Flowers vs. Devils: plants used against witchcraft in the urbanized Sonora Market, Mexico City / Flores vs Demonios: plantas usadas contra la brujería en el urbanizado Mercado de Sonora, Ciudad de México

Mexican markets embody cultural diversity and offer a wide range of products, serving as hubs for local exchange.In our study at Mexico City's Sonora Market, the country's prominent medicinal market, we explored the use of plant remedies against witchcraft in an urban environment. Through interviews with plant vendors and extensive data collection, we identified 21 plant species from 16 botanical families renowned for their effectiveness in combating sorcery, attracting good luck, and promoting success. Additionally, we documented 14 ailments associated with envy and negative emotions. These remedies involved practices and applications such as cleansings, decoctions, baths, and incense burning, aimed at alleviating afflictions and fostering positive outcomes. Notably, the Sonora Market continues to uphold the tradition of using plant remedies against witchcraft, even in the bustling setting of one of the world's largest cities. This highlights the enduring significance of these practices within Mexican society

Los mercados mexicanos encarnan diversidad cultural y ofrecen numerosos productos, sirviendo como centros de intercambio local. En nuestro estudio en el Mercado de Sonora en la Ciudad de México, el sitio de plantas medicinales más relevante del país, exploramos el uso de plantas contra la brujería en un entorno urbano. A través de entrevistas con locatarios, identificamos 21 especies de plantas pertenecientes a 16 familias botánicas usadas en la lucha contra la brujería, atrayendo buena suerte y promoviendo el éxito. Además, documentamos 14 enfermedades asociadas con la envidia y emociones negativas. Los remedios involucraban prácticas y aplicaciones como limpias, decocciones, baños, incienso, con el objetivo de aliviar dolencias y fomentar resultados positivos. En el Mercado deSonora persiste la tradición de utilizar plantas contra la brujería, incluso en el marco de una de las mayores ciudades del mundo, resaltando la importancia de estas prácticas dentro de la sociedad mexicana.

Acceptability and Feasibility of Initiating a Low Fat Eating Plan in Reproductive Aged Women with Obesity.

Adverse effects of obesity on reproduction are believed in part due to diet related factors leading to hyperlipidemia and hyperinsulinemia. It is unknown whether administration of a low fat eating plan, regardless of weight loss, will improve reproductive axis function in women with obesity. To develop an acceptable and feasible low fat eating plan for a diverse group of reproductive aged women with obesity. Focus groups to determine preferences and barriers to a planned dietary intervention providing very low fat (22% daily calories from fat) eucaloric food to control fat exposure, but not cause weight loss. Logistics of the intervention and monitoring over three menstrual cycles were discussed. Eighteen women enrolled into 4 different focus groups both live and video, 2 at the University of Colorado and 2 at the Morehouse School of Medicine. All participants expressed interest in implementing a low fat dietary intervention and were further interested in instruction on how to maintain healthy eating habits for future fertility. Provision of ethnically appropriate foods, social support to avoid lapses, and tasty alternatives to high fat foods were considered ideal aspects of a feasible intervention. Incentives and graduated compensation for adherence were considered desirable features. Women with obesity are interested in implementing dietary interventions that may improve their health and fertility. Given the diversity of responses based upon the demographics of our sample, it is important to assess geographical and cultural preferences prior to implementing of a dietary strategy.

Exploring ethical practice in NGOS on mental health research in Malawi.

In recent years, an increasing trend in mental health research has been to collaborate with non-governmental organizations [NGOs] and their constituents. However, ethical difficulties can arise as a result of such partnerships. Understanding the ethics-related practices of NGOs engaged in mental health research is therefore critical. This study addressed these questions in a Malawian context. The goal of this study was to investigate NGO's ethical practices in relation to mental health research by identifying characteristics that influence ethical practices and investigating staff conceptualization of ethics and mental health. Twenty individuals who work for different local NGOs took part in one-on-one interviews or a workshop about their engagement in diverse research initiatives. They pinpointed the areas that needed improvement, as well as the challenges and chances to create partnerships and increase research capability. The diversity in conceptualizing mental health was a key influence on research practices, with heterogeneity in definitions reflected in the use of cultural, spiritual, behavioural, or medical terms. Notably, there was also a greater emphasis on procedural ethics than ethics-in-practice. Collaboration dynamics and limited staffing capacity were cited as major ethical practice considerations. Each of these elements have an impact on NGOs' ethical behaviour when conducting mental health research. Participants in the study saw engagement with notions of both ethics and mental health as lacking or rudimentary in their institutions and felt that they needed to be improved through capacity building and stronger research involvement.

