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Jackson SS, Van De Wyngard V, Pfeiffer RM, Cook P, Hildesheim A, Pinto LA, Jackson SH, Choi K, Verdugo RA, Cuevas M, Yáñez C, Tobar-Calfucoy E, Retamales-Ortega R, Araya JC, Ferreccio C, Koshiol J. Inflammatory profiles in Chilean Mapuche and non-Mapuche women with gallstones at risk of developing gallbladder cancer. Sci Rep 2021; 11:3686. [PMID: 33574564 PMCID: PMC7878792 DOI: 10.1038/s41598-021-83300-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 02/01/2021] [Indexed: 01/11/2023] Open
Abstract
Chile has high incidence rates of gallbladder cancer globally, particularly among Amerindian women, who also have a high prevalence of gallstones. We examined differences in inflammatory biomarkers between Mapuche and non-Mapuche women from the Chile Biliary Longitudinal Study, a cohort of women with ultrasound-detected gallstones. We randomly selected 200 Mapuche women frequency matched to non-Mapuche women on age and statin use Inflammatory biomarkers were analyzed using a multiplex assay and linear regression to assess associations of a priori markers (CCL20, CXCL10, IL-6, and IL-8) with ethnicity. Novel biomarkers were analyzed using exploratory factor analysis (EFA) and sufficient dimension reduction (SDR) to identify correlated marker groups, followed by linear regression to examine their association with ethnicity. The mean values of IL-8 were higher in Mapuche than non-Mapuche women (P = 0.04), while CCL20, CXCL10, and IL-6 did not differ significantly by ethnicity. EFA revealed two marker groups associated with ethnicity (P = 0.03 and P < 0.001). SDR analysis confirmed correlation between the biomarkers and ethnicity. We found higher IL-8 levels among Mapuche than non-Mapuche women. Novel inflammatory biomarkers were correlated with ethnicity and should be studied further for their role in gallbladder disease. These findings may elucidate underlying ethnic disparities in gallstones and carcinogenesis among Amerindians.
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Affiliation(s)
- Sarah S Jackson
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, Rockville, MD, USA.
| | - Vanessa Van De Wyngard
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Advanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile
| | - Ruth M Pfeiffer
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, Rockville, MD, USA
| | - Paz Cook
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Advanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile
| | - Allan Hildesheim
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, Rockville, MD, USA
| | - Ligia A Pinto
- Frederick National Laboratory for Cancer Research, National Cancer Institute, Frederick, MD, USA
| | - Sharon H Jackson
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Kelvin Choi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Ricardo A Verdugo
- Programa de Genética Human, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Departamento de Oncología Básico Clínica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Mara Cuevas
- Programa de Genética Human, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Cristian Yáñez
- Programa de Genética Human, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Eduardo Tobar-Calfucoy
- Programa de Genética Human, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Rocío Retamales-Ortega
- Programa de Genética Human, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juan Carlos Araya
- Advanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile.,Hospital Dr. Hernan Henríquez Aravena, Temuco, Chile.,Department of Pathology, Faculty of Medicine, Universidad de la Frontera, Temuco, Chile
| | - Catterina Ferreccio
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.,Advanced Center for Chronic Diseases (ACCDiS), FONDAP, Santiago, Chile
| | - Jill Koshiol
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Institutes of Health, National Cancer Institute, Rockville, MD, USA
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152
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Arabic speaking migrant parents' perceptions of sex education in Sweden: A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 28:100596. [PMID: 33550052 DOI: 10.1016/j.srhc.2021.100596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 01/20/2021] [Accepted: 01/25/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND It is well established that migrants underutilise sexual and reproductive health (SRH) services for structural and socio-cultural reasons. Sex education at Swedish schools is compulsory and an important part of Swedish upbringing, yet little is known about how migrants perceive this. This study examined migrant parents' views on sex education that their children receive at Swedish schools. METHODS This is a qualitative study using 14 focus group discussions (74 = n) with Arabic speaking migrant parents attending Swedish integration courses. Qualitative data analysis was used following Saldana's coding method. RESULTS Migrants' perceptions about sex education provided at Swedish schools are influenced by their home countries, where most participants received no sex education at schools and very little sex education at home. Therefore, values about sex in home countries and Sweden are often contrasting. Consequently, migrant parents are concerned about sex education that their children receive at Swedish schools. There are varied interpretations of sex education, concern over the content and methods taught, and there are numerous assumptions about potential negative effects of sex education. CONCLUSION The study echoes findings on intergenerational challenges in migrant families surrounding the topic of gender and sex, often brought on by discussions about sex education at schools. Innovative approaches are needed to support migrant parents as part of Sweden's effort to strengthen effectiveness and inclusiveness of sex education.
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153
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White SJ, Barello S, Cao di San Marco E, Colombo C, Eeckman E, Gilligan C, Graffigna G, Jirasevijinda T, Mosconi P, Mullan J, Rehman SU, Rubinelli S, Vegni E, Krystallidou D. Critical observations on and suggested ways forward for healthcare communication during COVID-19: pEACH position paper. PATIENT EDUCATION AND COUNSELING 2021; 104:217-222. [PMID: 33419600 PMCID: PMC7833684 DOI: 10.1016/j.pec.2020.12.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Communication in healthcare has influenced and been influenced by the COVID-19 pandemic. In this position paper, we share observations based on the latest available evidence and experiential knowledge that have emerged during the pandemic, with a specific focus on policy and practice. METHODS This is a position paper that presents observations relating to policy and practice in communication in healthcare related to COVID-19. RESULTS Through our critical observations as experts in the field of healthcare communication, we share our stance how healthcare communication has occured during the pandemic and suggest possible ways of improving policy and professional practice. We make recommendations for policy makers, healthcare providers, and communication experts while also highlighting areas that merit further investigation regarding healthcare communication in times of healthcare crises. CONCLUSION We have witnessed an upheaval of healthcare practice and the development of policy on-the-run. To ensure that policy and practice are evidence-based, person-centred, more inclusive and equitable, we advocate for critical reflection on this symbiotic relationship between COVID-19 and the central role of communication in healthcare. PRACTICE IMPLICATIONS This paper provides a summary of the key areas for development in communication in healthcare during COVID-19. It offers recommendations for improvement and a call to review policies and practice to build resilience and inclusive and equitable responsiveness in communication in healthcare.
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Affiliation(s)
- Sarah J White
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Australia.
| | - Serena Barello
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, Italy
| | | | - Cinzia Colombo
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy
| | - Edgard Eeckman
- University Hospital Brussels, Belgium; CEMESO at the Free University Of Brussels (VUB), Belgium
| | - Conor Gilligan
- Faculty of Health and Medicine, University of Newcastle, Australia
| | - Guendalina Graffigna
- EngageMinds HUB - Consumer, Food & Health Engagement Research Center, Italy; Department of Psychology, Università Cattolica del Sacro Cuore, Italy
| | | | - Paola Mosconi
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Italy
| | - Judy Mullan
- School of Medicine, University of Wollongong, Australia
| | - Shakaib Ur Rehman
- Phoenix VA Health Care System, University of Arizona College of Medicine - Phoenix, USA
| | - Sara Rubinelli
- Department of Health Sciences and Medicine, University of Lucerne, Switzerland; Swiss Paraplegic Research, Switzerland
| | - Elena Vegni
- Unit of Clinical Psychology, Santi Paolo and Carlo Hospital, and Clinical Psychology, Department of Health Sciences, University of Milan, Italy
| | - Demi Krystallidou
- Centre for Translation Studies, School of Literature and Languages, University of Surrey, UK.
