Return to work post stroke is affected by sociodemographic factors and disability. We explored ethnic differences in employment among White, Black African, Black Caribbean, and other ethnic minority groups at 1 and 5 years post first stroke in a population-based cohort. Data on individuals with first-ever stroke were obtained from the South London Stroke Register ([SLSR] patients registered between 1995 and 2025). Analysis was restricted to individuals in employment at the time of first stroke (N=1737, 67% men, mean age: 54 years [SD: 12.1]), with employment status assessed at 1 year and 5 years follow-up. Associations between ethnicity and employment status (employed, retired or other) were examined using multinomial logistic regression adjusting for a range of sociodemographic (age, sex, study period, socioeconomic deprivation) and clinical factors (eg, stroke severity and management, co-occurring health conditions, functional indicators) at baseline and follow-up. After adjusting for baseline factors (socioeconomic deprivation/stroke severity/health conditions), Black African (relative risk ratio [RRR] 0.47 [95% CI 0.29-0.75]) and Black Caribbean (RRR, 0.40, [0.22-0.75]) groups were significantly less likely to be employed at 1 year post stroke than White individuals. At 5 years, only Black African individuals were less likely to be employed (RRR, 0.59 [95% CI, 0.30-1.15]). Similar ethnic disparities were observed at 1 year and 5 years in relation to clinical factors assessed at follow-up. Black survivors of stroke were ~50% less likely to be employed 1 year after stroke compared with White survivors, with Black African disadvantage persisting at 5 years after stroke. These persistent disparities were not explained by sociodemographic, stroke severity, and functional/health indicators. More research is required to better understand what drives the ethnic disparities in poststroke return to work.

ABSTRACT The translations of the folk literary work entitled The Epic of Baeuqloxdoh have attracted considerable attention in China, with three English-translated versions available. This article probes into their international dissemination, demonstrating that the translations by Australian scholar D. Holm have gained significant recognition in the receiving literary culture, whereas those by Chinese translators remain marginal within the same context. To interrogate this disparity, we integrate insights from Genette’s paratextual theory and Bourdieu’s sociology to explore how paratexts contribute to the reception and how their creation is conditioned by the capital accumulated by patrons and agents. Based on the findings, we suggest that when translating Chinese ethnic minority folk literature, Chinese translators should consider the importance of paratextual mediation for its international dissemination, and domestic patrons and agents should cooperate with foreign counterparts as the latter often possess forms of capital more readily convertible within the target literary field.

ABSTRACT Recent reforms to China's college admission policies have increased access to higher education for ethnic minority students. However, these students frequently encounter distinct challenges stemming from their cultural backgrounds, language proficiency, and prior educational experiences. This study focuses on the achievement gap between ethnic minority and non‐minority students within the Chinese higher education system. By analysing data from 19,637 undergraduates across 37 universities, this study used the Chinese version of the College Student Experiences Questionnaire to examine the influence of college environment on student learning gains and to determine whether the mediating effects of academic and social activities varied across ethnic groups. The structural equation modelling results suggested that: (1) a positive association existed between college environment and learning gains for both ethnic minority and non‐minority students; (2) both academic and social activities partially mediated this relationship; and (3) the impact of social activities on learning gains was significantly less pronounced for ethnic minority students, thereby revealing a critical disparity. This study underscores the important role of college environment in fostering student learning and emphasises the necessity of tailored support mechanisms designed to address the unique challenges experienced by ethnic minority students.

