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BackgroundIn inflammatory arthritis patients, the concomitant decline of their mental wellbeing is an increasing concern[1,2]. It is important to not only describe the trajectory of psychological distress in early disease stages, but also understand which clinical outcome measures are most associated with these changes.ObjectivesUsing data from the National Early Inflammatory Arthritis Audit (NEIAA), we assessed trends in psychological wellbeing over 12 months after initial diagnosis and mapped these against clinical outcomes to identify significant associations.MethodsNEIAA collects data from patients referred with suspected early inflammatory arthritis in rheumatology services in England and Wales. We used data provided by 20,472 patients eligible for follow-up (diagnosis of inflammatory arthritis) between May 1st, 2018, and April 1st, 2022. Data items included baseline demographics e.g., age and gender, and clinical variables e.g., rheumatic disease comorbidity index (RDCI), DAS28, and patient reported outcomes.Psychological distress was measured by the sum score of Patient Health Questionnaire Anxiety and Depression Screener (PHQ4ADS). Using mixed effects regression models, we analysed the co-variability of PHQ4ADS with demographic factors and clinical outcomes over 12 months. Time was included as a dummy-coded covariant.ResultsThe analysis included 36% of patients (7,378 out of 20,472) who completed the baseline patient outcome survey. In this cohort, PHQ4ADS scores decreased from a baseline average of 4.7 (CI: [4.6, 4.8]) to 2.62 (CI: [2.5, 2.8]) at 12 months post-diagnosis. The proportion of patients screening positive decreased from 50.0% (CI: [48.9, 51.1]) at baseline to 23.8% (CI: [21.8, 25.9]) at 12 months.At baseline, psychological distress correlated significantly with age, gender, ethnicity, RDCI, prior depression diagnosis, and baseline DAS28 (Figure 1). No significant correlations were found between psychological distress and working diagnosis, seropositivity, or the assessment being recorded after the start of the COVID-19 pandemic. Younger ages were nonlinearly associated with higher distress levels (coefficient per decade: -0.006;p<0.001;CI: [-0.009, -0.003]) (Figure 1a). Distress levels in females were higher than that of males (coefficient: 0.5;p<0.001;CI: [0.4, 0.7]) (Figure 1b). White patients reported lower PHQ4ADS scores compared to non-white patients (coefficient: -0.7;p<0.001;CI: [-1.0, -0.4]) (Figure 1c). Higher distress levels were also associated with higher RDCI (coefficient: 0.2;p<0.001;CI: [0.1, 0.3]) and prior diagnosis of depression (coefficient: 1.8;p<0.001;CI: [1.5, 2.2]) (Figure 1d, 1e). Furthermore, higher baseline DAS28 scores correlated with more severe psychological distress (coefficient: 0.8;p<0.001;CI: [0.7, 0.8]) (Figure 1f).By 12-months, psychological distress decreased significantly overall, which correlated significantly with ethnicity (coefficient: 0.8;p=0.005;CI: [0.3, 1.4]) and baseline DAS28 (coefficient: -0.5;p<0.001;CI: [-0.6, -0.4]). Compared to white patients, the reduction was significantly greater for non-white patients, but the level of distress was no longer different at 12 months (Figure 1c). While those with higher baseline DAS28 showed a greater reduction in psychological distress, the distress levels remained higher at 12 months (Figure 1f).Figure 1.Changes in psychological distress correlated with age, gender, ethnicity, RDCI, prior depression diagnosis, and baseline DAS28.[Figure omitted. See PDF]ConclusionIn this early inflammatory arthritis cohort, mental health burden was high. Age, gender, ethnicity, RDCI, prior depression diagnosis and baseline DAS28 significantly correlated with psychological distress at baseline. Supporting mental health should be a focus of clinical care for this population and it may be beneficial to use an approach that is culturally valid for non-white patients and accounts for multimorbidity.References[1]Euesden, J, et al. Psychosomatic medicine 79.6 (2017): 638.[2]Lwin, MN, et al. Rheumatology and therapy 7.3 (2020): 457-471.AcknowledgementsThe authors would like to thank the Healthcare Quality Improvement Partnership (HQIP) as the commisioner of NEIAA, British Society for Rheumatology as the audit providers, Net Solving as the audit platform developers, and the Wellcome Trust (ST12406) for funding to support L.Z..Disclosure of InterestsLucy Zhao: None declared, James Galloway Speakers bureau: Has received honoraria from AbbVie Celgene, Chugai, Gillead, Janssen, Eli Lilly, Pfizer, Roche, and UCB, Jo Ledingham: None declared, Sarah Gallagher: None declared, Neena Garnavos: None declared, Paul Amlani-Hatcher: None declared, Nicky Wilson: None declared, Lewis Carpenter Consultant of: Statistical consultancy for Pfizer, Kirsty Bannister: None declared, Sam Norton Speakers bureau: Has received honoraria from Janssen and Pfizer.
