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Fasoli F, Formanowicz M. Can agentic messages help? Linguistic strategies to counteract voice-based sexual orientation discrimination. Br J Soc Psychol 2024. [PMID: 38451067 DOI: 10.1111/bjso.12739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 02/23/2024] [Indexed: 03/08/2024]
Abstract
Gay men who believe to sound 'gay' expect to be discriminated against because of their voices and gay-sounding men are discriminated against in the hiring process. We examined whether uttering an agency-based message decreased discrimination expectancy and enactment. In Study 1a (N = 256; gay and bisexual men) and Study 1b (N = 216; gay men), speakers uttered agentic (vs. neutral) messages. We assessed their self-perception as gay sounding, agency self-attribution and discrimination expectancy. Uttering agentic (vs. neutral) messages made the speakers self-perceive as more agentic and this decreased discrimination expectancy. Additionally, self-perception as gay sounding predicted discrimination expectancy. In Study 2 (N = 466), heterosexual participants listened to gay- and straight-sounding speakers uttering either neutral or agentic messages and rated them in terms of agency and employability. Gay-sounding speakers uttering agentic messages were less likely to be discriminated against than when uttering neutral messages. Results show the positive impact of linguistic strategies involving agentic messages to reduce discrimination expectancy and hiring biases.
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Affiliation(s)
- Fabio Fasoli
- School of Psychology, University of Surrey, Guildford, UK
- Centro de Investigação e Intervenção Social, Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
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Gala P, Ticku A, Pawar T, Sapre S, Gupta P, Iyer K, Kapoor H, Kalahasthi R, Kulkarni S, Iyer P. Perspectives and presentation of mental health among women from rural Maharashtra (India): A qualitative study. Glob Ment Health (Camb) 2024; 11:e40. [PMID: 38618481 PMCID: PMC11016358 DOI: 10.1017/gmh.2024.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/21/2024] [Accepted: 02/23/2024] [Indexed: 04/16/2024] Open
Abstract
Objectives A significant gap is observed between the proportion of individuals suffering from mental health (MH)-related conditions and those receiving adequate MH care services, especially in rural areas. This study highlights and contextualizes MH concerns and its extant knowledge as well as gender roles in rural Maharashtra (India). Methods Using in-depth interviews, MH themes were highlighted analytically among 72 female beneficiaries of Svatantra from the six administrative divisions (Konkan, Nashik, Pune, Aurangabad, Amravati and Nagpur) in the state of Maharashtra, India. Results The notion that MH concerns exist among women from rural communities was well supported. Along with MH concerns, the participants reported somatic concerns in the context of adverse life experiences. Furthermore, systemic issues such as financial problems, familial concerns, presence of addictions and pressures of gender role-related responsibilities were significant triggers for MH problems. Conclusions Overall, this study aimed at improving the understanding of the MH needs of women in rural Maharashtra, which can further catalyze an exploration of their general MH and devise suitable interventions for the same.
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Affiliation(s)
| | | | | | | | - Pooja Gupta
- Department of Psychiatry, National institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Hansika Kapoor
- Department of Psychology, Monk Prayogshala, Mumbai, India
| | | | | | - Poorvi Iyer
- London School of Economics and Political Science, London, UK
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Marbaniang I, Moodie EEM, Latimer E, Skakoon-Sparling S, Hart TA, Grace D, Moore DM, Lachowsky NJ, Jollimore J, Lambert G, Zhang T, Dvorakova M, Cox J. Using an intersectionality-based approach to evaluate mental health services use among gay, bisexual and other men who have sex with men in Montreal, Toronto and Vancouver. Epidemiol Psychiatr Sci 2024; 33:e10. [PMID: 38438301 PMCID: PMC10940056 DOI: 10.1017/s2045796024000143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/18/2024] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
AIMS To cope with homonegativity-generated stress, gay, bisexual and other men who have sex with men (GBM) use more mental health services (MHS) compared with heterosexual men. Most previous research on MHS among GBM uses data from largely white HIV-negative samples. Using an intersectionality-based approach, we evaluated the concomitant impact of racialization and HIV stigma on MHS use among GBM, through the mediating role of perceived discrimination (PD). METHODS We used baseline data from 2371 GBM enrolled in the Engage cohort study, collected between 2017 and 2019, in Montreal, Toronto and Vancouver, using respondent-driven sampling. The exposure was GBM groups: Group 1 (n = 1376): white HIV-negative; Group 2 (n = 327): white living with HIV; Group 3 (n = 577): racialized as non-white HIV-negative; Group 4 (n = 91): racialized as non-white living with HIV. The mediator was interpersonal PD scores measured using the Everyday Discrimination Scale (5-item version). The outcome was MHS use (yes/no) in the prior 6 months. We fit a three-way decomposition of causal mediation effects utilizing the imputation method for natural effect models. We obtained odds ratios (ORs) for pure direct effect (PDE, unmediated effect), pure indirect effect (PIE, mediated effect), mediated interaction effect (MIE, effect due to interaction between the exposure and mediator) and total effect (TE, overall effect). Analyses controlled for age, chronic mental health condition, Canadian citizenship, being cisgender and city of enrolment. RESULTS Mean PD scores were highest for racialized HIV-negative GBM (10.3, SD: 5.0) and lowest for white HIV-negative GBM (8.4, SD: 3.9). MHS use was highest in white GBM living with HIV (GBMHIV) (40.4%) and lowest in racialized HIV-negative GBM (26.9%). Compared with white HIV-negative GBM, white GBMHIV had higher TE (OR: 1.71; 95% CI: 1.27, 2.29) and PDE (OR: 1.68; 95% CI: 1.27, 2.24), and racialized HIV-negative GBM had higher PIE (OR: 1.09; 95% CI: 1.02, 1.17). Effects for racialized GBMHIV did not significantly differ from those of white HIV-negative GBM. MIEs across all groups were comparable. CONCLUSIONS Higher MHS use was observed among white GBMHIV compared with white HIV-negative GBM. PD positively mediated MHS use only among racialized HIV-negative GBM. MHS may need to take into account the intersecting impact of homonegativity, racism and HIV stigma on the mental health of GBM.
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Affiliation(s)
- Ivan Marbaniang
- Department of Epidemiology, McGill University, Montreal, QC, Canada
| | - Erica E. M. Moodie
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Eric Latimer
- Mental Health and Society Division, Douglas Research Centre, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Shayna Skakoon-Sparling
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Trevor A. Hart
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - David M. Moore
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- Department of Medicine, Division of Infectious Disease, University of British Columbia, Vancouver, BC, Canada
| | - Nathan J. Lachowsky
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | | | - Gilles Lambert
- Institut National de Santé Publique du Québec, Montreal, QC, Canada
| | - Terri Zhang
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Milada Dvorakova
- Clinical Outcomes Research and Evaluation, Research Institute–McGill University Health Centre, Montreal, QC, Canada
| | - Joseph Cox
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
- Clinical Outcomes Research and Evaluation, Research Institute–McGill University Health Centre, Montreal, QC, Canada
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Zhou AE, Jain NP, Gronbeck C, Muzumdar S, Grant-Kels JM, Feng H. Ethics of Social Media Consent Forms. J Am Acad Dermatol 2024:S0190-9622(24)00443-2. [PMID: 38452819 DOI: 10.1016/j.jaad.2024.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/13/2024] [Accepted: 02/27/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Albert E Zhou
- Department of Dermatology, University of Connecticut, Farmington, CT, USA
| | - Neelesh P Jain
- Department of Dermatology, University of Connecticut, Farmington, CT, USA
| | - Christian Gronbeck
- Department of Dermatology, University of Connecticut, Farmington, CT, USA
| | - Sonal Muzumdar
- Department of Dermatology, University of Connecticut, Farmington, CT, USA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut, Farmington, CT, USA; Department of Dermatology, University of Florida, Gainesville, FL, USA
| | - Hao Feng
- Department of Dermatology, University of Connecticut, Farmington, CT, USA.
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Valentine SE, Gell-Levey IM, Godfrey LB, Livingston NA. The Associations Between Gender Minority Stressors and PTSD Symptom Severity Among Trauma-Exposed Transgender and Gender Diverse Adults. J Trauma Dissociation 2024:1-14. [PMID: 38436077 DOI: 10.1080/15299732.2024.2323977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/20/2023] [Indexed: 03/05/2024]
Abstract
This study investigates associations between minority stressors, traumatic stressors, and post-traumatic stress disorder (PTSD) symptom severity in a sample of transgender and gender diverse (TGD) adults. We utilized surveys and clinical interview assessments to assess gender minority stress exposures and responses, and PTSD. Our sample (N = 43) includes adults who identified as a minoritized gender identity (i.e., 39.5% trans woman or woman, 25.6% trans man or man, 23.3% genderqueer or nonbinary, 11.6% other identity). All participants reported at least one traumatic event (i.e., life threat, serious injury, or sexual harm). The most common trauma events reported by the sample were sexual (39.5%) and physical violence (37.2%), with 40.9% of participants anchoring their symptoms to a discrimination-based event. PTSD symptom severity was positively correlated with both distal (r = 0.36, p = .017) and proximal minority stressors (r = 0.40, p < .01). Distal minority stress was a unique predictor of current PTSD symptom severity (b = 0.94, p = .017), however, this association was no longer significant when adjusting for proximal minority stress (b = 0.18, p = 0.046). This study suggests that minority stress, especially proximal minority stress, is associated with higher PTSD symptom severity among TGD adults.
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Affiliation(s)
- Sarah E Valentine
- Department of Psychiatry, Boston Medical Center, Boston, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, USA
| | | | - Laura B Godfrey
- Department of Psychiatry, Boston Medical Center, Boston, USA
| | - Nicholas A Livingston
- Department of Psychiatry, Boston University School of Medicine, Boston, USA
- National Center for PTSD, Behavioral Science Division, Boston, USA
- US Department of Veteran Affairs, VA Boston Healthcare System, Boston, USA
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Younossi ZM, Alqahtani SA, Alswat K, Yilmaz Y, Keklikkiran C, Funuyet-Salas J, Romero-Gómez M, Fan JG, Zheng MH, El-Kassas M, Castera L, Liu CJ, Wai-Sun Wong V, Zelber-Sagi S, Allen AM, Lam B, Treeprasertsuk S, Hameed S, Takahashi H, Kawaguchi T, Schattenberg JM, Duseja A, Newsome PN, Francque S, Spearman CW, Castellanos Fernández MI, Burra P, Roberts SK, Chan WK, Arrese M, Silva M, Rinella M, Singal AK, Gordon S, Fuchs M, Alkhouri N, Cusi K, Loomba R, Ranagan J, Eskridge W, Kautz A, Ong JP, Kugelmas M, Eguchi Y, Diago M, Yu ML, Gerber L, Fornaresio L, Nader F, Henry L, Racila A, Golabi P, Stepanova M, Carrieri P, Lazarus JV. Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease. J Hepatol 2024; 80:419-430. [PMID: 37984709 DOI: 10.1016/j.jhep.2023.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND & AIMS Patients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers. METHODS Members of the Global NASH Council created two surveys about experiences/attitudes toward NAFLD and related diagnostic terms: a 68-item patient and a 41-item provider survey. RESULTS Surveys were completed by 1,976 patients with NAFLD across 23 countries (51% Middle East/North Africa [MENA], 19% Europe, 17% USA, 8% Southeast Asia, 5% South Asia) and 825 healthcare providers (67% gastroenterologists/hepatologists) across 25 countries (39% MENA, 28% Southeast Asia, 22% USA, 6% South Asia, 3% Europe). Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was "fatty liver" (88% at least sometimes); "metabolic disease" or "MAFLD" were rarely used (never by >84%). Regarding various perceptions of diagnostic terms by patients, there were no substantial differences between "NAFLD", "fatty liver disease (FLD)", "NASH", or "MAFLD". The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with "FLD" among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD. Among providers, 38% believed that the term "fatty" was stigmatizing, while 34% believed that "nonalcoholic" was stigmatizing, more commonly in MENA (43%); 42% providers (gastroenterologists/hepatologists 45% vs. 37% other specialties, p = 0.03) believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting "steatotic liver disease" as stigmatizing was low (14%). CONCLUSIONS The perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties. IMPACT AND IMPLICATIONS Over the past decades, efforts have been made to change the nomenclature of nonalcoholic fatty liver disease (NAFLD) to better align with its underlying pathogenetic pathways and remove any potential stigma associated with the name. Given the paucity of data related to stigma in NAFLD, we undertook this global comprehensive survey to assess stigma in NAFLD among patients and providers from around the world. We found there is a disconnect between physicians and patients related to stigma and related nomenclature. With this knowledge, educational programs can be developed to better target stigma in NAFLD among all stakeholders and to provide a better opportunity for the new nomenclature to address the issues of stigma.
