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2.
Artículo en Inglés | MEDLINE | ID: mdl-35682141

RESUMEN

Many studies have introduced principles for creating a sense of home in nursing homes, yet they mostly feature cases from low-density developments in Western countries. This raises a question about how those principles are interpreted and implemented in other cultural contexts, especially in high-density, multicultural environments such as Singapore. This paper examines how a sense of home is implemented in Singapore nursing homes, with a specific focus on the role of the built environment. Participant observations were conducted in five nursing homes in Singapore comprising various architectural design typologies, with the focus on the residents' everyday interactions with their built environment. The study identified the extent of the presence of a sense of home in Singapore's nursing homes and the prevalence of an institutional care model. More specifically, the study explicates Singapore nursing home residents' management of privacy and personalization in shared spaces, illuminates the need for holistic implementation of homelike environments integrated with building designs and care programs and reiterates the pivotal role of social relationships in fostering a sense of home for the residents in the nursing homes.


Asunto(s)
Relaciones Interpersonales , Casas de Salud , Diversidad Cultural , Humanos , Privacidad , Singapur
4.
GMS J Med Educ ; 39(2): Doc16, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35692361

RESUMEN

Background: A large part of the population in Germany makes use of naturopathic, complementary and integrative medical treatments. There are now numerous scientific studies that provide evidence of efficacy for certain indications. At German medical faculties, selected procedures and their application are taught within the cross-sectoral unit called QB 12 and some elective courses, with a focus on specific aspects are offered. So far, however, there has been no structured curriculum that longitudinally anchors teaching across medical studies and enables all students to consider naturopathic and complementary medical options for patient care later on and to integrate them effectively into the diagnostic and treatment process. Objective: The aim of this position paper is to show the relevance of this topic for medical education, to clarify terminology and to present core competencies and possible implementation options for training. Method: The Integrative Medicine and Perspective Pluralism Committee of the German Association for Medical Education developed this position paper in a multi-stage consensual process, in cooperation with the Forum of University Work Groups on Naturopathic Treatment and Complementary Medicine. Results: First, different umbrella terms were discussed and an existing definition of integrative medicine and health was chosen for subsequent use. Building on this step, the status of education and its scientific foundation in Germany was considered in an international context. In the next step, a competency profile for medical training, consisting of seven areas of competency, was developed and described in detail with regard to naturopathic, complementary and integrative medicine. Implementation options were identified using possible starting points in the curriculum and using established examples of best practice. Conclusion: Despite different priorities at each faculty, it was possible to find an agreement on the development of competencies and anchoring them in medical education on the basis of a common definition of terms. Currently, the implementation in the mandatory and elective areas is very heterogeneous. As part of the current revision of the Medical Licensure Act, there are many possible starting points for the integration of naturopathic and complementary medical teaching content, especially in interprofessional and general practice courses. The implementation and accompanying research of targeted teaching settings should lay the foundations for a long-term and binding integration into medical education. Overall, it is clear that medical education in the field of naturopathy and complementary and integrative medicine has the potential to develop comprehensive core medical competencies.


Asunto(s)
Educación Médica , Medicina Integral , Naturopatía , Diversidad Cultural , Curriculum , Docentes Médicos , Alemania , Humanos
5.
Proc Natl Acad Sci U S A ; 119(21): e2113936119, 2022 05 24.
Artículo en Inglés | MEDLINE | ID: mdl-35580185

RESUMEN

The evolutionary history of African hunter-gatherers holds key insights into modern human diversity. Here, we combine ethnographic and genetic data on Central African hunter-gatherers (CAHG) to show that their current distribution and density are explained by ecology rather than by a displacement to marginal habitats due to recent farming expansions, as commonly assumed. We also estimate the range of hunter-gatherer presence across Central Africa over the past 120,000 years using paleoclimatic reconstructions, which were statistically validated by our newly compiled dataset of dated archaeological sites. Finally, we show that genomic estimates of divergence times between CAHG groups match our ecological estimates of periods favoring population splits, and that recoveries of connectivity would have facilitated subsequent gene flow. Our results reveal that CAHG stem from a deep history of partially connected populations. This form of sociality allowed the coexistence of relatively large effective population sizes and local differentiation, with important implications for the evolution of genetic and cultural diversity in Homo sapiens.


