UNASSIGNED: Pediatric burns are common, especially in underdeveloped countries, and these can physically affect the children involved and have an impact on their mental health. The aim of the present study was to assess the effect of pediatric burns in underdeveloped minority areas of China.
UNASSIGNED: Case information from 192 children was collected from outpatient and inpatient clinics using a survey questionnaire. These included 90 pediatric burn cases and 102 controls who were children without burns. A stepwise logistic regression analysis was used to determine the risk factors for pediatric burns in order to establish a model. The goodness-of-fit for the model was assessed using the Hosmer and Lemeshow test as well as receiver operating characteristic and internal calibration curves. A nomogram was then used to analyze the contribution of each influencing factor to the pediatric burns model.
UNASSIGNED: Seven variables, including gender, age, ethnic minority, the household register, mother\'s employment status, mother\'s education and number of children, were analyzed for both groups of children. Of these, age, ethnic minority, mother\'s employment status and number of children in a household were found to be related to the occurrence of pediatric burns using univariate logistic regression analysis (p < 0.05). After a collinearity diagnosis, a multivariate logistic regression analysis of variables with tolerances of >0.2 and variance inflation factor <5 showed that age was a protective factor for pediatric burns [odds ratio (OR) = 0.725; 95% confidence interval (CI): 0.665-0.801]. Compared with single-child parents, those with two children were at greater risk of pediatric burns (OR = 0.389; 95% CI: 0.158-0.959). The ethnic minority of the child and the mother\'s employment status were also risk factors (OR = 6.793; 95% CI: 2.203-20.946 and OR = 2.266; 95% CI: 1.025-5.012, respectively). Evaluation of the model used was found to be stable. A nomogram showed that the contribution in the children burns model was age > mother\'s employment status > number of children > ethnic minority.
UNASSIGNED: This study showed that there are several risk factors strongly correlated to pediatric burns, including age, ethnic minority, the number of children in a household and mother\'s employment status. Government officials should direct their preventive approach to tackling the problem of pediatric burns by promoting awareness of these findings.

Despite the suspected higher prevalence of dementia in first generation ethnic minority populations, little is known about their pathway to geriatric diagnostic facilities. This study describes presenting symptoms, demographic and clinical characteristics of a large cohort of patients from ethnic minority populations at their first visit to a geriatric day clinic and compares them with those of native majority (Dutch) patients.
Retrospective case control study in an urban geriatric day clinic setting. Participants were 415 minority patients (cases) from 47 different countries and 428 native Dutch control patients. Measurements were demographic characteristics, cognitive screening results, informant questionnaires, neuropsychiatric and depressive symptoms and somatic comorbidity.
Ethnic minority patients presented with a different profile of psychiatric and somatic comorbidity. They were younger, had longer duration of symptoms and possibly presented somewhat later in the course of the dementia than the controls. Minority patients had more neuropsychiatric and depressive symptoms than native Dutch patients. They also had more often somatic comorbidities than controls, especially diabetes mellitus.
Clinicians in geriatric diagnostic facilities should be aware of the younger age at presentation and the high prevalence of some specific risk factors for dementia in ethnic minority patients.

OBJECTIVE: This discursive paper provides a call to action from an international collective of Indigenous nurse academics from Australia, Canada, Aotearoa New Zealand and the USA, for nurses to be allies in supporting policies and resources necessary to equitably promote Indigenous health outcomes.
BACKGROUND: Indigenous Peoples with experiences of colonisation have poorer health compared to other groups, as health systems have failed to address their needs and preferences. Achieving health equity will require leadership from Indigenous nurses to develop and implement new systems of care delivery. However, little is known about how Indigenous nurses influence health systems as levers for change.
METHODS: A Kaupapa Māori case study design.
METHODS: Using a Kaupapa Māori case study methodology, coupled with expert Indigenous nursing knowledge, we developed a consensus on key themes. Themes were derived from three questions posed across the four countries. Themes were collated to illustrate how Indigenous nurses have provided nursing leadership to redress colonial injustices, contribute to models of care and enhance the Indigenous workforce.
RESULTS: These case studies highlight Indigenous nurses provide strong leadership to influence outcomes for Indigenous Peoples. Five strategies were noted across the four countries: (1) Indigenous nationhood and reconciliation as levers for change, (2) Indigenous nursing leadership, (3) Indigenous workforce strategies, (4) Development of culturally safe practice and Indigenous models of care and (5) Indigenous nurse activism.
CONCLUSIONS: In light of 2020 declared International Year of the Nurse and Midwife, we assert Indigenous nurses\' work must be visible to support development of strategic approaches for improving health outcomes, including resources for workforce expansion and for implementing new care models.
CONCLUSIONS: Curating strategies to promote Indigenous nurse leaders around the world is essential for improving models of healthcare delivery and health outcomes for Indigenous Peoples.

