White Ethnic Groups Research Articles

Incidence of long-term conditions in the Latin American community of London: A validation and retrospective cohort study of 890,922 primary care records, 2005-2022.

Minoritised populations in the United Kingdom frequently identify in multiple ethnic groupings and therefore little is known of their health needs. There were 136,062 Latin American people recorded in the 2021 UK Census across six different ethnic groups. Characterise the incidence of long-term conditions (LTCs) and multiple LTCs (mLTCs) amongst the Latin American community of London. Compare the incidence of LTCs in the Latin American population to other ethnic groups. Retrospective cohort study using pseudonymised primary care data from 890,922 individuals in an urban, superdiverse area of London from 2005-2022. Latin American individuals were identified using country of birth, language and ethnicity codes, and validated against Census findings. Multivariable competing risks regression models estimated the effect of being Latin American, compared to the White British ethnic group, on incidence of 32 LTCs and risk factors relevant to urban populations. 28,617 Latin American people were identified in this cohort, 3.2% of total. In multivariable analysis, compared to the White British ethnic group, being Latin American was associated with twice the rate of HIV/AIDS (hazard ratio (HR) 2.00; 95% confidence interval (CI) 1.65-2.43), 60% increased rate of diabetes (HR 1.61; 95%CI 1.47-1.77) and almost twice the rate of systemic lupus erythematosus and rheumatoid arthritis (HRs 2.28; 95% CI 1.18-4.38 and 1.69; 95% CI 1.32-2.17 respectively). Using commonly-recorded primary care codes accurately and reliably identifies markedly higher risks of HIV/AIDS, diabetes and joint disease among London's Latin American population. These data can be used to target inclusive and equitable health interventions.

Incidence of diabetes mellitus following hospitalisation for COVID-19 in the United Kingdom: A prospective observational study.

People hospitalised for coronavirus disease 2019 (COVID-19) have elevated incidence of diabetes. However, it is unclear whether this is due to shared risk factors, confounding or stress hyperglycaemia in response to acute illness. We analysed a multicentre prospective cohort study (PHOSP-COVID) of people ≥18 years discharged from NHS hospitals across the United Kingdom following COVID-19. Individuals were included if they attended at least one research visit with a HbA1c measurement within 14 months of discharge and had no history of diabetes at baseline. The primary outcome was new onset diabetes (any type), as defined by a first glycated haemoglobin (HbA1c) measurement ≥6.5% (≥48 mmol/mol). Follow-up was censored at the last HbA1c measurement. Age-standardised incidence rates and incidence rate ratios (adjusted for age, sex, ethnicity, length of hospital stay, body mass index, smoking, physical activity, deprivation, hypertension, hyperlipidaemia/hypercholesterolaemia, intensive therapy unit admission, invasive mechanical ventilation, corticosteroid use and C-reactive protein score) were calculated using Poisson regression. Incidence rates were compared with the control groups of published clinical trials in the United Kingdom by applying the same inclusion and exclusion criteria, where possible. Incidence of diabetes was 91.4 per 1000 person-years and was higher in South Asian (incidence rate ratios [IRR] = 3.60; 1.77, 7.32; p < 0.001) and Black ethnic groups (IRR = 2.36; 1.07, 5.21; p = 0.03) compared with White ethnic groups. When restricted to similar characteristics, the incidence rates were similar to those in UK clinical trials data. Diabetes incidence following hospitalisation for COVID-19 is high, but it remains uncertain whether it is disproportionately higher than pre-pandemic levels.

