Racial Backgrounds Research Articles

Racial Disparities in Shared Decision-Making and the Use of mHealth Technology Among Adults With Hypertension in the 2017-2020 Health Information National Trends Survey: Cross-Sectional Study in the United States.

Mobile health (mHealth) technology has the potential to support shared decision-making (SDM) and improve hypertension control. However, our understanding of the variations in individuals' involvement in SDM and mHealth usage across different racial and ethnic groups in the United States is still limited. This study aimed to investigate the extent of involvement in SDM and the usage of mHealth technology in health-related activities among US adults with hypertension from diverse racial and ethnic backgrounds and to examine whether the mHealth usage differed by individuals' level of engagement in SDM. This study used cross-sectional data from the 2017 to 2020 Health Information National Trends Survey, which was conducted on US adults with self-reported hypertension, and race and ethnicity data were included. The exposure of interest was race and ethnicity. The outcomes were SDM and mHealth usage. SDM was assessed using an item: "In the past 12 months, how often did your health professional: involve you in decisions about your healthcare as much as you wanted?" mHealth usage was defined as using a smartphone or tablet to engage in (1) making health decisions, (2) discussing health decisions with health providers, (3) tracking health progress, and (4) sharing health information. Weighted multivariable logistic regression models were used to examine the association between race and ethnicity and SDM or mHealth usage adjusted for covariates and stratified by the level of engagement in SDM. This study included 4893 adults with hypertension, and the mean age was 61 (SD 13) years. The sample was 53% female, 61% (n=3006) non-Hispanic White, 19% (n=907) non-Hispanic Black or African American, 12% (n=605) Hispanic, 4% (n=193) non-Hispanic Asian, and 4% (n=182) non-Hispanic other. Compared to the non-Hispanic White adults, non-Hispanic Black adults were more likely to use mHealth to make health decisions (adjusted odds ratio [aOR] 1.70, 95% CI 1.23-2.34), share health information (aOR 1.46, 95% CI 1.02-2.08), and discuss health decisions with health providers (aOR 1.38, 95% CI 1.02-1.87). Significant associations were observed specifically among those who were always involved in SDM. Asian adults were less likely to be involved in SDM (aOR 0.51, 95% CI 0.26-0.99) and were more likely to use mHealth to track progress on a health-related goal (aOR 2.07, 95% CI 1.28-3.34) than non-Hispanic White adults. Hispanic adults were less likely to use mHealth to share health information (aOR 0.47, 95% CI 0.33-0.67) and discuss health decisions with health providers (aOR 0.65, 95% CI 0.46-0.94) compared to non-Hispanic White adults. This study observed racial and ethnic disparities in SDM and mHealth usage among US adults with hypertension. These findings emphasize the significance of comprehending the involvement of SDM and the usage of mHealth technology within racially and ethnically diverse populations.

Impacts of a COVID-19 Educational Video: Evaluation of the Influence of Race, Gender, Political Affiliation, Study Major, and Age on Vaccine Acceptance among University Students.

The World Health Organization (WHO) warns that vaccine hesitancy is an ongoing major global health threat. While vaccination against severe acute respiratory syndrome coronavirus (SARS-CoV-2) proves to be an effective strategy in protecting against the disease, vaccine hesitancy represents a major barrier to stopping the spread of the virus. Willingness for vaccination can be influenced by several factors, including education level and health literacy. Although several studies demonstrate the value of video educational programs in improving coronavirus disease 2019 (COVID-19) vaccine knowledge and acceptance, no studies to date have evaluated if race, gender, and other demographic factors impact the influence of an educational video on COVID-19 vaccine knowledge and hesitancy among university students in the United States (U.S.). This study was conducted to determine the impact of an educational video on U.S. university undergraduate students' COVID-19 vaccine perception and acceptance. It also aims to evaluate whether demographic factors affect the influence of the video. An online survey was used to measure perceived understanding and acceptance of COVID-19 vaccines before and after viewing a video regarding the effectiveness and safety of COVID-19 vaccinations. The impact of demographic factors on the Video Influence Score was analyzed. After viewing the video, respondents' (n = 285) perceived awareness and acceptance of COVID-19 vaccines significantly increased (p < 0.05). In addition, gender, political party affiliation, age, study major, and influenza vaccination history did not significantly impact the Video Influence Score (p > 0.05). However, African American/Black respondents (3.81 ± 4.24) were significantly more influenced by the video compared to respondents of other races (p < 0.05), such as White/Caucasian (1.91 ± 3.75), Hispanic/Latino (0.17 ± 3.67), Asian (0.29 ± 1.53), and Indigenous American (0.64 ± 2.52). This study suggests the potential impact of an educational video on COVID-19 vaccine perception and acceptance among university students. Despite limitations such as a modest survey response rate, this study provides valuable insight concerning the influential factors affecting vaccine acceptance in diverse student populations. Future studies are warranted to explore how student response to vaccine educational videos may vary depending on students' racial and cultural backgrounds. A targeted educational video to promote vaccine acceptance is a valuable tool for public health campaigns to combat vaccine hesitancy. The study also highlights the importance of tailoring interventions to specific demographic groups such as considering racial factors to maximize the impact of educational interventions on vaccine attitudes.

