Ethnic Minority Representation in Female Sexual Dysfunction Questionnaire Validation: A Scoping Review

Diversity is an essential element of an effective health care system. A key to developing a diverse workforce is establishing a diverse student population in health professions programs. To examine the diversity of students in Doctor of Medicine (MD), Doctor of Osteopathic Medicine (DO), Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DMD), and Doctor of Pharmacy (PharmD) programs with emphasis on the trends of underrepresented minoritized groups (American Indian or Alaska Native, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander) and sex relative to the overall age-adjusted US population. This cross-sectional study used deidentified, self-reported data from 2003 to 2019 from the Association of American Medical Colleges, American Association of Colleges of Osteopathic Medicine, American Dental Education Association, American Dental Association, and American Association of Colleges of Pharmacy. Data analysis was performed from 2003 to 2004 and from 2018 to 2019. Data on the race, ethnicity, and sex of applicants, matriculants, and degrees conferred by health professions programs were collected and compared with the age-adjusted population in the US Census (aged 20-34 years) over time. The main outcomes were trends in the proportions of underrepresented minoritized groups and sex diversity among applicants, matriculants, and degrees conferred relative to the overall age-adjusted US population. Trends were measured using the representation quotient, which is defined as the ratio of the proportion of each subgroup to the total population of applicants, matriculants, or graduates relative to the proportion for that subgroup within the US Census population of similar age. Regression analysis was used to evaluate the trend over time. A total of 594 352 applicants were analyzed across the examined programs. From 2003 to 2019, the proportions of individuals from underrepresented groups increased for DDS and DMD (applicants, from 1003 of 8176 to 1962 of 11 298 [5.1%]; matriculants, from 510 of 4528 to 966 of 6163 [4.2%]; degrees awarded, from 484 of 4350 to 878 of 6340 [2.7%]), PharmD (applicants, from 9045 of 71 966 to 11 653 of 50 482 [9.0%]; matriculants, from 5979 of 42 627 to 10 129 to 62 504 [6.3%]; degrees awarded, from 922 of 7770 to 2190 of 14 800 [3.0%]), and DO (applicants, from 740 of 6814 to 3478 of 21 090 [5.4%]; degrees awarded, 199 of 2713 to 582 of 6703 [1.4%]) programs, but decreased for MD programs (applicants, from 6066 of 34 791 to 7889 of 52 777 [-2.3%]; matriculants, 2506 of 16 541 to 2952 of 21 622 [-2.4%]; degrees awarded, from 2167 of 15 829 to 2349 of 19 937 [-0.1%]). Compared with age-adjusted US Census data, all programs had more Asian students and fewer male, American Indian or Alaska Native, Black or African American, Hispanic or Latino, and Native Hawaiian or Other Pacific Islander students (representation quotient <1). In this cross-sectional study, most of the health professions in the study saw increases in underrepresented minority applicants, matriculants, and degrees conferred from 2003 to 2019; however, all programs were below the age-adjusted US Census data. The increased racial, ethnic, and sex diversity in the programs illustrates progress, but additional strategies are needed to achieve a more representative health care workforce.

Improved clinical trial race/ethnicity reporting and updated inclusion profile, 2017–2022: A New Jersey snapshot

Public health professionals have long played a vital-albeit underappreciated-role in shaping, not simply using, US Census data, so as to provide the factual evidence required for good governance and health equity. Since its advent in 1790, the US Census has constituted a key political instrument, given the novel mandate of the US Constitution to allocate political representation via a national decennial census. US Census approaches to categorizing and enumerating people and places have profound implications for every branch and level of government and the resources and representation accorded across and within US states. Using a health equity lens to consider how public health has featured in each generation's political battles waged over and with census data, this essay considers three illustrations of public health's engagement with the enduring ramifications of three foundational elements of the US Census: its treatment of slavery, Indigenous populations, and the politics of place. This history underscores how public health has major stakes in the values and vision for governance that produces and uses census data.

Introduction Female sexual dysfunctions (FSDs) represent a common issue among the general population. However, in many cultures and societies, such as China, FSD still needs to be addressed in the urological setting, so far more focused on Andrology. However, FSDs can be easily investigated in clinical practice, and for research purposes using validated psychometric tools, including the Female Sexual Function Index (FSFI), the most commonly used diagnostic instrument, also validated in Mandarin. While the scientific interest in this field is growing, several issues remain unaddressed by the FSFI, such as orgasmic intensity or satisfaction associated with the frequency of sex. The Dr. Eros FSD scale aims to fill this gap. Objective We aimed to explore FSDs in the general population in order to address the unmet expectations and needs of Chinese women in China. Methods In our Clinic, the first established in China aiming to treat FSDs, we developed a modified version of the FSFI, which also focuses on sex frequency, sexual urges, satisfaction related to orgasm and sexual activity, and vaginal discomfort during sexual activity. These 5 questions were added to the 19 items of the FSFI, for 24 questions. The two questions on sex frequency and sexual urges were added to the desire domain of the FSFI, whereas the following three were included in the Orgasm, Satisfaction, and Pain domains, respectively. Results The Dr. Eros FSD scale was administered to 14 896 women (age: 36.2 ± 8.1 years, range 18-18) admitted to the outpatient service of our Clinic, from March 2020 to May 2024. Mean ± SD for the 6 domains were as follows: Desire, 12.9 ± 3.2; Arousal, 12.8 ± 5.4; Lubrication, 15.6 ± 5.9; Orgasm, 13.2 ± 5.7; Satisfaction, 13.8 ± 4.4; Pain, 14.0 ± 5.06. Since a lower score is suggestive of increased severity of SDs, the most severe female sexual complaints in China are seemingly hypoactive sexual desire disorder and poor overall satisfaction, in an age-dependent manner. Regression analysis showed a significant effect of aging on all six domains (p &amp;lt; 0.001 for all, fig. 1) when stratifying the population by age (age &amp;lt; 45, N = 12 666; age 45-55, N = 1924, age ≥ 55, N = 306). Conclusions The new Clinic, dealing with all FSDs, from HSSD to hypolubrication, from anorgasmia to vaginismus, from dyspareunia to couple’s problems, is the unique institution systematically addressing female sexual health in China. Our experimental data demonstrate that this is a major unmet need in this part of the world. The prevalence and severity of SDs among Chinese women are clinically relevant issues for healthcare, which should urgently be addressed with the instruments of modern Sexual Medicine, possibly involving both Western and traditional Chinese medicine (TCM) in a holistic perspective. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Mia Clinic.

