BACKGROUND Most studies have defined economic well-being as socioeconomic status,with little attention given to whether other indicators influence self-esteem.Little is known about racial/ethnic disparities in the rel...BACKGROUND Most studies have defined economic well-being as socioeconomic status,with little attention given to whether other indicators influence self-esteem.Little is known about racial/ethnic disparities in the relationship between economic wellbeing and self-esteem during adulthood.AIM To explore the impact of economic well-being on self-esteem in adulthood and differences in the association across race/ethnicity.METHODS The current study used data from the National Longitudinal Survey of Youth 1979.The final sample consisted of 2267 African Americans,1425 Hispanics,and 3678 non-Hispanic Whites.Ordinary linear regression analyses and logistic regression analyses were conducted.RESULTS African Americans and Hispanics were more likely to be in poverty in comparison with non-Hispanic Whites.More African Americans were unemployed than Whites.Those who received fringe benefits,were more satisfied with jobs,and were employed were more likely to have higher levels of self-esteem.Poverty was negatively associated with self-esteem.Interaction effects were found between African Americans and job satisfaction predicting self-esteem.CONCLUSION The role of employers is important in cultivating employees’self-esteem.Satisfactory outcomes or feelings of happiness from the workplace may be more important to non-Hispanic Whites compared to African Americans and Hispanics.展开更多
Non-alcoholic fatty liver disease(NAFLD)comprehends a wide range of conditions,encompassing from fatty liver or steatohepatitis with or without fibrosis,to cirrhosis and its complications.NAFLD has become the most com...Non-alcoholic fatty liver disease(NAFLD)comprehends a wide range of conditions,encompassing from fatty liver or steatohepatitis with or without fibrosis,to cirrhosis and its complications.NAFLD has become the most common form of liver disease in childhood as its prevalence has more than doubled over the past 20years,paralleling the increased prevalence of childhood obesity.It currently affects between 3%and11%of the pediatric population reaching the rate of46%among overweight and obese children and adolescents.The prevalence of hepatic steatosis varies among different ethnic groups.The ethnic group with the highest prevalence is the Hispanic one followed by the Caucasian and the African-American.This evidence suggests that there is a strong genetic background in the predisposition to fatty liver.In fact,since 2008several common gene variants have been implicated in the pathogenesis of fatty liver disease.The most important is probably the patatin like phospholipase containing domain 3 gene(PNPLA3)discovered by the Hobbs’group in 2008.This article reviews the current knowledge regarding the role of ethnicity and genetics in pathogenesis of pediatric fatty liver.展开更多
AIM To investigate whether minority ethnicity and the duration of education influence preoperative disability and expectations in patients undergoing total knee arthroplasty.METHODS We prospectively included 829 patie...AIM To investigate whether minority ethnicity and the duration of education influence preoperative disability and expectations in patients undergoing total knee arthroplasty.METHODS We prospectively included 829 patients undergoing primary unilateral total knee arthroplasty(TKA) from April 2013 to December 2014 at a single centre. Patients filled in pre-operative questionnaires with information regarding place of birth, duration of education, expectations for outcome of surgery and baseline characteristics. Patients were stratified based on ethnicity. Majority ethnicity was defined as born inthe study country and minority ethnicity was defined as born in any other country. Similarly, patients were stratified based on duration of education in groups defined as < 9 years, 9-12 years and > 12 years, respectively.RESULTS We found that 92.2% of patients were of majority ethnicity. We found that 24.5%, 44.8% and 30.8% of patients had an education of < 9 years, 9-12 years and > 12 years, respectively. The mean preoperative(preOP) oxford knee score(OKS) in the total population was 23.6. Patients of minority ethnicity had lower mean pre-OP OKS(18.6 vs 23.9, P < 0.001), higher pain levels(VAS 73.0 vs 58.7, P < 0.001), expected higher levels of post-OP pain(VAS 14.1 vs 6.1, P = 0.02) and of overall symptoms(VAS 16.6 vs 6.4, P = 0.006). Patients with > 12 years education had lower mean pre-OP OKS(21.5 vs 23.8 and 24.6, P < 0.001) and higher pre-OP VAS pain(65.4 vs 59.2 and 56.4, P < 0.001) compared to groups with shorter education. One year post-operative(post-OP) patients of minority ethnicity had lower mean OKS, higher pain and lower QoL. One year post-OP patients with > 12 years education reported higher pain compared to patients with shorter educations. However, the response-rate was low(44.6%), and therefore post-OP results were not considered to be significant.CONCLUSION Minority ethnicity and the duration of education influ-ence preoperative disability and expectation in patients undergoing TKA. This should be taken into account when patients are advised pre-operatively.展开更多
Irinotecan is now regarded as the most active drug for the treatment of colorectal cancer.However,one of the most difficult issues oncologists face is deciding the optimal dose for an individual patient,as each indivi...Irinotecan is now regarded as the most active drug for the treatment of colorectal cancer.However,one of the most difficult issues oncologists face is deciding the optimal dose for an individual patient,as each individual shows different outcomes even at the same dose with regard to treatment related adverse events,ranging from no toxicity to a lethal event.Inherited genetic polymorphism of a single gene or multiple genes(haplotype or linkage disequilibrium) involved in SN-38 glucuronidation,a predominant route of irinotecan detoxification,is now recognized as a significant factor that can alter the incidence of side effects.Attempts to explore such inherited genetic variability have been focused on elucidating interindividual as well as interethnic differences.Genotyping studies in relation to adverse events in an individual or in a group of similar ethnicity should contribute to establishing individualoriented or ethnicity-oriented irinotecan treatment regimens.This review highlights current single-or multi-tired approaches for the elucidation of genetic predispositions of patients to severe toxicities,especially among Asians.The purpose of this is to contribute to minimizing toxicity by dose modifications,with the consequent aim of maximizing dose intensity and efficacy,an ultimate goal of irinotecan-individualized therapy.展开更多