Inequalities in cancer incidence in Wales by sociodemographic characteristics: a population-based cohort study

BackgroundInternational studies suggest cancer incidence rates may vary by protected characteristics. This study aims to identify cancer incidence inequalities among different sociodemographic characteristics in Wales, including ethnicity, occupation, household tenure, and overcrowding, and determine which specific cancer types disproportionately affect certain groups. MethodsCancer incidence data for 2011–20 were obtained from the Welsh Cancer Intelligence and Surveillance Unit and linked to the National Census (2011) for sociodemographic characteristics. Cancer registration data captures all primary tumours for the resident population of Wales. Missing ethnicity data was supplemented using the SAIL Ethnicity Spine with 97·8% of cancer diagnoses linking to an ethnic group. The analysis considered all cancers combined, lung, female breast, prostate and colorectal cancers. Counts, crude rates, European age-standardised rates, and proportions of cancer incidence were calculated for each ethnic group. FindingsAge-standardised rates for all cancers combined are highest in the white ethnic group, but not statistically significantly higher than the mixed/multiple ethnic groups. Rates in the ‘Black/African/Caribbean/Black British’, ‘Asian/Asian British’ and ‘other ethnic group’ are significantly lower than the white ethnic group (by comparison on 95% confidence intervals). All ethnic groups follow similar trends over time at each stage of diagnosis, and the proportions of cancers diagnosed at stage 3 and 4 are comparable across the different ethnic groups. The proportions of cancers diagnosed at stage 1 and 2 varies across different ethnic groups, being lowest in the mixed/multiple ethnic group and highest in the Asian ethnic group, but these differences aren’t statistically significantly different due to small numbers. The results are due to be finalised in summer 2024. InterpretationSince cancer is more prevalent in older ages, and the white ethnic group have an older population compared to the others, this can partially explain the higher incidence rates amongst this group. However, as incidence rates are still higher in this group after accounting for age, it suggests inequalities may exist for this Population. Findings can help targeted prevention and intervention strategies to reduce inequality. FundingNone received.

Ethnic variations in post ST elevation myocardial infarction inflammatory kinetics

Abstract Introduction Sterile inflammation post myocardial infarction (MI) is essential to activation reparative mechanisms. However, excessive inflammation contributes to detrimental recovery and adverse outcomes(1). Several studies have reported an association between elevated leucocyte subpopulations and neutrophil-lymphocyte ratio (NLR) with poor prognosis after MI(2). In healthy volunteers, it is known that black individuals have a lower diurnal neutrophil, basophil, and monocyte count and the term ‘benign ethnic neutropenia’ has been used(3). However, the effect of ethnicity on leucocyte counts after MI is not known. Purpose We aimed to assess the interaction between ethnicity and leucocyte subpopulations and NLR. Understanding post-MI inflammation and its interaction with ethnicity is essential in providing personalised patient management and prognostication. Methods We conducted a single centre retrospective observational study of consecutive patients presenting with ST-segment elevation MI (STEMI) between 2016 and 2022. Patients were divided into white and other ethnic groups combined (‘ethnic minorities’) based on self-reported ethnicity. Leucocyte subpopulations, neutrophil and monocyte lymphocyte ratios (NLR and MLR, respectively) at baseline and for 4 days post admission were compared. Baseline variables were analysed with Shapiro-Wilk testing and presented as median (IQR). Area under the curve (AUC) was used to analyse magnitude of change in longitudinal analysis with smoothed conditional means (LOESS) to display trends in the data. Univariate and multivariate linear regression analyses were used to investigate for an association between ethnicity and baseline clinical variables. Results We included 1933 STEMI patients, of whom 1477 (76%) were white and 456 (24%) were from ethnic minority groups. Baseline neutrophils (7.73 [5.9-10] vs 9.04 [6.7-11.9] x109/L), monocytes (0.52 [0.38-0.69] vs 0.6 [0.44-0.82] x109/L), basophils (0.03 [0.02-0.04] vs 0.04 [0.02-0.06] x109/L), NLR (4.47 [2.93-7.19] vs 5.61 [3.64-8.89]) and MLR (0.3 [0.21-0.43] vs 0.36 [0.26-0.53]) were significantly lower (all p&amp;lt;0.001) in ethnic minority vs white patients. There were no differences in peak troponin T or CRP. Longitudinal assessment of leucocyte subgroups and NLR showed that white patients had a significantly higher AUC and difference between minimum and maximum values (delta) for neutrophils, monocytes, basophils and NLR (Panel 1). After correction, we observed a negative association between being in the ethnic minority group and baseline NLR (p=0.005) and basophil count (p&amp;lt;0.001). Conclusions Despite baseline differences in leucocyte subgroups and NLR according to ethnicity, there is a distinct interaction among patients with STEMI suggesting an ethnicity-specific inflammatory profile. Blunting of the magnitude and duration of leucocyte response is novel, and future work will focus on the implications for prognosis and tailored therapy.

