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PloS One 2018Percutaneous endoscopic gastrostomy (PEG) tubes are widely used for enteral feeding after stroke; however, PEG tubes placed in patients in whom death is imminent are...
BACKGROUND
Percutaneous endoscopic gastrostomy (PEG) tubes are widely used for enteral feeding after stroke; however, PEG tubes placed in patients in whom death is imminent are considered non-beneficial.
AIM
We sought to determine whether placement of non-beneficial PEG tubes differs by race and sex.
DESIGN AND SETTING/PARTICIPANTS
In this retrospective cohort study, inpatient admissions for stroke patients who underwent palliative/withdrawal of care, were discharged to hospice, or died during the hospitalization, were identified from the Nationwide Inpatient Sample between 2007 and 2011. Logistic regression was used to evaluate the association between race and sex with PEG placement.
RESULTS
Of 36,109 stroke admissions who underwent palliative/withdrawal of care, were discharge to hospice, or experienced in-hospital death, a PEG was placed in 2,258 (6.3%). Among PEG recipients 41.1% were of a race other than white, while only 22.0% of patients without PEG were of a minority race (p<0.001). The proportion of men was higher among those with compared to without a PEG tube (50.0% vs. 39.2%, p<0.001). Minority race was associated with PEG placement compared to whites (OR 1.75, 95% CI 1.57-1.96), and men had 1.27 times higher odds of PEG compared to women (95% CI 1.16-1.40). Racial differences were most pronounced among women: ethnic/racial minority women had over 2-fold higher odds of a PEG compared to their white counterparts (OR 2.09, 95% CI 1.81-2.41), while male ethnic/racial minority patients had 1.44 increased odds of a PEG when compared to white men (95% CI 1.24-1.67, p-value for interaction <0.001).
CONCLUSION
Minority race and male sex are risk factors for non-beneficial PEG tube placements after stroke.
Topics: Aged; Aged, 80 and over; Enteral Nutrition; Female; Gastrostomy; Humans; Male; Racial Groups; Retrospective Studies; Risk Factors; Sex Distribution; Stroke
PubMed: 29351343
DOI: 10.1371/journal.pone.0191293 -
Personality & Social Psychology Bulletin May 2022Individuals with other-race friends are perceived to identify less strongly with their racial in-group than are individuals with same-race friends. Using the...
Individuals with other-race friends are perceived to identify less strongly with their racial in-group than are individuals with same-race friends. Using the reverse-correlation technique, we show that this effect goes beyond perceptions of social identification, influencing how people are mentally represented. In four studies with Black and White American participants, we demonstrate a "racial assimilation effect": Participants, independent of their own race, represented both Black and White targets with other-race friends as phenotypically more similar to the respective racial out-group. Representations of targets with racial out-group friends were subsequently rated as more likely to engage in social action supportive of the racial out-group. Out-group targets with other-race friends were represented more favorably than out-group targets with mostly same-race friends. White participants had particularly negative representations of in-group members with mostly Black friends. The present research suggests that individuals' social networks influence how their race and associated traits are mentally represented.
Topics: Friends; Humans; Racial Groups; Social Cohesion; Social Identification; White People
PubMed: 34148457
DOI: 10.1177/01461672211024118 -
Journal of General Internal Medicine Feb 2015Patients with obesity face widespread social bias, but the importance of this social stigma to patients relative to other quality of life (QOL) factors is unclear.
BACKGROUND
Patients with obesity face widespread social bias, but the importance of this social stigma to patients relative to other quality of life (QOL) factors is unclear.
OBJECTIVE
Our aim was to examine the importance of obesity-related social stigma relative to other QOL factors on reducing patients' overall well-being.
DESIGN
We used a cross-sectional telephone interview.
SETTING
The study was conducted at four diverse primary care practices in Greater Boston.
PARTICIPANTS
Three hundred and thirty-seven primary care patients aged 18-65 years and with a body mass index (BMI) of 35 kg/m(2) or higher participated in the study.