Aim of Work: Initial observations implied IgG rheumatoid factor (RF) to be common among Malaysian rheumatoid arthritis (RA) patients. We tested this hypothesis and used a multiethnic RA cohort (Malays, Chinese and Ind...Aim of Work: Initial observations implied IgG rheumatoid factor (RF) to be common among Malaysian rheumatoid arthritis (RA) patients. We tested this hypothesis and used a multiethnic RA cohort (Malays, Chinese and Indians) to investigate whether the IgG RF predominance might be genetically or environmentally determined. Patients and Methods: 556 serum samples comprising 171 patients classified as RA according to the 1987 ACR criteria, 60 patients with other rheumatic diseases and 325 non-rheumatic controls were tested for IgG RF, IgM RF and anti-CCP by ELISA. The findings were then tested in a larger RA case-control cohort (n = 1844). Results: IgG RF predominated over IgM RF in all the investigated ethnic groups. The sensitivity, specificity, and diagnostic accuracy of IgG RF (55.6%, 91.2% and 80.2%, respectively) were superior compared to IgM RF, but comparable to anti-CCP. IgG RF was however, also increased in the Malaysian controls, but the IgG RF superiority over IgM RF was still apparent after cutoff adjustment according to the 1987 ACR criteria. Autoantibody levels did not differ between the three ethnic groups. The Receiver Operating Characteristics (ROC) curves showed larger areas under the curves for IgG RF (0.826) and for anti-CCP (0.867) than for IgM RF (0.737). Review of the literature showed consistently higher sensitivity for IgG RF in studies of Asian RA patients as compared to Caucasian and African-American studies. Conclusion: Increased frequency of IgG RF-positive in RA populations with different genetic background living in Malaysia argues for an environmental factor selectively amplifying the IgG RF response.展开更多
AIM:To investigate whether or not bariatric surgeryweight outcomes vary by ethnicity in a large,nationally representative sample of adolescents.METHODS:The Bariatric Outcomes Longitudinal Database was used for analysi...AIM:To investigate whether or not bariatric surgeryweight outcomes vary by ethnicity in a large,nationally representative sample of adolescents.METHODS:The Bariatric Outcomes Longitudinal Database was used for analysis and contains data on surgeries performed on adolescents from 2004 to 2010from 423 surgeons at 360 facilities across the United States Adolescents(n=827)between 11 and 19 years old who underwent either gastric bypass or adjustable gastric banding surgery were included in the analysis.Outcome measures included changes in anthropometric measurements[weight(kg)and body mass index]from baseline to 3(n=739),6(n=512),and 12(n=247)mo after surgery.RESULTS:A year after patients underwent either gastric bypass(51%)or adjustable gastric banding(49%)surgery,mean estimated weight loss for all ethnic groups differed by a maximum of only 1.5 kg,being34.3 kg(95%CI:30.0-38.5 kg)for Hispanics,33.8 kg(95%CI:27.3-40.3 kg)for non-Hispanic blacks,and32.8 kg(95%CI:30.9-34.7 kg)for non-Hispanic whites.No overall pairwise group comparisons were significant,indicating that no ethnic group had better weight loss outcomes than did another.CONCLUSION:Bariatric surgery substantially reduces the weight of severely obese adolescents at 1 year post-procedure with little variation by ethnicity and/or gender.These results suggest that bariatric surgery is a safe and reasonable treatment for all severely obese adolescents with the appropriate indications.展开更多
AIM: To investigate the influence of ethnicity in social anxiety disorder(SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences' students.METHODS: This was a c...AIM: To investigate the influence of ethnicity in social anxiety disorder(SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences' students.METHODS: This was a cross-sectional survey of 112 1st, 2nd and 3rd year students from the Faculty of Medicine and Health Sciences at Stellenbosch University, Cape Town, South Africa. The self-reported Social Anxiety Spectrum questionnaire was used to assess for SAD. The Social Phobia Inventory(SPIN) was adapted to a version called the E-SPIN(Ethnic-SPIN) in order to evaluate the effects of ethnicity. Two sub-questions per stem question were included to assess whether SAD symptoms in social interactions were ethnicity dependent. Substance use was assessed with the Alcohol UseDisorders Identification Test and Drug Use Disorders Identification Test, and depression with the Centre for Epidemiological Studies Depression Scale.RESULTS: Of 112 students who completed the E-SPIN questionnaire, 54.4%(n = 61) met criteria for SAD, with significantly more females than males meeting criteria. Ethnicity had a significant effect on SAD symptomatology, but there was no effect of ethnicity on the rates of drug and alcohol abuse in students with and without SAD. Overall significantly more students with SAD met criteria for depression compared with students without the disorder. CONCLUSION: Among university students, SAD is prevalent regardless of whether interactions are with individuals of the same or different ethnic group. However, ethnicity may be an important determinant of social anxiety for some ethnic groups. SAD was significantly associated with major depression but not significantly associated with drug or alcohol abuse.展开更多
BACKGROUND Inflammatory bowel disease(IBD)patients’expectations of treatment outcomes may differ by ethnicity.AIM To investigate treatment preferences of Jewish and Arabs patients.METHODS This prospective survey rank...BACKGROUND Inflammatory bowel disease(IBD)patients’expectations of treatment outcomes may differ by ethnicity.AIM To investigate treatment preferences of Jewish and Arabs patients.METHODS This prospective survey ranked outcomes treatment preferences among Arab IBD patients,based on the 10 IBD-disk items compared to historical data of Jews.An anonymous questionnaire in either Arabic or Hebrew was distributed among IBD patients.Patients were required to rank 10 statements describing different aspects of IBD according to their importance to the patients as treatment goals.Answers were compared to the answers of a historical group of Jewish patients.RESULTS IBD-disk items of 121 Arabs were compared to 240 Jewish patients.The Jewish patients included more females,[151(62.9%)vs 52(43.3%);P<0.001],higher education level(P=0.02),more urban residence[188(78.3%)vs 54(45.4%);P<0.001],less unemployment[52(21.7%)vs 41(33.9%);P=0.012],higher income level(P<0.001),and more in a partnership[162(67.8%)vs 55(45.4%);P<0.001].Expectations regarding disease symptoms:abdominal pain,energy,and regular defecation ranked highest for both groups.Arabs gave significantly lower rankings(range 4.29-6.69)than Jewish patients(range 6.25-9.03)regarding all items,except for body image.Compared to Arab women,Jewish women attached higher priority to abdominal pain,energy,education/work,sleep,and joint pain.Multivariable regression analysis revealed that higher patient preferences were associated with Jewish ethnicity(OR 4.77;95%CI 2.36-9.61,P<0.001)and disease activity.The more active the disease,the greater the odds ratio for higher ranking of the questionnaire items(1-2 attacks per year:OR 2.13;95%CI 1.02-4.45,P=0.043;and primarily active disease:OR 5.29;95%CI 2.30-12.18,P<0.001).Factors inversely associated with higher patient preference were male gender(OR 0.5;95%CI 0.271-0.935,P=0.030),UC(OR 0.444;95%CI 0.241-0.819,P=0.009),and above average income level(OR 0.267;95%CI:0.124-0.577,P=0.001).CONCLUSION The highest priority for treatment outcomes was symptom relief.,Patients preferences were impacted by ethnicity,gender,and socio-economic disparity.Understanding patients'priorities may improve communication and enable a personalized approach.展开更多