This paper investigates the impacts of Tropical Cyclone Winston (2016) on rural Indo-Fijians and their response to the devastation. Studies have previously examined how rural communities in Pacific Island countries respond to severe climatic events, arguing that traditional knowledge of the climate, together with indigenous techniques, contribute substantially to recovery from a disaster. Strong communal bonds have also been identified as an influencing factor. Disaster risk reduction frameworks often assume the availability of such knowledge and capital. Yet, little research has been done on how minority groups with limited access to such knowledge and capital cope with disaster-related damage. The current study shows that rural Indo-Fijians responded to the consequences of Tropical Cyclone Winston differently to indigenous Fijians, owing to relatively limited access to traditional awareness of the climate, communal labour sharing, and intra- and/or inter-community networks. The findings point to the necessity to implement a more inclusive disaster risk reduction framework.
تدرُس هذه الورقة آثار إعصار وينستون 2016 الاستوائي (TCW) على سكان فيجي في المناطق الريفية الهندية واستجابتها. أوضحت الدراسات سابقًا (في بلدان جزر المحيط الهادئ) كيفية استجابة المجتمعات الريفية للأحداث المناخية القاسية، بحجة أن المعرفة بالطرق التقليدية للمناخ، إلى جانب استخدام التقنيات الأصلية، تساهم بشكل كبير في التعافي من آثار الكوارث. كما جرى تحديد الروابط المجتمعية القوية كعامل مساهم. غالبًا ما تتنحل إطارات الحد من مخاطر الكوارث توافر مثل هذه المعرفة ورأس المال. وفي الوقت نفسه، كان هناك القليل من البحوث حول كيفية تعامل الأقليات ذات الوصول المحدود إلى هذه المعرفة ورأس المال مع أضرار الكوارث. تُظهر دراستنا استجابة سكان فيجي الريفيين لتأثير إعصار وينستون الاستوائي (TCW) بشكل مختلف عن سكان فيجي الأصليين، بسبب محدودية الوصول نسبيًا إلى المعارف التقليدية للمناخ، وتقاسم العمل المجتمعي، والشبكات داخل أو بين المجتمعات. تشير نتائجنا إلى ضرورة تنفيذ إطار عمل أكثر شمولية للحد من مخاطر الكوارث.
本文研究了2016年热带气旋“温斯顿”(TCW)对印度-斐济农村地区的影响及其响应。在太平洋岛屿国家，以前的研究审查了农村社区如何应对恶劣的气候事件，认为传统的气候知识加上当地的技术大大有助于从灾害影响中恢复。强大的公共关系也被认为是一个促成因素。减少灾害风险的框架常常假定有这类的知识和资本。与此同时，很少研究专注于那些获得此类知识和资金有限的少数群体如何应对灾害破坏。我们的研究表明，印度-斐济农村居民对TCW的影响的反应与斐济土著居民不同，原因是他们获得气候、集体劳动分享以及社区内部和/或社区间网络等传统知识的机会相对有限。我们的研究结果表明，实施一个更具包容性的减少灾害风险框架是完全有必要的。.

Hydroxychloroquine (HCQ) is a well-established and effective immunomodulatory therapy for systemic lupus erythematosus and other autoimmune diseases. While retinal toxicity is a well-recognized complication, cardiotoxicity is lesser known. This case consists of a 63-year-old Filipina on chronic HCQ treatment that led to severe biventricular hypertrophy, increased filling pressure, systemic and pulmonary hypertension, and elevated brain natriuretic peptide. Genetic testing ruled out lysosomal storage disorders but revealed five rare variants of uncertain significance, including one that was temporarily re-classified as likely pathogenic. Endomyocardial biopsy demonstrated myeloid bodies admixed with curvilinear bodies, most consistent with a diagnosis of HCQ toxicity. This case illustrates the importance of clinical integration of multiple causes of cardiomyopathy, recognition of HCQ cardiotoxicity, and increased uncertainty in genetic test findings among racial minorities.

