Underrepresented Ethnic Minority Research Articles

Abstract 4849: Mosaic chromosomal alterations in a prospective cohort of Mexican Americans for cancer risk and genetic insights

Abstract Introduction: In this study, we aim to explore mosaic chromosomal alterations (mCA) and their implications in cancer risk among Mexican Americans (MA) - an expanding yet historically underrepresented ethnic minority in the U.S. In addition, we propose to develop a novel method that identifies high mutant cell fraction (MCF) copy-neutral Loss of heterozygosity (cn-LOH). At sufficiently high MCF, these will look like runs of homozygosity (ROH) and may be missed by current mCA detection techniques that rely on identified germline heterozygote genotypes. Our preliminary findings revealed frequent and widespread homozygosity across the genome, predominantly in short regions (<10 Mb), although some exceeded 100 Mb. Our objective is to advance mCA detection techniques, differentiating cn-LOH from ROH, to deepen our understanding of mCA. Methods: We analyzed SNP array data from blood and saliva samples of 1657 individuals, focusing on cancer and chronic disease risk ages, from the Mano a Mano Mexican American Cohort Study. We applied hapLOH and MoChA, both haplotype-based methods, to detect mCA. To identify high-MCF cn-LOH, we first scanned for observed ROH using PLINK. Separately, we develop a statistical framework through simulations to differentiate high-MCF cn-LOH from ROH. We considered multiple methods; initially, we built a statistical framework using a hypothesis-testing approach (H0: ROH; H1: cn-LOH), where we compared the “B allele” frequency information within observed ROH. To split this information and obtain our groups, we used population genetic principles. Secondly, we classified our events, calculating the likelihood ratio of our statistical hypotheses. Finally, we explored a haplotype-based imputation approach that leverages flanking diploid region information. Results: We identified numerous mCA, predominantly in individuals without cancer. Simulations showed effective classification in larger homozygosity regions (>10 Mb), guiding our methodological focus on detecting shorter high-MCF regions. Not surprisingly, extremely high MCFs (0.99-1) presented challenges in accurate identification. Conclusion and Future Directions: To improve our mCA results description, we will thoroughly characterize and study their association with cancer phenotypes and environmental exposures. We are in the process of genotyping the entire cohort, which consists of over 25,000 participants. To date, our cohort includes 909 cancer cases, of which 262 are hematological malignancies. We sought to design a unique method that differentiates high-MCF cn-LOH from observed ROH, improving current mCA discovery. Our focus is on small regions as they provide limited information to infer event types. Our next step is to characterize and validate our results, especially in pathologically normal samples, as a way of identifying potential biomarkers of interest. Citation Format: Jessica Valdebenito, Justin Wong, Dahwei Chang, Henry Gomez, Kevin T Nead, Yasminka Jakubek, Paul Scheet. Mosaic chromosomal alterations in a prospective cohort of Mexican Americans for cancer risk and genetic insights [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4849.

Representing diversity in a liberal democracy: a case study of Australia

ABSTRACT Political representation of ethnic minorities in a liberal democratic system is a crucial step towards having the interests of ethnic minority groups heard. The under-representation of ethnic minorities in a political institution can exacerbate inequality between majority and minority populations and increase feelings of alienation among minority groups. As a country observing increasing ethnic diversity, Australia saw record-level ethnic minority candidates elected in the 2022 federal election. However, the shares of candidates and elected Members of Parliaments with ethnic minority backgrounds are still much lower than their relative shares in the population. In this regard, Australia has lagged behind other major settler countries. In this paper, we examine the political representation of ethnic minorities in Australia’s federal election. Drawing on data from the 2022 federal election and 2021 population census, we find a positive association between ethnic minority concentration and ethnic representation. However, for the two major parties, ethnic minority candidates are less likely to be in safe seats, even when the seat observes high ethnic minority concentration. Findings suggest that ethnic voting is evident but it is perhaps too early to celebrate higher levels of ethnic representation in Australian politics as political parties act as gatekeepers in safe seats.

