Cultural Advocacy for Indigenous Individuals With Serious Illness.

Indigenous American (I.A.) individuals with serious illness and their families have unmet needs. Often, this group is viewed as a minority within a minority. Numerous health challenges exist within the I.A. populations resulting in dire health care situations. Historical trauma and mistrust of the healthcare system impacts access to quality palliative care by this marginalized population. Given the range of social, spiritual, and cultural issues, the interprofessional team needs increased knowledge specific to the I.A. population to ensure holistic, culturally sensitive care. Utilizing a case study, this article reviews of the needs of I.A. individuals with serious illness and essential skills. The aim is empower palliative care clinicians the knowledge to provide culturally sensitive and congruent care to I.A. individuals with serious illness and their community.

Gloria Steinem: The childhood foundations of a feminist.

OBJECTIVE: Gloria Steinem is one of the best-known feminists active in the United States today. This article addresses aspects of Steinem's childhood and adolescence to help us understand how her experiences helped set the stage for Steinem's development into a feminist in midlife. METHODS: Using holistic narrative analysis, I identified themes that seemed to impact some of the fundamental values, assumptive frameworks, and expectations about the world that Steinem developed in childhood. RESULTS: Specifically, from her relationship with her father, Steinem learned that men were not responsible providers but could be fun adventure partners, and that women were just as competent as men. From witnessing her mother's psychological problems, Steinem learned that women's traditional roles could be damaging to women, that she did not want to be a traditional wife and mother, and that psychological treatment could be ineffective if underlying life circumstances were not addressed. CONCLUSIONS: Because her parents were not reliable caregivers, Steinem developed an insecure attachment style characterized by precocious independence and compulsive self-reliance, which allowed her to defy the gendered expectations of her emerging adulthood and set her up to be profoundly influenced by the 1970s Women's Movement in midlife.

A history of neurosurgical capabilities in the United States Pacific Command: from World War II to present.

Neurosurgery has benefited from innovations as a result of military conflict. The volume and complexity of injuries sustained on the battlefield require medical teams to triage, innovate, and practice beyond their capabilities in order to treat wartime injuries. The neurosurgeons who practiced in the Pacific Command (PACOM) during World War II, the Korean War, and the War in Vietnam built upon field operating room knowledge and influenced the logistics of treating battle-injured patients in far-forward environments. Modern-day battles are held on new terrain, and the military neurosurgeon must adapt. War in the PACOM uniquely presented significant obstacles due to geographic isolation, ultimately accelerating the growth and adaptability of military neurosurgery and medical evacuation. The advancements in infrastructure and resource mobilization made during PACOM conflicts continue to inform modern-day practices and provide insight for future conflicts. In this historical article, the authors review the development and evolution of neurosurgical care, forward surgical teams, and mobile field hospitals with surgical capabilities through US conflicts in the PACOM.

Education in the Jim Crow South and Black-White inequities in allostatic load among older adults.

In the U.S., Black adults consistently have higher allostatic load - an indicator of physiological dysregulation - than White adults. Education is considered a likely mechanism given racial differences in attainment, but evidence is mixed. This may be due, in part, to data limitations that have made it difficult for scholars to account for the structurally rooted systemic racism that shaped the U.S. education system and led to large racial inequities in school term length and school attendance among older adults who grew up in the Jim Crow South. Our study addresses this limitation by linking historical data on Black and White segregated school systems in the U.S. South from 1919 to 1954 to the Health and Retirement Study (HRS) to determine if a new measure of educational attainment that accounts for structural racism that led to differences in the number of school days attended by Black and White students across years and states better explains Black-White inequities in allostatic load among older adults who attended school during Jim Crow. We restrict our sample to HRS respondents racialized as White or Black, who resided in the South when they were school-aged, completed primary/secondary school between 1919 and 1954, and provided a measure of allostatic load (n = 1932). We find that our new measure of schooling - duration in school - reduced the Black-White inequity in allostatic load more so than self-reported years of schooling whether we measured allostatic load continuously (34% vs 16%) or categorically (45% vs 20%). Our findings highlight the importance of identifying and using historically informed measures of schooling that account for structurally rooted systemic racism when trying to understand how education shapes the health of individuals racialized as Black in the United States.