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This report uses Spring 2022 data from nationally representative surveys of principals and math teachers in kindergarten through grade 12 (K-12) to explore students' opportunities to prepare for and take advanced math. The authors found that small high schools, high schools in rural areas, and high schools that predominantly serve students from historically marginalized communities tend to offer fewer advanced math courses (e.g., precalculus, Advanced Placement math courses) and that uneven access to advanced math begins in middle school. K-12 teachers who work in schools that predominately serve students living in poverty are more likely to report skipping standards-aligned content and replacing the skipped content with concepts from previous grade levels. Also, more than half of K-12 math teachers said they need additional support for delivering high-quality math instruction, especially teachers who work in schools that serve predominantly high-poverty students. In the wake of the disproportionate impacts of the COVID-19 pandemic on students living in poverty and students of color, these results highlight a critical need for resources to support teachers and to increase student access to advanced courses. [For technical information about the surveys and analysis in this report, see "Learn Together Surveys. 2022 Technical Documentation and Survey Results. Research Report. RR-A827-9" (ED626092).]
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More recent policies aim to offset years of underenrollment of minority groups by expanding enrollment criteria, including more research sites in minority communities, and engaging investigators with diverse backgrounds. FDA has also sought to promote research diversity through its Drug Trials Snapshots program, established in 2015 to increase the visibility of clinical trial enrollment by age, sex, ethnicity and race. According to a recent report on the program's impact, though, there still may be a ways to go for clinical trials to reflect the diversity of the US population.
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The anti-colonial struggle against literary assimilation and the claim to our linguistic space in validating our own stories as W°C, first generation college students, first generation college graduates, and caregivers to dependents, elders, and extended family members requires an activist spirit. [...]someone posted that they would be hosting a virtual writing group on Saturday mornings. A few text messages, utilization of social capital to invite non-M°CA members and a few electronic RSVPs later, we had commitments from the four of us. Being genuine and vulnerable through convivencia allowed us to place extreme care and attention on building social relationships while tearing down the conventional power structure often found in groups.
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Minority groups have been disproportionately vulnerable to COVID-19's effects. Whereas, social workers have been instrumental in countering those effects, their roles have been understudied, particularly during the ‘new normal' that followed the outbreak. This gap is addressed by drawing on interviews with 28 social workers in the Jewish ultra-Orthodox (Haredi) society in Israel, held after the outbreak and during the ‘new normal'. Three main roles are identified: first responders, during the outbreak;a voice for community needs, in the ‘new normal';and policy translators – throughout. The findings contribute a temporal aspect to the literature by highlighting social workers' dynamic roles. [ FROM AUTHOR] Copyright of International Social Work is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
The United States faces an unprecedented mental health crisis, with youth and young adults at the center. Even before the COVID-19 pandemic, nearly 50 percent of college students reported at least one mental health concern. The COVID-19 pandemic notably exacerbated these issues and underscored the urgent need to identify and implement ways to ameliorate the youth mental health crisis. In 2021, the National Academies of Sciences, Engineering, and Medicine called on the field of higher education to address growing concerns about student mental health by identifying and elevating emerging and promising approaches that offer a more holistic way to support students' mental health. Serving as the main entry point for more than 40 percent of students seeking a postsecondary degree, community colleges represent a tremendous and untapped opportunity to better address mental health in the United States, particularly for students who have been traditionally underserved (e.g., students of color, first-generation students, and low-income students). However, community colleges have limited evidence and guidance to inform the implementation of multilevel, holistic approaches to support students with varying mental health needs. To address this knowledge gap, this report shares a descriptive study of eight community colleges at the forefront of implementing multilevel approaches (a combination of prevention, early intervention, and treatment services) to support student mental health, as well as key facilitators for and barriers to their success. [For "How Community Colleges Can Support Student Mental Health Needs. Research Brief. RB-A2552-1," see ED627489.]
