Dispersed DNA variants underlie hearing loss in South Florida's minority population.

BACKGROUND: We analyzed the genetic causes of sensorineural hearing loss in racial and ethnic minorities of South Florida by reviewing demographic, phenotypic, and genetic data on 136 patients presenting to the Hereditary Hearing Loss Clinic at the University of Miami. In our retrospective chart review, of these patients, half self-identified as Hispanic, and the self-identified racial distribution was 115 (86%) White, 15 (11%) Black, and 6 (4%) Asian. Our analysis helps to reduce the gap in understanding the prevalence, impact, and genetic factors related to hearing loss among diverse populations. RESULTS: The causative gene variant or variants were identified in 54 (40%) patients, with no significant difference in the molecular diagnostic rate between Hispanics and Non-Hispanics. However, the total solve rate based on race was 40%, 47%, and 17% in Whites, Blacks, and Asians, respectively. In Non-Hispanic Whites, 16 different variants were identified in 13 genes, with GJB2 (32%), MYO7A (11%), and SLC26A4 (11%) being the most frequently implicated genes. In White Hispanics, 34 variants were identified in 20 genes, with GJB2 (22%), MYO7A (7%), and STRC-CATSPER2 (7%) being the most common. In the Non-Hispanic Black cohort, the gene distribution was evenly dispersed, with 11 variants occurring in 7 genes, and no variant was identified in 3 Hispanic Black probands. For the Asian cohort, only one gene variant was found out of 6 patients. CONCLUSION: This study demonstrates that the diagnostic rate of genetic studies in hearing loss varies according to race in South Florida, with more heterogeneity in racial and ethnic minorities. Further studies to delineate deafness gene variants in underrepresented populations, such as African Americans/Blacks from Hispanic groups, are much needed to reduce racial and ethnic disparities in genetic diagnoses.

Foreign patients and multicultural challenges in pediatric oncology: The experience of the Istituto Nazionale dei Tumori in Milan.

This paper describes the complexity of the clinical management of foreign minors suffering from cancer, through the clinical experience of an Italian referral center. The study includes 50 patients less than 18 years (22% of the patients admitted to the unit in 2023), 32 foreigners who were Italian resident and 18 who had come to Italy specifically to receive cancer treatment. Patients who migrate for healthcare reasons often arrive at the referral center with advanced disease or relapse. Numerous socio-cultural issues were reported. To address them, specific strategies were implemented to ensure equal and high-quality care for all patients, respecting their needs.

Approaches for enhancing patient-reported experience measurement with ethnically diverse communities: a rapid evidence synthesis.

BACKGROUND: Patient-reported experience measures (PREMs) are used to drive and evaluate unit and organisational-level healthcare improvement, but also at a population level, these measures can be key indicators of healthcare quality. Current evidence indicates that ethnically diverse communities frequently experience poorer care quality and outcomes, with PREMs data required from this population to direct service improvement efforts. This review synthesises evidence of the methods and approaches used to promote participation in PREMs among ethnically diverse populations. METHODS: A rapid evidence appraisal (REA) methodology was utilised to identify the disparate literature on this topic. A search strategy was developed and applied to three major electronic databases in July 2022 (Medline; PsycINFO and CINAHL), in addition to websites of health agencies in Organisation for Economic Co-operation and Development countries via grey literature searches. A narrative evidence synthesis was undertaken to address the review question. RESULTS: The review resulted in 97 included studies, comprised 86 articles from electronic database searches and 11 articles from the grey literature. Data extraction and synthesis identified five strategies used in PREM instruments and processes to enhance participation among ethnically diverse communities. Strategies applied sought to better inform communities about PREMs, to create accessible PREMs instruments, to support PREMs completion and to include culturally relevant topics. Several methods were used, predominantly drawing upon bicultural workers, translation, and community outreach to access and support communities at one or more stages of design or administration of PREMs. Limited evidence was available of the effectiveness of the identified methods and strategies. PREMs topics of trust, cultural responsiveness, care navigation and coordination were identified as pertinent to and frequently explored with this population. CONCLUSIONS: The findings provide a basis for a maturity model that may guide change to increase participation of ethnically diverse communities in PREMs. In the short-medium term, health systems and services must be able to recognise and respond to cultural and linguistic diversity in the population when applying existing PREMs. In the longer-term, by working in collaboration with ethnically diverse communities, systems and services may co-create adapted or novel PREMs that tackle the factors that currently inhibit uptake and completion among ethnically diverse communities.