Background: The influence of race/ethnicity on the relationship between sedentary screen time and left ventricular mass has been recently suggested, but remains a subject of debate, and has never been explored in Afri...Background: The influence of race/ethnicity on the relationship between sedentary screen time and left ventricular mass has been recently suggested, but remains a subject of debate, and has never been explored in Africa. Purpose: To determine whether there is a racial/ethnic influence on the relationship between sedentary screen time and left ventricular mass in MAGhreb and Sub Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: 100 blacks sub-Saharan African and 187 white Maghreb aged 18 - 55 years underwent an interview on their behavioral measures, physical activity and eating habits. Their left ventricular mass has also been measured by a resting transthoracic echography according to the American Society of Echography. Generalized linear models evaluated a test-for-trend across higher levels of sedentary screen time in progressive models with left ventricular measurements as dependent variables. The study population was stratified into quartiles of sedentary screen time (separately for whites and blacks) and examined the joint association of sedentary screen time and LVM within quartiles of physical activity. Results: Among White Maghreb, higher screen time was associated with smaller left ventricular mass (P Conclusions: Sedentary screen time is associated with smaller left ventricular mass in White Maghreb, not in black sub-Saharan African. The lack of association in blacks supports a potential qualitative difference in the cardiovascular consequences of sedentary screen based behavior.展开更多
The description of various methods for ethnicity classification can be found in the literature, though their reliability still remains unclear. We examined inter-observer agreement in defining the ethnic identificatio...The description of various methods for ethnicity classification can be found in the literature, though their reliability still remains unclear. We examined inter-observer agreement in defining the ethnic identification of patients in a bi-ethnic population (Arab-Jewish) in northern Israel, using place of birth and residence in addition to given and family names. Data about 1006 consecutive patients with acute ischemic stroke were gathered from our stroke registry. The data were analyzed by four independent observers (authors MH, TD, HH, GT) aiming to assign patients either as Arabs or Jews. Agreement between all four observers was excellent, as assessed by Fleiss’ Kappa statistic (κ = 0.96). We conclude that the use of given and family names of patients, together with their place of birth and residence, achieved near-perfect inter-observer agreement and a highly reliable assignment of ethnicity in two large ethnic population groups–Arabs and Jews–in northern Israel.展开更多
This article is devoted to developing a recognition method of race and ethnicity of individual based on portrait photographs. The reference image is formed based on selected geometric points of the face and a special ...This article is devoted to developing a recognition method of race and ethnicity of individual based on portrait photographs. The reference image is formed based on selected geometric points of the face and a special algorithm for calculating the characteristic parameters of the images available in the database. Next, the original image is compared with the reference images of ethnic groups, and thus, the affiliation of the original image to a specific ethnic group is determined.展开更多
Various aspects of a job (e.g. contract clauses, promotion, wages, job security and workplacehierarchy) are becoming increasingly complex and have some effect on an employee’s wellbeing. Simultaneously,research about...Various aspects of a job (e.g. contract clauses, promotion, wages, job security and workplacehierarchy) are becoming increasingly complex and have some effect on an employee’s wellbeing. Simultaneously,research about an increase in mental health issues due to workplace obstacles for ethnic minorities is amassing butthere is a lack of policymaking to tackle this via accessible mental health support at the workplace. My study aimsto assess the effect of occupational class and ethnicity on wellbeing in the UK working population. Methods: Thestudy assessed 3,374 adult employees who participated in the Health Survey for England from 2014–2016 and werecategorised in 1/3 National Statistics Socio-economic Classification groups. The Warwick-Edinburgh MentalWellbeing Scale was used as a measure of mental wellbeing. I explored the relationship between occupational classand wellbeing score using linear regression, accounting for demographic and socioeconomic covariates: age, sex,income and education. My sample’s ethnicity breakdown was White: 3,051;Black: 83;Asian: 180;Mixed: 39;Other:21 adults. Results: Of the sample, 46.8% of adults belonged to managerial and professional occupations and 90.4%were of White ethnicity. Managerial and professional occupations had a higher mean wellbeing score (48.54;P <0.001) than routine and manual occupations (47.69;P < 0.05). Multiple ethnic background showed the highest meanwellbeing score (52.82;P < 0.05), compared to White adults with the lowest wellbeing score (48.57;P << 0.001).Unlike occupational class which had a small effect size (partial eta-squared = 0.02), when holding education, income,age and sex constant, ethnicity had a statistically significant association with wellbeing. Conclusion: White ethnicityand routine and manual occupations are high-risk groups for poor mental wellbeing. The impact of ethnicity andoccupational class on wellbeing scores remained after accounting for socioeconomic and demographic factors.展开更多