ABSTRACT Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic synovitis and multi‐joint destruction. The disease course is prolonged, recurrent, and associated with high disability rates. Patients often experience significant physical and mental suffering due to persistent pain, joint deformities, and multisystem complications. Clinical treatment faces dual challenges of controlling inflammation and delaying structural damage. Although current mainstream chemical drugs, such as disease‐modifying antirheumatic drugs (DMARDs), can relieve symptoms, their long‐term use can easily cause adverse reactions, including lung involvement and cardiovascular disease. Although biological agents exhibit strong targeting capabilities, they are costly and immunosuppressive, thus increasing the risk of infection and other complications. These limitations highlight the urgent need for developing new therapeutic agents with improved safety and efficacy profiles. In this context, traditional Chinese ethnomedicines, rooted in the medical systems of China's ethnic minorities, have gradually attracted attention due to their potential for multicomponent synergy, favorable safety profiles, and low cost. They have thus become a research hotspot for complementary and alternative RA therapies in recent years. A comprehensive literature review reveals that existing anti‐RA studies of traditional Chinese ethnomedicines mainly focus on regulating inflammation‐related signaling pathways. However, issues such as fragmented target verification and unclear active ingredients remain. Therefore, this study comprehensively reviews the research progress on the molecular mechanisms by which traditional Chinese ethnomedicines regulate RA‐related signaling pathways. It also examines the regulatory effects of certain ethnomedicines on crosstalk among multiple pathways and identifies active components in selected ethnomedicines. Acknowledging that the current evidence base is predominantly preclinical, this review highlights the critical need for rigorous clinical trials and comprehensive safety assessments to validate these findings. Ultimately, this work aims to provide new insights into clarifying the mechanisms of action of traditional Chinese ethnomedicines and to guide future targeted research for developing potential anti‐RA drugs.

Preconception health (PCH) is a globally accepted strategy to reduce preventable adverse pregnancy outcomes and ultimately improve the health of the unborn child. Optimal PCH can be achieved through preconception care (PCC), which encompasses the behavioural, biomedical, and social interventions women and couples undertake and/or receive before conception. However, there is a lack of clarity on various aspects of PCH and PCC, such as what constitutes preconception risk factors, what the optimal interventions are, when the preconception period is, and who the overall target population is. Additionally, marginalised groups such as sexual and racial or ethnic minority individuals are routinely excluded from PCH research and PCC interventions. PCH and PCC are topical issues given changing societal norms worldwide, such as delayed childbirth, exponential rises in fertility treatments, and the growing trend of unplanned pregnancies. We hypothesised that the ambiguity surrounding the definition of PCH and PCC may limit their understanding and application to improve pregnancy and childhood outcomes. This is a systematic review of existing definitions of PCH and PCC to understand the commonalities and disparities in definitions and critical components of PCH and PCC, to aid in the development of a comprehensive and globally standardised definition. MEDLINE, PubMed, EMBASE, Cochrane Library, CINAHL, Google Scholar, PsychINFO, and Google were searched to identify published studies, guidelines, and public health websites containing definitions of PCH and PCC published between January 1993 and October 2024. No restrictions were placed on language. We searched academic databases, organisational reports, and policy documents to capture the full range of definitions across clinical, health, and policy contexts. The narrative synthesis of 176 publications showed heterogeneity in the definitions of PCH and PCC. The themes developed from the thematic analysis showed that PCC is preventative care which identifies and utilises interventions to manage individuals' preconception risk factors and aims to improve pregnancy outcomes by optimising the short- and long-term health of potential parents and their children. The analysis also showed that PCH is relevant across the entire reproductive lifespan. PCC was described as a continuum of care that occurs before conception and encompasses the health of all potential parents, not just women. This systematic review found there is a lack of universality in the definitions of PCH and PCC. Current definitions often narrowly focus on women planning pregnancy, which may exclude important demographics such as unintended pregnancies and fathers, and aligned health needs such as contraception in the preconception period. We propose that there is a need for a definition that captures various demographics and emphasises a life-course approach to reproductive health, acknowledging that the preconception period is much wider than only the period in which couples are actively trying to conceive. Congruence between policymakers, researchers, and public health professionals on the definition of PCH and PCC may address research operationalisation and clinical implementation to better assess global uptake and impact. CRD42023480536.

Recovery Colleges are adult education initiatives supporting personal recovery for individuals with mental health difficulties. We characterised a national (England) inception cohort of mental health service users, students from the Recovery Colleges Characterisation and Testing 2 programme, and compared those attending different Recovery College types on sociodemographic, clinical, service use and student-reported outcomes over the 4 months prior to enrolment. Mixed-effects regression models were used to assess differences. The cohort comprised 498 students from 36 Recovery Colleges across England; 77.7% attended strengths-oriented Recovery Colleges. Mean age was 39 years (s.d.12); most were female (72.1%) and White (81.5%). Common diagnoses were mood (31.3%) and anxiety disorders (29.7%). No significant differences were found between students attending strengths- versus community-oriented Recovery Colleges. Strengths- and community-oriented Recovery Colleges have similar service user student populations. Certain groups that may be underrepresented in Recovery Colleges and Recovery College research include older adults, men, those with developmental disorders and ethnic minority populations.

