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Many areas of clinical informatics research rely on accurate and complete race and ethnicity (RE) patient information, such as estimating disease risk, assessing quality and performance metrics, and identifying health disparities. Structured data in the electronic health record (EHR) is an easily accessible source for patient-level information, however RE information is often missing or inaccurate in structured EHR data. Furthermore, current federal standards on RE categories have been acknowledged as inadequate, and in need of more granular realizations. While more difficult to extract data from, clinical notes provide a rich, nuanced and subjective source of information that can be leveraged to increase granularity and/or recover RE information missing in structured data. State-of-the-art clinical natural language processing (NLP) approaches can enable researchers to extract RE information from clinical notes, however, NLP has also been shown to inherit, exacerbate, and create new biased and harmful associations, especially in modern deep learning approaches. This thesis explores the relationships between direct and indirect explicit mentions of RE and RE inferences in clinical text annotated by humans, and leverages an approach to audit deep NLP models for their learned associations. We develop gold-standard annotations for information related to RE (RE indicators) and RE labels. We leverage four RE indicators: country of origin, spoken language, direct race, and direct ethnicity mention. We find high agreement between annotators for RE label assignments, and that sentences assigned RE categories have drastically different distributions of RE indicators. Furthermore, we find high agreement between structured and unstructured sources of RE information, and that unstructured data can be used to recover missing RE information in structured data. Leveraging the gold-standard RE annotations, we train a model to label sentences with RE information and audit the model to examine the alignment between salient features and RE indicators. While our models attain good classification performance, this does not translate into high overlap with RE indicators. We find evidence for learned associations that are benign mistakes, helpful but not strictly correct, and potentially harmful mistakes if not addressed by future work.

Yes / Craniofacial anthropometry plays an important role in facial structure. This review paper evaluates existing research surrounding population norms of studied facial parameters. The purpose is two-fold: (1) to determine variations in facial measurements due to demi-group or ethnic variations based on traditional (direct) caliper based and image based (indirect) anthropometric methods. (2) to compare where possible, measured facial parameters between referenced studies. Inter and intra-population variations in addition to sexual dimorphism of facial parameters such as the nose and eyes, singularly or in combination with one another, have been concluded. Ocular measurements have exhibited ethnic variations between males and females of the Saudi, Turkish, Egyptian and Iranian group. Moreover, demic variations are reported when the native language has been used a key criterion. It has been concluded that with the current state of migration and inter-demic marriages, the study of homogenous populations will prove difficult. Subsequently, this will result in ambiguous physical traits that are not representative for any one demic or ethnic population. In this paper, results for the following adult male and female populations have been discussed: African American, Azerbaijani, Caribbean, Chinese, Croatian, Egyptian, Italian, Iranian, Turkish, Saudi Arabian, Syrian and South African. The qualitative research presented serves as a knowledge base for learners and strikes up thought provoking concepts about the direction anthropometrical research is heading.