Introduction: Screening mammography has led to a marked increase in detection of in situ breast tumors in the United States. The University of Southern California/Van Nuys Prognostic Index (USC/VNPI) predicts the recu...Introduction: Screening mammography has led to a marked increase in detection of in situ breast tumors in the United States. The University of Southern California/Van Nuys Prognostic Index (USC/VNPI) predicts the recurrence rates of ductal carcinoma in situ (DCIS);however variations in tumor characteristics, USC/VNPI scores, receptor and human epithelial growth factor receptor (HER)-2/neu status across different ethnicities/races have not been well studied. This study aimed to evaluate the racial trends in incidence, patient demographics, tumor characteristics and treatment variations for patients with DCIS at a high volume teaching hospital. Methods: 395 women underwent surgical intervention for DCIS between 2000 and 2011. Their race/ethnicity was divided into five mutually exclusive categories and demographic and clinicopathological data was collected. Multivariate analysis was performed to evaluate variations in patient and tumor factors with respect to age, size and surgical management among different ethnicities and races. Results: 82.1% of Caucasian women underwent simple mastectomy with sentinel lymph node biopsy (SLNB) while lumpectomy with SLNB was highest in Hispanics (40%, p = 0.005). Overall, there was no significant difference in the incidence of receptor or HER-2/neu positivity, multicentricity, necrosis or grade of DCIS in the various racial groups, but there was a significant racial difference in the USC/VNPI scores (p < 0.001). Conclusion: On a community level, screening detected DCIS accounted for the vast majority of DCIS diagnosed, which reflected national trends. Although no racial variation in DCIS with respect to patient or tumor characteristics was observed, a racial difference in USC/VNPI score was identified among the Hispanic population. Additional studies are required to validate the significance of these findings.展开更多
Hypertensive disorders (HD) of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. Although several risk factors for hypertensive disorders of pregnancy have been firmly establis...Hypertensive disorders (HD) of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. Although several risk factors for hypertensive disorders of pregnancy have been firmly established, the risk attributable to specific race-ethnicities is less clear. The risk of preeclampsia-eclampsia may differ by maternal ethnicity 30 as also the course, severity </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> prognosis. This study aimed to compare severe preeclampsia and eclampsia in tribal and nontribal women of </span><span style="font-family:Verdana;">Jangalmahal</span><span style="font-family:Verdana;"> area of West Bengal in terms of incidence, clinical, demographic picture, severity, course of </span><span style="font-family:Verdana;">disease</span><span style="font-family:Verdana;">, response to treatment, complications </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> delivery outcome including </span><span style="font-family:Verdana;">foetal</span><span style="font-family:Verdana;"> outcome and maternal outcome.展开更多
Objective: The aims of this study were to examine the influence of maternal hypoadiponectinemia on the risk of varying degrees of gestational hyperglycemia as well as on ethnic differences in circulating levels of adi...Objective: The aims of this study were to examine the influence of maternal hypoadiponectinemia on the risk of varying degrees of gestational hyperglycemia as well as on ethnic differences in circulating levels of adiponectin. Methods: A case-control study nested within a prospective cohort of healthy pregnant women compared those who developed gestational diabetes mellitus (GDM, N = 80), or had an impaired glucose challenge test (GCT) non-GDM (defined as 1hr plasma glucose >140 mg/dl after a 50-g oral glucose load when screening for GDM but did not meet the diagnostic criteria for GDM by a diagnostic oral glucose tolerance test, N = 128) to normal controls (N = 557). Concentrations of serum adiponectin were determined at entry (~17 weeks) and during the 3rd trimester. Results: With multivariable adjustment, entry hypoadiponectinemia (the lowest tertile vs. other tertiles pooled) was strongly associated with an increased risk of GDM (AOR 2.68, 95% CI 1.62 - 4.41) and with impaired GCT non-GDM (AOR 1.58, 95% CI 1.05 - 2.38). This association persisted after adjustment for pregravid BMI despite the fact that the risk in obese women with low adiponectin was higher. Similar data were obtained during the 3rd trimester. The concentration of adiponectin during the 3rd trimester was significantly lower in African Americans compared to Hispanics or Caucasians and this difference was detectable in both cases and controls (p < 0.05 or p < 0.01 for each). Conclusions: The present results identified a unique graded association between hypoadiponectinemia during early pregnancy with risk of GDM and less severe hyperglycemia non-GDM independent of maternal BMI. The relationship persisted to the 3rd trimester. African American women have lower adiponectin level than Caucasian or Hispanic women. Hypoadiponectinemia may play a significant pathophysiological role in the development of GDM and of less severe gestational hyperglycemia.展开更多
In recent years,Francophone schools in Alberta,a province in western Canada,have seen significant ethnocultural diversification of their school population,thus reflecting recent migratory changes in Canada.The populat...In recent years,Francophone schools in Alberta,a province in western Canada,have seen significant ethnocultural diversification of their school population,thus reflecting recent migratory changes in Canada.The population of a Francophone school board located in an agglomeration of Alberta reflects these new migratory trends.A partial ethnodemographic portrait carried out in 2003 in six of its schools indicates that 50%of the pupils come from an immigrant background and come from 23 different countries;mostly from sub-Saharan African countries.This demographic reality,confirmed more than a decade later,represents a major structural change for Francophone schools.In Alberta,as in other Canadian provinces,inclusion is at the heart of discourse and educational practices.With a transformative aim,it intends to promote ethnocultural diversity in the classroom and equal opportunities through school equity practices.This article focuses on the settlement workers in schools responsible for bridging family,community,and school cultures.The analysis of the interviews of the four workers sheds light on and questions both the institutional practices and the personal strategies put in place to face the challenges encountered in this tripartite collaboration.展开更多