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Affiliation(s)
- Zobair M Younossi
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; The Global NASH Council, Washington, DC, USA.
| | - Saleh A Alqahtani
- The Global NASH Council, Washington, DC, USA; Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD, USA; Alfaisal University, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Khalid Alswat
- The Global NASH Council, Washington, DC, USA; Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Yusuf Yilmaz
- The Global NASH Council, Washington, DC, USA; Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Caglayan Keklikkiran
- The Global NASH Council, Washington, DC, USA; Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Jesús Funuyet-Salas
- The Global NASH Council, Washington, DC, USA; Department of Personality, Assessment, and Psychological Treatment, Faculty of Psychology, University of Seville, Seville, Spain
| | - Manuel Romero-Gómez
- The Global NASH Council, Washington, DC, USA; UCM Digestive Diseases and ciberehd, Virgen del Rocío University Hospital; Instituto de Biomedicina de Sevilla (HUVR/CSIC/US), Department of Medicine, University of Seville, Seville, Spain
| | - Jian-Gao Fan
- The Global NASH Council, Washington, DC, USA; Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ming-Hua Zheng
- The Global NASH Council, Washington, DC, USA; MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, China
| | - Mohamed El-Kassas
- The Global NASH Council, Washington, DC, USA; Infectious Diseases and Hepatology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Laurent Castera
- The Global NASH Council, Washington, DC, USA; Department of Hepatology, Beaujon Hospital; AP-HP, Université Paris Cité, Inserm UMR1149, Clichy, France
| | - Chun-Jen Liu
- The Global NASH Council, Washington, DC, USA; Hepatitis Research Center, Department of Internal Medicine and Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Vincent Wai-Sun Wong
- The Global NASH Council, Washington, DC, USA; Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shira Zelber-Sagi
- The Global NASH Council, Washington, DC, USA; School of Public Health, University of Haifa, Haifa, Israel
| | - Alina M Allen
- The Global NASH Council, Washington, DC, USA; Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Brian Lam
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; The Global NASH Council, Washington, DC, USA
| | - Sombat Treeprasertsuk
- The Global NASH Council, Washington, DC, USA; Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand
| | - Saeed Hameed
- The Global NASH Council, Washington, DC, USA; Department of Medicine, Clinical Trials Unit, Aga Khan University, Karachi, Pakistan
| | - Hirokazu Takahashi
- The Global NASH Council, Washington, DC, USA; Liver Center, Saga University Hospital, Saga, Japan
| | - Takumi Kawaguchi
- The Global NASH Council, Washington, DC, USA; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Jörn M Schattenberg
- The Global NASH Council, Washington, DC, USA; Metabolic Liver Research Program, Department of Medicine, University Medical Center Mainz, Mainz, Germany
| | - Ajay Duseja
- The Global NASH Council, Washington, DC, USA; Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Phil N Newsome
- The Global NASH Council, Washington, DC, USA; University of Birmingham, Birmingham, UK
| | - Sven Francque
- The Global NASH Council, Washington, DC, USA; Department of Gastroenterology and Hepatology, Antwerp University Hospital; InflaMed Centre of Excellence, Translational Sciences in Inflammation and Immunology, Laboratory of Experimental Medicine and Paediatrics (LEMP), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - C Wendy Spearman
- The Global NASH Council, Washington, DC, USA; Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Marlen I Castellanos Fernández
- The Global NASH Council, Washington, DC, USA; Institute of Gastroenterology, University of Medical Sciences of Havana, Havana, Cuba
| | - Patrizia Burra
- The Global NASH Council, Washington, DC, USA; Department of Gastroenterology, Universita Degli Studi Di Padova, Padova, Italy
| | - Stuart K Roberts
- The Global NASH Council, Washington, DC, USA; The Alfred, Melbourne, VIC, Australia
| | - Wah-Kheong Chan
- The Global NASH Council, Washington, DC, USA; University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Marco Arrese
- The Global NASH Council, Washington, DC, USA; Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo Silva
- The Global NASH Council, Washington, DC, USA; Hepatology and Liver Transplant Unit, Austral University Hospital, Buenos Aires, Argentina
| | - Mary Rinella
- The Global NASH Council, Washington, DC, USA; Pritzker School of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Ashwani K Singal
- The Global NASH Council, Washington, DC, USA; Division of Gastroenterology and Hepatology, University of Louisville School of Medicine; Trager Transplant Center and Jewish Hospital, Louisville, KY, USA
| | - Stuart Gordon
- The Global NASH Council, Washington, DC, USA; William Beaumont Hospital, Royal Oak, MI, USA
| | - Michael Fuchs
- The Global NASH Council, Washington, DC, USA; Central Virginia VA Health Care System (CVHCS); Virginia Commonwealth University (VCU), Richmond, VA, USA
| | - Naim Alkhouri
- The Global NASH Council, Washington, DC, USA; Arizona Liver Health, Phoenix, AZ, USA
| | - Kenneth Cusi
- The Global NASH Council, Washington, DC, USA; Division of Endocrinology, Diabetes and Metabolism, The University of Florida, Gainesville, FL, USA
| | - Rohit Loomba
- The Global NASH Council, Washington, DC, USA; University of California, San Diego, San Diego, CA, USA
| | - Jane Ranagan
- The Global NASH Council, Washington, DC, USA; Focus Medical Communications, East Hanover, NJ, USA
| | - Wayne Eskridge
- The Global NASH Council, Washington, DC, USA; Fatty Liver Foundation, Boise, ID, USA
| | - Achim Kautz
- The Global NASH Council, Washington, DC, USA; Kautz5 gUG, Köln, Germany
| | - Janus P Ong
- The Global NASH Council, Washington, DC, USA; College of Medicine, University of the Philippines, Manila, Philippines
| | - Marcelo Kugelmas
- The Global NASH Council, Washington, DC, USA; Department of Hepatology and Research, South Denver Gastroenterology, PC, Englewood, CO, USA
| | - Yuichiro Eguchi
- The Global NASH Council, Washington, DC, USA; Loco Medical General Institute; Saga University Faculty of Medicine, Saga, Japan
| | - Moises Diago
- The Global NASH Council, Washington, DC, USA; Department of Medicine, University of Valencia; Hospital General Universitario Valencia, Valencia, Spain
| | - Ming-Lung Yu
- The Global NASH Council, Washington, DC, USA; School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-Sen University; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Lynn Gerber
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; The Global NASH Council, Washington, DC, USA
| | - Lisa Fornaresio
- Division of Cardiac Surgery, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Fatema Nader
- The Global NASH Council, Washington, DC, USA; Center for Outcomes Research in Liver Diseases, Washington, DC, USA
| | - Linda Henry
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; The Global NASH Council, Washington, DC, USA; Center for Outcomes Research in Liver Diseases, Washington, DC, USA
| | - Andrei Racila
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh, India; Center for Outcomes Research in Liver Diseases, Washington, DC, USA
| | - Pegah Golabi
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; Center for Outcomes Research in Liver Diseases, Washington, DC, USA
| | - Maria Stepanova
- Beatty Liver and Obesity Research Program, Inova Health System, Falls Church, VA, USA; Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, VA, USA; The Global NASH Council, Washington, DC, USA; Center for Outcomes Research in Liver Diseases, Washington, DC, USA
| | - Patrizia Carrieri
- The Global NASH Council, Washington, DC, USA; Aix Marseille Univ, Inserm, IRD, Sesstim, Sciences Economiques & Sociales De La Santé Et Traitement De L'information Médicale, Marseille, France
| | - Jeffrey V Lazarus
- The Global NASH Council, Washington, DC, USA; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
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Paulden M, Sampson C, O'Mahony JF, Spackman E, McCabe C, Round J, Snowsill T. Logical Inconsistencies in the Health Years in Total and Equal Value of Life-Years Gained. Value Health 2024; 27:356-366. [PMID: 38048985 DOI: 10.1016/j.jval.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 10/07/2023] [Accepted: 11/08/2023] [Indexed: 12/06/2023]
Abstract
OBJECTIVES This study aimed to assess whether recently proposed alternatives to the quality-adjusted life-year (QALY), intended to address concerns about discrimination, are suitable for informing resource allocation decisions. METHODS We consider 2 alternatives to the QALY: the health years in total (HYT), recently proposed by Basu et al, and the equal value of life-years gained (evLYG), currently used by the Institute for Clinical and Economic Review. For completeness we also consider unweighted life-years (LYs). Using a hypothetical example comparing 3 mutually exclusive treatment options, we consider how calculations are performed under each approach and whether the resulting rankings are logically consistent. We also explore some further challenges that arise from the unique properties of the HYT approach. RESULTS The HYT and evLYG approaches can result in logical inconsistencies that do not arise under the QALY or LY approaches. HYT can violate the independence of irrelevant alternatives axiom, whereas the evLYG can produce an unstable ranking of treatment options. HYT have additional issues, including an implausible assumption that the utilities associated with health-related quality of life and LYs are "separable," and a consideration of "counterfactual" health-related quality of life for patients who are dead. CONCLUSIONS The HYT and evLYG approaches can result in logically inconsistent decisions. We recommend that decision makers avoid these approaches and that the logical consistency of any approaches proposed in future be thoroughly explored before considering their use in practice.
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Affiliation(s)
- Mike Paulden
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | | | | | - Eldon Spackman
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Christopher McCabe
- Centre for Public Health and Queens Management School, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Jeff Round
- Institute of Health Economics, Edmonton, AB, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Tristan Snowsill
- Health Economics Group, University of Exeter, Exeter, England, UK
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Abstract
Standard-accented job candidates are perceived as more hireable than non-standard-accented candidates. Two broad perspectives have emerged as to what drives this effect: (a) that it is a pragmatic response to the perception that non-standard accents can impede job-relevant communication (processing fluency explanation) and/or (b) that non-standard accents signal "otherness" and candidates are devalued as a result (prejudice explanation). This meta-analytic integration of 139 effect sizes (N = 4,576) examined these two perspectives. Standard-accented candidates were considered more hireable than non-standard-accented candidates (d = 0.47)-a bias that was stronger for high communication jobs. Other findings, however, are difficult to explain from a processing fluency explanation: candidates' relative comprehensibility was not a significant moderator of hiring bias. Moreover, the degree of accent bias was associated with perceptions of the candidates' social status, and accent bias was particularly pronounced among female candidates and for candidates who spoke in foreign (as compared with regional) accents.
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Affiliation(s)
| | | | | | - Kana Imuta
- The University of Queensland, Brisbane, Australia
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59
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Salcido VV, Stein GL. Proactive coping with discrimination: A mediator between ethnic-racial socialization and Latinx youth's internalizing symptoms. J Res Adolesc 2024; 34:45-55. [PMID: 37902094 DOI: 10.1111/jora.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 09/14/2023] [Accepted: 09/29/2023] [Indexed: 10/31/2023]
Abstract
There is a dearth of knowledge in the coping literature on how minoritized youth cope with racism-related stressors and the predictors of effective coping responses. This two-wave study examined the direct and indirect effects of ethnic-racial socialization on depressive and anxiety symptoms via proactive coping with discrimination in a community sample of 135 Latinx adolescents (Mage = 16, SD = 1.27; 59% female). Results indicate that cultural socialization was related to higher use of proactive coping with discrimination 6 months later, which in turn, was related to fewer depressive and anxiety symptoms. There were no direct or indirect effects between preparation for bias and mental health outcomes.
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Affiliation(s)
- Valerie V Salcido
- The University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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60
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Mutambudzi M, Brown MT, Chen NW. Association of Epigenetic Age and Everyday Discrimination With Longitudinal Trajectories of Chronic Health Conditions in Older Adults. J Gerontol A Biol Sci Med Sci 2024; 79:glae005. [PMID: 38190429 PMCID: PMC10878241 DOI: 10.1093/gerona/glae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Indexed: 01/10/2024] Open
Abstract
We investigated the strength of the association between baseline epigenetic age, everyday discrimination, and trajectories of chronic health conditions (CHCs) across 3 study waves, among adults 50 years of age and older. We used 2016-2020 data from the Health and Retirement Study (HRS). Data for the PhenoAge and DNAm GrimAge second-generation epigenetic clocks were from the 2016 HRS Venous Blood Study. CHC trajectories were constructed using latent class growth curve models. Multinomial logistic regression models assessed the strength of the association between accelerated epigenetic age, everyday discrimination, and the newly constructed CHC trajectories for participants with complete data (n = 2 893). In the fully adjusted model, accelerated PhenoAge (relative risk ratios [RRR] = 2.53, 95% confidence interval [95% CI] = 1.81, 3.55) and DNAm GrimAge (RRR = 2.79, 95% CI = 1.95, 4.00) were associated with classification into the high CHC trajectory class. Racial disparities were evident, with increased risk of classification into the high trajectory class for Black (PhenoAge: RRR = 1.69, 95% CI = 1.07, 2.68) and reduced risk for Hispanic (PhenoAge: RRR = 0.32, 95% CI = 0.16, 0.64; DNAm GrimAge: RRR = 0.34, 95% CI = 0.17, 0.68), relative to White participants. Everyday discrimination was associated with classification into the medium-high (RRR = 1.28, 95% CI = 1.00, 1.64) and high (RRR = 1.52, 95% CI = 1.07, 2.16) trajectory classes in models assessing DNAm GrimAge. More research is needed to better understand the longitudinal health outcomes of accelerated aging and adverse social exposures. Such research may provide insights into vulnerable adults who may need varied welfare supports earlier than the mandated chronological age for access to federal and state resources.