Validation of three health literacy screening questions compared with S-TOFHLA in a low-income diverse English- and Spanish-Speaking population.

BACKGROUND: Clinicians need a tool to gauge patients' ability to understand health conditions and treatment options. The Short-form Test of Functional Health Literacy in Adults (S-TOFHLA) is the gold standard for this, but its length is prohibitive for use in clinical settings. This study seeks to validate a novel three-item question set for predicting health literacy. METHODS: This cross-sectional study utilized an in-person questionnaire alongside the S-TOFHLA. The sample included 2027 English- and Spanish-speaking adults (≥18 years) recruited from primary care practices serving a low-income eastern Pennsylvania community. Most patients (57.7%) identified as Hispanic. Diagnostic accuracy of each question and aggregated scores were assessed against the validated survey by calculating the area under the receiver operating characteristic (AUROC) curve. RESULTS: Questions in the 'Problems Learning' and 'Help Reading' domains (AUROC 0.66 for each) performed better than the 'Confident Forms' question (AUROC 0.64). Summing all three scores resulted in an even higher AUROC curve (0.71). Cronbach's alpha of the combined items was 0.696. CONCLUSIONS: Study results suggest that any of the three questions are viable options for screening health literacy levels of diverse patients in primary care clinical settings. However, they perform better as a summed score than when used individually.

Uncovering the microbial diversity of Czech Republic archives: A study of metabolically active airborne microbes.

Despite the diligent efforts of libraries, archives, and similar institutions to preserve cultural monuments, biodeterioration continues to pose a significant threat to these objects. One of the main sources of microorganisms responsible for the biodeterioration process is the presence of airborne microorganisms. Therefore, this research aims to monitor and compare outcomes of both culture-dependent (utilising various cultivation strategies) and culture-independent approaches (RNA-based sequencing) to identifying metabolically active airborne microorganisms in archives in the Czech Republic. Through this study, several species that have the potential to pose risks to both cultural heritage objects and the health of institution employees were found. Additionally, the efficacy of different cultivation media was demonstrated to be varied across archive rooms, highlighting the necessity of employing multiple cultivation media for comprehensive analyses. Of noteworthy importance, the resuscitating-promoting factor (Rpf) proved to be a pivotal tool, increasing bacterial culturability by up to 30% when synergistically employed Reasoner's 2A agar (R2A) and R2A + Rpf media. Next, the study emphasises the importance of integrating both culture-dependent and culture-independent approaches. The overlap between genera identified by the culture-dependent approach and those identified also by the culture-independent approach varied from 33% to surpassing 94%, with the maximum alignment exceeding 94% in only one case. Our results highlight the importance of actively monitoring and assessing levels of microbial air contamination in archives to prevent further deterioration of cultural heritage objects and to promote improved conditions for employees in archives and similar institutions.

Cross-cultural ethnobotany of the Baltis and Shinas in the Kharmang district, Trans-Himalaya India-Pakistan border.