Estimating Prevalence and Number of People With Chronic Hepatitis B: A Multiplier Method Based on Public Health Surveillance Data in UK (2015-2021).

Estimates of chronic hepatitis B virus (HBV) prevalence and critically the amount of infection that is undiagnosed or unlinked to care are uncertain-even in countries like UK where vertical transmission and overall prevalence are very low. In the absence of country of birth data, we aim to estimate HBV prevalence through combining public health surveillance data on antenatally screened women by ethnic group and multipliers generated from non-antenatally screened populations by ethnic group with English population denominators. Of 714,287 women aged 16-49 years with ethnic group data tested as part of antenatal care between 2015 and 2021, 4174 (0.6%) were HBsAg-positive; 94% in people of ethnic groups other than White British. Of 1,447,467 people tested for HBsAg with ethnic group data from other testing sources (primary and secondary care excluding occupational health and renal services), 27,628 (1.9%) were HBsAg-positive; 87% in people of ethnic groups other than White British. We estimate that the overall number and prevalence of people with chronic hepatitis B in England is 268,767 (95% CI: 227,896-314,044) and 0.58% (95% CI: 0.50-0.68). Approximately two-thirds were male, one-third female, and 68% were aged under 50. We estimate that over 83% of HBV infections are in people of ethnic groups other than White British, with 23% in people from Black ethnic groups, 21% from other White ethnic groups and 19% in Asian ethnic groups. These estimates are the first step towards establishing whether England can meet World Health Organisation targets to eliminate HBV as a public health problem-using methods that can also be used by other countries.

Socioeconomic and ethnic disparities in preterm births in an English maternity setting: a population-based study of 1.3 million births

BackgroundPreterm birth is a major cause of infant mortality and morbidity and accounts for 7–8% of births in the UK. It is more common in women from socially deprived areas and from minority ethnic groups, but the reasons for this disparity are poorly understood. To inform interventions to improve child survival and their quality of life, this study examined the socioeconomic and ethnic inequalities in preterm births (< 37 weeks of gestation at birth) within Health Trusts in England.MethodsThis study investigated socioeconomic and ethnic inequalities in preterm birth rates across the National Health Service (NHS) in England. The NHS in England can be split into different units known as Trusts. We visualised between-Trust differences in preterm birth rates. Health Trusts were classified into five groups based on their standard deviation (SD) variation from the average national preterm birth rate. We used modified Poisson regression to compute risk ratios (RR) and 95% confidence intervals (95% CI) with generalised estimating equations.ResultsThe preterm birth rate ranged from 6.8/100 births for women living in the least deprived areas to 8.8/100 births for those living in the most deprived areas. Similarly, the preterm birth rate ranged from 7.8/100 births for white women, up to 8.6/100 births for black women. Some Health Trusts had lower than average preterm birth rates in white women whilst concurrently having higher than average preterm birth rates in black and Asian women. The risk of preterm birth was higher for women living in the most deprived areas and ethnicity (Asian).ConclusionsThere was evidence of variation in rates of preterm birth by ethnic group, with some Trusts reporting below average rates in white ethnic groups whilst concurrently reporting well above average rates for women from Asian or black ethnic groups. The risk of preterm birth varied substantially at the intersectionality of maternal ethnicity and the level of socioeconomic deprivation of their residency. In the absence of other explanations, these findings suggest that even within the same Health Trust, maternity care may vary depending on the women’s ethnicity and/or whether she lives in an area of high socioeconomic deprivation. Thus, social factors are likely key determinants of inequality in preterm birth rather than provision of maternity care alone.