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Affiliation(s)
- Miriam Mutambudzi
- Department of Public Health, Falk College of Sports and Human Dynamic, Syracuse University, Syracuse, New York, USA
| | - Maria T Brown
- School of Social Work and Aging Studies Institute, Syracuse University, Syracuse, New York, USA
| | - Nai-Wei Chen
- Department of Biomedical Informatics, Biostatistics and Medical Epidemiology, School of Medicine, University of Missouri, Columbia, Missouri, USA
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61
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Bloxom Q, Anderson B. Deconstructing Social Work Exam Bias: Advocacy Practice Guidelines to Close the Gap. J Evid Based Soc Work (2019) 2024; 21:236-264. [PMID: 37942617 DOI: 10.1080/26408066.2023.2278691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
INTRODUCTION The social work profession is in a precarious situation regarding licensure. Test takers of color are struggling to pass social work licensure exams at rates comparable to their White counterparts, per data released by the Association of Social Work Boards (ASWB). As a nation, we are required to meet the needs of our increasingly diverse population. Yet the recruitment and retention of a diverse body of social workers is unlikely to be actualized if disparities persist in these exams. Given ASWB's monopoly on social work exams and the likelihood that many states will continue to require the exams for licensure, we sought to explore public responses to the data released, using the National Association of Social Work (NASW) as our starting point. As the nation's largest association of social workers, having local chapters within each state, NASW serves as an area of connection between social workers nationwide. METHODS We utilized content analysis to explore emerging themes and conduct a review of the state chapter's public responses to exam pass rate data. RESULTS A variety of state chapter's responses, with few states engaging in advocacy efforts or taking action to facilitate change. DISCUSSION Advocacy efforts play a pivotal role in the restructuring of fragmented systems. This study revisits seemingly ignored disparities diverse test takers may face, while also serving as a call-to-action in advocacy engagement. We conclude with a set of advocacy practice guidelines for use in the promotion of equitable licensing opportunities for all test takers.
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Affiliation(s)
| | - Brandi Anderson
- College of Social Work, University of South Carolina, South Carolina, USA
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62
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Su S, Wang E, Su S. Perceived discrimination and multiple indicators of positive development among second-generation Chinese-American youth: The moderating role of ethnic identity. Child Care Health Dev 2024; 50:e13251. [PMID: 38529762 DOI: 10.1111/cch.13251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/20/2024] [Accepted: 02/24/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND The present study examined the associations among ethnic identity, perceived discrimination and multiple indicators of positive youth development (PYD; i.e., intrapersonal-oriented competence, interpersonal-oriented competence, confidence, caring, character, family connection, peer connection, school and community connection, positive attitudes towards diversity and cultural pride) that were specifically identified among second-generation Chinese-American youth. METHODS Participants were 196 second-generation Chinese-American youth (N girl = 93; M age = 14.56, SD age = 1.75) primarily from the greater Boston area in MA, United States. Multivariate regression models were estimated to examine the associations between ethnic identity, perceived discrimination, and each potential indicator of PYD, as well as the moderating role of ethnic identity, controlling for key demographics. RESULTS (1) Ethnic identity was positively related to all PYD indicators, βs = .32 to .72, ps < .01; (2) perceived discrimination was negatively associated with all indicators of PYD (βs = -.15 to -.32, ps < .05), except for interpersonal-oriented competence and caring; and (3) ethnic identity significantly moderated the relationship between perceived discrimination and family connection (β = .23, p < .01). CONCLUSIONS Findings indicate that whereas discrimination has potential negative effects on the positive development of second-generation Chinese-American youth, ethnic identity may be a key strength that should be considered in PYD promotion practices for these youth.
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Affiliation(s)
- Shaobing Su
- Implementation Science and Practice Advances Research Center (iSPARC), Department of Psychiatry, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Ellen Wang
- Stanford University, Stanford, California, USA
| | - Shaodan Su
- School of Law and Intellectual Property, Foshan University, Foshan, China
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Tyson L, Skinner J, Hariharan B, Josiah B, Okongwu K, Semlyen J. Tackling discrimination in medicine head on: The impact of bystander intervention training. Med Teach 2024:1-10. [PMID: 38401049 DOI: 10.1080/0142159x.2024.2316849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/06/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE A mixed-methods study to evaluate Bystander Intervention Training (BiT), a simulation-based small-group training programme designed to teach skills to tackle discrimination. MATERIALS AND METHODS Norwich Medical School delivered the intervention online between January 2020 and June 2023 to medical students, physician associate trainees, and qualified doctors. A sample of 569 participants was used in the main analysis. Participants completed pre- and post-training and follow-up evaluations. RESULTS Paired post-training scores were significantly different (all p < 0.001) from the pre-training scores for all 12 questions, in favour of the post-training scores. Of the 159 participants who completed follow-up questionnaires, 27 (17.9%) reported having the opportunity to be an active bystander; of those, 23 (85%) intervened. Scores in the follow-up questionnaire were significantly higher than those in the pre-training survey and significantly lower than those in the post-training questionnaire (p < 0.001). Participants had an increased sense of responsibility to be an active bystander and were empowered to challenge discrimination. Participants from marginalised groups expressed positive views about the training. CONCLUSIONS Interventions that allow open discussion and carefully supported personal disclosure in safe spaces, where difficult and uncomfortable discussions can occur, with an opportunity to change behaviour, must be developed to tackle discrimination.
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Affiliation(s)
- Leanne Tyson
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jane Skinner
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Benz Josiah
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Joanna Semlyen
- Norwich Medical School, University of East Anglia, Norwich, UK
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Surace A, Kang A, Kahler CW, Operario D. "I'm Gay With an Asterisk": How Intersecting Identities Influence LGBT Strengths. J Homosex 2024; 71:841-861. [PMID: 36480031 DOI: 10.1080/00918369.2022.2132579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Research attributes health disparities between sexual minority (those whose sexual orientation and/or practices differ from society, [SM]) and heterosexual populations to social marginalization. LGBT strengths (e.g., resiliency derived from LGBT identity) may reduce the impact of social marginalization. However, it is unclear how LGBT strengths are impacted by SMs' other identities (e.g., racial/ethnic and/or gender). To address this knowledge gap, the present study examined data from the LGBT Stress/Strength project, a qualitative research study investigating minority stress and LGBT strengths in relation to drinking. Participants (N = 22) were self-identified SMs in the northeastern U.S. Transcripts from in-depth interviews were coded using thematic analysis. Participants reported social support from other SMs and empathy toward others were forms of LGBT strength. Sampled SMs assigned female at birth had more intergenerational friendships and relied more on social support than those assigned male at birth. In addition, Black, indigenous, and people of color (BIPOC) participants described social marginalization from within the LGBT community, which reduced their reliance on social support. Our results suggest that LGBT strengths are influenced by LGBT community members intersecting identities. More research can expand upon these results by investigating how the confluence of SMs identities and LGBT strengths impact health disparities.
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Affiliation(s)
- Anthony Surace
- Public Health Institute, Alcohol Research Group, Emeryville, USA
| | - Augustine Kang
- Stanford University School of Medicine, Stanford, USA
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, USA
| | - Christopher W Kahler
- Center for Alcohol and Addictions Studies, Brown University School of Public Health, Providence, USA
| | - Don Operario
- Department of Behavioral and Social Sciences, Rollins School of Public Health, Atlanta, USA
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Okur S, Hashem T, Bogdanova E, Hodapp P, Heinke L, Bräse S, Wöll C. Optimized Detection of Volatile Organic Compounds Utilizing Durable and Selective Arrays of Tailored UiO-66-X SURMOF Sensors. ACS Sens 2024; 9:622-630. [PMID: 38320750 PMCID: PMC10898453 DOI: 10.1021/acssensors.3c01575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 12/27/2023] [Accepted: 01/05/2024] [Indexed: 02/24/2024]
Abstract
Metal-organic frameworks (MOFs), with their well-defined and highly flexible nanoporous architectures, provide a material platform ideal for fabricating sensors. We demonstrate that the efficacy and specificity of detecting and differentiating volatile organic compounds (VOCs) can be significantly enhanced using a range of slightly varied MOFs. These variations are obtained via postsynthetic modification (PSM) of a primary framework. We alter the original MOF's guest adsorption affinities by incorporating functional groups into the MOF linkers, which yields subtle changes in responses. These responses are subsequently evaluated by using machine learning (ML) techniques. Under severe conditions, such as high humidity and acidic environments, sensor stability and lifespan are of utmost importance. The UiO-66-X MOFs demonstrate the necessary durability in acidic, neutral, and basic environments with pH values ranging from 2 to 11, thus surpassing most other similar materials. The UiO-66-NH2 thin films were deposited on quartz-crystal microbalance (QCM) sensors in a high-temperature QCM liquid cell using a layer-by-layer pump method. Three different, highly stable surface-anchored MOFs (SURMOFs) of UiO-66-X obtained via the PSM approach (X: NH2, Cl, and N3) were employed to fabricate arrays suitable for electronic nose applications. These fabricated sensors were tested for their capability to distinguish between eight VOCs. Data from the sensor array were processed using three distinct ML techniques: linear discriminant (LDA), nearest neighbor (k-NN), and neural network analysis methods. The discrimination accuracies achieved were nearly 100% at high concentrations and over 95% at lower concentrations (50-100 ppm).
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Affiliation(s)
- Salih Okur
- Karlsruhe
Institute of Technology (KIT), Institute of Functional Interfaces, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Tawheed Hashem
- Karlsruhe
Institute of Technology (KIT), Institute of Functional Interfaces, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Evgenia Bogdanova
- Karlsruhe
Institute of Technology (KIT), Institute of Functional Interfaces, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Patrick Hodapp
- Karlsruhe
Institute of Technology (KIT), Institute for Biological Interfaces
3–Soft Matter Synthesis Laboratory (IBG3–SML), Kaiserstrasse 12, 76131 Karlsruhe, Germany
| | - Lars Heinke
- Karlsruhe
Institute of Technology (KIT), Institute of Functional Interfaces, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - Stefan Bräse
- Karlsruhe
Institute of Technology (KIT), Institute of Organic Chemistry (IOC), Kaiserstrasse 12,, 76131 Karlsruhe, Germany
- Karlsruhe
Institute of Technology (KIT), Institute of Biological and Chemical
Systems–Functional Molecular Systems (IBCS–FMS), Kaiserstrasse 12, 76131 Karlsruhe, Germany
| | - Christof Wöll
- Karlsruhe
Institute of Technology (KIT), Institute of Functional Interfaces, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
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Yang (杨菁艺) J, Saionz EL, Cavanaugh MR, Fahrenthold BK, Melnick MD, Tadin D, Briggs F, Carrasco M, Huxlin KR. Limited restoration of contrast sensitivity with training after V1 damage in humans. eNeuro 2024; 11:ENEURO.0020-24.2024. [PMID: 38395611 PMCID: PMC10941636 DOI: 10.1523/eneuro.0020-24.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Stroke damage to the primary visual cortex (V1) causes severe visual deficits, which benefit from perceptual retraining. However, whereas training with high-contrast stimuli can locally restore orientation and motion direction discrimination abilities at trained locations, it only partially restores luminance contrast sensitivity (CS). Recent work revealed that high-contrast discrimination abilities may be preserved in the blind field of some patients early after stroke. Here, we asked if CS for orientation and direction discrimination is similarly preserved inside the blind field, to what extent, and whether it could benefit from a visual training intervention. Thirteen subacute patients (<3 months post-V1-stroke) and 12 chronic patients (>6 months post-V1-stroke) were pre-tested, then trained to discriminate either orientation or motion direction of Gabor patches of progressively lower contrasts as their performance improved. At baseline, more subacute than chronic participants could correctly discriminate the orientation of high-contrast Gabors in their blind field, but all failed to perform this task at lower contrasts, even when 10Hz flicker or motion direction were added. Training improved CS in a greater portion of subacute than chronic participants, but no-one attained normal CS, even when stimuli contained flicker or motion. We conclude that, unlike the near-complete training-induced restoration of high-contrast orientation and motion direction discrimination abilities, V1 damage in adulthood may severely limit the residual visual system's ability to regain normal CS. Our results support the notion that CS involves different neural substrates and computations than those required for orientation and direction discrimination in V1-damaged visual systems.Significance statement Stroke-induced V1 damage in adult humans induces a rapid and severe impairment of contrast sensitivity for orientation and motion direction discrimination in the affected hemifield, although discrimination of high-contrast stimuli can persist for several months. Adaptive training with Gabor patches of progressively lower contrasts improves contrast sensitivity for both orientation and motion discriminations in the blind-field of subacute (<3 months post-stroke) and chronic (>6 months post-stroke) participants; however, it fails to restore normal contrast sensitivity. Nonetheless, more subacute than chronic stroke participants benefit from such training, particularly when discriminating the orientation of static, non-flickering targets. Thus, contrast sensitivity appears critically dependent on processing within V1, with perceptual training displaying limited potential to fully restore it after V1 damage.
