Visual Impairment, Inclusion and Citizenship in South Africa.

People with visual impairment face significant material challenges to access and inclusion in South Africa. These are in large part rooted in and supported by prejudiced assumptions about the needs, nature and capabilities of this group. The cultural and psychological face of oppression needs to be attended to. To this end, this viewpoint brings together the work of three visually impaired scholars in three key areas pertaining to the promotion of the inclusion and citizenship of visually impaired persons in South Africa. These areas are education; rehabilitation; and social inclusion and visibility. This work argues that undoing lifelong exclusion requires examining how disablism is embedded in the very fabric of our societies and operational at various levels: material, administrative, cultural and relational.

Teacher's social desirability bias and Migrant students: A study on explicit and implicit prejudices with a list experiment.

Scholarly research has consistently shown that teachers present negative assessments of and attitudes toward migrant students. However, previous studies have not clearly addressed the distinction between implicit and explicit prejudices, or identified their underlying sources. This study identifies the explicit and implicit prejudices held by elementary and middle school teachers regarding the learning abilities of an ethnic minority group: Haitian students within the Chilean educational system. We use a list experiment to assess how social desirability and intergroup attitudes toward minority students influence teachers' prejudices. The findings reveal that teachers harbor implicit prejudices towards Haitian students and are truthful in reporting their attitudes, thereby contradicting the desirability bias hypothesis. We suggest that teachers rely on stereotypes associated with the students' nationality when assessing Haitian students' learning abilities. The implications of these results are discussed in relation to theories grounded in stereotypes and intergroup attitudes.

The Mentors in Violence Prevention programme: impact on students' knowledge and attitudes related to violence, prejudice, and abuse, and willingness to intervene as a bystander in secondary schools in England.

BACKGROUND: Violence is a leading cause of death and disability for young people and has serious impacts on prospects across the lifecourse. The education sector is a crucial setting for preventing youth violence through incorporating programmes that address attitudes and behaviours. The Mentors in Violence Prevention (MVP) programme aims to change harmful attitudes and norms, and increase non-violent bystander intervention, through a peer mentoring approach. To date there is limited evidence on the effectiveness of the intervention in UK school settings. The aim of the current study was to evaluate the impact of the programme on students' attitudes and knowledge related to violence prevention. METHODS: The study employed a mixed methods design. Pre and post surveys measured changes in students' (aged 11-18) attitudes and knowledge related to violence prevention and bystander behaviour, gender stereotyping, acceptability of violence, and perceptions of others' willingness to intervene. Interviews/focus groups with programme delivers and students, and anonymised programme data were used to explore and supplement survey findings. RESULTS: Overall, perceptions of the programme content and delivery were positive. Several beneficial impacts of the programme were found for mentors (students delivering the programme), including significant positive changes on measures of knowledge and attitudes towards violence prevention and the bystander approach, acceptability of violence perpetration, and perceptions of other students' willingness to intervene (effect sizes were small-medium). However, the study found no significant change on any of the outcomes amongst mentees (younger students receiving the programme from mentors). Despite this, qualitative evidence suggested mentees enjoyed the content of the programme and the peer-led delivery, and this built relationships with older students. Qualitative evidence also identified additional benefits of the programme for mentors, including leadership and communication skills, and increased confidence and supportive relationships. CONCLUSIONS: Evidence from this study suggests MVP is effective as a targeted programme for mentors, but no significant evidence was found to demonstrate its effectiveness as a universal bystander and violence prevention programme for mentees. Whilst further research with more robust study design is needed, developing mentors as leaders in violence prevention is a valuable impact of the programme in its own right.

The physician experience of patient to provider prejudice (PPtP).

Background: Patients can demonstrate prejudice and bias toward minoritized physicians in a destructive dynamic identified as PPtP (Patient Prejudice toward Providers). These interactions have a negative impact on the physical and mental well-being of both those who are targeted and those who witness such behaviors. Study purpose: The purpose of this study was to explore the PPtP experiences of attending physicians who identify as a minority based on race, ethnicity, citizenship status, or faith preference. Methods: Qualitative methodology was used to collect data using in-depth interviews. 15 attending physicians (8 male, 7 female, aged 33-55 years) who identified as minorities based on ethnicity, citizenship status, or faith practices were interviewed individually. Interviews were conducted using a guide validated in previous studies and content analysis was performed by two trained researchers to identify themes. Results: Five themes were identified: A Continuum of Offenses, Professional Growth through Adversity, Organizational Issues, Role of Colleagues, and Consequences for Provision of Care. Findings suggest that although attending physicians learned to cope with PPtP, the experience of being treated with bias negatively impacted their well-being and work performance. Attending physicians also felt that white majority medical students sometimes treated them with prejudice but expressed a commitment to protecting vulnerable trainees from PPtP. Conclusion: The experience of PPtP occurs consistently throughout a career in medicine, often beginning in the years of training and persisting into the phase of attending status. This makes it imperative to include strategies that address PPtP in order to successfully recruit and retain minoritized physicians.