Palliative Care Clinical Trials in Underrepresented Ethnic and Racial Minorities: A Narrative Review

Palliative Care Clinical Trials in Underrepresented Ethnic and Racial Minorities: A Narrative Review

Representativeness in health research studies: an audit of Greater Manchester Clinical Research Network studies between 2016 and 2021

BackgroundThere are increasing concerns that participants in health research in the UK are not representative of the UK population, risking widening health inequities. However, detailed information on the magnitude of the problem is limited. Therefore, we evaluated if the health research conducted in the Greater Manchester region was broadly representative of its diverse population.MethodsWe conducted an audit of all health research studies conducted exclusively in Greater Manchester, using data from a national research network. Two researchers selected studies that were (1) an interventional or observational study of a health outcome; (2) ‘closed’ for recruitment between May 2016 and May 2021 and (3) human research. They extracted study information (dates, contacts, sample recruited, clinical speciality). Participant characteristics were sourced from published and unpublished manuscripts and requested directly from principal investigators and named study contacts.Data were extracted, summarised and compared to the Greater Manchester population for the following metrics: ethnicity, sex, age, deprivation and smoking status. A weighted mean age estimate was calculated to account for variation in age reporting. Too few studies provided patient-level deprivation data so, using the area code of the recruitment site, the area level multiple deprivation, health deprivation and disability index and decile was derived. These data were geo-mapped using QGIS 3.26.ResultsOverall, 145/153 (95%) studies met inclusion criteria and participant information was sourced for 85/145 (59%) studies, representing 21,797 participants. Participant information was incomplete for all metrics. Where ethnicity (N = 10,259) data were available and compared to Greater Manchester estimates there was evidence that ethnic minorities were under-represented (6% versus 16%). Most of the recruitment occurred in central Manchester (50%) and with NHS hospital settings (74%).ConclusionsGreater Manchester health research in 2016–2021 was centralised and under-represented ethnic minorities. We could not report which ethnic minority group was least represented because sourcing detailed participant information was challenging. Recommendations to improve the reporting of key participant characteristics with which to monitor representativeness in health research are discussed.

DISP-13. ENHANCING HISPANIC PARTICIPATION IN BRAIN TUMOR TRIALS

Abstract BACKGROUND Hispanics represent 18.9% of the U.S. population, 26.8% of Florida population, and is the fastest growing ethnicity in the country. Hispanic representation in clinical trials remains extremely low at less than 3%. Increasing the Hispanic participation rate in clinical trials has been a priority for the University of Miami (UM), who has implemented various initiatives to improve diversity and inclusion of underrepresented ethnic minorities (URM) within our clinical trials, especially brain tumor trials. Efforts such as community outreach raising awareness of clinical trials, translation of informed consents to Spanish, use of bilingual staff trained in cultural communication diversity and inclusion, dedicated social workers and community seminars have played a crucial role at enhancing Hispanic participation within our brain tumor studies. Method Retrospective review using UM’s clinical trial registry to analyze demographics of brain tumor patients consented to therapeutic/non-therapeutic trials between May 2017 to May 2023. RESULTS A total of 431 patients were consented of which 313 (72.4%) actively participated in therapeutic/non-therapeutic trials and 118 (25.1%) screened-failed. Of the accrued participants, 283 (90.42%) self-identified as White, 16 (5.11%) Black/African American, 5 (1.60%) more than one race, 4 (1.28%) Asian, 4 (1.28%) unknown/unreported and 1 (0.32%) American Indian/Alaskan Native. For ethnicity, 160 (51.12%) self-identified as Hispanic/Latino, 148 (47.28%) as non-Hispanic, and 5 (1.60%) were unknown/unreported. 143 (45.69%) were females and 170 (54.31%) were males. For age, 43 (13.73%) were 18-39, 191 (61.02%) 40-64 and 79 (25.24%) were 65 and over. CONCLUSION There is extensive evidence that patients from URM’s groups may not be afforded the same opportunity to participate in clinical trials and thus benefit from advanced therapies offered via them. Efforts to ensure meaningful representations of Hispanics in our brain tumor trials have led to a high accrual rate of Hispanics above national norms to better represent our community's demographics.

