Associations between multiple long-term conditions and mortality in diverse ethnic groups

Background Multiple conditions are more prevalent in some minoritised ethnic groups and are associated with higher mortality rate but studies examining differential mortality once conditions are established is US-based. Our study tested whether the association between multiple conditions and mortality varies across ethnic groups in England. Methods and Findings A random sample of primary care patients from Clinical Practice Research Datalink (CPRD) was followed from 1st January 2015 until 31st December 2019. Ethnicity, usually self-ascribed, was obtained from primary care records if present or from hospital records. Cox regression models were used to estimate mortality by number of long-term conditions, ethnicity and their interaction, with adjustment for age and sex for 532,059 patients with complete data. During five years of follow-up, 5.9% of patients died. Each additional long-term condition at baseline was associated with increased mortality. This association differed across ethnic groups. Compared with 50-year-olds of white ethnicity with no conditions, the mortality rate was higher for white 50-year-olds with two conditions (HR 1.77) or four conditions (HR 3.13). Corresponding figures were higher for 50-year-olds of Black Caribbean ethnicity with two conditions (HR=2.22) or four conditions (HR 4.54). The direction of the interaction of number of conditions with ethnicity showed higher mortality associated with long-term conditions in nine out of ten minoritised ethnic groups, attaining statistical significance in four (Pakistani, Black African, Black Caribbean and Black other ethnic groups). Conclusions The raised mortality rate associated with having multiple conditions is greater in minoritised ethnic groups compared with white people. Research is now needed to identify factors that contribute to these inequalities. Within the health care setting, there may be opportunities to target clinical and self-management support for people with multiple conditions from minoritised ethnic groups.

Outcome of Femoral Angioplasty/Stenting Procedures in Different Ethnic Groups in England: A Retrospective Analysis of Hospital Episode Statistics and Review of Literature

Purpose Various studies, mainly from North America, report worse outcomes in ethnic minority populations submitted to revascularization for peripheral arterial disease (PAD). Limited nationwide data in relation to ethnicity are available from Europe. Objective The objective of the study is to compare the outcomes of femoral angioplasty/stenting procedures among different ethnic groups in England during the 10-year period from 2006 to 2015. Materials and Methods The “Hospital Episode Statistics” database has been searched using International Classification of Diseases, Tenth Revision ( ICD-10) codes to identify all cases of femoral angioplasty or stenting from English NHS Hospitals between January 1, 2006, and December 31, 2015. Subsequent mortality, second open or endovascular infrainguinal procedures, and major amputations on the same side within 2 years after the first procedure have been recorded. Patients were broadly categorized according to ethnicity as whites, Asians, and blacks. Chi-square test was used to demonstrate significant differences among ethnic groups and odds ratios (ORs) were calculated using white ethnic group as reference. Results A total number of 70 887 femoral endovascular procedures were recorded in patients from the 3 ethnic groups. Two-year mortality in whites, Asians, and blacks was 18.3%, 22.1%, and 19.5% (p<0.001); rates of second endovascular procedure were 12.1%, 13.1%, and 13.5% (p=0.24); rates of open infrainguinal procedure were 5.6%, 4.5%, and 8.0% (p<0.001); and rates of major amputation were 4.8%, 4.1%, and 7.0% (p<0.001), respectively. Mortality was higher in Asians (OR=1.26, 95% confidence interval [CI]=1.10-1.45, p<0.01) compared with whites. On the contrary, blacks underwent more open arterial operations (OR=1.48, 95% CI=1.19-1.83, p<0.01) and more amputations (OR=1.49, 95% CI=1.18-1.87, p<0.01). There were no significant differences in the rates of second endovascular procedures. Conclusion Two-year mortality after femoral angioplasty/stenting is higher in Asians, whereas risk of limb loss is higher in blacks compared with whites. Reasons of these ethnic differences in outcomes following femoral endovascular procedures for PAD merit further study.