Adiposity and mortality among intensive care patients with COVID-19 and non-COVID-19 respiratory conditions: a cross-context comparison study in the UK

BackgroundAdiposity shows opposing associations with mortality within COVID-19 versus non-COVID-19 respiratory conditions. We assessed the likely causality of adiposity for mortality among intensive care patients with COVID-19 versus non-COVID-19 by examining the consistency of associations across temporal and geographical contexts where biases vary.MethodsWe used data from 297 intensive care units (ICUs) in England, Wales, and Northern Ireland (Intensive Care National Audit and Research Centre Case Mix Programme). We examined associations of body mass index (BMI) with 30-day mortality, overall and by date and region of ICU admission, among patients admitted with COVID-19 (N = 34,701; February 2020–August 2021) and non-COVID-19 respiratory conditions (N = 25,205; February 2018–August 2019).ResultsCompared with non-COVID-19 patients, COVID-19 patients were younger, less often of a white ethnic group, and more often with extreme obesity. COVID-19 patients had fewer comorbidities but higher mortality. Socio-demographic and comorbidity factors and their associations with BMI and mortality varied more by date than region of ICU admission. Among COVID-19 patients, higher BMI was associated with excess mortality (hazard ratio (HR) per standard deviation (SD) = 1.05; 95% CI = 1.03–1.07). This was evident only for extreme obesity and only during February–April 2020 (HR = 1.52, 95% CI = 1.30–1.77 vs. recommended weight); this weakened thereafter. Among non-COVID-19 patients, higher BMI was associated with lower mortality (HR per SD = 0.83; 95% CI = 0.81–0.86), seen across all overweight/obesity groups and across dates and regions, albeit with a magnitude that varied over time.ConclusionsObesity is associated with higher mortality among COVID-19 patients, but lower mortality among non-COVID-19 respiratory patients. These associations appear vulnerable to confounding/selection bias in both patient groups, questioning the existence or stability of causal effects.

Gender and ethnicity intersect to reduce participation at a large European hybrid HIV conference

ObjectiveTo evaluate how gender and ethnicity of panel members intersect to effect audience participation at a large European hybrid conference.DesignAn observational cross-sectional study design was used to collect data at...

Bridging the gap: Multi-omics profiling of brain tissue in Alzheimer's disease and older controls in multi-ethnic populations.

Multi-omics studies in Alzheimer's disease (AD) revealed many potential disease pathways and therapeutic targets. Despite their promise of precision medicine, these studies lacked Black Americans (BA) and Latin Americans (LA), who are disproportionately affected by AD. To bridge this gap, Accelerating Medicines Partnership in Alzheimer's Disease (AMP-AD) expanded brain multi-omics profiling to multi-ethnic donors. We generated multi-omics data and curated and harmonized phenotypic data from BA (n=306), LA (n=326), or BA and LA (n=4) brain donors plus non-Hispanic White (n=252) and other (n=20) ethnic groups, to establish a foundational dataset enriched for BA and LA participants. This study describes the data available to the research community, includingtranscriptome from three brain regions, whole genome sequence, and proteome measures. The inclusion of traditionally underrepresented groups in multi-omics studies is essential to discovering the full spectrum of precision medicine targets that will be pertinent to all populations affected with AD. Accelerating Medicines Partnership in Alzheimer's Disease Diversity Initiative led brain tissue profiling in multi-ethnic populations. Brain multi-omics data is generated from Black American, Latin American, and non-Hispanic White donors. RNA, whole genome sequencing and tandem mass tag proteomicsis completed and shared. Multiple brain regions including caudate, temporal and dorsolateral prefrontal cortex were profiled.

