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PubMedDate not supplied

The inclusion of minority groups in clinical trials: problems of under representation and under reporting of data.

OBJECTIVE: To evaluate the representation of minority groups in randomized control trials (RCTs), and the frequency with which this information is reported. STUDY DESIGN: Reviewers collected data on the racial/ethnic composition of study samples from all RCTs published in six leading medical journals in 1999. RESULTS: Of the 280 RCTs, most (204, 71.3%) provided no information on the race/ethnicity of participants. Of the 89 U.S.-based RCTs, 50 (56.1%) reported their minority distribution. Relative to other trials, those funded by the National Institute of Health (NIH) (n = 52) were more likely to report race/ethnicity data (55.8% vs. 23.7%; x2 = 20.9, p <_0.001) and to include nonwhite participants (13.5 % vs. 12.5%; x2=22.7, p<_0.001). CONCLUSION: Minority groups are currently under-represented in clinical trials. Information on the race and ethnicity of clinical trial participants is currently underreported in six leading medical journals. Reporting of minority group information was significantly better only in NIH funded trials, which also were more likely to include nonwhite participants. This suggests that mandatory reporting policies may have a positive effect on both reporting and representation.

Ethnicity↗
PubMed2002

Frequency Distribution and Haplotypic Heterogeneity of beta(E)-Globin Gene among Eight Minority Groups of Northeast Thailand.

The frequencies of hemoglobin E and beta(E)-globin gene haplotypes were determined in eight minority groups living in the northeastern part of Thailand. A total of 478 samples of eight minority groups, namely Soui, Thai Khmer, So, Yor, Phuthai, Thai Puan, Thai Loei and Thai Dam, were examined. High prevalences of hemoglobin E (>50%) were observed in Soui, Thai Khmer, So, Yor and Phuthai inhabiting the region near Cambodia and Laos. Thai Puan, Thai Loei, Thai Dam and native Thai living in the same geographical area had prevalences of 42.6, 35.9, 21.4 and 27.9%, respectively. A prevalence of 9.5% was found among the Thai with Chinese background living in the same area. Beta-globin gene haplotypes analysis demonstrated that most of the beta(E)-globin genes in these Thai populations were associated with two haplotypes: (- + - + + + -) and (+ - - - - + -) on chromosomes with framework 2 variety. Some beta(E)-globin genes in Soui and Thai Khmer groups were associated with the framework 3 chromosome. Genetic distances based on the beta( )-globin gene haplotypes between minority groups revealed that Soui and Thai Khmer were closely related to each other. This finding has a valuable implication for study of the origin and spread of hemoglobin E in the region.

Gene Frequency↗
PubMed2006

Improving access to dental care in East London's ethnic minority groups: community based, qualitative study.

UNLABELLED: There are few studies of access to dental care in ethnic minority groups which have compared their findings with those reported by the general adult population. Furthermore, studies have focused on either the younger or older members of these communities. AIM: This study aimed to identify barriers to the uptake of primary dental care in East London, to identify any variation in responses from the general adult population and to report ideas to improve access to primary dental care expressed by the participants. METHODS: A qualitative study using community based participatory methods was adopted. Data were generated through purposefully sampled focus groups and analysed using a grounded approach. SETTING: East London (UK), 2001. PARTICIPANTS: 68 volunteers aged 18-40 years, from the Bangladeshi, Indian, Black Caribbean communities and general adult population. RESULTS: Three inter-related themes were found to influence views on access: the structure of primary dental care, cost and anxiety. There was little evidence of differences in barriers to access based on ethnicity alone, reflecting the role of factors such as social class. Adult volunteers with young families enabled a wider perspective on barriers to access to be achieved, particularly with respect to the impact of the cost of dental care on family budgets. Proposals for reducing the barriers to accessing primary dental care were identified. These addressed a perceived need to extend services through outreach activity, develop communication skills within primary dental care practice and liaise with other primary health care services. CONCLUSION: This focus group study has confirmed the existence within East London's ethnic minority groups of barriers to accessing primary dental care reported within the general population for some time. That these responses are alike may be accounted for by the common levels of social disadvantage experienced. The rapid appraisal process enabled the identification of proposals to reduce access barriers. These are being implemented and their effectiveness in reducing barriers to accessing primary dental care remains to be established.

