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.

Data-rich textbook figures promote core competencies: Comparison of two textbooks.

Many molecular biology and biochemistry instructors have altered their classroom behavior in favor of evidence-based, active learning instructional strategies. Overwhelming evidence confirms that lecture-only classrooms are detrimental to student learning outcomes, but we know less about the impact textbooks have on students outside the classroom. Two influential projects, the AP Biology redesign and Vision and Change, called for extensive restructuring of course content and hoped that textbooks would be restructured accordingly. This study evaluated all figures and tables from two introductory biology textbooks to quantify how well they implement recommendations from Vision and Change and AP Biology redesign. We documented significant differences among figures and tables when looking for experimental data, questions for students to answer, and quantitative interpretation. Using think-aloud interviews, we interrogated whether students engage differently with figures from the two textbooks. When figures provided take-home messages, students relied on written text rather than analyzing the graphical information for their understanding. Students frequently employed words from summaries within the figures to construct "inflated explanations" that mimicked comprehension.

Preserving Abstinence and Preventing Rape: How Sex Education Textbooks Contribute to Rape Culture.

Recent academic and popular conversations regarding #MeToo, sexual violence and harassment, and rape culture have begun to focus on K-12 educational spaces in the U.S., but they rarely examine how educational curricula actually foster or combat these dynamics. In this article, we present a qualitative content analysis of health education textbooks, which explores the following question: What implicit and explicit messages do youth receive about sexual violence, and specifically, sexual violence prevention in health education textbooks? As we explored this question, we analyzed the roles that sex education curricula may play in shaping (e.g., contributing to, intervening upon) rape culture. We found the following messages across textbooks: abstinence is the only way to preserve one's safety; lack of abstinence increases risks, including the risk of being raped; and girls/women must assume personal responsibility and enact strategies that preserve one's abstinence and prevent them from being raped. This article concludes by teasing out how curricula can shape interactions, relationships, and culture, and by offering recommendations for improving sex education curricula.

[Discrepancies in medical textbooks and their impact on medical school students]. / Discordances entre les référentiels des collèges d'enseignants en médecine et leur impact sur les étudiants en médecine.

BACKGROUND: Textbooks endorsed by national medical specialty societies and colleges are used as official references for faculty and national examinations. Oncology is transdisciplinary, practiced and taught by oncologists but also by other specialists. We aimed at identifying discrepancies between chapters on cancers in different official specialty textbooks and evaluating their impact on students. MATERIAL AND METHODS: Volunteer 6th-year medical students of the Sorbonne University faculty were paired and asked to list the discrepancies between all official specialty textbooks addressing a given cancer and then individually asked to evaluate the impact of discrepancies on their learning experience. RESULTS: In March 2018, the 17 cancers listed in the French medical school education program were addressed in 14 official specialty textbooks (2 to 4 textbooks/cancer). Out of a class of 390 students, 78 volunteered and were paired; each cancer was analyzed by 3 pairs of students (1 or 2 cancers/pair); 154 discrepancies were reported (range: 4-18 per cancer). Discrepancies induced doubt and anxiety in students; 85% considered that harmonization should be achieved for all topics of the national medical school program. CONCLUSIONS: Discrepancies between official textbook are frequent, generate anxiety in students and impact learning experience.

A comprehensive validation of the novel 8th edition of American Joint Committee on Cancer staging manual for the long-term survivals of patients with non-functional pancreatic neuroendocrine neoplasms.