Human communities that inhabit the political borders live a transitional life, which is due to several socio-political and geo-climatic factors. The current cross-cultural ethnomedicinal study was conducted at the highly elevated Pakistan-India borders of the Western Himalayas in order to address the medicinal flora and folk knowledge of Balti and Shina communities. Ethnobotanical field surveys were conducted from May 2021 to September 2022. We used semi-structured interviews in order to collect the ethnomedicinal data. The collected data was analyzed using the relative frequency of the citations, use value, and Venn diagrams. A total of 140 interviews were conducted, which comprised of 90 (64.28%) Baltis and 50 (35.71%) Shinas. The interviews recorded 60 medicinal plant species that belong to 56 genera and 35 families. Asteraceae (5 spp.), Lamiaceae (5 spp.), and Apiaceae (4 spp.) were the families that were the most represented. These medicinally valued plants were being used for 55 health issues that are related to different body systems. Delphinium brunonianum, Thymus linearis, Hymenolaena candollei, Corydalis adiantifolia, and Seriphidium brevifolium were medicinal taxa with maximum RFCs and UV. The Baltis have comparatively more ethnomedicinal knowledge than the Shinas. The Baltis commonly used 22 (36.66%) species, which 34 (56.66%) were exclusive to the Baltis and 4 (6.66%) to the Shinas. Both ethnic groups collectively hold significant ethnobotanical knowledge that demands the preservation of risked folk knowledge, which is due to uncertain border situations, outmigration, and permeating allopathic drugs.

Strategies for nursing care of critically ill multicultural patients: A scoping review.

BACKGROUND: In society, people live in a social reality where multiculturalism is an increasingly relevant and prevalent topic in their contexts. Facing this, caring for multicultural patients in an emergency service or intensive care unit setting requires a high level of cultural competence due to the complexity, vulnerability of the patient, rapid changes in hemodynamic status, involvement of the family, their informational needs. OBJECTIVE: To map the strategies for nursing care of critically ill multicultural patients. METHOD: A Scoping Review was conducted following the Joanna Briggs Institute's recommendations, with the research question: What are the strategies for nursing care of critically ill multicultural patients? The study was guided by PRISMA. The research was conducted through the EBSCOHost platform, SciELO, Portugal's Open Access Scientific Repository, the Virtual Health Library and a search in grey literature. This was achieved by combining the descriptors DECS/MESH: cultural competence; critical care; emergency room; intensive care; and natural words: cultural care; nurs* interventions; nurs* strategies; within the time frame from 2012 to 2024. The study screening was performed by three independent reviewers through the reading of titles, abstracts and full texts, applying exclusion criteria. The study results were then subjected to content analysis, from which categories emerged. RESULTS: The selected articles highlight various strategies that contribute to the improvement of nursing care for critically ill multicultural patients, focusing on care practice and cultural diversity training for both nurses and nursing students. CONCLUSION: Nurses with cultural competence possess more knowledge and strategies to provide tailored care for multicultural critically ill patients, thereby enhancing the quality of care delivered and contributing to the humanization of healthcare. RELEVANCE TO CLINICAL PRACTICE: Nurses need to have knowledge of existing strategies for caring for multicultural critically ill patients. PATIENT OR PUBLIC CONTRIBUTION: No direct patient or public contribution to the review.

Assessing the Alignment of Large Language Models With Human Values for Mental Health Integration: Cross-Sectional Study Using Schwartz's Theory of Basic Values.

