Vaccination uptake amongst older adults from minority ethnic backgrounds: A systematic review

BackgroundOlder adults from minority ethnic backgrounds are at increased risk of contracting COVID-19 and developing severe infection and have increased risk of mortality. Whilst an age-based vaccination approach prioritising older groups is being implemented worldwide, vaccine hesitancy is high amongst minority ethnic groups.Methods and findingsWe conducted a systematic review and convergent synthesis to systematically examine perceptions of vaccinations amongst older adults from minority ethnic backgrounds. We included studies that reported on perceptions, beliefs, and attitudes towards vaccinations in older adults aged ≥65 years from a minority ethnic background. We excluded studies of vaccinations in investigation or development, studies focused on specific medical conditions, studies where ethnic background or age group was unidentifiable, systematic reviews, editorials, and conference abstracts. We searched MEDLINE, Embase, Virtual Health Library, Web of Science, Cochrane Library, medRxiv, and PROSPERO databases from inception to 15 July 2021. Risk of bias for studies was assessed using the Mixed Methods Appraisal Tool. The quality of evidence of collective outcomes was estimated using the Grading of Recommendations Assessment, Development and Evaluation–Confidence in the Evidence from Reviews of Qualitative research (GRADE–CERQual) framework. A total of 28 eligible studies conducted between 1997 and 2020 were included in the final analysis (17 quantitative surveys, 8 focus group or interview studies, 2 mixed methods studies, and 1 case–control study). The majority were US studies in English or Spanish, except for 6 studies set in Hong Kong, 2 studies in Japan, 1 study in Brazil, and 1 multi-centre study (including China, Indonesia, Turkey, South Korea, Greece, UK, Brazil, and Nigeria). In total, 28,262 individuals with an estimated mean age of 69.8 years were included, 63.2% of whom were female. We summarised the common concepts and themes across studies and populations using a convergent synthesis analysis. Thirteen themes categorised as barriers or facilitators were identified and grouped into structural factors—healthcare provider and system related, patient related, and policy and operational—and were analysed by minority ethnic group. The main limitation of the study was the predominance of studies from the US and East Asia.ConclusionsIn this systematic review, we found that factors influencing vaccination uptake involve healthcare provider and system, patient-related, and governance-level factors that are specific to the older ethnic minority community being served. The evidence included in this review is supported by high or moderate certainty and can be translated to practice and policy. A tailored, multi-level approach combining increased education, access, and culturally competent discussions with trusted healthcare professionals to address health beliefs can maximise the potential impact of widespread vaccination policies.

In a systematic review, Dr. Cini Bhanu and colleagues investigate factors influencing vaccination uptake among older adults from minority ethnic backgrounds.     

Ethnic intolerance and ethnic conflict in the dissolution of Yugoslavia

The causal link between ethnic intolerance and ethnic conflict is tested using four highly comparable data sets from Croatia that span the time before and after the violent dissolution of Yugoslavia: 1984–5, 1989–90, 1996 and 2003. Though most approaches to ethnic conflict posit a social-psychological dimension critical to violent encounters, our analysis provides an unprecedented empirical examination that dispels the commonly held view that ethnic hatred, hostility, and intolerance are the cause of ethnic conflict. After explaining the events and the shifting social, political and economic landscape that precipitated the war, we examine demographic, social structural and attitudinal changes between 1985 and 2003 that are associated with variation in ethnic intolerance, giving special attention to the connection between religiosity and intolerance. Prior to the war people were slow to translate public tensions into personal animosities. We find strong support for concluding that the events of the war itself and especially elite manipulation of public images of these events, are strongly implicated in rising intolerance during the war, and that the war's residual effect has been slow to dissipate.     