「人」與其社會組織在地理空間中運作，相對地，空間的結構將反過來影響人的活動；另一方面，傳統的空間研究卻常為描述空間而研究空間，而忽略了空間背後所隱含之社會意涵。這實甚相近的二個主題，在學術研究的累積上卻尚存有一段極大的落差。本研究從這段落差中去尋求一個連結「人與空間」關係的一個有趣旨題，即是「族群因素與地域空間發展之關係的研究」。研究的主要目的在於：由空間結構和社會觀點出發，去探討「族群分布、族群關係」與「地域空間發展」間的關連性，並推演「族群因素與地域空間發展」之間互動關係的一般性法則和模式理念。 理論上，從環境決定論者的觀點，人的行為模式乃是受實質環境(空間)所主導；但反對者則認為人的政經活動與行為組織才是主導空間形成的原因…為匯整這種差異，本文首先回顧了一些較重要學派的空間結構理論，以及一些基本的社會文化理論，以了解各理論對空間結構的解析方式和對族群因素的論述觀點，據此歸結出一些「族群因素」在空間結構發展上的意涵，作為初步的推論以及後面實例分析的重點啟示。 本研究認為「環境(空間)」與「人」二者之間會因社會時代背景與人之關係的差異而有不同的互動情形與循環影響。是以在實例分析上，以台灣的聚落發展史為軸心，將各個不同時期(包括了原鄉地域之爭的清代移民時期、殖民空間改造的日據時期、具省籍隔離情結的國民政府遷台時期，以及開始產生本土化族群融合的現代化時期)之族群分布、族群關係情況與同時期的台灣地域空間結構發展作一對照分析，以解讀二者之間的關連性與互動情況。 經由結合初步的推論與實例分析所得到的發現，推導出族群因素與地域空問發展之關係的最後結論，包括如不同社會發展時期的族群關係具有差異性；影響族群空間分布與關係的主要因素有四者；不同的族群分布產生對地域空間發展的不同影響，也形塑出不同的空間結構特質；族群因素與地域空間的發展關係具有一種對等循環的特性…。然後回頭去對以往之空間結構理論，在本研究主題結論上作一番辯證，以解讀各不同論點的理論觀點在族群因素與空間發展關係上的解釋性和缺漏所在。最後，除了扼要歸結本研究的結論外，且簡單地引申研究發現在空間規劃上之意涵的啟示，並提出一些研究中所受的限制與可作為後續研究的課題以供參考。 / The study attempes to discern social implications of spatial structure．It is precisely for this reason that the primary purpose of the study is to discuss interactive relations between the"ethnic group"and"spatial development",and to infer its evolution law. The environmenal determinism afgues that the human activities are contingent uponthe environment However, opponents contest that political,economic and behavior organizations are the determinant factors of spatial form．Theories of spatial Structureand social culture, and Taiwan's history of social spatial development divided into four different periods are examined. It is argued that the relation between"environment (space)"and"human(ethnic group)"evoluts according to the difference of social back ground and time presenting a changing cycle. Rooted in a case study and rigour theorical discussions,the conclusion reachs that,for example,(l)different relationships of period of ethnic groups present different period Of social development;(2)the influencial causes of the relationships and distribution of ethnic groups are four;(3)different distribution of ethnic groups imposes different impacts upon spatial developmentk,and forms different characteristics of spatial struCture;(4)the relative development of ethnic groups and spatial structure manifestscyclical characteristics．in the final part of this thesis, the implications for the spatial planning and further studies are examined.

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Submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2014. / Aim: The aim of this study was to evaluate the normal selected radiographic parameters (thoracic kyphosis (TK), anterior vertebral body height (AVBH), posterior vertebral body height (PVBH), intervertebral disc height (IVDH) and interpedicular distance (IPD)) in young to middle-aged males across the four racial groups in Durban. Participants: Eighty young to middle-aged apparently healthy males between the ages of 18-45 years from the White, Black, Indian and Coloured racial groups in Durban. Methodology: After written informed consent was acquired, all participants underwent a case history, physical examination and thoracic orthopaedic examination. An AP and lateral radiograph of the thoracic spine was then obtained. The TK, AVBH, PVBH, IVDH and IPD were assessed using methods described previously. The IBM SPSS version 20 was utilized for the data analysis. Mean, standard deviation (SD) and range are reported for the TK, AVBH, PVBH and IPD for each of the four racial groups. For the IVDH, however, the median for the respective vertebral levels is given. ANOVA testing with Bonferroni post-hoc tests were used to determine overall inter-group variations and compare each group to the other. Pearson’s correlation test was used to determine the relationship between the thoracic kyphosis and the other radiographic parameters that were assessed. Results : The mean, SD, minimum and maximum values of the thoracic kyphosis by racial group There was no significant difference in the TK among the four race groups. Significant differences (p < 0.05) were observed in the AVBH, PVBH, IVDH and IPD between the White, Black, Indian and Coloured males at various thoracic levels. Conclusion: The trends of the various radiographic parameters observed in this study support the argument that these parameters should be based on sex, age and geographic race. These values would be useful for South African spinal health care practitioners in the diagnosis and management of spinal disorders.