Assessing the impact of an online dementia awareness initiative co-created with and for English, Arabic and Vietnamese speaking communities: A case study.

BACKGROUND: Awareness and understanding of dementia remain limited in ethnically diverse populations in multicultural societies due to culturally inappropriate and inaccessible information. OBJECTIVE: To establish the impact, helpers and hinderers of an online multilingual dementia awareness initiative co-created with and for English, Arabic and Vietnamese speaking people. DESIGN: A case study using mixed methods to assess the impact and implementation of an information session on dementia knowledge. SETTING AND PARTICIPANTS: The study was conducted with English, Arabic and Vietnamese speaking individuals in Canterbury-Bankstown, Australia. INTERVENTION STUDIED: A dementia alliance co-created an online multilingual dementia information session, which was delivered synchronously in English, Arabic and Vietnamese by trained facilitators. MAIN OUTCOME MEASURES: In-session group discussions, quizzes and a postsession survey assessed the impact on dementia knowledge. A postimplementation focus group explored the factors that helped and hindered the initiative. RESULTS: The online dementia information session successfully supported participants understanding of dementia causes, impacts and care strategies. The initiative was hindered by competing priorities and limited accessibility to target audiences, while it was helped by the support of an established organisation and feedback mechanisms. DISCUSSION: Ongoing dementia education and awareness-raising campaigns that are culturally sensitive are needed in communities to promote dementia literacy and help-seeking. CONCLUSIONS: An online multilingual dementia information session can be an effective way to improve dementia literacy and advocate for change in multicultural communities. PATIENT OR PUBLIC CONTRIBUTION: English, Arabic and Vietnamese speaking members of the Canterbury Bankstown Dementia Alliance participated in the co-creation and evaluation of this initiative.

Family member and service provider experiences and perspectives of a digital surveillance and service navigation approach in multicultural context: a qualitative study in identifying the barriers and enablers to Watch Me Grow-Electronic (WMG-E) program with a culturally diverse community.

BACKGROUND: Children and families from priority populations experienced significant psychosocial and mental health issues to the COVID-19 pandemic. Yet they also faced significant barriers to service access, particularly families from culturally and linguistically diverse (CALD) backgrounds. With most child and family health nurse clinics ceasing in-person consultations due to the pandemic, many children missed out on health and developmental checks. The aim of this study was to investigate the perspectives and experiences of family members and service providers from an urban, CALD community regarding the implementation of a digital, developmental surveillance, Watch Me Grow-Electronic (WMG-E) program. METHODS: Semi-structured interviews were conducted with 17 family members, service navigators, and service providers in a multicultural community in South Western Sydney, Australia. This qualitative study is an implementation evaluation which formed as part of a larger, two-site, randomised controlled trial of the WMG-E program. A reflexive thematic analysis approach, using inductive coding, was adopted to analyse the data. RESULTS: Participants highlighted the comprehensive and personalised support offered by existing child and family health services. The WMG-E was deemed beneficial because the weblink was easy and quick to use and it enabled access to a service navigator who support family access to relevant services. However, the WMG-E was problematic because of technology or language barriers, and it did not facilitate immediate clinician involvement when families completed the weblink. CONCLUSIONS: Families and service providers in this qualitative study found that using WMG-E empowered parents and caregivers to access developmental screening and learn more about their child's development and engage with relevant services. This beds down a new and innovative solution to the current service delivery gap and create mechanisms that can engage families currently not accessing services, and increases knowledge around navigating the health and social care services. Notwithstanding the issues that were raised by families and service providers, which include accessibility challenges for CALD communities, absence of clinical oversight during screening, and narrow scope of engagement with available services being offered, it is worth noting that improvements regarding these implementation factors must be considered and addressed in order to have longevity and sustainability of the program. TRIAL REGISTRATION: The study is part of a large randomised controlled trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.