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Affiliation(s)
- Jingyi Yang (杨菁艺)
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York 14642
- Department of Neuroscience, University of Rochester Medical Center, Rochester, New York 14642
- Center for Visual Science, University of Rochester, Rochester, New York 14627
| | - Elizabeth L. Saionz
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York 14642
- Center for Visual Science, University of Rochester, Rochester, New York 14627
| | - Matthew R. Cavanaugh
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York 14642
- Center for Visual Science, University of Rochester, Rochester, New York 14627
| | - Berkeley K. Fahrenthold
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York 14642
- Center for Visual Science, University of Rochester, Rochester, New York 14627
| | - Michael D. Melnick
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York 14642
- Center for Visual Science, University of Rochester, Rochester, New York 14627
- Department of Brain & Cognitive Sciences, University of Rochester, Rochester, New York 14627
| | - Duje Tadin
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York 14642
- Center for Visual Science, University of Rochester, Rochester, New York 14627
- Department of Brain & Cognitive Sciences, University of Rochester, Rochester, New York 14627
| | - Farran Briggs
- Department of Neuroscience, University of Rochester Medical Center, Rochester, New York 14642
- Center for Visual Science, University of Rochester, Rochester, New York 14627
- Department of Brain & Cognitive Sciences, University of Rochester, Rochester, New York 14627
| | - Marisa Carrasco
- Department of Psychology and Center for Neural Science, New York University, New York, New York 10003
| | - Krystel R. Huxlin
- Flaum Eye Institute, University of Rochester Medical Center, Rochester, New York 14642
- Department of Neuroscience, University of Rochester Medical Center, Rochester, New York 14642
- Center for Visual Science, University of Rochester, Rochester, New York 14627
- Department of Brain & Cognitive Sciences, University of Rochester, Rochester, New York 14627
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Fairlamb S, Cheso D, Giddens EK, Akhter ZJ. Death and Sexuality: Mortality Salience Increases Heteronormative Preferences and Stereotyping Among Those with High Need for Closure. J Homosex 2024; 71:758-774. [PMID: 36228166 DOI: 10.1080/00918369.2022.2132575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Terror Management Theory has shown that mortality salience can increase outgroup stereotyping and dislike of people who are different. We examined heterosexual participant reactions to profiles of homosexual and heterosexual men after mortality salience utilizing need for closure (NFC) as a moderating variable. We also examined the role of death-thought accessibility (DTA) in these effects. Among those with high NFC, mortality salience increased stereotyping and preference for the heterosexual individual. This effect only occurred when participants examined the profiles before completing the DTA measure. Control participants showed parallel reactions to the mortality salience condition when completing the DTA measure first. We found no reliable effects of mortality salience increasing DTA, and defensiveness decreasing DTA. The current findings demonstrate how two different death reminders can affect reactions to homosexual men among those in high NFC. Potential reasons for the lack of support for DTA in these effects are discussed.
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Affiliation(s)
- Samuel Fairlamb
- Psychology Department, Royal Holloway, University of London, Egham, UK
| | - Diana Cheso
- Psychology Department, Royal Holloway, University of London, Egham, UK
| | - Eloise K Giddens
- Psychology Department, Royal Holloway, University of London, Egham, UK
| | - Zaida J Akhter
- Psychology Department, Royal Holloway, University of London, Egham, UK
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Ojilere A. Discrimination on Grounds of Sexual Orientation and Gender Identity: The Limits of Human Rights in Africa. J Homosex 2024; 71:803-827. [PMID: 36264260 DOI: 10.1080/00918369.2022.2132577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The right to sexual orientation and gender identity (SOGI) are integral to and manifest in LGBTIQ rights including homosexuality and same-sex marriage. International law promotes these rights and prohibits discrimination on these grounds. Many western countries endorse these rights and prohibitions in parliamentary legislation or judicial fiat. In comparison with all other jurisdictions worldwide, and within the African sub-region, only South Africa specifically prohibits unfair direct or indirect discrimination based on "sexual orientation" in its national constitution. This paper explores African approach to SOGI and LGBTIQ rights including homosexuality and same-sex marriage. It argues that despite the threat of homocapitalism, prevalent Afrocentrism and religions reject these form of "new rights" for being immoral, ungodly, unnatural and un-African, thereby underlining the limits of human rights in the sub-region.
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Affiliation(s)
- Aloy Ojilere
- Faculty of Law, Imo State University, Owerri, Nigeria
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69
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Yazdani N, Hoyt LT, Pathak A, Breitstone L, Cohen AK. Inequalities in emerging adult college students' sleep quality during the COVID-19 pandemic. J Am Coll Health 2024:1-11. [PMID: 38376566 DOI: 10.1080/07448481.2024.2317178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To examine inequalities in sleep quality during the COVID-19 pandemic by gender, sexual orientation, race/ethnicity, and socioeconomic position (SEP), and test associations between discrimination and sleep quality in a national longitudinal cohort of emerging adult college students. PARTICIPANTS Participants were enrolled in college full-time and were aged 18-22 at baseline. METHODS Participants completed online surveys in spring 2020 (N = 707) and summer 2021 (n = 313). Measures included the Pittsburgh Sleep Quality Index (PSQI) and the Everyday Discrimination Scale. RESULTS Most students reported poor sleep quality (78% in 2020; 82% in 2021) and those from marginalized groups generally experienced worse sleep quality. Discrimination was associated with poorer concurrent sleep quality at both time points. CONCLUSIONS Sleep inequalities among college students continued to manifest during the pandemic, even when students were not necessarily on campus. Colleges should take a multi-pronged approach to promote sleep quality through individual, community, and institutional interventions.
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Affiliation(s)
- Neshat Yazdani
- Department of Psychology, Fordham University, Bronx, New York, USA
| | | | - Ayurda Pathak
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Lauren Breitstone
- Silver School of Social Work, New York University, New York, New York, USA
| | - Alison K Cohen
- Department of Epidemiology & Biostatistics, University of California San Francisco, School of Medicine, San Francisco, California, USA
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70
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El Halabi S, Fish E, Boroon M, de Filippis R, El Hayek S, Larnaout A, Ori D, Pinto da Costa M, Ramalho R, Ransing R, Raza F, Shalbafan M. The role of arts in moderating mental health-related stigma: views of early career psychiatrists and trainees from different parts of the world. Front Psychiatry 2024; 15:1293142. [PMID: 38445091 PMCID: PMC10912178 DOI: 10.3389/fpsyt.2024.1293142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/29/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Sarah El Halabi
- Westchester Medical Center Psychiatry Department, Valhalla, NY, United States
| | - Ely Fish
- Westchester Medical Center Psychiatry Department, Valhalla, NY, United States
| | - Mahsa Boroon
- Department of Psychiatry, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Samer El Hayek
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | - Amine Larnaout
- Department of Psychiatry, Razi Hospital, Faculty of Medicine, University of Tunis, El Manar, Tunisia
| | - Dorottya Ori
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
- Department of Mental Health, Heim Pal National Pediatric Institute, Budapest, Hungary
| | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Rodrigo Ramalho
- Department of Social and Community Health, University of Auckland, Auckland, New Zealand
| | - Ramdas Ransing
- Department of Psychiatry, Clinical Neurosciences and Addiction Medicine, All India Institute of Medical Sciences, Guwahati, Assam, India
| | - Fajar Raza
- Westchester Medical Center Psychiatry Department, Valhalla, NY, United States
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Adekoya P, Lannap FD, Ajonye FA, Amadiegwu S, Okereke I, Elochukwu C, Aruku CA, Oluwaseyi A, Kumolu G, Ejeh M, Olutola AO, Magaji D. Experiences of Stigmatization and Discrimination in Accessing Health Care Services Among People Living with HIV (PLHIV) in Akwa Ibom State, Nigeria. HIV AIDS (Auckl) 2024; 16:45-58. [PMID: 38406768 PMCID: PMC10891273 DOI: 10.2147/hiv.s447551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/01/2024] [Indexed: 02/27/2024] Open
Abstract
Background Recent advances in care and treatment have turned HIV into a "chronic but manageable condition". Despite this, some people living with HIV (PLHIV) continue to suffer from stigma and discrimination in accessing health care services. This study examined the experience of stigma and discrimination and access to health care services among PLHIV in Akwa Ibom State. Methods The Center for Clinical Care and Clinical Research (CCCRN), implementing a USAID-funded Integrated Child Health and Social Services Award (ICHSSA 1) project, conducted a community-based cross-sectional survey in 12 randomly selected local government areas in Akwa Ibom State, Nigeria. A structured quantitative questionnaire was used for data collection. In total, 425 randomly selected PLHIV were interviewed after providing informed consent. Descriptive statistics and bivariate analyses were conducted using the data analytical application Stata 14. Results The study revealed that 215 PLHIV (50.4%) had been denied access to health care services, including dental care, because of their HIV status in Akwa Ibom State. Respondents reported being afraid of: gossip (78%), being verbally abused (17%), or being physically harassed or assaulted because of their positive status (13%). Self-stigmatization was also evident; respondents reported being ashamed because of their positive HIV status (29%), exhibiting self-guilt (16%), having low self-esteem (38%), and experiencing self-isolation (36%). Women, rural residents, PLHIV with no education, unemployed, single, young people aged between 19 and 29 years, and older adults were more likely to experience HIV-related stigmatization. Conclusion Data from the study revealed that the percentage of PLHIV who experience health-related stigmatization because of their HIV status is high in Akwa Ibom State. This finding calls for the prioritization of interventions to reduce stigma, enhance self-esteem, and promote empathy and compassion for PLHIV. It also highlights the need for HIV education for family and community members and health care providers, to enhance the knowledge of HIV and improve acceptance of PLHIV within families, communities, and health care settings.
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Affiliation(s)
- Peters Adekoya
- Centre for Clinical Care and Clinical Research, Abuja, Nigeria
| | - Faith D Lannap
- Centre for Clinical Care and Clinical Research, Abuja, Nigeria
| | | | | | | | | | | | | | - Grace Kumolu
- Centre for Clinical Care and Clinical Research, Abuja, Nigeria
| | - Michael Ejeh
- Centre for Clinical Care and Clinical Research, Abuja, Nigeria
| | | | - Doreen Magaji
- United States Agency for International Development, Abuja, Nigeria
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72
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Alegría M, Cruz-Gonzalez M, Yip T, Wang L, Park IJK, Fukuda M, Valentino K, Giraldo-Santiago N, Zhen-Duan J, Alvarez K, Barrutia XA, Shrout PE. Yearly and Daily Discrimination-Related Stressors and Mexican Youth's Mental Health and Sleep: Insights From the First Wave of a Three-Wave Family Study. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00066-2. [PMID: 38367767 DOI: 10.1016/j.jaac.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/14/2023] [Accepted: 02/08/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Research is needed to examine discrimination-related stressors and their social and psychological shaping of mental health and sleep outcomes of Latinx youth. The background, design, and methodology of a longitudinal study of Mexican families in Indiana and the initial findings of associations between discrimination-related stressors and youth mental health and sleep outcomes are presented. METHOD Initiating wave 1 of a 3-wave (yearly) longitudinal study, investigators surveyed an ethnically homogeneous sample of 344 Mexican-origin adolescents (ages 12-15) and their primary caregivers, assessing risks and protective factors for mental health and sleep outcomes. Youth also completed a one-time 21-day daily diary after wave 1. Self-reported measures of youth mental health, sleep, and discrimination across wave 1 and the daily diary were evaluated to compare the cross-sectional (wave 1) and daily associations between discrimination and youth mental health and sleep outcomes. RESULTS Of youth, 88.1% reported at least one incident of lifetime discrimination. Almost one-third had elevated depressive symptoms, 44.5% had probable generalized anxiety disorder, and 50.9% had poor sleep quality. Between-youth correlations at wave 1 and in the daily diary were consistent in that perceived racial discrimination was positively correlated with worse mental health and poorer sleep quality. Smaller within-youth correlations were observed in the daily diary, but there was striking variability in the effect of discrimination across youth. CONCLUSION The present results illustrate the powerful methods of combining yearly and daily time data to investigate how and for whom discrimination-related stressors lead to adverse outcomes. DIVERSITY & INCLUSION STATEMENT We worked to ensure that the study questionnaires were prepared in an inclusive way. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. CLINICAL TRIAL REGISTRATION INFORMATION Seguimos Avanzando - Latino Youth Coping With Discrimination; https://clinicaltrials.gov/; NCT04875208.
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Affiliation(s)
- Margarita Alegría
- Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
| | - Mario Cruz-Gonzalez
- Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | | | - Lijuan Wang
- University of Notre Dame, Notre Dame, Indiana
| | - Irene J K Park
- Indiana University School of Medicine-South Bend, South Bend, Indiana
| | - Marie Fukuda
- Massachusetts General Hospital, Boston, Massachusetts
| | | | | | - Jenny Zhen-Duan
- Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Kiara Alvarez
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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73
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Sombrea DP, Santarin SLM, Verde TGM, Tidalgo AD, Tolosa CS. The Unheard Stories: Experiences of Young People Living with Human Immunodeficiency Virus in Dealing with Discrimination in the Philippines. HIV AIDS (Auckl) 2024; 16:33-43. [PMID: 38375060 PMCID: PMC10875183 DOI: 10.2147/hiv.s438280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/18/2023] [Indexed: 02/21/2024] Open
Abstract
Purpose The aim of this study is to gain an in-depth understanding of the experiences of young people living with the human immunodeficiency virus (YPLHIV) in dealing with discrimination and contribute to a more efficient response. Patients and Methods We utilised qualitative descriptive research-narrative inquiry. Twenty YPLHIV aged 19 to 24 under treatment from HIV hubs in Metro Manila, Philippines were purposely selected for an in-depth individual interview. Data were transcribed verbatim and manually coded and analysed using narrative thematic analysis. Results We found that HIV knowledge and beliefs of YPLHIV plays a huge role in their experience. Second, dealing with HIV stereotypes contributed to how they assume judgments from others (perceived stigma) and may have internalised the stigma which alters their belief toward self and the disease. Third, thoughts of suicide, experiencing emotional dissonance, and having difficulty embracing one's identity indicate declined mental health. Fourth, they continuously seek and may have received support from significant others and the community. Some may have directly received or perceived discrimination, but the YPLHIV reported that support received from others plays positively vital role in their journey. Finally, the disease helped change their behaviour and, in turn, brought them to lifestyle change as they are eager to be undetectable and untransmissible (U=U) and perpetually reflect on the ordeal challenge of adhering to treatment. Conclusion Our study concluded that the stigma and discrimination that YPLHIVs endured were caused by misinformation about the disease and stems from both within themselves and from others around them. Support received from friends, family members, and the community helped them deal with their circumstances. We recommend that efforts be made by both the government and non-government to develop programs distinctly for YPLHIV. Future research may explore the mental health aspect as this has been found concerning in the narratives among young population patients.
