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1.
Nat Immunol ; 25(2): 189, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38302778
3.
J Physician Assist Educ ; 35(1): 43-51, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38227674

RESUMO

ABSTRACT: As an ever-increasing number of physician assistant (PA) programs moves toward holistic admissions, a better understanding of how to achieve their stated admission goals becomes more important. With the June 2023 US Supreme Court decision effectively ending affirmative action in higher education, navigating holistic admissions is now an even greater challenge. In this article, the PA Education Association's Presidents Commission offers a guide for programs to use in implementing holistic admissions at their institutions and key considerations. Is the process mission-driven? Does it follow principles of quality improvement and incorporate ongoing assessment of that process? Using data can be a constructive and insightful way to inform the process. The authors hope that tools, resources, and recommendations offered in this article will serve as valuable resources for any program attempting to institute or improve its holistic admissions process.


Assuntos
Assistentes Médicos , Critérios de Admissão Escolar , Humanos , Diversidade Cultural , Assistentes Médicos/educação , Faculdades de Medicina , Escolaridade
4.
J Physician Assist Educ ; 35(1): 101-104, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38251925

RESUMO

ABSTRACT: The 2023 US Supreme Court holding in Students for Fair Admissions, Inc. v. President and Fellows of Harvard College and Students for Fair Admissions, Inc. v. University of North Carolina, et al. has changed the landscape in higher education admissions processes by declaring affirmative action unlawful. It is imperative that those working in higher education admissions understand the ruling and implement contemporary best practices. Institutions of higher education who wish to promote student diversity are tasked with developing alternative strategies to affirmative action and must steer clear from using race as a determinant factor in admissions decisions. Aiming to identify diversity in individuals' lived experiences, focusing on recruitment efforts that organically lead to diverse applicants, adopting holistic, mission-driven admissions processes, and enhancing robust retention efforts may be effective means of fostering student diversity.


Assuntos
Assistentes Médicos , Critérios de Admissão Escolar , Humanos , Diversidade Cultural , Assistentes Médicos/educação , Estudantes , Universidades
5.
Stud Hist Philos Sci ; 103: 95-104, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38096675

RESUMO

Evidence-based policy has achieved great relevance in policy-making and social research. Nonetheless, over the past few years, several problematic aspects of this approach have been identified. This paper discusses whether, and to what extent, evidence of mechanisms could contribute to addressing certain difficulties faced by evidence-based policy. I argue that it could play a crucial role in the assessment of the efficacy of interventions, the extrapolation of interventions to target populations, and the identification of side effects. For analysing the potential contribution of evidence of mechanisms, the previous debate on the pluralist approach to evidence-based medicine is taken as reference.


Assuntos
Medicina Baseada em Evidências , Formulação de Políticas , Diversidade Cultural , Políticas
7.
Philos Trans R Soc Lond B Biol Sci ; 379(1893): 20220263, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37952613

RESUMO

Global consciousness (GC), encompassing cosmopolitan orientation, global orientations (i.e. openness to multicultural experiences) and identification with all humanity, is a relatively stable individual difference that is strongly associated with pro-environmental attitudes and behaviours, less ingroup favouritism and prejudice, and greater pandemic prevention safety behaviours. Little is known about how it is socialized in everyday life. Using stratified samples from six societies, socializing institution factors correlating positively with GC were education, white collar work (and its higher income) and religiosity. However, GC also decreased with increasing age, contradicting a 'wisdom of elders' transmission of social learning, and not replicating typical findings that general prosociality increases with age. Longitudinal findings were that empathy-building, network-enhancing elements like getting married or welcoming a new infant, increased GC the most across a three-month interval. Instrumental gains like receiving a promotion (or getting a better job) also showed positive effects. Less intuitively, death of a close-other enhanced rather than reduced GC. Perhaps this was achieved through the ritualized management of meaning where a sense of the smallness of self is associated with growth of empathy for the human condition, as a more discontinuous or opportunistic form of culture-based learning. This article is part of the theme issue 'Evolution and sustainability: gathering the strands for an Anthropocene synthesis'.