Evaluating the cross-cultural competence instrument for healthcare professionals (CCCHP) among nurses in Okinawa, Japan.

BACKGROUND: To provide better quality healthcare services to patients with different linguistic and cultural backgrounds, the cross-cultural competence of medical professionals is important. However, assessing and improving the cross-cultural competence of healthcare professionals is difficult in Japan, as there is no standardized scale to measure the competence. This study's purpose was to translate the Cross-Cultural Competence instrument for Healthcare Professionals (CCCHP), which was developed and used in Europe, and to examine its reliability and validity among Japanese nurses. METHODS: During June and July 2021, nursing staff were invited to take web- and paper-based surveys in Okinawa Japan. The CCCHP (five-factor model with 27 items across motivation, attitude, skills, emotion, and knowledge) was translated using a combination translation method, and a five-point Likert scale was used for responses. Exploratory and confirmatory factor analyses and known-group method were used to examine structural validity, while Cronbach's alpha coefficient was used to test reliability. RESULTS: A total of 294 responses were analyzed; 77.2% had more than five years of experience. Since the fit index indicated that the five-factor model was not a good fit, it was modified to a four-factor model (J-CCCHP24) by moving three variables, removing the knowledge factor, and using the error covariance of the variables. The fit index after the modification was improved to comparative fit index (CFI) = 0.92, Tucker-Lewis index (TLI) = 0.91, root mean square error of approximation (RMSEA) = 0.05, and standardized root mean square residual (SRMR) = 0.06, and Cronbach's alpha was 0.85. The mean scores of J-CCCHP24 were significantly higher in the group with a history of overseas travel, higher foreign language skill, training in intercultural care, experience of foreign patient care, and intercultural interactions outside the workplace than in the group without these characteristics. CONCLUSION: This study confirmed the validity and reliability of the modified Japanese version of the CCCHP (four-factor model with 24 items). The results suggest that the exposure to different cultures on a personal level may help improve nurses' cross-cultural competence. Further refinement of this scale for practical use would encourage the implementation of necessary countermeasures to improve the cross-cultural competence of Japanese healthcare professionals.

It's not what you say it's what you do: School diversity ideologies and adolescent mental health and academic engagement.

This study examined the relation between schools' color-evasive versus multicultural diversity ideologies, school characteristics, and adolescent development. Across two datasets linking individual-level survey data (N = 1692) and administrative records (N = 300,063; Mage = 12.4, 52% female, 48% male), schools' stated support for diversity (via a pro-diversity mission statement) was related to adolescent mental health and academic achievement, but in nuanced ways depending on individual racial/ethnic backgrounds, the racial/ethnic diversity of the student body and teachers, and the extent of racial disparities in discipline and gifted education. Findings suggest that communicating support for diversity without redressing systemic inequities in school discipline and academic tracking will not reduce racism-related achievement gaps and may instead exacerbate mental health disparities.

Twelve tips for creating a multicultural mindfulness-based intervention in diverse healthcare settings.

High levels of stress and burnout, low help-seeking behaviour and unhealthy coping in healthcare professionals (HCPs), are a critical concern globally. Mindfulness-based interventions (MBIs) reduce stress, are a healthy coping mechanism and have become increasingly popular among HCPs, especially during the Covid-19 pandemic. Nevertheless, HCPs' busy schedules require the intervention to be accessible, pragmatic, and context specific. Key to this goal is approaching mindfulness from a multicultural perspective, especially in diverse settings such as Africa. This paper aims to provide practical tips to ensure that the MBI offered is effective with multicultural HCPs during intense stress. Four tips each discuss the curriculum, implementation, and sustainability, respectively. The tips are elucidated by practical examples of regulating stress in healthcare settings and to offer a guideline to help structure future MBIs to be culturally and context appropriate.

The changes in biethnic acceptance across daily settings and biethnic adolescents' psychological well-being during middle school transition.

