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Background Colorectal cancer is a leading cause of morbidity and mortality across U.S. racial/ethnic groups. Existing studies often focus on a particular race/ethnicity or single domain within the care continuum. Granular exploration of disparities among different racial/ethnic groups across the entire colon cancer care continuum is needed. We aimed to characterize differences in colon cancer outcomes by race/ethnicity across each stage of the care continuum. Methods We used the 2010–2017 National Cancer Database to examine differences in outcomes by race/ethnicity across six domains: clinical stage at presentation; timing of surgery; access to minimally invasive surgery; post-operative outcomes; utilization of chemotherapy; and cumulative incidence of death. Analysis was via multivariable logistic or median regression, with select demographics, hospital factors, and treatment details as covariates. Results 326,003 patients (49.6% female, 24.0% non-White, including 12.7% Black, 6.1% Hispanic/Spanish, 1.3% East Asian, 0.9% Southeast Asian, 0.4% South Asian, 0.3% AIAE, and 0.2% NHOPI) met inclusion criteria. Relative to non-Hispanic White patients: Southeast Asian (OR 1.39, p  < 0.01), Hispanic/Spanish (OR 1.11 p  < 0.01), and Black (OR 1.09, p  < 0.01) patients had increased odds of presenting with advanced clinical stage. Southeast Asian (OR 1.37, p  < 0.01), East Asian (OR 1.27, p  = 0.05), Hispanic/Spanish (OR 1.05 p  = 0.02), and Black (OR 1.05, p  < 0.01) patients had increased odds of advanced pathologic stage. Black patients had increased odds of experiencing a surgical delay (OR 1.33, p  < 0.01); receiving non-robotic surgery (OR 1.12, p  < 0.01); having post-surgical complications (OR 1.29, p  < 0.01); initiating chemotherapy more than 90 days post-surgery (OR 1.24, p  < 0.01); and omitting chemotherapy altogether (OR 1.12, p  = 0.05). Black patients had significantly higher cumulative incidence of death at every pathologic stage relative to non-Hispanic White patients when adjusting for non-modifiable patient factors ( p  < 0.05, all stages), but these differences were no longer statistically significant when also adjusting for modifiable factors such as insurance status and income. Conclusions Non-White patients disproportionately experience advanced stage at presentation. Disparities for Black patients are seen across the entire colon cancer care continuum. Targeted interventions may be appropriate for some groups; however, major system-level transformation is needed to address disparities experienced by Black patients.

Introduction Given the high prevalence of family violence (FV) amongst South Asian women, the experiences and expectations of addressing FV within healthcare, is of policy, practice and research interest. Whilst FV is shaped and influenced by various interconnected sociodemographic and cultural factors, it can be addressed in healthcare settings through identification and response. Objective To explore South Asian women's lived experiences and expectations about identifying and responding to FV within healthcare. Methods This review utilised a systematic methodology; nine databases were searched up to June 2024. A total of 8,217 records were screened by two reviewers independently based on a priori inclusion and exclusion criteria. A thematic analytical approach guided the integration of findings from 14 qualitative studies. Results Thematic synthesis of the articles generated three themes (1) I was afraid to share , (2) They just walk away , (3) Understand and listen to my pain . These themes represented the perspectives, feelings, and expectations of both local and migrant South Asian women survivor participants. Cultural factors and social obstacles may prevent South Asian women from seeking and using appropriate support services. Additional barriers may include healthcare providers’ reluctance to address FV with South Asian women because of a lack of cultural knowledge and/or appropriate methods to address FV. South Asian women participants reflected that they want healthcare providers to understand them, acknowledge their discomfort, and provide culturally appropriate strategies and solutions. Conclusion It is highly recommended that policymakers and health-care providers continue to be mindful of the social and cultural challenges faced by South Asian women who experience FV.