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154
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Zheng X, Wang R, Hoekstra AY, Krol MS, Zhang Y, Guo K, Sanwal M, Sun Z, Zhu J, Zhang J, Lounsbury A, Pan X, Guan D, Hertwich EG, Wang C. Consideration of culture is vital if we are to achieve the Sustainable Development Goals. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.oneear.2021.01.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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155
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Baugh RF, Baugh AD. Cultural influences and the Objective Structured Clinical Examination. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:22-24. [PMID: 33507878 PMCID: PMC7883802 DOI: 10.5116/ijme.5ff9.b817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 01/09/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Reginald F. Baugh
- Department of Surgery, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Aaron D. Baugh
- Pulmonary, Critical Care, Allergy, Sleep Medicine, Department of Internal Medicine University of California San Francis-co Medical School, University of California San Francisco Medical Center, San Francisco, CA, USA
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156
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Lee CW, Lin LC, Hung HC. Art and Cultural Participation and Life Satisfaction in Adults: The Role of Physical Health, Mental Health, and Interpersonal Relationships. Front Public Health 2021; 8:582342. [PMID: 33558844 PMCID: PMC7864897 DOI: 10.3389/fpubh.2020.582342] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 12/14/2020] [Indexed: 01/07/2023] Open
Abstract
Many different forms of art and cultural participation, for example, visiting museums and galleries, have received increasing attention as an important new focus for public health. While a growing body of evidence suggests that art and cultural participation enhance human health and well-being in the West, the research is just in the infancy in the East. The purpose of this study was to explore the effects of art and cultural participation of museums and galleries on life satisfaction intervened and controlled by physical and mental health and interpersonal relationships and individual's background. This study adopted large-sample data from the seventh period of the Taiwan Social Change Survey. The sample population comprised 2,034 adult participants, involving 1,042 males and 992 females. The average age of the respondents was 47.67 ± 17.48 years. The results showed that individuals aged 30–64 years with an average monthly income between NT$20,000–NT$40,000 had a higher frequency of art and cultural participation of museums and galleries. Women under 29 years reported better life satisfaction. Individuals with a higher frequency of art and cultural participation of museums and galleries affected life satisfaction not only directly but also indirectly through interpersonal relationships, particularly among women and the elderly. Individuals who visited museums and galleries more frequently had greater life satisfaction and higher frequency of interpersonal contact. This was particularly evident in older females. Art and cultural participation of museums and galleries directly affected individual's life satisfaction and indirectly affected it via interpersonal relationships after controlling for gender, age, and monthly income. These findings indicate that visiting museums and galleries can enhance the frequency of interpersonal interactions and life satisfaction.
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Affiliation(s)
- Chia-Wen Lee
- College of Modern Management, Yango University, Fuzhou, China
| | - Li-Ching Lin
- Department of Art Industry, National Taitung University, Taitung, Taiwan
| | - Huang-Chia Hung
- Department of Physical Education, National Taitung University, Taitung, Taiwan
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157
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A Mixed-Methods Systematic Review of the Impacts of Coronavirus on Society and Culture. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020491. [PMID: 33435337 PMCID: PMC7827960 DOI: 10.3390/ijerph18020491] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 12/19/2022]
Abstract
Little is understood of the social and cultural effects of coronaviruses such as coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS-CoV). This systematic review aims to synthesize existing findings (both qualitative and quantitative) that focus on the social and cultural impacts of coronaviruses in order to gain a better understanding of the COVID-19 pandemic. Utilizing a predetermined search strategy, we searched CINAHL, PsycINFO, PubMed, and Web of Science to identify existing (qualitative, quantitative, and mixed-methods) studies pertaining to the coronavirus infections and their intersection with societies and cultures. A narrative synthesis approach was applied to summarize and interpret findings of the study. Stemming from SARS outbreak in 2003, qualitative and quantitative findings (twelve adopted quantitative methods and eight exclusively used qualitative methods) were organized under five topical domains: governance, crisis communication and public knowledge, stigma and discrimination, social compliance of preventive measures, and the social experience of health workers. The selected studies suggest that current societies are not equipped for effective coronavirus response and control. This mixed-methods systematic review demonstrates that the effects of coronaviruses on a society can be debilitating.
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158
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Dowhaniuk N, Ojok S, McKune SL. Setting a research agenda to improve community health: An inclusive mixed-methods approach in Northern Uganda. PLoS One 2021; 16:e0244249. [PMID: 33411706 PMCID: PMC7790286 DOI: 10.1371/journal.pone.0244249] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/07/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The United Nations Sustainable Development Goals stress the importance of equitable partnerships in research and practice that integrate grass-roots knowledge, leadership, and expertise. However, priorities for health research in low-and-middle income countries are set almost exclusively by external parties and priorities, while end-users remain "researched on" not "researched with". This paper presents the first stage of a Community-Based Participatory Research-inspired project to engage communities and public-health end-users in setting a research agenda to improve health in their community. METHODS Photovoice was used in Kuc, Gulu District, Uganda to engage community members in the selection of a research topic for future public health research and intervention. Alcohol-Use Disorders emerged from this process the health issue that most negatively impacts the community. Following identification of this issue, a cross-sectional survey was conducted using the Alcohol Use Disorder Identification Test (n = 327) to triangulate Photovoice findings and to estimate the prevalence of Alcohol-Use Disorders in Kuc. Logistic regression was used to test for associations with demographic characteristics and Alcohol-Use Disorders. RESULTS Photovoice generated four prominent themes, including alcohol related issues, sanitation and compound cleanliness, water quality and access, and infrastructure. Alcohol-Use Disorders were identified by the community as the most important driver of poor health. Survey results indicated that 23.55% of adults in Kuc had a probable Alcohol Use Disorder, 16.45 percentage points higher than World Health Organization estimates for Uganda. CONCLUSIONS Community members engaged in the participatory, bottom-up approach offered by the research team to develop a research agenda to improve health in the community. Participants honed in on the under-researched and underfunded topic of Alcohol-Use Disorders. The findings from Photovoice were validated by survey results, thereby solidifying the high prevalence of Alcohol-Use Disorders as the health outcome that will be targeted through future long-term research and partnership.
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Affiliation(s)
- Nicholas Dowhaniuk
- Department of Geography, University of Florida, Gainesville, Florida, United States of America
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, United States of America
- Tropical Conservation and Development Program, University of Florida, Gainesville, Florida, United States of America
| | - Susan Ojok
- Uganda Women's Action Program, Gulu, Uganda
| | - Sarah L. McKune
- Department of Environmental and Global Health, University of Florida, Gainesville, Florida, United States of America
- African Studies Program, University of Florida, Gainesville, Florida, United States of America
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159
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Vinnicombe Z, Little M, Super J, Anakwe R. Surgical training in the UK: is cost a barrier to entry? Postgrad Med J 2021; 98:281-284. [PMID: 33414177 DOI: 10.1136/postgradmedj-2020-139170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is good quality evidence linking socioeconomic background and the likelihood of a surgical career. Additionally, training in surgery is more expensive than in other specialties. Our aim was to assess the awareness and perceptions of trainees and medical students of the relative costs of surgical training and to determine whether perceptions of cost deter potential surgical trainees. METHODS Medical students, foundation doctors and core trainees in England were surveyed over a 2-week period. χ2 tests of independence were used to assess statistically significant associations between measured variables MAIN FINDINGS: A total of 284 responses were received. More than half of respondents (54%) were not previously aware of the high costs of surgical training. More than a quarter of respondents (27%) did not take out a student loan. There was a significant association (p=0.003) between familial income and being less likely to consider a surgical career due to the costs. Respondents who reported receipt of a student loan were also significantly less likely to consider a surgical career due to the costs (p=0.033). CONCLUSION Our study demonstrates an important relationship between perceived costs of surgical training and future career aspirations. This suggests that access to surgical training may still be difficult for many. This study also highlights a general lack of awareness of high surgical training costs. It is important that surgical training is accessible. Financial status should not be a significant disincentive and widening access to surgical training can only serve to enrich and advance the specialty.