INTRODUCTION: Patterns of biethnic adolescents' perceived biethnic acceptance across families, peers, and school contexts were examined during the transition from elementary to middle school in South Korea. We also examined how the transition patterns were related to their psychological outcomes during this period. METHODS: Utilizing 2-wave data (2017 and 2019) from the Panel Survey of Korean Multicultural Youth Adjustment, a latent transition analysis was conducted. Participants were biethnic adolescents who were in 5th or 6th grade at Wave 1 (N = 245; 51.02% female; Mage = 11.38). Their fathers were Korean, and mothers were immigrants from neighboring countries. Familial ethnic socialization, peer discrimination, and school multicultural climate scores were used as indicators of biethnic acceptance. Outcomes of self-esteem, depression, and biethnic affirmation were also examined. RESULTS: Latent profile and transition analyses yielded two groups (i.e., high acceptance and low acceptance) at each wave and four transition patterns (i.e., high-high, low-high, low-low, and high-low). Compared to high-high group, which was the most prevalent group, low-low and high-low groups reported lower self-esteem and ethnic affirmation, and greater depression at Wave 3. CONCLUSIONS: While for the majority of participants, their daily settings continued to be high in biethnic acceptance across the transition period, most at risk were those who perceived a decrease in biethnic acceptance in their daily settings. Results shed light on the need for support to maintain the context of high biethnic acceptance surrounding biethnic adolescents for their psychological well-being in school transitions.

Starting conversations about mental health and wellbeing in Australian culturally and linguistically diverse communities.

Australia is a multicultural nation with nearly 30% of the population born overseas. Migrants' mental health can be impacted by discrimination, racism and experiences relating to asylum and immigration. These can be compounded by low help-seeking caused by stigmatized beliefs and poor mental health literacy. My Mind, My Voice (MMMV) is a co-designed program aiming to promote awareness of mental health and wellbeing for people with a culturally and linguistically diverse (CALD) background. This research project explored the perceived impacts and value of MMMV and processes leading to those impacts. A mixture of internal quantitative and qualitative evaluation surveys (n = 32) and researcher-conducted semi-structured interviews (n = 9) were conducted with CALD organization and community members who attended training workshops, presented MMMV events or attended an event. Data were analysed using a reflexive thematic analysis approach. Five themes were developed: culturally relevant and respectful, cross-cultural connections, the importance of language, increasing confidence and literacy and the potential to change attitudes. Being involved with a co-produced program that was culturally relevant and respectful was a positive experience that enhanced people's confidence and literacy. Feeling respected, valued and validated helped participants feel empowered to develop and deliver mental health and wellbeing education in their community. Open, honest conversations are an important way to break down stigma and start conversations about mental health and wellbeing in CALD communities. Evaluation outcomes demonstrate the success of MMMV's collaborative approach, which can inform the development and evaluation of CALD mental health promotion interventions.

Swimming and water safety delivery for newly arrived Australians.

In Victoria, Australia, culturally and linguistically diverse communities are more than twice as likely to drown than their Australian-born counterparts. One explanation is the lack of feasible, community-led approaches to water safety and swimming education. A community engagement framework was used to develop and implement a 5-day pool program to teach swimming and water safety to newly arrived migrant children attending an English language school in Victoria. Socio-cultural needs of the predominantly Afghan cohort were incorporated through in-language consultation with parents who requested males and females be educated separately. Participants were assessed against Victorian aquatic competency benchmark standards at pre- and post-program, however, there was no expectation to achieve these competencies within the 5 days due to a lack of prior aquatic exposure. Independent and paired samples t-tests determined changes in skills, including by sex and number of lessons attended. Forty-one participants completed all assessments. Excluding lifesaving skills, there was a significant increase in total competency attainment overall from pre- to post-program (p < 0.001), and for each competency (p's ≤ 0.002)-predominantly knowledge and rescue skills. Improvements were mostly recorded among males, demonstrating that females may require more specialized support to achieve similar outcomes. Improvements in rescue skills and knowledge indicate the program's effectiveness in increasing newly arrived migrant children's awareness of, and exposure to, foundations of safe aquatic behaviours. Future programs tailored to newly arrived migrant communities should consider implementing water familiarization activities as a stepping stone to engagement with structured swimming and water safety education.

The influence of culture on the health beliefs and health behaviours of older Vietnam-born Australians living with chronic disease.

