Ethnic considerations

Ethnic considerations relating to siting of toilet accommodation ... 

Where building employees are from mainly ethnic communities, consideration should be given to the positioning of toilet facilities so that religious beliefs are not compromised. 

Chnical and epidemiological observations suggest that inhalant use in humans occurs along a continuum, with considerable variability in usage patterns among individuals as a function of age, gender, socioeconomic status, ethnicity, avahabihty and type of inhalant, and other clinical variables. As a general rule, it is expected that as inhalant consumption and frequency of intoxication increase, the incidence and severity of medical and psychosocial problems wiU increase. 

Callender VD (2004) Acne in ethnic skin special considerations for therapy. Dermatol Ther 17 184-195... 

It is clear that ethnic differences in response to antipsychotics exist (Emsley et al, 2002 Frackiewicz et al, 1997). Whereas there has been some work examining first-generation antipsychotics (FGAs) (for reviews, see Frackiewicz etal, 1997 Poolsup et al, 2000), there remains a considerable dearth of research that has examined ethnic differences with respect to the second-generation antipsychotics (SGAs). 

Ethnic differences have been shown to influence response to psychotropic medications. Much of the focus on the explanation for such differences has been on drug-metabolizing (CYP) enzymes of the liver and their sway over pharmacokinetic factors. It is now well recognized that differences in the distribution of polymorphic variants of CYP enzymes exist between different ethnic groups. However, within ethnic groups there are considerable inter-individual variations in drug kinetics, which may not be accounted for solely by genetic variation. Responses to pharmacotherapy are multifaceted and involve the interaction of environmental and... 

Smith, M., Lin, K.M. 8c Mendoza, R. (1993). Non-biological issues affecting psychopharmacotherapy cultural considerations. In K. M. Lin, R. E. Poland and G. Nakasaki, eds., Psychopharmacology and Psychobiology of Ethnicity. Washington DC American Psychiatric Press, pp. 37-58. 

As general knowledge of the role of the gene in biology and in the practice of medicine increases, the definitions of race and ethnicity are likely to evolve in social discourse to reflect a more scientific understanding of biological diversify. The value of race as a predictor of disease and response to, or compliance with, drug therapy is an area of considerable debate. The... 

Geiger, J., "Racial and Ethnic Disparities in Diagnosis and Treatment A Review of the Evidence and A Consideration of Causes," Unequal Treatment Confronting Ethnic and Racial Disparities in Care. Washington, DC National Academy Press (2001). 

Considerable heterogeneity has been demonstrated with respect to average plasma Lp(a) levels in different ethnic groups. These differences cannot be entirely explained by differences in allele frequencies that exist between these groups [i.e., are not entirely due to allele-specific effects on Lp(a) concentrations] (M13, S3, S4). Interestingly, in the Sudanese population, Lp(a) levels are primarily (81%) determined by factors other than the size of the apo(a) allele, while in the Malay population, only 23% of the variation in Lp(a) levels could not be accounted for by size differences in the gene (S3). In Caucasians, it has previously been reported that 40-70% of the variance in Lp(a) levels can be... 

The existence of various isoforms of many of the enzymes involved with phase I and phase II reactions has been noted above. Key enzymes are also subject to variation by genetic polymorphisms so there may be considerable difference in the metabolic efficiency between individuals and between different ethnic groups. Such genetic differences account for most the variability we see between individuals capacity to metabolise certain drugs. For example, refer to Section 6.4.3. 

Gene frequencies and allelic mutations for ADH vary considerably and significant interpersonal and ethnic variations have been described. Furthermore, functional ADH is a dimer, usually of identical subunits but heterodimers are also possible and to date approximately 20 ADH isoenzymes are known. There are notable kinetic differences between the various functional ADH isoenzymes for example, Km values differ almost 1000-fold and Vmax by approximately 40-fold (see Table 6.4). These differences account, to some extent, for variation in alcohol tolerance between individuals. 

Japan has adopted the ICH GCP guidelines for clinical trials since 1997. It upholds the Helsinki Declaration to ensure the rights, welfare, and privacy of subjects are protected in clinical trials. Japan accepts foreign clinical trials, but bridiging trials may need to be performed to take into consideration effects of ethnic factors. 

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