Adolescent↗
PubMed1994

Members of the low density lipoprotein receptor family mediate cell entry of a minor-group common cold virus.

A protein binding to a minor-group human rhinovirus (HRV2) was purified from HeLa cell culture supernatant. The amino acid sequences of tryptic peptides showed identity with the human low density lipoprotein (LDL) receptor (LDLR). LDL and HRV2 mutually competed for binding sites on human fibroblasts. Cells down-regulated for LDLR expression yielded much less HRV2 upon infection than cells with up-regulated LDLR. Virus also bound to the large subunit of the alpha 2-macroglobulin receptor/LDLR-related protein (alpha 2MR/LRP). LDLR-deficient fibroblasts yielded considerably less virus in the presence of receptor-associated protein (RAP), providing evidence that alpha 2MR/LRP also acts as a minor group HRV receptor.

Amino Acid Sequence↗
PubMed2005

"Reduced to nods and smiles": experiences of professionals caring for people with cancer from black and ethnic minority groups.

Despite growing research in the UK suggesting that patients from black and ethnic minority groups feel that they do not always receive the best treatment and care, little is known about how care professionals themselves respond to working with this group. The study, involving focus groups with health and social care staff, was undertaken to learn about their views and experiences. The principal finding was the extent to which staff experience difficulties in caring for patients from black and ethnic minority groups. Entailing serious challenges to their own professional practice, these were found to arise at all stages of patients' experience of cancer, including at diagnosis, during treatment and at the palliative phase. Staff were concerned that their inability to communicate with some patients meant that they were not able to provide them a good service, as they could not develop an easy relationship and talk around issues. Yet it could be difficult to work with interpreters, as well as family members, both of who could be reluctant to translate important information. They were also conscious of not being fully sensitive to patients' differing cultures, while noting the importance of not making assumptions about particular beliefs or behaviour. Staff would welcome training to help them to explore their attitudes and assumptions in working with black and ethnic minority patients, but did not seek induction into the detailed practices of different cultures. Some staff felt they would benefit from training in working with interpreters.

Adaptation, Psychological↗
PubMed2004

Specific health issues in ethnic minority groups.

The study of disease patterns in ethnic minority groups offers insights into the causation of disease. Ethnic minorities have wide variations in health conditions and behaviors, and stereotyping can lead to spurious assumptions in caring for patients. This article presents basic information relating to major illnesses such as cardiovascular disease, diabetes, and cancer and common health disorders observed among ethnic groups primarily in the United Kingdom and United States.

Attitude to Health↗
PubMed1991

The major and minor group receptor families contain all but one human rhinovirus serotype.

Previous studies have assigned 88 human rhinovirus (HRV) serotypes to major and minor receptor groups. Extension of these studies to include the remaining 14 unassigned serotypes indicated that 13 serotypes belong to the major group since their infection of HeLa cells is completely blocked by a monoclonal antibody that recognizes the major group receptor. This result indicates that the major group now accounts for 91 of the 102 known serotypes, while the minor group contains 10 serotypes. One serotype, HRV-87, appears to utilize neither the major nor minor group receptor and may represent a third receptor group. HRV-87 attachment cannot be blocked by other serotypes and displays a binding tropism similar to but distinct from minor group viruses. Unlike major and minor group serotypes, HRV-87 attachment and infection requires the presence of sialic acid on cellular receptors.

Animals↗
PubMed1987

Alcohol use among adolescent minority groups.

Drinking and drug use in a sample of minority students in the state of New York were studied. Minority groups were compared with White groups and with each other on the prevalence of drinking and heavy drinking, distribution of quantity of consumption, relationship between drinking and social problems, and relationship between drinking and drug use. There are high proportions of heavy drinkers and drug users among American Indian adolescents. Black students are relatively low in alcohol and drug use in comparison to Hispanics and Whites who have intermediate levels of heavy drinking and drug use. The drinking by Oriental youths is unique in that males drink heavily and females are light drinkers. Those groups with the highest proportion of drinkers also have the highest proportion of heavy drinkers. The groups with the most drinking also have the highest prevalence of drug use.