Abstract 18478: Association of Family History and Cardiomyopathy-Associated Gene Variants of Unknown Significance in Ethnic Minority Patients With Early Onset Atrial Fibrillation

Introduction: Underrepresentation of ethnic minorities in genetic studies can complicate interpretation of variants of unknown significance (VUS) in these groups. Likely pathogenic or pathogenic (LP/P) cardiomyopathy (CM) gene variants are associated with early onset-atrial fibrillation (EOAF) in a cohort of predominantly European ancestry, but prevalence in minorities, and the role of VUS, is unclear. Three-generation family history (FH) may provide insight into the potential pathogenicity of VUS in ethnic minorities. Hypothesis: In patients with EOAF and low comorbidity burden carrying CM VUS, does positive FH suggest variant pathogenicity? Aims: To determine whether CM gene VUS in ethnic minority probands with EOAF are associated with a FH of arrhythmia, stroke, or heart failure. Methods: Of 301 individuals from the University of Illinois Health Multi-Ethnic AF Registry who underwent whole exome sequencing, we identified 89 with either LP/P variant, positive FH from medical records, or AF diagnosis age ≤55 years and ≤2 comorbidities. We examined 22 genes strongly associated with CM and graded pathogenicity according to American College of Medical Genetics criteria. A three-generation FH was obtained by contacting probands or family members. Results: A FH was obtained in 36 patients (Figure 1a; median age 52 years, 56% female, 83% African-American, 17% Hispanic/Latinx). LP/P variants were present in 3 (8%) probands, VUS in 10 (28%), and likely benign/benign (LB/B) or no variant in 23 (64%). A FH of arrhythmia, heart failure, or stroke was present in 27 subjects (75%) with a FH of heart failure more likely in VUS carriers compared to those with LB/B or no variant (70% vs 26%, p=0.02), with no difference in FH of arrhythmia or stroke. Conclusion: Probands with EOAF who carry CM VUS have greater rates of FH of heart failure than those without disease-associated variants. This suggests pathogenicity of CM VUS in ethnic minorities with EOAF.

Breaking barriers: Effective interventions amplifying minority participation in cancer clinical trials.

201 Background: Cancer-related mortality is disproportionately higher in marginalized populations, necessitating adequate representation in cancer clinical trials. Historically, this goal has been challenging, despite recognition of the importance for clinical practice. Moreover, minority recruitment has decreased in oncology clinical trials published from 2003-2016, indicating an urgent need for effective interventions for this issue. Methods: We conducted a systematic review of interventions focused on increasing minority recruitment/retention in cancer clinical trials between 2012-2023, or on improving attitudes of minority groups towards enrollment. We queried Embase and Scopus databases for articles/abstracts that focused on underrepresented ethnic minority enrollment in cancer clinical trials, in English language, were conducted in the US, Canada, Australia, New Zealand, or Western Europe, and were investigating effectiveness of interventions to improve minority enrollment in adult populations. Results: 261 unique articles/abstracts met our search criteria, with an additional 55 duplicates. 117 were removed for being irrelevant or too old, 31 for being reviews, 85 due to not containing an intervention, 5 for not reporting minority data, and 6 for not adequately comparing the strength of interventions. 17 met all inclusion criteria. Several interventions were identified, including targeted patient education (n=7), assigning patient navigators (n=6), community organization engagement (n=3), nested family/community approaches (n=2), and financial assistance (n=1). Targeted education involved video, audio, or interactive mediums. Most studies involved Black (n=12) and Hispanic (n=5) populations, with a smaller number focusing on Asian/Asian Pacific Islanders (n=2), Arabs (n=1), and Indian/South Asians (n=1). Geographically, these studies were notably concentrated in the American South (n=7). The Midwest and Mid-Atlantic regions contributed equally (n=3 each), and fewer studies were from the Northeast and West (n=2 each). Conclusions: Racial minorities continue to be underrepresented in cancer clinical trials, underscoring the need for concerted efforts to promote healthcare equity and enhance these trials’ generalizability. In our systematic review, targeted education, patient navigators, and active community engagement emerged as efficacious strategies, and were the most frequently utilized to bolster minority enrollment. Future studies should prioritize investigating and implementing these interventions, to ensure diverse, representative, and applicable clinical trial participation.