Asunto(s)
Antropología Cultural , Arqueología , Variación Genética , Densidad de Población , África , Agricultura , Diversidad Cultural , Humanos
6.
Artículo en Inglés | MEDLINE | ID: mdl-35564510

RESUMEN

Using the transformational learning theory and action research method, this study captured the experiences of students from health-related disciplines in the cultural immersion program From the World to Western. A total of nine students participated in the pilot program with four host families from Culturally and Linguistically Diverse (CALD) backgrounds, and four cultural facilitators who connected the host families and students. The findings of this research showed that it was beneficial for students in health-related disciplines to engage in the cultural immersion program to further prepare them for culturally competent care in their future roles as healthcare professionals. In addition, the students indicated the need for the cultural immersion program to be part of the curriculum for future students to develop cultural skills, awareness and encounters with diverse populations.


Asunto(s)
Estudiantes de Enfermería , Competencia Cultural/educación , Diversidad Cultural , Asistencia Sanitaria Culturalmente Competente , Curriculum , Atención a la Salud , Personal de Salud/educación , Humanos
7.
Infant Ment Health J ; 43(3): 440-454, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35613369

RESUMEN

IECMHC can and should be a vehicle that promotes greater equity in access to high quality relationships within an early classroom environment. It is important to consider consultation through a racial equity lens to ensure that it is integrated in all levels of work. The goal of the study was to replicate the results from other IECMHC programs with a diverse, largely Latinx, population. The Jump Start program was given the unique opportunity to adapt the Georgetown Framework of Infant and Early Childhood Mental Health Consultation to a multicultural population in Miami. A total of 88 early learning programs and 244 teachers participated. Services were provided in English, Spanish, and Creole at the program- and classroom-level. Pre- and post-data were collected at both levels. Significant improvements at the program- and classroom-level were found post-consultation. Consultants demonstrated fidelity to core program practices while providing culturally and linguistically competent service. The current study replicated findings regarding the effectiveness of IECMHC while expanding results to a diverse metropolitan community. Key features of program success may be attributed to the use of highly trained consultants, action planning, fidelity monitoring, and enrollment of programs that were ready and have a champion for IECMHC.


Asunto(s)
Salud Mental , Derivación y Consulta , Preescolar , Diversidad Cultural , Humanos , Lactante
9.
Public Health ; 207: 119-126, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35640452

RESUMEN

OBJECTIVES: The COVID-19 pandemic has highlighted the importance of access to telehealth as an alternative model of service during social restrictions and for urban and remote communities alike. This study aimed to elucidate whether First Nations and culturally and linguistically diverse (CALD) patients also benefited from the resource before or during the pandemic. STUDY DESIGN: This study was a scoping review. METHODS: A scoping review of MEDLINE, CINAHL and PsycINFO databases from 2000 to 2021 was performed. Paired authors independently screened titles, abstracts and full texts. A narrative synthesis was undertaken after data extraction using a standard template by a team including First Nations and CALD researchers. RESULTS: Seventeen studies (N = 4,960 participants) mostly qualitative, covering First Nations and CALD patient recipients of telehealth in the United States, Canada, Australia, and the Pacific Islands, met the inclusion criteria. Telehealth was perceived feasible, satisfactory, and acceptable for the delivery of health screening, education, and care in mental health, diabetes, cancer, and other chronic conditions for remote and linguistically isolated populations. The advantages of convenience, lower cost, and less travel promoted uptake and adherence to the service, but evidence was lacking on the wider availability of technology and engagement of target communities in informing priorities to address inequalities. CONCLUSIONS: Further studies with larger samples and higher level evidence methods involving First Nations and CALD people as co-designers will assist in filling the gap of safety and cultural competency.


