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To date, the research that examines food accessibility has tended to ignore ethnic food outlets. This void leaves us with a limited understanding of how such food stores may, or may not, impact food security. The study discussed herein addressed this by conducting a geospatial assessment of ethnic food outlet accessibility in two U.S. cities: Flint and Grand Rapids, Michigan. We used Geographic Information Systems (GIS) tools to create a revealed accessibility index for each food outlet, and used the index to determine access within active travel service areas. We utilized an ordinary least squares regression (OLS), and two local models: spatial autoregression (SAR) and geographically weighted regression (GWR) to enhance our understanding of global and localized relationships between outlet accessibility and type (while controlling for known covariates). The results show that the local models outperformed ( R max = 0.938) the OLS model. The study found that there was reduced access to ethnic restaurants in all service areas of Grand Rapids. However, in Flint, we observed this association in the bicycling areas only. Also notable were the influences that demographic characteristics had on access in each city. Ultimately, the findings tell us that nuanced planning and policy approaches are needed in order to promote greater access to ethnic food outlets and reduce overall food insecurity.2 max = 0.938) the OLS model. The study found that there was reduced access to ethnic restaurants in all service areas of Grand Rapids. However, in Flint, we observed this association in the bicycling areas only. Also notable were the influences that demographic characteristics had on access in each city. Ultimately, the findings tell us that nuanced planning and policy approaches are needed in order to promote greater access to ethnic food outlets and reduce overall food insecurity.

Background: Presurgical psychological screening is used to identify factors that may impact postoperative adherence and surgical outcomes in bariatric surgery candidates. Minnesota Multiphasic Personality Inventory - 2 Restructured Form (MMPI-2-RF) findings have demonstrated utility for this task., Objectives: To explore whether there are clinically meaningful gender, ethnicity, or age differences in presurgical MMPI-2-RF scores and the validity of these scores in bariatric surgery candidates., Methods: The sample was composed of 872 men and 2337 women. Ethnicity/race groups included 2,204 Caucasian, 744 African American, and 96 Hispanic individuals. A sample of 165 were not included in the ethnicity/race analyses because they were of another descent. Ages groups included 18-35 year olds (n = 454), 36-49 year olds (n = 1154), 50-64 year olds, (n = 1246), and 65 years old or older (n = 355). Validity data, obtained via a retrospective chart review, were available for a subset patients (n = 1,268) who were similarly distributed. Step-down hierarchical regression analyses were conducted to assess for differential validity., Results: Bariatric surgery candidates produced comparable MMPI-2-RF scores in all subsamples, indicating that the test norms generalize across demographic groups. Validity findings were also generally comparable, indicating that MMPI-2-RF scores have the same interpretive implications in demographically diverse subgroups of bariatric surgery candidates., Conclusions: The MMPI-2-RF can assist in presurgical psychological screening of demographically diverse bariatric surgery candidates., (Copyright © 2015 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)

Aim: To assess mortality and complication trends in people with type 1 diabetes during the 11 years before the SARS‐CoV2 pandemic (2009–2019). Materials and Methods: Sequential cohorts of people in England with type 1 diabetes aged ≥20 years from the National Diabetes Audit (2006/2007 to 2016/2017) were analysed. Discretized Poisson regression models, adjusted for age, sex, ethnicity, socioeconomic deprivation and duration of diabetes, were used to calculate mortality and hospitalization rates. Results: Demographic characteristics changed little; average diabetes duration increased. All‐cause mortality was unchanged. Cardiovascular and kidney disease mortality declined. Mortality from respiratory disease, diabetes and dementia increased in younger people (aged 20–74 years) as did mortality from liver disease and dementia in the elderly (aged ≥75 years). Younger Asian and Black people had lower all‐cause mortality than those of White ethnicity; elderly Mixed, Asian and Black people had lower all‐cause mortality. People from more deprived areas had higher all‐cause mortality. The deprivation gradient for mortality was steeper at younger ages. In younger people, rates of hospitalization increased for myocardial infarction, stroke, heart failure and kidney disease but only for kidney disease in the elderly. Rates of a composite measure of cardiovascular hospitalizations increased in younger people (rate ratio [RR] 1.07, 95% confidence interval [CI] 1.03–1.11) but declined in the elderly (RR 0.91, 95% CI 0.86–0.95). Conclusion: Between 2009 and 2019, hospitalizations for cardiovascular disease increased at younger ages (20–74 years) and hospitalizations for kidney disease increased at all ages, but mortality from cardiovascular and kidney disease declined. All‐cause mortality rates were unchanged. [ABSTRACT FROM AUTHOR]

• Teacher and child race are important as racialized interactions impact children's development. • The quality of early learning environments may look different for Black and Latine populations. • Various levels of racism and biases may interrupt Black and Latine children's learning. The purpose of the current study is to use secondary data to examine the extent to which the ECERS-3, specifically the factor structure, is equivalent across Black and Latine/Hispanic teachers, racial and ethnic classroom composition, and race/ethnicity of students. Data were drawn from a large-scale 2015-16 validation study of the ECERS-3 in three states (Georgia, Pennsylvania, and Washington) that were using the ECERS-3 as part of their quality rating and improvement systems (QRIS). Approximately 1,063 classrooms serving children between the ages of 3 and 5 were included in the final sample, and about 69 percent of the teachers identified as White. Findings revealed that the basic factor structure of the ECERS-3 was similar in the sample of classrooms when compared across lead teacher race, classroom racial composition, and lead teacher-child match; however, some differences were found in factor loadings and item thresholds. These findings have implications for ensuring that measures to assess global quality consider differential effects of race of the teacher, child, and classroom composition. [ABSTRACT FROM AUTHOR]

Although perception of stigma (PS) has been dubbed as a key barrier to the optimal uptake of PrEP, research on PS is sparse. More specifically, no scholarly work has explored factors associated with the expression of PS toward PrEP use. This study addresses the literature gap by investigating factors associated with PS toward PrEP use. Data were drawn from the baseline survey (2017–2019) of the "Keeping It LITE Study", involving a large cohort (n = 3330) of young sexual minority men, transgender men and women, and non-binary individuals in the US. Participants' ages ranged from 13 to 34 years, with the majority (87%) assigned male at birth. The racial composition of the sample was diverse, with 53.9% identifying as white, 19.8% as Latinx, 10.7% as Black or African American, and smaller proportions as Asian, American Indian or Alaska Native, Native Hawaiian or other Pacific Islander, and another race/ethnicity. Logistic regression models were utilized to examine two common measures of PS in PrEP use: (1) the perception that PrEP users are seen as promiscuous and (2) the perception that PrEP users are assumed to be HIV-positive. Two sets of models were developed to account for the correlation between gender identity and sex assigned at birth. The results suggest strong PS among current PrEP users, which can explain the weak PrEP adherence reported among this group. The findings underscore the need for targeted interventions to mitigate PS and enhance PrEP uptake and adherence in vulnerable populations. Social and practical implications of the results and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

The influence of demographic characteristics and social determinants on cancer outcomes is widely recognized in various malignancies but remains understudied in myelofibrosis (MF). This study aims to investigate social and demographic variables associated with MF survival. We retrospectively reviewed data of biopsy-proven MF patients from the Surveillance, Epidemiology and End Results (SEER) database (2000–2021) and Montefiore Medical Center (2000–2023), an underserved inner-city hospital. The SEER cohort included 5,403 MF patients and was predominantly Non-Hispanic (NH) White (82%) with a median age of 69 years. The age-adjusted incidence rate of MF was 0.32 cases per 100,000 person-years, increasing annually by 1.3% from 2000 to 2021. Two- and five- year overall survival rates were 69% and 42%, respectively. Worse cause-specific survival was associated with older age, male sex, and diagnosis before 2011 (year of Ruxolitinib approval). NH-Black ethnicity, unmarried status and lower median income were independent predictors of worse overall survival. The single-center analysis included 84 cases, with a median age of 66 years. NH-White patients comprised 37% of the sample, followed by NH-Black (28.5%). Two- and five- year overall survival rates were 90% and 61%, respectively, with NH-Black patients exhibiting the lowest median survival, although the difference was not statistically significant. Age was a significant predictor of worse survival in this cohort. NH-Black and Hispanic patients lived in areas with higher socioeconomic and demographic stress compared to NH-White patients. Overall, this study highlights the association of social and demographic factors with MF survival and emphasizes the need for equitable healthcare and further exploration of social-demographic factors affecting MF survival. [ABSTRACT FROM AUTHOR]