Classical and Modern Prejudice toward Individuals with Intellectual Disabilities: The Role of Experienced Contact, Beliefs in a Just World and Social Dominance Orientation.

This study investigates the impact of experienced contact on prejudiced attitudes towards individuals with intellectual disabilities (IDs), examining beliefs in a just world (BJW) and social dominance orientation (SDO) as potential serial mediators. Data were collected from 224 university students (M = 23.02, SD = 2.48). Path analysis modelling assessed the structural relationships between the study variables. The findings revealed that experienced contact was negatively and significantly associated with BJW and SDO. Additionally, BJW and SDO fully mediated the relationship between experienced contact and overt prejudice. These findings underscore the influence of individual differences on attitudes towards individuals with ID, establishing a crucial foundation for future research and the development of interventions aimed at reducing prejudice and discrimination.

The Lancet and colonialism: past, present, and future.

The historical and contemporary alignment of medical and health journals with colonial practices needs elucidation. Colonialism, which sought to exploit colonised people and places, was justified by the prejudice that colonised people's ways of knowing and being are inferior to those of the colonisers. Institutions for knowledge production and dissemination, including academic journals, were therefore central to sustaining colonialism and its legacies today. This invited Viewpoint focuses on The Lancet, following its 200th anniversary, and is especially important given the extent of The Lancet's global influence. We illuminate links between The Lancet and colonialism, with examples from the past and present, showing how the journal legitimised and continues to promote specific types of knowers, knowledge, perspectives, and interpretations in health and medicine. The Lancet's role in colonialism is not unique; other institutions and publications across the British empire cooperated with empire-building through colonisation. We therefore propose investigations and raise questions to encourage broader contestation on the practices, audience, positionality, and ownership of journals claiming leadership in global knowledge production.

Does attitude importance moderate the effects of person-first language? A registered report.

Previous research has demonstrated that exposure to outgroup descriptions that use person-first, as compared to identity-first, language can attenuate negative stereotypes or prejudice and enhance support for policies that seek to advance outgroup rights. However, those benefits of person-first language may not apply to all social groups equally. The present study examines a boundary condition of the effects of person-first language. Specifically, we postulate that person-first language reduces the stigmatization of outgroups to a lesser degree if individuals hold more important negative attitudes towards the respective communities. We will test this hypothesis in a two-factorial 2 (target group) x 2 (descriptor) online experiment that includes a control group and for which we will recruit a general-population sample (N = 681). Stereotyping, dehumanization, as well as negative affect and behavioral intentions towards two outgroups will be compared: people with a physical disability/the physically disabled (i.e., negative attitudes are expected to be less important) and people who have committed a violent crime/violent criminals (i.e., negative attitudes are expected to be more important). Our findings will bear implications for understanding when language use could influence public opinion of different social groups. Additionally, the research can inform the development of more effective communication policies to promote inclusion and reduce stigma.

Experiences of social stigma of people living with Hansen's disease in Brazil: silencing, secrets and exclusion.