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Affiliation(s)
- Zak Vinnicombe
- Department of Plastic and Reconstructive Surgery, St George's Healthcare NHS Trust, London, UK
| | - Max Little
- Department of Orthopaedic Surgery, Whittington Hospital, London, UK
| | - Jonathan Super
- Department of Gastroenterology, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, UK
| | - Raymond Anakwe
- Department of Orthopaedic Surgery, Imperial College Healthcare NHS Trust, London, UK
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160
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VanNoy BN, Bowleg L, Marfori C, Moawad G, Zota AR. Black Women's Psychosocial Experiences with Seeking Surgical Treatment for Uterine Fibroids: Implications for Clinical Practice. Womens Health Issues 2021; 31:263-270. [PMID: 33610438 PMCID: PMC9835088 DOI: 10.1016/j.whi.2021.01.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 12/23/2020] [Accepted: 01/08/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Black women are more likely to undergo surgery for uterine fibroids compared with non-Black women. However, few studies have characterized the psychosocial experiences of Black women seeking fibroid treatment. We aimed to identify factors that shape Black women's fibroid management decisions; explore how discrimination based on race, class, and gender feature in treatment-seeking experiences, and compare experiences across age and socioeconomic status. METHODS We conducted semistructured interviews with 37 Black women undergoing surgery for fibroid management. We used a thematic analysis to code transcripts and identify themes. RESULTS Participants were predominately single, college educated, and insured. Respondents reported that patient-doctor interactions, support from social networks, fertility consequences, and fear of fibroid malignancy influenced their fibroid management decisions. Knowledge and perceptions of fibroids were also influenced by community norms and differed by socioeconomic status; women of higher socioeconomic status had greater fibroid awareness than women of lower socioeconomic status. Discrimination was discussed in the context of historical inequity against Black women, with one participant questioning whether Black women were valued less in clinical settings compared with non-Black women. Although several women discussed positive experiences seeking fibroids care, others expressed medical mistrust or said that alternative management options were not offered by clinicians. CONCLUSIONS Fibroid management decisions were influenced not only by interactions with clinicians and social networks, and concerns about fertility and fibroid malignancy, but also by broader social and historical conditions. These findings suggest that clinicians should deliver intersectional gynecologic care that centers the voices of Black women seeking fibroid treatment.
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Affiliation(s)
- Brianna N. VanNoy
- Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington DC, USA
| | - Lisa Bowleg
- Department of Psychology, The George Washington University, Washington DC, USA
| | - Cherie Marfori
- Department of Obstetrics and Gynecology, The George Washington University, Washington DC, USA
| | - Gaby Moawad
- Department of Obstetrics and Gynecology, The George Washington University, Washington DC, USA
| | - Ami R. Zota
- Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington DC, USA
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161
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Newland J, Lestari D, Poedjanadi MN, Kelly-Hanku A. Co-locating art and health: engaging civil society to create an enabling environment to respond to HIV in Indonesia. Sex Health 2021; 18:84-94. [PMID: 33612154 DOI: 10.1071/sh20125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/13/2020] [Indexed: 01/10/2023]
Abstract
Background This paper will report on the successful co-location of a community-based arts and sexual health project that aimed to engage, educate and create testing, treatment and care pathways at a co-located mobile sexual health clinic and community-controlled art gallery in Yogyakarta, Indonesia. METHODS Mixed methods were used to evaluate the project, including a visitor (n = 1181) and artist (n = 85) log book, a convenience audience survey (n = 231), and qualitative semi-structured interviews (n = 13) with artists and audience to explore the effect of arts-based activities on access to sexual health information and services, and stigma and discrimination. RESULTS In total, 85 artists curated five separate exhibitions that were attended by 1181 people, of which 62% were aged ≤24 years. Gallery attendance improved awareness and participatory and interactive engagement with sexual health information through a medium described as interesting, fun, cool, and unique. The co-located clinic facilitated informal pathways to sexual health services, including HIV/AIDS testing, treatment, and care. Importantly, the project created shared understandings and empathy that challenged stereotypes and myths, reducing stigmatising beliefs and practices. CONCLUSIONS Arts-based programs are transformative and can be effectively implemented, replicated and scaled up in low-resource settings to create awareness and initiate for HIV prevention, testing, treatment, and care. Art-based health programs engages people in their communities, mobilises civil society, builds enabling environments to reduce stigma and discrimination and improves access to testing and prevention; essential features needed to end AIDS in Indonesia (and the Southeast Asia region) while improving the lives of those most vulnerable to infection.
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Affiliation(s)
- Jamee Newland
- Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, NSW, Australia; and Corresponding author.
| | - Dwi Lestari
- Perkumpulan Keluarga Berencana Indonesia, Yogyakarta, Indonesia
| | | | - Angela Kelly-Hanku
- Kirby Institute for Infection and Immunity in Society, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, NSW, Australia; and Sexual and Reproductive Health Unit, Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
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162
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Burns R, Zhang CX, Patel P, Eley I, Campos-Matos I, Aldridge RW. Migration health research in the United Kingdom: A scoping review. J Migr Health 2021; 4:100061. [PMID: 34405201 PMCID: PMC8352015 DOI: 10.1016/j.jmh.2021.100061] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/05/2021] [Accepted: 07/05/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND One in seven people living in the United Kingdom (UK) is an international migrant, rendering migrants an important population group with diverse and dynamic health and healthcare needs. However, there has been no attempt to map contemporary trends within migration health research conducted in the UK. The aim of this scoping review was to describe trends within migration health research and identify gaps for future research agendas. METHODS PubMed and Embase were systematically searched for empirical research with a primary focus on the concepts "health" and "migrants" published between 2001 and 2019. Findings were analysed using the UCL-Lancet Commission on Migration and Health Conceptual Framework for Migration and Health. RESULTS In total, 399 studies were included, with almost half (41.1%; 164/399) published in the last five years of the study period between 2015 and 2019 and a third (34.1%; 136/399) conducted in London. Studies included asylum seekers (14.8%; 59/399), refugees (12.3%; 49/399), and undocumented migrants or migrants with insecure status (3.5%; 14/399), but most articles (74.9%; 299/399) did not specify a migrant sub-group. The most studied health topics were specific disease outcomes such as infectious diseases (24.1% of studies) and mental health (19.1%) compared to examining systems or structures that impact health (27.8%), access to healthcare (26.3%), or specific exposures or behaviours (35.3%). CONCLUSIONS There has been a growing interest in migration health. Ensuring a diverse geographic distribution of research conducted in the UK and disaggregation by migrant sub-group is required for a nuanced and region-specific understanding of specific health needs, interventions and appropriate service delivery for different migrant populations. More research is needed to understand how migration policy and legislation intersect with both the social determinants of health and access to healthcare to shape the health of migrants in the UK.