Adolescent↗
PubMed1985

Characterization of Haemophilus spp. isolated from healthy swine and evaluation of cross-reactivity of complement-fixing antibodies to Haemophilus pleuropneumoniae and Haemophilus taxon "minor group".

Of 30 sows from a herd believed to be free of Haemophilus pleuropneumoniae infection, 2 had complement-fixing antibodies to H. pleuropneumoniae serotype 5. Necropsy and microbiological examination of the two sows revealed no evidence of H. pleuropneumoniae infection; however, Haemophilus taxon "minor group" and a urease-negative, indole-positive Haemophilus sp. were isolated from numerous respiratory tract sites in both sows. Isolation of these Haemophilus spp. was facilitated by serially diluting specimens in two broth media. Pigs from a closed, respiratory disease-free herd were inoculated with four strains of Haemophilus taxon "minor group" to determine whether the organism induces antibodies which cross-react with H. pleuropneumoniae in the complement fixation test. Antigenic heterogeneity among the taxon "minor group" strains was apparent; however, antibodies cross-reacting between these strains and H. pleuropneumoniae serotypes 1 through 5 and 7 were not detected.

Animals↗
PubMed1989

Prospective study of the disadvantage of people from ethnic minority groups applying to medical schools in the United Kingdom.

To assess whether the ethnic origin of applicants affects their likelihood of being accepted into medical school in the United Kingdom the outcome for the 2399 applicants who applied to read medicine at university in 1986 and included St Mary's Hospital Medical School as one of their five choices was studied prospectively. Altogether 2040 of the 2399 applicants were British (United Kingdom) nationals, constituting 24.7% (n = 8249) of all home applicants for medicine in 1986, and 1971 of them with postal addresses in the United Kingdom were sent questionnaires asking about their ethnic origin, whether English was their first language, and about their attitudes to ethnic monitoring. A total of 1817 (92.2%) applicants returned the questionnaire, 401 (22.6%) saying that they were from an ethnic minority group and 393 (21.6%) having non-European surnames. Multiple logistic regression identified 11 significant predictors of successful application, of which grades at O and A level, application after A levels, and date of application were the most important. After taking these four variables into account the predicted acceptance rates for home students on the basis of their application forms alone were 47.8% for white applicants and 35.6% for applicants from ethnic minority groups compared with actual acceptance rates of 49.6% and 27.3%, respectively. The difference in success of white and non-white applicants could partly but not entirely be explained by differences in the characteristics considered to be important in a professional context by selectors during shortlisting of candidates: academic ability, interests, and contribution to the community. No differences in the success rate of applicants from ethnic minority groups to individual medical schools could be identified. More research is needed to discover how perceptions of professional suitability are assessed from application forms and interviews.

Educational Measurement↗
PubMed2004

End-of-life care for ethnic minority groups.

Death and dying are profound events that bring into focus important ethical and medical questions for all patients, whatever their cultural background. For ethnic minority groups and their families, specific issues or barriers may arise related to culturally appropriate health care practices, cultural or religious differences, diverse health beliefs, and access to services for care and support during end-of-life conditions. National policy and local initiatives in both the United States and the United Kingdom support the development of services that address the care of ethnic minorities. This article examines end-of-life care for ethnic minority groups.

Attitude to Death↗
PubMed2005

Racism, psychosis and common mental disorder among ethnic minority groups in England.

BACKGROUND: The aim of this study was to explore the relationship between risk of psychosis, common mental disorder (CMD) and indicators of racism among ethnic minority groups in England and how this relationship may vary by particular ethnic groups. METHOD: A multivariate analysis was carried out of quantitative, cross-sectional data from a nationally representative community sample of people aged between 16 and 74 years from the largest ethnic minority groups in England: those of Caribbean, Indian, Pakistani, Bangladeshi and Irish origin. RESULTS: Experience of interpersonal racism and perceiving racism in the wider society each have independent effects on the risk of CMD and psychosis, after controlling for the effects of gender, age and socio-economic status. There was some variation in the findings when they were conducted for separate ethnic and gender groups. CONCLUSIONS: An understanding of the relationship between racism and mental health may go some way towards explaining the ethnic variations found in both CMD and, particularly, psychosis.