Standardized Postoperative Adverse Event Data Collection to Document, Inform, and Improve Patient Care.

There is great potential for standardized postoperative adverse events data collection to document, inform, audit, and feedback, all to optimize patient care. Adverse events, defined as any deviation from expected recovery from surgery, have harmful implications for patients, their families, and clinicians. Postoperative adverse events occur frequently in thoracic surgery, predominately due to the high-stakes (ie, high potential for cure) and high-risk (ie, vital physiology and anatomy and preexisting disease) nature of the surgery. As discussed, engaging surgeons in audit and feedback practices informed by standardized data collection would generate consensus recommendations to reduce adverse events and improve patient outcomes.

Favorable Evaluations of Black and White Women's Workplace Anger During the Era of #MeToo.

Researchers investigating gender and anger have consistently found that White women, but not White men, are evaluated unfavorably when experiencing anger in the workplace. Our project originally aimed to extend findings on White women's, Black women's, and White men's workplace anger by examining whether evaluations are exacerbated or buffered by invalidating or affirming comments from others. In stark contrast to previous research on gender stereotyping and anger evaluations, however, results across four studies (N = 1,095) showed that both Black and White women portrayed as experiencing anger in the workplace were evaluated more favorably than White men doing so. After Study 1's initial failure to conceptually replicate, we investigated whether perceivers' evaluations of women's workplace anger could have been affected by the contemporaneous cultural event of #MeToo. Supporting this possibility, we found evaluations were moderated by news engagement and beliefs that workplace opportunities are gendered. Additionally, we found invalidating comments rarely affected evaluations of a protagonist yet affirming comments tended to favorably affect evaluations. Overall, findings suggest the need for psychologists to consider the temporary, or perhaps lasting, effects of cultural events on research outcomes.

The Historical, Psychosocial, and Cultural Context of Breastfeeding in the African American Community.

Breastfeeding provides a range of benefits for the infant's growth, immunity, and development. It also has health benefits for the mother, including a reduced risk of premenopausal breast cancer, earlier return to prepregnancy weight, reduction of postpartum bleeding, and reduced risk of osteoporosis. There are a number of complex factors that influence the decision to initiate and continue breastfeeding, including those "external" to women, such as cultural beliefs. The cultural context and environment of decision making are illuminated through the prism of traditions and historical and cultural events. The ideology and sentiment of breastfeeding have changed during the course of history and have evolved within the African American community. Throughout the evolution of infant feeding practices, historical aftermaths have contributed to the legacy and emotional context of infant feeding trends. The tradition of wet nursing for African American women is inherently linked to white supremacy, slavery, medical racism and the physical, emotional, and mental abuse that enslaved African American women endured. Thus, the decision to breastfeed and the act of breastfeeding may remain deeply affected by the generational trauma of wet nursing during slavery. The associated negative connotation of wet nursing, slavery, and medical exploitation is one of the many nuanced cultural barriers that denies Black women and infants the many health benefits of breastfeeding.

Perspectives on the knowledge of asbestos disease in the United States - what was known, by whom, and when.

Historical research on asbestos disease can be traced back to the early twentieth Century. The majority, if not all of the early research was conducted outside the United States. There are a number of historical time-lines published that chronical these studies. However, what these time-lines do not address is how widespread this information was, who had access to it, and who may have been furthering this research here in the United States. To address these questions, we can look to the writings of early pioneers in occupational medicine like Alice Hamilton and Carey P. McCord from that era to determine the extent that asbestos disease was mentioned or being discussed. Based on the works of Dr. Hamilton and Dr. McCord, the dissemination and penetration of knowledge about asbestos within the medical and industrial hygiene communities during the first half of the twentieth Century in the United States were very limited or non-existent.

The maximality of circular codes in genes statistically verified.