Marginalized Communities are Underrepresented as Creative Contributors

We investigate the socially inferred gender and racial/ethnic identities of influential creative artists in four domains. Women make up 51% of the U.S. population but are underrepresented in contemporary art (28%), fashion (45%), box office film (27%), and popular music (17%). Marginalized racial/ethnic groups make up 39% of the U.S. population yet comprise approximately half that figure in contemporary art (22%), fashion (22%), and film (19%). Black musical artists have higher representation (48%), though higher representation does not equate with equity and inclusion. As for intersectional identity, white men are overrepresented in all four domains by factors ranging from 1.4 to 2 as compared to the U.S. population, and most other gender-racial/ethnic groups are further minoritized. Our study is the first comprehensive, comparative, empirical look at intersectional identity across creative fields. The exclusion of marginalized individuals, including those who are women, American Indian / Alaska Native, Asian, Black, Latinx, and Native Hawaiian / Pacific Islander, is severe. The lack of self-expressed demographic data is a challenge, as is the erasure of certain identity groups from the American Community Survey, including agender, gender noncomforming, nonbinary, and transgender individuals. These are challenges that, if addressed, would enhance our collective understanding of diversity in creative fields. Efforts taken by executives, influencers, and other power brokers to make creative fields more diverse, equitable, and inclusive would amplify the many well-documented benefits of art to individuals and to society.

Languages Speak Reconciliation: An Interdisciplinary Study on the Impact of National Language in Post War Reconciliation Sri Lanka

The Role of National Language is endorsed in different contexts and it has triggered an inspirited debate within the Sri Lankan political history when its discriminatory nature policies marked a triumph of linguist nationalism. The recognition of the Sinhala language as the only National Language in Sri Lanka and its dominance, drifted both communities apart causing frustration and tension among ethnic groups, which have ultimately culminated in ethnic strife that lasted almost three decades. National Languages, hence wield as a sociopolitical tool that demands a balance among languages, recognition, and policies. Similarly, Sri Lanka, in its path to reconciliation also demands a balance among National Languages, policies, and its recognition among the communities. This study thus explores the Role of National Language in promoting social cohesion and coexistence among ethnic groups to achieve anticipated “Reconciliation” within Sri Lankan social fabric. The paper draws upon a mixed approach employing qualitative methods, including in-depth interviews. Data were gathered from interviewing 20 undergraduates from the Faculty of Social Sciences and Languages at the Sabaragamuwa University of Sri Lanka. Data were coded and analyzed using thematic analysis. Findings revealed that the recognition of National languages in their due status will make a huge impact on fostering reconciliation within Sri Lankan Society. It is further not to be confused with the Link Language as a National Language since its duty in social integration is relatively limited in the cases where the understanding of cultural, traditional, and historical attributes of an ethnic community is more pronounced especially in grappling with attitudinal problems inherited within ethnic communities.

Ethnopharmacological Studies of Medicinal plants Used by Ethnic Groups in Bardsir Region, Kerman Province

Ethnobotanical studies try to gather indigenous cultures plant knowledge from different regions and tribes all over the world. This study aimed at obtaining, documenting and analyzing medicinal plants used by some ethnic groups in Bardsir region, Kerman province, Iran. Data collection was done through face-to-face interviews, and finally, 120 questionnaires were filled out. Based on the local knowledge, the data collection was analyzed using quantitative values including family importance value (FIV), relative frequency of citation (RFC), fidelity level (FL), use-value index (UV), and factor of informant consensus (FIC). In this study, 47 medicinal plants were recorded belonging to 22 families. The results expressed the highest FIV belonged to Lamiaceae (57%) family. The hemicryptophytes (49%) were also regarded as the most common life forms of the used species. In the current study, the highest RFCs and UV indices belonged to Urtica urens L. 0.21, and 0.39, respectively. Achillea santolinoides subsp. wilhelmsii (K.Koch) Greuter, and Teucrium polium L. had the maximum percentage of FL for treating digestive system disorders. In the present study, the highest indices belonged to U. urens, A. santolinoides subsp. wilhelmsii and T. polium; thus, it is recommended conducting further in vitro and in vivo pharmacological studies on the mentioned species.

Ethnocentrism and University Students in Ethiopia (1995–2018)

Since 1995 and until it apparently eased with the coming of Prime Minister Abiy Ahmed, ethnicity has become the dogmatic principle of the country for its social and political policies. Consequently, it has permeated through university campuses and affected relationships among students belonging to different ethnic groups. This study makes a micro-sociological ethnographic description and analysis of different “sites” of student interactions in curricular activities such as in classroom learning, extracurricular activities such as sporting, and service deliveries such as common residential compounds and dining halls at Addis Ababa University’s Main Campus.