COVID-19 pandemic impact on hypertension management in North East London: an observational cohort study using electronic health records

ObjectiveThere are established inequities in the monitoring and management of hypertension in England. The COVID-19 pandemic had a major impact on primary care management of long-term conditions such as hypertension....

Ethnic Density and Mental Health: Does it Matter Whether the Ethnic Density is Co-ethnic or Multi-ethnic and How Important is Change in Ethnic Density?

The ethnic density thesis suggests a protective health benefit for ethnic minorities living in places with higher concentration of co-ethnic residents. This paper aims to make a step change in the examination of this thesis by proposing ethnic diversity rather than co-ethnic density will be more protective for mental health. The paper proposes ethnic diversity could be a community asset that benefits the health of all people in a neighbourhood regardless of their own ethnic group. Individual data is taken from the UK Household Longitudinal Study, 2009-2019 linked to aggregate data from the 2001 and 2011 Censuses to test the association between co-ethnic density, ethnic diversity and mental health using the General Health Questionnaire 12-item scale. The paper takes a novel approach by measuring pre-existing (in 2001) and change in (2001-2011) co-ethnic density and ethnic diversity. Moderating effects of individual ethnic group, neighbourhood deprivation and perceived social cohesion are tested. Results show lower pre-existing co-ethnic density is related to lower mental health amongst the White British ethnic group but not in most ethnic minority groups. Greater pre-existing ethnic diversity in more deprived neighbourhoods is associated with better mental health regardless of individual ethnic group. A point of contention in the findings is no association between change in ethnic diversity and mental health.

Food insecurity: The resilient, but “silent poverty” perspectives of older ethnic minority individuals within UK communities

AbstractFood insecurity is acknowledged as a key social determinant of health among older adults. Despite recording significantly higher levels of poverty in comparison to white ethnic groups, older individuals from ethnic minorities are under‐represented as recipients of food aid. Thus, there are knowledge gaps in our understanding of older people and their experiences of food insecurity within ethnic minority communities. Through the theoretical lens of Individual and Community Resilience, we empirically advance our understanding of food security and resilience within South Asian communities via in‐depth interviews with community stakeholders and older individuals from Bangladeshi and Pakistani communities across the Greater Manchester region. Our findings reveal that the integration of temporal, environmental and social constructs within a resilience framework reveals significant potential for further negative social, cultural and economic impact on older ethnic minorities in the future, especially as current food support services do not appear to cater for ethnic dietary preferences, language accessibility and/or cultural norms regarding asking for help/charity outside the home. We predict therefore, in combination with the identified persistent stressors, that food insecurity issues within older ethnic minority communities are likely to get much worse, resulting in the need for extensive resilient capacities to cope with future cost‐of‐living challenges. In acknowledging previous limitations within previous resilience frameworks, we propose an incremental contribution to theory and conclude by identifying culturally and operationally appropriate food support system approaches, which can be used to address the increasing prevalence of “silent poverty” within ethnic minority communities.

Equity in the Setting of Heart Failure Diagnosis: An Analysis of Differences Between and Within Clinician Practices.