How does competition for school resources, along with racial and socioeconomic biases, shape parental preferences for schools? In this article, I investigate how school attributes affect preferences and choice, which sheds light on the processes that maintain school segregation. To do so, I conduct a survey experiment that explores parental preferences and the tradeoffs inherent in the process of school selection using school profiles that resemble those available on widely used education data platforms. I find that parents hold the strongest positive preferences for learning opportunities and overall school achievement compared to other attributes, including school racial and socioeconomic composition. Additionally, though parents prefer schools that have higher equity rankings, highly equitable schools are less desirable to parents than schools with more status and learning opportunities. However, parents also hold independent racial and socioeconomic preferences and —on average—avoid schools with more students of color and low-income students. Furthermore, results suggest they are largely unwilling to make tradeoffs that would result in schools with higher fractions of students of color or low-income students. Taken together, this study links prior studies on the segregating effects of educational data with literatures on school segregation by illustrating the specific dimensions that drive school choice. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Although the antidepressant effect of ketamine on treatment‐resistant depression (TRD) has been frequently reported in North American and European countries, evidence is scarce among the Asian population. We aimed to evaluate the efficacy and safety of intravenous ketamine in Japanese patients with TRD.In this double‐blind randomized placebo‐controlled trial, 34 Japanese patients with TRD were randomized to receive either intravenous ketamine (0.5 mg/kg) or placebo, administered over 40 min, twice a week, for 2 weeks. The primary outcome was the change in the Montgomery Åsberg Depression Rating Scale (MADRS) total score from baseline to post‐treatment. Secondary outcomes included changes in other depressive symptomatology scores and remission, response, and partial response rates. We also examined the association between baseline clinical demographic characteristics and changes in the MADRS total score.Intention‐to‐treat analysis indicated no significant difference in the decrease in MADRS total score between the groups (−8.1 ± 10.0 vs −2.5 ± 5.2, t[32] = 2.02, P = 0.052), whereas per‐protocol analysis showed a significant reduction in the ketamine group compared to the placebo group (−9.1 ± 10.2 vs −2.7 ± 5.3, t[29] = 2.22, P = 0.034). No significant group differences were observed in other outcomes. Adverse events were more frequent in the ketamine group than in the placebo group, and no serious adverse events were reported. A higher baseline MADRS total score and body mass index were associated with a greater reduction in the MADRS total score.Intravenous ketamine outperformed placebo in Japanese patients with TRD who completed the study, suggesting that ketamine could alleviate depressive symptoms of TRD across diverse ethnic populations. [ABSTRACT FROM AUTHOR]

Background Methods Results Discussion This study aimed to compare the demographic differences between Māori and NZ Europeans with neck of femur fracture (NOF), identify any differences in management, surgical and post‐op care and outcomes.All cases in New Zealand between 2018 and 2020 were collected from the Australia & New Zealand Hip Fracture Registry (ANZHFR). Basic demographics, management factors, and surgical factors were collected. Key outcomes at 120 days post‐fracture included walking status, residential status and survival. Univariate analysis was performed to compare differences in demographics, and management factors between ethnicities. Multivariable analysis was conducted on key outcome comparisons and management differences.Data from 9432 patients were analyzed. 305 patients were Māori (3.2%). Age‐standardized incidence between Māori and NZ European were similar (103 (95% CI 91–115) vs. 95 (95% CI 92–99)/100 000/year). Māori had a longer time to theatre (38.7 vs. 34.5 h, P = 0.01). The only difference between Māori and NZ European in the key outcomes was private residential status (67% vs. 62% P < 0.01). There was no difference in survival (87% vs. 87% P = 0.68) and decrease in walking status (0.43 vs. 0.41 P = 0.99). Following multivariable analysis, Māori ethnicity was an independent risk factor for time to theatre >48 hours after adjustment for other factors (OR 1.44 (95% CI 1.07, 1.93), P = 0.016).Although Māori were a small percentage of patients with NOFs, there was similar age‐standardized incidence compared to NZ Europeans. While there were no differences in key outcomes, identifying reasons for longer time to theatre for Māori patients is required. [ABSTRACT FROM AUTHOR]

Introduction: Differences in the prevalence of psychiatric conditions such as psychosis as well as patterns of comorbidity for psychosis have been reported between racial and ethnic groups. It is unclear whether those differences are consistent for comorbid psychosis Methods: Self-reported diagnostic data from American adults ages 18-99 participating in the Collaborative Psychiatric Epidemiology Surveys (CPES) (N ~ 11,844) were used to test the association between four racial and ethnic group categories (White, Asian, Hispanic, Black) and comorbid psychosis. Comorbid psychosis was measured as a 4-level categorical variable (No mental illness nor psychosis, Mental Illness, Psychosis only, comorbid psychosis (i.e., Psychosis + Mental Illness). Chi-square tests were used to determine significant differences in the prevalence of comorbid psychosis by race and ethnicity. A multinomial logistic regression was used to test the association between racial and ethnic classifications and comorbid psychosis after adjusting for common demographic characteristics (i.e., education, sex, income, and age). Results: Relative to White participants, Hispanic and Asian participants were less likely to be affected with comorbid psychosis. (Adjusted Odds Ratio, AORAsian = 0.32, CI = 0.22 - 0.47, p <0.0001, AORHispanic = 0.66, CI = 0.48 - 0.92, p = 0.012). Relative to White participants there was not significant association for comorbid psychosis in Black participants (AORBlack = 0.91, CI = 0.70 - 1.20, p = 0.52) In contrast Hispanic and Black participants were more likely to report psychosis alone (AORHispanic = 1.94, CI = 1.27-2.98, p = 0.002, AORBlack = 1.86, 1.24-2.82, p = 0.003) compared to White participants. Conclusion: There were different patterns of associations by race and ethnicity for psychosis and comorbid psychosis. The lower prevalence of comorbid psychosis in non-White groups may be due to underdiagnosis or underreporting of other mental disorders. [ABSTRACT FROM AUTHOR]

Rationale: Exposure to particulate matter is associated with various adverse health outcomes. Ultrafine particles (UFPs; diameter <0.1 μm) are a unique public health challenge because of their size. However, limited studies have examined their impacts on human health, especially across seasons and demographic characteristics. Objectives: To evaluate the effect of UFP exposure on the risk of visiting the emergency department (ED) for a chronic lower respiratory disease (CLRD) in New York State in 2013–2018. Methods: We used a case-crossover design and conditional logistic regression to estimate how UFP exposure led to CLRD-related ED visits. GEOS-Chem Advanced Particle Microphysics, a state-of-the-art chemical transport model with a size-resolved particle microphysics model, generated air pollution simulation data. We then matched UFP exposure estimates to geocoded health records for asthma, bronchiectasis, chronic bronchitis, emphysema, unspecified bronchitis, and other chronic airway obstructions in New York State from 2013 through 2018. In addition, we assessed interactions with age, ethnicity, race, sex, meteorological factors, and season. Results: Each 1-(interquartile range [IQR]) increase in UFP exposure led to a 0.37% increased risk of a respiratory-related ED visit on lag 0–0, or the day of the ED visits, (95% confidence interval [CI], 0.23–0.52%) and a 1.81% increase on lag 0–6, or 6 days before the ED visit, (95% CI, 1.58–2.03%). The highest risk was in the emphysema subtype (lag 0–5, 4.18%; 95% CI, 0.16–8.37%), followed by asthma (lag 0–6, 2.00%), chronic bronchitis (lag 0–6, 1.78%), other chronic airway obstructions (lag 0–6, 1.60%), and unspecified bronchitis (lag 0–6, 1.49%). We also found significant interactions between UFP health impacts and season (Fall, 3.29%), temperature (<90th percentile, 2.27%), relative humidity (>90th percentile, 4.63%), age (children aged <18 yr, 3.19%), and sex (men, 2.06%) on lag 0–6. Conclusions: In this study, UFP exposure increased CLRD-related ED visits across all seasons and demographic characteristics, yet these associations varied according to various factors, which requires more research. [ABSTRACT FROM AUTHOR]