BACKGROUND: Hansen's disease is a chronic, infectious and transmissible disease that is considered a public health problem in Brazil. Hansen's disease is marked by stigma and prejudice, because it carries with it a strong negative social image, reinforced by policies of social isolation in the community. METHODS: A qualitative study was conducted in Ribeirão Preto, an inland city of the state of São Paulo, Brazil. Eleven patients under treatment for the disease were interviewed. The interviews were audio recorded and transcribed in full, then were analyzed through the stages of transcription, transposition and reconstitution, as informed by concepts proposed by Goffman. RESULTS: The results showed that the marks of stigma are still present in the twenty-first century and were presented in two axes: 'Stigma and work for the person affected by Hansen's disease' and 'The experience of stigma in the family'. The participants refer to fears of losing their jobs and of being ridiculed, which stops them talking about the disease. Regarding their families, the participants reported episodes of discrimination, the creation of family secrets and fear of relatives' reactions. CONCLUSIONS: All these aspects interfere in the follow-up and treatment of patients and need to be considered and welcomed by health professionals. It is recommended that these aspects are addressed in the initial training and continuing education of health professionals. CONTEXTE: La maladie de Hansen est une maladie chronique, infectieuse et transmissible, considérée comme un problème de santé publique au Brésil. La maladie de Hansen est marquée par la stigmatisation et les préjugés, car elle véhicule une image sociale fortement négative, renforcée par des politiques d'isolement social au sein de la communauté. MÉTHODES: Étude qualitative menée à Ribeirão Preto, une ville intérieure de l'État de São Paulo, au Brésil. Onze patients traités pour la maladie ont été interrogés. Les entretiens ont été enregistrés et transcrits intégralement, et ont été analysés en suivant les étapes de transcription, de transposition et de reconstitution, selon les concepts proposés par Goffman. RÉSULTATS: Les résultats montrent que les marques de la stigmatisation sont toujours présentes au 21ème siècle et ont été présentées selon deux axes : 'La stigmatisation et le travail pour la personne affectée par la maladie de Hansen' et 'L'expérience de la stigmatisation dans la famille'. Les participants évoquent la peur de perdre leur emploi, la peur d'être ridiculisés, ce qui les pousse à ne pas parler de la maladie. En ce qui concerne les familles, les participants ont rapporté des épisodes de discrimination, la création de secrets de famille et la peur des réactions des proches. CONCLUSIONS: Tous ces aspects interfèrent dans le suivi et le traitement des patients et doivent être pris en compte et accueillis par les professionnels de la santé. Il est recommandé que ces aspects soient abordés dans la formation initiale et la formation continue des professionnels de la santé. ANTECEDENTES: La enfermedad de Hansen es una enfermedad crónica, infecciosa y transmisible, considerada un problema de salud pública en Brasil. La enfermedad de Hansen está marcada por el estigma y el prejuicio, ya que conlleva una fuerte imagen social negativa, reforzada por políticas de aislamiento social en la comunidad. MÉTODOS: Estudio cualitativo realizado en Ribeirão Preto, una ciudad del interior del estado de São Paulo, Brasil. Se entrevistaron a once pacientes en tratamiento para la enfermedad. Las entrevistas fueron grabadas en audio, transcritas en su totalidad y analizadas a través de etapas de transcripción, transposición y reconstitución, según los conceptos propuestos por Goffman. RESULTADOS: Los resultados muestran que las marcas del estigma siguen presentes en el siglo XXI y se presentaron en dos ejes: 'Estigma y trabajo para la persona afectada por la enfermedad de Hansen' y 'La experiencia del estigma en la familia'. Los participantes mencionan el miedo a perder sus trabajos, el temor a ser ridiculizados, lo que les impide comentar sobre la enfermedad. En cuanto a las familias, los participantes reportaron episodios de discriminación, la creación de secretos familiares y el miedo a las reacciones de los familiares. CONCLUSIONES: Todos estos aspectos interfieren en el seguimiento y tratamiento de los pacientes y deben ser considerados y acogidos por los profesionales sanitarios. Se recomienda abordar estos aspectos en la formación inicial y la educación continua de los profesionales sanitarios.

Social representations of tuberculosis by people with the disease.

OBJECTIVE: To understand the social representations of people with tuberculosis about the disease and its implications for following treatment. METHOD: A descriptive, qualitative study based on the Theory of Social Representations. It was conducted in a municipal health unit in the city of Belém. The participants were people diagnosed with tuberculosis and undergoing directly observed treatment, with the sample size defined by the data saturation technique. Data collection was done through semi-structured interviews. For data analysis it was used thematic content analysis. RESULTS: The records converged into three categories: Representations of tuberculosis and its impacts on the diagnosis; The faces of treatment: challenges facing follow-up and hope; and Constructions of living with the disease in family and society. FINAL CONSIDERATIONS: Living with the disease transforms everyday life and relationships. Discrimination and prejudice denote the need to reconfigure such representations for patients to be embraced.

Evidence from 43 countries that disease leaves cultures unchanged in the short-term.