Adolescent↗
PubMed1994

Methods for epidemiological surveys of ethnic minority groups.

OBJECTIVE--Research into the health of minority ethnic groups is often restricted by methodological difficulties. These include the lack of accurate population denominators, the choice of an appropriate sampling frame, correctly assigning ethnic group, and biases in techniques used for sampling and investigation. This article reviews the available sources or mortality and morbidity data, and assesses their uses and limitations for research involving ethnic minority groups. Suitable sampling frames and review methods used to assign ethnicity are discussed. Sources of bias are high-lighted and methods used to overcome these biases are presented. CRITERIA FOR INCLUSION OF ARTICLES--Articles have been chosen which best illustrate the problems encountered and show how these problems can be addressed. CONCLUSIONS--The increased documentation of ethnic origin on routine data sources is welcomed, but attention must be paid to ensuring that congruent definitions in data collection are used. The worrying consequences of the Commission of European Communities directive, which describes the need for explicit consent to be obtained from subjects before data is used for anything other than its original purpose, are discussed.

Data Collection↗
PubMedDate not supplied

A comparison of perceptions of problematic behavior by six minority groups and mental health professionals.

This study compared the perceptions of problematic behavior and the suggested management of those behaviors by six minority groups and mental health professionals. Minority respondents (N = 159) included Chinese-Americans, Mexican-Americans, Filipino-Americans, Native-Americans, Black-Americans, and Appalachians. Mental health professional respondents (N = 68) were from Pennsylvania, Louisiana, and California. All respondents were interviewed using a structured interview schedule. Groups were compared on responses to 10 vignettes. There were significant differences between minority and mental health professional groups, both in the labels placed on problematic behaviors and in the suggested management of the behaviors. The relationship of sample variables to response revealed that minority group status was the strongest descriptor of group response.

Adult↗
PubMed1995

Ethnic minority groups in regional and local labour markets in Britain: a review of data sources and associated issues.

"This paper outlines the context of, and discusses the need for, local information on the demographic patterns and labour market experience of ethnic minority groups in many parts of Britain. The specific focus is on the identification and assessment of the strengths and weaknesses of particular data sources providing spatially disaggregated information on the economic position of ethnic minority groups."

Culture↗
PubMed2005

Accessibility and use of touchscreens by black and ethnic minority groups in the three cities project.

OBJECTIVES: The public are being encouraged by Government, at a national level, to take a greater role in the management of their health and healthcare but information to support this is not always accessible to black and ethnic minority group members who do not speak or read English. This study looks at the feasibility of providing health-related information in a multilanguage format through a touchscreen kiosk. DESIGN: Three touchscreen kiosks were programmed with information on 10 health topics translated into five languages: Chinese, Bengali, Gujarati, Urdu and Mirpuri Punjabi. Information was provided orally and in written format. Over an 18-month period the touchscreens were rotated between settings including health centres and libraries, located in deprived areas of Leicester, Sheffield and Nottingham. Information was logged on each individual user with respect to language used, topic selected, age group and gender of user. A number of users were invited to complete a short questionnaire about their use and ease of use of the touchscreen. RESULTS: Touchscreens were accessed by 2,456 people across all ages, 53% of whom were male. Urdu and Gujarati were the most frequently accessed languages (37 and 38%, respectively) and Bengali used least (9%). There was some variation in use by setting. Most of the 508 people questioned who had used the touchscreen found it easy to use. Ease of use was related to home computer use and to being younger in age. The five most popular topics accessed by 12% or more users were stress, diabetes, blood pressure, healthy eating and exercise. Topic choice varied by language used by males but not by females. CONCLUSION: Touchscreens providing health information in ethnic minority languages can be successfully accessed by black and ethnic minority groups, particularly those living in deprived areas. Touchscreens proved acceptable to, and were used by, the targeted audience.

Adolescent↗