Background Equitable representation of members from historically marginalized groups is important in clinical trials, which inform standards of care. The goal of this study was to characterize the demographics and proportional subgroup reporting and representation of participants enrolled in randomized controlled trials (RCTs) of antibacterials used to treat Staphylococcus aureus infections. Methods We examined randomized controlled registrational and strategy trials published from 2000 to 2021 to determine the sex, race, and ethnicity of participants. Participant to incidence ratios (PIRs) were calculated by dividing the percentage of study participants in each demographic group by the percentage of the disease population in each group. Underrepresentation was defined as a PIR < 0.8. Results Of the 87 included studies, 82 (94.2%) reported participant sex, 69 (79.3%) reported participant race, and 20 (23.0%) included ethnicity data. Only 17 (19.5%) studies enrolled American Indian/Alaskan Native participants. Median PIRs indicated that Asian and Black participants were underrepresented in RCTs compared with the incidence of methicillin-resistant S. aureus infections in these subgroups. Underrepresentation of Black participants was associated with a larger study size, international sites, industry sponsorship, and phase 2/3 trials compared with phase 4 trials (P <.05 for each). Black participants had more than 4 times the odds of being underrepresented in phase 2/3 trials compared with phase 4 trials (odds ratio, 4.57; 95% confidence interval: 1.14–18.3). Conclusions Standardized reporting methods for race and ethnicity and efforts to increase recruitment of marginalized groups would help ensure equity, rigor, and generalizability in RCTs of antibacterial agents and reduce health inequities. [ABSTRACT FROM AUTHOR]

AbstractThis study examines how the public views gangs, surveying 1,000 US adults using a vignette of a teenage collective. Through a factorial design, elements crucial to gang definition debates were randomly manipulated: the name of the group, its racial composition, behavior severity, and organizational structure. Findings reveal that a name associated with known gangs significantly impacts perception, making it more likely for a group to be identified as a gang. The collective’s activity and organizational structure also swayed perceptions, with violent and structured groups more readily classified as gangs. Surprisingly, the group’s racial makeup did not markedly alter perceptions, although joint effects show it did affect the interpretation of other factors. These insights suggest a need to reassess how research shapes our understanding of gangs and, in turn, how public concerns inform policymakers; highlighting the nuances in public opinion that could factor into legal responsibility and guide future legislative decisions. [ABSTRACT FROM AUTHOR]

The study investigated differences and similarities in criminal thinking between men and women attending a multi-site Batterer Intervention Program (BIP). Overall, rates of criminal thinking were low. However, the results of the multivariate analyses suggest that, after controlling for demographic characteristics (i.e., race, ethnicity, education, SES) and personal experiences (i.e., prior convictions, mental health problems, substance abuse, experience of abuse) female participants significantly differed from men in patterns of Power Orientation. If replicated by other studies, especially studies that use larger samples of women enrolled in BIPs, these findings may contribute to identifying rehabilitation programs that best address women's needs. [ABSTRACT FROM AUTHOR]

Background/Objectives Methods Results Conclusions Caucasian and Asian patients with hidradenitis suppurativa demonstrate significant differences with regard to age, gender and body mass index. Demographic characteristics are known to influence the efficacy and drug survival of hidradenitis suppurativa therapeutics including biologic therapies. What remains unknown is the impact of ethnicity upon the efficacy of therapeutics once demographic and disease characteristics have been taken into account. This is an important question given the expansion of biologic therapies for HS into the global patient community.We assessed 170 patients from a single HS specialist centre in Australia stratified by patient‐identified ethnicity including those identifying as either Caucasian or Asian.Asian patients demonstrated lower BMI, higher rates of smoking and greater odds of Hurley stage 3 disease with tunnels than Caucasian patients in line with the reported literature. There was no significant difference between percentage of individuals achieving HiSCR50 or IHS4‐55 at Week 16. Significant differences were seen in median time to secondary loss of response, and Kaplan–Meier curve analysis showed a significant difference between curves when stratified by patient‐reported ethnicity. Cox regression analysis demonstrated after accounting for age, gender, BMI, smoking and Hurley stage, the significance of ethnicity in influencing time to secondary loss of response disappears.Caucasian or Asian ethnicity does not influence response to adalimumab treatment on patients with hidradenitis suppurativa. [ABSTRACT FROM AUTHOR]

Objective: Physician adherence to evidence-based clinical practice parameters impacts outcomes of amyotrophic lateral sclerosis (ALS) patients. We sought to investigate compliance with the 2009 practice parameters for treatment of ALS patients in the United States, and sociodemographic and provider characteristics associated with adherence. Methods: In this population-based, retrospective cohort study of incident ALS patients in 2009–2014, we included all Medicare beneficiaries age ≥20 with ≥1 International Classification of Diseases, Ninth Revision, Clinical Modification ALS code (335.20) in 2009 and no prior years (N = 8,575). Variables of interest included race/ethnicity, sex, age, urban residence, Area Deprivation Index (ADI), and provider specialty (neurologist vs. non-neurologist). Outcomes were use of practice parameters, which included feeding tubes, non-invasive ventilation (NIV), riluzole, and receiving care from a neurologist. Results: Overall, 42.9% of patients with ALS received neurologist care. Black beneficiaries (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.47–0.67), older beneficiaries (OR 0.964, 95% CI 0.961–0.968 per year), and those living in disadvantaged areas (OR 0.70, 95% CI 0.61–0.80) received less care from neurologists. Overall, only 26.7% of beneficiaries received a feeding tube, 19.2% NIV, and 15.3% riluzole. Neurologist-treated patients were more likely to receive interventions than other ALS patients: feeding tube (OR 2.80, 95% CI 2.52–3.11); NIV (OR 10.8, 95% CI 9.28–12.6); and riluzole (OR 7.67, 95% CI 6.13–9.58), after adjusting for sociodemographics. These associations remained marked and significant when we excluded ALS patients who subsequently received a code for other diseases that mimic ALS. Conclusions: ALS patients treated by neurologists received care consistent with practice parameters more often than those not treated by a neurologist. Black, older, and disadvantaged beneficiaries received less care consistent with the practice parameters. [ABSTRACT FROM AUTHOR]

Evidence-based parenting interventions (EBPI) support children and families to promote resilience, address emotional and behavioral concerns, and prevent or address issues related to child maltreatment. Critiques of EBPIs include concerns about their relevance and effectiveness for diverse populations when they are implemented at population scale. Research methods that center racial equity and include community-based participatory approaches have the potential to address some of these concerns. The purpose of the present review was to document the extent to which methods associated with promoting racial equity in research have been used in studies that contribute to the evidence base for programs that meet evidentiary standards for a clearinghouse that was developed to support the Family First Prevention Services Act in the United States. We developed a coding system largely based on the Culturally Responsive Evaluation model. A sample of 47 papers that are part of the evidence base for ten in-home parent skill-based programs were reviewed and coded. Only three of 28 possible codes were observed to occur in over half of the studies (including race/ethnicity demographic characteristics, conducting measure reliability for the study sample, and including information on socioeconomic status). Although the overall presence of equity-informed methods was low, a positive trend was observed over time. This review highlights ways in which rigorous research can incorporate racial equity into the planning, design, execution, and interpretation and dissemination of programs of study. We posit that doing so improves the external validity of studies while maintaining high-quality research that can contribute to an evidence base. [ABSTRACT FROM AUTHOR]

This article examines how multiethnic individuals in Japan navigate both racial and ethno-national boundaries between Japanese and non-Japanese, and how these boundaries shape or constrain their identity option as Japanese. While previous research primarily focused on the (in)visibility of mixedness (race) as constraints, this study emphasises the role of ethnicity and nation in shaping their identity choices and constraints. Through interviews with 17 individuals born to Japanese and non-Japanese Asian parents, the study reveals that ethno-national boundaries often limit their self-identification as Japanese, even though their non-Japanese backgrounds are not visibly apparent. It challenges the dominant narrative surrounding 'hāfu', which emphasises a desire to be fully seen as Japanese, by revealing that some multiethnic individuals in Japan do not aspire to be perceived as entirely Japanese. Despite the contrasting nature of these two identifications, they both stem from the same issue ― the narrow conceptualisation of Japaneseness. [ABSTRACT FROM AUTHOR]

