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Improving health care quality for racial/ethnic minorities: a systematic review of the best evidence regarding provider and organization interventions
Mary Beach, Tiffany L Gary, Eboni G Price, Karen Robinson, Aysegul Gozu, Ana Palacio, Carole Smarth, Mollie Jenckes, Carolyn Feuerstein, Eric B Bass, Neil R Powe, Lisa A Cooper
BMC Public Health , 2006, DOI: 10.1186/1471-2458-6-104
Abstract: We performed electronic and hand searches from 1980 through June 2003 to identify randomized controlled trials or concurrent controlled trials. Reviewers abstracted data from studies to determine study characteristics, results, and quality. We graded the strength of the evidence as excellent, good, fair or poor using predetermined criteria. The main outcome measures were evidence of effectiveness and cost of strategies to improve health care quality or reduce disparities in care for racial/ethnic minorities.Twenty-seven studies met criteria for review. Almost all (n = 26) took place in the primary care setting, and most (n = 19) focused on improving provision of preventive services. Only two studies were designed specifically to meet the needs of racial/ethnic minority patients. All 10 studies that used a provider reminder system for provision of standardized services (mostly preventive) reported favorable outcomes. The following quality improvement strategies demonstrated favorable results but were used in a small number of studies: bypassing the physician to offer preventive services directly to patients (2 of 2 studies favorable), provider education alone (2 of 2 studies favorable), use of a structured questionnaire to assess adolescent health behaviors (1 of 1 study favorable), and use of remote simultaneous translation (1 of 1 study favorable). Interventions employing more than one main strategy were used in 9 studies with inconsistent results. There were limited data on the costs of these strategies, as only one study reported cost data.There are several promising strategies that may improve health care quality for racial/ethnic minorities, but a lack of studies specifically targeting disease areas and processes of care for which disparities have been previously documented. Further research and funding is needed to evaluate strategies designed to reduce disparities in health care quality for racial/ethnic minorities.In recent years, it has become clear that th
The Role of Public Health in Addressing Racial and Ethnic Disparities in Mental Health and Mental Illness
Annelle B. Primm, MD, MPH,Melba J. T. Vasquez, PhD,Robert A. Mays, PhD, MSW,Doreleena Sammons-Posey, SM
Preventing Chronic Disease , 2010,
Abstract: Racial/ethnic minority populations are underserved in the American mental health care system. Disparity in treatment between whites and African Americans has increased substantially since the 1990s. Racial/ethnic minorities may be disproportionately affected by limited English proficiency, remote geographic settings, stigma, fragmented services, cost, comorbidity of mental illness and chronic diseases, cultural understanding of health care services, and incarceration. We present a model that illustrates how social determinants of health, interventions, and outcomes interact to affect mental health and mental illness. Public health approaches to these concerns include preventive strategies and federal agency collaborations that optimize the resilience of racial/ethnic minorities. We recommend strategies such as enhanced surveillance, research, evidence-based practice, and public policies that set standards for tracking and reducing disparities.
The Politics of Imagining and Forgetting in Chinese Ethnic Minorities' Museums  [cached]
Marzia Varutti
Outlines : Critical Practice Studies , 2010,
Abstract: Through an exploration of the representation of ethnic minorities in the museums of Kunming, Yunnan Province of China, this article discusses the active role that museums play in the processes of memory and identity engineering, whereby museum images and narratives are used to support collective imagination about ethnic minorities' identities and past. Drawing from a comparative analysis of museum displays in Kunming, I discuss how the image of ethnic minorities is conveyed through a selective process of i) remembering and emphasizing specific cultural elements, ii) forgetting other elements, and lastly, iii) modifying the perception of ethnic minorities relation to the Han majority. By revealing the extent and modalities through which museum representations manipulate ethnic minorities' identities in China, the analysis aims to contribute to our understanding of the multiple ways in which museums act as sites for the enactment of collective memory and imagination.