ABSTRACT
The United States faces an unprecedented mental health crisis, with youth and young adults at the center. Even before the coronavirus disease 2019 (COVID-19) pandemic, nearly 50 percent of college students reported at least one mental health concern. Without adequate mental health support, college students, including those at community colleges, may be at risk for a variety of academic and nonacademic consequences that negatively affect their overall well-being, including lower college completion rates, higher rates of substance use, and lower lifetime earning potential. This research brief describes a study examining eight community colleges from across the United States which found that, although the institutions did offer mental health services, most lacked a clear organizing framework for those efforts, and that financial challenges limited the support offered to students. The research also highlighted the importance of community college leaders explicitly prioritizing student mental health, as well as broad staff buy-in to the effort. [For the full report, "Supporting the Mental Health Needs of Community College Students. Research Report. RR-A2552-1," see ED627480.]
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Using a multilevel modelling approach, this study investigates the impact of urban inequalities on changes to rail ridership across Chicago's "L” stations during the pandemic, the mass vaccination rollout, and the full reopening of the city. Initially believed to have an equal impact, COVID-19 disproportionally impacted the ability of lower socioeconomic status (SES) neighbourhoods' to adhere to non-pharmaceutical interventions: working-from-home and social distancing. We find that "L” stations in predominately Black or African American and Hispanic or Latino neighbourhoods with high industrial land-use recorded the smallest behavioural change. The maintenance of higher public transport use at these stations is likely to have exacerbated existing health inequalities, worsening disparities in users' risk of exposure, infection rates, and mortality rates. This study also finds that the vaccination rollout and city reopening did not significantly increase the number of users at stations in higher vaccinated, higher private vehicle ownership neighbourhoods, even after a year into the pandemic. A better understanding of the spatial and socioeconomic determinants of changes in ridership behaviour is crucial for policymakers in adjusting service routes and frequencies that will sustain reliant neighbourhoods' access to essential services, and to encourage trips at stations which are the most impacted to revert the trend of declining public transport use.
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This article shows that the COVID-19 pandemic exposed informal institutional voids that exist for Black, Asian and Minority Ethnic (BAME) business owners in the United Kingdom. Based on a primary database of surveys and semi-structured interviews, the results show that many BAME small and medium-sized enterprise (SME) owners encountered informal institutional voids that White SME owners did not face during the pandemic. The article also shows how these BAME SME owners created value amid these institutional voids and how they can continue to do so. The article concludes by suggesting that bridging these voids is crucial for promoting a more inclusive environment where ethnic and non-ethnic entrepreneurs can succeed. It also presents policy implications and offers directions for future research.
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ContextThe Federation of Ethnic Minority Healthcare Organisations (FEMHO) was established in 2022 in light of the disproportionate inequalities experienced by this group before, during and after the COVID-19 pandemic.The FEMHO is as a multidisciplinary consortium representing Ethic Minority organisations and individuals within the health and social care in the UK. At the time of writing, FEMHO represents over 55,000 individual members, covering various disciplines, specialisms and levels of seniority, spanning across 43 organisations and interest groups. As a self-governed union, FEMHO encourages organisations to collaborate and work collectively to achieve better outcomes through the implementation of improved policies and opinion formers as well regulators and commissioners both locally and nationally.Issue/ChallengeOf the 1.2 million staff employed by NHS, 20.7% belong to Black, Asian and minority ethnic (BAME) background. However, analysis of deaths of NHS Staff during the pandemic showed that 64% of those who died belonged to a BAME background. Such disproportionate impacts were seen when the number of deaths amongst doctors and nurses were further analysed, where 20% of nursing staff identified as BAME yet 64% of nurses who died were BAME and 44% of medical staff identified as BAME and 95% of doctors who died were BAME.Doctors from BAME backgrounds also reported:Feeling less confident that appropriate adjustments had been made to mitigate riskFeeling less confident about PPE provision and feeling safe to report PPE shortagesHigher rates of bullying and harassment during the pandemic periodSuch inequalities are believed to be as a result of a number of structural inequalities that existed well beyond the pandemic. it also hypothesised that several inequalities may persist well beyond the pandemic, such as the disproportionate impact of long-covid of health workers from an ethnic minority, which is currently being investigated by researchers at the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre.In view of these challenges, the FEMHO was established as a method of collaborating and co-ordinating the efforts of grassroots organisations, policy makers, regulators and commissioners to ensure that the lived experiences and potential solutions offered by organisations and individuals within this group can be better heard and acted upon.Assessment of issue and analysis of its causesThe FEMHO was established to promote a more concerted approach for the advocacy for health workers from ethnic minority backgrounds, with the aim of reducing the inequalities experienced by this group. A two pronged approach of galvanising grassroots organisations already working tirelessly to support ethnic minority health workers along with lobbying and collating interests amongst policy makers, commissioners and regulators was utilised.For grassroots organisations, a mixed methodology of targeted invitations and open advertisement of opportunities for membership was utilised. Several mediums were used to spread the word of such opportunities, including social media posts, word of mouth and email.For policy makers and systems leaders, a more targeted approach was adopted to acquire their support. A targeted email campaign