How is ethnicity reported, described, and analysed in health research in the UK? A bibliographical review and focus group discussions with young refugees

BackgroundThe ethnicity data gap pertains to 3 major challenges to address ethnic health inequality: 1) Under-representation of ethnic minorities in research; 2) Poor data quality on ethnicity; 3) Ethnicity data not being meaningfully analysed. These challenges are especially relevant for research involving under-served migrant populations in the UK. We aimed to review how ethnicity is captured, reported, analysed and theorised within policy-relevant research on ethnic health inequities.MethodsWe reviewed a selection of the 1% most highly cited population health papers that reported UK data on ethnicity, and extracted how ethnicity was recorded and analysed in relation to health outcomes. We focused on how ethnicity was obtained (i.e. self reported or not), how ethnic groups were categorised, whether justification was provided for any categorisation, and how ethnicity was theorised to be related to health.We held three 1-h-long guided focus groups with 10 young people from Nigeria, Turkistan, Syria, Yemen and Iran. This engagement helped us shape and interpret our findings, and reflect on.1) How should ethnicity be asked inclusively, and better recorded?2) Does self-defined ethnicity change over time or context? If so, why?ResultsOf the 44 included papers, most (19; 43%) used self-reported ethnicity, categorised in a variety of ways. Of the 27 papers that aggregated ethnicity, 13 (48%) provided justification. Only 8 of 33 papers explicitly theorised how ethnicity related to health.The focus groups agreed that 1) Ethnicity should not be prescribed by others; individuals could be asked to describe their ethnicity in free-text which researchers could synthesise to extract relevant dimensions of ethnicity for their research; 2) Ethnicity changes over time and context according to personal experience, social pressure, and nationality change; 3) Migrants and non-migrants’ lived experience of ethnicity is not fully inter-changeable, even if they share the same ethnic category.ConclusionsEthnicity is a multi-dimensional construct, but this is not currently reflected in UK health research studies, where ethnicity is often aggregated and analysed without justification. Researchers should communicate clearly how ethnicity is operationalised for their study, with appropriate justification for clustering and analysis that is meaningfully theorised. We can only start to tackle ethnic health inequity by treating ethnicity as rigorously as any other variables in our research.

A structural model of student experiences in a career‐forward chemistry laboratory curriculum

AbstractPersistence is a major issue facing students, particularly those who are both female and from underrepresented ethnic minorities (URM). A closer look at the variables affecting their commitment and capacity for continuing the pursuit of their goal allows us to better design support systems that bolster persistence. This study tests a structural equation model (SEM) for students using a career‐forward laboratory chemistry curriculum based upon the Mediation Model of Research Experience (MMRE) that explains the relationships among self‐efficacy, identity as an engineer, and commitment to an engineering career. Data were collected from 426 undergraduate engineering majors at the end of the semester using a previously constructed survey for three semesters of general chemistry laboratory for engineering majors. The research question was addressed using bivariate correlations and a series of SEMs where multigroup analyses were conducted separately for non‐URM and URM participants. Bivariate correlations show significant positive associations between all four variables for the entire group of students. However, when disaggregated, the only significant association for URM participants (n = 109) was between identity as an engineer and commitment to an engineering career. Notably, teamwork self‐efficacy was a negative predictor of commitment to an engineering career for URM participants. Beta‐coefficients from the SEM show that identity and engineering self‐efficacy are the variables most predictive of commitment, with identity being nearly twice as predictive for URM students. This study adds support for professional identity as a key predictive variable for career commitment for URM participants and indicates that a laboratory curriculum that emphasizes applied professional practice can support persistence. Considering the degree to which teamwork is emphasized generally, additional studies are needed to better understand the implications for URM students. Particularly in applications that emphasize long‐term outcomes.

Factors associated with emergency physician income.