Racial/Ethnic Differences in Poststroke Rehabilitation Outcomes  [PDF]
Charles Ellis,Hyacinth I. Hyacinth,Jamie Beckett,Wuwei Feng,Marc Chimowitz,Bruce Ovbiagele,Dan Lackland,Robert Adams
Stroke Research and Treatment , 2014, DOI: 10.1155/2014/950746
Abstract: Background. Significant racial and ethnic disparities in stroke incidence, severity, and morbidity have been consistently reported; however, less is known about potential differences in poststroke rehabilitation outcomes. Objective. To examine racial and ethnic differences in poststroke rehabilitation outcomes. Methods. We completed an in-depth search of Medline and several major journals dedicated to publishing research articles on stroke, rehabilitation, and racial-ethnic patterns of disease over a 10-year period (2003–2012). We identified studies that reported rehabilitation outcomes and the race or ethnicity of at least two groups. Results. 17 studies involving 429,108 stroke survivors met inclusion criteria for the review. The majority (94%) of studies examined outcomes between Blacks and Whites. Of those studies examining outcomes between Blacks and Whites, 59% showed that Blacks were generally less likely to achieve equivalent functional improvement following rehabilitation. Blacks were more likely to experience lower FIM gain or change scores (range: 1–60%) and more likely to have lower efficiency scores (range: 5–16%) than Whites. Conclusions. Black stroke survivors appear to generally achieve poorer functional outcomes than White stroke survivors. Future studies are warranted to evaluate the precise magnitude of these differences, whether they go beyond chance, and the underlying contributory mechanisms. 1. Background Stroke is a leading cause of long-term disability and the fourth leading cause of death in the US [1]. Estimates indicate that ~795,000 Americans experience a stroke each year [1]. Among those are non-Hispanic Blacks (Blacks) who are at twice the risk of first-ever stroke compared to non-Hispanic Whites (Whites) [2]. The age-adjusted risk of ischemic stroke is 0.88 in Whites, 1.49 in Hispanics, and 1.91 in Blacks [3]. Blacks are also more likely to experience a stroke at a younger age and more likely to become disabled and experience difficulties with daily living and activities [2]. Similarly, older Blacks and Hispanics are more likely to experience higher odds of one-year all-cause poststroke rehospitalization compared to Whites after adjusting for patient and hospital characteristics [4]. Interestingly, there has been a decrease in ischemic stroke incidence among Whites in the US; however the incidence of overall ischemic stroke among Blacks has remained virtually the same [5]. Studies continue to demonstrate a differential impact of stroke between racial/ethnic groups with minorities experiencing worse poststroke outcomes.
Introduction: Racial and Ethnic Conflict and Violence  [cached]
Werner Bergmann,Robert D. Crutchfield
International Journal of Conflict and Violence , 2009,
Abstract: Racial and ethnic violence takes many forms. Genocides, ethnic cleansing, pogroms, civil wars, and violent separatist movements are the most obvious and extreme expressions, but less organized violence such as rioting, and hate crimes by individuals or small groups are products of racial and ethnic conflict as well. Also, the distribution of criminal violence within societies, which may or may not be aimed at members of another group, is in some places a by-product of ongoing conflicts between superior and subordinated racial or ethnic groups. Although estimates of the number of deaths attributable to ethnic violence vary widely, range of eleven to twenty million given for the period between 1945 and the early 1990s show the gravity of this type of conflict (Williams 1994, 50). So it comes as no surprise that scholars have paid increasing attention to such conflicts over the last decades.
Appreciative semiotic and hermeneutic practices in the analysis of ethnic minorities  [PDF]
Antonio SANDU
Revista de Cercetare ?i Interven?ie Social? , 2010,
Abstract: Socio-cultural research of ethnic minorities, is a hermeneutical process involving simultaneously the analysis of discursive strategies available to communities (ethnic),and the meta-narrative material. The type of discourse research dominant in the community, produces changes in the social pragmatics of that community. Action research study presents the discursive strategy of socio-cultural action. It emphasizes on quality characteristics of the method, which can be interpreted as a semiotic analysis of communication practices in the community, with effects in changing behavior patterns. Community development resulting from changes to the rhetoric used by the community. Understood in the manner proposed by Gergen constructionism, community is the space where there is a process of constant renegotiation of the meaning of social reality. A specific way of social pragmatics which can be used in transforming the social rhetoric of ethnic and multi-ethnic communities is the appreciative inquiry, transformative method aimed at harnessing the resources within the community by exploring the discourse level of positive experiences.