was developed to raise awareness of FEMHO's work with the aim of acquiring their official support, particularly in the form of endorsing FEMHO's call for the inclusion of race inequality in the COVID-19 public enquiry.ImpactAt the time of writing, the FEMHO has been successful in galvanising the membership and support of both grassroots organisations and policy makers respectively at a national level.FEMHO now represents over 55,000 individual members, covering various disciplines, specialisms and levels of seniority, spanning across 43 organisations and interest groups.The targeted email campaign saw the achievement of 39 cross party MPs officially supporting FEMHO's call for inclusion of race inequality in the COVID-19 public enquiry.An inaugural meeting was also held within th Houses of Parliament, where grassroot organisation leads as well as MPs were invited to discuss the strategic priorities and direction of the organisation such as the organisations contribution to the COVID-19 public enquiry, to ensure that inequality is truly at the ‘forefront' of issues.Feedback acquired during the inaugural meeting from MPs and front-line workers was incredibly positive, with attendees welcoming this concerted approach to effect change.Challenges faced in this process largely themed around the limited time availability of the several individuals involved with this project. Executive members of the union as well as grassroots member leads largely worked full time in a variety of demanding healthcare professionals, making communication, organisation and prioritisation of voluntary roles such as contribution to FEMHO work difficult at times.InterventionThe intervention, being the development of a national union equipped with the lived experience and expertise of members who are able to effectively advocate for the interests for health workers from ethnic minority backgrounds, has had numerous positive outcomes:A shared space for grassroots organisations to share best practice for support of healthcare workers from ethnic minority backgroundsA concerted voice to contribute to policy change to address the structural inequalities that adversely impact healthcare workers from ethnic minority backgroundsFrom this experience thus far I have learnt that leadership, with regards to solving complex problems, can often be a journey of harnessing the voices, expertise and influence of several individuals and organisations to effect change. Such a journey can come with numerous hurdles: from stakeholder mapping to initiatives to promote cross-specialty, cross-seniority, cross-political party discussions. But I have learnt, particularly from the exec leadership team, made up Ade Adeyemi MBE (a Global Health Policy Expert) and Professor JS Bamrah CBE (Chair, British Association of Physicians of Indian Origin), and other notable individuals, that such efforts to galvanise individuals who have seemingly different priorities is often possible when you are able to see beyond this as a leader and define, clarify and communicate where such individuals share interests and focuses in common.Involvement of stakeholders, such as patients, carers or family members:As mentioned, the main stakeholders that had to be consulted within this process were front-line care workers from ethnic minority backgrounds and any relevant organisations who may work at a grassroots level to support them.Such stakeholders were involved through the establishment of communication channels as well as feedback sessions to ensure that the FEMHO was sufficiently and accurately representing the interests of the group in question.Key MessagesSolving complex problems as a leader requires the ability to create a collaborative environment that often sees the development, nurturing or new relationships at both an individuals and organisation levelLeaders are able to harness human energy through the development and forecast of a vision and mission that is inspiring and compelling, encouraging individuals to sacrifice their time for a matter bigger than themChange that is sustainable and impactful can often be slow, as seen with the policy changes we continue to advocate for as an organisation, but leaders must be patient.Lessons learntAs mentioned, I have learnt that to effect change, one must be patient as a leader. Our policy activities has taken a great deal of time to be heard and seen, and it can often be tempting to grow impatient and quit.Future barriers to our work include the degree to which can promote regular communication and collaboration amongst member organisations who are often time poor, competing with a number of other priorities such as a demanding full time career in healthcare. Other barriers include maintaining political interest from policy makers, commissioners, MPs, many of which may not hold positions for a long-term basis, as a r sult of the political nature of many of their positions.Measurement of improvementWe will measure the effect of our initiative through a series of feedback forms, particularly of member organisations and their members to assess the degree to which front-line care workers from ethnic minority backgrounds feel that progress in being made in the level of advocacy and campaigning on their behalf. Additionally, we will seek to gather feedback on our members perception of ways of working and any suggestions to ensure that all member organisations feel empowered to influence the direction of the federationStrategy for improvementAfter each feedback round, held on a quarterly basis, executive members of the FEMHO will analyse findings and implement changes accordingly where possible
ABSTRACT
"Minority populations were three times more likely to experience complications from COVID-19 but were not equitably represented in clinical trials for the vaccine," says Greater Gift board member Harsha Rajasimha, PhD, CEO and Founder, Jeeva Informatics Solutions, Inc. "This challenge presents itself across varying disease states. According to a recent article in the Harvard Business Review: "Most clinical trials are not representative of the general population or of those with a particular disease. [...]many may be missing required documentation to obtain an ITIN, such as a passport, which excludes potential trial participation entirely. Since payment received is considered reimbursement vs. compensation, there is no need for W-2 forms, which are often required by sponsors, sites, and CROs. * Relaxing of the regulation that governs principal investigator in-person oversight that greatly limits the locations where clinical trials can be conducted. * Pursuit of federal legislation that will allow reimbursement costs to clinical trial participants to be optional and non-taxable. * Introduce legislation that relaxes requirements that limit mobile clinical trial units from traveling to minority communities.