Assuntos
Evolução Cultural , Humanos , Idoso , Estado de Consciência , Comportamento Social , Preconceito , Diversidade Cultural
8.
J Alzheimers Dis ; 97(2): 715-726, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38143364

RESUMO

BACKGROUND: Cognitive assessment for foreign-born individuals is suboptimal. The Multicultural Cognitive Examination (MCE) was developed for use in culturally, linguistically and educationally diverse populations. The MCE includes the Rowland Universal Dementia Assessment Scale (RUDAS) and performs assessment of memory, verbal fluency, and visuospatial function. OBJECTIVE: To compare the psychometric properties of the Swedish version of the Multicultural Cognitive Examination (MCE-S) with the Swedish versions of the RUDAS (RUDAS-S), the Mini-Mental State Examination (MMSE-SR), and the Clock Drawing Test (CDT), and to explore the ability of the MCE-S test to differentiate patients with and without dementia in a multicultural population. METHODS: 117 outpatients at four memory clinics were tested using the MCE-S to complement the routine cognitive assessment. RESULTS: Significant differences between patients with and without dementia were observed for all MCE-S components. There were significant differences between foreign-born and Swedish-born patients in the MMSE-SR, but not in the MCE-S or the RUDAS-S. The MCE-S, had good diagnostic performance for detecting dementia (AUC, 0.82), and was at least as good as the RUDAS-S alone (AUC, 0.79). The MCE-S also distinguished Alzheimer's disease (AD) from non-AD dementia. Contrary to expectations, the MCE-S was also at least as good as the MMSE-SR among the Swedish-born patients. CONCLUSIONS: The MCE-S is adequate for detecting dementia in both foreign-born and Swedish-born populations. Based on the cultural diversity of general society, adapted cognitive tests that can be used for everyone are practical and beneficial for both patients and health-care professionals. Further studies are needed within primary care.


Assuntos
Transtornos Cognitivos , Demência , Humanos , Demência/diagnóstico , Suécia , Transtornos Cognitivos/diagnóstico , Testes Neuropsicológicos , Diversidade Cultural , Cognição
9.
J Ethnobiol Ethnomed ; 19(1): 63, 2023 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-38105250

RESUMO

BACKGROUND: Ethnobotanical studies in metropolitan areas and urban ethnic markets have grown considerably in recent years as large cities have demonstrated to be significantly rich in biocultural diversity and in driving its evolution, as human populations migrate from one region to another. Urban spaces also represent important places of rich multicultural and multilingual interaction and exchange, where ethnobotany can act as a bridge between research and action. The purpose of this study is to present a case study on how to use ethnobotany in multicultural urban settings by studying people-plant interactions and the larger implications and applications to promote biocultural learning in these areas. METHODS: We inventoried the botanical composition of fresh and dry products sold in most food stores owned by Chinese immigrants in Fondo, a neighbourhood of Barcelona's metropolitan area, in Santa Coloma de Gramenet municipality (Barcelonès county, Catalonia, Iberian Peninsula), pharmacologically validating the obtained list with the Chinese Pharmacopoeia. We also participated in multiple dissemination activities and materials (non-academic and academic), along with exchanges with the broader community in relation to this research. RESULTS: In total, 103 plants were identified at the species level, pertaining to 88 genera and 46 botanical families. Including the infraspecific level, a total of 113 plant taxa were inventoried. One algal and six fungal species were also recorded, but not included in the analyses. Brassicaceae (12.4%) and Fabaceae (10.6%) were the most predominant families inventoried, followed by Cucurbitaceae (7.1%) and Poaceae (7.1%). Over three-quarters of all the taxa have an Asian origin (76.11%), indicating a high conservation of the use of Asian taxa. Over one-third (36.89%) of the plant parts pertain to species contained in the Chinese Pharmacopoeia, showing the relevance of medicinal plants in local stores and the preponderance of Eastern Asian food-medicine continuums. To promote ethnobotanical education programmes, over 50 dissemination activities and educational materials were produced from this study and shared with the local urban community in different fora. CONCLUSIONS: Further research in these and similar settings can provide significant ethnographic information to better understand anthropological processes and phenomena underlying migration and transculturation that can be used in an umbrella of applications, from adequate nomenclature and labelling of foreign products in local languages to multicultural integration and social cohesion programmes along with educational activities on biocultural topics.


Assuntos
Fabaceae , Plantas Medicinais , Humanos , Etnobotânica , Espanha , Diversidade Cultural
10.
J Am Heart Assoc ; 12(24): e030042, 2023 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-38108253

RESUMO

The United States witnessed a nearly 4-fold increase in personal health care expenditures between 1980 and 2010. Despite innovations and obvious benefits to health, participants enrolled in clinical trials still do not accurately represent the racial and ethnic composition of patients nationally or globally. This lack of diversity in cohorts limits the generalizability and significance of results among all populations and has deep repercussions for patient equity. To advance diversity in clinical trials, robust evidence for the most effective strategies for recruitment of diverse participants is needed. A major limitation of previous literature on clinical trial diversity is the lack of control or comparator groups for different strategies. To date, interventions have focused primarily on (1) community-based interventions, (2) institutional practices, and (3) digital health systems. This review article outlines prior intervention strategies across these 3 categories and considers health policy and ethical incentives for substantiation before US Food and Drug Administration approval. There are no current studies that comprehensively compare these interventions against one another. The American Heart Association Strategically Focused Research Network on the Science of Diversity in Clinical Trials represents a multicenter, collaborative network between Stanford School of Medicine and Morehouse School of Medicine created to understand the barriers to diversity in clinical trials by contemporaneous head-to-head interventional strategies accessing digital, institutional, and community-based recruitment strategies to produce informed recruitment strategies targeted to improve underrepresented patient representation in clinical trials.