The maximality of circular codes in genes has 20 preferential trinucleotides in each frame. This combinatorial property is statistically verified in the genes of both bacteria and eukaryotes, and by two approaches computing the trinucleotide occurrence frequencies in the 3 frames at the gene population level (classical method) and at the gene level (recent method). Several remarks explain why the codon usage parameter is unable to identify the circular codes. Some historical and theoretical considerations on comma-free and circular codes are presented. An evolutionary process by trinucleotide permutation is proposed to describe the transformation of a circular code (and its motifs) into another circular code.

Stereotypes as Historical Accidents: Images of Social Class in Postcommunist Versus Capitalist Societies.

Stereotypes are ideological and justify the existing social structure. Although stereotypes persist, they can change when the context changes. Communism's rise in Eastern Europe and Asia in the 20th century provides a natural experiment examining social-structural effects on social class stereotypes. Nine samples from postcommunist countries (N = 2,241), compared with 38 capitalist countries (N = 4,344), support the historical, sociocultural rootedness of stereotypes. More positive stereotypes of the working class appear in postcommunist countries, both compared with other social groups in the country and compared with working-class stereotypes in capitalist countries; postcommunist countries also show more negative stereotypes of the upper class. We further explore whether communism's ideological legacy reflects how societies infer groups' stereotypic competence and warmth from structural status and competition. Postcommunist societies show weaker status-competence relations and stronger (negative) competition-warmth relations; respectively, the lower meritocratic beliefs and higher priority of embeddedness as ideological legacies may shape these relationships.

Internationally qualified nurses' perceptions of the competencies that pertain to patient safety.

Internationally qualified nurses represent 25% of the New Zealand nursing workforce, similar to Australia, Canada, the US and UK. The transition from vastly different health systems can have implications for patient safety. Through understanding the perspectives of internationally qualified nurses, educational and healthcare agencies may be better able to support this transition. This study investigated internationally qualified nurses' perceptions of the competencies that pertain to patient safety. These were analysed alongside the Nursing Council of New Zealand (NCNZ) competencies designed to define and measure competence for patient safety. Qualitative case studies of four internationally qualified nurses were discussed using Communities of Practice theory as the conceptual framework. The primary data sources were two semi-structured interviews with each of the internationally qualified nurses during a Competency Assessment Programme to obtain New Zealand nursing registration. Competency Assessment programme documents also provided data. Thematic analysis of the individual cases followed by cross-case analysis revealed that the social, cultural, and historical context of the health system and nursing role mediates how maintaining patient safety is perceived and enacted in practice. Recommendations from the findings of this study are important for ongoing internationally qualified nurses' transition support.

Strengths and limitations of a family physician.

Family physicians (FP) practising in different parts of the world may require different sets of knowledge and skills to satisfy the needs of the communities in which they work as well as the requirements of the professional bodies with which they are registered. This article gives an overview of the strengths and limitations of the FP globally and more specifically within India, South Africa, and the United States of America. The historical context and evolution of FM as a clinical and academic discipline is discussed in this article. The article recommends suggestions for a better future for Family Medicine as a specialty thereby providing quality primary healthcare to the community, based on the needs of the population of each country.

Mundane? Demographic characteristics as predictors of enrolment onto the National Health Insurance Scheme in two districts of Ghana.