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This rapid review provides an overview of recent literature on the nature of digital interventions for young people in terms of technologies used, substances and populations targeted, and theoretical or therapeutic models employed. A keyword search was conducted using MEDLINE and other databases for 2015-2021. Following a title/ and full-text screening of articles and consensus decision on study inclusion, data extraction proceeded using an extraction grid. Data synthesis relied on an adapted conceptual framework (Stockings et al., 2016) that involved a three-level treatment spectrum for youth substance use (prevention, early intervention, and treatment). The review identified 43 articles describing 39 digital interventions. Most were early interventions (n = 28), followed by prevention (n = 6) and treatment (n = 5). Of the five technologies identified, web-based interventions (n = 14) were most common. Digital interventions have mainly focused on alcohol use (n = 20), reflecting limited concern for other substance use and co-occurring use. Yet the rise in substance use and related harms during the Covid-19 pandemic highlights a critical need for more innovative substance use interventions. Technologies with more immersive and interactive features, such as VR and game-based interventions, call for further exploration. Only one intervention was culturally tailored and purposefully designed for gender minority youth, and another was geared to young men. As well, most interventions used a personalized or normative feedback approach, while a harm reduction approach guided only one intervention. The incorporation of culturally tailored interventions and harm reduction approaches may promote uptake and stronger engagement with digital interventions amongst youth.
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In South Africa, sexual and gender minorities experience a wide array of health inequities and face many difficulties in accessing health services. This is largely due to the general heteronormative-based health system that is not well equipped to meet the needs of those not conforming to "normal" forms of gender and sexuality. In addition, the heteronormative-based approach to LGBT health has rendered the unique needs and experiences of sexual and gender minorities invisible within mainstream health data, systems and policies. Increasing evidence suggests that the COVID-19 pandemic has worsened health disparities and this is likely a consequence of existing challenges related to structural violence that persisted prior to its emergence. Given the current structure of South Africa's health system, this chapter examines structural violence in the context of healthcare and draws on in-depth interviews conducted with 12 LGBT students at a university in South Africa. The findings highlight the importance of raising awareness on the spectrum of sexual orientation and gender identity, applying an intersectional lens to the health system to address health inequities and gearing healthcare programs to provide services for all. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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PurposeIn March 2020, the UK entered its first lockdown responding to the Covid-19 pandemic. In the same month, the Domestic Abuse Bill had its first reading in Parliament. Charities and non-governmental organisations critiqued the Bill for failing to protect migrants from domestic abuse, and not complying with the Istanbul Convention. Drawing on interviews with staff from Southall Black Sisters, this paper aims to foreground the experiences of practitioners within the women's sector to explore the unique experiences and challenges migrant and racially minoritised women encountered when seeking support from domestic abuse during the Covid-19 pandemic. It highlights how the pandemic-related lockdowns created barriers to accessing support services and housing, creating an epidemic within the pandemic, and how minoritised women and the organisations that supported them had to overcome structural barriers and racism.Design/methodology/approachIn-depth semi-structured interviews were conducted with staff from a leading women's organisation that supports migrant and racially minoritised women. Four participants were asked questions within four themes: domestic abuse before and during the pandemic;accessing support from and reporting domestic abuse;accessibility of resources;and post-pandemic challenges. A phenomenological approach was used to analyse the transcribed interviews.FindingsParticipants consistently highlighted the unique threats and barriers migrant and racially minoritised women faced when seeking support. Barriers included racism, language barriers, cultural constraints, the triple threat of destitution, detention, deportation, and political resistance to protect migrant women from destitution/homelessness.Originality/valueThis paper provides a unique insight into the experiences of staff members within a specialist by and for women's support organisation in England and their perspectives on the barriers racially minoritised and migrant women experienced during the Covid-19 pandemic. It offers rare insights into how service users' needs changed during the lockdowns and how the pandemic affected their ability to operate.