Histologically, the World Health Organization has classified pancreatic neuroendocrine neoplasms (p-NENs) into well-differentiated pancreatic neuroendocrine tumors (G1/G2 p-NETs) and poorly-differentiated pancreatic neuroendocrine carcinoma (G3 p-NECs) based on tumor mitotic counts and Ki-67 index. Recently, the 8th edition of American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging manual has incorporated some major changes in 2017 that the TNM staging system for p-NENs should only be applied to well-differentiated G1/G2 p-NETs, while poorly-differentiated G3 p-NECs be classified according to the new system for pancreatic exocrine adenocarcinomas. However, this new manual for p-NENs has seldom been evaluated.Data of patients with both G1/G2 and G3 non-functional p-NENs (NF-p-NENs) from our institution was retrospectively collected and analyzed using 2 new AJCC 8th staging systems. We also made survival comparisons between the 8th and 7th edition system separately for different subgroups.For G1/G2 NF-p-NETs, there were 52 patients classified in AJCC 8th edition stage I, 40 in stage II, 41 in stage III and 19 in stage IV. As for G3 NF-p-NECs, 17, 19, 24, and 18 patients were respectively defined from AJCC 8th edition stage I to stage IV. In terms of the AJCC 7th staging system, the 230 patients with NF-p-NENs were totally distributed from stage I to stage IV (94, 63, 36, 37, respectively). For the survival analysis of both G1/G2 NF-p-NETs and G3 NF-p-NECs, the AJCC 7th edition system failed to discriminate the survival differences when compared stage III with stage II or stage IV (P > .05), while the 8th edition ones could perfectly allocate patients into 4 statistically different groups (P < .05). The HCIs of AJCC 8th stage for G1/G2 NF-p-NETs [HCI=0.658, 95% confidence interval (CI)=0.602-0.741] and stage for G3 NF-p-NECs (HCI=0.704, 95% CI=0.595-0.813) was both statistically larger than those of AJCC 7th stage for different grading NF-p-NENs [(HCI=0.578, 95% CI=0.557-0.649; P=.031), (HCI=0.546, 95% CI=0.531-0.636; P = .019); respectively], indicating a more accurate predictive ability for the survivals of NF-p-NENs.Our data suggested the 2 new AJCC 8th staging systems were superior to its 7th edition for patients with both G1/G2 NF-p-NETs and G3 NF-p-NECs.

Do nursing textbooks accurately describe pulse oximetry? An audit of current literature.

BACKGROUND: The assessment of a patient's vital signs is a critical nursing task. Despite this, research has found that many nurses have a poor understanding of pulse oximetry. AIM: As undergraduate students rely heavily on textbooks as an educational resource, an audit was conducted of nursing texts to determine the quality of pulse oximetry descriptions. METHOD: The audit was guided by questions based on the findings of research examining nurses' understanding of pulse oximetry. Two researchers used these questions to appraise textbook content. FINDINGS: A convenience sample of 32 contemporary nursing textbooks was appraised. Text descriptions of pulse oximetry varied from brief to more extensive, with the content ranging from superficial to detailed. CONCLUSION: Superficial, inconsistent or misleading information within basic nursing textbooks may be one factor associated with nurses' knowledge deficits about pulse oximetry. Academics and nurse educators should appraise core content of textbooks carefully before recommending textbooks to nursing students.

Elisabeth Kübler-Ross and the 5 Stages Model in a Sampling of Recent North American Nursing Textbooks.

Nursing education programs and nursing textbooks often present accounts of the work of Dr Elisabeth Kübler-Ross and her "5 stages" model. In this article, we examine a sampling of recent North American nursing textbooks to illustrate the different ways those subjects are discussed. Unfortunately, the information provided is not always accurate or helpful in guiding readers. We describe why that is so and suggest some ways in which better guidance could be delivered. It is particularly timely to undertake this examination since 2019 is the 50th anniversary of the publication of On Death and Dying, the well-known book in which Dr Kübler-Ross first published her theory and descriptions of the work that led to it.

[Historical perspective of progress and achievement on three-dimensional construction of epidemiological textbooks in the past 70 years in China].

Since the founding of the People's Republic of China, the epidemiological textbooks in China have gone through an all-round development consistently, from nothing to something, from paper to multimedia. After the reform and opening up, especially after the 18th National Congress of the Communist Party of China (CPC), in order to meet the needs of training multi-level public health talents, a group of epidemiologists, represented by professor Qian Yuping, Wu Xike, Li Liming, Zhan Siyan, et al, have always devoting themselves to the construction of epidemiological textbooks, so that the theory, teaching and scientific research of epidemiology had their own series of specialized textbooks. For nearly 20 years, epidemiological textbooks are obviously updated and improved under the convergence of new technology and media. Digital resources, such as CD, Mooc and electronic schoolbag, together with traditional paper textbooks, perfectly contribute to the modern comprehensive three-dimensional epidemiological textbooks and lay a solid foundation for talent cultivation, discipline construction, scientific research and disease prevention and control.

[Ivory-Coast: Textbooks Misinform on HIV]. / Côte d'Ivoire : la désinformation des manuels scolaires sur l'infection à VIH.

Schools are considered as one of the most effective vectors for education on sexually transmitted diseases among young people. We report here the results of a study of HIV infection as presented in school textbooks in Ivory Coast, conducted in June 2018 as part of the development of a communication strategy to increase demand for HIV infection testing, especially among young people. Surprisingly, even though the textbooks studied were published between 2007 and 2017, almost all of them stated that HIV infection leads to death, with no mention of the existence of treatments that make it possible to live in good health. Some textbooks even stated that no treatment is available. These findings highlight one cause - perhaps major - for the reluctance of young people to get tested. The misrepresentation of HIV infection, reinforced by education, hampers incentive campaigns for HIV testing, for which the best argument is that awareness of a positive HIV status makes it possible to benefit from treatment. The present study included textbooks from the French educational program, used throughout French-speaking Africa, and from the Ivory Coast program. It would be interesting to conduct a similar study in other French-speaking and English-speaking African countries. Adapting the presentation of HIV in school textbooks to reflect the current situation in the fight against HIV infection should be a priority.