• COVID-19 vaccine mandates are controversial but proposed to increase vaccination. • 59% of vaccinated individuals who responded to a survey at a vaccine clinic in South Texas in the U.S. supported a COVID-19 vaccine mandate. • Significant racial, ethnic and age differences were found in mandate endorsement. • Demographic differences must be considered when promoting COVID-19 vaccination. Vaccine mandates are controversial, and people vary widely in their preferences to support or reject vaccine mandates. For some, vaccine mandates represent a commitment to reduce harm and support public health. For others, vaccine mandates are viewed as a threat to individual freedom and a violation of personal choice. This manuscript investigated support for a COVID-19 vaccine mandate among COVID-19-vaccinated individuals and identified differences by demographic characteristics and COVID-19 experience. Cross-sectional surveys were given to COVID-19-vaccinated individuals at a vaccination clinic in South Texas in the U.S. with the goal of identifying attitudes, beliefs, and perceptions about COVID-19 vaccination and willingness to support a COVID-19 vaccination mandate. Associations of interest were analyzed using descriptive statistics. Approximately half of the sample was of Hispanic or Latino origin (48 %); most respondents identified as White (59 %), followed by 12 % who identified as Asian. Overall, 59 % of participants supported the possibility for a COVID-19 vaccine mandate. Preliminary data showed significant racial differences in willingness to support a possible COVID-19 vaccine mandate (χ 2 (1, n = 893) = 26.7, p <.001, phi =.17); 80 % of Asian people reported support for COVID-19 vaccination mandate compared to 50 % to 57 % for other racial groups. Significant differences also emerged by ethnicity (χ 2 (4, n = 1033) = 7.12, p =.008, phi =.08) whereby a higher percentage of Latino participants (66 %) reported willingness to support a COVID-19 vaccine mandate. Similarly, significant differences were found by age (χ 2 (4, n = 1045) = 20.92, p <.001, phi =.21), yet no significant differences were found by sex or previous COVID-19 diagnosis. Support for a COVID-19 vaccination mandate is controversial even among vaccinated people. Identifying and understanding cultural and contextual factors that underlie differences in attitudes and beliefs about COVID-19 vaccination mandates is essential to advance dialogue and inform educational health campaigns to increase COVID-19 vaccination rates. [ABSTRACT FROM AUTHOR]

The National Health Service has pledged to improve equal opportunities for their workforce and has highlighted race, gender, and sexual orientation as specific areas of focus. In addition to striving towards equal opportunities for staff, it is vital that the workforce is representative of the UK population it serves. Literature has highlighted a lack of diversity specifically in the field of clinical psychology according to multiple areas of difference, including gender, disability, socio-econimic background, and ethnicity. Health Education England have published an action plan to improve equity of access to Clinical Psychology and one of the action points stipulates that course centres should be transparent about diversity data relating to their selection process. This evaluation considers diversity in the selection process between 2017-2020 for the Doctorate in Clinical Psychology (DClinPsy) programme at Coventry and Warwick Universities (C&W); data for C&W is compared with national data for all DClinPsy courses. This evaluation considers six demographic characteristics (gender, sexual orientation, age, socio-economic background, ethnicity, disability) across three stages of the selection process (application, shortlisting, acceptance). Findings are considered in the context of existing literature and compared against results from a previous audit conducted in 2009. Limitations of the study are discussed, and key recommendations are made based on the findings. [ABSTRACT FROM AUTHOR]

Compare the construct validity and predictive utility of cognitive intraindividual variability (IIV) in a sample of community-dwelling Hispanic and non-Hispanic white (NHW) older adults. The present study included annual data from 651 older adult control participants (Hispanic = 293; NHW = 358) enrolled in the Texas Alzheimer's Research and Care Consortium for at least 5 years. Mean composite z-scores were calculated for attention, language, memory, and executive domains. IIV was calculated as was the standard deviation both within (IIV-Within) and between (IIV-Between) these domains. At baseline, NHW individuals obtained significantly higher mean scores in each domain than their Hispanic counterparts. They also showed significantly greater variability within and between domains, except for IIV-Within the language domain which was significantly larger in the Hispanic group. IIV-Between domains was driven primarily by IIV-Within the executive function domain in the NHW cohort and by IIV-Within the language domain in the Hispanic cohort. In both groups, the addition of IIV-Within and IIV-Between cognitive domains at baseline significantly improved prediction of global cognitive status after 5 years above and beyond demographic characteristics, genetic and cardiovascular risk. However, IIV-Between domains was the strongest predictor in the NHW group, while IIV-Within the attention domain was the strongest predictor in the Hispanic group. Findings suggest that, while IIV-Between domains is a promising adjunctive method for predicting future cognitive decline, its construct validity and predictive utility varies based on ethnic group. [ABSTRACT FROM AUTHOR]

Different lines of research have argued that specific groups, such as boys or ethnic minorities, are more prone to develop an anti-school culture than others, leading to group differences in the social acceptance of high performers. Taking an ecological view, we ask to what extent the school context promotes or prevents the emergence of group-specific oppositional cultures. Theoretically, we argue that group-based oppositional cultures become more likely in schools with low socio-economic resources and in schools where socio-economic differences align with demographic attributes. We test our hypotheses based on data from a large-scale, four-wave network panel survey among more than 4000 students in Germany. Applying stochastic actor-oriented models for the coevolution of networks and behavior, we find that group-based oppositional cultures in which students like high performers less are very rare. However, in line with theoretical expectations, the less resourceful a school is, the more boys tend to evaluate high-performing peers less positively than girls do. Moreover, the more ethnic minority boys are socioeconomically disdvantaged in a school, the more they tend to evaluate high performers less positively than majority boys do. • We seek to identify school characteristics that promote gender-based or ethnicity-based oppositional cultures. • We analyze new data from a four-wave network panel survey among more than 4000 students in Germany. • Group-based oppositional cultures in which students like high performers less are rare. • The less resourceful a school is, the more likely boys rate high-performing peers less positively than girls do. • The more ethnic minority and majority boys' SES differs in a school, the more likely they rate high performers differently. [ABSTRACT FROM AUTHOR]

This study compared marginal and conditional modeling approaches for identifying individual, park and neighborhood park use predictors. Data were derived from the ParkIndex study, which occurred in 128 block groups in Brooklyn (New York), Seattle (Washington), Raleigh (North Carolina), and Greenville (South Carolina). Survey respondents (n = 320) indicated parks within one half-mile of their block group used within the past month. Parks (n = 263) were audited using the Community Park Audit Tool. Measures were collected at the individual (park visitation, physical activity, sociodemographic characteristics), park (distance, quality, size), and block group (park count, population density, age structure, racial composition, walkability) levels. Generalized linear mixed models and generalized estimating equations were used. Ten-fold cross validation compared predictive performance of models. Conditional and marginal models identified common park use predictors: participant race, participant education, distance to parks, park quality, and population >65yrs. Additionally, the conditional mode identified park size as a park use predictor. The conditional model exhibited superior predictive value compared to the marginal model, and they exhibited similar generalizability. Future research should consider conditional and marginal approaches for analyzing health behavior data and employ cross-validation techniques to identify instances where marginal models display superior or comparable performance. [ABSTRACT FROM AUTHOR]

To examine whether hospital closure is associated with high levels of area socioeconomic disadvantage and racial/ethnic minority composition. Pooled cross-sectional analysis (2007–2018) of 6467 U.S. hospitals from the American Hospital Association's Annual Survey, comparing hospital population characteristics of closed hospitals to all remaining open hospitals. We used multilevel mixed-effects logistic regression models to assess closure as a function of population characteristics, including area deprivation index ([ADI], a composite measure of socioeconomic disadvantage), racial/ethnic composition, and rural classification, nesting hospitals within hospital service areas (HSAs) and hospital referral regions. Secondary analyses examined public or private hospital type. Overall, 326 (5.0%) of 6467 U.S. hospitals closed during the study period. In multivariable models, hospitals in HSAs with a higher burden of socioeconomic disadvantage (per 10% above median ADI ZIP codes, AOR 1.05; 95% CI, 1.01–1.09) and Black Non-Hispanic composition (highest quartile, AOR 4.03; 95% CI, 2.62–6.21) had higher odds of closure. We did not observe disparities in closure by Hispanic/Latino composition or rurality. Disparities persisted for Black Non-Hispanic communities, even among HSAs with the lowest burden of disadvantage. Disproportionate hospital closure in communities with higher socioeconomic disadvantage and Black racial composition raises concerns about unequal loss of healthcare resources in the U.S. [ABSTRACT FROM AUTHOR]