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Disparities exist in access to early oral health care, disproportionately impacting minority ethnic groups and populations with low socioeconomic status. Medical dental integration provides an opportunity to create a new dental access point for early prevention and intervention as well as care coordination. The Wisconsin Medical Dental Integration (WI-MDI) model expanded early access to preventive oral health services by integrating dental hygienists (DHs) into pediatric primary care and prenatal care teams to address oral health inequities with the goal of reducing dental disease. This case study will describe how DHs were incorporated into the medical care teams in Wisconsin and how legislation expanding scope of practice made this possible. Since 2019, five federally qualified health systems, one non-profit clinic, and two large health systems have enrolled in the WI-MDI project. Thirteen DHs have worked across nine clinics in the WI-MDI project and over 15,000 patient visits to a medical provider included oral health services provided by DHs from 2019 to 2023. Dental hygienists working in alternative practice models such as those demonstrated in the innovative WI-MDI approach are positioned to reduce oral health disparities through the provision of early and frequent dental prevention, intervention, and care coordination.
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Introduction: Historically, clinical trial patient populations have lacked adequate diversity while studies have shown that differences exist in the biological response of different ethnicities to various healthcare interventions. Minority populations have suffered higher rates of Covid-19 infection, hospitalization, and mortality than their non-Hispanic white counterparts. It is vital that Covid-19 treatment research is appropriately diverse. This paper aims to define the demographic characteristics of COVID-19 therapeutic clinical trials to date. Method(s): A literature search initially returned 117 unique publications, 67 of which met the inclusion criteria and were analyzed. Main variables of interest were reporting of demographic data, percent white, Black, and Asian, and type of study. Statistical analysis was carried out via Stata software. Result(s): Among analyzed studies, 74.63% reported demographics. The demographic representation was 78.87%, 12.27% and 8.86% for white, Black, and Asian populations. Among vaccine related studies, the representation for Black, Asian, and Hispanic individuals was 5.01%, 6.40%, and 13.71%. A qualitative analysis of outlier studies with high (>30%) Black populations revealed that none were vaccine related, 1/3 were in hospitalized patients, and none were related to pharmacologic interventions. Of the studies with low levels (<2%) of Black patients, 4/6 were vaccine related, none were in hospitalized patients, and all were related to pharmacologic interventions. Conclusion(s): This analysis reveals concerning trends in therapeutic clinical trial enrollment to date. In the context of yet another health insult that disproportionately affects minority populations, America's scientific community is not doing enough to produce equitable scientific evidence on Covid-19 treatment.
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Billed as a review into ethnic disparities and covid-19, it devotes only a small proportion of its pages to ethnicity, and, while confirming what we knew—that people from ethnic minority groups are more likely to become infected and to die from covid-19—it makes no attempt to explain the disparities or make recommendations for action. Covid-19 has produced a "stress test” for structural racism in healthcare and public health, say Christine Douglass and colleagues (https://blogs.bmj.com/bmj/2020/06/08/structural-racism-in-society-and-the-covid-19-stress-test). The NHS's response in setting up a Race and Health Observatory is another (doi:10.1136/bmj.m2191).
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Transgender and gender diverse (TGD) individuals experience high levels of minority stress, as well as a high prevalence of suicidality and self-harm. The current study investigates if emotion regulation mediates the relationships of minority stressors with self-harm and suicidality. TGD adult primary care patients (N = 115) completed a survey including measures of minority stressors, emotion dysregulation, self-harm, and suicidality. Emotion regulation mediated the relationship between victimisation and suicidality. Emotion regulation did not mediate the relationship between victimisation and self-harm. TGD individuals' suicide risk may be increased when they experience victimisation through increased emotion dysregulation.
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Drawing on the disability justice paradigm of care work (Piepzna-Samarasinha), this article moves to shift the labor of resilience from students to our course design, noting how models of student resilience are often tied to ableist expectations of performance and coherence. The authors share their ongoing experiments in creating disability-centric, care-centered course designs, which are meant to offer students more flexibility while respecting the required labor asked of instructors.