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Affiliation(s)
- Rachel Burns
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
- Corresponding author at: Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom.
| | - Claire X. Zhang
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
- Public Health England, Wellington House, 133-155 Waterloo Rd, South Bank, London SE1 8UG, United Kingdom
| | - Parth Patel
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
| | - Ida Eley
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
| | - Ines Campos-Matos
- Public Health England, Wellington House, 133-155 Waterloo Rd, South Bank, London SE1 8UG, United Kingdom
- Collaborative Centre for Inclusion Health, Institute of Epidemiology and Healthcare, University College London, 1-19 Torrington Place, London WC1E 7HB, United Kingdom
| | - Robert W. Aldridge
- Centre of Public Health Data Science, Institute of Health Informatics, University College London, 222 Euston Road, London NW1 2DA, United Kingdom
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Grupp F, Skandrani S, Moro MR, Mewes R. Relational Spirituality and Transgenerational Obligations: The Role of Family in Lay Explanatory Models of Post-traumatic Stress Disorder in Male Cameroonian Asylum Seekers and Undocumented Migrants in Europe. Front Psychiatry 2021; 12:621918. [PMID: 33959046 PMCID: PMC8093444 DOI: 10.3389/fpsyt.2021.621918] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Context: Diasporic Cameroonians are increasingly leading a transnational life in which family members are sustained through networks of relations and obligations. However, before arriving in Europe, the vast majority of African migrants who take the Mediterranean route are exposed to trauma and hardship. Moreover, the joint occurrence of forced displacement, trauma, and extended separation from families has a significant impact on mental health. Objectives: This study explores the role of culture-specific conceptualizations of family structures and transnationalism in explanatory models of post-traumatic stress disorder (PTSD) among male Cameroonian asylum-seekers and undocumented migrants in Europe. Methods: An in-depth study of two samples of Cameroonian migrants with a precarious residency status in Europe was conducted. Focus group discussions and interviews were carried out with asylum seekers in Germany (n = 8) and undocumented migrants and failed asylum seekers in France (n = 9). The verbatim transcripts of these interviews served as the data for interpretative phenomenological analyses. Results, Analysis, and Discussion: Family was conceptualized in religious and spiritual terms, and relational spirituality appeared to be a crucial element of family cohesion. Explanatory models of PTSD were mainly based on an intersection of family and spirituality. The disrespect of transgenerational, traditional, and spiritual obligations toward parents and ancestral spirits represented a crucial causal attribution for post-traumatic symptoms. Conclusions: Conceptualizations of post-traumatic stress were based on a collective family and spiritual level instead of an individualized illness-centered perception. The Western psychological and psychiatric perspective on post-traumatic stress might conflict with traditional, religious, and spiritual practices in the context of family conceptualizations of Cameroonian forced migrants with a precarious residency status.
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Affiliation(s)
- Freyja Grupp
- Division of Clinical Psychology, Department of Psychology, University of Marburg, Marburg, Germany
| | - Sara Skandrani
- University of Paris Nanterre, Hospital Cochin Paris, Paris, France
| | - Marie Rose Moro
- University of Paris, Hospital Cochin AP-HP, Unite Inserm 1018, CESP, Paris, France
| | - Ricarda Mewes
- Outpatient Unit for Research, Teaching, and Practice, Faculty of Psychology, University of Vienna, Wien, Austria
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164
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Croucher K, Büster L, Dayes J, Green L, Raynsford J, Comerford Boyes L, Faull C. Archaeology and contemporary death: Using the past to provoke, challenge and engage. PLoS One 2020; 15:e0244058. [PMID: 33373412 PMCID: PMC7771686 DOI: 10.1371/journal.pone.0244058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 12/02/2020] [Indexed: 11/18/2022] Open
Abstract
While death is universal, reactions to death and ways of dealing with the dead body are hugely diverse, and archaeological research reveals numerous ways of dealing with the dead through time and across the world. In this paper, findings are presented which not only demonstrate the power of archaeology to promote and aid discussion around this difficult and challenging topic, but also how our approach resulted in personal growth and professional development impacts for participants. In this interdisciplinary pilot study, archaeological case studies were used in 31 structured workshops with 187 participants from health and social care backgrounds in the UK, to explore their reactions to a diverse range of materials which documented wide and varied approaches to death and the dead. Our study supports the hypothesis that the past is a powerful instigator of conversation around challenging aspects of death, and after death care and practices: 93% of participants agreed with this. That exposure to archaeological case studies and artefacts stimulates multifaceted discourse, some of it difficult, is a theme that also emerges in our data from pre, post and follow-up questionnaires, and semi-structured interviews. The material prompted participants to reflect on their biases, expectations and norms around both treatment of the dead, and of bereavement, impacting on their values, attitudes and beliefs. Moreover, 87% of participants believed the workshop would have a personal effect through thinking differently about death and bereavement, and 57% thought it would impact on how they approached death and bereavement in their professional practice. This has huge implications today, where talk of death remains troublesome, and for some, has a near-taboo status-'taboo' being a theme evident in some participants' own words. The findings have an important role to play in facilitating and normalising discussions around dying and bereavement and in equipping professionals in their work with people with advanced illness.
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Affiliation(s)
- Karina Croucher
- School of Archaeological and Forensic Sciences, Faculty of Life Sciences, University of Bradford, Bradford, United Kingdom
| | - Lindsey Büster
- School of Archaeological and Forensic Sciences, Faculty of Life Sciences, University of Bradford, Bradford, United Kingdom
- Department of Archaeology, University of York, York, United Kingdom
| | - Jennifer Dayes
- Department of Psychology, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Laura Green
- Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Justine Raynsford
- Faculty of Health Studies, University of Bradford, Bradford, United Kingdom
| | - Louise Comerford Boyes
- Division of Psychology, School of Social Sciences, Faculty of Management, Law & Social Sciences, University of Bradford, Bradford, United Kingdom
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165
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Pearson O, Schwartzkopff K, Dawson A, Hagger C, Karagi A, Davy C, Brown A, Braunack-Mayer A. Aboriginal community controlled health organisations address health equity through action on the social determinants of health of Aboriginal and Torres Strait Islander peoples in Australia. BMC Public Health 2020; 20:1859. [PMID: 33276747 PMCID: PMC7716440 DOI: 10.1186/s12889-020-09943-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Indigenous populations globally are continually striving for better health and wellbeing due to experiencing significant health and social inequities. The social determinants of health are important contributors to health outcomes. Comprehensive primary health care that is governed and delivered by Indigenous people extends beyond the biomedical model of care to address the social determinants of health. Aboriginal Community Controlled Health Organisations (ACCHOs) are known to provide culturally informed, holistic health services that directly and indirectly address the social determinants of health. The range and extent of their activities in addressing the social determinants of health, however, is not well documented. METHODS The most recent ACCHO annual reports were retrieved online or by direct correspondence. For coding consistency, a dictionary informed by the World Health Organization's Conceptual Framework for Action on the Social Determinants of Health was developed. A document and textual analysis of reports coded ACCHO activities and the determinants of health they addressed, including intermediary determinants, socio-economic position and/or socio-political context. Summary statistics were reported. Representative quotes illustrating the unique nature of ACCHO service provision in addressing the social determinants of health were used to contextualise the quantitative findings. RESULTS Sixty-seven annual reports were collected between 2017 and 2018. Programs were delivered to population groups across the life span. Fifty three percent of reports identified programs that included work at the socio-political level and all annual reports described working to improve socioeconomic position and intermediary determinants of health through their activities. Culture had a strong presence in program delivery and building social cohesion and social capital emerged as themes. CONCLUSIONS This study provides evidence of the considerable efforts of the ACCHO sector, as a primary health care provider, in addressing the social determinants of health and health inequity experienced by Indigenous communities. For the Aboriginal and Torres Strait Islander population, ACCHOs not only have an essential role in addressing immediate healthcare needs but also invest in driving change in the more entrenched structural determinants of health. These are important actions that are likely to have an accumulative positive effect in closing the gap towards health equity.