AIM: To explore the health beliefs and health behaviours of older Vietnam-born people living with chronic disease in Western Australia. DESIGN: This study was designed as a focused ethnography guided by the interpretative research paradigm and Leininger's Theory of Culture Care. METHODS: Data were collected through participant observation and interviews undertaken at participants' homes in Western Australia over 7 months in 2019. Data were analysed using Wolcott's approach for transferring qualitative data, comprising three phases: description, thematic analysis and interpretation. RESULTS: This study included 12 participants. The health perspectives and practices of older Vietnam-born Australians significantly reflected the traditional Vietnamese values. These included the stigma towards chronic disease as an inevitable consequence of ageing; self-blame thoughts about chronic disease causations and maintained traditional dietary practices. However, some aspects of their health behaviours such as beliefs and practices in traditional medicine, Western medicine and physical exercise reflected a blended approach combining both Vietnamese-oriented and Westernized-orientated practices. Individual factors were also identified as contributing to chronic disease self-care among participants. CONCLUSION: This study emphasizes culture played a significant role in shaping the way that older Vietnam-born Australians believed and behaved while living with chronic conditions. However, it also indicates that culture is not a stationary concept, it evolves gradually and is socially constructed. IMPLICATIONS: A better understanding of the health beliefs and practices of older Vietnam-born Australians is expected to contribute to the delivery of culturally safe and effective support for this population. The achievement of culturally safe care requires a systemic approach and collaboration of strategies across sectors. PATIENT AND PUBLIC CONTRIBUTION: This study encompassed the contribution of 12 older Vietnam-born Australians who offered the researcher the privilege to enter their world and the staff of social care organization who opened the gate for the researcher to approach participants.

Structuralizing Culture: Multicultural Neoliberalism, Migration, and Mental Health in Santiago, Chile.

The arrival of Afro-descendant migrants, mainly from Haiti and the Dominican Republic, has led to the emergence of new discourses on migration, multiculturalism, and mental health in health services in Chile since 2010. In this article, I explore how mental health institutions, experts, and practitioners have taken a cultural turn in working with migrant communities in this new multicultural scenario. Based on a multisited ethnography conducted over 14 months in a neighbourhood of northern Santiago, I focus on the Migrant Program-a primary health care initiative implemented since 2013. I argue that health practitioners have tended to redefine cultural approaches in structural terms focusing mainly on class aspects such poverty, social stratification, and socioeconomic inequalities. I affirm that this structural-based approach finds its historical roots in a political and ideological context that provided the conditions for the development of community psychiatry experiences during the 1960s and 1970s, as well as in multicultural and gender policies promoted by the state since the 1990s. This case reveals how health institutions and practitioners have recently engaged in debates on migration and intersectionality from a structural approach in Chile.

Parents' comprehensive health literacy and child health after attending extended home visiting in Swedish multicultural settings-A case-comparison study.

BACKGROUND: Parents' low health literacy (HL) has negative impacts on child health. Parental interventions may improve parents' HL and thus impact child health positively. OBJECTIVES: This study aimed to gain knowledge about associations between parents' comprehensive HL (CHL) and child health after an extended postnatal home visiting program in Swedish multicultural, disadvantaged settings compared to parents receiving regular child healthcare (CHC). MATERIALS AND METHODS: This quasi-experimental study used a case-control sampling method to recruit first-time parents through two CHC centres in Stockholm (2017-2020). Participants (N = 151) were interviewed twice through structured questionnaires when their child was <2 months and 15-18 months old. HLS-EU-Q16 assessed parents' CHL. Children's medical records (0-18 months) were reviewed regarding breastfeeding, children's exposure to smoking, language development and healthcare utilisation. Data were analysed with regression models and non-parametric tests. RESULTS: No significant association was found between parents' CHL and child health. However, significantly fewer unplanned visits to the CHC centre were observed among children (0-18 months) in the intervention group irrespective of CHL, compared with children to parents with improved CHL in the comparison group (F = 3.856, p = 0.011). CONCLUSIONS: Postnatal home visiting interventions practicing proportional universalism and family-centred care may reduce unplanned visits within CHC in disadvantaged settings despite parents' CHL. Further studies with long-term follow-up are suggested to explore associations between parents' CHL and child health. TRIAL REGISTRATION: As a clinical study (not a clinical trial) with appropriate ethical permission with participants' consents, this study was retrospectively registered (18 February 2020) in the ISRCTN registry (ISRCTN10336603).