MAIN MEASURES
Patients' health utility (preference-based QOL measure) was determined via responses to a series of standard gamble scenarios assessing willingness to risk death to lose various amounts of weight or to achieve perfect health. We used the Impact of Weight on Quality of Life-lite instrument to assess QOL domains specific to obesity (physical function, self-esteem, sexual life, public distress or social stigma, and work), and we examined variation in utility explained by these domains.
KEY RESULTS
Depending on patients' race/ethnicity, mean health utilities ranged from 0.92 to 0.99 among men and from 0.89 to 0.93 among women. After adjustment for race, BMI, and education, none of the QOL domains explained much of the variation in utility among men, except for work function among Hispanic men. In contrast, social stigma was the leading QOL contributor to utility for Caucasian women (explaining 6 % of the marginal variation beyond demographics and BMI). In contrast, sexual function was the most important contributor among African American women (3 % marginal variation), and work life was most important among Hispanic women (> 20 % in variation). Lower scores in one domain did not always translate into lower well-being. Moreover, QOL summary scores often explained less of the variation than some individual domains.
CONCLUSION
Obesity-related social stigma had disproportionate adverse effects on Caucasian women patients' well-being, whereas weight-related impairment in work function was particularly important among Hispanic patients and impaired sexual function was important to diminished well-being among African American women although its impact appeared modest.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Obesity; Obesity, Morbid; Primary Health Care; Quality of Life; Racial Groups; Sexual Behavior; Social Stigma
PubMed: 25341644
DOI: 10.1007/s11606-014-3041-4 -
Fertility and Sterility Jun 2024To study racial and ethnic disparities among women undergoing hysterectomy performed for adenomyosis across the United States.
OBJECTIVE
To study racial and ethnic disparities among women undergoing hysterectomy performed for adenomyosis across the United States.
DESIGN
A cohort study.
SETTING
Data from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) from 2012-2020.
PATIENTS
Patients with an adenomyosis diagnosis.
INTERVENTION
Hysterectomy for adenomyosis.
MAIN OUTCOME MEASURES
Patients were identified using the International Classification of Diseases 9th and 10th editions codes 617.0 and N80.0 (endometriosis of the uterus). Hysterectomies were classified on the basis of the Current Procedural Terminology codes. We compared baseline and surgical characteristics and 30-day postoperative complications across the different racial and ethnic groups. Postoperative complications were classified into minor and major complications according to the Clavien-Dindo classification system.
RESULTS
A total of 12,599 women underwent hysterectomy for adenomyosis during the study period: 8,822 (70.0%) non-Hispanic White, 1,597 (12.7%) Hispanic, 1,378 (10.9%) non-Hispanic Black or African American, 614 (4.9%) Asian, 97 (0.8%) Native Hawaiian or Pacific Islander, and 91 (0.7%) American Indian or Alaska Native. Postoperative complications occurred in 8.8% of cases (n = 1,104), including major complications in 3.1% (n = 385). After adjusting for confounders, non-Hispanic Black race and ethnicity were independently associated with an increased risk of major complications (adjusted odds ratio 1.54, 95% confidence interval [CI] {1.16-2.04}). Laparotomy was performed in 13.7% (n = 1,725) of cases. Compared with non-Hispanic White race and ethnicity, the adjusted odd ratios for undergoing laparoscopy were 0.58 (95% CI 0.50-0.67) for Hispanic, 0.56 (95% CI 0.48-0.65) for non-Hispanic Black or African American, 0.33 (95% CI 0.27-0.40) for Asian, and 0.26 (95% CI 0.17-0.41) for Native Hawaiian or Pacific Islander race and ethnicity.
CONCLUSION
Among women undergoing hysterectomy for postoperatively diagnosed adenomyosis, non-Hispanic Black or African American race and ethnicity were associated with an increased risk of major postoperative complications. Compared with non-Hispanic White race and ethnicity, Hispanic ethnicity, non-Hispanic Black or African American, Asian, Native Hawaiian, or Pacific Islander race and ethnicity were less likely to undergo minimally invasive surgery.