OBJECTIVE: To determine if ethnic disparities exist with regard to the risk of injury and injury outcomes among elderly hospitalized casualties in Israel.
METHODS: A retrospective study based on data from the Israeli National Trauma Registry between 2008 and 2017. Data included demographic, injury and hospitalization characteristics. Descriptive statistics and adjusted logistic regression were used to examine the differences between Jewish and Arab casualties, aged 65 and older.
RESULTS: The study included 96,795 casualties. The proportion of elderly hospitalized casualties was 2.8 times greater than their proportion in the population (3.1 times greater among Jews and 2.1 times among Arabs). In comparison to Arabs, Jews suffered from a greater percentage of head injuries (10.5 and 8.9%, respectively for Jews and Arabs p < .001), but fewer extremity injuries (46.7% vs. 48.0% respectively for Jews and Arabs p < .05). Among severe/critical casualties and among casualties with severe head injuries, Arabs were more likely to be transported to the hospital in a private car (27% vs. 21% respectively for Arabs and Jews p < .001; 30.5% vs. 23.3% respectively for Arabs and Jews p < .001). Logistic regression analysis, adjusted for age, gender, injury severity, type of injury, type of trauma center and year of admission, shows that Jews, relative to Arabs, were more likely to be hospitalized for more than seven days, admitted to the intensive care unit (ICU) and to be discharged to a rehabilitation center (OR: 1.3, 1.3 and 2.4 respectively). No differences regarding surgery (OR: 0.95) or in-hospital mortality (OR: 0.99) were found.
CONCLUSIONS: Ethnic disparities between Jewish and Arab hospitalized casualties were observed with regard to hospital stay, ICU admission and rehabilitation transfer. However, no differences were found with regard to mortality and surgery. While the reported disparities may be due in part by cultural differences and accessibility, health policy decision makers should aim to reduce the gaps by optimizing the accessibility of ambulance and rehabilitation services as well as increasing awareness regarding the availability of these medical services among the Arab population.

OBJECTIVE: The Health Career Academy (HCA) is a national program which provides a structure to introduce underserved high school students to healthcare careers. Utilizing the HCA framework, we adapted the curriculum to emphasize surgical cases and invited physicians to enrich the learning experience.
METHODS: Medical students adapted a surgical case-based learning (CBL) curriculum at a local high school serving students from a primarily ethnic minority and low-income community (61% Black, 20% Hispanic; 58% free or reduced lunch). Each grade level received a minimum of ten, 90-minute CBL sessions. Expert faculty lecturers supplemented lessons. Medical student volunteers and 10th and 11th grade students completed postsemester surveys.
RESULTS: Over four semesters, HCA held 44 sessions, with 81 students graduating from the program. A total of 66% of sessions featured at least one faculty volunteer. A total of 36 students in 10th and 11th grade and 15 medical student volunteers completed postparticipation surveys. A total of 46.2% of 11th grade students previously participated in the 10th grade curriculum. On a scale of 1 to 4, students rated HCA highly in its overview of career options (mean 3.61, [SD 0.5]) and instilling understanding of patient care (3.78 [0.42]). Students enjoyed learning about career paths (3.61 [0.50]) and health topics (3.83 [0.39]). Of 10th and 11th grade students, 100% considered a healthcare career, with 34.8% of 10th and 61.5% of 11th grade students expressing interest in pursuing a surgical specialty. After volunteering, medical students felt like better educators (4.47 [0.64]) and were more likely to pursue teaching roles (4.2 [0.86]).
CONCLUSIONS: The Duke HCA chapter implemented the HCA program featuring CBL sessions emphasizing surgical cases. This program engaged minority students and potentially contributed to student interest in surgical careers. It helped to prepare medical students for future teaching roles. An interactive, surgery-focused program may increase the number of minority youth interested in pursuing health careers.