Timely heart failure (HF) diagnosis can lead to earlier intervention and reduced morbidity. Among historically marginalized patients, new-onset HF diagnosis is more likely to occur in acute care settings (emergency department or inpatient hospitalization) than outpatient settings. Whether inequity within outpatient clinician practices affects diagnosis settings is unknown. We determined the setting of incident HF diagnosis among Medicare fee-for-service beneficiaries between 2013 and 2017. We identified sociodemographic and medical characteristics associated with HF diagnosis in the acute care setting. Within each outpatient clinician practice, we compared acute care diagnosis rates across sociodemographic characteristics: female versus male sex, non-Hispanic White versus other racial and ethnic groups, and dual Medicare-Medicaid eligible (a surrogate for low income) versus nondual-eligible patients. Based on within-practice differences in acute diagnosis rates, we stratified clinician practices by equity (high, intermediate, and low) and compared clinician practice characteristics. Among 315 439 Medicare patients with incident HF, 173 121 (54.9%) were first diagnosed in acute care settings. Higher adjusted acute care diagnosis rates were associated with female sex (6.4% [95% CI, 6.1%-6.8%]), American Indian (3.6% [95% CI, 1.1%-6.1%]) race, and dual eligibility (4.1% [95% CI, 3.7%-4.5%]). These differences persisted within clinician practices. With clinician practice adjustment, dual-eligible patients had a 4.9% (95% CI, 4.5%-5.4%) greater acute care diagnosis rate than nondual-eligible patients. Clinician practices with greater equity across dual eligibility also had greater equity across sex and race and ethnicity and were more likely to be composed of predominantly primary care clinicians. Differences in HF diagnosis rates in the acute care setting between and within clinician practices highlight an opportunity to improve equity in diagnosing historically marginalized patients.

Exploring Potential Ethnic Bias Among MMPI-3 Scales in Assessing Personality Psychopathology.

This study examined statistical bias in the measurement of personality psychopathology in the Latinx population using the Minnesota Multiphasic Personality Inventory-3 (MMPI-3). Data were extracted from two studies that yielded a composite data set of 103 White individuals and 250 Latinx individuals. All participants were administered the MMPI-2-Restructured Form-Extended Battery (MMPI-2-RF-EX) or MMPI-3 and the Personality Inventory for the DSM-5 Short Form (PID-5-SF). First, we conducted correlation analyses between theoretically overlapping scales of the PID-5-SF and the MMPI-3 among White and Latinx individuals. The majority of theoretically associated scales were found to be at least moderately associated in the total sample. In addition, Steiger's z-tests indicated that correlations were similar in magnitude across the White and Latinx ethnic groups. Hierarchical regression subsequently determined the presence of slope and/or intercept bias. Only one analysis (the MMPI-3 Anger Proneness prediction of PID-5-SF Negative Affectivity) indicated statistically significant intercept bias. No evidence of slope bias was found. In other words, these analyses indicated that the vast majority of the relationships between MMPI-3 scales and associated personality psychopathology constructs (as measured by the PID-5-SF) remained consistent across both ethnic groups. Overall, the results supported the appropriate cross-cultural use of the MMPI-3 to assess personality psychopathology.

Ethnic differences in meat consumption attitudes, norms and behaviors: A survey of White, South Asian and Black ethnic groups in the UK

A reduction in meat consumption is necessary to mitigate negative impacts of climate change and adverse health outcomes. The UK has an increasingly multi-ethnic population, yet there is little research on meat consumption habits and attitudes among ethnic groups in the UK. We ran a survey (N = 1014) with quota samples for ethnic groups and analyzed attitudes, behaviors and norm perceptions of White, South Asian and Black British respondents. Most respondents believe overconsumption of red and processed meat has negative impacts on health (73.3%) and the environment (64.3%).South Asian respondents were statistically significantly less likely to be meat eaters than White respondents (OR = 0.44, 95% CIs: 0.30-0.65, t = −4.15, p = 0.000), while there was no significant difference between White and Black respondents (OR = 1.06, 95% CIs: 0.63–1.76, t = 0.21, p = 0.834). Both South Asian (OR = 2.76, 95% CIs: 1.89–4.03 t = 5.25, p = 0.000) and Black respondents (OR = 2.09, 95% CIs: 0.1.30–3.35, t = 3.06, p = 0.002) were significantly more likely to express being influenced by friends and family in their food choices than White respondents. South Asian (OR = 3.24,95% CIs: 2.17–4.84, t = 5.74, p = 0.000) and Black (OR = 2.02,95% CIs: 1.21–3.39, t = 2.69, p = 0.007) respondents were also both significantly more likely to report they would want to eat similarly to their friends and family than White respondents. Statistical analyses suggested some gender and socioeconomic differences across and among ethnic groups, which are reported and discussed. The differences in meat consumption behaviors and norm conformity between ethnic groups raises the prospect that interventions that leverage social norms may be more effective in South Asian groups than Black and White groups in the UK.