Background This study investigates how migration affects the culinary practices of Syrian, Afghan, and Egyptian Coptic communities living in Northwest Italy, specifically focusing on how these groups preserve, adapt, or abandon traditional foodways in a new socio-cultural environment. The objective is to understand the role of food in maintaining cultural identity and navigating integration in the host country. Methods Using a multidisciplinary approach, the research combines semi-structured interviews with 64 participants. Data were analyzed using SAS 9.4 and R 4.4.2. Descriptive and frequency analyses summarized demographic and food-related patterns, while Fisher’s exact tests and logistic regression assessed differences and predictors of traditional food maintenance. Qualitative data from interviews were thematically analyzed using an inductive approach, highlighting key themes such as adaptation, resilience, and cultural continuity. Results The findings reveal distinct culinary patterns shaped by each group’s cultural and ecological heritage, Syrian horticultural traditions, Afghan pastoral legacies, and the Coptic plant-based diet. While culinary resilience, adaptation, and loss occur across all groups, the extent varies. Influencing factors include ingredient availability, economic constraints, and levels of social integration. Age, gender, religion, and migration history further shape food behavior. Conclusions This research underscores the dynamic relationship between migration and food, highlighting how culinary practices serve as a site of both cultural preservation and adaptation in diaspora contexts.

Nasopharyngeal carcinoma (NPC) shows geographic and ethnic variation with specific etiopathogenesis. This study characterized the distribution of NPC patients stratified by ethnicity, geography, and histology in a tertiary-level cancer center in Nepal. A descriptive retrospective study was designed to analyze NPC cases from different regions among patients visiting the hospital from 2016 to 2021. Demographic and clinical information was obtained from medical records. Ethical approval was granted by the Nepal Health Research Council (NHRC). Data analyses and visualization were carried out with R software. During the six-year period, a total of 65 individuals were diagnosed with NPC, comprising 42 males and 23 females. Patient median age was 43 years (range 11-85 years). A bimodal age distribution of cases was observed with peaks in patients aged 30-39 years and 50-59 years. Of the NPC patients studied, 29 were from Koshi Province, with 7 cases from Ilam district and 6 cases from Morang district. There were 18 patients in Bagmati Province, and Kathmandu district had the highest number of cases within this region, with 8 patients. The highest proportion of cases were observed among patients of Janajati ethnicity (60%), including Rai, Limbu, and Sherpa people. Histologically, undifferentiated non-keratinizing NPC was the most commonly observed subtype, accounting for 43.1% of cases, followed by 20% differentiated non-keratinizing NPC and 4.6% keratinizing NPC across the entire sample population. The majority of patients (75.3%) were diagnosed at an advanced stage (stage III or IV) with none diagnosed at stage I. In our study, most cases of NPC occurred in patients from provinces in eastern Nepal (Koshi province), and of the Janajati ethnic community. The most common histological subtype was undifferentiated non-keratinizing carcinoma. Further epidemiological studies could address differences in prevalence and the challenge of late presentation of NPC patients in Nepal.

Background Maternal and child health among tribal populations in Odisha, India, is significantly influenced by socio-economic, cultural, and infrastructural factors. Cultural practices, reliance on traditional medicine, and limited awareness of modern healthcare benefits shape health-seeking behavior. This scoping review synthesises evidence on health-seeking behaviour, healthcare utilisation, awareness of healthcare services, government policies, and barriers in tribal communities in Odisha, India. Methods This scoping review was conducted following the Joanna Briggs Institute guidelines. We followed the Arksey and O’Malley methodological framework and applied the PAGER framework (Patterns, Advances, Gaps, Evidence for Practice, Research Recommendations) for quality of reporting. Studies were identified through systematic searches of international and Indian databases, Indian journal websites, organisational websites, repositories, and registries, focusing on health-seeking behaviour and healthcare utilisation among Odisha’s tribal communities. Only English-language articles published between January 2011 and July 2024 were included. The methodological quality of the selected studies was independently assessed by two reviewers using the JBI Quality Assessment Checklist. Results A total of 39 studies, encompassing 36,613 participants, were included in the review. The findings highlight significant barriers to healthcare access among tribal communities, including poverty, illiteracy, cultural practices, geographic isolation, distance to healthcare centres, transportation availability and mistrust of government services. While some tribes have shown progress in adopting modern healthcare services, many continue to rely on traditional medicine and indigenous practices. Socio-cultural factors, such as patriarchal norms and religious rituals, further influence healthcare-seeking behavior. Government initiatives like the National Rural Health Mission and the Integrated Child Development Services have had some success in improving healthcare utilisation among tribal populations. However, strengthening community support, conducting village-level awareness campaigns, and implementing targeted educational interventions can play a transformative role in enhancing healthcare access and overall well-being. Conclusion Improving maternal and child health in Odisha’s tribal populations requires culturally sensitive approaches integrated with modern healthcare strategies. Enhancing awareness, infrastructure, and community health workers’ roles can bridge access gaps while respecting tribal traditions.