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Affiliation(s)
- O Pearson
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia. .,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia.
| | - K Schwartzkopff
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - A Dawson
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - C Hagger
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - A Karagi
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia.,Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - C Davy
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - A Brown
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia.,Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - A Braunack-Mayer
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia.,Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.,Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
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166
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O’Beirne C, Doody G, Agius S, Warren A, Krstic L. Experiences of Widening Participation students in undergraduate medical education in the United Kingdom: a qualitative systematic review protocol. JBI Evid Synth 2020; 18:2640-2646. [DOI: 10.11124/jbies-20-00064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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167
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War RJ, Gharat VV, Chandramouleeshwaran S, Nayak S, Nimgaonkar VL, Devi S. A Three-Site Study of Alcohol Consumption among Adolescents from Indigenous Tribes in India. Indian J Psychol Med 2020; 42:S51-S56. [PMID: 33487803 PMCID: PMC7802039 DOI: 10.1177/0253717620969737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Alcohol use disorder is elevated among members of indigenous tribes in India, like native populations in several other countries. Despite constituting 8.6% of the Indian population, tribals are among the most geographically isolated, socioeconomically underdeveloped, and underserved communities in the country. Based on the experience from our centers (in Tamil Nadu, Meghalaya, and Gujarat), we are aware of escalating alcohol use among tribal communities. The aims of this study are (a) to estimate alcohol use and psychiatric morbidity among teenagers from indigenous tribes, and (b) pilot test a psychoeducational efficacy study. METHODS The biphasic study is being conducted in three states of India: Tamil Nadu in South, Meghalaya in Northeast, and Gujarat in West. Phase 1 is a cross-sectional study of tribal adolescents at each site. The MINI 6.0/MINI Kid 6.0 questionnaire was used to estimate extent of psychiatric morbidity and substance addiction. Phase 2 is an intervention trial of 40 participants at each site to assess the effectiveness of NIMHANS LSE module in protecting the tribal adolescents from alcohol use. CONCLUSIONS The desired primary outcome will be forestalling the onset of alcohol use among this group. This paper focuses on the methodology and strategies to be used to achieve the objectives.
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Affiliation(s)
| | - Vaibhav V Gharat
- Dept. of Community Medicine, Gujarat Medical Education and Research Society Medical College, Valsad, Gujarat
| | | | - Sunil Nayak
- Dept. of Community Medicine, Gujarat Medical Education and Research Society Medical College, Valsad, Gujarat
| | - Vishwajit L Nimgaonkar
- Behavioral Health Service Line, VA Pittsburgh Healthcare System, Western Psychiatric Institute and Clinic, University of Pittsburgh, Pennsylvania, USA
| | - Shylaja Devi
- Association for Health Welfare in the Nilgiris, Gudalur, Nilgiris, Tamil Nadu
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168
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Adama EA, Sundin D, Bayes S. Sociocultural Practices Affecting the Care of Preterm Infants in the Ghanaian Community. J Transcult Nurs 2020; 32:458-465. [PMID: 33225863 PMCID: PMC8404725 DOI: 10.1177/1043659620975098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Introduction Although culture is an integral part of health, there is scarcity of evidence on the influence of culture on caregiving experiences of parents of preterm infants. The aim of this study was to explore the influence of sociocultural practices on caring for preterm infants in the Ghanaian community. Method Narrative inquiry was utilized to explore the influence of sociocultural practices on the care of preterm infants from 21 mothers, 9 fathers, and 12 household members. Data were collected through face-to-face semistructured interviews and observations at participants’ homes. Results Analysis of data resulted in three threads/themes—respect for the elderly, use of herbal medicines, and communal living. Discussion Community and extended family members have great influence on the care of preterm infants. Traditional herbal medicines are considered effective in treating traditional illnesses among preterm infants. Understanding the influence of culture on the care of vulnerable preterm infants in the community is essential in developing interventions for infant survival.
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Affiliation(s)
| | - Deborah Sundin
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Sara Bayes
- Edith Cowan University, Joondalup, Western Australia, Australia
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169
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Gallego-Pérez DF, Abdala CVM, Amado DM, Carvalho de Sousa IM, Aldana-Martínez NS, Ghelman R. [Equity, intercultural approaches and access to information on traditional, complementary and integrative medicines in the AmericasEquidade, abordagens interculturais e acesso a informações sobre medicinas tradicionais, complementares e integrativas nas Américas]. Rev Panam Salud Publica 2020; 44:e143. [PMID: 33196705 PMCID: PMC7655062 DOI: 10.26633/rpsp.2020.143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/30/2020] [Indexed: 01/21/2023] Open
Abstract
El acceso a la información y los abordajes interculturales en el ámbito de la salud son esenciales para la eliminación de inequidades en el acceso a los servicios de salud y la atención sanitaria. Los modelos interculturales, como las medicinas tradicionales, complementarias e integrativas (MTCI) son una parte importante del cuidado de la salud en la mayoría de los países y frecuentemente contribuyen a ampliar el acceso a la atención primaria de salud. A pesar del reconocimiento legal y de la existencia de políticas para la integración de las MTCI en los sistemas de salud, aún se subestima su contribución a la salud, el bienestar y la atención de la salud centrada en las personas para alcanzar la salud universal. En este artículo se presentan los avances (2017-2020) alcanzados por la Biblioteca Virtual en Salud especializada en las MTCI (BVS MTCI Américas), iniciativa creada como herramienta para disminuir las brechas en la producción y el acceso a la información validada sobre las MTCI. Mediante el trabajo colaborativo en red, la BVS MTCI Américas contribuye a la democratización de la salud, el acceso a datos científicos verificados disponibles, la visibilización de conocimientos no convencionales, el fortalecimiento de capacidades de investigación y el intercambio de experiencias para la toma informada de decisiones.
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Affiliation(s)
- Daniel F Gallego-Pérez
- School of Public Health, Boston University Boston United States of America School of Public Health, Boston University, Boston, United States of America
| | - Carmen Verônica Mendes Abdala
- Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud (BIREME) São Paulo Brasil Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud (BIREME), São Paulo, Brasil
| | - Daniel Miele Amado
- Ministério da Saúde do Brasil Brasília Brasil Ministério da Saúde do Brasil, Brasília, Brasil
| | | | | | - Ricardo Ghelman
- Consórcio Acadêmico Brasileiro de Saúde Integrativa São Paulo Brasil Consórcio Acadêmico Brasileiro de Saúde Integrativa, São Paulo, Brasil
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170
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Dudgeon P, Bray A, D'costa B, Walker R. Decolonising Psychology: Validating Social and Emotional Wellbeing. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12294] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Pat Dudgeon
- The School of Indigenous Studies, University of Western Australia,
| | - Abigail Bray
- The School of Indigenous Studies, University of Western Australia,
| | | | - Roz Walker
- Telethon Kids Institute, University of Western Australia,
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171
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Tong CE, McKay HA, Martin-Matthews A, Mahmood A, Sims-Gould J. "These Few Blocks, These Are My Village": The Physical Activity and Mobility of Foreign-Born Older Adults. THE GERONTOLOGIST 2020; 60:638-650. [PMID: 30794287 DOI: 10.1093/geront/gnz005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The self-reported health of foreign-born older adults (FBOAs) is lower than that of nonimmigrant peers. Physical activity (PA) and mobility enhance health in older age, yet we know very little about the PA and mobility of FBOAs. In this analysis we sought to determine: (a) What factors facilitate PA amongst FBOAs? and (b) How do gender, culture, and personal biography affect participants' PA and mobility? RESEARCH DESIGN AND METHODS We worked closely with community partners to conduct a mixed-method study in Vancouver, Canada. Eighteen visible minority FBOAs completed an in-depth interview in English, Cantonese, Mandarin, Punjabi, or Hindi. RESULTS Three dominant factors promote participants' PA and mobility: (a) participants walk for well-being and socialization; (b) participants have access to a supportive social environment, which includes culturally familiar and linguistically accessible shops and services; and (c) gender and personal biography, including work history and a desire for independence, affect their PA and mobility behaviors. DISCUSSION AND IMPLICATIONS We extend the Webber et al. mobility framework, with examples that further articulate the role of gender (e.g., domestic work), culture (cultural familiarity) and personal biography (work history and a desire for familial independence) (Webber, S. C., Porter, M. M., & Menec, V. H. (2010). Mobility in older adults: A comprehensive framework. The Gerontologist, 50, 443-450. doi:10.1093/geront/gnq013). Future programming to support the PA of FBOAs should be culturally familiar and linguistically accessible.