Topics: Adult; Female; Humans; Middle Aged; Adenomyosis; American Indian or Alaska Native; Asian; Black or African American; Cohort Studies; Ethnicity; Healthcare Disparities; Hispanic or Latino; Hysterectomy; Native Hawaiian or Other Pacific Islander; Postoperative Complications; Racial Groups; Retrospective Studies; Risk Factors; Treatment Outcome; United States; White
PubMed: 38342374
DOI: 10.1016/j.fertnstert.2024.02.003 -
JAAPA : Official Journal of the... Oct 2015The physician assistant (PA) profession has long had a focus on providing primary healthcare to all. In order to best serve an increasingly diverse population, we...
The physician assistant (PA) profession has long had a focus on providing primary healthcare to all. In order to best serve an increasingly diverse population, we examine the racial and ethnic diversity trends experienced in PA education and the PA profession, in the context of national demographics, and the racial and ethnic diversity of other health professions. We also offer recommendations to improve the racial and ethnic diversity of the PA profession.
Topics: Cultural Diversity; Ethnicity; Health Occupations; Humans; Physician Assistants; Racial Groups; United States
PubMed: 26406176
DOI: 10.1097/01.JAA.0000471609.54160.44 -
JAMA Network Open Jan 2022This cross-sectional study investigates intersections among race, ethnicity, and sex from 2000 to 2019 among senior faculty in radiation oncology.
This cross-sectional study investigates intersections among race, ethnicity, and sex from 2000 to 2019 among senior faculty in radiation oncology.
Topics: Cross-Sectional Studies; Ethnicity; Faculty, Medical; Female; Humans; Male; Racial Groups; Radiation Oncologists; United States
PubMed: 35015068
DOI: 10.1001/jamanetworkopen.2021.42720 -
Social Science Research Nov 2016A systematic analysis of residential segregation and spatial interaction by income reveals that as income rises, minority access to integrated neighborhoods, higher...
A systematic analysis of residential segregation and spatial interaction by income reveals that as income rises, minority access to integrated neighborhoods, higher levels of interaction with whites, and more affluent neighbors also increase. However, the income payoffs are much lower for African Americans than other groups, especially Asians. Although Hispanics and Asians have always displayed declining levels of minority-white dissimilarity and rising levels of minority-white interaction with rising income, income differentials on these outcomes for blacks did not appear until 1990 and since then have improved at a very slow pace. Given their higher overall levels of segregation and income's limited effect on residential attainment, African Americans experience less integration, more neighborhood poverty at all levels of income compared to other minority groups. The degree of black spatial disadvantage is especially acute in the nation's 21 hypersegregated metropolitan areas.
Topics: Black or African American; Hispanic or Latino; Humans; Income; Racial Groups; Residence Characteristics; Social Segregation; United States; Urban Population; White People
PubMed: 27712688
DOI: 10.1016/j.ssresearch.2016.08.003 -
American Journal of Obstetrics and... Nov 2021The inclusion of participants who are Black, Indigenous people of color, and participants of various ethnicities is a priority of federally sponsored research.
BACKGROUND
The inclusion of participants who are Black, Indigenous people of color, and participants of various ethnicities is a priority of federally sponsored research.
OBJECTIVE
This study aimed to describe the reporting of race and ethnicity in federally funded research published by the Eunice Kennedy Shriver National Institute of Child Health and Human Development-funded Pelvic Floor Disorders Network.
STUDY DESIGN
Pelvic Floor Disorders Network publications were reviewed to determine whether race or ethnicity was reported. The number of participants included in each manuscript who were identified as White, Black, Asian, American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, and "other," and the number of participants who identified as having Hispanic ethnicity were recorded. Data were analyzed by publication and by the pelvic floor disorder investigated, including urinary incontinence, pelvic organ prolapse, fecal incontinence, pregnancy-related pelvic floor disorders, and multiple pelvic floor disorders. Many publications reported on overlapping patient populations, which included primary trials and secondary analyses and studies. Data were analyzed both by counting participants every time they were reported in all papers and by counting the unique number of participants in only the original trials (primary paper published).