Asunto(s)
COVID-19 , Telemedicina , Diversidad Cultural , Estudios de Factibilidad , Humanos , Pandemias , Satisfacción Personal
11.
BMC Psychol ; 10(1): 119, 2022 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-35526020

RESUMEN

BACKGROUND: Racial, ethnic, religious, and cultural diversity in Australia is rapidly increasing. Although Indigenous Australians account for only approximately 3.5% of the country's population, over 50% of Australians were born overseas or have at least one migrant parent. Migration accounts for over 60% of Australia's population growth, with migration from Asia, Sub-Saharan African and the Americas increasing by 500% in the last decade. Little is known about Australian mental health care practitioners' attitudes toward this diversity and their level of cultural competence. AIM: Given the relationship between practitioner cultural competence and the mental health outcomes of non-White clients, this study aimed to identify factors that influence non-White and White practitioners' cultural competence. METHODS: An online questionnaire was completed by 139 Australian mental health practitioners. The measures included: the Balanced Inventory of Desirable Responding (BIDR); the Multicultural Counselling Inventory (MCI); and the Color-blind Racial Attitudes Scale (CoBRAS). Descriptive statistics were used to summarise participants' demographic characteristics. One-way ANOVA and Kruskal-Wallis tests were conducted to identify between-group differences (non-White compared to White practitioners) in cultural competence and racial and ethnic blindness. Correlation analyses were conducted to determine the association between participants' gender or age and cultural competence. Hierarchical multiple regression analysis was conducted to predict cultural competence. RESULTS: The study demonstrates that non-White mental health practitioners are more culturally aware and have better multicultural counselling relationships with non-White people than their White counterparts. Higher MCI total scores (measuring cultural competence) were associated with older age, greater attendance of cultural competence-related trainings and increased awareness of general and pervasive racial and/or ethnic discrimination. Practitioners with higher MCI total scores were also likely to think more highly of themselves (e.g., have higher self-deceptive positive enhancement scores on the BIDR) than those with lower MCI total scores. CONCLUSION: The findings highlight that the current one-size-fits-all and skills-development approach to cultural competence training ignores the significant role that practitioner diversity and differences play. The recommendations from this study can inform clinical educators and supervisors about the importance of continuing professional development relevant to practitioners' age, racial/ethnic background and practitioner engagement with prior cultural competence training.


Asunto(s)
Competencia Cultural , Salud Mental , Actitud , Australia , Competencia Cultural/educación , Competencia Cultural/psicología , Diversidad Cultural , Humanos
12.
Cancer ; 128(11): 2051, 2022 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-35532191
14.
BMC Health Serv Res ; 22(1): 644, 2022 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-35568939

RESUMEN

BACKGROUND: Cultural competence is considered a core qualification for dealing with socio-cultural diversity and balancing disparities in health care. OBJECTIVES: To explore features supporting and inhibiting cultural competence in the hospital at both organisational and staff levels. DESIGN: Cross-sectional online survey in the form of a full census from May to November 2018. SETTING: Two organisations that run a total of 22 hospitals in Germany. PARTICIPANTS: Eight hundred nursing and medical professionals [nurses: n = 557; doctors: n = 243]. METHODS: Using the Short Form Cultural Intelligence SCALE (SFCQ), cultural competence was measured and its relation to potential influencing factors at staff level and organisational level examined, using bivariate (t-Test, one-way ANOVA, Pearson and Spearman correlations) and multivariate (multiple linear regression) approaches. Model 1 examined features at organisational level, Model 2 at individual level and Model 3 included organisational and individual features. RESULTS: The mean cultural competence measured was 3.49 [min.: 1.3; max.: 5.0]. In the bivariate and isolated multivariate models [Models 1 and 2], factors on both organisational and individual levels were significantly related to the hospital staff's cultural competence. The multivariate overview [Model 3], however, revealed that individual features at staff level were the statistically relevant predictors. Positive influencing features included staff's assessment of the importance of cultural competence in their professional context [B: 0.368, 95% confidence interval 0.307; 0.429], participation in competence training [B: 0.193; 95% confidence interval 0.112; 0.276] and having a migration background [B: 0.175; 95% confidence interval 0.074; 0.278], while negative features included length of medical service [B: -0.004; 95% confidence interval -0.007; -0.001]. CONCLUSIONS: The development and practice of cultural competence appear to be determined less by organisational features and more on the level of individual actors. In addition to staff development, adequate organisational structures and an economic incentive system are required to promote sociocultural diversity in hospitals.