The Improvement of Foreign Language Teachers’ Affective Variables in Universities for Ethnic Minorities  [cached]
Kun Li
English Language Teaching , 2012, DOI: 10.5539/elt.v5n12p70
Abstract: This paper states the current situation of foreign language teachers’ affective variables in universities for ethnic minorities when teaching a foreign language. It emphasizes the urgent need of improvement of affective variables in such universities based on relevant research results and an interview performed in a university for ethnic minorities. Its purpose is to arouse people’s attention on teachers’ quality development, especially teachers’ affective variables. Several methods are mentioned to help teachers build a harmonious atmosphere in the classroom and improve teachers’ quality and future language teaching.
Genetic Relationships of Ethnic Minorities in Southwest China Revealed by Microsatellite Markers  [PDF]
Hongbin Lin,Hao Fan,Feng Zhang,Xiaoqin Huang,Keqin Lin,Lei Shi,Songnian Hu,Jiayou Chu,Duen-Mei Wang
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0009895
Abstract: Population migrations in Southwest and South China have played an important role in the formation of East Asian populations and led to a high degree of cultural diversity among ethnic minorities living in these areas. To explore the genetic relationships of these ethnic minorities, we systematically surveyed the variation of 10 autosomal STR markers of 1,538 individuals from 30 populations of 25 ethnic minorities, of which the majority were chosen from Southwest China, especially Yunnan Province. With genotyped data of the markers, we constructed phylogenies of these populations with both DA and DC measures and performed a principal component analysis, as well as a clustering analysis by structure. Results showed that we successfully recovered the genetic structure of analyzed populations formed by historical migrations. Aggregation patterns of these populations accord well with their linguistic affiliations, suggesting that deciphering of genetic relationships does in fact offer clues for study of ethnic differentiation.
Racial and Ethnic Differences in Individuals with Sporadic Creutzfeldt-Jakob Disease in the United States of America  [PDF]
Brian S. Appleby, Tonya D. Rincon-Beardsley, Kristin K. Appleby, Mitchell T. Wallin
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0038884
Abstract: Background Little is known about racial and ethnic differences in individuals with sporadic Creutzfeldt-Jakob disease (sCJD). The authors sought to examine potential clinical, diagnostic, genetic, and neuropathological differences in sCJD patients of different races/ethnicities. Methodology/Principal Findings A retrospective study of 116 definite and probable sCJD cases from Johns Hopkins and the Department of Veterans Affairs Healthcare Systems was conducted that examined differences in demographic, clinical, diagnostic, genetic, and neuropathological characteristics among racial/ethnic groups. Age at disease onset differed among racial/ethnic groups. Non-Hispanic Whites had a significantly older age at disease onset compared to the other groups (65 vs. 60, p = 0.036). Non-Whites were accurately diagnosed more rapidly than Whites (p = 0.008) and non-Hispanic Whites were more likely to have normal appearing basal ganglia on brain magnetic resonance imaging (MRI) compared to minorities (p = 0.02). Whites were also more likely to undergo post-mortem evaluation compared to non-Whites (p = 0.02). Conclusions/Significance Racial/ethnic groups affected by sCJD demonstrated differences in age at disease onset, time to correct diagnosis, clinical presentation, and diagnostic test results. Whites were more likely to undergo autopsy compared to non-Whites. These results have implications in regards to case ascertainment, diagnosis, and surveillance of sCJD and possibly other human prion diseases.
Why Are the Disabled People Willing to Participate in Sports: Taking Chinese Disabled Table Tennis Players as the Object of Investigation?  [PDF]
Jiandong Zhou, Feng Yuan, Tao Yu, Futao Liu
Advances in Physical Education (APE) , 2016, DOI: 10.4236/ape.2016.62010
Abstract: In this paper, questionnaire survey and data analysis are the main research methods. Its main purpose is to try to answer the question “why are the disabled people willing to participate in sports” and to explore some of the important factors that affect the participation of persons with disabilities. The object of the study is the 83 disabled table tennis players in the national training base. “Questionnaire of Motivation Adapted Athletes (AQAM)” is an international standard. Through descriptive analysis and independent sample T test data analysis, this study concludes three points: 1) “enhancing physical fitness”, “loving table tennis sport” and “winning the respect of others” are the main reasons that contribute to the participation in sports of disabled persons; 2) The motives of male and female athletes with disabilities to participate in sports are quite different; 3) The sports participation motivation of persons with disabilities is positively related to their family circumstances.
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