Representation of dark skin tones in foundational nursing textbooks: An image analysis.

PURPOSE: This study aimed to analyze and quantify the representation of dark skin tones (DST) images/graphics across fifteen foundational and clinical nursing textbooks to understand the degree of portrayed diversity in current nursing texts. BACKGROUND: The United States (U.S.) population is becoming more ethnically and racially diverse. There is a scarcity of nursing literature, studies, and educational materials on the assessment and early recognition of common skin assessment in patients with dark skin tones (DST). The underrepresentation of people with DST images in didactic material suggests that omissions of these images in educational resources may introduce bias in health care provider education and practice. METHODS: Fifteen popular foundational and clinical nursing textbooks were selected and analyzed. All the photo images and drawn graphics in these textbooks were coded according to Fitzpatrick's skin phototype (FSP) scale, which categorizes skin tone as (a) "Light" or Fitzpatrick scale I or II, (b) "Medium" or Fitzpatrick scale III or IV, and (c) "Dark" or Fitzpatrick scale V or VI. The training was provided for data collectors before analysis to ascertain good inter-rater reliability (Cohen's kappa = 0.960 for light skin tone, Cohen's kappa = 0.899 for medium skin tone, and Cohen's kappa = 0.913 for dark skin tone). RESULTS: Analysis of 14,192 photo images and drawn graphics depicting skin tone was completed across 15 foundational and clinical nursing textbooks. 12.3 % of photo images and 2.4 % of drawn graphics depicted dark skin tones, compared to 60.9 % of photo images and 82.8 % of drawn graphics that displayed light skin tones in these textbooks. CONCLUSIONS: Nursing textbooks overrepresent light skin tones and underrepresent dark skin tones. While the approximate racial distribution of the U.S. population is 59.3 % non-Hispanic-White, 13.6 % Black/African American, and 26.6 % Person of Color, the images and graphics of skin tones represented 68 % light, 15 % medium, and 9.4 % dark. RELEVANCE TO CLINICAL PRACTICE: All healthcare providers are expected and required to deliver competent clinical care to an increasingly diverse population. For teaching-learning, more visual representations of DST and comparative images between what to expect in dark, medium, and light skin tones can help improve knowledge deficits and increase health equity.

On Kidney and Bladder Diseases in Nuzhat al-adhhan fi islah al-abdan by Physician Dawud b. 'Umar al-Antaki.

OBJECTIVES: Dawud b. 'Umar al-Antaki, known as the Avicenna of his time, was an Ottoman physician and scholar who wrote medical texts in Arabic in the 16th century. He was taught by an Iranian medical scholar, Muhammad Sharif, in the fields of logic, physical sciences, Greek, and medicine. After leaving Antioch, he traveled to Lebanon and then to Damascus, where he began writing his work, Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab. Dawud b. 'Umar al-Antaki settled in Egypt, where he taught at the Zahiriyya Madrasa and practiced medicine before dying in Mecca in 1599. Here, we examined al-Antaki's writings on kidney and bladder diseases in his work Nuzhat al-adhhan fi islah al-abdan. MATERIALS AND METHODS: We translated sections on kidney and bladder diseases into English and compared Ilter Uzel's copy of Nuzhat al-adhhan fi islah al-abdan with a printed copy. We compared the relevant sections of Nuzhat al-adhhan fi islah al-abdan with the relevant sections of other important works of al-Antaki, al-Nuzhat al-mubhija fi tashhidh al-adhhan wa ta'dil al-amzija, and Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab. The similarities and differences between these works were revealed. RESULTS: Kidney and bladder diseases are briefly discussed in Nuzhat al-adhhan fi islah al-abdan under the headings "amrad al-kula wa l-mathana," "al-hisa," and "harqan al-bawl wa taqtiruhu." CONCLUSIONS: Issues concerning kidney and bladder diseases are addressed more briefly in Nuzhat al-adhhan fi islah al-abdan than in al-Nuzhat al-mubhija fi tashhidh al-adhhan wa ta'dil al-amzija. Tadhkiratu uli l-albab wa l-jami' li l-'ajab al-'ujab consists solely of kidney and bladder stones. When these works are combined, the information in them complements each other.