BACKGROUND: In 2003, Ghana passed a law to establish a National Health Insurance Scheme (NHIS) to serve as the main vehicle for achieving universal health coverage. Over 60% of the population had registered by 2009. Current active membership is however 40%. The stagnation in growth has been recorded across all the membership categories. Clearly, the Scheme is falling short of its core objective. This analysis is a critical thematic contextual examination of the effects of demographic factors on enrolment onto the Scheme. METHODS: Demographic secondary data for 625 respondents collected (using a structured questionnaire) during a cross-sectional household survey in an urban, Ashaiman, and rural, Adaklu, districts was analyzed in univariate and multivariate logistic regression models using Statistical Package for Social Scientists (SPSS). Statistical significance was set at P-value < 0.05. Variables included in the analysis were age, gender, education, occupation and knowledge about the NHIS. RESULTS: Seventy-nine percent of the survey respondents have ever enrolled onto the NHIS with three-fifths being females. Of the ever enrolled, 63% had valid cards. Age, gender and educational level were significant predictors of enrolment in the multivariate analysis. Respondents between the ages 41-60 years were twice (p = 0.05) more likely to be enrolled onto a district Scheme compared with respondents between the ages 21-40 years. Females were thrice (p = 0.00) more likely to enroll compared with males. Respondents educated to the tertiary, five times (p = 0.02), and post-graduate, four times (p = 0.05), levels were more likely to enroll compared with non-educated respondents. No significant association was observed between occupation and enrolment. CONCLUSION: Uptake of the scheme is declining despite high awareness and knowledge. Leadership, innovation and collaboration are required at the district Scheme level to curtail issues of low self-enrolment and to grow membership. Otherwise, the goal of universal coverage under the NHIS will become merely a slogan and equity in financial access to health care for all Ghanaians will remain elusive.

It was all planned now what? Claiming agency in later life in reforming China.

This study explores the social construction of agency and wellbeing among 20 Chinese urban retirees aged between 50 and 82 years old (averaging 67), with a special focus on the impact of earlier life experiences in shaping later-life pathways. Today's retirees in urban China have experienced the communist collectivist ideology during the Mao era as well as the changes to everyday life brought about by the economic transformation from centrally planned socialism to a market-orientated economy. Thereby, life in retirement for Chinese elders becomes more than just an issue of dealing with increases in discretionary time after exit from full-time work, but also one of making sense of their earlier life experiences in the midst of dramatic social changes. A grounded theory approach with semi-structured, in-depth, face-to-face interviews was used for data collection and analysis. Three interrelated themes emerged: (a) reminiscence as a mechanism of meaning-making, (b) discovery and exercise of agency in later life in contrast to a rigidly structured earlier life, and (c) varying pathways to constructing the life-stage of retirement. The findings have refuted gerontological literature and public discourse that often portray Chinese elders as passive care recipients or helpless dependants. Further, the present study has practical implications for developing policies, designing programmes and providing services to improve the quality of life for today's older Chinese people.

Reflections on a Community Psychology Setting and the Future of the Field.

The 50th anniversary of the Swampscott Conference offers an opportunity to reflect on a community psychology setting, The Consultation Center at Yale, that was formed in response to the 1963 Community Mental Health Act and the 1965 Swampscott Conference. The Center has flourished as a community psychology setting for practice, research, and training for 39 of the 50 years since Swampscott. Its creation and existence over this period offers an opportunity for reflection on the types of settings needed to sustain the field into the future.

The 20th anniversary of proteomics and some of its origins.

The term "proteome" was first introduced into the scientific literature in July 1995. Almost 20 years ago attempts to characterize the "total protein complement able to be encoded by a given genome" only became possible due to privileged access to what were then the world's most complete sets of genomic data. Today, proteomics has become an important pillar in the fields of disease diagnosis and drug research and development, while also playing a critical role in the much larger field of Healthcare Analytics and Biomarker Discovery and Detection. It is important to note that this industry originated mostly from building blocks in analytical science that predated the term "proteomics" by many decades. However, proteomics, as a discipline, has allowed protein scientists to more favorably compete in the face of highly fashionable Big Science and, more specifically, genomics.

O adolescente e suas representações sociais: apontamentos sobre a importância do contexto histórico / Adolescents and their social representations: notes on the importance of the historical context

O propósito desta discussão consiste em problematizar os modos de representação social da adolescência. A tradição cientifica, especificamente a partir de Erikson (1976), favoreceu a representação social segundo a qual a adolescência é um período de passagem entre a infância e a idade adulta, isto é, um período marcado pela instabilidade, crise e turbulência cuja principal característica manifesta-se pela perda da infância e a entrada no mundo adulto. A problematização aqui apresentada deriva da hipótese de que, quando o universo adolescente adquire status de legitimidade social, que pode ser visto através da mídia e das representações sociais, então a adolescência deixa de ser aquele período de instabilidade e crise; período não familiar cujo único sentido consiste em chegar à fase adulta. A adolescência, uma vez que é representada socialmente em sua própria construção simbólica, não mais poderá ser vista apenas em seu caráter de interface, mas terá legitimado o seu próprio espaço social.