Introduction: There are known disparities in the treatment of infectious diseases. However, disparities in treatment of complicated urinary tract infections (UTIs) are largely uninvestigated. Objectives: We characterized UTI treatment among males in Veterans Affairs (VA) outpatient settings by age, race, and ethnicity and identified demographic characteristics predictive of recommended first‐choice antibiotic therapy. Methods: We conducted a national, retrospective cohort study of male VA patients diagnosed with a UTI and dispensed an outpatient antibiotic from January 2010 through December 2020. Recommended first‐choice therapy for complicated UTI was defined as use of a recommended first‐line antibiotic drug choice regardless of area of involvement (ciprofloxacin, levofloxacin, or sulfamethoxazole/trimethoprim) and a recommended duration of 7 to 10 days of therapy. Multivariable models were used to identify demographic predictors of recommended first‐choice therapy (adjusted odds ratio [aOR] > 1). Results: We identified a total of 157,898 males diagnosed and treated for a UTI in the outpatient setting. The average antibiotic duration was 9.4 days (±standard deviation [SD] 4.6), and 47.6% of patients were treated with ciprofloxacin, 25.1% with sulfamethoxazole/trimethoprim, 7.6% with nitrofurantoin, and 6.6% with levofloxacin. Only half of the male patients (50.6%, n = 79,928) were treated with recommended first‐choice therapy (first‐line drug choice and appropriate duration); 77.6% (n = 122,590) were treated with a recommended antibiotic choice and 65.9% (n = 104,070) with a recommended duration. Age 18–49 years (aOR 1.07, 95% confidence interval [CI] 1.03–1.11) versus age ≥65 years was the only demographic factor predictive of recommended first‐choice therapy. Conclusions: Nearly half of the patients included in this study did not receive recommended first‐choice therapies; however, racial and ethnic disparities were not identified. Underutilization of recommended first‐choice antibiotic therapy in complicated UTIs continues to be an area of focus for antimicrobial stewardship programs. [ABSTRACT FROM AUTHOR]

Background: Screening for mental health problems has been shown to be effective to detect depression and initiate treatment in primary care. Current guidelines recommend periodic screening for depression and anxiety. This study examines the association of patient sociodemographic factors and clinic characteristics on mental health screening in primary care. Design: In this retrospective cohort study, electronic medical record (EMR) data from a 14-month period from 10/15/2021 to 12/14/2022 were analyzed. Data were retrieved from 18 primary care clinics from the Corewell Health healthcare system in West Michigan. The main outcome was documentation of any Patient Health Questionnaire (PHQ-4/PHQ-9/GAD-7) screening in the EMR within the 14-month period at patient level. General linear regression models with logit link function were used to assess adjusted odds ratio (aOR) of having a documented screening. Results: In total, 126,306 unique patients aged 16 years or older with a total of 291,789 encounters were included. The prevalence of 14-month screening was 79.8% (95% CI, 79.6–80.0). Regression analyses revealed higher screening odds for patients of smaller clinics (<5,000 patients, aOR 1.88; 95% CI 1.80–1.98 vs. clinics >10.000 patients), clinics in areas with mental health provider shortages (aOR 1.69; 95% CI 1.62–1.77), frequent visits (aOR 1.80; 95% CI, 1.78–1.83), and having an annual physical / well child visit encounter (aOR 1.52; 95% CI, 1.47–1.57). Smaller positive effect sizes were also found for male sex, Black or African American race, Asian race, Latinx ethnicity (ref. White/Caucasians), and having insurance through Medicaid (ref. other private insurance). Discussion: The 14-month mental health screening rates have been shown to be significantly lower among patients with infrequent visits seeking care in larger clinics and available mental health resources in the community. Introducing and incentivizing mandatory mental health screening protocols in annual well visits, are viable options to increase screening rates. [ABSTRACT FROM AUTHOR]

Predictive policing is a tool used increasingly by police departments that may exacerbate entrenched racial/ethnic disparities in the Prison Industrial Complex (PIC). Using a Critical Race Theory framework, we analyzed arrest data from a predictive policing program, the Strategic Subject List (SSL), and questioned how the SSL risk score (i.e., calculated risk for gun violence perpetration or victimization) predicts the arrested individual's race/ethnicity while accounting for local spatial conditions, including poverty and racial composition. Using multinomial logistic regression with community area fixed effects, results indicate that the risk score predicts the race/ethnicity of the arrested person while accounting for spatial context. As such, despite claims of scientific objectivity, we provide empirical evidence that the algorithmically‐derived risk variable is racially biased. We discuss our study in the context of how the SSL reinforces a pseudoscientific justification of the PIC and call for the abolition of these tools broadly. Highlights: Guided by Critical Race Theory, this study assesses the racialization of risk in the SSL The PIC uses surveillance to aid the criminalization of racialized communities Multinomial logistic regression found strong bias in the SSL while controlling for spatial effects Predictive policing tools offer pseudoscientific justification of the PIC and cannot be reformed [ABSTRACT FROM AUTHOR]

Background: Quantifying movement behaviours over 24-hours enables the combined effects of and inter-relations between sleep, sedentary time and physical activity (PA) to be understood. This is the first study describing 24-hour movement behaviours in school-aged children and adolescents in South-East Asia. Further aims were to investigate between-participant differences in movement behaviours by demographic characteristics and timing of data collection during Ramadan and COVID-19 restrictions. Methods: Data came from the South-East Asia Community Observatory health surveillance cohort, 2021–2022. Children aged 7–18 years within selected households in Segamat, Malaysia wore an Axivity AX6 accelerometer on their wrist for 24 hours/day over 7 days, completed the PAQ-C questionnaire, and demographic information was obtained. Accelerometer data was processed using GGIR to determine time spent asleep, inactive, in light-intensity PA (LPA) and moderate-to-vigorous PA (MVPA). Differences in accelerometer-measured PA by demographic characteristics (sex, age, ethnicity, socioeconomic group) were explored using univariate linear regression. Differences between data collected during vs outside Ramadan or during vs after COVID-19 restrictions, were investigated through univariate and multiple linear regressions, adjusted for age, sex and ethnicity. Results: The 491 participants providing accelerometer data spent 8.2 (95% confidence interval (CI) = 7.9–8.4) hours/day asleep, 12.4 (95% CI = 12.2–12.7) hours/day inactive, 2.8 (95% CI = 2.7–2.9) hours/day in LPA, and 33.0 (95% CI = 31.0–35.1) minutes/day in MVPA. Greater PA and less time inactive were observed in boys vs girls, children vs adolescents, Indian and Chinese vs Malay children and higher income vs lower income households. Data collection during Ramadan or during COVID-19 restrictions were not associated with MVPA engagement after adjustment for demographic characteristics. Conclusions: Demographic characteristics remained the strongest correlates of accelerometer-measured 24-hour movement behaviours in Malaysian children and adolescents. Future studies should seek to understand why predominantly girls, adolescents and children from Malay ethnicities have particularly low movement behaviours within Malaysia. [ABSTRACT FROM AUTHOR]

Objectives: It is well established that defendants who plead guilty receive reduced sentences compared to the likely outcome if convicted at trial. Prominent theories of plea bargaining posit that the plea discount is determined by the strength of the evidence against the defendant. Research on this claim has produced mixed findings, however, and others have suggested that discounts may be influenced by extra-legal characteristics such as race, age, and sex. To date, there have been few attempts to directly compare the effects of these factors on plea discount estimates. Methods: This study uses a penalized ridge regression to predict counterfactual trial sentences for a sample of defendants who pled guilty. Plea discounts are estimated using each defendant's predicted trial sentence and observed plea sentence. Discount estimates are then regressed on variables related to case evidence and the demographic characteristics of the defendant. Results: Results suggest that increases in the amount of evidence associated with a case lead to decreases in the size of the plea discount. Both main and interaction effects are observed for race/ethnicity and sex, with Hispanic and male defendants receiving significantly smaller discounts than White or female defendants. Calculation of standardized effect sizes further indicates that demographic characteristics exert larger effects on plea discount estimates than evidentiary variables. Conclusions: Plea discounts appear to be influenced by both evidence and extra-legal factors. Legal participants may indeed consider the strength of the evidence when determining acceptable plea discounts, but this alone appears to be an insufficient explanation. [ABSTRACT FROM AUTHOR]

Despite home visiting's established legacy, the potential influence of intersecting parental characteristics on parent–worker relationships is less understood. This study examines the main and interaction effects of parents' demographic characteristics on positive relationships with workers in home visiting and compares whether and how these effects differ between fathers and mothers. This study analyzed 130 mothers and 180 fathers who participated in home visiting services. Immigrant status was a significant predictor of positive worker relationships for mothers and fathers, whereas ethnicity was only significant for fathers. Interaction analyses indicated that U.S.-born Hispanic/Latinx fathers faced greater challenges in building positive worker relationships than their foreign-born counterparts. These findings highlight the importance of developing gender-specific and culturally responsive strategies to enhance parent–worker relationships. [ABSTRACT FROM AUTHOR]