BACKGROUND: Large language models (LLMs) hold potential for mental health applications. However, their opaque alignment processes may embed biases that shape problematic perspectives. Evaluating the values embedded within LLMs that guide their decision-making have ethical importance. Schwartz's theory of basic values (STBV) provides a framework for quantifying cultural value orientations and has shown utility for examining values in mental health contexts, including cultural, diagnostic, and therapist-client dynamics. OBJECTIVE: This study aimed to (1) evaluate whether the STBV can measure value-like constructs within leading LLMs and (2) determine whether LLMs exhibit distinct value-like patterns from humans and each other. METHODS: In total, 4 LLMs (Bard, Claude 2, Generative Pretrained Transformer [GPT]-3.5, GPT-4) were anthropomorphized and instructed to complete the Portrait Values Questionnaire-Revised (PVQ-RR) to assess value-like constructs. Their responses over 10 trials were analyzed for reliability and validity. To benchmark the LLMs' value profiles, their results were compared to published data from a diverse sample of 53,472 individuals across 49 nations who had completed the PVQ-RR. This allowed us to assess whether the LLMs diverged from established human value patterns across cultural groups. Value profiles were also compared between models via statistical tests. RESULTS: The PVQ-RR showed good reliability and validity for quantifying value-like infrastructure within the LLMs. However, substantial divergence emerged between the LLMs' value profiles and population data. The models lacked consensus and exhibited distinct motivational biases, reflecting opaque alignment processes. For example, all models prioritized universalism and self-direction, while de-emphasizing achievement, power, and security relative to humans. Successful discriminant analysis differentiated the 4 LLMs' distinct value profiles. Further examination found the biased value profiles strongly predicted the LLMs' responses when presented with mental health dilemmas requiring choosing between opposing values. This provided further validation for the models embedding distinct motivational value-like constructs that shape their decision-making. CONCLUSIONS: This study leveraged the STBV to map the motivational value-like infrastructure underpinning leading LLMs. Although the study demonstrated the STBV can effectively characterize value-like infrastructure within LLMs, substantial divergence from human values raises ethical concerns about aligning these models with mental health applications. The biases toward certain cultural value sets pose risks if integrated without proper safeguards. For example, prioritizing universalism could promote unconditional acceptance even when clinically unwise. Furthermore, the differences between the LLMs underscore the need to standardize alignment processes to capture true cultural diversity. Thus, any responsible integration of LLMs into mental health care must account for their embedded biases and motivation mismatches to ensure equitable delivery across diverse populations. Achieving this will require transparency and refinement of alignment techniques to instill comprehensive human values.

Invesigate How Cultural and Socioeconomic Factors Influence Oral Cancer Prevention Behaviors, Screening Uptake, and Treatment Outcomes.

Background: Oral cancer is a significant global health issue, with prevention and early detection being pivotal for improved outcomes. This study investigates the impact of cultural and socioeconomic factors on oral cancer prevention behaviors, screening participation, and treatment outcomes. Materials and Methods: A cross-sectional study design was employed, involving a sample size of 1,000 participants. Participants were recruited through stratified sampling to ensure cultural and socioeconomic diversity. Statistical analyses, including logistic regression, were used to explore associations between factors and outcomes. Results: The study revealed multifaceted influences of cultural and socioeconomic factors on oral cancer-related aspects. Cultural factors significantly influenced prevention behaviors, with participants from certain cultural backgrounds exhibiting higher rates of tobacco use and lower rates of dietary adherence). Socioeconomic status played a role in screening uptake, with individuals from lower income brackets less likely to undergo regular screenings. Conclusion: Cultural and socioeconomic factors have a substantial influence on oral cancer prevention behaviors, screening participation, and treatment outcomes.

#Wematter: Creating culturally tailored health promotion content for Black and Latina college women on Instagram.

Objective: Although students at Minority-Serving Institutions (HBCUs, HSIs, TCUs, AAPISIs) have been found to make sound health choices as compared to their counterparts at Predominately White Institutions and have positive expectancy outcomes of physical activity engagement, it is consistently suggested that MSIs examine and bolster health enhancing avenues. Black and Latina women frequently use social media platforms to connect to content that can initiate and support lifestyle changes or improvements. Thus, establishing culturally relevant health related social media content geared toward Black and Latina College Women (BLCW) may be successful in achieving health-related goals. Therefore, the purpose of this study using social identity theory as a theoretical lens, was to identify the fundamental characteristics of culturally tailored health-related content for BLCW. Method: This study employed a qualitative approach to ascertain the characteristics of culturally tailored health-related content for BLCW. Black and Latina college women were asked to provide feedback on mock culturally tailored health-related content in semi-structured focus groups. Participants discussed the authenticity and cultural relevancy of images designed to promote physical activity engagement and other healthy behaviors. Results: Results indicated that at a minimum, culturally tailored health-related content should include an array of body shapes, authentic language and messaging, in relevant settings. Moreover, BLCW prefer content that is realistic, reflects their experiences, and embodies their relevant identities. Conclusion: Social media content designed to attract and promote healthy lifestyles of BLCW must be comprised of imagery and language that represent the diversity of the priority group. The findings from this study can help to establish best practices when designing content intended to strengthen wellness among college students and young adults.