The Use of Address Terms by Thomas Shelby as the Main Character in Peaky Blinders

This research seeks to study the use of address terms in a business talk. Address terms such as FN, LN, T, TLN, KT, PN, or Miscellaneous, are selectively used to address others depending on some social factors such as age, gender, social occasions, social relationship, family relationship, occupational hierarchy, as well as racial background. This research studies qualitatively the utterances of Thomas Shelby, the main character in Peaky Blinders. The findings show that Thomas Shelby only uses FN, TLN, and Miscellaneous, such as person deixis and zero address term. Therefore, in a business talk, a speaker may choose the use of appropriate terms of address in accordance with the social factors to maximize communication’s purposes.

Abstract 15 A State-Run Public Cord Blood Collection Program

Abstract Introduction The Arizona Public Cord Blood Program was created in 2011 by the Arizona Biomedical Research Centre, a sub-section of the Arizona Department of Health Services, to advance the collection and increase the number of racially and ethnically diverse cord blood units available for transplantation, as well as promote awareness of the benefits of cord blood stem cells through our educational partner, Save the Cord Foundation (STCF). Objectives Create a sustainable program for women of all racial and ethnic backgrounds to have the opportunity to donate cord blood, with the primary goal of transplantation, and secondary goal of providing non-transplantable cord blood units for research. A second objective was to educate the residents of the state of Arizona about cord blood stem cells and the need for their preservation. Methods A portion of state lottery funds supports the program monetarily. Those funds are provided to four collection hospitals who employ "cord blood consenters" whose responsibility it is to consent patients, assist delivery providers with collections, and package and ship cord blood units to our partner cord blood bank at MD Anderson Cancer Center. There are also two clinical coordinators who educate and train hospital staff on quality collection practices, with special emphasis on the importance of high volume, sterile collections. STCF provides education across the state to expectant parents, healthcare providers, schools, and the public about the need for cord blood stem cell donation for transplant and research. Results Since 2011, the Arizona Public Cord Blood Program has banked hundreds of racially and ethnically diverse cord blood units with the National Marrow Donor Program, and has had 86 life-saving cord blood units matched with patients in need around the globe. This innovative program has not only expanded cord blood awareness and promoted the preservation of cord blood; it has resulted in the creation of an economic engine for the state of Arizona that is an attractant for STEM based businesses and careers. Discussion A decade later, the Arizona Public Cord Blood Program has proven to be a sustainable model for collecting and providing suitable cord blood units for transplant to diverse patient populations.