Rationale: Pulmonary arterial hypertension (PAH) is a heterogeneous disease within a complex diagnostic and treatment environment. Other complex heart and lung diseases have substantial regional variation in characteristics and outcomes; however, this has not been previously described in PAH. Objectives: To identify baseline differences between U.S. census regions in the characteristics and outcomes for participants in the Pulmonary Hypertension Association Registry (PHAR). Methods: Adults with PAH were divided into regional groups (Northeast, South, Midwest, andWest), and baseline differences between census regions were presented. Kaplan-Meier survival analyses and Cox proportional hazards were used to estimate the association between region and mortality in unadjusted and adjusted models. Results: Substantial differences by census regions were seen in age, race, ethnicity, marital status, employment, insurance payor breakdown, active smoking, and current alcohol use. Differences were also seen in PAH etiology and baseline 6-minute walk distance test results. Treatment characteristics varied by census region, and mortality appeared to be lower in PHAR participants in the West (hazard ratio, 0.60; 95% confidence interval, 0.43-0.83, P = 0.005). This difference was not readily explained by differences in demographic characteristics, PAH etiology, baseline severity, baseline medication regimen, or disease prevalence. Conclusions: The present study suggests significant regional variation among participants at accredited pulmonary vascular disease centers in multiple baseline characteristics and mortality. This variation may have implications for clinical research planning and represent an important focus for further study to better understand whether there are remediable care aspects that can be addressed in the pursuit of providing equitable care in the United States. [ABSTRACT FROM AUTHOR]

We investigated 328 SARS-CoV-2 cases in Barwon South West, Victoria, Australia, in the 2020 pre-vaccination period, comparing infections with symptoms to those that remained asymptomatic. De-identified self-reported data on case characteristics and symptom progression from three sequential questionnaires were examined. Multivariable logistic regression was used to model associations between demographic profiles and symptoms. Asymptomatic infections were more than three times as likely to be seen in ethnic minority groups than the Caucasian population after adjusting for gender and age [OR 3.2, 95% CI 1.5–6.7, p < 0.01] and were more common among cases of Asian background [OR 2.8, 95%CI 1.2–6.4]. Asymptomatic infections were also more common in youth and younger adults, but cases were approximately seven times more likely to be in seniors (≥65 years) compared with those 24 years of age or younger after adjusting for sex and ethnicity [OR 6.9, 95% CI 1.3–35.8]. The overrepresentation of ethnic minority groups among asymptomatic infections is suggestive of genetic haplotype variability by ethnic group, conferring greater cross-protection from other coronaviruses in the initial phase of the COVID-19 pandemic. Replication of this analysis in the post-vaccination era and reassessment of symptom expression according to ethnicity in a community with established vaccine and infection-induced immunity would determine whether this is a sustained association or one confined to the early stages of a pandemic in an immunologically naive population. These findings may, in part, reflect differences in testing patterns by ethnicity and true differences in disease expression, both of which are important to understand in order to inform transmission prevention strategies and tailored risk messaging according to ethnic background. [ABSTRACT FROM AUTHOR]

Vaccination has proven to be effective at preventing severe outcomes of COVID-19 infection, and uptake in the population has been high in Wales. However, there is a risk that high-level vaccination coverage statistics may mask hidden inequalities in under-served populations, many of whom may be at increased risk of severe outcomes of COVID-19 infection. The study population included 1,436,229 individuals aged 18 years and over, alive and residence in Wales as at 31st July 2022, and excluded immunosuppressed or care home residents. We compared people who had received one or more vaccinations to those with no vaccination using linked data from nine datasets within the Secure Anonymised Information Linkage (SAIL) databank. Multivariable analysis was undertaken to determine the impact of a range of sociodemographic characteristics on vaccination uptake, including ethnicity, country of birth, severe mental illness, homelessness and substance use. We found that overall uptake of first dose of COVID-19 vaccination was high in Wales (92.1 %), with the highest among those aged 80 years and over and females. Those aged under 40 years, household composition (aOR 0.38 95 %CI 0.35–0.41 for 10+ size household compared to two adult household) and being born outside the UK (aOR 0.44 95 %CI 0.43–0.46) had the strongest negative associations with vaccination uptake. This was followed by a history of substance misuse (aOR 0.45 95 %CI 0.44–0.46). Despite high-level population coverage in Wales, significant inequalities remain across several underserved groups. Factors associated with vaccination uptake should not be considered in isolation, to avoid drawing incorrect conclusions. Ensuring equitable access to vaccination is essential to protecting under-served groups from COVID-19 and further work needs to be done to address these gaps in coverage, with focus on tailored vaccination pathways and advocacy, using trusted partners and communities. [ABSTRACT FROM AUTHOR]

Background:The COVID-19 pandemic demanded rapid development of telemedicine services for pediatric care and highlighted disparities for marginalized communities. Objective:To understand the demographic characteristics of patients with completed and incomplete telemedicine visits at Ann and Robert H. Lurie Children's Hospital of Chicago. Methods:This was a cross-sectional retrospective analysis of telemedicine visits for patients <25 years old scheduled between March 21, 2020, and March 17, 2021. We examined visit outcomes and compared outcomes by race/ethnicity, language, and payer using logistic regression. Geographic information system mapping and linear regression were used to examine the relationship between incomplete visits and broadband access within Cook County. Results:A total of 13,655 eligible video visits were scheduled for children within 147 ZIP codes during the study time frame. Patient characteristics included median age 9 years, 53% female, 42% non-Latinx White, 31% Latinx, 13% non-Latinx Black, 11% non-Latinx other, and 3% declined/unknown. Preferred language was 89% English, 10% Spanish, and 1% other. Payer was 56% private, 43% public, and <1% other/self-pay. Overall, 86% video visits were completed, 7% cancelled, and 7% no-show with significant variation by patient demographic. Odds of incomplete visits were higher for Latinx patients (odds ratio [OR] 1.93) and non-Latinx Black patients (OR 2.33) than for non-Latinx White patients, patients with preferred language other than English (OR 1.53), and patients not privately insured (OR 1.89). Incomplete visit rates and broadband access were inversely related. Conclusion:System and policy solutions are needed to ensure equitable access and address disparities in incomplete telemedicine visits for marginalized populations in urban areas with lower broadband. [ABSTRACT FROM AUTHOR]

A summary of the article "Developing Therapy for Every Kid With Cancer – Summary of a Scientific Session at the 2023 ASCPT Meeting" highlights the challenges and opportunities in developing treatment for children with cancer. The session emphasized the need for a multidisciplinary approach to address the limited understanding of physiological differences, ethical considerations, and small patient populations. The first talk focused on the challenges of treating infants and neonates, who require unique dosing regimens due to their rapidly maturing physiological processes. The second talk discussed racial and ethnic disparities in childhood cancer outcomes, with specific genetic variants and socio-economic factors contributing to worse outcomes for minority children. The final talk addressed roadblocks in clinical trial development and suggested flexible approaches to prioritize scientifically necessary aspects of trials and reduce travel costs for families. The session aimed to stimulate further discussions and collaborations among attendees. [Extracted from the article]