基于多位点序列分型对新疆伊宁学龄儿童肠道两歧双歧杆菌(Bifidobacterium bifidum)群体遗传差异解析

【背景】两歧双歧杆菌(Bifidobacterium bifidum)是专性代谢人体母乳寡糖(human milk oligosaccharides, HMOs)和宿主肠道黏膜上皮黏蛋白聚糖的肠道共栖益生菌,对生命早期健康和发育至关重要,目前对其不同人群来源的群体遗传报道较少。【目的】探究在有限地域内遗传、饮食相近人群来源的B. bifidum菌株集的遗传结构是否具有族群特异的规律性,为开发个性化的益生菌株提供理论基础。【方法】对来自新疆伊宁两个族群(维吾尔族和哈萨克族)学龄儿童队列的肠道两歧双歧杆菌进行分离和鉴定,共获得115个菌株,对基于细菌基因组重复序列PCR (repetitive sequence-PCR, rep-PCR)方法筛选的53株代表菌株采用多位点序列分型(multilocus sequence typing, MLST)进行群体遗传差异分析。【结果】53株代表菌株共分为37个序列型(sequence type, ST),具有很高的遗传多样性;其中26株源自维吾尔族儿童的菌株有17个ST,而20个ST来自27株哈萨克族儿童的菌株,两个族群来源的菌株之间检测到较少的同源基因重组事件。goeBURST分析显示,来自同一族群的B. bifidum分离株比来自另一族群的菌株更有可能被归入特定的系统发育分支或克隆复合体(clonal complexes, CC)。【结论】不同族群来源的B. bifidum分离株显示出较高的遗传多样性,群体遗传结构一定程度上呈现出民族族群来源的特异性,需要更大规模的取样证实。这为进一步开展体内外实验并筛选针对区域族群的特色优良益生菌株提供了理论基础。     

Ethnic diversity and cord blood banking: satisfying the unmet need

Background aimsIn this study, the authors sought to assess whether cord blood units (CBUs) collected from donors of non-European ethnic backgrounds are utilized for umbilical cord blood transplantation (UCBT) at a different rate than those of European ethnic backgrounds. The authors also examined potential methods of enriching these under-represented ethnic backgrounds in cord blood bank (CBB) inventories without increasing financial overheads and without compromising total inventory utilization or post-transplant outcomes.MethodsData from N = 6506 searchable or shipped Anthony Nolan Cell Therapy Centre grafts were used in this study. Banked grafts were graded from A+ to D based on total nucleated cell and CD34+ cell content. Utilizations of each grade group were further stratified by graft ethnic background. The Mantel–Cox log-rank test was performed in conjunction with Kaplan–Meier survival analysis to compare utilization rates and post-transplant outcomes. For shipped grafts, levels of HLA matching at HLA-A, HLA-B and HLA-DR loci were also analyzed by graft ethnic background and grade using data from the Eurocord/EBMT registry.ResultsOverall utilization of non-European grafts did not significantly differ from that of European grafts (2.5% versus 2.2%, P = 0.23). However, significant differences were found when stratifying utilization rates by cell content. The probability of non-European D grade grafts being utilized was 3-fold higher than that of European D grade grafts (1.1% versus 0.4%, P = 0.03) and comparable to that of European C grade grafts (1.1% versus 0.9%, P = 0.90). No significant differences were found between D and C grade grafts in terms of overall survival (OS) (P = 0.12), in part due to a disproportionate utilization of D grade grafts for pediatric UCBT (74% versus 39%, age difference P < 0.001). Furthermore, non-European graft shipments were 4-fold less likely to be a 6/6 HLA match to their recipients relative to European graft shipments (7% versus 29%).ConclusionsThe authors have identified a niche for CBUs of low cell content collected from donors of non-European ethnic backgrounds that has been overlooked by previous studies. Banking of these CBUs for pediatric UCBT instead of CBUs from European donors containing modestly higher cell content is an ethical approach to increasing the ethnic diversity of CBB inventory—and, consequently, the probability of non-European recipients finding a 6/6 HLA-matched graft—without compromising post-transplant OS or overall rate of inventory utilization.     

A critical race theory approach to black American entrepreneurship

ABSTRACT

In recent years, a growing literature has suggested that self-employment is a viable means of solving economic problems for a wide range of groups who are subject to poverty, discrimination and other disadvantages. Yet African Americans have not developed an ethnic economy large enough to solve many of their economic problems. To explore the question, this paper reviews three of the most common explanations for black Americans’ low rates of entrepreneurship: the cultural/psychological perspective, the ethnic enterprise perspective and the critical race approach. While the first two are widely accepted, neither approach identifies black Americans as a racial group, instead defining them as a cultural or ethnic group. Accordingly, neither apprehends the full impact of racial inequality in limiting black Americans’ entrepreneurial opportunities. Following a discussion of race-based obstacles to entrepreneurship, the paper concludes that the critical race view provides the most convincing explanation for black Americans’ limited entrepreneurial achievements.     

