Diversity, Equity, and Inclusion Milestones: Creation of a Tool to Evaluate Graduate Medical Education Programs.

Background: As the Accreditation Council for Graduate Medical Education (ACGME) began to ask programs to report their efforts surrounding diversity, equity, and inclusion (DEI), program directors felt ill prepared to evaluate their programs and measure change. Objective: To develop a tool that would allow graduate medical education (GME) programs to evaluate the current state of DEI within their residencies, identify areas of need, and track progress; to evaluate feasibility of using this assessment method within family medicine training programs; and to analyze and report pilot data from implementation of these milestones within family medicine residency programs. Methods: The Association of Family Medicine Residency Directors (AFMRD) Diversity and Health Equity (DHE) Task Force developed a tool for program DEI evaluation modeled after the ACGME Milestones. These milestones focus on DEI assessment in 5 key domains: Institution, Curriculum, Evaluation, Resident Personnel, and Faculty Personnel. After finalizing a draft, a pilot implementation of the milestones was conducted by a convenience sample of 10 AFMRD DHE Task Force members for their own programs. Results: Scores varied widely across surveyed programs for all milestones. Highest average scores were seen for the Curriculum milestone (2.65) and the lowest for the Faculty Personnel milestone (2.0). Milestone assessments were completed within 10 to 40 minutes using various methods. Conclusions: The AFMRD DEI Milestones were developed for program assessment, goal setting, and tracking of progress related to DEI within residency programs. The pilot implementation showed these milestones were easily used by family medicine faculty members in diverse settings.

Food Systems Development: The Necessary Paradigm Shift for a Healthy and Sustainable Agrarian Transition, a Case Study from Bougainville, Papua New Guinea.

Classical agricultural development paradigms prioritise basic requirements such as agronomic, caloric and economic needs for the target environment and for beneficiaries. As challenges associated with climate change, globalisation, and population growth compound and amplify one another, project scope must be broadened to take a holistic food systems approach that includes sociocultural and historical contexts, as well as climate impacts as underpinning project design. In this paper, we illustrate the importance of adopting a food systems development paradigm rather than a classical agricultural development paradigm through a case study in Bougainville, Papua New Guinea. The case uses Rich Picturing, targeted and focus-group interviews, and garden visits in remote Bougainville; it provides a poignant illustration of the importance of this more holistic perspective given the historical inefficacy of food systems development, as well as Papua New Guinea's exposure to a plethora of compounding environmental, social, economic, and political stresses and shocks that demonstrate the important linkages between ecosystem services and health. The study aims to demonstrate how including localised gender dynamics, climate vulnerability, rapidly morphing social norms, and climate analogue environments is critical in building food systems resilience and is key to designing policies, programs, and development projects that more effectively address environmental, sociocultural, and health considerations. Building on the inadequacies in agricultural development efforts previously documented for Papua New Guinea, we propose an improved framing for food systems development and identify areas for future research.

Crowdfunding biodiversity conservation.

Raising funds is critical for conserving biodiversity and hence so is scrutinizing emerging financial mechanisms that may help achieve this goal. Anecdotal evidence indicates crowdfunding is being used to support activities needed for biodiversity conservation, yet its magnitude and allocation remain largely unknown. To help address this knowledge gap, we conducted a global analysis based on conservation-focused projects extracted from crowdfunding platforms. For each project, we determined the funds raised, date, country of implementation, proponent characteristics, activity type, biodiversity realm, and target taxa. We identified 72 relevant platforms and 577 conservation-focused projects that raised $4,790,634 since 2009. Although proponents were based in 38 countries, projects were delivered across 80 countries, indicating a potential mechanism of resource mobilization. Proponents were affiliated with nongovernmental organizations (35%) or universities (30%) or were freelancers (26%). Most projects were for research (40%), persuasion (31%), and on-the-ground actions (21%). Projects were more focused on species (57.7%) and terrestrial ecosystems (20.3%), and less focused on marine (8.8%) and freshwater ecosystems (3.6%). Projects focused on 208 species, including a disproportionate number of threatened birds and mammals. Crowdfunding for biodiversity conservation is a global phenomenon and there is potential for expansion, despite possible pitfalls (e.g., uncertainty about effectiveness). Opportunities to advance conservation through crowdfunding arise from its capacity to mobilize funds spatially and increase steadily over time, inclusion of overlooked species, adoption by multiple actors, and funding of activities beyond research. Our findings pave the way for further research on key questions, such as campaign success rates, effectiveness of conservation actions, and drivers of crowdfunding adoption. Even though crowdfunding capital raised has been modest relative to other conservation-finance mechanisms, its contribution goes beyond funding research and providing capital. Embraced with due care, crowdfunding could become an important financial mechanism for biodiversity conservation.

Equity trade-offs in conservation decision making.

Conservation decisions increasingly involve multiple environmental and social objectives, which result in complex decision contexts with high potential for trade-offs. Improving social equity is one such objective that is often considered an enabler of successful outcomes and a virtuous ideal in itself. Despite its idealized importance in conservation policy, social equity is often highly simplified or ill-defined and is applied uncritically. What constitutes equitable outcomes and processes is highly normative and subject to ethical deliberation. Different ethical frameworks may lead to different conceptions of equity through alternative perspectives of what is good or right. This can lead to different and potentially conflicting equity objectives in practice. We promote a more transparent, nuanced, and pluralistic conceptualization of equity in conservation decision making that particularly recognizes where multidimensional equity objectives may conflict. To help identify and mitigate ethical conflicts and avoid cases of good intentions producing bad outcomes, we encourage a more analytical incorporation of equity into conservation decision making particularly during mechanistic integration of equity objectives. We recommend that in conservation planning motivations and objectives for equity be made explicit within the problem context, methods used to incorporate equity objectives be applied with respect to stated objectives, and, should objectives dictate, evaluation of equity outcomes and adaptation of strategies be employed during policy implementation.

Cognitive reappraisal and acceptance: Effects on emotion, physiology, and perceived cognitive costs.

Two emotion regulation strategies-cognitive reappraisal and acceptance-are both associated with beneficial psychological health outcomes over time. However, it remains unclear whether these 2 strategies are associated with differential consequences for emotion, physiology, or perceived cognitive costs in the short-term. The present study used a within-subjects design to examine the effects of reappraisal (reframing one's thoughts) and acceptance (accepting feelings without trying to control or judge them) on the subjective experience of negative emotions, positive emotions, and physiological responses during and following recovery from sad film clips shown in the laboratory. Participants also reported on perceived regulatory effort, difficulty, and success after deploying each emotion regulation strategy. In 2 samples of participants (N = 142), reappraisal (vs. acceptance) was associated with larger decreases in negative and larger increases in positive emotions, both during the film clips and recovery period. However, acceptance was perceived as less difficult to deploy than reappraisal, and was associated with a smaller dampening of skin conductance level (indicating more successful regulation) during the film clips in 1 sample. These results suggest that reappraisal and acceptance may exert differential short-term effects: Whereas reappraisal is more effective for changing subjective experiences in the short term, acceptance may be less difficult to deploy and be more effective at changing one's physiological response. Thus, these 2 strategies may both be considered "effective" for different reasons. (PsycINFO Database Record