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Affiliation(s)
- Donna P Sombrea
- Psychology Department, Adamson University, Manila, Philippines
| | | | | | | | - Coleen S Tolosa
- Psychology Department, Adamson University, Manila, Philippines
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74
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Roth S, Owczarzak J, Baker K, Davidson H, Jamal L. Experiences of hereditary cancer care among transgender and gender diverse people: "It's gender. It's cancer risk…it's everything". J Genet Couns 2024. [PMID: 38342966 DOI: 10.1002/jgc4.1867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/15/2023] [Accepted: 12/27/2023] [Indexed: 02/13/2024]
Abstract
Transgender and gender diverse (TGD) individuals are a significant yet underrepresented population within genetic counseling research and broader LGBTQI+ health studies. This underrepresentation perpetuates a cycle of exclusion from the production of medical knowledge, impacting the quality and equity of care received by TGD individuals. This issue is particularly poignant in cancer genetic counseling, where TGD individuals with elevated cancer risk receive risk assessment, counseling, and referral to support based on risk figures and standards of care developed for cisgender individuals. The experiences of TGD individuals navigating inherited cancer syndromes remain largely undocumented in medical literature, posing challenges to the provision of inclusive care by genetics providers. To bridge this knowledge gap, we conducted a cross-sectional qualitative study. Nineteen semi-structured interviews were held with gender diverse adults having hereditary cancer syndromes, family histories of such syndromes, or personal histories of chest cancer. Our study employed thematic analysis using combined inductive and deductive methods to illuminate how hereditary cancer care intersects with participants' gender identities, gender expression, and gender-affirming care experiences. Participants reflected on care experiences that felt affirming or triggered gender dysphoria. Participants also discussed the interplay between risk-reducing mastectomy and top surgery, exploring co-emergent dynamics between cancer risk management and gender expression. Significantly, participants identified actionable strategies for healthcare providers to enhance support for gender diverse patients, including the mindful use of gendered language, collaborative decision-making, and conveying allyship. These findings offer valuable insights into tailoring genetic counseling to meet the unique needs of TGD individuals, advancing the path toward inclusive and appropriate care for LGBTQI+ individuals with hereditary cancer syndromes.
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Affiliation(s)
- Sarah Roth
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Precision Health Research, NHGRI, NIH, Bethesda, Maryland, USA
| | - Jill Owczarzak
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kellan Baker
- Whitman-Walker Health, Washington, District of Columbia, USA
| | - Hannah Davidson
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Precision Health Research, NHGRI, NIH, Bethesda, Maryland, USA
| | - Leila Jamal
- Department of Bioethics, NIH, Bethesda, Maryland, USA
- Center for Cancer Research, NCI, NIH, Bethesda, Maryland, USA
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75
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Li Y, Fuentes K, Hsu S, Ragunathan S, Lindsay S. Types and factors affecting and impact of ableism among Asian children and youth with disabilities and their caregivers: a systematic review of quantitative studies. Disabil Rehabil 2024:1-21. [PMID: 38339994 DOI: 10.1080/09638288.2024.2310755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 01/20/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE Asian children and youth with disabilities often experience multiple barriers and discrimination in education, healthcare, and social settings, which influence their well-being, especially the transition to adulthood. This review aims to explore the types, factors affecting and impact of ableism on Asian children and youth with disabilities and their caregivers. METHODS We conducted a systematic review and a narrative synthesis whereby we searched the literature from six international databases, including Healthstar, Ovid Medline, Embase, PsycInfo, Scopus, and Web of Science. RESULTS Twenty-nine studies were included in the review, and three themes were identified that related to ableism: (1) types and rates of ableism (i.e., stigma, bullying and victimization, and discrimination and inequalities); (2) factors affecting ableism (i.e. sociodemographic factors, familial factors, and societal factors); and (3) impacts of ableism (i.e. mental health, family impacts, and societal impacts). CONCLUSIONS Our review highlights that ableism has various types and can be influenced by multiple factors, influencing social and health outcomes of Asian families with children and youth with disabilities. This review also emphasizes the importance of increasing the public's awareness regarding disabilities to reduce ableism among Asian families with children with disabilities.
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Affiliation(s)
- Yiyan Li
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Kristina Fuentes
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Shaelynn Hsu
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Faculty of Science, York University, Toronto, Canada
| | - Sharmigaa Ragunathan
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
| | - Sally Lindsay
- Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
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76
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Bernard A, Cottenet J, Quantin C. Is the Validity of Logistic Regression Models Developed with a National Hospital Database Inferior to Models Developed from Clinical Databases to Analyze Surgical Lung Cancers? Cancers (Basel) 2024; 16:734. [PMID: 38398124 PMCID: PMC10886576 DOI: 10.3390/cancers16040734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/11/2023] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
In national hospital databases, certain prognostic factors cannot be taken into account. The main objective was to estimate the performance of two models based on two databases: the Epithor clinical database and the French hospital database. For each of the two databases, we randomly sampled a training dataset with 70% of the data and a validation dataset with 30%. The performance of the models was assessed with the Brier score, the area under the receiver operating characteristic (AUC ROC) curve and the calibration of the model. For Epithor and the hospital database, the training dataset included 10,516 patients (with resp. 227 (2.16%) and 283 (2.7%) deaths) and the validation dataset included 4507 patients (with resp. 93 (2%) and 119 (2.64%) deaths). A total of 15 predictors were selected in the models (including FEV1, body mass index, ASA score and TNM stage for Epithor). The Brier score values were similar in the models of the two databases. For validation data, the AUC ROC curve was 0.73 [0.68-0.78] for Epithor and 0.8 [0.76-0.84] for the hospital database. The slope of the calibration plot was less than 1 for the two databases. This work showed that the performance of a model developed from a national hospital database is nearly as good as a performance obtained with Epithor, but it lacks crucial clinical variables such as FEV1, ASA score, or TNM stage.
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Affiliation(s)
- Alain Bernard
- Department of Thoracic and Cardiovascular Surgery, Dijon University Hospital, 21000 Dijon, France;
| | - Jonathan Cottenet
- Service de Biostatistiques et d’Information Médicale (DIM), CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, 21000 Dijon, France;
| | - Catherine Quantin
- Service de Biostatistiques et d’Information Médicale (DIM), CHU Dijon Bourgogne, Inserm, Université de Bourgogne, CIC 1432, Module Épidémiologie Clinique, 21000 Dijon, France;
- CESP, Inserm, UVSQ, Université Paris-Saclay, 94807 Villejuif, France
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77
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Farr RH, Cashen KK, Siebenthaler KA, Simon KA. Microaggression and discrimination experiences among diverse youth with LGBTQ+ parents in the United States. J Res Adolesc 2024. [PMID: 38339824 DOI: 10.1111/jora.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/08/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
Family-based microaggressions and discrimination experienced by youth with LGBTQ+ parents are important to understand from their perspectives. Using mixed methods, we examined such experiences among 12- to 25-year-old youth (N = 51) with at least one LGBTQ+ parent in the United States. Youth were diverse in race/ethnicity, family structure, gender and sexual identities, socioeconomic status, and geographic region. Using interviews, we explored LGBTQ+ family-based microaggressions (reported through scale items with feedback) and discrimination (assessed via thematic analysis). Microaggressions and discrimination based on having LGBTQ+ parents were common, yet there were distinctions in direct and indirect stigma across the quantitative items and qualitative themes. These results underscore the value of mixed methods research with youth and implications for future research, practice, and policy.
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Affiliation(s)
| | | | | | - Kay A Simon
- University of Minnesota, Minneapolis, Minnesota, USA
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78
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Klein H, Washington TA. The Relationship of Anti-Transgender Discrimination, Harassment, and Violence to Binge Drinking among Transgender Adults. Subst Use Misuse 2024; 59:583-590. [PMID: 38105183 DOI: 10.1080/10826084.2023.2293731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Purpose: Using a minority stress paradigm, this paper examines the relationship between anti-transgender discrimination, harassment, and violence among transgender adults. Methods: Data from the 2015 U.S. National Transgender Survey were used to examine twenty types of anti-transgender experiences/problems (e.g., harassment at work, problems with police officials, verbal and physical assaults) in a sample of 27,715 transgender Americans aged 18 or older. Binge drinking during the previous month was the dependent variable, and eight control measures were examined in the multivariate analysis. Results: Experiencing any of the twenty types of anti-transgender discrimination, harassment, or violence increased the odds of binge drinking by 48%. Experiencing many such problems increased the odds of binge drinking by 104%. Multivariate analysis showed that anti-transgender discrimination, harassment, and violence remains a predictor of binge drinking even when other key measures are taken into account. Younger people, racial minority group members, and persons who were not married or "involved" were at particularly great risk. Conclusions: Consistent with the minority stress paradigm, the more different types of anti-transgender experiences people had, the more likely they were to engage in binge drinking. Targeted intervention needs to help transgender persons to avoid anti-transgender discrimination, harassment, and violence to the greatest extent possible, and to develop resiliency skills whenever they are victimized. This is particularly true for transgender persons who are younger, minority, and not "involved" in a relationship.
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Affiliation(s)
- Hugh Klein
- Kensington Research Institute, Silver Spring, Maryland, USA
- School of Social Work, California State University-Long Beach, Long Beach, California, USA
| | - Thomas Alex Washington
- School of Social Work, California State University-Long Beach, Long Beach, California, USA
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79
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Okoro O, Umaru O, Ray M. Women of Color in the Health Professions: A Scoping Review of the Literature. Pharmacy (Basel) 2024; 12:29. [PMID: 38392936 PMCID: PMC10893211 DOI: 10.3390/pharmacy12010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/15/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Women of color (WoC) in the health professions encounter challenges in advancement to higher positions, disparities in wages, discrimination, lack of expectation to achieve leadership positions, and absence of extensive support networks. Articles in the literature have addressed race and/or gender in the context of professional development. However, applying an intersectional lens or framework to better understand the contextual issues of professional development for WoC remains to be addressed. Thus, this scoping review aimed to (i) identify health professions literature that addresses disparities affecting WoC, and (ii) describe strategies and approaches to support WoC in the health professions. Methods: The literature searches were conducted in multiple databases, including PubMed and MEDLINE (Ovid); and Google and Google Scholar were used to "hand search" further articles including gray literature. Three independent reviewers reviewed and screened articles for inclusion in accordance with a guide. Search included articles on pharmacy or healthcare professions, published in English, and which met three content criteria: racial disparities/inequities, professional development/career advancement, and women or gender disparities Results: A total of 31 articles were included-medicine (17), nursing (1), pharmacy (7), other (4), and multiple health professions (2). Key findings included underrepresentation of women and minority groups, inequities in professional advancement and leadership positions for WoC, and greater dissatisfaction and attrition among minority and women professionals. Conclusion: WoC face unique and distinct challenges and barriers in their professional careers resulting from the intersectionality of not only race and gender, but also lived experiences and opportunities. Strategies to improve diversity and representation should include an intersectional framework or lens and be critically evaluated.
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Affiliation(s)
- Olihe Okoro
- Department of Pharmacy Practice and Pharmaceutical Sciences, University of Minnesota, Duluth, MN 55812, USA;
| | - Omolayo Umaru
- Department of Pharmaceutical Care & Health Systems, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Meghana Ray
- HEED Lab, LLC, Health Analytics Network, LLC, Rockville, MD 20852, USA
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80
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Dupuis HE, Girme YU. "Cat Ladies" and "Mama's Boys": A Mixed-Methods Analysis of the Gendered Discrimination and Stereotypes of Single Women and Single Men. Pers Soc Psychol Bull 2024; 50:314-328. [PMID: 37876182 PMCID: PMC10860362 DOI: 10.1177/01461672231203123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 08/30/2023] [Indexed: 10/26/2023]
Abstract
Do single women and single men differ in their experiences of "singlism"? This mixed-methods research examined whether single women and single men report quantitative differences in amounts of singlehood-based discrimination and explored qualitative reports of stereotypic traits associated with single women and single men. We recruited Canadian and American single adults across two Prolific studies (total N = 286). The results demonstrated that single female and male participants did not differ in their personal discrimination, but female participants perceived single women to experience more discrimination than single men. Furthermore, qualitative analyses revealed four overlapping "archetypes" of single women and men including: Professional ("independent," "hard-working"), Carefree ("free," "fun"), Heartless ("selfish," "promiscuous"), and Loner ("lonely," "antisocial"). Overall, single women and men may experience similar stereotypes and discrimination, but there are also important nuances that highlight the need for more research at the intersection of gender and singlehood.