This paper presents the results of a research project on the intercultural climate in schools and the academic success of immigrant students in Quebec.The intercultural climate in eight secondary public schools is doc...This paper presents the results of a research project on the intercultural climate in schools and the academic success of immigrant students in Quebec.The intercultural climate in eight secondary public schools is documented from the standpoint of various school and community stakeholders,students,and parents.More specifically,the paper focuses on the commitment to promoting cultural equity,which is identified through interviews with the targeted stakeholders on exclusionary practices and processes and the practices implemented to counter them.The results identify five areas of vulnerability among certain minoritized groups of students:the transition from welcoming to regular classes for those students learning French,evaluation and support for those experiencing learning or behavioral difficulties,the referral of these students to adult education programs or work-oriented training programs,their participation in extracurricular activities,and their access to special school projects.Nonetheless,some schools do report the introduction of many equity practices in response to the exclusionary ones.However,these initiatives are mostly occasional and voluntary and pertain to interactions between individuals.These findings call for a discussion on the importance of systemic and concerted initiatives towards achieving equity.展开更多
The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the sc...The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it.展开更多
文摘BACKGROUND Most studies have defined economic well-being as socioeconomic status,with little attention given to whether other indicators influence self-esteem.Little is known about racial/ethnic disparities in the relationship between economic wellbeing and self-esteem during adulthood.AIM To explore the impact of economic well-being on self-esteem in adulthood and differences in the association across race/ethnicity.METHODS The current study used data from the National Longitudinal Survey of Youth 1979.The final sample consisted of 2267 African Americans,1425 Hispanics,and 3678 non-Hispanic Whites.Ordinary linear regression analyses and logistic regression analyses were conducted.RESULTS African Americans and Hispanics were more likely to be in poverty in comparison with non-Hispanic Whites.More African Americans were unemployed than Whites.Those who received fringe benefits,were more satisfied with jobs,and were employed were more likely to have higher levels of self-esteem.Poverty was negatively associated with self-esteem.Interaction effects were found between African Americans and job satisfaction predicting self-esteem.CONCLUSION The role of employers is important in cultivating employees’self-esteem.Satisfactory outcomes or feelings of happiness from the workplace may be more important to non-Hispanic Whites compared to African Americans and Hispanics.
基金Supported by The American Heart Association(13SDG14640038)2012 Yale Center for Clinical Investigation cholar award to Santoro NThis publication was also made possible by CTSA Grant Number UL1 RR024139 from the National Center for Advancing Translational Science,a component of the National Institutes of Health(NIH),and NIH roadmap for Medical Research,Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH
文摘Non-alcoholic fatty liver disease(NAFLD)comprehends a wide range of conditions,encompassing from fatty liver or steatohepatitis with or without fibrosis,to cirrhosis and its complications.NAFLD has become the most common form of liver disease in childhood as its prevalence has more than doubled over the past 20years,paralleling the increased prevalence of childhood obesity.It currently affects between 3%and11%of the pediatric population reaching the rate of46%among overweight and obese children and adolescents.The prevalence of hepatic steatosis varies among different ethnic groups.The ethnic group with the highest prevalence is the Hispanic one followed by the Caucasian and the African-American.This evidence suggests that there is a strong genetic background in the predisposition to fatty liver.In fact,since 2008several common gene variants have been implicated in the pathogenesis of fatty liver disease.The most important is probably the patatin like phospholipase containing domain 3 gene(PNPLA3)discovered by the Hobbs’group in 2008.This article reviews the current knowledge regarding the role of ethnicity and genetics in pathogenesis of pediatric fatty liver.
基金Supported by the Danish Rheumatism Association,No.R111-A2587
文摘AIM To investigate whether minority ethnicity and the duration of education influence preoperative disability and expectations in patients undergoing total knee arthroplasty.METHODS We prospectively included 829 patients undergoing primary unilateral total knee arthroplasty(TKA) from April 2013 to December 2014 at a single centre. Patients filled in pre-operative questionnaires with information regarding place of birth, duration of education, expectations for outcome of surgery and baseline characteristics. Patients were stratified based on ethnicity. Majority ethnicity was defined as born inthe study country and minority ethnicity was defined as born in any other country. Similarly, patients were stratified based on duration of education in groups defined as < 9 years, 9-12 years and > 12 years, respectively.RESULTS We found that 92.2% of patients were of majority ethnicity. We found that 24.5%, 44.8% and 30.8% of patients had an education of < 9 years, 9-12 years and > 12 years, respectively. The mean preoperative(preOP) oxford knee score(OKS) in the total population was 23.6. Patients of minority ethnicity had lower mean pre-OP OKS(18.6 vs 23.9, P < 0.001), higher pain levels(VAS 73.0 vs 58.7, P < 0.001), expected higher levels of post-OP pain(VAS 14.1 vs 6.1, P = 0.02) and of overall symptoms(VAS 16.6 vs 6.4, P = 0.006). Patients with > 12 years education had lower mean pre-OP OKS(21.5 vs 23.8 and 24.6, P < 0.001) and higher pre-OP VAS pain(65.4 vs 59.2 and 56.4, P < 0.001) compared to groups with shorter education. One year post-operative(post-OP) patients of minority ethnicity had lower mean OKS, higher pain and lower QoL. One year post-OP patients with > 12 years education reported higher pain compared to patients with shorter educations. However, the response-rate was low(44.6%), and therefore post-OP results were not considered to be significant.CONCLUSION Minority ethnicity and the duration of education influ-ence preoperative disability and expectation in patients undergoing TKA. This should be taken into account when patients are advised pre-operatively.
