Racial and Ethnic Disparities in the Use and Outcomes of Transcatheter Mitral Valve Replacement: Analysis From the National Inpatient Sample Database.

Background Racial and ethnic disparities in outcomes exist following many cardiac procedures. Transcatheter mitral valve replacement (TMVR) has grown as an alternative to mitral valve surgery for patients at high surgical risk. The outcomes of TMVR by race and ethnicity are unknown. We aimed to evaluate racial and ethnic disparities in the outcomes of TMVR. Methods and Results We analyzed the National Inpatient Sample database from 2016 to 2020 to identify hospitalizations for TMVR. Racial and ethnic disparities in TMVR outcomes were determined using logistic regression models. Between 2016 and 2020, 5005 hospitalizations for TMVR were identified, composed of 3840 (76.7%) White race, 505 (10.1%) Black race, 315 (6.3%) Hispanic ethnicity, and 345 (6.9%) from other races (Asian, Pacific Islander, American Indian or Alaska Native, Other). Compared with other racial and ethnic groups, Black patients were significantly younger and more likely to be women (both P<0.01). There were no significant differences between White, Black, and Hispanic patients in in-hospital mortality (5.2% versus 5.0% versus <3.5%; P=0.89) and procedural complications, including heart block (P=0.91), permanent pacemaker (P=0.49), prosthetic valve dysfunction (P=0.45), stroke (P=0.37), acute kidney injury (P=0.32), major bleeding (P=0.23), and blood transfusion (P=0.92), even after adjustment for baseline characteristics. Adjusted vascular complications were higher in Black compared with White patients (P=0.03). Trend analysis revealed a significant increase in TMVR in all racial and ethnic groups from 2016 to 2020 (Ptrend<0.05). Conclusions Between 2016 and 2020, Black and Hispanic patients undergoing TMVR had similar in-hospital outcomes compared with White patients, except for higher vascular complications in Black patients. Further comparative studies of TMVR in clinically similar White patients and other racial and ethnic groups are warranted to confirm our findings.

Racial Prejudice and Police Stops: A Systematic Review of the Empirical Literature.

A police stop must be based on founded suspicion: an officer's ability to correctly discriminate suspicious behavior. However, police stops can be influenced by negative attitudes toward Black individuals. We conducted a systematic review of empirical articles published from 2014 to 2019 that investigated the relationship between racial prejudice and police stops on PsycInfo using keywords such as "race," "ethnic," "police stop," "traffic stop," and "stop and frisk." Results included 16 studies conducted in the United States, England, Wales, and the Netherlands and showed that Black men were the most frequent targets of police stops; that many individuals who have been stopped by the police reported negative perceptions of the police force; that the Stop, Question, and Frisk strategy used by some U.S. police departments proved to be a type of stop that favors racial selectivity; and that traffic stops were favorable environments for racially biased actions by officers. We conclude that institutional racism in police stops proves to be a problem shared by several countries, including Brazil. We suggest more investigations to characterize institutional racism in the police force and in other settings and interventions aimed at reducing individual biases and collective racist practices.

As concepções de cuidado em saúde de mulheres de uma comunidade quilombola da região metropolitana de Fortaleza (CE): uma investigação a partir dos afetos / The concepts of health care according to women from a Quilombola community in the metropolitan area of Fortaleza, in the State of Ceará: an investigation via affections

Resumo Este artigo foi construído junto a mulheres de uma comunidade quilombola situada na região metropolitana de Fortaleza (CE), a partir da investigação sobre lugares de cuidado em saúde. Destacamos a importância de debater a dimensão afetiva das práticas de saúde com base nos cotidianos das comunidades, considerando questões sociopolíticas como o debate étnico-racial. Nosso objetivo foi reconhecer concepções de saúde e demandas trazidas pelas participantes e, a partir disso, discutir modos de fazer saúde. Foi utilizado o Instrumento Gerador dos Mapas Afetivos para captar questões relacionadas ao cuidado advindas dos afetos. Contamos com 13 participantes, mulheres com idades entre 38 e 77 anos, e, baseadas em suas respostas, categorizamos quatro lugares: igrejas evangélicas, casa, espaços de convivência comunitária e centros comerciais. Outros espaços foram citados secundariamente e tiveram maior variabilidade. Percebemos a relevância que a coletividade, o acesso, o território e os afetos têm na construção dos processos de saúde das participantes. Por fim, discutimos os modos de fazer cuidado institucionalizados nos serviços de saúde e apontamos questões para a construção de processos mais dialógicos e pautados na autonomia.

Abstract This study aims to investigate the health care settings by interviewing women from a Quilombola community in the metropolitan region of Fortaleza, in the State of Ceará. We highlight the importance of discussing the dimensions of affection within health care practices based on the daily lives of communities, considering socio-political issues, such as the ethnic-racial debate. We aim to identify the participants' health care concepts and demands and, discuss new ways to think and act in health. The Affective Map Generator Questionnaire was used to capture issues related to health care according to affections. In total, 13 women aged from 38 to 77 years participated in this survey. We categorized four health care settings based on their answers: evangelical churches, home, community spaces, and commercial centers. Participants gave less important to other spaces, which showed greater variability. We found that collectivity, access, territory, and affections are relevant in the development of participants' health processes. Finally, we discuss ways of conducting institutionalized care in health services and we raised some considerations for the construction of more dialogical processes that value autonomy.

Questões étnico-raciais, educação física escolar e educação para o lazer / The financing of leisure in Brazil by the different federated entities

Este artigo tem como objetivo analisar o tema questões étnico-raciais e Educação Física escolar e apresentar apontamentos sobre a educação para o lazer. Desde a promulgação da lei 10.639/2003, com o reconhecimento da necessidade da presença da história e cultura afro-brasileira nos currículos escolares, tem sido um importante passo para o reforço do trabalho pedagógico com as questões étnico-raciais na Educação Física. Como procedimentos metodológicos foi realizada pesquisa bibliográfica. Foram selecionados textos com data de publicação de 2016 a 2020. A análise é de natureza qualitativa. As questões étnico-raciais trabalhadas na Educação Física escolar com foco na educação para o lazer são uma oportunidade para a discussão/vivência sobre práticas de diversas culturas e etnias e sua valorização. Conclui-se que este pode ser um caminho efetivo para minimizar problemas sociais como o preconceito.

This paper aims at analyzing ethnic-racial issues and school Physical Education as well as presenting notes on leisure for education. Since the enactment of Law 10.639 / 2003, with the recognition of the need for the presence of Afro-Brazilian history and culture in school curricula, it has been an important step towards strengthening the pedagogical work with ethnic-racial issues in Physical Education. Methodological procedures were performed by bibliographical research. Texts with publication data from 2016 to 2020 were selected. This is a qualitative analysis. Ethnicracial issues addressed in school Physical Education with a focus on education for leisure are an opportunity for discussion/experience on practices of different cultures and ethnicities and their appreciation. We concluded that this can be an effective way to minimize social problems such as prejudice.