This study aims to discuss the modes of social representation of adolescence. Scientific tradition, especially from Erikson (1976), favored the social representation according to which adolescence is a period of transition between childhood and adulthood, ie, a period marked by instability, crisis and turbulence whose main characteristic is manifested by the loss of childhood and the beginning of adult life. The discussion presented here derives from the assumption that, when the adolescent universe acquires social status of legitimacy, which can be seen through the media and social representation, then adolescence is no longer that period of instability and crisis; unfamiliar period which only sense is to reach adulthood. Adolescence, as it is represented in its own socially symbolic construction, can no longer be seen only as an interface, but has legitimated its own social space.

A importância da abordagem contextual no ensino de biossegurança / The importance of the contextual approach in the teaching of biosafety

A biossegurança é um campo do conhecimento que insere questões voltadas para organismos geneticamente modificados e relacionadas à proteção social e ocupacional do trabalhador. O seu processo educativo visa à formação de um agente participativo-transformador e, portanto, deve ultrapassar a simples ideia da normalização. Dessa forma, é importante contextualizar a biossegurança dentro de uma estratégia de ensino construtivista com a identificação dos seus conceitos estruturantes - risco, perigo e acidente - que permitam ao indivíduo compreender como o risco é percebido na sociedade e enfocado na academia para, em seguida, agregar múltiplas competências e enfrentá-lo. Conhecer como as relações de trabalho-saúde, suas implicações e impactos vem sendo construídas ao longo do tempo, pode formar um cidadão mais crítico e preparado para participar das decisões de ordem político-social que podem influenciar o seu futuro.

Biosafety is a field of knowledge that raises questions geared to genetically modified organisms that are linked to social and job-related employee protection. The educational process involves seeking to create a participative and transforming agent and must therefore transcend the simple concept of teaching. Thus, it is important to contextualize biosafety within a constructive teaching strategy by identification of its core concepts - risk, hazard and accident - which allows each individual to understand how risk is perceived within society and dealt with in academia in order to add multiple skills to tackle the situation. Understanding how the relationship between work and health and its consequences and effects are constructed over the course of time, makes it possible to train more critical and well prepared citizens to participate in decisions of a political and social nature that can influence their future.

Eponyms in dermatology literature linked to Japan.

There are many different eponyms in common use in dermatology today, originating from a variety of countries worldwide. This review discusses a selection of dermatological eponyms that are linked to Japan.

Direitos da criança e do adolescente: um debate necessário / Children and adolescents' rights: a necessary debate

Para dar força de lei aos direitos da criança, a Organização das Nações Unidas constituiu, em 1979, um Grupo de Trabalho que deu início à elaboração do texto da Convenção sobre os Direitos da Criança, debatido durante 10 anos. Adotada por unanimidade, a Convenção é considerada um dos mais importantes instrumentos de direitos humanos jamais adotado pela comunidade internacional. No entanto, e sem que isto implique desconsiderar a sua importância, a Convenção deve ser problematizada, levando-se em conta os dez anos em que o pré-texto foi debatido, a complexidade de suas afirmações e as dificuldades existentes para sua efetivação.

To give force of law on child rights, the United Nation established in 1979 a Working Group to begin drafting the text of the Convention on the Rights of the Child, which was debated for 10 years. Adopted unanimously, the Convention is considered one of the most important human rights instruments ever adopted by international community. However, without this implying to disregard their importance, the Convention should be analyzed taking into account the ten years that the pre-text was discussed, the complexity of their claims and the difficulties in its implementation.