Re-making the majority? Ethnic New Zealanders in the 2006 census

Abstract

The national census is often seen as a site of struggle for minorities seeking recognition and equality. Much less is known about the conditions under which ethnic majorities are galvanized to stake identity claims in the census. This article examines recent trends in New Zealand where an increasing number of people from the dominant New Zealand European group are redefining themselves as ethnic New Zealanders. Drawing from the literature on ethnic boundaries, we theorize the factors underlying the surge in New Zealander identification, and present census data to demonstrate its selective appeal. We also review patterns of national naming in North America and Australia to show that the New Zealander phenomenon reflects a broader shift by settler state majorities to reimagine their identities. The implications for ethnic counting in other contexts are briefly considered.     

Generation,ethnic and religious diversity in friendship choice: exploring interethnic close ties in Britain

Abstract

Interethnic friendships can reflect intergroup relations and immigrants' integration into host societies. Using pooled 2007–09 Citizenship Surveys, this study investigates interethnic friendship patterns and determinants of friendship choice in Britain. The paper focuses on generational, ethnic and religious diversity in forming interethnic close ties. The most common friendship pattern is having co-ethnic close friends. This ethnic boundary in interethnic ties, however, weakens across generations whereby those born in or migrated to Britain at young ages have a higher chance of having close friends from other ethnic groups. We find that interethnic friendships are formed in a ‘pan-ethnic’ pattern by which those with similar ethnic/racial and religious background such as Muslim Indians and Pakistanis, or mixed white and black Caribbean and black Caribbean, are more likely to nominate one another as close friends.     

Nations: Old and new Comments on Anthony D. Smith's ‘The myth of the “Modern Nation” and the myths of nations’

Abstract

Do common ethnicity and ethnic solidarity constitute preconditions for the successful formation of modern nations? In response to Anthony Smith's contention to this effect, it is here argued that ethnic solidarity at a large‐enough scale to constitute a nation is a problematic notion. Solidarities beyond small local communities require ideological and political underpinning. Rather than being preconditions of nation‐formation, ethnic homogeneity and solidarity are often products of a stable history of state and nation formation. The failures of some modern nation‐states with diverse ethnic compositions are an indication of inadequacy of resources for achieving stable ‘governability’.     

De-naturalizing the national in research methodologies: key concepts of transnational studies in migration

Abstract

Building on the transnational approach to migration, this introduction outlines some elements of the programme of an emergent methodological transnationalism. This effort aims to de-naturalize the concept of the national within migration studies. First, the analysis identifies methodological challenges of migration studies, such as contextualization, the ethnic lens and the essentializing view on ethnicity. Second, it indicates the relevant conceptual elements which deal with these methodological challenges, such as the critique of methodological nationalism, cosmopolitanism and the relational concept of space. Third, it addresses the relevant methods, such as multi-sited ethnography, the mobile methods approach, as well as researchers' positionality and strategies of de-ethnicization, all of which correspond to the new epistemology of migration studies. Finally, it highlights the common characteristics of the contributions to this special issue, which go beyond the normative view of cross-border migration.     

Ethnic groups and high sensitivity C-reactive protein in Israel

Abstract

High-sensitivity C-reactive protein (hs-CRP) is a biomarker that correlates with atherothrombotic risk and outcome. hs-CRP is influenced by various modifiable and non-modifiable factors. We studied the relationship between ethnic background and hs-CRP level, among the Jewish population in Israel. A total of 3659 men and 2180 women were divided into two ethnic groups (Ashkenazi and Sephardic Jews), based on the knowledge of Jewish immigration patterns throughout the centuries. Mean hs-CRP levels were calculated for each group and were adjusted for various factors known to influence hs-CRP. Sephardic Jews were found to have higher adjusted mean hs-CRP levels (2.0 mg l^?1 for men and 3.9 mg l^?1 for women) compared with Ashkenazi Jews (1.5 mg l^?1 for men and 2.9 mg l^?1 for women). Ethnic background emerged as an independent significant predictor of hs-CRP levels. We demonstrated that ethnicity is an important factor when considering hs-CRP as a marker of atherothrombotic risk.     

Which groups are mostly responsible for problems in your neighbourhood?