L'éducation scolaire est connue comme l'un des vecteurs les plus efficaces d'éducation sur les maladies sexuellement transmissibles chez les jeunes. Nous rapportons ici les résultats d'une étude de la présentation de l'infection à VIH dans les manuels scolaires en Côte d'Ivoire. De façon surprenante, bien qu'ils aient été imprimés entre 2007 et 2017, ces manuels affirment dans leur quasi-totalité que le VIH conduit à la mort, sans mentionner l'existence de traitements qui permettent de vivre en bonne santé, voire pour certains en affirmant qu'il n'existe pas de traitement. Ceci met en lumière une cause, peut-être majeure, de la réticence des jeunes à se faire dépister. La représentation erronée de l'infection à VIH renforcée par l'enseignement entrave les campagnes d'incitation au passage du test de dépistage, le meilleur argument pour celui-ci étant que connaître son statut positif permet de bénéficier des traitements. Certains des livres étudiés sont utilisés dans toute l'Afrique francophone. Il serait intéressant de mener une étude similaire dans d'autres pays d'Afrique francophone et anglophone. Vérifier le contenu scientifique et adapter le discours des manuels scolaires sur le VIH à la situation actuelle de la lutte contre l'infection devraient être une urgence.

Analysis of type 2 diabetes mellitus and arterial hypertension content in exercise physiology textbooks.

The textbook is a pedagogical tool that provides students and professionals with scientific information. As exercise is an important strategy for the prevention and treatment of noncommunicable diseases, such as type 2 diabetes mellitus (T2DM) and arterial hypertension, the presence of correct and up-to-date scientific information in exercise physiology textbooks is important. Our aim was to analyze T2DM and arterial hypertension content in exercise physiology textbooks and compare this content with the American College of Sports Medicine (ACSM) position stands. Comparative descriptions were made between information regarding T2DM and arterial hypertension found in textbooks (n = 10) and similar information contained in the official ACSM position stands. The quality of the content was compared with current scientific information present in the ACSM position stands. In regards to T2DM, eight textbooks provided information regarding the purpose and benefits of exercise, two provided information regarding exercise prescription, seven provided information regarding the type of exercise, six provided information regarding general care and recommendations, and five provided information regarding the mechanisms involved. In regards to arterial hypertension, all textbooks provided information regarding the purpose and benefit of exercise, six provided information regarding exercise prescription, nine provided information regarding the type of exercise, two provided information regarding general care and recommendations, and seven provided information regarding the mechanisms involved. All textbooks analyzed contained information related to physical exercise for patients with T2DM and arterial hypertension. However, the textbooks differed in terms of the quality of the contents, especially in regard to exercise prescription.

Basic, High-Risk, and Critical Care Intrapartum Nursing: Clinical Competencies and Education Guide, 6th edition.

This education guide provides a framework for educational content and skills verification for nurses who care for women and their newborns in basic, high-risk, and critical care obstetric settings.

Gender perspectives in medical education.

Medical students have to go through an incredibly vast number of voluminous textbooks in their undergraduate years. But most of us learn next to nothing about the intricacies of the social determinants of health and the larger socio-political-cultural spaces we will have to negotiate. Without any exposure to the larger patriarchal, economic and historical systems, which are bound to collide with our textbook learning, we will be highly unprepared to locate our own biomedical skills within the larger context. The objective of this article is to analyse the current level of gender sensitivity in the textbooks being used for undergraduate medical training, and the potential impact that this has on developing attitudes towards a gender and rights-based approach.

Coverage of child maltreatment and adult trauma in graduate psychopathology textbooks.