Paradox of life after work: A systematic review and meta-analysis on retirement anxiety and life satisfaction.

Retirement is a pivotal life transition that often changes routines, identity, and objectives. With increasing life expectancies and evolving societal norms, examining the interplay between retirement anxiety and life satisfaction is vital. This study delves into this relationship, recognising the complexities of retirement. A systematic review and meta-analysis followed PRISMA guidelines. Research from 2003 to 2023 was sourced from databases like CINAHL, PubMed/Medline, PsycINFO, ERIC, and Google Scholar, focusing on diverse methodologies and outcomes related to retirement registered in Prospero database (CRD42023427949). The quality assessment used an eight-criterion risk of bias scale, and analyses included qualitative and quantitative approaches, such as random-effects meta-analysis and moderator analyses. After reviewing 19 studies with varied geographical and demographic scopes, a mixed relationship between retirement and life satisfaction emerged: 32% of studies reported a positive relationship, 47% were negative, and 21% found no significant correlation. Meta-analysis indicated high heterogeneity and non-significant mean effect size, suggesting no consistent impact of retirement on life satisfaction. Moderator analyses highlighted the influence of measurement tools on outcomes. The findings reveal a complex interplay between retirement anxiety and life satisfaction, stressing the need for holistic retirement policies that encompass mental health, social integration, and adaptability, focusing on cultural sensitivity. Challenges include potential biases in data sources, methodological diversity, the scarcity of longitudinal studies, and difficulties in addressing recent societal shifts, like the COVID-19 pandemic. Variability in measurement tools and possible publication bias may have also influenced results. This study contributes to understanding retirement, emphasising the relationship between retirement anxiety and life satisfaction. It advocates for ongoing, detailed, culturally informed research to grasp retirement's multifaceted aspects fully.

Breaking Academic Silos: Pedagogical Recommendations for Equitable Obesity Prevention Training and Research During an Age of Nutrition Polarization.

Introduction: Obesity is a preventable chronic condition and a risk factor for poor health and early mortality. Weight stigma and weight-neutral medicine are popular topics in social media that are often at odds with current medical guidelines on obesity treatment and prevention. This conflict may erode the public's trust in science, impede research progress on preventing obesity in marginalized groups, and uphold the ongoing and historical lack of diversity among nutrition trainees. Methods: The authors conducted a series of student-led dialogue sessions with nutrition graduate students in Boston, Massachusetts, from March to May 2023 to understand perceptions of obesity research, health equity, and racism and discrimination. This article summarizes the lessons learned and provides pedagogical recommendations for jointly addressing obesity at the population level and the recruitment, training, and retention of diverse scholars, clinicians, and public health practitioners. Results: Dialogue sessions revealed that students perceive a disproportionate focus on the harms of obesity as a chronic disease, highlighting that inadequate attention is given to weight stigma and discrimination. Some participants believed that weight-based discrimination is equally detrimental to individual health and wellbeing as having obesity. Discussions also emphasized the need to pinpoint the multidimensional and cultural manifestations of weight stigma, which necessitates collaboration across social sectors and academic disciplines. Students recognized the urgent need to apply an equity lens to obesity research and teaching but felt limited in their access to experts within nutrition science who specialize in racism, discrimination, eating disorders, and weight stigma. Conclusions: This study identified concrete opportunities for urgently needed new training and research in population-level obesity prevention, emphasizing antiracism, harm reduction, and elimination of stigma and bias across multiple levels of science and society. Overall, the decision to use the BMI within pedagogy and training must be explicitly stated-research, population surveillance, decision-making, or treatment pedagogy and training-while acknowledging its strengths and limitations across diverse settings. Finally, the social determinants of obesity should incorporate not only weight stigma but also racism and multiple forms of discrimination.

Bioeconomy and Ethnopharmacology- Translational Perspective and Sustainability of the Bioresources of Northeast Region of India.