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81
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Mansukhani T, Wright A, Arechvo A, Laich A, Iglesias M, Charakida M, Nicolaides KH. Ophthalmic artery Doppler at 36 weeks' gestation in prediction of pre-eclampsia: validation and update of previous model. Ultrasound Obstet Gynecol 2024; 63:230-236. [PMID: 37616530 DOI: 10.1002/uog.27464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To validate and extend a model incorporating maternal ophthalmic artery Doppler at 35-37 weeks' gestation in the prediction of subsequent development of pre-eclampsia (PE). METHODS This was a prospective validation study of screening for PE (defined according to the 2019 American College of Obstetricians and Gynecologists criteria) by maternal ophthalmic artery peak systolic velocity (PSV) ratio in 6746 singleton pregnancies undergoing routine care at 35 + 0 to 36 + 6 weeks' gestation (validation dataset). Additionally, the data from the validation dataset were combined with those of 2287 pregnancies that were previously used for development of the model (training dataset), and the combined data were used to update the original model parameters. The competing-risks model was used to estimate the individual patient-specific risk of delivery with PE at any time and within 3 weeks from assessment by a combination of maternal demographic characteristics and medical history with PSV ratio alone and in combination with the established PE biomarkers of mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), serum placental growth factor (PlGF) and serum soluble fms-like tyrosine kinase-1 (sFlt-1). We evaluated the predictive performance of the model by examining, first, the ability to discriminate between the PE and non-PE groups using the area under the receiver-operating-characteristics curve and the detection rate (DR) at fixed screen-positive (SPR) and false-positive rates of 10% and, second, calibration by measuring the calibration slope and calibration-in-the-large. McNemar's test was used to compare the performance of screening by a biophysical test (maternal factors, MAP, UtA-PI and PSV ratio) vs a biochemical test (maternal factors, PlGF and sFlt-1), low PlGF concentration (< 10th percentile) or high sFlt-1/PlGF concentration ratio (> 90th percentile). RESULTS In the validation dataset, the performance of screening by maternal factors and PSV ratio for delivery with PE within 3 weeks and at any time after assessment was consistent with that in the training dataset, and there was good agreement between the predicted and observed incidence of PE. In the combined data from the training and validation datasets, good prediction for PE was achieved in screening by a combination of maternal factors, MAP, UtA-PI, PlGF, sFlt-1 and PSV ratio, with a DR, at a 10% SPR, of 85.0% (95% CI, 76.5-91.4%) for delivery with PE within 3 weeks and 65.7% (95% CI, 59.2-71.7%) for delivery with PE at any time after assessment. The performance of a biophysical test was superior to that of screening by low PlGF concentration or high sFlt-1/PlGF concentration ratio but not significantly different from the performance of a biochemical test combining maternal factors with PlGF and sFlt-1 for both PE within 3 weeks and PE at any time after assessment. CONCLUSION Maternal ophthalmic artery PSV ratio at 35-37 weeks' gestation in combination with other biomarkers provides effective prediction of subsequent development of PE. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- T Mansukhani
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - A Wright
- Institute of Health Research, University of Exeter, Exeter, UK
| | - A Arechvo
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - A Laich
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - M Iglesias
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
| | - M Charakida
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - K H Nicolaides
- Harris Birthright Research Centre for Fetal Medicine, King's College Hospital, London, UK
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Fuentes K, Hsu S, Patel S, Lindsay S. More than just double discrimination: a scoping review of the experiences and impact of ableism and racism in employment. Disabil Rehabil 2024; 46:650-671. [PMID: 36724368 DOI: 10.1080/09638288.2023.2173315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/21/2023] [Indexed: 02/03/2023]
Abstract
PURPOSE Research has shed light on the employment barriers faced by individuals with disabilities, and by racialized people. The challenges faced by people belonging to both marginalized groups are less well-understood. The purpose of this scoping review was to examine existing research on labour market and workplace experiences of racialized people with disabilities, and to identify how ableism and racism intersect to shape employment experiences and outcomes. METHODS Seven international databases were searched, covering the period from 2000 to April 2022. Four reviewers independently conducted the screening, and data extraction and analysis were performed on 44 articles that met our inclusion criteria. RESULTS The findings highlighted rates of workplace ableism and racism (including discrimination allegations and perceived discrimination); types and forms of experiences arising from the intersection of ableism and racism (including unique individual stereotyping and systemic and institutional discrimination); and the role of other demographic variables. The intersection of ableism and racism impacted labour market outcomes, well-being in the workplace, and career/professional advancement. CONCLUSIONS Our review highlights the need for greater in-depth research focusing explicitly on the intersection of ableism and racism (and of other forms of discrimination), to better understand and address the barriers that racialized people with disabilities face in employment.IMPLICATIONS FOR REHABILITATIONThe experiences of racialized people with disabilities have been under explored, and clinicians and rehabilitation specialists should consider incorporating intersectionality into their practices to better understand and serve these populations.Ableism and racism do not operate in isolation, and clinicians and other professionals need to be aware that racialized people with disabilities may face unique challenges and barriers as a result.Service providers should aim to address gaps and inequities in services faced by racialized people with disabilities which may prevent them from finding and/or maintaining meaningful employment.
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Affiliation(s)
- Kristina Fuentes
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Shaelynn Hsu
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - Stuti Patel
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Psychology, University of Toronto Mississauga campus, Mississauga, Canada
| | - Sally Lindsay
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
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83
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El Hayek S, Foad W, de Filippis R, Ghosh A, Koukach N, Mahgoub Mohammed Khier A, Pant SB, Padilla V, Ramalho R, Tolba H, Shalbafan M. Stigma toward substance use disorders: a multinational perspective and call for action. Front Psychiatry 2024; 15:1295818. [PMID: 38362033 PMCID: PMC10867215 DOI: 10.3389/fpsyt.2024.1295818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/18/2024] [Indexed: 02/17/2024] Open
Affiliation(s)
- Samer El Hayek
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | - Wael Foad
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Abhishek Ghosh
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nadine Koukach
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | | | - Sagun Ballav Pant
- Department of Psychiatry, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Vanessa Padilla
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL, United States
| | - Rodrigo Ramalho
- Department of Social and Community Health, University of Auckland, Auckland, New Zealand
| | - Hossameldin Tolba
- Medical Department, Erada Center for Treatment and Rehabilitation in Dubai, Dubai, United Arab Emirates
| | - Mohammadreza Shalbafan
- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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84
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Thomas C, Dwyer A, Batchelor J, Van Niekerk L. A qualitative exploration of gynaecological healthcare experiences of lesbian, gay, bisexual, transgender, queer people assigned female at birth. Aust N Z J Obstet Gynaecol 2024; 64:55-62. [PMID: 37496286 DOI: 10.1111/ajo.13741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/13/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Lesbian, gay, bisexual, transgender, queer, asexual/aromantic (LGBTQA+) people, assigned female at birth (AFAB), experience disproportionately poorer gynaecological healthcare outcomes compared to their cisgender, heterosexual peers. The barriers to gynaecological care remain poorly understood. In a step toward bridging this gap, the current study explored the lived gynaecological healthcare experiences of Australian LGBTQA+ AFAB people and the barriers they experience in accessing care. MATERIALS AND METHODS Semi-structured interviews were conducted with 22 LGBTQA+ AFAB people. An inductive thematic qualitative design was used to explore the lived experiences and identify themes associated with the reported experiences. RESULTS Thematic analysis identified seven themes related to experiences in accessing gynaecological healthcare, including discrimination, fear, perceived provider or cultural incompetency, accessibility, and gender identity. Several sub-themes were also identified such as refusal of care, microaggression, misgendering, and patient as educator. CONCLUSIONS Participants suggested that barriers to care could be alleviated by the integration of LGBTQA+ specific healthcare training into the university-level medical curriculum and professional development programs that address cultural competency and inclusive healthcare. These preliminary findings inform the necessity for the development of evidence-based practice guidelines that specifically address the unique and diverse needs of the LGBTQA+ AFAB population.
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Affiliation(s)
- Cleo Thomas
- School of Psychological Sciences, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Angela Dwyer
- School of Social Sciences, College of Arts, Law, & Education, University of Tasmania, Hobart, Tasmania, Australia
| | - Jack Batchelor
- School of Social Sciences, College of Arts, Law, & Education, University of Tasmania, Hobart, Tasmania, Australia
| | - Leesa Van Niekerk
- School of Psychological Sciences, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
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85
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Hawley N, Green J, Ahlich E, Hauff C, Hermer J, Skiba MB, James DL, Nash SH. Patient perspectives of weight stigma across the cancer continuum: A scoping review. Cancer Med 2024; 13:e6882. [PMID: 38205894 PMCID: PMC10905240 DOI: 10.1002/cam4.6882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/22/2023] [Accepted: 12/16/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Weight stigma has been defined as the social devaluation and denigration of individuals because of their weight. The purpose of this scoping systematic review was to assess and understand patient experiences with weight stigma in the cancer care setting. METHODS We conducted a systematic scoping review of studies examining shame, prejudice, bias, and stigma in relation to weight and cancer-related care using five databases: PubMed, CINAHL Plus Full Text (ProQuest), Cochrane Library, PsycINFO (EBSCO), and Scopus. Articles were uploaded into Covidence for de-duplication and screening. Included studies were peer reviewed, reported adult patient experiences in cancer-related care, and were published in English between October 2012 and February 2023. Study characteristics and key findings were abstracted and qualitatively synthesized. RESULTS Publications meeting inclusion criteria yielded five studies (n = 113 participants). Most focused on the experiences of women (n = 4) and cancers which predominantly impact women (i.e., breast, cervical, endometrial; n = 4). All stages of the cancer continuum were included with studies examining screening (n = 2), treatment (n = 1), and post-treatment survivorship (n = 2). Weight discrimination was discussed in four studies and weight-biased stereotypes were discussed in three studies. Experiences of weight bias internalization were reported in four studies. One study described an instance of implicit weight bias. CONCLUSIONS Limited studies examine patient experiences of weight stigma in cancer care; however, current evidence suggests that patients do experience weight stigma in cancer-related care. This review highlights critical gaps and a need for more research on the prevalence and impact of weight stigma in cancer screening and care.
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Affiliation(s)
- Nanako Hawley
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Jennifer Green
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Erica Ahlich
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Caitlyn Hauff
- Department of Health, Kinesiology, and Sport, University of South Alabama, Mobile, Alabama, USA
| | - Janice Hermer
- Arizona State University Library, Arizona State University, Tempe, Arizona, USA
| | - Meghan B Skiba
- College of Nursing, University of Arizona, Tucson, Arizona, USA
| | - Dara L James
- College of Nursing, University of South Alabama, Mobile, Alabama, USA
- Edson College of Nursing and Health Innovation, Arizona State University, Tempe, Arizona, USA
| | - Sarah H Nash
- Department of Epidemiology, University of Iowa, Iowa, Iowa, USA
- Holden Comprehensive Cancer Center, University of Iowa, Iowa, Iowa, USA
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86
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Mulder L, Garcia E, Sirintrapun SJ, Kundu I, Soles R. Examining the role of diversity, equity, and inclusion in mitigating workforce burnout in laboratory medicine. Am J Clin Pathol 2024; 161:130-139. [PMID: 37793038 DOI: 10.1093/ajcp/aqad123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/29/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVES The clinical laboratory workforce plays a crucial role in health care delivery, yet little is known about the unique pressures and challenges this workforce faces. The objective of this study was to identify factors that contribute to burnout, discrimination, exclusion, and inequity in pathology and laboratory medicine. METHODS A nationwide survey was conducted in 2 phases. In phase 1, 2391 laboratory professionals were surveyed over a 1-week period about their experiences with burnout, discrimination, and work-related stress. In phase 2, the survey was extended to 1 month and questions were added to elicit more detailed information about diversity, equity, and inclusion (DEI) as well as wellness. RESULTS Results showed a high prevalence of burnout, discrimination, and stress among laboratory professionals, with significant differences among certain demographic groups. Women, Black, indigenous, or people of color individuals and those with disabilities reported higher rates of discrimination. The study also showed a need for mentorship and resources to address educational barriers. CONCLUSIONS Findings from this study highlight the urgent need for interventions to address burnout, discrimination, exclusion, and inequity in the laboratory workforce. Initiatives to increase workforce diversity, promote mentorship and diversity training programs, and improve recognition of the laboratory workforce are recommended. The results underscore the pressing need to addressing the challenges and apprehensions laboratory professionals face, including enhancing recognition of their role in patient care, tackling systemic problems related to discrimination and equity, and enhancing the provision of support and resources for managing burnout and fostering well-being.
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Affiliation(s)
- Lotte Mulder
- Department of Organizational Development and Leadership, American Society for Clinical Pathology, Chicago, IL, US
| | - Edna Garcia
- Institute of Science, Technology and Policy, American Society for Clinical Pathology, Washington, DC, US
| | - S Joseph Sirintrapun
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Iman Kundu
- Institute of Science, Technology and Policy, American Society for Clinical Pathology, Washington, DC, US
| | - Ryan Soles
- Department of Learning and Educational Research, American Society for Clinical Pathology, Chicago, IL, US
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87
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Mendoza-Núñez VM, Mendoza-Soto AB. Is Aging a Disease? A Critical Review Within the Framework of Ageism. Cureus 2024; 16:e54834. [PMID: 38405657 PMCID: PMC10894070 DOI: 10.7759/cureus.54834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2024] [Indexed: 02/27/2024] Open
Abstract
Ageism is a type of discrimination characterized by negative social representations of old age and aging, with prejudices and stereotypes that cause rejection and marginalization of older adults, generally considering them as fragile and unproductive. For this reason, it is recognized as one of the main enemies of healthy aging, especially when it arises from the scientific and professional fields. In this sense, the proposals promoted by some researchers regarding the World Health Organization (WHO) classifying aging as a disease goes against the healthy aging approach. In this sense, we consider that there is no theoretical or scientific support to classify aging as a disease, so we must advocate before the WHO so that aging is eliminated within its disease classification codes. In this framework, this review proposes the concept of "hallmarks of ageism" defined as the characteristics, representations and attitudes of rejection and discrimination towards aging, old age and older people, at the political and institutional, scientific or professional, technological and digital, social, family and personal levels, which are presented in an articulated and structured manner. For this reason, it is essential to comprehensively identify and analyze the "hallmarks of ageism", in order to propose programs that include strategies and public policies that promote "anti-ageism" as a counterproposal to the "hallmarks of aging", whose biological changes related to aging are intended to be comparable to chronic non-communicable diseases.