Background/Aim The Kaiser Permanente (KP) Northern California Heart Health for South Asians (HHSA) Program is a two-hour educational class that provides culturally relevant lifestyle and dietary recommendations to South Asian (SA) patients, in an effort to reduce their known disproportionate burden of cardiovascular (CV) disease. We evaluated the impact of the HHSA Program on CV risk factors and major adverse CV events (MACE). Methods A retrospective cohort study identified 1517 participants of SA descent, ≥ 18 years old from 2006 to 2019. We evaluated the change in risk factors with program attendance (median follow up of 6.9 years) for systolic blood pressure (SBP), diastolic blood pressure (DBP), triglycerides (TG), LDL, HDL, BMI, and HbA1c. We also performed a propensity matched analysis to evaluate differences in MACE including stroke, myocardial infarction (MI), coronary revascularization, and all-cause mortality. Results There were significant improvements in DBP, TG, LDL-c, HDL-c, BMI, and HbA1c at one year follow up and sustained improvements in DBP (-1.01mmHg, p = 0.01), TG (-13.74 mg/dL, p = 0.0001), LDL-c (-8.43 mg/dL, p = < 0.0001), and HDL-c (3.16 mg/dL, p = < 0.0001) levels at the end of follow up. In the propensity matched analysis, there was a significant reduction in revascularization (OR 0.33, 95% CI 0.14–0.78, p = 0.011) and mortality (OR 0.41, 95% CI 0.22–0.79, p = 0.008), and a trend towards reduction in stroke. Conclusions Our study demonstrates the efficacy of a culturally tailored SA health education program in improving CV risk factors and reducing MACE. The program highlights the importance and value of providing culturally tailored health education in primary CV disease prevention.

South Asian infants and children have a higher predisposition to central adiposity, increasing their risk of metabolic diseases in childhood. Infant feeding practices are a key factor in reducing the risk of obesity in children. The current study aimed to compare infant feeding practices of South Asian-born mothers to Australin-born mothers. The 2010 Australian National Infant Feeding Survey data were used to compare infant feeding practices between South Asian-born mothers and Australian-born mothers with children aged up to 2 years. Chi-square and t-tests were conducted, as well as regression models, with adjustment for covariates, to assess individual infant feeding practices between the two groups. A total of 298 South Asian-born mothers and 294 Australian-born mothers were included. The age at which a child stopped receiving breast milk was lower among Australian-born mothers (3 months) compared with South Asian-born mothers (5 months, p < 0.001). A greater proportion of South Asian-born mothers reported that solids were introduced at or after 6 months of age compared to Australian-born mothers (86% vs. 69%, p < 0.001, respectively). South Asian-born mothers were engaging in some health-promoting infant feeding practices compared to Australian-born mothers; however, they were not meeting the infant feeding guidelines for exclusive breastfeeding and the introduction of solids. Further research is needed to better understand factors influencing infant feeding practices in South Asian-born immigrant mothers in Australia to determine whether culturally tailored interventions are needed to help these women achieve optimal feeding practices for their infants.