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Affiliation(s)
- Catherine E Tong
- Centre for Hip Health and Mobility, University of British Columbia and Vancouver Coastal Health Research Institute, Canada
| | - Heather A McKay
- Centre for Hip Health and Mobility, University of British Columbia and Vancouver Coastal Health Research Institute, Canada.,Department of Family Practice, Faculty of Medicine
| | | | - Atiya Mahmood
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Joanie Sims-Gould
- Centre for Hip Health and Mobility, University of British Columbia and Vancouver Coastal Health Research Institute, Canada.,Department of Family Practice, Faculty of Medicine
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172
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Pulimeno M, Piscitelli P, Colazzo S, Colao A, Miani A. School as ideal setting to promote health and wellbeing among young people. Health Promot Perspect 2020; 10:316-324. [PMID: 33312927 PMCID: PMC7723000 DOI: 10.34172/hpp.2020.50] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 07/24/2020] [Indexed: 01/19/2023] Open
Abstract
Background: Nowadays, young people face several health challenges. As children and teenagers spend most of their time in the classroom, schools may have the opportunity to positively influence students' quality of life, playing a crucial role in fostering their health. The aim of this review was to analyze evidence that demonstrated why school is the ideal setting for thepromotion of young generations' wellbeing. Methods: We have reviewed the available literature about health promotion in school setting, searching for articles and books published from 1977 to 2020. A total of 74 articles and 17books were selected and assessed. Results: The promotion of students' wellbeing could reduce the prevalence of measurable unhealthy outcomes and improve their academic achievements. At least 80% of all cases of heart diseases, strokes, type 2 diabetes and one third of all cancers can be prevented through health education. In this perspective, primary prevention and health promotion should start as early as possible, finding in the school the ideal setting of action. Effective school-based preventive approaches should raise students' motivation towards a personal interiorization of health knowledge and develop in young people a critical thinking about harmful consequences of the most common risky behaviours. Educators should receive adequate training concerning health topics and become expert in the most innovative approaches to effectively engage students in adopting healthy lifestyles. Conclusion: As primary educational institution, school should integrate students' health promotion in its ordinary teaching and learning practices in the perspective of "better health through better schools".
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Affiliation(s)
- Manuela Pulimeno
- UNESCO Chair on Health Education and Sustainable Development, Naples, Italy
- Doctorate in Human Relations Sciences, University of Bari “Aldo Moro”, Bari, Italy
| | - Prisco Piscitelli
- UNESCO Chair on Health Education and Sustainable Development, Naples, Italy
- Euro Mediterranean Scientific Biomedical Institute, ISBEM, Bruxelles, Italy
| | - Salvatore Colazzo
- UNESCO Chair on Health Education and Sustainable Development, Naples, Italy
- Department of History, Society and Human Studies, University of Salento, Lecce, Italy
| | - Annamaria Colao
- UNESCO Chair on Health Education and Sustainable Development, Naples, Italy
- Department of Clinical Medicine and Surgery, Federico II University School of Medicine, Naples, Italy
| | - Alessandro Miani
- Department of Environmental Science and Policy, University of Milan, Milan, Italy
- Italian Society of Environmental Medicine, SIMA, Milan, Italy
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173
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Bune GT, Yalew AW, Kumie A. Predictors of Metabolic Syndrome Among People Living with HIV in Gedeo-Zone, Southern-Ethiopia: A Case-Control Study. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:535-549. [PMID: 33116916 PMCID: PMC7547778 DOI: 10.2147/hiv.s275283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/10/2020] [Indexed: 12/29/2022]
Abstract
Background Intensive access to antiretroviral therapy improved the prognosis of HIV. As a result, a non-communicable disease risk marker known as metabolic syndrome (MS) has emerged. It is a public health issue in sub-Saharan Africa including Ethiopia. However, there is little literature on predictors of MS among people living with HIV (PLHIVs) in the study area context. Purpose To identify predictors of metabolic syndrome among PLHIVs, Gedeo Zone, Southern-Ethiopia. Methods Health institutions-based unmatched case–control study was conducted. All HIV-infected adult persons who are receiving routine care in the randomly selected two hospitals and two health centers of the Gedeo zone, southern Ethiopia were involved in the study, conducted from December 29th, 2017, to January 22nd, 2019. PLHIVs diagnosed with MS using ATP III criteria were considered as a case, and subjects free of MS in the survey were enrolled as controls. Binary logistic regression was employed to identify predictors of MS. Results A total of 633 (139 cases and 494 controls) PLHIVs were included in the study. The multivariable analysis result found that age (AOR=1.09, 95% CI (1.05–1.12)); educational status being completed secondary school (AOR=0.22, 95% CI (0.02–0.42)); occupational status being of students (AOR=0.11, 95% CI (0.24–0.51)); wealth index being in the middle quintile (AOR=0.22, 95% CI (0.06–0.79)); ART status exposed to ART (AOR=3.07, 95% CI (1.37–6.89)); total physical activity state being physically active (AOR=0.36, 95% CI (0.16–0.79)), and engaged in low levels physical activity (AOR=3.83, 95% CI (1.46–10.05)) were the factors significantly associated with MS. Conclusion While education, occupation, wealth index, antiretroviral therapy status, total physical activity, and lower physical activity levels were concluded by the study as modifiable predictors of metabolic syndrome, age was found as a non-modifiable independent risk of metabolic syndrome. There is a need for an ongoing effort to realize an integrated care plan that addresses both the routine care and regular screening programs to reduce the risks associated with MS and its traits in these subjects.
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Affiliation(s)
| | | | - Abera Kumie
- Schools of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
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174
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Batt-Rawden K, Andersen S. 'Singing has empowered, enchanted and enthralled me'-choirs for wellbeing? Health Promot Int 2020; 35:140-150. [PMID: 30715392 DOI: 10.1093/heapro/day122] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Singing in groups is a global phenomenon and there is a growing body of evidence that singing can affect health and wellbeing. This is the first gender-based study to explore how women's perceptions of their own health and wellbeing can be affected by singing in a choir; and also how choral singing may have an impact on social inclusion. Qualitative data was collected from nine choirs in two regions of Norway. The sample consisted of 19 (n = 19) women aged 21-75 (mean age, 51.3.) who had sung in choirs from 6 months to 20 years (mean, 6.2 years). The sample population included those who identified as 'healthy' and those experiencing health issues such as cancer, depression, anxiety or fatigue. Two focus groups and 16 semi-structured interviews were carried out and the data were analyzed using grounded theory. Findings were that choral singing can affect women's perceptions of their wellbeing in four distinct ways: (i) through the joy of singing, (ii) experiencing singing as essential for survival, (iii) group singing as a route to social connection, which enhanced a sense of identity and of belonging, and thereby increased self-confidence and self-esteem and (iv) through promoting social inclusion. In the context of these findings, choral singing can be understood as a 'salutogenic' activity, that is, one that supports health and wellbeing. This has implications for self-care practice, social prescribing programs and public health policy.