Abstract

Why and under which conditions do people employ ethnic categories rather than others (such as age, class, gender, and so on) to conceptually organize their social environment? This article analyses an open-ended question on who is seen as responsible for neighbourhood problems taken from a recently conducted large-scale survey in Germany. By doing so, this study tries to give novel insight on native Germans' use of ethnic folk classifications and aims to identify contextual factors that might explain why people characterize problem-groups in ethnic terms. This article shows that drunkards, the elderly and especially teenagers are seen as problem-groups more frequently than any ethnic minority. Conditions of economic decline and out-group size are analysed as to whether they are associated with a higher likelihood of using ethnic categories. The findings suggest that the effects of out-group size are diminishing in their impact, whereas the effects of economic decline are accumulating in strength.     

Beriberi (Thiamine Deficiency) and High Infant Mortality in Northern Laos

BackgroundInfantile beriberi (thiamine deficiency) occurs mainly in infants breastfed by mothers with inadequate intake of thiamine, typically among vulnerable populations. We describe possible and probable cases of infantile thiamine deficiency in northern Laos.ConclusionThiamine deficiency may be a major cause of infant mortality among ethnic groups in northern Laos. Mothers’ and children’s symptoms are compatible with thiamine deficiency. The severity of this nutritional situation requires urgent attention in Laos.     

Rejoinder: race scholarship and the future

ABSTRACT

In this Rejoinder we seek to address the key issues raised by the four commentaries on our edited book. We focus on the question of the shifting boundaries of the field of race and ethnic studies, the absences and gaps in what is covered, the limits of the post-racial, and the whitening of sociology. In conclusion, we suggest some alternative ways in which we would seek to address them.     

Introduction: Patterns of generational change: convergent,reactive or emergent?

Abstract

The aim of this special issue is to map the extent of generational change among Britain's ethnic minority population and to understand some of the underlying processes involved. Is there greater integration across generations, or has the ‘new second generation’ in Britain remained isolated from the mainstream, perhaps as a result of the prejudice and discrimination from the white British that they have encountered or because of desires to maintain ethnic values and resist western practices? We also ask whether processes of generational change have proceeded at the same pace and direction in different domains – notably cultural, social, structural and political – and whether it has proceeded at the same pace among different minorities.     

A maximum-likelihood approach for building cell-type trees by lifting

Background

In cell differentiation, a less specialized cell differentiates into a more specialized one, even though all cells in one organism have (almost) the same genome. Epigenetic factors such as histone modifications are known to play a significant role in cell differentiation. We previously introduce cell-type trees to represent the differentiation of cells into more specialized types, a representation that partakes of both ontogeny and phylogeny.

Results

We propose a maximum-likelihood (ML) approach to build cell-type trees and show that this ML approach outperforms our earlier distance-based and parsimony-based approaches. We then study the reconstruction of ancestral cell types; since both ancestral and derived cell types can coexist in adult organisms, we propose a lifting algorithm to infer internal nodes. We present results on our lifting algorithm obtained both through simulations and on real datasets.

Conclusions

We show that our ML-based approach outperforms previously proposed techniques such as distance-based and parsimony-based methods. We show our lifting-based approach works well on both simulated and real data.

     

Ethnic Variation in the Correlation Between Fasting Glucose Concentration and Glycated Hemoglobin (HbA1C)

ObjectiveWe aimed to determine the relationship between fasting serum glucose (FSG) concentration and glycated hemoglobin-Alc (HbAlc) in the 3 ethnicities in Singapore after adjustment for demographic and therapeutic variables.MethodsFasting serum glucose (FSG), HbAlc, and serum creatinine levels were simultaneously sampled from 575 patients with diabetes (389 Chinese, 97 Indians, 89 Malays) in this cross-sectional study between January and May 2008, and the results were subjected to multivariate linear regression analysis.ResultsWe found a significant interaction between FSG and ethnicity on HbAlc. The correlation between FSG and HbAlc among Chinese subjects was 0.25 (95% confidence interval [CI]:0.2-0.3) relative to the Malays (0.38, 95% CI: 0.30-0.45) after adjustment for age; gender; serum creatinine concentrations; body mass index (BMI); duration of diabetes; use of sulfonylureas, metformin, and insulin; and hemoglobin (Hb) and red cell indices (P = .005). Hence, for a given FSG, the predicted HbAlc will be higher in Malays compared to Chinese subjects.We did not observe a statistically significant difference between Indians and Malays with respect to the correlation between FSG and HbAlc.ConclusionWe showed a higher correlation between HbAlc and FSG in Malay subjects relative to the Chinese in this cohort. The ethnic variation in the HbAlc-FSG relationship may be related to differences in percentage contribution by the FSG to overall HbAlc among ethnic groups. Future studies using continuous glucose monitoring (CGM) to elucidate the relative contributions by FSG and postprandial glucose (PPG) to the daily blood glucose profile and the overall HbA1c by ethnicity are required. (Endocr Pract. 2013;19:812-817)     