Background South Asians living in urbanized settings are facing disproportionate cardiovascular burden largely attributable to modifiable risk factors. Given the rapid surge in South Asian population in Hong Kong, this study aims to identify and distinguish clusters of cardiovascular risk profiles among community-dwelling South Asian adults. Methods Between June 2022 and December 2023, 1181 South Asian adults were recruited through territory-wide outreach health assessments on lifestyle, psychological distress, obesity, clinical cardiovascular conditions, and sociodemographic factors. Latent class analysis was performed to classify the cardiovascular profiles, followed by multinomial logistic regression to identify the sociodemographic characteristics across classes. Results Five latent classes were identified: low risk (19.6%), lifestyle risk plus distress (8.9%), obesity risk (33.4%), lifestyle risk plus distress with obesity (26.6%), and high clinical risk (11.4%). Apart from the higher clinical risk in older adults, women tended to cluster into classes with obesity, while men and the economically active were more likely in classes with poorer lifestyles and stress. Pakistani and Nepalese consistently exhibited higher risks compared to Indians, whereas the less educated tended to cluster into the high clinical risk class. Conclusion This study revealed distinct cardiovascular risk patterns and sociodemographic features within the South Asian community in Hong Kong. The heavy burden on obesity especially in women, lifestyle and psychological risks especially in men, and low overall physical activity level may be translated into a tremendous cardiovascular disease burden in the forthcoming decades, in particular among Pakistani and Nepalese as well as the socioeconomically disadvantaged.

Background South Asians are at higher risk for type 2 diabetes (T2D) than many other race/ethnic groups. Ectopic adiposity, specifically hepatic steatosis and visceral fat may partially explain this. Our objective was to derive metabolite risk scores for ectopic adiposity and assess associations with incident T2D in South Asians. Methods We examined 550 participants in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort study aged 40–84 years without known cardiovascular disease or T2D and with metabolomic data. Computed tomography scans at baseline assessed hepatic attenuation and visceral fat area, and fasting serum specimens at baseline and after 5 years assessed T2D. LC-MS-based untargeted metabolomic analysis was performed followed by targeted integration and reporting of known signals. Elastic net regularized linear regression analyses was used to derive risk scores for hepatic steatosis and visceral fat using weighted coefficients. Logistic regression models associated metabolite risk score and incident T2D, adjusting for age, gender, study site, BMI, physical activity, diet quality, energy intake and use of cholesterol-lowering medication. Results Average age of participants was 55 years, 36% women with an average body mass index (BMI) of 25 kg/m 2 and 6% prevalence of hepatic steatosis, with 47 cases of incident T2D at 5 years. There were 445 metabolites of known identity. Of these, 313 metabolites were included in the MET-Visc score and 267 in the MET-Liver score. In most fully adjusted models, MET-Liver (OR 2.04 [95% CI 1.38, 3.03]) and MET-Visc (OR 2.80 [1.75, 4.46]) were associated with higher odds of T2D. These associations remained significant after adjustment for measured adiposity. Conclusions Metabolite risk scores for intrahepatic fat and visceral fat were strongly related to incident T2D independent of measured adiposity. Use of these biomarkers to target risk stratification may help capture pre-clinical metabolic abnormalities.

Background Indigenous people are the most vulnerable and marginalised parts of society. Health services available to the tribal people are in developing face when compared to non-indigenous people. The situation with palliative care services exhibits a similar discrepancy. This study aims to explore the challenges and needs of palliative care within the tribal communities of Kerala. Methods The study followed a case study method conducted among the Paniya tribal community in Kambhatti, Maani, and Ozhakodi settlements of the Wayanad district, Kerala. The researchers used semi-structured interviews and observation as data collection methods. The data were collected from tribal people, ASHA workers, and promoters. Tribal people older than 18 years are considered for this study. A six-step model of reflexive thematic analysis was used for analysis. Open coding, followed by axial coding, was used to analyse the data collected from the participants. The codes were combined to form themes. Results A total of 12 participants were interviewed for the study, among them 8 participants were tribal people, 2 participants were promoters and 2 participants were ASHA workers. The majority of the tribal individuals live in joint families inside their settlement. Most of the participants were women, compared to men. Most of the women are employed through the Mahatma Gandhi National Rural Employment Guarantee Act. Nine major themes related to the challenges of palliative care were derived after the analysis are, lack of awareness, accessibility, financial issues, cultural beliefs and practice, fear and communication barriers, insufficient health care workforce, palliative care services, and health-related issues. Conclusions This study highlights the significance of palliative care for tribal populations. There is an increased need for palliative care, accompanied by challenges with receiving it in a culturally acceptable and sensitive manner. Developing a hybrid healthcare approach that integrates both traditional and modern medications exclusively for tribes is essential. The tribal population requires support in accessing comprehensive palliative care services from various professionals. It is crucial to establish healthcare programs aimed at addressing the entire healthcare needs of the tribal populations.