Abstract 2 Results of an Open Label Expanded Access Study of Omidubicel-onlv for Allogeneic Transplantation (allo-HCT) in Patients with Hematologic Malignancies

Abstract Introduction Omidubicel, a nicotinamide expanded allogeneic hematopoietic progenitor cell therapy derived from umbilical cord blood (UCB) was recently FDA approved for use as a sole donor source in allo-HCT based on phase III study results showing improved hematopoietic recovery and decreased infection rate compared to standard UCB. Objectives Open label, single arm expanded access program (EAP) evaluating clinical outcomes for patients with hematologic malignancies following omidubicel allo-HCT. Methods Eligible patients (&amp;gt;12 years) received myeloablative conditioning with supportive care per institutional guidelines. Patients were followed for engraftment, infections, graft versus host disease (GVHD), and two year post-transplantation outcomes. Results Between July 2020 and April 2023, 36 patients were enrolled at 5 US centers, and 29 (18 male, 11 female) were transplanted; median age was 38 years (range: 20-73); 55.2% white, 17.2% Black, 20.7% Asian, 10.3% other. Diagnoses included AML (37.9%), ALL (27.6%), MDS (20.7%) and other (13.8%). Median transplanted CD34+ cell dose was 5.6x106 cells/kg and HLA match was 4/6 in 51.7%, 5/6 in 44.8%, and 6/6 in 3.5%. Median follow-up was 6.25 months (range 0.33-27.7). At 100 and 365 days post-transplant, PFS rates were 95.5% and 82.9%, and OS rates were 96.3% and 84.4%, respectively. No infusion reactions were reported. Median neutrophil (&amp;gt;500/µl x3 days) and platelets (&amp;gt;20,000/µl x7 days) engraftment times were 12 and 33 days, respectively. Primary graft failure occurred in 2 (6.9%) patients, both alive &amp;gt;100 days after second transplant. Incidence of first grade 2 or 3 bacterial, viral, or invasive fungal infections through 100 days post-transplantation were 13.8%, 24.1% and 0%, respectively. Acute GVHD was reported in 13 (44.8%) patients (grade II: 34.5%, grade III: 10.3%) and mild chronic GVHD in 1 (3.5%). There were 4 deaths (13.8%): 2 due to relapse @275 and 381 days, 1 due to infection (day 135) and 1 due to pulmonary failure on day 10. Post-transplant lymphoproliferative disease was reported in one. Discussio In this real-world EAP setting, allo-HCT with omidubicel was well tolerated, and observed engraftment and infections consistent with published Phase 3 data. These data further support the role of omidubicel particularly for patients from diverse racial backgrounds.

Similar response to omalizumab in children with allergic asthma from different racial backgrounds.

Similar response to omalizumab in children with allergic asthma from different racial backgrounds.

RNF213 p.R4810K variant in moyamoya disease in adults and children from a Malaysian tertiary center

Background: Ring finger protein 213 (RNF213) is a major susceptibility gene for moyamoya disease (MMD). A single nucleotide variant known as c.14429G&gt;A (p.R4810K, rs112735431) is strongly associated with MMD, weakly associated with moyamoya syndrome (MMS) and intracranial atherosclerosis (ICAS) in East Asians. The percentage of patients carrying p.R4810K and the effect sizes vary between different racial backgrounds. We aimed to investigate the prevalence of p.R4810K in MMD, MMS, and ICAS patients in Malaysia. Methods: We genotyped p.R4810K in DNA extracted from 9 MMD, 13 MMS, 15 ICAS cases, and 45 controls using TaqMan SNP genotyping assay. Clinical and neuroradiological data was collected for each patient and the distribution of genotype frequencies compared between cases and controls and tested for association. Results: Two of seven (28.6%) Chinese MMD cases had heterozygous p.R4810K (GA) genotype. The remaining MMD cases (5 Chinese and 2 Malays), all 13 MMS, 15 ICAS cases and 45 controls had homozygous wild-type (GG) genotype. Higher frequency of GA genotype was observed in Chinese MMD patients compared with controls, indicating an association between p.R4810K and Chinese MMD subgroup under a dominant model (P=0.0398). Conclusion: This is the first study reporting p.R4810K in a multiracial Asian population. The p.R4810K missense mutation was detected in MMD cases of Chinese descent in Malaysia. Further studies are needed to identify other susceptibility variants and genes in Malaysian patients with moyamoya and ICAS.