Immigrant generation,religiosity and civic engagement in Britain

Abstract

Immigrant integration appears to be generational in the USA, and further facilitated by religious involvement. We examine whether similar patterns exist in Britain. We find evidence for secularization across ethnic minority groups, measured by private religious practice and religious salience. Communal religious practice appears robust to generational decline. Ethnic minority members of the second generation exhibit lower social trust; for the 1.5 generation, being more religious is associated with lower trust. However, members of the 1.5 and second generation are more civically involved than the first and religiosity further increases civic involvement. While anecdotal accounts suggest that religiosity has a particularly dissociative effect on the second generation, we find no evidence for this. In sum, successive generations of ethnic minority respondents appear to be secularizing; successive generations are more civically involved than the arriving generation, although less trusting; and immigrant religiosity promotes civic integration.     

Livestock herding and Fulani ethnicity are a combined risk factor for development of early adverse reactions to antivenom treatment: Findings from a cross-sectional study in Nigeria

BackgroundAdverse reactions to antivenom considerably complicate the clinical management of snakebite envenomed patients because it necessitates a temporary suspension of life-saving antivenom, increases costs and can compromise patient outcomes. This study sought to explore the association between cattle-herding occupation and ethnic group and the occurrence of early adverse reactions to antivenom.MethodsThis cross-sectional study was conducted between the 25th April and 11th July 2011 at the Kaltungo General Hospital in north east Nigeria. The exposure variable of cattle-herding occupation showed a strong correlation with the ethnic group variable, thus these were combined into a new variable with three categories (Fulani and herder, either Fulani or herder, and neither Fulani nor herder). The outcome variable was the occurrence of early adverse reactions, defined as any new symptoms occurring within 6 hours of antivenom administration. Odds Ratios were estimated using multivariable logistic regression models controlling for potential confounders.ResultsAmong 231 envenomed snakebite victims, the overall incidence of early adverse reactions was 11.9% (95% confidence intervals: 8.0–16.9%). Patients who were Fulani and herders had a higher incidence of early adverse reactions compared to patients who were neither Fulani nor herders (20% vs 5.7%). After adjusting for age and gender, victims who were Fulani and herders were 5.9 times more likely to have an early adverse reaction, compared to victims who were neither Fulani nor herders (95% CI: 1.88–18.59; p = 0.002).InterpretationTo the best of our knowledge, this is the first study to provide evidence of higher odds of early adverse reactions among patients from a particular occupation and/or ethnic group. We recommend that snake envenomed patients of Fulani origin be especially closely monitored for adverse reactions, that hospitals receiving these patients be appropriately resourced to manage both envenoming and adverse reactions and that premedication with adrenaline should be considered. Our findings provide an argument for speculation on the influence of immunological or lifestyle-related differences on the occurrence of early adverse reactions to antivenom.     

Postcolonial France: race,Islam, and the future of the republic

Abstract

The study explored feelings of European identity and attitudes towards Europe manifested in two groups within the British population: the indigenous white British population (N?=?58) and the South-Asian ethnic minority (N?=?44). A social survey approach was used with scales to evaluate British, European and ethnic identities and also attitudes towards Europe. Perceived compatibility of identities was also assessed using a visual representation of identities task. Previous research findings were confirmed with the indigenous white British respondents, who displayed a strong sense of national identity negatively correlated with European identity. In contrast, the South Asian respondents displayed positive feelings of identification on all three levels, and a British identity that correlated positively with European identification.     

Enhancing students’ experimental planning competences by introducing and evaluating the IS4O teaching approach

ABSTRACT

We herein report the introduction of the IS⁴O (Improving Students’ Scientific Skills by Using Scaffolding Outlines) teaching approach and its implementation to successfully empower students with initial minor planning competences in mastering complex scientific challenges in the course of Germany’s most-renowned scientific competitions. The IS⁴O teaching approach itself comprises the unique combination of the differentiating teaching methods Backward Planning and Project Mapping as core teaching elements. The beneficial effect of the IS⁴O teaching approach on the enhancement of the students planning competences is also discussed. Based on the given results, this teaching approach is mandatory to empower students with initial minor competences in completing a scientific competition successfully with very high assignment of tasks.