-frame deletions/insertions. The 4 most frequent BrS1-associated mutations were E1784K (14x), F861WfsX90 (11x), D356N (8x), and G1408R (7x). Most mutations localized to the transmembrane-spanning regions. This international consortium of BrS genetic testing centers has added 200 new BrS1-associated mutations to the public domain. Overall, 21% of BrS probands have mutations in SCN5A compared to the 2% to 5% background rate of rare variants reported in healthy control subjects. Additional studies drawing on the data presented here may help further distinguish pathogenic mutations from similarly rare but otherwise innocuous ones found in cases.