Examining and promoting women’s health through a descriptive analysis of a novel health tool: the ‘Circle of Health’

ABSTRACT A comprehensive perspective of women’s health increases healthy equity and broadens the spectrum of care for women. The Circle of Health, a holistic health assessment tool, was created by the National Centers of Excellence in Women’s Health (NCEWH). This initiative focuses on advancing women’s health needs by empowering them to actively engage about their own health care. The tool includes surveys for seven distinct domains of health: physical, social, emotional, intellectual, environmental, financial, and spiritual. The present study reports comprehensive health findings for a sample of 169 females from Region VIII with data collected from February 2014 to April 2019. The Circle of Health tool highlights distinct health needs across the seven domains. For the present sample of mostly female college students, areas of concern included the emotional, financial, and environmental health domains. Further research is needed to examine the holistic health of women from diverse cultural, racial, age, and socioeconomic backgrounds. The Circle of Health tool describes health, for both women and their health providers, more holistically and encourages an integrative model of care.

Revealing the Myths in Iphone 14 Advertisement: Semiotics Approach

Semiotics is a branch of science that examines human signs. The semiotic aspects and cases are exciting topics to discuss in interpreting the meaning of advertising because the ambiguous message conveyed in the advertisement may cause difficulties in understanding its meaning among the customers. This research aims to discover the connotative and denotative meanings of the signs in the iPhone 14 advertising video. This study was qualitative research. The data of the study is iPhone 14 advertising video; Action Mode Feature. The data were analyzed with verbal and nonverbal signs according to Saussure's theory (1950) in the form of words, phrases, sentences, sounds, situations, models, motion, and video images of iPhone 14 advertisement and then searched for connotative and denotative meanings according to Barthes' theory (1983). The results revealed that the advertisement aims to create consumer appeal by emphasizing the iPhone 14's luxurious design and the quality associated with the Apple brand. In addition, by featuring Black individuals prominently, the ad sends a message of inclusivity and empowerment, suggesting that success and prestige are attainable by all, regardless of their racial or ethnic background. Therefore, the iPhone 14 positions itself as a symbol of progress, both technologically and socially.

Corneal Sensitivity Is Inversely Correlated With Severity of Diabetic Retinopathy in a Predominantly Underrepresented Population

PurposeTo assess the relationship between diabetic retinopathy (DR) and corneal sensitivity. MethodsIn this prospective study, 100 eyes of 50 patients from primarily underrepresented racial and ethnic backgrounds with DR underwent assessment of corneal sensitivity using a Cochet-Bonnet esthesiometer. Severity of DR was graded by a masked reading center. Corneal sensitivity was compared in eyes with current or regressed proliferative DR (PDR) (n=35) and eyes with non-proliferative DR (NPDR) with no history of PDR (n=65). Corneal sensitivity in eyes that regressed from PDR to NPDR with anti-vascular endothelial growth factor (VEGF) therapy (n=7) was compared to treatment-naïve eyes with no current or prior PDR (n=55) and to eyes with newly diagnosed, treatment-naïve PDR (n=12). ResultsIn eyes with current or prior PDR, the median corneal sensitivity (average of 4 quadrants) was 0.5 cm (IQR 0-3.375), while in eyes with no current or prior PDR, the median corneal sensitivity was 4.75 cm (IQR 2.0-6.0, P<.0001). The median corneal sensitivity in eyes with regressed PDR was 0 cm (IQR 0-0.875), significantly lower than eyes with no current or prior PDR (4.5 cm, IQR 4.0, P=.0076) and no different than eyes with untreated PDR (0 cm, IQR 1.25). The odds of eyes with DRSS ≥ 60 having complete corneal sensitivity loss was 3.6 times that of eyes with NPDR. ConclusionsCorneal sensitivity is impaired in eyes with PDR compared to NPDR, and is not rescued by anti-VEGF therapy. Assessment of corneal sensitivity in eyes with DR may identify patients at risk for additional complications including neurotrophic keratopathy.