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Affiliation(s)
| | - Ana Belén Mendoza-Soto
- Posdoc Research of Biology, Centro Interdisciplinario de Investigación para el Desarrollo Integral Regional - Sinaloa, Mexico, MEX
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88
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Albertsen A, Pedersen VML. Workplace heating and gender discrimination. Bioethics 2024; 38:107-113. [PMID: 37929808 DOI: 10.1111/bioe.13234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/14/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023]
Abstract
Across Europe, countries are reducing CO2 emissions and energy demand by lowering the temperature in public office buildings. These measures affect men and women unequally because the latter prefer and, indeed, perform better under higher temperatures than the standard temperature. Lowering the temperature thus further increases an already existing inequality. We show that the philosophical literature on discrimination provides an interesting theoretical approach to understanding such measures. On prominent understandings of what discrimination is, the policy would be considered direct discrimination against women if it could be shown to reflect a broader inattentiveness to the needs of women in society. Alternatively, and more straightforwardly, the policies can be considered indirect discrimination because of their disparate effects on men and women. The final part of the paper shows that the policies are also wrong for the reasons it is often argued that discrimination is wrong-to wit, that it harms or disrespects those who are discriminated against. The final section suggests a range of measures to offset the discriminatory aspects of the policy.
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Affiliation(s)
- Andreas Albertsen
- Centre for the Experimental-Philosophical Study of Discrimination, Department of Political Science, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Viki M L Pedersen
- Centre for the Experimental-Philosophical Study of Discrimination, Department of Political Science, Aarhus BSS, Aarhus University, Aarhus, Denmark
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89
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Eom YJ, Lee H, Choo S, Kim R, Yi H, Kim R, Kim SS. Situational Avoidance and Its Association with Mental Health Among Transgender Adults in South Korea: A Nationwide Cohort Study. LGBT Health 2024; 11:122-130. [PMID: 37831924 DOI: 10.1089/lgbt.2023.0060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023] Open
Abstract
Purpose: In fear of discrimination or unwanted disclosure of their transgender identity, transgender and nonbinary (TGNB) people may commonly avoid daily activities. We assessed the prevalence of situational avoidance among TGNB people and examined its associations with mental health outcomes. Methods: We analyzed data from a longitudinal survey conducted at baseline (2020) and follow-up (2021) among 268 TGNB people in South Korea. Situational avoidance due to transgender identity within the past 12 months was assessed based on 12 kinds of daily activities (e.g., public bathroom use, job applications, and hospital visits). Past-week depressive symptoms and past 2-week anxiety symptoms were measured with the Center for Epidemiologic Studies-Depression Scale and General Anxiety Disorder Scale, respectively. Results: Of 268 participants, 135 (50.4%) have ever avoided daily activities. The most frequently reported situational avoidance was public bathroom use (32.1%), followed by job applications (24.3%) and hospital visits (12.3%). After adjusting for confounders including baseline depressive symptoms and experience of anti-transgender discrimination, participants with any situational avoidance experience were 1.30 times (95% confidence intervals [CI] = 1.01-1.69) more likely to have anxiety symptoms compared with those without situational avoidance experience. In particular, participants who avoided three or more kinds of daily activities were 1.40 times (95% CI = 1.02-1.93) more likely to have anxiety symptoms than those without any experience of situational avoidance. No association was observed with depressive symptoms. Conclusion: Multilateral interventions including anti-discrimination law enactment are necessary to reduce transphobia and provide support for TGNB people in Korea, thus reducing their fear of participating in daily activities and promoting their mental well-being.
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Affiliation(s)
- Yun-Jung Eom
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Hyemin Lee
- Jeju Institute of Public Health & Health Policy, Jeju, South Korea
| | - Sungsub Choo
- Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Ranyeong Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
| | - Horim Yi
- Solidarity for LGBT Human Rights of Korea, Seoul, South Korea
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, South Korea
- Division of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea
| | - Seung-Sup Kim
- Department of Environmental Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, South Korea
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90
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Yu X, Zhou X, He Z, He B, Wan K, Wei M, Guo T, Han Y. Sleep and APOE-ε4 have a synergistic effect on plasma biomarkers and longitudinal cognitive decline in older adults. CNS Neurosci Ther 2024; 30:e14558. [PMID: 38421124 PMCID: PMC10850800 DOI: 10.1111/cns.14558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 10/31/2023] [Accepted: 11/25/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Sleep disorders are prevalent among patients with Alzheimer's disease (AD), and the APOE ε4 genotype is a key genetic risk factor for sporadic AD. However, the combined effect of the genotype and sleep disorders on cognitive decline remains uncertain. METHODS A total of 972 participants were drawn from the SILCODE cohort, comprising 655 without the ε4 allele (APOE-) and 317 with ε4 allele (APOE+). Data were collected, including neuropsychological assessments, sleep measurements, plasma biomarkers, and PET imaging. A Sleep Composite Index (SCI) was created, categorizing participants into high risk (Sleep+) and low risk (Sleep-). RESULTS Significant predictions of dementia risk associated with plasma p-tau181, neurofilament light chain (NfL), and SCI. Individuals with both Sleep+ and APOE+ had a higher risk of dementia compared to those with Sleep-. The Sleep+/APOE+ group had higher plasma NfL levels than the Sleep-/APOE- group. Similar trends emerged in plasma NfL levels among the Aβ PET-positive subgroup. Plasma NfL levels explained 23% of the relationship between SCI and cognitive impairment. CONCLUSION Our study highlights sleep disorder was associated with cognitive decline, with plasma NfL playing a partial mediating role. These findings explain how sleep disorders affect cognitive function and emphasize the importance of healthy sleep for older adults.
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Affiliation(s)
- Xianfeng Yu
- Department of NeurologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Xia Zhou
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Zhengbo He
- Institute of Biomedical EngineeringShenzhen Bay LaboratoryShenzhenChina
| | - Beiqi He
- School of Information and Communication EngineeringHainan UniversityHaikouChina
| | - Ke Wan
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Min Wei
- Department of NeurologyXuanwu Hospital of Capital Medical UniversityBeijingChina
| | - Tengfei Guo
- Institute of Biomedical EngineeringShenzhen Bay LaboratoryShenzhenChina
| | - Ying Han
- Department of NeurologyXuanwu Hospital of Capital Medical UniversityBeijingChina
- School of Information and Communication EngineeringHainan UniversityHaikouChina
- Center of Alzheimer's DiseaseBeijing Institute for Brain DisordersBeijingChina
- National Clinical Research Center for Geriatric DisordersBeijingChina
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91
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Siegel MR, Simione M, James KE, Perkins ME, Luo M, Swift H, Kim J, Jasset OJ, Shook LL, Taveras EM, Edlow AG. Helping Us Grow Stronger (HUGS)/Abrazos: a community-based initiative improved perinatal mental health in an urban cohort. Am J Obstet Gynecol MFM 2024; 6:101264. [PMID: 38135219 PMCID: PMC10922876 DOI: 10.1016/j.ajogmf.2023.101264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Targeted programs aimed at improving maternal mental health, particularly among those exposed to social determinants of health, are increasingly critical since the onset of the COVID-19 pandemic, yet the impact of such programs is poorly understood. OBJECTIVE This study aimed to evaluate the impact of a novel, language-concordant community-based program on perinatal mental health. STUDY DESIGN We conducted a prospective cohort study of peripartum individuals referred to a new community-based intervention known as Helping Us Grow Stronger (HUGS/Abrazos). Participants received up to 4 remote sessions with a cognitive behavioral therapy trained social worker, up to 3 resource navigation sessions with a community health worker, and direct relief with a grocery gift card and care package. Before and after the program, participants completed validated survey instruments to assess mental health and social determinants of health. RESULTS A total of 178 participants were assessed after program completion, including 133 who were assessed before and after the program. The cohort was composed of 62.9% Hispanic or Latinx participants with a mean age of 29.8 year (standard error of mean, 0.46). There were high rates of food insecurity (111/178; 62.4%), experiences of discrimination (119/178; 66.9%), and SARS-CoV-2 infection (105/178; 59.0%). The program was associated with statistically significant improvements in the Edinburgh Postnatal Depression scores (baseline [mean±standard error of mean], 8.44±0.55 vs 6.77±0.51 after program completion; P=.0001) and Perceived Stress Scale scores (baseline, 15.2±0.74 vs 14.0±0.71; P=.035). Participants exposed to stressors including food insecurity and experiences of discrimination had higher baseline depression, stress, and anxiety scores. Those with experiences of discrimination, food insecurity, and SARS-CoV-2 infection during pregnancy were more likely to have improvements in mental health scores postintervention. CONCLUSION In this diverse urban cohort, a novel community-based intervention was associated with improvements in depressive symptoms, perceived stress, and anxiety, particularly among those with social determinants of health.
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Affiliation(s)
- Molly R Siegel
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (Drs Siegel, James, Shook, and Edlow).
| | - Meg Simione
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General Hospital for Children, Boston, MA (Dr Simione, Mses Perkins and Luo, and Dr Taveras)
| | - Kaitlyn E James
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (Drs Siegel, James, Shook, and Edlow)
| | - Meghan E Perkins
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General Hospital for Children, Boston, MA (Dr Simione, Mses Perkins and Luo, and Dr Taveras)
| | - Man Luo
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General Hospital for Children, Boston, MA (Dr Simione, Mses Perkins and Luo, and Dr Taveras)
| | - Hannah Swift
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA (Mses Swift, Kim, and Jasset and Drs Shook and Edlow)
| | - Joon Kim
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA (Mses Swift, Kim, and Jasset and Drs Shook and Edlow)
| | - Olyvia J Jasset
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA (Mses Swift, Kim, and Jasset and Drs Shook and Edlow)
| | - Lydia L Shook
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (Drs Siegel, James, Shook, and Edlow); Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA (Mses Swift, Kim, and Jasset and Drs Shook and Edlow)
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Mass General Hospital for Children, Boston, MA (Dr Simione, Mses Perkins and Luo, and Dr Taveras); Kraft Center for Community Health, Massachusetts General Hospital, Boston, MA (Dr Taveras); Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (Dr Taveras)
| | - Andrea G Edlow
- Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (Drs Siegel, James, Shook, and Edlow); Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA (Mses Swift, Kim, and Jasset and Drs Shook and Edlow).
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92
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Rivera KM, D'Anna-Hernandez KL, Hankin BL, Davis EP, Doom JR. Experience of discrimination reported during pregnancy and infant's emerging effortful control. Dev Psychobiol 2024; 66:e22455. [PMID: 38388206 PMCID: PMC10928799 DOI: 10.1002/dev.22455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 11/29/2023] [Accepted: 12/16/2023] [Indexed: 02/24/2024]
Abstract
Discrimination reported during pregnancy is associated with poorer offspring emotional outcomes. Links with effortful control have yet to be examined. This study investigated whether pregnant individuals' reports of lifetime racial/ethnic discrimination and everyday discrimination (including but not specific to race/ethnicity) reported during pregnancy were associated with offspring emerging effortful control at 6 months of age. Pregnant individuals (N = 174) and their offspring (93 female infants) participated. During pregnancy, participants completed two discrimination measures: (1) lifetime experience of racial/ethnic discrimination, and (2) everyday discrimination (not specific to race/ethnicity). Parents completed the Infant Behavior Questionnaire-Revised when infants were 6 months old to assess orienting/regulation, a measure of emerging effortful control. Analyses were conducted in a subsample with racially/ethnically marginalized participants and then everyday discrimination analyses were repeated in the full sample. For racially/ethnically marginalized participants, greater everyday discrimination (β = -.27, p = .01) but not greater lifetime experience of racial/ethnic discrimination (β = -.21, p = .06) was associated with poorer infant emerging effortful control. In the full sample, greater everyday discrimination was associated with poorer infant emerging effortful control (β = -.24, p = .002). Greater perceived stress, but not depressive symptoms, at 2 months postnatal mediated the association between everyday discrimination and emerging effortful control. Further research should examine additional biological and behavioral mechanisms by which discrimination reported during pregnancy may affect offspring emerging effortful control.