The effect of workplace mobility on air pollution exposure inequality—a case study in the Central Belt of Scotland

A large number of epidemiological studies have identified air pollution as a major risk to human health. Exposures to the pollutants PM2.5, NO2 and O3 cause cardiovascular and respiratory diseases, cancer and premature mortality. Whilst previous studies have reported demographic inequalities in exposure, with the most deprived and susceptible often being disproportionately exposed to the highest pollutant concentrations, the vast majority of these studies have quantified exposure based only on individuals’ place of residence. Here we use anonymised personal data from UK Census 2011, and hourly modelled air pollution concentrations at 0.8 km × 1.4 km spatial resolution in the Central Belt of Scotland, to investigate how inclusion of time spent at place of work or study affects demographic inequalities in exposure. We split the population by sex, ethnic group, age and socio-economic status. Exposure gradients are observed across all demographic characteristics. Air pollution exposures of males are more affected by workplace exposures than females. The White ethnic group has the lowest exposures to NO2 and PM2.5, and highest to O3. Exposures to NO2 and PM2.5 tend to peak between the ages of 21 and 30, but those aged 31–50 tend to be most impacted by the inclusion of time spent at workplace in the exposure assessment. People in the two least deprived deciles consistently have the lowest residential-only and combined residential-workplace exposure to NO2 and PM2.5, but experience the highest increase in exposure when including workplace. Overall, including workplace exposure results in relatively small change in median exposure but attenuates some of the exposure inequalities associated with ethnicity and socioeconomic status observed in exposure assessments based only on place of residence.

An exploration of how specialist dementia nurses perceive and maintain the skills and competencies that frame their specialism: A qualitative survey

BackgroundUK policy for complex and long-term health conditions including dementia has recommended that specialist nursing intervention is offered across the trajectory of the condition, but there is a lack of agreement regarding the skills and competencies that specialist nurses are expected to possess. Admiral Nurses are the largest UK group of specialist dementia nurses. ObjectiveTo explore how Admiral Nurses met and were supported to meet competencies as defined in the Admiral Nurse Competency Framework, and to develop and maintain skills as dementia specialists. DesignCross-sectional, semi-structured survey. SettingOnline national survey. ParticipantsAdmiral (specialist dementia) Nurses. MethodsWe co-designed our survey with Admiral Nurses; then invited Admiral Nurses to complete it in 2022-23 Data were analysed thematically. Results68 (20% of all Admiral Nurses) completed the survey; most were female (85.2%), from a white ethnic group (88.2%); they reported on average 24 years of nursing experience. We identified three themes in responses: 1.Having time and skills for meaningful support, explored how participants were resourced with time and skills to understand and address family carer client needs by active listening, tailoring person-centred support, and “walking alongside” families. 2.Partnering family carers, concerned how they co-designed interventions with family carers, learning from these collaborative partnerships where expertise was shared. 3.Practice and peer-based learning, explored how participants took responsibility for using available training, peer learning and self-reflection to develop their practice. ConclusionsAdmiral Nurse roles enabled respondents to develop as autonomous practitioners and to access resources that supported them to build and sustain their dementia specialist practice. Learning was practice based, through partnerships with family carer clients, peer support and self-directed learning. Specialist nursing models may help address the global health workforce emergency, through enabling creative practice development and valued roles that support retention of experienced nurses.

Ethnic differences in depression and anxiety among adults with atopic eczema: Population-based matched cohort studies within UK primary care.