文摘Irinotecan is now regarded as the most active drug for the treatment of colorectal cancer.However,one of the most difficult issues oncologists face is deciding the optimal dose for an individual patient,as each individual shows different outcomes even at the same dose with regard to treatment related adverse events,ranging from no toxicity to a lethal event.Inherited genetic polymorphism of a single gene or multiple genes(haplotype or linkage disequilibrium) involved in SN-38 glucuronidation,a predominant route of irinotecan detoxification,is now recognized as a significant factor that can alter the incidence of side effects.Attempts to explore such inherited genetic variability have been focused on elucidating interindividual as well as interethnic differences.Genotyping studies in relation to adverse events in an individual or in a group of similar ethnicity should contribute to establishing individualoriented or ethnicity-oriented irinotecan treatment regimens.This review highlights current single-or multi-tired approaches for the elucidation of genetic predispositions of patients to severe toxicities,especially among Asians.The purpose of this is to contribute to minimizing toxicity by dose modifications,with the consequent aim of maximizing dose intensity and efficacy,an ultimate goal of irinotecan-individualized therapy.
基金This study was supported by the Ministry of Health(MoH),Malaysia:MRG 7/2005,IMR/PK/05/061 and JPP-IMR 08-012.
文摘Aim of Work: Initial observations implied IgG rheumatoid factor (RF) to be common among Malaysian rheumatoid arthritis (RA) patients. We tested this hypothesis and used a multiethnic RA cohort (Malays, Chinese and Indians) to investigate whether the IgG RF predominance might be genetically or environmentally determined. Patients and Methods: 556 serum samples comprising 171 patients classified as RA according to the 1987 ACR criteria, 60 patients with other rheumatic diseases and 325 non-rheumatic controls were tested for IgG RF, IgM RF and anti-CCP by ELISA. The findings were then tested in a larger RA case-control cohort (n = 1844). Results: IgG RF predominated over IgM RF in all the investigated ethnic groups. The sensitivity, specificity, and diagnostic accuracy of IgG RF (55.6%, 91.2% and 80.2%, respectively) were superior compared to IgM RF, but comparable to anti-CCP. IgG RF was however, also increased in the Malaysian controls, but the IgG RF superiority over IgM RF was still apparent after cutoff adjustment according to the 1987 ACR criteria. Autoantibody levels did not differ between the three ethnic groups. The Receiver Operating Characteristics (ROC) curves showed larger areas under the curves for IgG RF (0.826) and for anti-CCP (0.867) than for IgM RF (0.737). Review of the literature showed consistently higher sensitivity for IgG RF in studies of Asian RA patients as compared to Caucasian and African-American studies. Conclusion: Increased frequency of IgG RF-positive in RA populations with different genetic background living in Malaysia argues for an environmental factor selectively amplifying the IgG RF response.
基金Supported by National Institutes of Health Grant K01 DA026993(Messiah SE)
文摘AIM:To investigate whether or not bariatric surgeryweight outcomes vary by ethnicity in a large,nationally representative sample of adolescents.METHODS:The Bariatric Outcomes Longitudinal Database was used for analysis and contains data on surgeries performed on adolescents from 2004 to 2010from 423 surgeons at 360 facilities across the United States Adolescents(n=827)between 11 and 19 years old who underwent either gastric bypass or adjustable gastric banding surgery were included in the analysis.Outcome measures included changes in anthropometric measurements[weight(kg)and body mass index]from baseline to 3(n=739),6(n=512),and 12(n=247)mo after surgery.RESULTS:A year after patients underwent either gastric bypass(51%)or adjustable gastric banding(49%)surgery,mean estimated weight loss for all ethnic groups differed by a maximum of only 1.5 kg,being34.3 kg(95%CI:30.0-38.5 kg)for Hispanics,33.8 kg(95%CI:27.3-40.3 kg)for non-Hispanic blacks,and32.8 kg(95%CI:30.9-34.7 kg)for non-Hispanic whites.No overall pairwise group comparisons were significant,indicating that no ethnic group had better weight loss outcomes than did another.CONCLUSION:Bariatric surgery substantially reduces the weight of severely obese adolescents at 1 year post-procedure with little variation by ethnicity and/or gender.These results suggest that bariatric surgery is a safe and reasonable treatment for all severely obese adolescents with the appropriate indications.
基金Supported by The South African Research Chairs Initiative of the Department of Science and Technology and the National Research Foundation
文摘AIM: To investigate the influence of ethnicity in social anxiety disorder(SAD), and the relationship with symptom severity, depression and substance use or abuse, in health sciences' students.METHODS: This was a cross-sectional survey of 112 1st, 2nd and 3rd year students from the Faculty of Medicine and Health Sciences at Stellenbosch University, Cape Town, South Africa. The self-reported Social Anxiety Spectrum questionnaire was used to assess for SAD. The Social Phobia Inventory(SPIN) was adapted to a version called the E-SPIN(Ethnic-SPIN) in order to evaluate the effects of ethnicity. Two sub-questions per stem question were included to assess whether SAD symptoms in social interactions were ethnicity dependent. Substance use was assessed with the Alcohol UseDisorders Identification Test and Drug Use Disorders Identification Test, and depression with the Centre for Epidemiological Studies Depression Scale.RESULTS: Of 112 students who completed the E-SPIN questionnaire, 54.4%(n = 61) met criteria for SAD, with significantly more females than males meeting criteria. Ethnicity had a significant effect on SAD symptomatology, but there was no effect of ethnicity on the rates of drug and alcohol abuse in students with and without SAD. Overall significantly more students with SAD met criteria for depression compared with students without the disorder. CONCLUSION: Among university students, SAD is prevalent regardless of whether interactions are with individuals of the same or different ethnic group. However, ethnicity may be an important determinant of social anxiety for some ethnic groups. SAD was significantly associated with major depression but not significantly associated with drug or alcohol abuse.