Insecure attachment and eating disorder symptoms: Intolerance of uncertainty and emotion regulation as mediators.

OBJECTIVE: Literature on eating disorder (ED) symptoms of Black, Indigenous, and People of Color (BIPOC) group is extremely scarce. This study aimed to understand the mechanisms underlying the associations between insecure attachment and ED symptoms and examine whether these mechanisms differed between White and BIPOC groups. METHOD: The study investigated direct and indirect relationship between attachment anxiety/avoidance and ED symptoms via intolerance of uncertainty (IU) and emotion regulation strategies of suppression and reappraisal. Further, we examined whether the proposed mechanisms equally represented White versus BIPOC using Multigroup Structural Equation Model (MG-SEM). A total of 1227 college students (48.50% BIPOC and 51.50% White) completed research questionnaires. RESULTS: Results showed that IU and suppression mediated the relations between insecure attachment and ED symptoms for both White and BIPOC groups. Uniquely, reappraisal mediated the relations between insecure attachment and ED symptoms for the White group, but not for the BIPOC group. DISCUSSION: The implications of the findings for culturally informed practice are discussed, including targeting increasing tolerability of uncertainties and improving emotion regulation to mitigate ED symptoms for those with insecure attachment.

'The Relentless Nature of Whiteness': Black Psychologists' Experiences of Racial Microaggressions in Cross-Cultural Supervision.

OBJECTIVES: Research suggests that cross-cultural supervision can be prone to microaggressions with deleterious effects for ethno-racial minorities. There are currently no known studies examining the impact of racial microaggressions in supervision on qualified psychologists. This study aimed to explore Black psychologists' experiences of microaggressions in supervision with a White supervisor and their impact. METHODS: Semi-structured interviews were conducted with 10 individuals who had completed clinical or counselling psychology doctoral training. Interviews were transcribed and analysed using interpretative phenomenological analysis. RESULTS: Three superordinate themes and 12 subthemes were derived from the analysis. The superordinate themes were: 'It's the subtle things', 'It's an ordeal' and 'Surviving Whiteness in psychology'. The findings illustrate the complex nature of racial microaggressions and their profound and lasting impact on individuals. The cumulative impact of these experiences resulted in significant negative psychological outcomes. CONCLUSIONS: The results suggest that there are common microaggressions that recur in supervision. Encountering microaggressions impeded the supervisory relationship, supervision and professional development. Clinical implications include recommendations for including multicultural competency in psychology trainings and ongoing professional development plans.

The development of the Broaching Assessment Scale: A client-rated measure of therapists' broaching behaviour in clinical counselling.

Objective: Addressing ethnic-cultural topics during the process of psychotherapy, i.e. broaching, is considered highly important for ethnic minority clients who consult mental health care services. Surprisingly little is known, however, about clients' perception of a therapist's broaching qualities, and how clients' mental construction of broaching translates into behavioural broaching acts a therapist may display.Method: Based on previous work and nine in-depth interviews with ethnic minority clients, a client-rated measure of therapists' broaching behaviour was developed and psychometrically evaluated in two samples. Sample 1 (N = 252 UK ethnic minority clients) was used to empirically delineate the factor structure of an initial item set. Participants were then resolicited to complete a revised item pool.Results: The empirical structure resulted in a final 25-item broaching instrument with five subscales probing into therapists' broaching behaviour. This Broaching Assessment Scale (BrAS) was validated in Sample 2 (N = 239 US ethnic minority clients). Strict measurement invariance of the factor structure was observed across the two samples and distinctive correlational patterns with therapeutic process measures were found.Conclusion: The BrAS provides new insights on how sensitivity to ethnic-cultural topics can be targeted along its concrete features, and is a promising tool for conceptualizing culturally sensitive mental healthcare assessment.

Common Language Development in Multilingual Contexts: A Study of Russian Language Policy in the Early Years of the Soviet Union.