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Affiliation(s)
- Kenia M Rivera
- Department of Psychology, University of Denver, Denver, Colorado, USA
| | | | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, Colorado, USA
- Department of Pediatrics, University of California, Irvine, Orange, California, USA
| | - Jenalee R Doom
- Department of Psychology, University of Denver, Denver, Colorado, USA
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93
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Sartori LRM, Henzel LT, Chisini LA, de Oliveira LJC, Sabóia VDPA, Correa MB. Discrimination and dental students: What is the reality in Brazilian institutions? Eur J Dent Educ 2024; 28:130-141. [PMID: 37315153 DOI: 10.1111/eje.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/05/2022] [Accepted: 05/26/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION This study aimed to evaluate whether there is discrimination in the dental educational environment, assess the main reasons for the discriminatory events, and if there is an association between discriminatory episodes and sociodemographic characteristics of undergraduate dental students. MATERIALS AND METHODS This observational cross-sectional study was conducted with a self-administered questionnaire to students enrolled in three Brazilian dental schools. Questions included sociodemographic characteristics and the occurrence of discriminatory episodes in the dental academic environment. Descriptive analysis was performed in RStudio 1.3 (R Core Team, RStudio, Inc., Boston, USA) software and the associations were tested using Pearson's chi-square test, considering 95% confidence intervals. RESULTS A total of 732 dental students were included, with a response rate of 70.2%. The vast majority of students were female (66.9%), with white/yellow skin colour (67.9%), and with a mean age of 22.6 (SD 4.1) years. Sixth-eight percent of students reported having experienced some discrimination in the academic environment and most reported feeling uncomfortable with the episode. The main reasons to have been discriminated against raised by students were specific behaviour/habit, have specific moral, ethical, and aesthetic values, gender, and socioeconomic status or social class. The occurrence of discriminatory episodes was associated with female gender (p = .05), non-heterosexual sexual orientation (p < .001), studying in public institutions (p < .001), receiving an institutional scholarship (p = .018), and being in the final undergraduate cycle (p < .001). CONCLUSION The occurrence of discriminatory episodes was common in Brazilian dental higher education. Discriminatory situations generate traumas and psychological marks, causing a loss of diversity within the academic environment that leads to loss of productivity, creativity, and innovation. Thus, strong institutional policies against discrimination are crucial to create a healthy dental academic environment.
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94
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Moss J, Roberts S. Enhancing gender equality for women using person-centred care and cultural curiosity. Nurs Stand 2024; 39:71-75. [PMID: 38282426 DOI: 10.7748/ns.2024.e12221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 01/30/2024]
Abstract
Socially constructed gender norms influence people's access to, and experience of, healthcare. Gender norms can negatively affect the health of women, men and people with other gender identities, such as transgender or non-binary individuals. Person-centred care and shared decision-making, which are widely recognised as essential aspects of healthcare, could be effective approaches for enhancing gender equality in healthcare for women. However, many women appear to receive suboptimal person-centred care. Additionally, there is a lack of representation of diverse gender identities in research, as well as a lack of awareness of diverse gender identities among nurses and other healthcare professionals. To enhance gender equality in healthcare for women, nurses and nursing students should be encouraged to reflect on their unconscious biases and adopt a stance of cultural curiosity, while organisations need to improve preregistration and post-registration training on equality and diversity.
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Affiliation(s)
- Jadzia Moss
- School of Nursing and Public Health, Faculty of Health and Education, Manchester Metropolitan University, Manchester, England
| | - Stuart Roberts
- School of Nursing and Public Health, Faculty of Health and Education, Manchester Metropolitan University, Manchester, England
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95
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Daniel M, Kallakuri S, Gronholm PC, Wahid SS, Kohrt B, Thornicroft G, Maulik PK. Cultural adaptation of INDIGO mental health stigma reduction interventions using an ecological validity model in north India. Front Psychiatry 2024; 15:1337662. [PMID: 38356906 PMCID: PMC10864454 DOI: 10.3389/fpsyt.2024.1337662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/11/2024] [Indexed: 02/16/2024] Open
Abstract
Background The International Study of Discrimination and Stigma Outcomes (INDIGO) Partnership is a multi-country international research program in seven sites across five low- and middle-income countries (LMICs) in Africa and Asia to develop, contextually adapt mental health stigma reduction interventions and pilot these among a variety of target populations. The aim of this paper is to report on the process of culturally adapting these interventions in India using an established framework. Methods As part of this larger program, we have contextualized and implemented these interventions from March 2022 to August 2023 in a site in north India. The Ecological Validity Model (EVM) was used to guide the adaptation and contextualization process comprising eight dimensions. Findings Six dimensions of the Ecological Validity Model were adapted, namely language, persons, metaphors, content, methods, and context; and two dimensions, namely concepts and goals, were retained. Conclusion Stigma reduction strategies with varied target groups, based on culturally appropriate adaptations, are more likely to be acceptable to the stakeholders involved in the intervention, and to be effective in terms of the program impact.
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Affiliation(s)
- Mercian Daniel
- Research Department, George Institute for Global Health, New Delhi, India
| | - Sudha Kallakuri
- Research Department, George Institute for Global Health, New Delhi, India
| | - Petra C. Gronholm
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Syed Shabab Wahid
- Department of Global Health, School of Health, Georgetown University, Washington, DC, United States
| | - Brandon Kohrt
- Center for Global Mental Health Equity, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Pallab K. Maulik
- Research Department, George Institute for Global Health, New Delhi, India
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
- Department of Brain Sciences, Imperial College London, London, United Kingdom
- Department of Public Health, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
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96
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Abed MG, Abed LG, Shackelford TK. A Qualitative, Small-Sample Study of Employment Challenges for People with Disabilities in Saudi Arabia. Healthcare (Basel) 2024; 12:346. [PMID: 38338230 PMCID: PMC10855392 DOI: 10.3390/healthcare12030346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/16/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Many people live with disabilities and many countries worldwide are acting to provide people with disabilities opportunities to find and sustain gainful employment. Notwithstanding, people with disabilities still do not have the same access to employment as their counterparts without disabilities. Although some research has investigated these issues in Western countries, very little research has investigated these issues in the Middle East, in general, and in Saudi Arabia, in particular. The aim of the present study is to gain an initial understanding of the employment experiences of people with disabilities and prospective employers of people with disabilities in Saudi Arabia. We identify several potential obstacles preventing people with disabilities from securing and maintaining gainful employment in Saudi Arabia. We secured qualitative data from semi-structured interviews with five prospective employers and five individuals with disabilities in Saudi Arabia. We focused on identifying barriers to employment. The impact of demographic factors such as age, gender, and education on employment opportunities was also examined. The results suggest several practical conclusions and recommendations relating to improving and enhancing opportunities for employment for people with disabilities in Saudi Arabia.
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Affiliation(s)
- Mohaned G. Abed
- Department of Special Education, Faculty of Educational Graduate Studies, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Lowai G. Abed
- Department of Communication and Media Technology, College of Social Sciences and Media, University of Jeddah, Jeddah 21493, Saudi Arabia;
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Schmidig FJ, Geva-Sagiv M, Falach R, Yakim S, Gat Y, Sharon O, Fried I, Nir Y. A visual paired associate learning (vPAL) paradigm to study memory consolidation during sleep. J Sleep Res 2024:e14151. [PMID: 38286437 DOI: 10.1111/jsr.14151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/22/2023] [Accepted: 01/10/2024] [Indexed: 01/31/2024]
Abstract
Sleep improves the consolidation and long-term stability of newly formed memories and associations. Most research on human declarative memory and its consolidation during sleep uses word-pair associations requiring exhaustive learning. In the present study, we present the visual paired association learning (vPAL) paradigm, in which participants learn new associations between images of celebrities and animals. The vPAL is based on a one-shot exposure that resembles learning in natural conditions. We tested if vPAL can reveal a role for sleep in memory consolidation by assessing the specificity of memory recognition, and the cued recall performance, before and after sleep. We found that a daytime nap improved the stability of recognition memory and discrimination abilities compared to identical intervals of wakefulness. By contrast, cued recall of associations did not exhibit significant sleep-dependent effects. High-density electroencephalography during naps further revealed an association between sleep spindle density and stability of recognition memory. Thus, the vPAL paradigm opens new avenues for future research on sleep and memory consolidation across ages and heterogeneous populations in health and disease.
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Affiliation(s)
- Flavio Jean Schmidig
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Physiology & Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Geva-Sagiv
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA
| | - Rotem Falach
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Physiology & Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharon Yakim
- Edmond and Lily Safra Center for Brain Sciences (ELSC), Hebrew University, Jerusalem, Israel
| | - Yael Gat
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Physiology & Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer Sharon
- Center for Human Sleep Science, Department of Psychology, University of California, Berkeley, Berkeley, USA
| | - Itzhak Fried
- Department of Neurosurgery, University of California, Los Angeles, Los Angeles, California, USA
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yuval Nir
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- Department of Physiology & Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Tel Aviv, Israel
- The Sieratzki-Sagol Center for Sleep Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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98
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Brener L, Cama E, Broady T, Harrod ME, Holly C, Caruana T, Beadman K, Treloar C. Experiences of stigma and subsequent reduced access to health care among women who inject drugs. Drug Alcohol Rev 2024. [PMID: 38271084 DOI: 10.1111/dar.13806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Research into stigma and injecting drug use has typically involved predominantly male participants, with limited research about the unique experience of women who inject drugs. METHODS This study used survey methods to assess reduced access to health care due to stigma among a sample of women who inject drugs. Women (n = 232) completed a survey as part of a broader national study of people who inject drugs. RESULTS Only 46 (19.9%) women reported that they had not experienced any injecting drug use-related stigma in the past year and most commonly noted 'sometimes' experiencing injecting-related stigma (36.8%) with more than 75% of women reporting that health workers had treated them negatively because of their injecting drug use. Most women undertook strategies to prevent experiencing stigma, such as not disclosing drug use to a health worker (81.3%), not attending follow-up appointments (76.7%) and delaying accessing health care (76.8%). Women with lower levels of personal wellbeing, who had experienced poorer treatment by health workers, had engaged in greater past month injecting, were employed and identified as lesbian, gay, bisexual, transgender or queer (LGBTQ) reported more reduced access to health care. DISCUSSION AND CONCLUSIONS Stigma has concerning health care implications for women who inject drugs and this research highlights the importance of understanding the impact of stigma in impeding health care access. Public health interventions should focus on addressing the systemic factors that reduce health care access for women who inject and take account of the impact of stigma in diminishing the quality and accessibility of health care for this group.
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Affiliation(s)
- Loren Brener
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Elena Cama
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Timothy Broady
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | | | | | - Theresa Caruana
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Kim Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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Lozano P, Peters A, Southworth A, Mo Y, Lam H, Randal FT, Kim KE. Smoking behavior among Asian Americans during the initial phase of the COVID-19 pandemic: The influence of pandemic stressors and depression. Tob Induc Dis 2024; 22:TID-22-28. [PMID: 38274001 PMCID: PMC10809060 DOI: 10.18332/tid/176923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/13/2023] [Accepted: 12/16/2023] [Indexed: 01/27/2024] Open
Abstract
INTRODUCTION Heightened levels of distress among Asian Americans during the initial phases of the pandemic may be associated with current smoking behavior. In this study, we examine differences in current smoking among Asian Americans from two different ethnic backgrounds before and during the COVID-19 pandemic. METHODS We analyzed cross-sectional survey data (n=202) from Chinese and South Asian adults in Chicago, collected between February and May 2020. We conducted logistic regression models to estimate the relationship between exposure to the COVID-19 pandemic and current smoking. We tested whether the association varied by Asian American ethnic group, unemployment, racial discrimination, and depression symptoms. RESULTS We found that current smoking increased from 28% to 48% among Asian Americans (i.e. Chinese and South Asians) during the pandemic. We found a statistically significant interaction between the COVID-19 period indicator variable and current smoking by Asian American ethnic groups (p=0.014), such that current smoking was lower for Chinese compared to South Asians before COVID-19, but was comparable for both groups during the pandemic. We also found a statistically significant interaction between the period indicator variable and current smoking by racial discrimination (p=0.047) and depression symptoms (p=0.02). Results from these interactions suggest that Asian Americans who experienced racial discrimination and depression during the pandemic may be more likely to be current smokers compared to their pre-pandemic counterparts. CONCLUSIONS The findings of the study highlight the need for culturally tailored smoking cessation interventions for Asian American communities that address pandemic-related stressors such as discrimination that may trigger cigarette use.
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Affiliation(s)
- Paula Lozano
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | - Aven Peters
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | | | - Yicklun Mo
- Asian Health Coalition, Chicago, United States
| | - Helen Lam
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
| | | | - Karen E. Kim
- Department of Biomedical Sciences, Center for Asian Health Equity - University of Chicago Medicine, Chicago, United States
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Olinger R, Matejka B, Chakravarty R, Johnston M, Ornelas E, Draves J, Jain N, Hentschel J, Owen W, Ma Y, Marx W, Freitag J, Zhang N, Guage C, Crabtree C. Americans do not select their doctors based on race. Front Sociol 2024; 8:1191080. [PMID: 38328739 PMCID: PMC10847235 DOI: 10.3389/fsoc.2023.1191080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 11/28/2023] [Indexed: 02/09/2024]
Abstract
To what extent do Americans racially discriminate against doctors? While a large literature shows that racial biases pervade the American healthcare system, there has been no systematic examination of these biases in terms of who patients select for medical treatment. We examine this question in the context of the ongoing global COVID-19 pandemic, where a wealth of qualitative evidence suggests that discrimination against some historically marginalized communities, particularly Asians, has increased throughout the United States. Conducting a well-powered conjoint experiment with a national sample of 1,498 Americans, we find that respondents do not, on average, discriminate against Asian or doctors from other systematically minoritized groups. We also find no consistent evidence of treatment effect heterogeneity; Americans of all types appear not to care about the racial identity of their doctor, at least in our study. This finding has important implications for the potential limits of American prejudice.
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