OBJECTIVE: Undergraduate psychology textbooks often present trauma, particularly child maltreatment (CM) and its consequences, inadequately or inaccurately. Adequate education about CM and adult trauma (AT) is crucial because they are prevalent and their health impacts are widespread and enduring. Furthermore, mental health professionals are called upon to treat disorders and problematic behaviors associated with trauma yet have often not received adequate knowledge and training about trauma and its treatment. This is the first study to investigate the adequacy and accuracy of the coverage of CM and AT in graduate psychology psychopathology textbooks. METHOD: To address this gap, we reviewed and scored 10 graduate psychology psychopathology textbooks to determine the adequacy, completeness, and balance in their coverage of CM and AT. RESULTS: There was a surprisingly wide range of scores, with some textbooks presenting little research on trauma or unbalanced coverage of trauma-related debates. Even the texts that earned the highest scores could more fully address trauma and/or provide more balanced discussion of debates. CONCLUSIONS: Graduate textbooks would benefit from increased attention to, and more balanced coverage of, CM and AT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Inconsistencies in some common terms and notations in enzymology: Textbook examples and suggestions.

A number of terms have been defined and inconsistently used across various texts in enzymology which may attract the attention of undergraduate students and instructors. At some places, inconsistent use results in confusions as well as leads to the misuse of these terms. Although it is difficult to resolve such inconsistencies, attempts have constantly been made by international regulatory forums such as International Union of Biochemistry and Molecular Biology (IUBMB) and other similar organizations to abolish the inconsistencies. This article highlights some of the most commonly occurring confusing and inconsistent terms in enzymology. We have gathered shreds of evidences and provide here possible suggestions and caution for readers and instructors, so that mistakes can be minimized and possible guidelines can be prepared for their usage. A few inconsistencies observed and discussed here include different notations of activation energy, differences in terms uncompetitive and noncompetitive in enzyme inhibition, classification of cofactors and definitions of their sub-types, and confusing usage of the enzyme-inhibitor dissociation constant. Besides this, we have also highlighted the inconsistencies in the enzyme nomenclature. © 2018 International Union of Biochemistry and Molecular Biology, 47(2): 140-144, 2019.

Palliative and end of life care content within common pharmacy textbooks.

INTRODUCTION: This study compared the end-of-life care (EOLC) content in pharmacy-related textbooks to textbooks evaluated in a comparable 2003 study. METHODS: Six common pharmacy-related textbooks were reviewed for content relating to EOLC. Five of the textbooks were the newest editions of the same texts reviewed in a similar 2003 study, and one focused primarily on clinical ethics, a topic that was underrepresented in the previous study. The six texts were searched for a list of 33 keywords or phrases pertaining to EOLC. Entries containing any of these 33 keywords were assigned a domain and scored using a simple scoring system of one if minimally helpful content was present or two if helpful content was present. The total number of entries and their average scores were compared to the results of the previous study. RESULTS: The average number of entries per textbook was 154, which represents an increase from the 110.1 average number of entries in the 2003 study. However, one of the textbooks had a total of 470 entries alone. Of a total number of 78 possible domains, 40 had either zero or one entries. The average ratings for each book ranged from 0.5 to 1.6, whereas they ranged from 0.9 to 1.6 in 2003. Four of six books in this study had average rating of less than 0.9. CONCLUSION: Although certain texts have made strides to include more EOLC content, overall, EOLC content in pharmacy textbooks may still be improved.

Textbook descriptions of people with psychosis - some ethical aspects.

BACKGROUND: Textbooks are central for the education of professionals in the health field and a resource for practitioners already in the field. OBJECTIVES: This article focuses on how 12 textbooks in psychiatric nursing and psychiatry, published in Norway between 1877 and 2012, describe and present people with psychosis. RESEARCH DESIGN: We used qualitative content analysis. ETHICAL CONSIDERATIONS: The topic is published textbooks, made available to be read by students, teachers and professionals, and no ethical approval was required. FINDINGS: The analysis shows that all 12 textbooks describe and present people who are considered as psychotic from a 'perspective from above'. In this perspective, the readers are learning about psychosis in the professional's language and from the author's viewpoint. Most often the textbooks communicate a universal image of people with psychosis, a description that fits with the diagnostic criteria. The analysis also shows that two textbooks in psychiatric nursing combined this perspective with a 'perspective from within'. Here, the readers are learning about psychosis from the patients' own viewpoint. The authors communicate a personal, psychotic universe that differs from various people, even if they have the same diagnosis, and the descriptions are focusing on the patient as a whole person. DISCUSSION AND CONCLUSION: Drawing partly on Rita Charon's writings about narrative knowledge in the health field, and partly on insights from Martha Nussbaum and her concept of narrative imagination, we argue that mental health professionals need to learn about, understand and fathom what patients go through by reading, listening to and acknowledging the patients' own stories and experiences. Cultivating the capacity for empathy and compassion are at the very heart of moral performance in the mental health field. A valuable moral resource in that regard is leading textbooks and how they describe and present people with severe mental illness.