ETHNOPHARMACOLOGICAL RELEVANCE: The ecological environment of Northeast region of India (NER), with its high humidity, has resulted in greater speciation and genetic diversity of plant, animal, and microbial species. This region is not only rich in ethnic and cultural diversity, but it is also a major biodiversity hotspot. The sustainable use of these bioresources can contribute to the region's bioeconomic development. AIM OF THE STUDY: The review aimed to deliver various perspectives on the development of bioeconomy from NER bioresources under the tenets of sustainable utilization and socioeconomic expansion. MATERIALS AND METHODS: Relevant information related to prospects of the approaches and techniques pertaining to the sustainable use of ethnomedicine resources for the growth of the bioeconomy were retrieved from PubMed, ScienceDirect, Google Scholar, Scopus, and Springer from 1984-2023. All the appropriate abstracts, full-text articles and various book chapters on bioeconomy and ethnopharmacology were conferred. RESULT: As the population grows, so does the demand for basic necessities such as food, health, and energy resources, where insufficient resource utilization and unsustainable pattern of material consumption cause impediments to economic development. On the other hand, the bioeconomy concept leads to "the production of renewable biological resources and the conversion of these resources and waste streams into value-added products. CONCLUSIONS: In this context, major emphasis should be placed on strengthening the economy's backbone in order to ensure sustainable use of these resources and livelihood security; in other words, it can boost the bio-economy by empowering the local people in general.

Treatment seeking behaviour and associated factors among adults with high blood pressure from three selected states in Nigeria.

Management of hypertension is challenging in multi-cultural and multi-ethnic sub-Saharan African countries like Nigeria. This diversity calls for multi-dimensional interventional approaches for hypertension control. This study assessed the treatment seeking behaviour and associated factors among adults with high blood pressure from three ethnic groups in Nigeria. A cross-sectional study was conducted among 762 adults with high blood pressure from three purposively selected States representing the three main tribes in Nigeria. Using a multistage stratified sampling technique, five communities were selected from two Local Government Areas (LGAs) stratified into urban and rural LGAs in each State. All consenting respondents in each community were consecutively screened for hypertension and recruited. A pretested interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, treatment seeking behaviour and factors affecting their choice. Data were summarized using descriptive statistics. Relationship between individual, health-related factors and treatment seeking behaviour, as well as the predictors were assessed using a binary logistic regression. at p<0.05 Participants' mean age was 55.4 ± 16.6 years, 63.0% were females and most were Igbo speaking (39.9%). About half (368, 48.3%) were unaware of their status. Of those aware, most (58.9%) went to hospital upon diagnosis of hypertension while some sought advice from health care professionals (28.5%) mostly Hausas, others either went to chemists (6.2%) or did nothing (5.1%), predominantly Yorubas. Significant predictors of orthodox treatment seeking practices for hypertension were female gender [(AOR = 2.60; 95%CI (1.18-5.71)], availability of medicine and personnel [(AOR = 8.7; 95%CI (4.15-18.3)] and perceived good quality of care [(AOR = 4.88; 95%CI (1.81-13.1)]. Orthodox treatment was the common choice among adults with high blood pressure. To further encourage patronage of orthodox treatment, the health facilities should be adequately equipped with medications and trained personnel to improve the quality of care. Targeted education on continuous practice of orthodox treatment is recommended.

Salud en la Frontera: Desafíos y Oportunidades para el Bienestar de las Comunidades Fronterizas

La salud en la frontera presenta una serie de desafíos y oportunidades para el bienestar de las comunidades fronterizas. Estas zonas geográficas, donde los límites políticos y territoriales se entrelazan, enfrentan problemas de salud únicos que requieren enfoques innovadores y colaborativos. Uno de los desafíos principales es el acceso limitado a servicios de atención médica de calidad. Las comunidades fronterizas a menudo carecen de infraestructuras de salud adecuadas, incluyendo hospitales y clínicas, lo que dificulta el acceso a servicios esenciales. Además, las barreras lingüísticas y culturales pueden dificultar aún más la comunicación entre los proveedores de salud y los pacientes, lo que limita la calidad de la atención. A pesar de estos desafíos, también existen oportunidades para mejorar la salud en la frontera. La colaboración transfronteriza puede ser una herramienta poderosa para abordar los problemas de salud comunes. Los países vecinos pueden compartir recursos, conocimientos y mejores prácticas para fortalecer los sistemas de salud en ambos lados de la frontera. Esto incluye la promoción de la formación y capacitación conjunta de profesionales de la salud, el intercambio de información epidemiológica y la armonización de políticas de salud. Además, las comunidades fronterizas pueden aprovechar su diversidad cultural y su conocimiento tradicional para mejorar la atención médica.