Evidence demonstrates that individuals with atopic eczema (eczema) have increased depression and anxiety; however, the role of ethnicity in these associations is poorly understood. We aimed to investigate whether associations between eczema and depression or anxiety differed between adults from white and minority ethnic groups in the UK. We used UK Clinical Practice Research Datalink GOLD to conduct matched cohort studies of adults (≥18years) with ethnicity recorded in primary care electronic health records (April 2006-January 2020). We matched (age, sex, practice) adults with eczema to up to five adults without. We used stratified Cox regression with an interaction between eczema and ethnicity, to estimate hazard ratios (HRs) for associations between eczema and incident depression and anxiety in individuals from white ethnic groups and a pooled minority ethnic group (adults from Black, South Asian, Mixed and Other groups). We identified separate cohorts for depression (215,073 with eczema matched to 646,539 without) and anxiety (242,598 with eczema matched to 774,113 without). After adjusting for matching variables and potential confounders (age, sex, practice, deprivation, calendar period), we found strong evidence (p<0.01) of ethnic differences in associations between eczema and depression (minority ethnic groups: HR=1.33, 95% CI=1.22,1.45; white ethnic groups: HR=1.15, 95% CI=1.12,1.17) and anxiety (minority ethnic groups: HR=1.41, 95% CI=1.28,1.55; white ethnic groups: HR=1.17, 95% CI=1.14,1.19). Adults with eczema from minority ethnic groups appear to be at increased depression and anxiety risk compared with their white counterparts. Culturally adapted mental health promotion and prevention strategies should be considered in individuals with eczema from minority ethnic groups.

The national profile of the prosthetic and orthotic workforce in the UK: Sociodemographics and employment characteristics.

Prosthetists and orthotists (POs) are essential members of the health care workforce and one of the United Kingdom's (UK's) allied health professions. There is a paucity of information on their demographics, which is essential for the development of the profession. To fill this void, this study has attempted to comprehensively explore the sociodemographics and work-related characteristics of the entire workforce. Data were collected in 2022 through multiple sources, including surveys of POs, private companies employing POs, and freedom of information requests to National Health Service Trusts/Health Boards and higher education institutes offering programs leading to registration as a prosthetist/orthotist. The workforce survey had 641 respondents (74% response rate). The estimated national ratio of POs per million population was 13, with all bar of the 12 regions below the World Health Organization minimum recommendation of 15 POs per million population. Most of the survey respondents were female (47.6%) and younger than male respondents, were British (75.8%), and in the White ethnic group (74.3%). Most of them were employed by private companies (59.9% vs. 31.4% employed by the National Health Service) and had clinical duties (94%), permanent contracts (90%), worked full-time (75%), and treated a wide range of clinical conditions. The national UK prosthetist and orthotist ratio falls below the recommended international standards. The versatility and broad skill set of POs highlight their crucial role in multidisciplinary teams. Establishing a centralized prosthetist and orthotist workforce database system is recommended for data-driven strategic planning.

The annual rate of sacroiliitis and disease detection using magnetic resonance imaging, computed tomography, and X-ray: A single-center experience

Abstract: Inflammation of the sacroiliac joint (SIJ), termed sacroiliitis, commonly presents as chronic back pain. A definitive diagnosis is made using a variety of radiological techniques that differ in specificity and sensitivity. This study aims to estimate the annual incidence of sacroiliitis and to explore the frequency of multiple modalities used in its evaluation. a retrospective analytic study that examined patients’ records of diagnostic imaging of the SIJ (magnetic resonance imaging [MRI], computerized tomography, and X-ray) at a tertiary center in Jeddah, Saudi Arabia, from January 2012 to June 2016. Sacroiliitis was diagnosed in 129 patients out of 338 over 4 years, giving an annual incidence of 28.17%, with an increase of 6% reaching 36% in 2015. Patients with sacroiliitis were older and obese which was statistically significant. There was a significant risk in the white ethnic group and female gender (P &lt; 0.005). The incidence of sacroiliitis is increasing. MRI exceeded other radiological modalities in the diagnostic process. The results are supported by existing guidelines recommending MRI for early detection; however, other modalities are to be replaced depending on the preclinical probability.