Reflections on women’s activism in twentieth-century Britain

ABSTRACT This article is based on a talk I gave at the London School of Economics in March 2023. The talk was structured in a way to give me the freedom to reflect upon some of the key themes in my book Women’s Activism in Twentith Century Britain; making a difference across the political spectrum. I wrote the book during the pandemic. Archives were closed and even when they opened I could not use them as I had to shield because of health issues. Consequently, the material I relied on was what I could access on-line and on people who I could interview on Zoom. My book drew on my own experiences as an activist and my own theoretical development as a feminist. History and activism intertwined: my story as a former activist and my view that feminist historical scholarship is itself a type of activism came together to give direction and meaning both to my research and to my writing. In my talk, and in this Viewpoint, I want to show the heterogeneous nature of activism, of how individuals and groups from a range of different class and racial background sought to make a difference to their locality, their country and sometimes the world. I argue that women are not a homogenous group but are united—and divided—by class, ethnicity, gender and so on. For instance, not all female activists campaigned for progressive measures, indeed many promoted reactionary agendas.

An exploration of cultural competency training and genetic counselors' racial biases.

Research shows genetic counselors generally have pro-White implicit biases-both prejudice and stereotyping. Cultural competency training aims to foster equitable beliefs, behaviors, and attitudes in cross-cultural genetic counseling sessions, including those that are racially discordant (genetic counselors and patients are from different racial backgrounds). Therefore, cultural competency training has the potential to mitigate bias and reduce disparities. Here, we report the prevalence of cultural competency training among genetic counselors and associations between recency of training and counselors' racial biases. We conducted an online survey of genetic counselors and trainees in fall 2021. The survey assessed four types of bias (implicit/explicit prejudice and implicit/explicit stereotyping), time since last cultural competency training, time since last communication skills training, and frequency of clinic sessions with Black patients. Multiple linear regressions modeled associations between cultural competency training and different types of bias, adjusting for communication skills training, frequency of encounters with Black patients, and counselor race (White vs. non-White). Two hundred fifteen participants (107 genetic counselors and 108 trainees) responded, and 205 reported whether they had prior cultural competency training. Of these, 187 (91%) reported ever having cultural competency training, most (53%) of participants who had training had it within 6 months prior to survey completion. We found no clear pattern of associations between cultural competency training and racial biases (implicit or explicit) in adjusted analyses. Participants who had cultural competency training four or more years prior demonstrated less negative implicit stereotyping toward Black individuals compared with those having more recent training; but no statistically significant effect was found for participants who reported never having cultural competency training, compared with those having training more recently than 4 years prior. Overall, our findings do not support that cultural competency training is negatively associated with, or mitigates, Black/White racial prejudices and stereotypes against Black patients. These findings suggest more effective interventions are needed to reduce racial biases.

Applicant Experience in Communication With Residency Programs After the Introduction of Program Signaling

Examine the applicant experience after introduction of program signaling for the 2023 obstetrics and gynecology (OBGYN) residency application cycle. Responses to an online survey of OBGYN applicants participating in the 2023 match who participated in residency program signaling were compared to responses from a similar survey conducted in 2022. Demographic information included personal and academic background and how applicants and advisors communicated with programs. Numbers of applications and interviews, second look visits, away rotations, manner of contact, and timing of communication was compared. Statistical analysis included ANOVA for interval data, and χ2 and Kruskal-Wallis tests for categorical data. A total of 711 of 2631 (27%) applicants responded in 2022 and 606 of 2492 (24.3%) responded in 2023. Approximately 2/3 of gold signals and 1/3 of silver signals led to an interview. There was no change in number of applications or interviews per applicant, but there was a broader distribution of interviews per applicant in 2023. Applicants in 2023 were less likely to engage in preinterview communication or do an away rotation to indicate interest in a program. There was decreased communication between applicants and programs after signaling was introduced. Informal communication continued to differ by racial and medical school background. Applicants from DO programs and international medical graduates (IMG) had more communication with programs than MD applicants but received fewer interview invitations. Fewer Black and Latin(x)/Hispanic applicants had faculty reach out to residency programs on their behalf compared to White and Asian applicants. There were differences in the number of interviews received based on racial and ethnic identity. In the first year after implementation of program signaling, there was a decrease in preinterview communication and a broader distribution of interviews among applicants. Further efforts to create standard means of program communication may help to begin leveling the uneven playing field for applicants.