Border health presents a series of challenges and opportunities for border communities' well-being. These geographic areas, where political and territorial boundaries are intertwined, face unique health issues that require innovative and collaborative approaches. One of the main challenges is limited access to quality health care services. Border communities often lack adequate health infrastructure, including hospitals and clinics, which makes it difficult to access essential services. In addition, language and cultural barriers can further hinder communication between healthcare providers and patients, thereby limiting the quality of care. Despite these challenges, there are opportunities to improve border health. Cross-border collaboration can be a powerful tool for addressing common health problems. Neighboring countries can share resources, knowledge, and best practices to strengthen their health systems on both sides of their borders. This includes the promotion of joint education and training of health professionals, exchange of epidemiological information, and harmonization of health policies. In addition, border communities can take advantage of cultural diversity and traditional knowledge to improve healthcare.

Suicide and mortality following self-harm in Culturally and Linguistically Diverse communities in Victoria, Australia: insights from a data linkage study.

Background: While cultural backgrounds are well-documented to be relevant to intentional self-harm, little is known about how cultural and linguistically diverse (CALD) backgrounds affect mortality outcomes following self-harm. Aim: This study aimed to compare the risk of all-cause mortality and suicide after intentional hospital admissions for self-harm among people from CALD (vs. non-CALD) backgrounds. Method: Linked hospital and mortality data in Victoria, Australia, was used to assess suicide and all-cause death after hospital admissions for self-harm among patients aged 15+ years. All-cause death was identified by following up on 42,122 self-harm patients (hospitalized between 01 July 2007 and 30 June 2019) until death or 15 February 2021. Suicide death was evaluated in 16,928 self-harm inpatients (01 January 2013 and 31 December 2017) until death or 28 March 2018. Cox regression models were fitted to compare mortality outcomes in self-harm patients from CALD vs. non-CALD backgrounds. Outcomes: During the follow-up periods, 3,716 of 42,122 (8.8%) participants died by any cause (by 15 February 2021), and 304 of 16,928 (1.8%) people died by suicide (by 28 March 2018). Compared to the non-CALD group, CALD intentional self-harm inpatients had a 20% lower risk of all-cause mortality (HR: 0.8, 95% CI: 0.7-0.9) and a 30% lower risk of suicide (HR: 0.7, 95% CI: 049-0.97). Specifically, being from North Africa/Middle East and Asian backgrounds lowered the all-cause mortality risk; however, the suicide risk in Asians was as high as in non-CALD people. Conclusion: Overall, people from CALD backgrounds exhibited lower risks of all-cause mortality and suicide following hospital admission for self-harm compared to the non-CALD group. However, when comparing risks based on regions of birth, significant variations were observed. These findings underscore the importance of implementing culturally tailored background-specific suicide preventive actions. The study focussed on outcomes following hospital admission for self-harm and did not capture outcomes for cases of self-harm that did not result in hospital admission. This limits generalisability, as some CALD people might avoid accessing healthcare after self-harm due to cultural factors. Future research that not limited to hospital data is suggested to build on the results.

Editorial: Equity/inequality, diversity and inclusion in child and adolescent mental health - a perspective from the South Asian region.