Income fairness is important, but there are limited data that describe income equity among emergency physicians. Understanding the magnitude of and factors associated with income differences may be helpful in eliminating disparities. This study analyzed the associations of demographic factors, training, practice setting, and board certification with emergency physician income. We distributed a survey to professional members of the American College of Emergency Physicians. The survey included questions on annual income, educational background, practice characteristics, gender, age, race, ethnicity, international medical graduate status, type of medical degree (MD vs DO), completion of a subspecialty fellowship, job characteristics, and board certification. Respondents also reported annual income. We used linear regression to determine the respondent characteristics associated with reported annual income. From 45,961 members we received 3407 responses (7.4%); 2350 contained complete data for regression analysis. The mean reported annual income was $315,306 (95% confidence interval [CI], $310,649 to $319,964). The mean age of the respondents was 47.4 years, 37.4% were women, 3.2% were races underrepresented in medicine (Black, American Indian, or Alaskan Native), and 4.8% were Hispanic or Latino. On linear regression, female gender was associated with lower reported annual income; difference -$43,565, 95% CI, -$52,217 to -$34,913. Physician age, degree (MD vs DO), underrepresented racial minority status, and underrepresented ethnic minority status were not associated with annual income. Fellowship training was associated with lower income; Accreditation Council for Graduate Medical Education (ACGME) program difference -$30,048; 95% CI, -$48,183 to -$11,912, non-ACGME-program difference -$27,640, 95% CI, -$40,970 to -$14,257. Working at a for-profit institution was associated with higher income; difference $12,290, 95% CI, $3693 to $20,888. Board certification was associated with higher income; difference, $43,267, 95% CI, $30,767 to $55,767. This study identified income disparities associated with gender, practice setting, fellowship completion, and American Board of Emergency Medicine or American Osteopathic Board of Emergency Medicine certification.

The Maoist Insurgency and Peace Process in Nepal

The Nepalese civil war, or People’s War, was the result of stalled peace negotiations between the democratic government and the paramilitary wing of the Communist Party of Nepal (Maoist). Nepal's first decade of democracy is considered turbulent due to frequent government changes, internal party battles and corruption. Politics continued to be dominated by the Brahmin and Chhetri castes with an underrepresentation of ethnic minorities and women. Nepal Communist Party Maoist said that the insurgency began to fight against the 250 years long monarchy, deeply rooted economic & social discrimination & prejudices, Feudal system and against all kinds of injustices & inequalities prevalent in the society.

UCHINANCHU AMERICAN OLDER ADULTS’ INFORMATION PREFERENCES AND BEHAVIORS IN END-OF-LIFE DECISION-MAKING

Abstract End-of-life (EOL) decisions are unique and sensitive, requiring nuanced health information. Careful examination of ethnic minority older adults’ information preferences and behaviors in EOL decision making from a cultural perspective is increasingly necessary as the national and global population grows older and more diverse. Little is known about the information preferences and behaviors of Asian American older adults in EOL decision-making, especially for underrepresented ethnic minorities such as Uchinanchu American older adults. This pilot study examined Uchinanchu American older adult’s information preferences and behaviors in EOL decision making. In November 2019, I interviewed 4 Uchinanchu American older adults (age range: 67-85 years; Mean: 76 years; SD: 8.04) recruited from personal contacts and through Uchinanchu cultural groups in Texas and Hawaii. The interviews took place in-person and via phone. Each interview lasted approximately 90 minutes. Interviews were transcribed verbatim and analyzed using inductive thematic analysis. I identified three themes from the data: (1) EOL decision-making information not coming from healthcare professionals; (2) Funeral planning easier to talk about than advance EOL medical decision making; and (3) Cultural traditions may exclude people (women; non-first born children) from EOL decision making. My findings suggest possible misalignments of EOL communication between medical professionals and Asian ethnic minority older adults. These findings may inform the development of culturally competent interventions to enhance EOL decision making.

Characteristics and Outcomes of Multiple Myeloma in Hispanic Versus Non-Hispanic Patients in Central California