Assuntos
American Heart Association , Instalações de Saúde , Estados Unidos , Humanos , Política de Saúde , Assistência Médica , Diversidade Cultural , Estudos Multicêntricos como Assunto
11.
Neurosurg Focus ; 55(5): E10, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37913532

RESUMO

OBJECTIVE: The aim of this study was to assess the diversity of neurosurgeons in terms of lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) gender and sexual minority status using the Graduation Questionnaire (GQ) as the single nationalized source of LGBTQ+ identification. Additionally, inclusivity was assessed through interviews by residents and attendings in the field. METHODS: First, a PRISMA literature review was conducted and independently reviewed by two authors on studies involving LGBTQ+ representation in neurosurgery from PubMed, Web of Science, and Google Scholar. Then, aggregate responses of 16,901 participants' sexual and gender identities from the GQ administered between 2016 and 2022 were compiled. To statistically analyze the response frequencies, the authors performed a chi-square analysis. Finally, interviews were conducted with individuals who identify as LGBTQ+ and are currently neurosurgical residents or attendings. Direct invitations were extended to participate in interviews, and all participants gave informed consent prior to the interview. Interviews were conducted using standardized questions and were video recorded. RESULTS: Two studies were identified by literature review that referenced the LGBTQ+ community in neurosurgery. A GQ chi-square analysis comparing neurosurgical with nonneurosurgical LGBTQ+ identification proved statistically insignificant (p = 0.65). More broad analysis of majority sexual and gender identification (heterosexual and cisgendered) compared with the total gender and sexual minority group also proved statistically insignificant (p = 0.32) in response frequency. Five interviews, including 4 residents and 1 attending, provided several overarching themes including self-identification as an invisible minority, self-limiting behavior to ensure inclusion, and LGBTQ+ status as a direct departure from the stereotypical neurosurgeon. CONCLUSIONS: Results from the GQ analysis indicate that neurosurgery is achieving LGBTQ+ diversity of its incoming members comparable to that of other fields in medicine. However, qualitative data from the interviews and a lack of specific literature indicate that despite obtaining diversity, inclusion of LGBTQ+ neurosurgeons and trainees is lacking.


Assuntos
Neurocirurgia , Minorias Sexuais e de Gênero , Feminino , Humanos , Comportamento Sexual , Identidade de Gênero , Diversidade Cultural
12.
Front Immunol ; 14: 1306025, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38022662

RESUMO

Katalin Karikó and Drew Weissman were given the 2023 Nobel Prize in Physiology or Medicine for their findings of nucleoside base modifications that lead to the development of effective mRNA vaccines against COVID-19. This was a remarkable achievement, given that their initial manuscript was rejected by Nature and Science in 2005. The development of mRNA vaccines lagged for more than a decade for several reasons, including the lack of funding, the perceived risks of the technology, and the scepticism of many scientists. Furthermore, Karikó and Weissman's study appeared to be technical and difficult to understand. The COVID-19 pandemic, on the other hand, has shown the importance of mRNA vaccine technology. COVID-19 mRNA vaccines have been highly effective in preventing serious illness, hospitalization, and death. The Nobel Prize for Karikó and Weissman highlights the importance of perseverance, diversity, and inclusion in translational immunology. We need to build a more inclusive scientific community, where scientists from all backgrounds are supported and their work is valued. This will result in more scientific breakthroughs and better healthcare for everyone.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Humanos , Prêmio Nobel , Pandemias , COVID-19/prevenção & controle , Diversidade Cultural
13.
J Int Neuropsychol Soc ; 29(10): 994-1001, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37989559