文摘BACKGROUND Inflammatory bowel disease(IBD)patients’expectations of treatment outcomes may differ by ethnicity.AIM To investigate treatment preferences of Jewish and Arabs patients.METHODS This prospective survey ranked outcomes treatment preferences among Arab IBD patients,based on the 10 IBD-disk items compared to historical data of Jews.An anonymous questionnaire in either Arabic or Hebrew was distributed among IBD patients.Patients were required to rank 10 statements describing different aspects of IBD according to their importance to the patients as treatment goals.Answers were compared to the answers of a historical group of Jewish patients.RESULTS IBD-disk items of 121 Arabs were compared to 240 Jewish patients.The Jewish patients included more females,[151(62.9%)vs 52(43.3%);P<0.001],higher education level(P=0.02),more urban residence[188(78.3%)vs 54(45.4%);P<0.001],less unemployment[52(21.7%)vs 41(33.9%);P=0.012],higher income level(P<0.001),and more in a partnership[162(67.8%)vs 55(45.4%);P<0.001].Expectations regarding disease symptoms:abdominal pain,energy,and regular defecation ranked highest for both groups.Arabs gave significantly lower rankings(range 4.29-6.69)than Jewish patients(range 6.25-9.03)regarding all items,except for body image.Compared to Arab women,Jewish women attached higher priority to abdominal pain,energy,education/work,sleep,and joint pain.Multivariable regression analysis revealed that higher patient preferences were associated with Jewish ethnicity(OR 4.77;95%CI 2.36-9.61,P<0.001)and disease activity.The more active the disease,the greater the odds ratio for higher ranking of the questionnaire items(1-2 attacks per year:OR 2.13;95%CI 1.02-4.45,P=0.043;and primarily active disease:OR 5.29;95%CI 2.30-12.18,P<0.001).Factors inversely associated with higher patient preference were male gender(OR 0.5;95%CI 0.271-0.935,P=0.030),UC(OR 0.444;95%CI 0.241-0.819,P=0.009),and above average income level(OR 0.267;95%CI:0.124-0.577,P=0.001).CONCLUSION The highest priority for treatment outcomes was symptom relief.,Patients preferences were impacted by ethnicity,gender,and socio-economic disparity.Understanding patients'priorities may improve communication and enable a personalized approach.
文摘Background: The influence of race/ethnicity on the relationship between sedentary screen time and left ventricular mass has been recently suggested, but remains a subject of debate, and has never been explored in Africa. Purpose: To determine whether there is a racial/ethnic influence on the relationship between sedentary screen time and left ventricular mass in MAGhreb and Sub Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: 100 blacks sub-Saharan African and 187 white Maghreb aged 18 - 55 years underwent an interview on their behavioral measures, physical activity and eating habits. Their left ventricular mass has also been measured by a resting transthoracic echography according to the American Society of Echography. Generalized linear models evaluated a test-for-trend across higher levels of sedentary screen time in progressive models with left ventricular measurements as dependent variables. The study population was stratified into quartiles of sedentary screen time (separately for whites and blacks) and examined the joint association of sedentary screen time and LVM within quartiles of physical activity. Results: Among White Maghreb, higher screen time was associated with smaller left ventricular mass (P Conclusions: Sedentary screen time is associated with smaller left ventricular mass in White Maghreb, not in black sub-Saharan African. The lack of association in blacks supports a potential qualitative difference in the cardiovascular consequences of sedentary screen based behavior.
文摘The description of various methods for ethnicity classification can be found in the literature, though their reliability still remains unclear. We examined inter-observer agreement in defining the ethnic identification of patients in a bi-ethnic population (Arab-Jewish) in northern Israel, using place of birth and residence in addition to given and family names. Data about 1006 consecutive patients with acute ischemic stroke were gathered from our stroke registry. The data were analyzed by four independent observers (authors MH, TD, HH, GT) aiming to assign patients either as Arabs or Jews. Agreement between all four observers was excellent, as assessed by Fleiss’ Kappa statistic (κ = 0.96). We conclude that the use of given and family names of patients, together with their place of birth and residence, achieved near-perfect inter-observer agreement and a highly reliable assignment of ethnicity in two large ethnic population groups–Arabs and Jews–in northern Israel.
文摘This article is devoted to developing a recognition method of race and ethnicity of individual based on portrait photographs. The reference image is formed based on selected geometric points of the face and a special algorithm for calculating the characteristic parameters of the images available in the database. Next, the original image is compared with the reference images of ethnic groups, and thus, the affiliation of the original image to a specific ethnic group is determined.
文摘Various aspects of a job (e.g. contract clauses, promotion, wages, job security and workplacehierarchy) are becoming increasingly complex and have some effect on an employee’s wellbeing. Simultaneously,research about an increase in mental health issues due to workplace obstacles for ethnic minorities is amassing butthere is a lack of policymaking to tackle this via accessible mental health support at the workplace. My study aimsto assess the effect of occupational class and ethnicity on wellbeing in the UK working population. Methods: Thestudy assessed 3,374 adult employees who participated in the Health Survey for England from 2014–2016 and werecategorised in 1/3 National Statistics Socio-economic Classification groups. The Warwick-Edinburgh MentalWellbeing Scale was used as a measure of mental wellbeing. I explored the relationship between occupational classand wellbeing score using linear regression, accounting for demographic and socioeconomic covariates: age, sex,income and education. My sample’s ethnicity breakdown was White: 3,051;Black: 83;Asian: 180;Mixed: 39;Other:21 adults. Results: Of the sample, 46.8% of adults belonged to managerial and professional occupations and 90.4%were of White ethnicity. Managerial and professional occupations had a higher mean wellbeing score (48.54;P <0.001) than routine and manual occupations (47.69;P < 0.05). Multiple ethnic background showed the highest meanwellbeing score (52.82;P < 0.05), compared to White adults with the lowest wellbeing score (48.57;P << 0.001).Unlike occupational class which had a small effect size (partial eta-squared = 0.02), when holding education, income,age and sex constant, ethnicity had a statistically significant association with wellbeing. Conclusion: White ethnicityand routine and manual occupations are high-risk groups for poor mental wellbeing. The impact of ethnicity andoccupational class on wellbeing scores remained after accounting for socioeconomic and demographic factors.