Did cultures change shortly after, and in response to, the COVID-19 outbreak? If so, then in what way? We study these questions for a set of macro-cultural dimensions: collectivism/individualism, duty/joy, traditionalism/autonomy, and pro-fertility/individual-choice norms. We also study specific perceptions and norms like perceived threats to society (e.g. immigration) and hygiene norms. We draw on Evolutionary Modernization Theory, Parasite Stress Theory, and the Behavioural Immune System, and existing evidence, to make an overarching prediction: the COVID-19 pandemic should increase collectivism, duty, traditionalism, conformity (i.e. pro-fertility), and outgroup prejudice. We derive specific hypotheses from this prediction and use survey data from 29,761 respondents, in 55 cities and 43 countries, collected before (April-December 2019) and recently after the emergence of COVID-19 (April-June 2020) to test them. We exploit variation in disease intensity across regions to test potential mechanisms behind any changes. The macro-cultural dimensions remained stable. In contrast, specific perceptions and norms related to the pandemic changed: norms of hygiene substantially increased as did perceived threats related to disease. Taken together, our findings imply that macro-cultural dimensions are primarily stable while specific perceptions and norms, particularly those related to the pandemic, can change rapidly. Our findings provide new evidence for theories of cultural change and have implications for policy, public health, daily life, and future trajectories of our societies.

Investigation the relationship between xenophobic attitude and intercultural sensitivity level in nurses.

OBJECTIVE: The level of intercultural sensitivity is important for nurses to approach the individual's culture in care and treatment without prejudice. In this study, it was aimed to determine the effect of nurses' intercultural sensitivity level on xenophobic attitude. METHODS: This quantitative cross-sectional study was conducted at Van Training and Research Hospital between January and June 2022. The Introductory Information Form, the Xenophobia Scale, and the Intercultural Sensitivity Scale were used to collect the research data. SPSS-25 package program and R programming language 4.1.3 are used. RESULTS: This study was conducted with 235 nurses. According to the findings obtained in our study, the regression model determine the effect of intercultural sensitivity on xenophobia level was found to be F(1,233) = 69.857, p = 0.001, and 23.1 % (R2 = 0.231) of the variance in the dependent variable was explained by the independent variable. Intercultural sensitivity has a negative and significant effect on the level of xenophobia (ß = -0.480; t (233) = -8.358, p = 0.001). When comparing the performance of all variables with machine learning algorithms for the prediction model, the best performing algorithm was found to be Random Forest (RF). The contributions of these variables to the model were calculated with Shapley Additive Explanations (SHAP) values. The most important variables that should be included in the model to predict the xenophobia variable are the respect for cultural differences sub-dimension and intercultural sensitivity variables. CONCLUSION: It was determined that as the level of intercultural sensitivity of the nurses increased, their xenophobic attitudes decreased. Longitudinal studies on xenophobic attitude in nurses are recommended. It is recommended to make predictions with different machine learning models.

Affirming Care for LGBTQ+ Patients.

The lesbian, gay, bisexual, transgender, and queer(LGBTQ +) community is a marginalized minority group who continues to face and experience significant discrimination, prejudice, stigma, oppression, and abuse in various societal domains including health care. The older adult LGBTQ + community is an especially vulnerable group as they have unique minority stressors attributed to intersectional identities of age, ableism, ethnicity, and employment, among other factors. It is critical for health care providers to recognize and mitigate disproportionate care by engaging in strategies that promote inclusion and affirmation of their sexual orientation and gender identity. The biopsychosocial, cultural, and spiritual framework is a useful tool to care for this community in a holistic and compassionate way.

Racial stereotypes and facial physical attractiveness: exploring their implications in moral assessments in healthcare. / Estereótipos raciais e atratividade física facial: explorando suas implicações nas avaliações morais em saúde.

In this study of 333 participants, we investigated how racial stereotypes and facial attractiveness impact moral evaluations in healthcare. We used pictures of faces with different levels of attractiveness in moral dilemma scenarios, performing statistical analyses such as ANOVA and ANCOVA to examine these complex interactions. We found that physical attractiveness positively influences moral evaluations only in low moral conflict scenarios and does not apply to high conflict or impersonal situations. The relationship between self-declared skin color and participants' gender was only confirmed in a specific scenario, highlighting the complexity of these influences. Hypotheses three and four, which suggested that participants' ethnic and moral identity would suppress the effects of racial stereotypes and facial attractiveness, were not confirmed. However, we observed that the ethnic profile of the faces and the participants' motivation to control prejudice positively influenced moral evaluations. These results are interpreted in light of theories on interpersonal attraction, moral judgment, and intergroup relationships, providing essential insights into the complex dynamics that shape moral evaluations in healthcare.