Asunto(s)
Competencia Cultural , Personal de Enfermería en Hospital , Estudios Transversales , Diversidad Cultural , Hospitales , Humanos , Cuerpo Médico , Encuestas y Cuestionarios
15.
J Prof Nurs ; 40: 96-104, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35568466

RESUMEN

The COVID-19 pandemic and the significant disparities experienced by Black, Indigenous, and people of color (BIPOC) in infections, hospitalizations, and deaths associated with the Coronavirus have underscored the imperative to increase the size and diversity of the healthcare workforce, including nursing. Academically focused pipeline development programs have led to some advances in minority recruitment and retention; however, emerging research highlights the importance of extra-academic factors that reduce the sense of belonging and persistence among underrepresented and minority students. The purpose of this manuscript is to describe the diversity, equity, and inclusion goals and activities of a college of nursing located in a minority-serving institution. Here, we emphasize the description of a range of activities aimed at meeting our diversity goals. Further, we highlight the actions initiated in response to emergent "extra-academic" student needs over the past year related to the COVID-19 pandemic and police brutality. The strategies described have implications for improving diversity, equity, and inclusion among higher education institutions in nursing.


Asunto(s)
COVID-19 , Estudiantes de Enfermería , COVID-19/epidemiología , Diversidad Cultural , Humanos , Grupos Minoritarios/educación , Pandemias , Proyectos Piloto
16.
Artículo en Inglés | MEDLINE | ID: mdl-35546908

RESUMEN

Objective: This paper presents a rapid assessment of coronavirus disease 2019 (COVID-19) pandemic plans and explores the representation of culturally and linguistically diverse (CALD) communities in such plans. Four levels of pandemic plans were reviewed: regional, state, national and international. Methods: Discussions with representatives from four CALD communities informed the development of search and selection criteria for the COVID-19 plans, which were gathered and assessed using a CALD lens. Six COVID-19 pandemic plans that met the inclusion criteria were critically assessed. Results: The reviewed plans did not report any CALD community voices, views or consultations with community groups in the development phase, nor did they acknowledge the diversity of CALD populations. A few plans noted the vulnerability of CALD communities, but none discussed the challenges CALD communities face in accessing health information or health services during the pandemic, or other structural barriers (social determinants of health). Discussion: Our analysis revealed major gaps in all pandemic plans in terms of engaging with immigrant or CALD communities. Policies and plans that address and consider the complex needs and challenges of CALD communities are essential. Collaboration between public health services, multicultural services and policy-makers is vital for the inclusion of this higher-risk population.


Asunto(s)
COVID-19 , COVID-19/epidemiología , Diversidad Cultural , Humanos , Pandemias , Políticas , Estados Unidos
17.
J Physician Assist Educ ; 33(2): 101-106, 2022 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-35499398