RESUMO

OBJECTIVE: Subjective cognitive decline (SCD) and how much cognitive decline impacts one's ability to perform instrumental activities of daily living (iADLs) are necessary elements of neuropsychological assessment when diagnosing mild cognitive impairment (MCI) and dementia. Though limited, the literature suggests that culture and self-appraisal of cognitive abilities are related. However, it is unclear if differences exist in the subjective elements of neuropsychological assessments between patients born in Anglosphere countries (Canada, the USA, and the UK) versus immigrants born elsewhere (International Group). METHOD: We conducted a retrospective chart review of advanced Parkinson's disease (PD) patients (n = 764). Reports of SCD and iADL difficulties were extracted from neuropsychological reports and coded by two independent raters. We also examined responses on self- and family-rated questionnaires of executive functioning and iADL difficulties. RESULTS: Anglosphere and International patients did not differ on overall, memory, or attention SCD, or overall iADL difficulties based on interviews. Anglosphere patients reported more executive and language SCD during the interview but International care-partners reported more current executive dysfunction on a questionnaire. International patients and care-partners reported more iADL difficulties on a questionnaire, which they ascribed to motor (not cognitive) symptoms. The effects on questionnaires were small and persisted after accounting for depression severity ratings. CONCLUSION: There were no consistent group differences in the number or pervasiveness of SCD or iADL difficulties reported by Anglosphere versus International groups. Immigration status has limited effect on these subjective elements and they should be given significant weight when diagnosing cognitive dysfunction in PD.


Assuntos
Disfunção Cognitiva , Doença de Parkinson , Humanos , Atividades Cotidianas/psicologia , Estudos Retrospectivos , Doença de Parkinson/complicações , Doença de Parkinson/psicologia , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/psicologia , Cognição , Testes Neuropsicológicos , Diversidade Cultural
14.
J Clin Ethics ; 34(4): 296-306, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37991731

RESUMO

AbstractThere is a clear need for interventions that reduce moral distress among healthcare providers (HCPs), given the high prevalence of moral distress and the far-ranging negative consequences it has for them. Healthcare ethics consultants are frequently called upon to manage moral distress, especially among nursing staff. Recently, researchers have both broadened the definition of moral distress and demarcated subcategories of the phenomenon with the intent of creating more targeted and effective interventions. One of the most frequently occurring subcategories of moral distress in this new taxonomy has been labeled "moral-constraint distress," though scholars have argued that not all constraints on HCPs' moral agency are inappropriate given the often-competing healthcare values of patients, families, and clinical staff. To attempt to reduce the instances of moral distress in cases in which the constraints on HCPs' moral agency are justified, we propose an intervention that focuses on shifting the HCPs' "frame of reference" on moral-constraint distress, teaching HCPs how to distinguish unjustified and justified constraints on their moral agency. The anchors of this blueprint for reducing moral-constraint distress are the philosophical concepts of "values pluralism" and "values imposition." The rationale for this intervention is that, in situations where the constraint on moral agency is justified but the experience of moral distress could nevertheless be severe, the emphasis needs to be on helping the HCP to "think differently" rather than "act differently."


Assuntos
Bioética , Pessoal de Saúde , Humanos , Consultores , Diversidade Cultural , Princípios Morais
15.
Creat Nurs ; 29(3): 252-257, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37920981

RESUMO

Graduate students in a psychiatric mental health nurse practitioner program in the United States and undergraduate students in a first-year English course, Writing and Rhetoric, at a university in Ecuador participated in a Collaborative Online International Learning (COIL) experience in Fall Semester 2021. The purpose of the COIL experience was to develop global perspectives and cultural competencies regarding diversity and inclusion in mental health. The objectives of the COIL experience were to identify and discuss changes in thinking in four areas: eugenics and cultural bias, cultural bias in research, culture and mental illness, and institutional and care policies. Groups of students created educational posters about diversity and inclusion in mental health that were presented at a virtual mini conference to which other students and faculty at the participating universities were invited.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Humanos , Estados Unidos , Saúde Mental , Pesquisa em Educação de Enfermagem , Estudantes de Enfermagem/psicologia , Diversidade Cultural
16.
FASEB J ; 37(11): e23224, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37779389

RESUMO

A wealth of data has consistently demonstrated that a diverse faculty maximizes productivity and innovation in the research enterprise and increases the persistence and success of groups that are underrepresented in STEM. While the diversity of students in graduate programs has steadily increased, faculty diversity, particularly in the biomedical sciences, continues to remain relatively flat. Several issues contribute to this mismatch between the pipeline and the professoriate including biases in search and hiring practices, lack of equity and equal opportunities for individuals from underrepresented backgrounds, and unwelcoming campus climates that lead to marginalization and isolation in academic life. A comprehensive approach that addresses these challenges is necessary for institutions of higher education to achieve their faculty diversity goals and create a climate where individuals from all groups feel welcomed and succeed. This article focuses on the first step in this approach-diversifying faculty recruitment through adopting search practices that generate an applicant pool that matches national availability, ensures equity in evaluation and hiring practices, and promotes inclusion and belonging in the hiring experience. These strategies have been recently used at the University of California, Irvine's School of Biological Sciences and while the long-term impact remains unknown, short-term outcomes in recruitment and hiring have demonstrated significant improvement over previous years.