Background: Multiple Myeloma (MM) accounts for roughly 10% of all hematologic cancers in the U.S., with 37% of MM patients being non-white minorities. Advanced stage at diagnosis and specific cytogenetic abnormalities are associated with high-risk disease and poor prognosis. Studies evaluating these risk factors, however, consisted of mostly Caucasian patients with an underrepresentation of ethnic minorities. In the phase III DETERMINATION trial, ~18% of the study population was Black compared to only ~6% Hispanic, with the rest being Caucasian. Although this study showed significant overall progression free survival (PFS) benefit in transplant patients, this was not seen in the Black patient subgroup. To further investigate outcomes of other ethnic MM patients in the Central Valley of CA, we analyzed characteristics and outcomes of MM patients who were seen at Community Medical Centers in Fresno CA (49.6% Hispanic population). Methods: Patients diagnosed with MM at Community Medical Centers from January 2011 to December 2020 were included. High risk disease was defined by the Mayo Clinic mSMART 3.0 classification. Demographic and disease-relevant information including age at diagnosis, gender, ethnicity (Hispanic vs non-Hispanic), insurance, median income by zip code, laboratory data at diagnosis (hemoglobin, creatinine, corrected Ca, LDH, beta 2 microglobulin), immunoglobulin type, light chain type, cytogenetic abnormalities, stage (R-ISS), 1st line treatment (doublet vs triplet), transplant status, and treatment response (IMWG response criteria) were collected. Comparisons between Hispanics and non-Hispanics were made by Fisher's exact test and nonparametric equality-of-medians test where appropriate. Outcomes were compared via log-rank testing and Kaplan-Meier estimates for 2 year PFS and overall survival (OS). Univariate cox proportional hazard model for survival was used to examine the association of demographic and MM variables with mortality risk after first line therapy. Results: 117 MM patients were included with 42 high risk patients identified (11 Hispanic, 31 non-Hispanic). Median age at diagnosis of Hispanics vs non-Hispanics was 61.7 vs 66.5 years (p=0.046). Hispanic vs non-Hispanic median income was $49734.50 vs $62588.90 (p=0.003). Insurance status differed significantly with more Hispanics having Medi-Cal and non-Hispanics having private/Medicare (p=0.001). 13 non-Hispanics had 17p del vs 0 Hispanics (p=0.001). Hispanics and non-Hispanics did not have significantly different responses to first line therapy per IMWG criteria (p=0.535). Hispanic and non-Hispanic patients experienced similar 2 year PFS and OS (PFS: 63% vs. 60%, p=0.744; OS: 94% vs 85%, p=0.145). 14 Hispanics and 20 non-Hispanics underwent autologous stem cell transplant. No significant difference in 2 year PFS was seen in transplanted Hispanics vs transplanted non-Hispanics (p=0.228) and transplanted Hispanics vs non-transplant Hispanics (p=0.297). High risk transplanted Hispanics showed significantly worse 2 year PFS vs standard risk transplanted Hispanics (25% vs 80%, p=0.009). Transplanted Hispanics differed from non-transplant Hispanics by median age (55.5 vs 67, p=0.05) and income ($56510.00 vs $42418.00, p=0.01). Conclusions: Hispanic MM patients were younger at diagnosis, earned a lower median income, and had more Medicaid coverage compared to non-Hispanics. These differences did not translate to a difference in first line therapy, treatment response, or survival. Transplanted Hispanics were younger and had higher income than non-transplant Hispanics, suggesting that socioeconomic factors may play a role in transplant eligibility. Undergoing transplant, however, did not show a significant PFS benefit compared to Hispanics and non-Hispanics who did not undergo transplant. High risk Hispanics still had inferior PFS compared to standard risk Hispanics after transplant. Additional studies and longer follow-up are needed to confirm these findings. If validated, they could potentially influence treatment decisions for Hispanic MM patients. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Intentional and unintentional benefits of minority writing accountability groups.

A faculty position can be a balancing act. Many new faculty, particularly minorities, struggle due to a lack of mentorship. Writing accountability groups (WAGs) offer new faculty an opportunity to glean advice from mentors and improve their writing skills and enhance their career development in science, technology, engineering, and mathematics (STEM).

Diversity trends in the leadership of the American Society for Laser Medicine And Surgery, 1996-2021.