Background: Women with early breast cancer who meet guideline-based criteria should be offered breast conserving surgery (BCS) with adjuvant radiotherapy as an alternative to mastectomy. New Zealand (NZ) has documented ethnic disparities in screening access and in breast cancer treatment pathways. This study aimed to determine whether, among BCS-eligible women, rates of receipt of mastectomy or radiotherapy differed by ethnicity and other factors. Methods: The study assessed management of women with early breast cancer (ductal carcinoma in situ [DCIS] and invasive stages I-IIIA) registered between 2010 and 2015, extracted from the recently consolidated New Zealand Breast Cancer Registry (now Te Rēhita Mate Ūtaetae NZBCF National Breast Cancer Register). Specific criteria were applied to determine women eligible for BCS. Uni- and multivariable analyses were undertaken to examine differences by demographic and clinicopathological factors with a primary focus on ethnicity (Māori, Pacific, Asian, and Other; the latter is defined as NZ European, Other European, and Middle Eastern Latin American and African). Results: Overall 22.2% of 5520 BCS-eligible women were treated with mastectomy, and 91.1% of 3807 women who undertook BCS received adjuvant radiotherapy (93.5% for invasive cancer, and 78.3% for DCIS). Asian ethnicity was associated with a higher mastectomy rate in the invasive cancer group (OR 2.18; 95%CI 1.72–2.75), compared to Other ethnicity, along with older age, symptomatic diagnosis, advanced stage, larger tumour, HER2-positive, and hormone receptor-negative groups. Pacific ethnicity was associated with a lower adjuvant radiotherapy rate, compared to Other ethnicity, in both invasive and DCIS groups, along with older age, symptomatic diagnosis, and lower grade tumour in the invasive group. Both mastectomy and adjuvant radiotherapy rates decreased over time. For those who did not receive radiotherapy, non-referral by a clinician was the most common documented reason (8%), followed by patient decline after being referred (5%). Conclusion: Rates of radiotherapy use are high by international standards. Further research is required to understand differences by ethnicity in both rates of mastectomy and lower rates of radiotherapy after BCS for Pacific women, and the reasons for non-referral by clinicians. [ABSTRACT FROM AUTHOR]

This study examines the connection between education and terrorism. By using information provided by the police and the army during the various terrorist assaults in the Sahel region and the filtering method, we build a micro data set from 2019 to 2021 from interventions in Burkina Faso, Niger, and Mali. Implementing several models, we find a positive association between education and terrorism which suggests that more educated people are more likely to engage in terrorism. We also find that terrorists are generally active in the labour market. These results are associated with socio-economic and demographic characteristics of the individual and institutional framework, especially attendance to religious school, gender, age, and the presence of law enforcement in the attack place. Furthermore, we provide evidence that unlike "the old paradigm", terrorists come more from urban than rural areas and are sensitive to spatial heterogeneity which contributes to reduce their motivation. The negative binomial results confirm that the higher the level of education of the terrorist, the greater the number of victims. Educated terrorists cause the most damage and are the most dangerous. In view of the results, policies are suggested. [ABSTRACT FROM AUTHOR]

This study identified patterns of classroom and family experiences and developmental outcomes for young children in segregated early education. This study is based on data from a high-quality early education program serving young children from low-income households in 19 schools across the U.S. The sample included 1,521 children during the 2016–2017 school year. The analysis examined patterns of association between the racial/ethnic composition of Educare sites and family risk factors, classroom quality, and children's language and social-emotional performance and growth across the academic year. Research Findings: Findings indicated that although classroom quality, measured through traditional tools, did not vary by school racial/ethnic composition, sociodemographic risk factors, children's language and social-emotional outcomes did vary by this variable. Practice or Policy: We discuss our results in relation to promotive and inhibitive processed within and outside early education programs, as well as the continued impact of structural equities and lack of culturally responsive pedagogy on children's learning opportunities and development. [ABSTRACT FROM AUTHOR]

Background: TheUnited States' (U.S.) initiative to End the HIV Epidemic aims to reduce new HIV infections in areas of high HIV prevalence. Despite national efforts to reduce HIV incidence, cisgender women continue to represent approximately one out of every five new HIV diagnoses in the U.S. Taking pre-exposure prophylaxis (PrEP) is an effective HIV prevention strategy; however, PrEP initiation among cisgender women is suboptimal, with only 10% of eligible women receiving PrEP prescriptions in 2019. Methods:We designed a trial to test the effectiveness of interventions to increase PrEP initiation, while evaluating the implementation strategy (hybrid type II trial) in seven obstetrics and gynecology (OB/GYN) clinics (two federally qualified health centers, three community-based, and two academic) in Baltimore, Maryland. A total of 42 OB/GYN providers will be enrolled and randomized (1:1:1) into one of three clinical trial arms (standard of care, patient-level intervention, or multi-level intervention). Eligible patients of enrolled providers will receive a sexual health questionnaire before their appointment through the electronic health record's (EHR) patient portal. The questionnaire will be scored in three tiers (low, moderate, and high) to assess HIV risk. Patients at low risk will be offered an HIV test only, while those who score medium or high risk will be included in the clinical trial and assigned to the clinical trial arm associated with their provider. Differences in PrEP initiation, our primary outcome, across the three arms will be analyzed using generalized linear mixedeffect models with logistic regression. We will adjust results for demographic differences observed between arms and examine PrEP initiation stratified by patient's and provider's race and ethnicity. Additionally, a comprehensive economic analysis for each intervention will be conducted. Discussion: We hypothesize that gathering information on sensitive sexual behaviors electronically, communicating HIV risk in an understandable and relatable format to patients and OB/GYN providers, and deploying EHR alerts will increase PrEP initiation and HIV testing. [ABSTRACT FROM AUTHOR]

COVID-19 has disproportionately impacted individuals depending on where they live and work, and based on their race, ethnicity, and socioeconomic status. Studies have documented catastrophic disparities at critical points throughout the pandemic, but have not yet systematically tracked their severity through time. Using anonymized hospitalization data from March 11, 2020 to June 1, 2021 and fine-grain infection hospitalization rates, we estimate the time-varying burden of COVID-19 by age group and ZIP code in Austin, Texas. During this 15-month period, we estimate an overall 23.7% (95% CrI: 22.5–24.8%) infection rate and 29.4% (95% CrI: 28.0–31.0%) case reporting rate. Individuals over 65 were less likely to be infected than younger age groups (11.2% [95% CrI: 10.3–12.0%] vs 25.1% [95% CrI: 23.7–26.4%]), but more likely to be hospitalized (1,965 per 100,000 vs 376 per 100,000) and have their infections reported (53% [95% CrI: 49–57%] vs 28% [95% CrI: 27–30%]). We used a mixed effect poisson regression model to estimate disparities in infection and reporting rates as a function of social vulnerability. We compared ZIP codes ranking in the 75th percentile of vulnerability to those in the 25th percentile, and found that the more vulnerable communities had 2.5 (95% CrI: 2.0–3.0) times the infection rate and only 70% (95% CrI: 60%-82%) the reporting rate compared to the less vulnerable communities. Inequality persisted but declined significantly over the 15-month study period. Our results suggest that further public health efforts are needed to mitigate local COVID-19 disparities and that the CDC's social vulnerability index may serve as a reliable predictor of risk on a local scale when surveillance data are limited. Author summary: COVID-19 disproportionately impacted communities based on their socioeconomic and racial composition. Studies have documented catastrophic disparities at multiple geographic scales, but have not yet tracked how they evolved over time. Here, we use fine-grain epidemiological data to estimate the time-varying disparate burden of COVID-19 by age group and ZIP code in Austin, Texas. During this 15-month period, we estimate that 23.7% (95% CrI: 22.5–24.8%) of the population was infected and 29.4% (95% CrI: 28.0–31.0%) of those infections were reported. Infections were not spread evenly across the region. Individuals over 65 were significantly less likely to be infected than younger age groups (11.2% [95% CrI: 10.3–12.0%] vs 25.1% [95% CrI: 23.7–26.4%]), suggesting that efforts to protect those populations may have been effective. We found that the most vulnerable ZIP codes in the region faced 2.5 times the infection risks compared with the least vulnerable ZIP codes, and that infections were only 70% as likely to be reported in vulnerable communities. Inequality persisted but declined significantly over the 15-month study period. Further public health efforts are needed to address local COVID-19 disparities. [ABSTRACT FROM AUTHOR]

Objective: Facial palsy affects patients of all backgrounds, yet no existing studies describe differences in its treatment patterns between demographic groups. Methods: We used the National Surgical Quality Improvement Project database to investigate whether race and sex disparities exist in facial reanimation surgery. Patients were identified using CPT codes corresponding to facial‐nerve procedures. Results: Seven hundred sixty‐one patients met criteria; 681 self‐identified as White (89.5%), 51 as Black (6.7%), 43 as Hispanic (5.6%), 23 as Asian (3.0%), and 5 patients as other (0.61%). White patients were more than twice as likely to undergo brow ptosis repair than Non‐White patients (OR 2.49, 95% CI 1.16–6.15, p =.03). After controlling for malignancy, men had longer operative times than women (480.2 vs. 413.9 min, p =.04) and higher likelihood of free tissue transfer (OR 4.1, 95% CI 1.9–9.8), fascial free tissue transfer (OR 10.7, 95% CI 2.1–195), and ectropion repair (OR 1.8, 95% CI 1.2–2.8). Conclusion: Most patients undergoing facial reanimation surgery in the United States are White. Men have longer operative times and a higher likelihood of undergoing free fascial grafts and cutaneous and fascial free tissue transfer than women regardless of malignancy status. Level of Evidence: 2c. [ABSTRACT FROM AUTHOR]