The United States (U.S.) healthcare system consistently underperforms in equity and value compared to peer countries. Socially disadvantaged groups, such as racial and ethnic minorities, refugees, and low-income populations, experience worse access to healthcare and poorer health outcomes. This issue highlights the need for targeted interventions to reduce disparities and improve healthcare quality in both public health and clinical practice. This scoping review aims to map existing literature on interventions that promote healthcare equity and value in the US, focusing on access to healthcare and health outcomes for disadvantaged populations. A scoping review of systematic reviews was conducted to map literature on high-value, equitable healthcare in the U.S. Using the Arksey and O'Malley framework and PRISMA-ScR guidelines, the review focused on systematic reviews of interventions, strategies, and policies promoting healthcare equity and value published between 2018 and 2023 that addressed U.S.-based healthcare. A two-step article selection process and qualitative synthesis of findings were employed. The review synthesized 54 studies, comprising mostly systematic reviews, scoping reviews, and meta-analyses. These studies focused on disadvantaged populations, including racial and ethnic minorities, refugees, and low-income groups. Interventions were categorized into four themes: community engagement and outreach (e.g., use of community health workers), culturally-tailored interventions (e.g., language-concordant care), technology adoption (e.g., digital health tools), and policy reforms (e.g., Medicaid expansion). Findings highlighted the critical role of community health workers and culturally responsive programs in improving access to care and health outcomes for disadvantaged populations. However, most interventions, including these approaches, aim to improve health outcomes measured across whole populations, rather than healthcare gaps between groups within populations. This review underscores the importance of culturally tailored interventions, community engagement and outreach, and policy reforms in addressing equity and value in healthcare. There is a significant gap in research directly tackling healthcare inequities. Future research should focus on system accountability, addressing structural inequities, and developing new care models to enhance equity and value.

ABSTRACT This paper critically examines how color-blind policies at a Minzu university that serves minority students shape the experiences of indigenous Tibetan students. It focuses on how ‘multicultural education’ (duoyuan wenhua jiaoyu) is implemented to integrate ethnic minority students in China’s ‘Minzu’ higher education system, while highlighting discrepancies between policy and practice. Drawing on critical ethnography of participant observation and in-depth interviews, this study explores how classroom interactions, campus life, and daily practices reflect contested expressions of ethnic identity. Despite institutional claims of inclusion, Tibetan students’ linguistic and cultural values are often overlooked, leading to their exclusion from both academic support and social integration. Although Tibetan students uphold strong cultural solidarity, the institutional structure of Minzu universities limits their ability to integrate their linguistic and cultural knowledge into academic success. Drawing on China’s experience, this paper explores how a top-down, color-blind approach marginalises minority groups, ultimately reinforcing linguistic and cultural exclusion in higher education. It challenges prevailing diversity rhetoric in educational practices and contributes to a reconsideration of educational inclusion from a contextually informed perspective.

Cardiovascular disease (CVD) remains the leading cause of premature death in England, with ethnic minority populations disproportionately affected, largely due to differences in socioeconomic factors, exposure and/or susceptibility to CVD risk factors. Midlife risk assessment does not fully account for observed variation in CVD incidence and mortality. Early and precise quantification of risk factor burden across diverse populations is therefore essential to inform targeted prevention strategies. This study assessed the prevalence of CVD risk factors in apparently healthy individuals residing in London. This cross-sectional study included CVD-free individuals aged 30-90years residing in London and registered with general practices using the Egton Medical Information Systems (EMIS) electronic health record system. Unadjusted, crude estimates of traditional CVD risk factors were assessed across participants of different ethnicities who underwent a CVD risk assessment between 2009-2020. Among 607,327 registered individuals, 83,414 were included (52.0% women, median age 45 [IQR:36-48] years). Ethnic distribution was as follows: White (43.6%), Asian (30.1%), Black (9.7%), Chinese/Other (4.0%), Mixed (2.1%). Overall, 7.8% were current smokers, 31.5% had obesity (universally defined as body mass index (BMI) ≥ 30.0kg/m2), 48.5% had elevated blood pressure (BP ≥ 140/90mmHg), 44.9% had hypercholesterolemia (≥ 5.0mmol/l), 28.2% had elevated triglycerides (TG) ≥ 1.7mmol/l, and 25.9% had low high-density lipoprotein cholesterol (HDL-C < 1.0/1.3mmol/l for males/females, respectively). Smoking prevalence was highest among White individuals (9.7%). Obesity prevalence varied across groups, with higher proportions in Black participants (42.3%) and lower in Asian individuals (26.1%). Elevated BP was recorded more frequently in Mixed (54.9%) and Black (53.0%) participants and less frequently in those classified as Chinese/Other (42.7%). Total cholesterol ≥ 5.0mmol/L was more commonly documented in Mixed (56.8%) and White (49.8%) participants. Higher proportions of Asian individuals had elevated TG (30.9%) and low HDL-C (31.6%), while corresponding proportions were lower among Black participants (14.4% and 19.5%, respectively). This large-scale analysis of a diverse population suggests variation in CVD risk factor burden among relatively young individuals without CVD. While not implying causality, these findings reflect inequalities between ethnic groups and support an appraisal of early, tailored, and equitable public health policies to improve CVD risk management across diverse populations.