To evaluate the temporal trends in diversity within the ASLMS board of directions from 1996 to 2021. A list of Board of Directors from 1996 to 2021 was obtained from ASLMS headquarters. Using a composite of publicly available resources through internet searches, board director characteristics, such as age, gender, race/ethnicity, terminal degrees, specialties/field of expertise, and current full-time affiliations, were recorded. One hundred forty-six unique individuals held 628 ALSMS board member positions from the years 1996-2021. The median age of the board members started with a median age of 43.0 years old in 1996 to 54.5 years old in 2021. The age spread between first and third quartiles (interquartile range) in each year in more recent years (2014-2019) was 17.0, 20.0, 18.8, 18.8, 18.0, and 15.3 years, respectively. Female representation started with 10.5% in 1996 to 30.8% in 2021. Diversity, by racial/ethnicity measures, has more representation of Asian (average across 1996-2010: 2.3% to 2010-2022: 19.0%) and Hispanic (average 1996-2010: 0.7% to 2010-2022: 4.4%) board members. No African American has held a position across these decades. MD holders (average 66.5%) and other degree holders (average 33.5%) have been relatively consistent across all years observed. From 2016 to 2021, dermatologists held board member seats at an average rate of 56.5% across these years, while prior, from 1996 to 2015, 67.3% of board member seats on average were held by members of other expertises. Most board members have full-time affiliations in private practice across most years observed (average 43.7% across all years observed). After analyzing the diversity trends across board members in ASLMS across 1996-2020, we have noticed overall trends of increased diversity over time that reflect a greater chance of bringing in new ideas and experiences to grow ASLMS. Although the leadership of ASLMS has become significantly more diverse over time, there remain opportunities to increase diversity further, including women, underrepresented ethnic minorities, and other experts of specialties other than dermatology.

Nutritional Challenges and Dietary Practices of Ethnic Minority (Indigenous) Groups in China: A Critical Appraisal

Indigenous food systems can affect multiple aspects of Indigenous people's health. In China, the government declared that there are no Indigenous people in China and used the term “ethnic minority groups” instead. However, to date, no attempt has been made to investigate the nutrition status and dietary practices of all 55 ethnic minority groups. To understand this pertinent issue, a systematic review is required. The main selection criteria were publications should be about nutrition status or dietary practices among ethnic minority groups in China, specify the name of the ethnic minority group, and be published within the past 10 years. For this literature review, 111 publications were selected through Wanfang Med Online for Chinese publications and Google Scholar for English publications. Linear regressions were applied to explore what factors can affect the total number of publications for an ethnic minority group. The main findings include that only 15 ethnic minority groups have dietary intake data representing the general people of the ethnic group; only seven ethnic minority groups have data for both nutrition status (anthropometric and nutrients intake/deficiency) and dietary practices (dietary intake and dietary habits); there are still 10 ethnic minority groups with a total number of population 845,420 that lack studies on both nutrition status and dietary practices; ethnic minority groups are suffering from double-burden malnutrition and consuming unbalanced diets; primary and middle school students are the most prevalent study population than any other age group due to easy access; and an ethnic minority group is likely to have more publications about nutrition status and dietary practices if they have a larger population or are unique to a region. The results indicate that more national-level programs and timely nutrition and dietary reports should be implemented to address double-burden malnutrition and unbalanced diets among ethnic minority groups in China. More studies involving maternal nutrition, targeting underrepresented ethnic minority groups and age groups, and exploring traditional food systems in China are also essential to better understand and address this issue.

Underrepresentation of ethnic minorities in hypertension research—a survey of enablers and barriers among South Asian and African communities in Glasgow

BackgroundHypertension is the biggest contributor to the global cardiovascular burden with evidence for ethnic differences in treatment response and outcomes. Under-representation of ethnic minorities in clinical research is well known, and despite wide-ranging public engagement events by the Glasgow Blood Pressure Clinic team, there was a lack of participation of ethnic minorities in both engagement activities and clinical trials conducted by them. This study aims to explore the awareness and knowledge of hypertension and the facilitators and barriers to participation in hypertension clinical research among South Asian (SA) and African (AFR) communities in Glasgow.MethodsA survey questionnaire was co-developed with representatives from South Asian (SA) and African (AFR) patients and community members in Glasgow to understand awareness and knowledge of hypertension and enablers and barriers to participation in clinical research. The survey was distributed to adults (aged > 18) years of SA or AFR ancestry at public engagement events at venues that were frequently visited by these two communities in Glasgow.ResultsThe survey response rate was 337 (67.4%) consisting of 242 (71.8%) South Asian (SA) and 56 (16.9%) African (AFR) respondents. Thirty-nine questionnaires were excluded because of incompletion. Most of the respondents were not born in the UK and were in the 35–53-year group (AFR 29 (51%), SA 113 (47%)). The proportion living in the most deprived (SIMD 1) and least deprived (SIMD 5) was respectively 26 (12.4%) and 34 (16.2%) for SA and 20 (42.6%) and 2 (4.3%) for AFR. There was a considerable recognition that treatment needs to be ethnicity-specific (SA/AFR = 107 (48%)/23 (45.1%)) and that current cardiovascular disease treatment guidelines were not tailored for different ethnicities 84 (38.5%)/23 (45.1%). The key enablers encouraging research participation are enhanced health information, conducting aspects of their clinical research visits/appointments at a location they frequently visited and allowing a family member to accompany them. Barriers included concerns about the use of personal information and side effects of the new treatment.ConclusionOur survey confirmed enablers and barriers to ethnic minority participation in research. We find improving and evolving awareness and beliefs among the ethnic minority population including community leaders. Thus, continual review of researchers’ beliefs and attitudes is also essential to ensure engagement activities keep up with these changing perceptions.