Assuntos
Diversidade Cultural , Grupos Minoritários , Humanos , Grupos Minoritários/educação , Docentes , Estudantes , Instituições Acadêmicas
17.
J Surg Educ ; 80(11): 1648-1652, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37867058

RESUMO

INTRODUCTION: Explored the diversity and inclusion of our annual meeting. The authors compared our members' diversity to the participation in the impactful portions of our annual conference as a measure of our organizational inclusion. METHODS: The authors retrospectively reviewed and calculated the diversity demographics of our membership based on our 2022 data. Demographics consisted of institutional affiliation and gender. Also the authors retrospectively analyzed the topics discussed at our annual meeting from 2010 to 2022. RESULTS: In 2022, the Association of Program Directors in Surgery (APDS) had 308 members; while we had 100% of the institutional affiliation, most members did not self-report gender or ethnicity information. One hundred eleven members self-reported gender information in 2022: 76% were men and 24% were women. Fifty-seven percent of our institutions had a medical school affiliation, 40% had a nonmedical school affiliation, and 3% had a military instillation affiliation. CONCLUSION: The authors' current analysis demonstrates disparities in the distribution of meaningful space in the APDS meeting program. Future efforts are ongoing to identify members and their demographics, track participation, and encourage more diverse involvement across membership.


Assuntos
Etnicidade , Faculdades de Medicina , Masculino , Humanos , Feminino , Estudos Retrospectivos , Autorrelato , Diversidade Cultural
18.
Ther Umsch ; 80(7): 312-319, 2023 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-37855561

RESUMO

INTRODUCTION: Language, cultural identity, values, or migration experiences of patients, relatives and medical professionals have a significant influence on health care. In individual cases, this can lead to the perceptions of moral problems and conflicts, and to requests for clinical ethics support service. What is the role of clinical ethicists in the face of such perceptions? How does a culturally competent clinical ethics support service look like? In the present contribution, this question will be examined on the basis of reflections on the relationship between culture and ethics as well as the discussion about culturally competent medical ethics. On that basis, recommendations for a culturally competent clinical ethics support are derived.


Assuntos
Diversidade Cultural , Eticistas , Humanos , Ética Médica , Atenção à Saúde
19.
Ther Umsch ; 80(7): 298-301, 2023 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-37855558

RESUMO

INTRODUCTION: Modern societies are multicultural and diverse in many ways. Among numerous other facets, they are characterised by linguistic and cultural diversity. In health care, encounters, exchange and understanding between people of different cultural backgrounds are part of everyday life and require intercultural competence. The aim of this article is to shed more light on this ability as well as on important concepts related to interculturality.


Assuntos
Competência Cultural , Atenção à Saúde , Humanos , Diversidade Cultural
20.
Dementia (London) ; 22(8): 2024-2046, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37871120

RESUMO

People with dementia from culturally and linguistically diverse backgrounds often face poor health and social outcomes such as stigma, depression, and reduced help seeking behaviours. Dementia friendly communities have been shown to reduce stigma, and the gap in health and social outcomes for people impacted by dementia. Despite the large presence of established dementia friendly communities, their functioning in multicultural communities remains underexplored. The aim of this review was to identify the barriers and facilitators of cultural inclusivity to inform the development of a multicultural dementia friendly community. We systematically searched for academic and grey literature regarding existing and prospective age or dementia-friendly communities that engaged with culturally and linguistically diverse communities. Using the matrix method, data on the barriers and facilitators to engagement were extracted. Papers were analysed for common themes and findings were integrated in a narrative format. A total of 3,164 papers were identified, 11 of which met inclusion criteria. There were 6 dementia friendly communities in North America, 3 in Europe, 1 in Australia and 1 in Asia. Analyses revealed that barriers to cultural inclusivity were centered around the accessibility of services, sociocultural factors, and the environment, including issues such as low awareness of dementia and stigma, language barriers, isolation, and the inaccessibility of transport and buildings. Leveraging existing cultural leaders and social structures to target culturally and linguistically diverse populations and develop tailored dementia friendly initiatives were key facilitators. To foster cultural inclusivity in dementia friendly communities, a culturally specific lens that addresses these barriers and utilises facilitators must be applied from the design stage through to implementation and evaluation.


Assuntos
Demência , Humanos , Estudos Prospectivos , Idioma , Diversidade Cultural , Austrália
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