Comparing the Addiction Severity Index (ASI) and Measurements in the Addictions for Triage and Evaluation (MATE)

Substance use disorder (SUD) assessment and measurement in Brazil, as well as in many other countries, face significant shortcomings. The Measurement in the Addictions for Triage and Evaluation (MATE) was developed as a public domain tool, drawing from validated scales and incorporating World Health Organization International Classification of Functioning, Disability, and Health (ICF) framework. The Brazilian version of the MATE (MATE-pt-BR) was evaluated for its reliability and validity, with a total of 239 subjects participating in the study, and data collected between 11/01/2021 and 09/01/2022. The majority were male (79.2%), with diverse racial backgrounds. The substances most prevalently used in the last 30 days were. Alcohol (73.2%), nicotine (63.6%), and cocaine (44.2%). The mean scores for MATE modules showed variations, with Module Q2 assessing psychological well-being having high internal consistency (Cronbach’s alpha = 0.92). MATE-pt-BR demonstrated robust internal consistency, with Module 6 (personality) and Module 2 (medical and psychiatric consultation indicators) being exceptions. MATE-pt-BR exhibited significant correlations among its sections and strong discriminant validity. Moreover, the paper compares MATE-pt-BR with the Addiction Severity Index (ASI-6), which is considered the gold-standard measure for SUD assessments. MATE-pt-BR offers a valuable tool for assessing substance use and related functional impairments in the Brazilian context.

Role of School Quality and Neighborhood Disadvantage in Educational Attainment: Do They Vary by Race?

Schools and neighborhoods are adolescents' primary environments, and each has a significant influence on their academic success. The majority of studies on educational attainment have examined the impact of a single context-either the school or the neighborhood-suggesting mixed findings on school and neighborhood effects as well as potential disparities across racial groups. To address this gap, the present study examined the roles of school quality and neighborhood disadvantage on educational attainment for White and Black adolescents. This study used the National Longitudinal Study of Adolescent to Adult Health data collected from a nationally representative sample of U.S. adolescents, merging multiple data sources including in-home surveys, school administrator surveys, student-level educational records, and contextual data. Educational attainment was measured using college enrollment and graduation status. School quality was a significant predictor of college enrollment and graduation for both White and Black adolescents. Neighborhood disadvantage is significantly associated with college enrollment for both racial groups; however, college graduation is significant only for White adolescents. These findings suggest that improving school quality is particularly important for educational attainment regardless of racial background. The article concludes with a discussion on the differential roles of school quality and neighborhood disadvantage in relation to White and Black adolescents.

Racial Disparities in Liver Transplantation for Hepatocellular Carcinoma in the United States: An Update.

Previous studies have demonstrated a disparity in liver transplantation (LT) for hepatocellular carcinoma (HCC) among races in the United States (U.S.). We aimed to update the literature on the odds, trends, and complications of LT in the treatment of hepatocellular carcinoma (HCC), among individuals of different racial backgrounds. This is a nationwide study of adult individuals admitted for LT with a primary diagnosis of HCC. Using weighted data from the National Inpatient Sample (NIS) database, we compared the odds of LT among different races from 2016 to 2020, using a multivariate regression analysis. We further assessed the trends and outcomes of LT among races. A total of 112,110 adult were hospitalized with a primary diagnosis of HCC. 3020 underwent LT. When compared to Whites, the likelihood of undergoing LT for HCC was significantly reduced in Blacks (OR = 0.60, 95% CI = 0.46-0.78). Further, Blacks had increased mortality rates (7% in Blacks vs. 1% in Whites, p < 0.001), sepsis (11% in Blacks vs. 3% in Whites, p = 0.015), and acute kidney injury (AKI) (54% in Blacks vs. 31% in Whites, p < 0.001) following LT. Individuals identifying as Blacks were less likely to undergo LT for HCC, and more likely to develop complications. Further initiatives are warranted to mitigate the existing disparities among racial groups.