Managing diversity: an assessment of the national question in Pakistan

ABSTRACT Modern societies are confronted with a plethora of issues that have far-reaching socio-political ramifications. The negative effects of diversity are primarily the result of state policies. Where societies were not homogenous, attempts were made to bring desperate populations together to advance official nationalist projects. Pakistan, being dominantly a Muslim state, has religio-cultural and ethnic diversity where minority groups have raised their voices against the unjust state’s policies. This study examines how these issues evolved over the course of Pakistan’s history. The paper attempts to answer the question ‘why has Pakistan’s plurality become unmanageable?’ The results demonstrate that a high degree of centralization of authority, the adoption of Urdu as a national language, a sense of domination of the central institutions by the Punjabis, underrepresentation of ethnic minorities in state institutions, and controlled society has aggravated the position of diverse groups in Pakistan, with colossal consequences to national economy and social harmony.

Underrepresented Ethnic Minority Nursing Students' Perceptions of Factors That Enhanced or Hindered Their Self-Efficacy.

Self-efficacy is the perceived confidence of students in their ability to learn new skills and knowledge. This study examined underrepresented ethnic minority students' perceptions of the factors that enhanced/hindered their self-efficacy in a bachelor of science in nursing program. Qualitative analysis revealed three themes: 1) doing it, 2) connecting with clinical faculty, and 3) dealing with multiple stressors. Students described clinical faculty's teaching strategies that enhanced their nursing self-efficacy as they managed multiple stressors in their lives.

The varied experience of undergraduate students during the transition to mandatory online chem lab during the initial lockdown of the COVID-19 pandemic

The radical global shift to online teaching that resulted from the initial lockdown of the COVID-19 pandemic forced many science educators into the predicament of translating courses, including teaching laboratories, that were based upon face-to-face or practical goals and conventions into ones that could be delivered online. We used this phenomenon at the scale of a research-intensive, land-grant public institution to understand the various ways that the switch was experienced by a large cohort of 702 undergraduate students taking General Chemistry Laboratory. Data was collected over 3 weeks with identical surveys involving four prompts for open-ended responses. Analysis involved sequential explanatory mixed methods where topic modeling, a machine learning technique, was used to identify 21 topics. As categories of experience, these topics were defined and further delineated into 52 dimensions by inductive coding with constant comparison. Reported strengths and positive implications tie predominantly to the topics of Time Management Across a Lab Activity and a Critique of Instruction. Consistent with other reports of teaching and learning during the pandemic, participants perceived Availability of the Teaching Assistant for Help as a positive implication. Perceptions of weakness were most associated with Having to Work Individually, the Hands On Experience, a Critique of Instruction, and Learning by Doing. Hands on Experience, which was interpreted as the lack thereof, was the only topic made up nearly entirely of weaknesses and negative implications. The topic of Learning by Doing was the topic of greatest occurrence, but was equally indicated as strengths, positive implication, weakness, and negative implication. Ramifications are drawn from the weaknesses indicated by students who identified as members of an underrepresented ethnic minority. The results serve as a reminder that the student experience must be the primary consideration for any educational endeavor and needs to continue as a principal point of emphasis for research and development for online science environments.