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2011. / Introduction: Radiographic parameters of the cervical spine are utilized by chiropractors and spinal surgeons for making diagnoses and determining management protocols. However several researchers have reported discrepancies in these parameters which need to be investigated across ethnic groups and gender. Aim: To evaluate the normal selected cervical spine radiographic parameters i.e. the cervical lordosis (CL), sagittal canal diameter (SCD), interpedicular distance (IPD), and the cervical gravity line (CGL) in apparently healthy young to middle-aged males across four ethnic groups in Durban, KwaZulu Natal. Participants: Eighty healthy male participants between 18 and 45 years of age of White, Black, Indian and Coloured ethnicity. Methodology: A case history, physical examination and an orthopedic assessment of the cervical spine was conducted for each participant. Study-specific data such as age, ethnicity, weight and height were recorded. A lateral and an A-P radiograph of the cervical spine was taken of each participant. Selected radiographic parameters viz. SCD, IPD, CL, CGL were assessed and recorded. SPSS version 15.0 (SPSS Inc., Chicago, Illinois, USA) was used for data analysis. Results: The mean (± SD) values of the CL, SCD and IPD are shown in the table below for the respective ethnic groups Parameter Ethnic Group Black (Mean (± SD)) White(Mean (± SD)) Indian(Mean (± SD)) Coloured (Mean (± SD)) CL° (C1-C7 method) 42.6° (± 9.6°) 46.2° (± 11.0°) 46.5° (± 11.3°) 47.7° (± 9.1°) CL° (C2-C7 method) 15.1° (± 6.4°) 17.4° (± 9.3°) 13.1° (± 10.2°) 18.1° (± 10.4°) SCD (mm) C2 22.1mm (± 1.6) 24.1mm (± 1.4) 22.8mm (± 1.7) 22.9mm (± 1.5) C3 19.5mm (± 1.6) 20.6mm (± 1.4) 19.7mm (± 1.6) 20.0mm (± 1.5) C4 18.6mm (± 1.9) 19.9mm (± 1.3) 19.1mm (± 1.6) 19.5mm (± 1.3) C5 18.9mm (± 1.8) 20.0mm (± 1.5) 19.3mm (± 1.7) 19.8mm (± 1.6) C6 18.8mm (± 1.7) 20.4mm (± 1.5) 19.5mm (± 1.6) 20.0mm (± 1.8) iv C7 18.5mm (± 1.7) 20.3mm (± 1.5) 19.4mm (± 1.6) 19.7mm (± 1.9) IPD (mm) C3 28.2mm (± 1.2) 28.9mm (± 1.8) 27.8mm (± 1.1) 29.1mm (± 1.4) C4 28.6mm (± 1.4) 29.6mm (± 1.8) 28.5mm (± 1.4) 29.5mm (± 1.6) C5 29.4mm (± 1.2) 30.0mm (± 1.7) 28.8mm (± 1.2) 30.1mm (± 1.5) C6 29.3mm (± 1.6) 30.7mm (± 1.6) 30.0mm (± 1.6) 30.1mm (± 1.5) C7 29.3mm (± 1.2) 30.1mm (± 1.5) 29.6mm (± 1.6) 30.3mm (± 1.9) There was anterior placement of the CGL in 60% of the Black ethnic group, 45% of the White ethnic group, 55.6% of the Indian ethnic group and 52.6% of the Coloured ethnic group. No significant differences in mean CL was observed across the four ethnic groups for both methods utilized (p > 0.05). The significant differences in SCD lay between the White and Black ethnic groups at C2, C6 and C7 (p = 0.002, 0.030 and 0.017, respectively, ANOVA). The C3 and C5 IPD varied significantly between the Coloured and Indian ethnic group (p = 0.048 and 0.027, respectively, ANOVA). The CGL was not influenced by the CL in all the ethnic groups. Conclusion: Significant differences were observed between ethnic groups for the SCD and IPD. These will assist South African health care practitioners with patient management within these ethnic groups when diagnosing spinal stenosis and tumors. A larger South African based population should be evaluated to confirm the trends observed utilizing digitized diagnostic imaging modalities including radiographs, CT and MRI scans as errors may occur during manual assessment of conventional radiographs.