Over 1.8 billion people, about a quarter of the world's population live in the seven countries of South Asia: Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. The population is characterized by a significant demographic youth bulge, with over 40% under the age of 18. This young population poses challenges related to ensuring their well-being and development. Issues such as poverty, undernutrition, lack of early stimulation, limited access to quality education and health care, and gender disparities persist in large parts of South Asia, affecting the lives of many children and adolescents. The promotion of child and adolescent mental health remains a challenge. Accumulating evidence suggests that early interventions can provide long-term health and socioeconomic benefits by prevention of the onset of mental health problems and their development into chronic disorders. This needs to be coupled with specialist services that can cater to the needs of children with greater needs, and support the community and schools-based non-specialist led services. Addressing child and adolescent mental health in South Asia presents a window of opportunity, because this regional youth bulge can contribute significantly to the global economy of the future.

Editorial perspective: Transforming child and adolescent mental health services and systems (CAMHSS) around the globe - the importance of diversity, inclusion and equity in CAMHSS research.

Children and adolescents around the globe have mental health and neurodevelopmental needs. However, no country or region of the world has found good solutions to meet these needs, which are often long-term and complex. Most child and adolescent mental health research comes from high-income, mostly English-speaking, contexts even though 95% of the world's children and adolescents live in low- and middle-income countries (LMIC), where there is vast cultural, linguistic, and socio-economic diversity, with limited services and systems for child and adolescent mental health (CAMH). There is therefore both a 'knowledge gap' (more than 90% of all research represents less than 10% of the global population) and an 'identification and treatment gap' (fewer than 1 in 10 children in LMIC ever receive a diagnosis or any kind of treatment). The purpose of this editorial perspective was to consider the challenges of diversity, inclusion and equity in CAMH research around the globe, and to present some practical things we can all do to close these gaps and transform the global CAMH research agenda.

Do religious and cultural considerations militate against body donation? An overview and a Christian perspective.

The development of anatomy as a scientific undertaking appears to have left little room for religious and cultural input into the conduct of anatomical investigations. This has been brought to the fore by questionnaires regarding the willingness or otherwise of individuals to donate their bodies for dissection, with higher levels of willingness from those without religious affiliations. This has led to the assumption that there is inherent opposition to body donation by those with a religious stance, although there has been little exploration of this. This is increasingly important with growing awareness that anatomy is an international discipline, leading to increasing attention to the religious and cultural contexts within which it is practiced. There is a diversity of responses toward body donation within different countries, as well as by those influenced by Islam, Hinduism, and Buddhism. Additionally, there are diverse cultural attitudes within Confucianism in Asia, Zulu in Africa, and Maori in New Zealand. Even those within the Christian church are influenced by a variety of values, some of which are in tension, with emphasis on the sacredness of life and the significance of burial being negative toward body donation, with informed consent and altruism pointing in a positive direction. The challenge for anatomists is to understand those within their communities, seek to appreciate their perspectives, and also make known the potential of body donation and dissection for enhancing medical practice and improving the education of future health workers.

The Impact of Social Determinants of Health on Transition from Pediatric to Adult Cardiology Care.

Social determinants of health (SDoH) are the economic, social, environmental, and psychosocial factors that influence health. Adolescents and young adults with congenital heart disease (CHD) require lifelong cardiology follow-up and therefore coordinated transition from pediatric to adult healthcare systems. However, gaps in care are common during transition, and driven in part by pervasive disparities in SDoH including race, ethnicity, socioeconomic status, access to insurance, and remote location of residence. These disparities often co-exist, and compound challenges faced by patients and families. For example, Black and Indigenous individuals are more likely to be subject to systemic racism and implicit bias within healthcare and other settings, be unemployed and poor, have limited access to insurance, and have a lower likelihood of transfer of care to adult CHD specialists. SDoH are also associated with acquired cardiovascular disease, a co-morbidity that adults with CHD face. This review summarizes existing evidence regarding the impact of SDoH on transition to adult care and proposes strategies at the individual, institutional, and population/system levels to reduce inequities faced by transition-age youth. These include routinely screening for SDoH in clinical settings with referral to appropriate services for those who screen positive, providing formal transition education for all transition-age youth including training on navigating complex medical systems, creating satellite cardiology clinics to facilitate access to care for those who live remote from tertiary centers, advocating for lifelong insurance coverage where applicable, mandating cultural sensitivity training for providers, and increasing the diversity of healthcare providers in pediatric and adult CHD care.