Black Educators’ Racial Identity Attitudes and Culturally Relevant Pedagogy: A Psychological Framework and Survey of Within-Race Diversity

Historically, Black educators have played a critical role in Black youth's well-being. Consequently, they are often assumed to “naturally” engage culturally relevant pedagogy (CRP), obscuring the diverse ways Black individuals identify, think, and behave regarding race and culture. This psychological survey study examines in-service Black educators’ ( N = 238) multidimensional racial identity attitudes, background sociodemographics, and education contexts (postsecondary and current/teaching) in relation to their varied enactments of three CRP domains ( African American Curriculum, Culturally Relevant Teaching, Sociopolitical Commitment). Results show CRP variation across individuals according to their racial identity attitudes, backgrounds, and contexts. The resulting conceptual framework advances research and discourse on teacher race by challenging homogenizing, detrimental narratives. Findings have important implications for teacher workforce diversification, training, and retention.

Health disparities in the detection and prevalence of pediatric obstructive sleep apnea

IntroductionPediatric Obstructive Sleep Apnea (OSA) is associated with negative health outcomes, behavior problems, and poor academic performance when left untreated. Prior research has shown that children from racial and ethnic minority backgrounds and those living in lower socioeconomic status (SES) homes or neighborhoods have higher prevalence of OSA but lower likelihood of receiving evidence-based care for OSA. Disparities in pediatric OSA detection (e.g., timely assessment and diagnosis) likely contribute to this observed inequity in receiving treatment. A polysomnogram (PSG) is the gold standard for diagnosing OSA but completing PSG can be challenging. Study aims were to examine racial, ethnic, and SES differences in (1) OSA prevalence and severity and (2) OSA detection, specifically PSG completion rates, timing since referral, and age of diagnosis.MethodsChildren (aged 1–18, N = 1,860, 56% male) were referred for PSG during a 6-month period. Participants' racial/ethnic background were as follows: 64.8% White non-Hispanic, 23.5% Black non-Hispanic, 9.4% White Hispanic, and 2.4% other. Children predominantly had Medicaid insurance (64.5%). SES was measured by insurance type and neighborhood SES using the Distressed Communities Index (DCI) for each participant's zip code (Economic Innovations Group; https://eig.org/dc). Covariates included child age and sex, BMI, premature birth status, and smoke exposure in the home.ResultsWe replicated previous research by showing that children from minority racial/ethnic backgrounds and lower SES backgrounds had higher prevalence rates of OSA and worse disease severity. Across racial, ethnic, and socioeconomic backgrounds, only 31.6% of the children referred successfully completed PSG. Insurance coverage (Medicaid or private vs. self-pay), was an important factor in predicting earlier timing and better completion rates of PSG, which is essential for successful diagnosis and treatment of pediatric OSA.

Spectrum of Gender Self-Presentations among Women Candidates

In the 2018 U.S. midterm elections, Democratic women, especially those from diverse racial and ethnic backgrounds, were elected in record numbers. Drawing on qualitative website and Twitter bio data, this paper examines twenty key races at varying levels that had women candidates. We extend our previously-developed typology of gender self-presentations by classifying these approaches on a spectrum, ranging from gender traditional on one side to feminist on the other (with gender neutral and gender nontraditional in the middle). Illustrating the utility of this typology by applying it to a variety of races in the 2018 U.S. midterm elections, we extend prior work and suggest that gender nontraditional and feminist self-presentations highlight women candidates’ power and agency.

Suspended, restrained, and secluded: Exploring the relationship between school punishment, disability, and black and white parents’ health outcomes

Several studies confirm that school suspension is associated with declines in students’ academic performance, school dropout, and incarceration. Despite the extensive literature documenting the adverse impact of school suspension on students, few studies have investigated how out-of-school suspension, seclusion, and restraint impact parents of children with disabilities. Using DisCrit as a theoretical framework, we interviewed fifty parents of Black and white children who were diagnosed with cognitive, physical, and behavioral disabilities. Parents stated that school officials suspended, restrained, and secluded their children between 1 and over 30 times. This article features data that suggests the burden of navigating the disciplinary processes associated with out-of-school suspension, seclusion, and restraint are so stressful that they contribute to a deterioration in parents’ physical and mental health. Irrespective of their racial backgrounds, parents expressed that the trauma associated with their child’s school punishment led them to develop physiological and psychosomatic health challenges, such as depression, hypertension, stroke, peri-traumatic emesis, and other health impairments. In this article, we shed light on parents' accounts of how school punishment harmed their children, contributed to job loss, and disrupted their household.