Neste estudo com 333 participantes, investigamos como estereótipos raciais e atratividade facial impactam as avaliações morais na área de saúde. Utilizamos imagens de rostos com diferentes níveis de atratividade em cenários de dilemas morais, realizando análises estatísticas, como ANOVA e ANCOVA, para examinar essas interações complexas. Descobrimos que a atratividade física influencia positivamente as avaliações morais apenas em cenários de baixo conflito moral, não se aplicando a situações de alto conflito ou impessoais. A relação entre a cor da pele autodeclarada e o sexo dos participantes só se confirmou em um cenário específico, destacando a complexidade dessas influências. As hipóteses três e quatro, que sugeriam que as identidades racial e moral dos participantes suprimiriam os efeitos dos estereótipos raciais e da atratividade facial, não foram confirmadas. Entretanto, observou-se que o perfil étnico dos rostos, junto com a motivação dos participantes para controlar preconceitos, influenciou positivamente as avaliações morais. Esses resultados são interpretados à luz de teorias sobre atração interpessoal, julgamento moral e relações intergrupais, fornecendo insights importantes para as complexas dinâmicas que moldam as avaliações morais na área da saúde.

The emotional impact of baseless discrediting of knowledge: An empirical investigation of epistemic injustice.

According to theoretical work on epistemic injustice, baseless discrediting of the knowledge of people with marginalized social identities is a central driver of prejudice and discrimination. Discrediting of knowledge may sometimes be subtle, but it is pernicious, inducing chronic stress and coping strategies such as emotional avoidance. In this research, we sought to deepen the understanding of epistemic injustice's impact by examining emotional responses to being discredited and assessing if marginalized social group membership predicts these responses. We conducted a novel series of three experiments (Total N = 1690) in which participants (1) shared their factual knowledge about how a game worked or their personal feelings about the game; (2) received discrediting feedback (invalidating remarks), validating feedback (affirming remarks), or insulting feedback (general negative social evaluation); and then (3) reported their affect. In all three studies, on average, affective responses to discrediting feedback were less negative than to insulting feedback, and more negative than to validating feedback. Participants who shared their knowledge reported more negative affect after discrediting feedback than participants who shared their feelings. There were consistent individual differences, including a twice-replicated finding of reduced negative affect after receiving discrediting and insulting feedback for Black men compared to White men and women and Black women. Black men's race-based traumatic symptom scores predicted their affective responses to discrediting and insulting feedback, suggesting that experience with discrimination contributed to the emotional processing of a key aspect of epistemic injustice: remarks conveying baseless discrediting of knowledge.

The Pregnant Workers Fairness Act-a Bipartisan Step Forward.

This Viewpoint describes key provisions of the Pregnant Workers Fairness Act and discuss the proposed Equal Employment Opportunity Commission rule, as well as its application to health care employment in particular.

Stigma as a local process: Stigma associated with opioid dependency in a rural-mixed Indiana county.

BACKGROUND: Because the nature and magnitude of stigmatizing views associated with opioid dependency vary by social, cultural, and structural factors, strategies to reduce public stigma towards opioid dependency should vary by context. We leverage a unique dataset with evidence of multiple stigmatizing views to understand how to target interventions to reduce stigma in a state disproportionately impacted by the opioid epidemic, with a specific focus on a rural-mixed county. METHODS: Data come from the representative Person-to-Person Health Study (2018-2020) of 2,050 Indiana residents, 224 from the rural-mixed Fayette County. Bivariate statistics and multivariate regression analyses were used to evaluate the association between Fayette County and measures of stigma (e.g., desire for social distance, prejudice, causal attributions) relative to the rest of Indiana. RESULTS: Fayette County statistically differed from the rest of Indiana on most demographic characteristics and measures of stigmatizing views. Multivariate regressions revealed that compared to the rest of Indiana, residence in Fayette County was associated with a higher desire for social distance, perceptions of unpredictability, and attributing opioid dependency to genetics and the way the person was raised. CONCLUSION: Our results contribute to growing evidence supporting the need for local approaches to address stigma. Stigma in Fayette County primarily reflects concerns about how people manage their opioid dependency. Strategies focusing on treatment and recovery potential, accompanied by extending the influence of supportive stakeholders and policies, will become important to address this stigma.