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Affiliation(s)
- Kari Batt-Rawden
- Norwegian University of Science and Technology (NTNU), Department of Health Sciences, Gjøvik, Norway
| | - Sarah Andersen
- General Practitioner at Herstmonceux Integrative Health Centre, Hailsham, East Sussex, UK
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175
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Gómez-Carrillo A, Lencucha R, Faregh N, Veissière S, Kirmayer LJ. Engaging culture and context in mhGAP implementation: fostering reflexive deliberation in practice. BMJ Glob Health 2020; 5:e002689. [PMID: 32967978 PMCID: PMC7513569 DOI: 10.1136/bmjgh-2020-002689] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/16/2020] [Accepted: 07/21/2020] [Indexed: 01/11/2023] Open
Abstract
In 2002, WHO launched the Mental Health Gap Action Programme (mhGAP) as a strategy to help member states scale up services to address the growing burden of mental, neurological and substance use disorders globally, especially in countries with limited resources. Since then, the mhGAP program has been widely implemented but also criticised for insufficient attention to cultural and social context and ethical issues. To address this issue and help overcome related barriers to scale-up, we outline a framework of questions exploring key cultural and ethical dimensions of mhGAP planning, adaptation, training, and implementation. This framework is meant to guide mhGAP activity taking place around the world. Our approach is informed by recent research on cultural formulation and adaptation, and aligned with key components of the WHO implementation research guide (Peters, D. H., Tran, N. T., & Adam, T. (2013). Implementation research in health: a practical guide. Implementation research in health: a practical guide.). The framework covers three broad domains: (1) Concepts of wellness and illness-how to examine cultural norms, knowledge, values and attitudes in relation to the "culture of the mhGAP"; (2) Systems of care-identifying formal and informal systems of care in the cultural context of practice.; and (3) Ethical space: examining issues related to power dynamics, communication, and decision-making. Systematic consideration of these issues can guide integration of cultural knowledge, structural competence, and ethics in implementation efforts.
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Affiliation(s)
- Ana Gómez-Carrillo
- Division of Social and Transcultural Psychiatry, Culture Mind and Brain Program and Global Mental Health Program, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Raphael Lencucha
- School of Physical and Occupational Therapy, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Neda Faregh
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Samuel Veissière
- Division of Social and Transcultural Psychiatry, Culture Mind and Brain Program and Global Mental Health Program, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Laurence J Kirmayer
- Division of Social and Transcultural Psychiatry, Culture Mind and Brain Program and Global Mental Health Program, McGill University Faculty of Medicine, Montreal, Quebec, Canada
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176
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Ventres W. Toward a New Ethic in Global Health Practice: Perspectives from Central America. South Med J 2020; 113:374-377. [PMID: 32747964 DOI: 10.14423/smj.0000000000001126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- William Ventres
- From the Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock
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177
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Paralikar VP, Deshmukh A, Weiss MG. Qualitative Analysis of Cultural Formulation Interview: Findings and Implications for Revising the Outline for Cultural Formulation. Transcult Psychiatry 2020; 57:525-541. [PMID: 30636531 DOI: 10.1177/1363461518822407] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The DSM-IV Outline for Cultural Formulation (OCF) was a framework for assessment based on principles of cultural psychiatry. The Cultural Formulation Interview (CFI) for DSM-5 provided a tool enabling wider use of cultural formulation in clinical cultural assessment. Validation to justify the inclusion of the CFI in DSM-5 involved quantitative analysis of debriefing interviews of patients and clinicians for feasibility, acceptability and clinical utility. We now further examine qualitative field trial data from the CFI interviews and the debriefing interviews in Pune, India. Administration of the CFI was followed by routine diagnostic assessment of 36 psychiatric outpatients-11 found to have severe mental disorders (SMD) and 25 with common mental disorders (CMD). Domain-wise thematic analyses of the CFI and debriefing interviews identified recurrent themes based on cultural identity, illness explanatory models, stressful and supportive social relationships, and the impact of political, economic, and cultural contexts. A tendency to elaborate accounts, rather than simply name their problem, and more diverse past help-seeking distinguished CMD from SMD groups. Patients valued the CFI more than clinicians did, and most patients did not consider cultural background differences of clinician-patient relationships to be relevant. Qualitative analysis of CFI data and critical analysis of domain mapping of CFI content to the structure of OCF domains indicated the value of revising the dimensional structure of the OCF. A proposed revision (OCF-R) is expected to better facilitate clinical use and research on cultural formulation and use of the CFI.
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Affiliation(s)
| | | | - Mitchell G Weiss
- Swiss Tropical and Public Health Institute; and University of Basel
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178
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Shaw CV, D'Souza AJ, Cunningham R, Sarfati D. Revolutionized Public Health Teaching to Equip Medical Students for 21st Century Practice. Am J Prev Med 2020; 59:296-304. [PMID: 32376145 DOI: 10.1016/j.amepre.2020.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 11/28/2022]
Abstract
Medical graduates increasingly need public health skills to equip them to face the challenges of healthcare practice in the 21st century; however, incorporating public health learning within medical degrees remains a challenge. This paper describes the process and preliminary outcomes of the transformation, between 2016 and 2019, of a 5-week public health module taught within an undergraduate medical degree in New Zealand. The previous course consisted of a research project and standalone lectures on public health topics. The new course takes an active case-based learning approach to engage student interest and stimulate a broadening of perspective from the individual to the population while retaining relevance to students. A combination of individual- and population-level case scenarios aim to help students understand the context of health, think critically about determinants of health and health inequities, and develop skills in disease prevention, health promotion, and system change that are relevant to their future clinical careers. The new module is based on contemporary medical education theory, emphasizes reflective practice, and is integrated with other learning in the degree. It challenges students to understand the relevance of public health to every aspect of medicine and equips them with the skills needed to act to improve population health and reduce inequities as health professionals and leaders of the future.
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Affiliation(s)
- Caroline V Shaw
- Department of Public Health, University of Otago, Wellington, New Zealand.
| | - Amanda J D'Souza
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Diana Sarfati
- Department of Public Health, University of Otago, Wellington, New Zealand
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179
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Abstract
Data on COVID-19 supports targeted social distancing could be an effective way to reduce morbidity and mortality, but could inadvertently increase stigma for affected populations. As health care providers we must be aware of the facts of COVID-19, cultural implications, and potential for stigmatization of populations affected by COVID-2019. It is important to consider the real economic impact related to lost workdays due to quarantine and social isolation efforts as well as travel restrictions that may negatively impact access to care and ability to pay for care. Efforts geared towards general education about the disease and the rationale for quarantine and public health information provided to the general public can reduce stigmatization. Countries who are successful at aggressive screening, early identification, patient isolation, contact tracing, quarantine, and infection control methods should also address the risk of stigmatization among populations and the negative effects which could occur. The cases of COVID-19 will continue to rise and the virus will be sustainable for future infections. Timely and appropriate public health interventions addressing cultural impact and risk for stigmatization along with proper screening, treatment, and follow up for affected individuals and close contacts can reduce the number of infections, serious illness, and deaths.