RESUMEN

PURPOSE: A new physician assistant (PA) program accreditation standard requires institutional support for PA student diversity. Therefore, preadmission factors associated with diversity should be identified to inform decision-making. The purpose of this study was to explore associations between preadmission factors of interest and percentages of underrepresented minority (URM) students in PA programs. METHODS: Physician Assistant Education Association (PAEA) survey responses from 169 PA programs were analyzed by using simultaneous multiple regression. The variables included the standardized testing requirement of the Graduate Record Examinations (GRE), undergraduate preprofessional phase, public or private institution, writing sample requirement, mission statement inclusive of care for underserved populations, and local racial or ethnic demographics. RESULTS: GRE score requirements were found to be negatively associated with percentages of African American and total non-White, non-Asian students (p < .05). Local URM racial and ethnic population demographics were shown to be positively associated with African American, Hispanic, and total non-White, non-Asian students (p < .05). Undergraduate preprofessional phase, type of institution, writing sample requirement, and mission statement supportive of underserved populations did not show significant associations with URM diversity. CONCLUSIONS: Faculty and administration members who are involved in decision-making in PA admissions processes should consider the potentially negative impact of a GRE requirement as it relates to the percentages of African American and total non-White, non-Asian matriculants. Educational institutions might also consider exploring new PA program development in geographic areas with supportive local demographics as an approach to achieving more student diversity.


Asunto(s)
Asistentes Médicos , Diversidad Cultural , Humanos , Grupos Minoritarios , Asistentes Médicos/educación , Estudiantes , Estados Unidos
19.
BMJ Open ; 12(5): e057062, 2022 05 09.
Artículo en Inglés | MEDLINE | ID: mdl-35534057

RESUMEN

OBJECTIVES: To assess the attitude of medical students towards cultural diversity aiming to elucidate our current status in understanding cultural awareness and sensitivity. DESIGN, SETTING AND PARTICIPANTS: A web-based cross-sectional study was carried out among 601 undergraduate health science students (medical and dental courses) at a health sciences university in eastern Nepal via various modes of social-media platforms like WhatsApp, Messenger, Gmail, etc. OUTCOME MEASURES: Medical students' attitude towards cultural diversity and its association with the sociodemographic profile of the students. RESULTS: A total of 601 students participated in the study, out of which, 64.2% were men with a sex ratio of 1.8:1 and a mean age of 22.3±1.9 years. More than two-thirds (77.2%) of the students had an excellent to good attitude towards cultural diversity. The proportion of students reporting 'excellent' attitude towards cultural diversity was higher among male students compared with female students (37.8% vs 20.5%) and students aged >22 years compared with younger students (37.1% vs 26.7%). Gender (p<0.001) and age (p=0.009) were significantly associated with the attitude towards cultural diversity. CONCLUSIONS: Medical students, in general, are aware of the impacts of a cross-cultural society on the delivery of quality healthcare and also about the need to be aware of prejudices doctors may have towards certain cultures. Majority suggest the inclusion of concepts of multicultural awareness and sensitivity in the medical curriculum itself.


Asunto(s)
Estudiantes de Medicina , Adulto , Actitud del Personal de Salud , Estudios Transversales , Diversidad Cultural , Curriculum , Femenino , Humanos , Masculino , Nepal , Encuestas y Cuestionarios , Universidades , Adulto Joven
20.
HEC Forum ; 34(2): 103-114, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35604507

RESUMEN

Bioethicists often remind health care professionals to pay close attention to issues of diversity and inclusion. Approaches to ethics consultation, where the perspective of the bioethicist is taken to be more morally correct or necessarily authoritative, have been critiqued as inappropriately authoritarian. Despite such apparent recognition of the importance of respecting moral diversity and the inclusion of different viewpoints, authoritarianism is all too often the approach adopted, especially as bioethics has shifted evermore into concerns for public policy. Yet, secular values and philosophical principles are not morally neutral; nor are the private moral convictions of bioethicists. Such analysis is always grounded in particular understandings of the right and the good, the virtuous and the just. Critical examination of common treatments and new alternatives is essential for the careful scientific practice of medicine. The same is true with regard to bioethics. Stagnating in customary or accepted claims of a common secular morality or a standard set of bioethical principles out of an unwillingness to explore the real diversity of moral thought, including traditional religious and cultural worldviews, fails to tap the human capacity to find innovative solutions to the complex challenges facing medicine.


Asunto(s)
Bioética , Consultoría Ética , Diversidad Cultural , Eticistas , Humanos , Principios Morales
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