RESULTS
A total of 132 Pelvic Floor Disorders Network publications were published between 2003 and 2020. Of these, 21 were excluded because they were methods papers or described research without participants. Of the 111 remaining articles, 90 (81%) included descriptions of race and 55 (50%) included descriptions of ethnicity. All 13 primary trials described race and 10 of 13 (76.9%) described ethnicity. Of those publications that described race, 50 of 90 (56%) included only the categories of "White," "Black," and "Other," and 14 of 90 (16%) only described the percentage of White patients. Of the 49,218 subjects, there were 43,058 (87%) with reported race and 27,468 (56%) with reported ethnicity. Among subjects with race and ethnicity reported, 79% were reported as White, 9.9% as Black, 0.4% as Asian, 0.1% as American Indian or Alaska Native, and 4% as "other," whereas 13% were reported to be of Hispanic ethnicity. The racial and ethnic diversity varied based on the pelvic floor disorder studied (P<.01), which was driven by pregnancy-related and fecal incontinence studies because these had lower proportions of White patients than studies of other pelvic floor disorders.
CONCLUSION
Federally funded Pelvic Floor Disorders Network research does not consistently report the race and ethnicity of participants. Even in the publications that report these characteristics, Black, Indigenous people of color, and people of Hispanic ethnicity are underrepresented. Consistent reporting and recruitment of a diverse population of women is necessary to address this systemic inequity.
Topics: Biomedical Research; Ethnicity; Female; Humans; National Institute of Child Health and Human Development (U.S.); Pelvic Floor Disorders; Racial Groups; Research Subjects; Research Support as Topic; United States
PubMed: 34464584
DOI: 10.1016/j.ajog.2021.08.036 -
JAMA Network Open Nov 2020This cohort study describes the distribution of race/ethnicity among cases of coronavirus disease 2019 (COVID-19)–associated multisystem inflammatory syndrome in... (Observational Study)
Observational Study
This cohort study describes the distribution of race/ethnicity among cases of coronavirus disease 2019 (COVID-19)–associated multisystem inflammatory syndrome in children reported to the New York City Department of Health and Mental Hygiene.
Topics: Black or African American; Asian; COVID-19; Child; Child, Preschool; Ethnicity; Female; Hispanic or Latino; Humans; Male; Native Hawaiian or Other Pacific Islander; New York City; Racial Groups; SARS-CoV-2; Systemic Inflammatory Response Syndrome; White People
PubMed: 33252688
DOI: 10.1001/jamanetworkopen.2020.30280 -
Nicotine & Tobacco Research : Official... Apr 2020Although there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study...
INTRODUCTION
Although there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative US data.
METHODS
Data were drawn from the 2002-2016 National Survey on Drug Use and Health public use data files (total analytic sample n = 630 547 including 54 060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models.
RESULTS
In 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps < .001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p < .001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps = .001), whereas no change in prevalence was observed among NH Black (p = .779) and NH Other/Mixed Race/Ethnicity respondents (p = .152). Cigar use decreased for NH White men (p < .001) and did not change for NH White women (p = .884). Conversely, cigar use increased for NH Black women (p < .001) and did not change for NH Black men (p = .546).
CONCLUSIONS
Cigar use remains significantly more common among NH Black individuals in the United States and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals.
IMPLICATIONS
This study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of US individuals. The highest prevalence of cigar use in 2016 was found among NH Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.
Topics: Adolescent; Adult; Black or African American; Child; Cross-Sectional Studies; Ethnicity; Female; Hispanic or Latino; Humans; Male; Prevalence; Racial Groups; Smoking; Time Factors; Tobacco Products; United States; Young Adult
PubMed: 31013341
DOI: 10.1093/ntr/ntz060