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Aim: To evaluate the normal selected cervical spine radiographic parameters i.e. the cervical lordosis (CL), sagittal canal diameter (SCD), interpedicular distance (IPD) and cervical gravity line (CGL) in asymptomatic young to middle-aged females across four ethnic groups (Black, White, Indian and Coloured) in Durban, KwaZulu Natal, South Africa. Participants: Eighty apparently healthy females between the ages of 18 and 45 years from the Black, Indian, Coloured and White ethnic groups in Durban, KwaZulu Natal. Methodology: Written informed consent was obtained from each participant. A case history, physical examination and an orthopaedic assessment of the cervical spine was conducted for each participant. Study specific data such as ethnicity, age, height and weight was recorded. A lateral and an A-P radiograph of the cervical spine were taken for each participant. The selected radiographic parameters viz. cervical lordosis (CL), sagittal canal diameter (SCD), interpedicular distance (IPD) and cervical gravity line (CGL) were evaluated according to methods described previously. SPSS version 15.0 (SPSS Inc., Chicago, Illinois, USA) was used for data analysis. Coefficients of variation were calculated within ethnic groups to assess intra-group variation. Inter-group variation was assessed using ANOVA testing with Bonferroni-adjusted post-hoc tests in the case of a significant ANOVA test. Pearson’s chi square test was used to assess the association between ethnic groups and position of the CGL. T-tests were used to compare mean CL between those with anterior and normally placed CGL within each ethnic group. Results: The mean ± SD of the CL in South African females by ethnic group using the C1-C7 and C2- C7 methods CERVICAL LORDOSIS (mean ± SD) (°) ETHNICITY C1-C7 C2-C7 Black 42.1° (±13.4) 16.3° (±8.3) White 37.4° (±10.3) 9.9° (±4.8) Indian 33.7° (±9.7) 6.9° (±4.8) Coloured 42.5°(±10.9) 12.1° (±9.5) The mean ± SD of the SCD in South African females by ethnic group SAGITTAL CANAL DIAMETER (mean ±SD)(mm) ETHNICITY Black White Indian Coloured SCDC2 SCDC3 SCDC4 SCDC5 SCDC6 SCDC7 20.2 (±1.7) 17.4 (±1.4) 17.2 (±1.4) 17.0 (±1.4) 17.6 (±1.3) 17.5 (±1.4) 20.8 (± 2.2) 17.9 (±1.6) 17.6 (±1.6) 17.4 (±1.6) 17.6 (±1.4) 21.0 (±2.0) 18.2 (±1.7) 17.5 (±1.5) 17.4 (±1.7) 17.6 (±1.6) 17.1 (±1.5) 20.3 (±1.6) 17.5 (±1.8) 17.4 (±1.5) 17.7 (±1.2) 17.6 (±1.3) 16.9 (±1.2) 16.9 (±1.4) The mean ± SD of the IPD in South African females by ethnic group INTERPEDICULAR DISTANCE (mean ±SD)(mm) ETHNICITY IPDC3 IPDC4 IPDC5 IPDC6 IPDC7 Black 27.0 (±2.8) 27.6 (±3.2) 28.2 (±4.0) 28.9 (±4.2) 27.5 (±3.5) White 28.4 (±2.6) 28.8 (±2.2) 29.5 (±2.3) 29.3 (±2.5) 28.2 (±2.9) Indian 27.2 (±1.8) 27.5 (±1.8) 27.9 (±1.6) 27.9 (±1.6) 27.5 (±2.0) Coloured 27.9 (±2.3) 27.8 (±2.3) 28.3 (±2.2) 28.4 (±1.8) 28.2 (±1.7) The placement of the CGL in South African females in each ethnic group CERVICAL GRAVITY LINE ETHNICITY PLACEMENT OF CGL Black 70% anterior placement White 70% anterior placement Indian 60% anterior placement Coloured 60% anterior placement The C1-C7 measurements and the C2-C7 CL measurements were significantly different amongst the ethnic groups. For the C2-C7 method, Blacks differed significantly from both Whites (p = 0.037) and Indians (p = 0.001; Bonferroni adjusted post-hoc test); with the values for the Blacks being higher than both Whites and Indians. There was no correlation between CL and BMI amongst any of the selected ethnic groups. There were no significant differences in the mean SCD and IPD amongst the ethnic groups (p > 0.05; ANOVA test). There was no significant association between any ethnic group and the position of the CGL (p = 0.830; Pearson’s chi square test). In Black females, those with a normally positioned CGL had significantly higher C2-C7 CL measurements (p = 0.008; T- tests). There was no correlation between the CL and anterior placing of the CGL in any of the ethnic groups. Conclusion: No individual differences were observed in the CL amongst the ethnic groups when using the C1-C7 method. However, significant differences were observed when the C2-C7 method was used. There were no significant differences observed in the mean SCD and IPD amongst the ethnic groups. In Black females, those with a normally positioned CGL had significantly higher C2-C7 CL measurements. The trends observed in this research study and the differences in the findings to those of previous studies lay the platform for a larger population-based study across South Africa to establish normative reference values for each radiographic parameter specific for gender and ethnicity.