Using national online surveys of U.S. adults who know a missing person, the current study explores factors influencing missing person case outcomes (i.e. the person being found alive, an arrest occurring). Both demographic characteristics (e.g. the missing person's sex, race/ethnicity, income) and search activities (e.g. case reported to the police, social media posts) were significantly related to these case outcomes. Multivariate analyses confirmed the strong net effect of federal police reporting on case outcomes, but the impact of search activities and the missing person's socio-economic characteristics were context specific. These results are discussed in terms of their implications for public policy and future research on the nature and sources of disparities in missing person case outcomes across different situational contexts. [ABSTRACT FROM AUTHOR]

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We know from election studies which demographic characteristics best predict vote choice, but we know far less about how citizens perceive their similarity to one another in terms of these characteristics. Previous research suggests that such perceptions may be crucial for the politicization of social identities and the emergence of political identities. I present results from a novel measurement strategy where respondents are presented with the profiles of two fellow citizens, including several demographic attributes. Respondents are asked which of the two they perceive themselves to have more in common with in terms of politics. Respondents' implicit trade-off of different demographic similarities allows me to measure the relative strength of their perceived political similarities. I find an important role for shared ethnicity, noticeably surpassing shared social class, age and education. Finally, I find that shared ethnicity receives substantially more weight among 2017 Conservative and 2016 Leave voters than among Labour and Remain voters. [ABSTRACT FROM AUTHOR]

To adhere to health regulations and reduce the risks associated with the COVID-19 pandemic, employers, mobility operators, and travelers alike adopted new strategies such as teleworking, rigorous sanitation, and social distancing. In this research, we examine the individual-level factors contributing to transit ridership abandonment and return decisions. We utilize comprehensive survey-based data of transit users in the Chicago metropolitan area (N = 5648) collected prior to reopening. We investigate three ridership behaviors, namely (1) discontinued public transit ridership, (2) the intent to return to pre-pandemic transit ridership levels once health concerns are alleviated, and (3) the likelihood of using public transit more often if its fare systems are integrated with other mobility services such as ridehailing and micromobility. Examining the role of sociodemographics, employment characteristics, transit investment priorities, and travel behavior before and during the pandemic, this research reveals fine-grained details about transit usage decline, as well as future intentions. The results indicate that teleworking, unemployment, and vehicle access are the major factors behind discontinued transit ridership. Analysis of race, ethnicity, and gender effects reveals that vulnerable users often have a higher risk of abandonment coupled with a lower likelihood of returning. These results point to the need for transit agencies to consider the specific concerns of ethnic/racial minorities and women. Encouragingly, there is an opportunity for agencies to attract more ridership with fare integration. Several respondent segments would use transit more if fare systems are integrated with ridehailing and micromobility, highlighting the importance of lowering the barriers to accessing these mobility services. This research informs several policies that can be adopted by transit agencies and other mobility providers. We discuss the importance of an equitable return to transit, possibilities for Mobility-as-a-Service with fare integration as a starting point and stress the significance of teleworking in future transit policies. • Study pandemic abandonment of transit, intentions to return to riding transit, and likelihood of increased ridership with fare integration. • Assess the role of sociodemographics, employment characteristics, transit investment priorities, and travel behavior. • Compare the ridership return intentions by multiple transit agency types (e.g. urban/suburban, bus/rail). • Teleworking, vehicle access, racial or ethnic minority status or priority for sanitation of transit facilities impact future ridership intentions. • Discussion of how transit can attract vulnerable customer segments during the pandemic recovery phase. [ABSTRACT FROM AUTHOR]

BACKGROUND: New York City's (NYC's) taxi/for-hire vehicle (FHV) drivers have occupational and demographic characteristics associated with food insecurity (low income, comorbidities, minority race/ethnicity). OBJECTIVE: To analyze food insecurity rates in a sample of NYC drivers and to identify associated factors. METHODS: At health fairs, we recruited a cross-sectional sample of licensed taxi/FHV drivers willing to receive study text messages. Most lacked a primary care provider. Food insecurity prevalence and associations with health and economic indicators were analyzed. RESULTS: Of 503 participants who completed a 2-item food security screener, 39.2% were food insecure. Significantly fewer food insecure than food secure drivers reported a doctor visit within the past year (48% vs 25%; P <.001). Food insecure drivers had greater weekly traffic ticket expenditure ($34 vs $24; P =.02) and were more likely to report insufficient household income (61% vs 39%; P <.001) and history of depression (14% vs 7%; P =.02), to have elevated (>200) measured total cholesterol (50% vs 37%; P =.02), and to have Perceived Stress Scale scores indicating greater stress than food secure drivers (14 vs 11; P =.002). In a binary logistic regression analysis, drivers who reported that their total household income was enough to meet their basic needs had significantly lower odds of being food insecure (0.695 odds ratio; P =.016). CONCLUSION: Food insecurity was high in this group of taxi/FHV drivers. Food insecurity interventions are needed and could be occupationally based, with worksite screening and resource navigation. Policies should address improving wages and healthcare access. [ABSTRACT FROM AUTHOR]

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For patients with type 2 diabetes, metformin is the most often recommended drug. However, there are substantial individual differences in the pharmacological response to metformin. To investigate the effect of transporter polymorphisms on metformin pharmacokinetics in an environment free of confounding variables, we conducted our study on healthy participants. This is the first investigation to consider demographic characteristics alongside all transporters involved in metformin distribution. Pharmacokinetic parameters of metformin were found to be affected by age, sex, ethnicity, and several polymorphisms. Age and SLC22A4 and SLC47A2 polymorphisms affected the area under the concentration-time curve (AUC). However, after adjusting for dose-to-weight ratio (dW), sex, age, and ethnicity, along with SLC22A3 and SLC22A4, influenced AUC. The maximum concentration was affected by age and SLC22A1, but after adjusting for dW, it was affected by sex, age, ethnicity, ABCG2, and SLC22A4. The time to reach the maximum concentration was influenced by sex, like half-life, which was also affected by SLC22A3. The volume of distribution and clearance was affected by sex, age, ethnicity and SLC22A3. Alternatively, the pharmacokinetics of metformin was unaffected by polymorphisms in ABCB1, SLC2A2, SLC22A2, or SLC47A1. Therefore, our study demonstrates that a multifactorial approach to all patient characteristics is necessary for better individualization. [ABSTRACT FROM AUTHOR]

Background/Context: The sense of belonging to a school is important for students, in terms of various short- and long-term developmental and academic outcomes. The inequities in the sense of school belonging among Asian American and Pacific Islander (AAPI) students may reveal a severe lack of opportunities or serious process gaps for these students. Purpose/Objective: This study investigated the nuances and complexities involved in the sense of school belonging among AAPI students in U.S. high schools, and particularly how such perceptions relate to various demographic characteristics (i.e., ethnicity, gender, socioeconomic status, and immigration status) and their intersectionalities. The study disaggregated this group into subgroups based on their ethnicities, with the aim of challenging the model minority stereotype that generalizes the experiences of AAPI students. Research Design: This study used base-year data of the High School Longitudinal Study of 2009 (HSLS:09) provided by the National Center for Education Statistics (NCES). Linear mixed-effects modeling was used to analyze a nationally representative sample. Multiple statistical interaction terms were used to identify the specific contributions (intersectionality) of AAPI students' converging demographic characteristics. Findings/Results: This study found that the sense of school belonging was stronger for South Asian students and weaker for East Asian students when compared to the overall level, with other demographic characteristics held constant. The intersectionality model using disaggregated data revealed that the convergence of AAPI students' ethnicity and gender creates additional nuances in their sense of school belonging, particularly for Southeast Asian and East Asian students. Conclusions/Recommendations: The findings support the call for more accurate narratives and a deeper understanding of intersectionality among AAPI students. The study suggests to policymakers and school leaders that a universal strategy for encouraging students' sense of school belonging may not effectively address the nuanced intersectional disparities that AAPI students experience. Instead, the intersection of students' ethnicity and gender indicates that responsive strategies that address their unique needs can better promote their perceptions of belonging to their schools. [ABSTRACT FROM AUTHOR]