Interventions to improve cancer screening adherence in migrants and ethnic minorities in the European Region: A systematic review.

The presence of historically underrepresented minority employees who defy negative stereotypes can have widespread organizational benefits. For example, hiring highly successful women and racial minority employees can reduce stereotypes about their groups, set a precedent for more inclusive norms, and create role models for members of stereotyped groups. Yet, defying stereotypes also makes these employees particularly salient, as their success in organizations conflicts with stereotyped expectations regarding their career outcomes. By integrating insights from the stereotype content model and the process of attribute substitution from dual process theory, we argue that the salience of highly successful women and racial minority employees can ironically have negative secondary consequences for the groups from which they hail. Specifically, we propose that exposure to successful women and racial minorities can lead to inflated perceptions of gender and racial diversity, as the salience of such stereotype defiers is used to evaluate their groups' prevalence. We further suggest that such inflated diversity perceptions can significantly hinder organizational efforts to advance the interests of the historically underrepresented minority groups in question. We test our predictions across four complementary studies: three experiments (including stimuli generated with real data for gender diversity in organizations in the United States) and a study that combines real gender diversity and gender pay gap data from organizations in the United Kingdom with experimental data on diversity perceptions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Workplace discrimination among registered nurses: The role of the nurse work environment.

Shifts in diversity along the spine surgery training pathway: racial, ethnic, and gender representation from medical school to fellowship.

Associations between state-level abortion restrictions and postpartum depression symptoms from a United States nationwide cohort.

Racial and Ethnic Disparities Persist in Outcomes After the 2015 Severe Sepsis and Septic Shock Early Management (SEP-1) Bundle.

Perceived need for care and treatment-seeking behaviour among ethnic minority groups exhibiting signs of mental illness.

Health experiences and inequalities across intersecting social identities in health research: a scoping review.

The Effects of Discrimination on Sleep, Diagnosis of Sleep Disorders, and Treatment.

Post-acute care (PAC) utilization following sepsis hospitalization remains understudied, particularly concerning racial and ethnic and urban-rural disparities. To examine trends and disparities in PAC utilization after sepsis hospitalization, focusing on race, ethnicity, and rurality. A comprehensive search of databases (PubMed, CINAHL, Embase, Web of Science, and Scopus) was conducted for eligible studies using data through March 2020. The Social Ecological Model guided the review. Eleven studies met inclusion criteria. Our synthesis found a discontinuous increase in PAC use, with a shift from home discharges toward greater use of nursing homes and home health care after 2006. White patients had higher PAC utilization than racial and ethnic minority individuals. Rural and urban non-teaching hospitals discharged more sepsis survivors to long-term care hospitals, while urban teaching hospitals had more discharges to HHC. This review establishes a pre-reform, pre-pandemic baseline for PAC utilization among sepsis survivors. Despite overall gains, disparities in PAC utilization persist by race, ethnicity, and hospital type. As payment and care delivery models have evolved since 2016, future research should leverage this historical baseline to assess the impact of new policies on equitable PAC access for sepsis survivors.

Racial and/or ethnic and rural disparities in health care utilization before major lower extremity amputation in patients with peripheral artery disease.