Variation in Incidence of ESKD Among Individuals of Native Hawaiian/Pacific Islander Race Based on Data From the US Renal Data System

Introduction: Lipoprotein (a) [Lp(a)] is an emerging target for atherosclerotic cardiovascular disease (ASCVD) with racial/ethnic differences that may link with ASCVD. Compared to non-Hispanic White (NHW) individuals, Asian and Black individuals have high Lp(a) levels. We evaluated diverse racial/ethnic reporting and representation in high impact studies of Lp(a) and ASCVD that inform major Lp(a) scientific statements. Methods: We reviewed the 2022 American Heart Association (AHA) Scientific Statement on Lipoprotein (a) and the 2019 Scientific Statement from the National Lipid Association (NLA) on the Use of Lipoprotein (a) in Clinical Practice for all cited observational studies or trials of Lp(a) and ASCVD. For studies of the same cohort, only the one with the largest sample size was included. Meta-analyses were excluded to avoid duplication. Manuscripts and supplements were systematically reviewed for participant race/ethnicity data. Participation (%) was pooled across studies for overall representation. In a sub-analysis of US studies, pooled representation was compared with 2020 US Census data. Results: A total of 58 studies met inclusion criteria. Only 33 (57%) reported any race/ethnicity. Reporting studies (participant n=701859) had 92% NHW, 2.6% Black, 0.6% Hispanic, 3.2% Asian, and &lt;0.1% American Indian/Alaskan Native or Native Hawaiian/Pacific Islander participants. No Lp(a) studies disaggregated Hispanic subgroups and 5 disaggregated Asian subgroups. In US studies, Hispanic and Asian representation was lower than 2020 US Census data (Fig). Conclusions: High impact studies of Lp(a) and ASCVD underreport and rarely disaggregate participant race/ethnicity and have low overall Black, Hispanic, and Asian representation. Among US studies, Hispanic and Asian groups are underrepresented versus 2020 Census data. Efforts are needed to improve diverse study race/ethnicity reporting and representation for this emerging therapeutic target.

Evaluating Age, Sex, Racial, and Ethnic Representation in Acute Ischemic Stroke Trials, 2010 to 2020: A Systematic Review and Meta-Analysis.

Normative Values for the Forgotten Joint Score-12 for the US General Population

Abortion travel within the United States: An observational study of cross-state movement to obtain abortion care in 2017

Ethnoracial and Geographic Representation in United States Glaucoma Clinical Trials (2004-2023).

Women and ESRD: Modalities, Survival, Unique Considerations

Objectives. To assess health-related quality of life (HRQOL) in patients three years after coronary artery bypass grafting (CABG) compared to the general Norwegian population, with emphasis on age and gender-differences. Design. A cross-sectional postal survey of patients who underwent CABG in 2000. HRQOL was assessed using the Short Form 36 (SF-36). Subgroup analyses were performed according to age (<70 versus ≥70 years) and gender. Results. Of 233 eligible patients 203 responded (mean age 67.6 years, 17% females). Patients reported better scores on bodily pain than the general population (p = 0.008), but did not differ on other subscales of SF-36. Younger patients tended to score lower, older patients higher than the general population on HRQOL. Female patients reported lower HRQOL than the general female population and reported significantly lower scores than male patients on 3 of 8 subscales. Conclusions. Three years after CABG the HRQOL is comparable to the general Norwegian population even in older patients. The older patients reported less pain than the general population.

Asian Americans and disproportionate exposure to carcinogenic hazardous air pollutants: A national study

The emergence of drug-resistant Streptococcus pneumoniae poses new clinical challenges and may also reflect a change in the epidemiology of S. pneumoniae infections. A variety of studies have shown that drug-resistant S. pneumoniae infections are linked to antimicrobial use. It has been hypothesized that persons of high socioeconomic status are at increased risk for a drug-resistant infection because of greater access to antimicrobial drugs. To assess whether median household income is associated with increased risk of penicillin-nonsusceptible S. pneumoniae infections, the authors geocoded and linked data from population-based surveillance for invasive pneumococcal disease with data from the 1990 US Census. Among invasive pneumococcal isolates from Atlanta, Georgia, in 1994, increasing proportions of penicillin-nonsusceptible isolates were associated with higher median household incomes (chi2 for trend, 15.17; p=0.002). Despite higher rates of invasive pneumococcal disease among blacks and persons who resided within lower median household income areas, white patients in areas with higher median household income had a higher risk of being infected with strains that were not susceptible to penicillin (Wilcoxon rank sum, Z=2.66, p=0.008). These findings demonstrated the utility of geocoding and US Census data in describing the epidemiology of drug-resistant S. pneumoniae and also provided more evidence that socioeconomic factors may influence the development of drug resistance.

Suicide in European Hodgkin Lymphoma Patients