In the field of Russian linguistics, history, and jurisprudence, the Russian language is widely regarded as a political instrument and, to some extent, reflects the development and influence of contemporary language policy of the Russian language in the Soviet Union. This study aims to examine the process, characteristics, influencing psychological and sociological factors, and consequences of Russian language policy in the early Soviet Union (1917-1930s). Thematic analysis and discourse strategy analysis methods were employed to achieve this goal. The results indicate that a well-thought-out language policy necessitates the establishment of language legislation and a precise legal definition of the status and use of different languages. The absence of language legislation can be a major drawback of language policy. While the Soviet Constitution and other relevant political documents broadly define the status and use of Russian and other languages, there is no specific language legislation regulating the use of each language. Analysis of word frequency statistics demonstrates that the key concepts of Stalinist policy differed compared to the time of Lenin's rule, resulting in a lack of effective legal force and strong mechanisms for controlling language policy practices. As the functional advantages of the Russian language become increasingly evident, some ethnic minorities tend to lean towards studying and using it, leading to the emergence of many bilingual and even trilingual individuals. Other minorities with small or underdeveloped populations turn to the Russian language, which is the most widely spoken language. These findings contribute to the theoretical and practical knowledge base for research in the fields of linguistics, linguistic culturology, history, psycholinguistics, and political science. Subsequent research can focus on current aspects of the country's language policy.

Nursing roles in disaster zones: Experiences and lessons from Turkey's 2023 earthquakes.

BACKGROUND: Disasters affect human health and well-being globally. Nursing plays a vital role in disaster preparedness and response, ensuring efficient early care coordination and delivering effective field treatment. AIM: This study investigates the challenges an Israeli humanitarian delegation encountered during their response to major earthquakes in Turkey in 2023. It explicitly focuses on difficulties in preparation, operations, and collaboration with local teams. The study further analyzes the findings and extracts valuable lessons from the mission. METHODS: Using a qualitative descriptive design, 22 out of 32 nurses involved in delegation participated in three focus group discussions within two months of returning to Israel. The discussions were recorded, transcribed verbatim, and analyzed thematically. The study followed the COREQ guidelines, ensuring comprehensive reporting and methodological rigor in qualitative research. FINDINGS: The study's main findings spanned predeparture preparation, mission challenges in the disaster zone, and postmission lessons, each highlighted by subthemes and participant quotations. A strong sense of mission was evident among the participants, along with frustration at inefficient time management prior to deployment. Many participants noted additional challenges, related to the difficulty of working in multiple languages and across cultures, and the opportunities for resolution. Finally, participants called for better psychological support following the mission. CONCLUSION: Nurses in disaster zones offer valuable insights to enhance preparation, cross-cultural communication, and postmission implementation. NURSING AND HEALTH POLICY IMPLICATIONS: Nurse managers and healthcare policymakers can utilize this study's findings to develop future nursing training programs in disaster-related skills. Additionally, it can help foster collaboration among international healthcare teams.

Trends in diversity-related learning among secondary schools in 35 US states, 2014-2018.

Objective: School Health Profiles (Profiles) is a national surveillance system operated by the US Centers for Disease Control and Prevention. A school-based system of surveys, Profiles monitors school health policies and practices in US states and other jurisdictions through questionnaires completed by school principals and lead health education teachers. This study used the Profiles principal survey to identify trends in US schools' implementation of diversity-related learning opportunities (i.e., opportunities to learn about people who are different from them) in secondary classroom and extracurricular settings. Methods: Logistic regression models using data from three cycles of School Health Profiles from 35 US states examined trends in the percentages of secondary schools offering students diversity-related learning opportunities in the following settings, each measured by using dichotomous yes/no response options: a) clubs; b) lessons in class; and c) special events (e.g., multicultural week, family night) sponsored by the school or community organisations. Results: During 2014-2018, no states experienced decreases in opportunities for students to learn about people who are different from them; most states demonstrated no significant change. Conclusion: Findings suggest efforts are needed to strengthen capacity for and prioritisation of policies, programmes, and practices promoting diversity and culturally relevant education in schools, and in turn, promote positive health and educational outcomes for youth.