文摘Introduction: Screening mammography has led to a marked increase in detection of in situ breast tumors in the United States. The University of Southern California/Van Nuys Prognostic Index (USC/VNPI) predicts the recurrence rates of ductal carcinoma in situ (DCIS);however variations in tumor characteristics, USC/VNPI scores, receptor and human epithelial growth factor receptor (HER)-2/neu status across different ethnicities/races have not been well studied. This study aimed to evaluate the racial trends in incidence, patient demographics, tumor characteristics and treatment variations for patients with DCIS at a high volume teaching hospital. Methods: 395 women underwent surgical intervention for DCIS between 2000 and 2011. Their race/ethnicity was divided into five mutually exclusive categories and demographic and clinicopathological data was collected. Multivariate analysis was performed to evaluate variations in patient and tumor factors with respect to age, size and surgical management among different ethnicities and races. Results: 82.1% of Caucasian women underwent simple mastectomy with sentinel lymph node biopsy (SLNB) while lumpectomy with SLNB was highest in Hispanics (40%, p = 0.005). Overall, there was no significant difference in the incidence of receptor or HER-2/neu positivity, multicentricity, necrosis or grade of DCIS in the various racial groups, but there was a significant racial difference in the USC/VNPI scores (p < 0.001). Conclusion: On a community level, screening detected DCIS accounted for the vast majority of DCIS diagnosed, which reflected national trends. Although no racial variation in DCIS with respect to patient or tumor characteristics was observed, a racial difference in USC/VNPI score was identified among the Hispanic population. Additional studies are required to validate the significance of these findings.
文摘Hypertensive disorders (HD) of pregnancy are a leading cause of maternal and perinatal mortality and morbidity worldwide. Although several risk factors for hypertensive disorders of pregnancy have been firmly established, the risk attributable to specific race-ethnicities is less clear. The risk of preeclampsia-eclampsia may differ by maternal ethnicity 30 as also the course, severity </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> prognosis. This study aimed to compare severe preeclampsia and eclampsia in tribal and nontribal women of </span><span style="font-family:Verdana;">Jangalmahal</span><span style="font-family:Verdana;"> area of West Bengal in terms of incidence, clinical, demographic picture, severity, course of </span><span style="font-family:Verdana;">disease</span><span style="font-family:Verdana;">, response to treatment, complications </span><span style="font-family:Verdana;">and</span><span style="font-family:Verdana;"> delivery outcome including </span><span style="font-family:Verdana;">foetal</span><span style="font-family:Verdana;"> outcome and maternal outcome.
文摘Objective: The aims of this study were to examine the influence of maternal hypoadiponectinemia on the risk of varying degrees of gestational hyperglycemia as well as on ethnic differences in circulating levels of adiponectin. Methods: A case-control study nested within a prospective cohort of healthy pregnant women compared those who developed gestational diabetes mellitus (GDM, N = 80), or had an impaired glucose challenge test (GCT) non-GDM (defined as 1hr plasma glucose >140 mg/dl after a 50-g oral glucose load when screening for GDM but did not meet the diagnostic criteria for GDM by a diagnostic oral glucose tolerance test, N = 128) to normal controls (N = 557). Concentrations of serum adiponectin were determined at entry (~17 weeks) and during the 3rd trimester. Results: With multivariable adjustment, entry hypoadiponectinemia (the lowest tertile vs. other tertiles pooled) was strongly associated with an increased risk of GDM (AOR 2.68, 95% CI 1.62 - 4.41) and with impaired GCT non-GDM (AOR 1.58, 95% CI 1.05 - 2.38). This association persisted after adjustment for pregravid BMI despite the fact that the risk in obese women with low adiponectin was higher. Similar data were obtained during the 3rd trimester. The concentration of adiponectin during the 3rd trimester was significantly lower in African Americans compared to Hispanics or Caucasians and this difference was detectable in both cases and controls (p < 0.05 or p < 0.01 for each). Conclusions: The present results identified a unique graded association between hypoadiponectinemia during early pregnancy with risk of GDM and less severe hyperglycemia non-GDM independent of maternal BMI. The relationship persisted to the 3rd trimester. African American women have lower adiponectin level than Caucasian or Hispanic women. Hypoadiponectinemia may play a significant pathophysiological role in the development of GDM and of less severe gestational hyperglycemia.
文摘In recent years,Francophone schools in Alberta,a province in western Canada,have seen significant ethnocultural diversification of their school population,thus reflecting recent migratory changes in Canada.The population of a Francophone school board located in an agglomeration of Alberta reflects these new migratory trends.A partial ethnodemographic portrait carried out in 2003 in six of its schools indicates that 50%of the pupils come from an immigrant background and come from 23 different countries;mostly from sub-Saharan African countries.This demographic reality,confirmed more than a decade later,represents a major structural change for Francophone schools.In Alberta,as in other Canadian provinces,inclusion is at the heart of discourse and educational practices.With a transformative aim,it intends to promote ethnocultural diversity in the classroom and equal opportunities through school equity practices.This article focuses on the settlement workers in schools responsible for bridging family,community,and school cultures.The analysis of the interviews of the four workers sheds light on and questions both the institutional practices and the personal strategies put in place to face the challenges encountered in this tripartite collaboration.
文摘This paper presents the results of a research project on the intercultural climate in schools and the academic success of immigrant students in Quebec.The intercultural climate in eight secondary public schools is documented from the standpoint of various school and community stakeholders,students,and parents.More specifically,the paper focuses on the commitment to promoting cultural equity,which is identified through interviews with the targeted stakeholders on exclusionary practices and processes and the practices implemented to counter them.The results identify five areas of vulnerability among certain minoritized groups of students:the transition from welcoming to regular classes for those students learning French,evaluation and support for those experiencing learning or behavioral difficulties,the referral of these students to adult education programs or work-oriented training programs,their participation in extracurricular activities,and their access to special school projects.Nonetheless,some schools do report the introduction of many equity practices in response to the exclusionary ones.However,these initiatives are mostly occasional and voluntary and pertain to interactions between individuals.These findings call for a discussion on the importance of systemic and concerted initiatives towards achieving equity.
文摘The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it.