Análisis de los textos escolares del estudiante de ciencias naturales en primer ciclo básico desde la perspectiva de la terminología anatómica internacional / Analysis of science and biology school textbooks in primary from the perspective of international anatomical terminology

A pesar de los esfuerzos por generar una terminología unificada, hoy en día aún se implementan términos morfológicos obsoletos en diferentes contextos, como por ejemplo, los textos escolares, que son herramientas ampliamente utilizadas por el sistema escolar chileno. Se analizó la terminología morfológica utilizada en textos del estudiante de enseñanza básica (1° básico a 6° básico) propuestos por el Ministerio de Educación de Chile. Este análisis se realizó comparando los términos hallados en los textos mencionados, con la terminología morfológica propuesta por la federación internacional de terminología anatómica. Además, se propone una traducción al español para aquellos términos que se encuentran erróneos en los textos analizados. Los resultados muestran que de un total de 254 términos el 35,8 % es incorrecto. De estos, los más mencionados por los textos son: sistema locomotor, sistema circulatorio, brazo, entre otros. Frente a esto, se concluye que es importante que los textos escolares utilizados en el sistema educativo sean revisados por expertos, para evitar obstáculos en el aprendizaje de la anatomía.

SUMMARY: Despite efforts to generate a unified terminology, obsolete morphological terms are still used in different contexts, such as school textbooks, which are tools widely used by the Chilean school system. The morphological terminology used in texts for elementary school students (grades 1 to 6) proposed by the Chilean Ministry of Education was analyzed. This analysis was carried out by comparing the terms found in the school texts with the morphological terminology proposed by the international federation of anatomical terminology. In addition, a translation into Spanish is proposed for those terms that are found to be erroneous in the texts analyzed. The results show that out of a total of 254 terms, 35.8 % are incorrect. Among the terms with errors, the most mentioned by the texts are: locomotor system, circulatory system, arm, among others. In view of this, we conclude that it is important that the textbooks used in the educational system be reviewed by experts to avoid obstacles in the learning of anatomy.

Ceguera de género en los libros de texto de medicina. El caso de las leucemias / Gender blindness in medical textbooks: the case of leukemias

Objetivo: Analizar los contenidos sobre las diferencias por sexo en las leucemias en libros de texto de hematología y medicina interna utilizados en el Grado de Medicina en España, en el curso 2019-2020, por comparación con las diferencias reconocidas en la literatura científica. Método: Análisis del contenido manifiesto de los capítulos sobre leucemias en los libros de medicina interna, hematología clínica y pregrado de hematología. Categorías de análisis: epidemiología, etiopatogenia, diagnóstico, tratamiento y pronóstico de las leucemias. Resultados: La información epidemiológica de los libros revisados tiene mayor consideración de las diferencias por sexo en la incidencia y el pronóstico, pero no en la mortalidad y la supervivencia. La etiopatogenia está descrita en todos los libros como un proceso fisiopatológico igual para ambos sexos, pero ninguno describe diferencias por sexo en su presentación clínica. Tres libros describen un tratamiento único, asumido igual para ambos sexos; dos libros mencionan el tratamiento de la leucemia mieloide aguda en las embarazadas y uno el tratamiento de la leucemia mieloide crónica. Ningún libro menciona diferencias por sexo en la farmacocinética, la eficacia y la toxicidad del tratamiento, aunque existe amplia evidencia. Conclusiones: Los contenidos sobre las diferencias según sexo y de género en los capítulos sobre leucemias analizados son insuficientes por comparación con las evidencias en la literatura científica. La inclusión de conocimiento sobre la interacción sexo-género en las diferentes secciones de los capítulos de leucemias de los libros de texto de hematología y medicina interna incrementará su calidad científica en ediciones futuras, contribuyendo a unas mejores prácticas profesionales, más eficientes y equitativas. (AU)

Objective: To analyse the existence of sex-differences in the content on leukemias in the Haematology and Internal Medicine textbooks recommended in the Medical Degrees, 2019-2020, by comparison with the sex-differences recognized in the scientific literature. Method: Manifest content analysis of the content of chapters on leukemias in the books on hematology and internal medicine, clinical haematology and haematology undergraduate. Analysis categories: epidemiology, etiopathogenesis, diagnosis, treatment and prognosis of leukemias. Results: Epidemiological information from the revised books has a greater consideration of sex differences in incidence and prognosis but does not contain data on mortality and survival. Etiopathogenesis is described in all books as the same physiological process for both sexes and no differences in the presentation of symptoms are described in any book. Three books describe a unique treatment that is assumed equal for both sexes; two books mention the treatment of acute myeloid leukemia in pregnant women and one in chronic myeloid leukemia. No book mentions sex-differences in pharmacokinetics, efficacy, or treatment toxicity, although there is greater evidence on unequal behavior between the sexes. Conclusions: The contents of sex and gender differences in the leukemia chapters analyzed are insufficient compared to the evidence in the scientific literature today. Hematology textbooks might increase their scientific quality in future editions, including knowledge of sex-gender interaction in the sections of epidemiology, etiology, pathogenesis, diagnosis, treatment, prognosis, and consequences of leukemias, which will contribute to better professional practices, more efficient and equitable. (AU)