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180
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Rodin D, Giuliani M. Global Health in Radiation Oncology: The Intention-Investment Gap. Int J Radiat Oncol Biol Phys 2020; 107:426-428. [PMID: 32531387 PMCID: PMC7282756 DOI: 10.1016/j.ijrobp.2020.03.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/28/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Danielle Rodin
- Radiation Medicine Program, Princess Margret Cancer Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada.
| | - Meredith Giuliani
- Radiation Medicine Program, Princess Margret Cancer Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada
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181
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Tatari CR, Andersen B, Brogaard T, Badre-Esfahani SK, Jaafar N, Kirkegaard P. Perceptions about cancer and barriers towards cancer screening among ethnic minority women in a deprived area in Denmark - a qualitative study. BMC Public Health 2020; 20:921. [PMID: 32532227 PMCID: PMC7291658 DOI: 10.1186/s12889-020-09037-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/03/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Screening programmes for cervical cancer, breast cancer and colorectal cancer have been implemented in many Western countries to reduce cancer incidence and mortality. Ethnic minority women are less likely to participate in cancer screening than the majority population. In worst case this can result in higher incidence rates, later diagnosis and treatment and ultimately inferior survival. In this paper we explored the perceptions about cancer and perceived barriers towards cancer screening participation among ethnic minority women in a deprived area in Denmark. METHODS Interview study with ethnic minority women in a deprived area in Denmark. The interviews were transcribed verbatim followed by an inductive content analysis. RESULTS Cancer was perceived as a deadly disease that could not be treated. Cancer screening was perceived as only relevant if the women had symptoms. Knowledge about cancer screening was fragmented, often due to inadequate Danish language skills and there was a general mistrust in the Danish healthcare system due to perceived low medical competences in Danish doctors. There was, however, a very positive and curious attitude regarding information about the Danish cancer screening programmes and a want for more information. CONCLUSION Ethnic minority women did not have sufficient knowledge about cancer and the purpose of cancer screening. Perceptions about cancer screening were characterised by openness and the study showed positive and curious attitudes towards screening participation. The findings emphasise the importance of culturally adapted interventions for ethnic minority women in attempts to reduce inequality in screening participation.
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Affiliation(s)
- Camilla Rahr Tatari
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.
| | - Berit Andersen
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Sara Koed Badre-Esfahani
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Negin Jaafar
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
| | - Pia Kirkegaard
- Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark
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182
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Chentsova‐Dutton YE, Ryder AG. Cultural models of normalcy and deviancy. ASIAN JOURNAL OF SOCIAL PSYCHOLOGY 2020. [DOI: 10.1111/ajsp.12413] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Andrew G. Ryder
- Concordia University Montreal Quebec Canada
- Jewish General Hospital Montreal Quebec Canada
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183
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Rovers J, Becker M, Andreski M, Gray J. Short-term Experiences in Global Health: What is the Cost of Cultural Competence? MEDICAL SCIENCE EDUCATOR 2020; 30:927-932. [PMID: 34457751 PMCID: PMC8368303 DOI: 10.1007/s40670-020-00975-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Students in a wide variety of health professions are increasingly interested in volunteering on a short-term experience in global health (STEGH). The literature suggests that STEGHs pose a variety of potential risks and benefits, and may carry a significant cost to plan and provide. One potential mitigating factor for any risks and costs is that student participation on a STEGH may enhance their cultural competence. Since monies spent on STEGHs are fungible, and there may be other opportunities to improve students' cultural competence, the objectives of this study were to determine if participation on a STEGH increased students' cultural competence and if so, what the cost for any such increase was. In this study, 20 students who participated on a 1-week STEGH to the Dominican Republic completed the Inventory for Assessing the Process of Cultural Competence Among Health Care Professionals - Student Version (IAPCC-SV) before and after the STEGH. The costs for all students and 7 supervising health professionals to volunteer for the STEGH were calculated, and the size of any increase in cultural competence was determined. The cost was divided by the change in cultural competence to ascertain the cost of the change. Students showed a measureable increase on the IAPCC-SV overall and on the subscales of knowledge and skill. The cost of a 1% overall increase in students' cultural competence ranged from $287 to $401. These results may allow schools offering STEGHs to determine if their offerings are cost-effective or not.
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Affiliation(s)
- John Rovers
- College of Pharmacy & Health Sciences, Drake University, Des Moines, IA 50311 USA
| | - Michelle Becker
- College of Pharmacy & Health Sciences, Drake University, Des Moines, IA 50311 USA
- Pharmacy Department, Mayo Clinic, 200 First St. SW, Rochester, MN 55905 USA
| | - Michael Andreski
- College of Pharmacy & Health Sciences, Drake University, Des Moines, IA 50311 USA
| | - Jeffrey Gray
- College of Medicine, Des Moines University, Des Moines, IA 50312 USA
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184
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Engebretsen E, Fraas Henrichsen G, Ødemark J. Towards a translational medical humanities: introducing the cultural crossings of care. MEDICAL HUMANITIES 2020; 46:e2. [PMID: 32341131 PMCID: PMC7402465 DOI: 10.1136/medhum-2019-011751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/12/2020] [Indexed: 05/31/2023]
Abstract
In this introductory essay, we will present a translational medical humanities approach where the humanities are not only an auxiliary to medical science and practice, but also an interdisciplinary space where both medicine and the humanities mutually challenge and inform each other. First, we explore how medicine's attempt to tackle the nature-culture divide is emblematically expressed in the concept and practice of knowledge translation (hereinafter KT). Second, we compare and contrast KT as an epistemic ideology and a socio-medical practice, with concepts and practices of translation developed in the human sciences. In particular, we emphasise Derrida's understanding of translation as inherent in all meaning making, as a fundamentally textual process and as a process necessarily creating difference rather than semantic equivalence. Finally, we analyse a case from clinical medicine showing how a more refined notion of translation can enlighten the interaction between biomedical and cultural factors. Such a translational medical humanities approach also requires a rethinking of the concept of evidence in medicine.
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Affiliation(s)
- Eivind Engebretsen
- Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Gina Fraas Henrichsen
- Centre for Health Science Education, University of Oslo Faculty of Medicine, Oslo, Norway
| | - John Ødemark
- Department of Cultural Studies and Oriental Languages, University of Oslo, Oslo, Norway
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185
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Hamelin AM, Caux C, Désy M, Guichard A, Ouédraogo S, Tremblay MC, Vissandjée B, Godard B. Developing the culture of ethics in population health intervention research in Canada. Glob Health Promot 2020; 27:69-77. [PMID: 32400273 DOI: 10.1177/1757975920913547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Population health intervention research (PHIR) is a particular field of health research that aims to generate knowledge that contributes to the sustainable improvement of population health by enabling the implementation of cross-sectoral solutions adapted to social realities. Despite the ethical issues that necessarily raise its social agenda, the ethics of PHIR is still not very formalized. Unresolved ethical challenges may limit its focus on health equity. This contribution aims to highlight some of these issues and calls on researchers to develop a culture of ethics in PHIR. Three complementary ways are proposed: to build an ethical concept specific to this field, to promote a shared space for critical reflection on PHIR ethics, and to develop the ethical competence in PHIR for which a preliminary framework is proposed.
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Affiliation(s)
| | | | - Michel Désy
- Institut national de santé publique du Québec, Montreal, Canada
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186
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Golden TL, Wendel ML. Public Health's Next Step in Advancing Equity: Re-evaluating Epistemological Assumptions to Move Social Determinants From Theory to Practice. Front Public Health 2020; 8:131. [PMID: 32457863 PMCID: PMC7221057 DOI: 10.3389/fpubh.2020.00131] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 03/31/2020] [Indexed: 11/13/2022] Open
Abstract
The field of public health has increasingly promoted a social ecological approach to health, shifting from an individual, biomedical paradigm to a recognition of social and structural determinants of health and health equity. Yet despite this shift, public health research and practice continue to privilege individual- and interpersonal-level measurements and interventions. Rather than adapting public health practice to social ecological theory, the field has layered new concepts (“root causes,” “social determinants”) onto a biomedical paradigm—attempting to answer questions presented by the social ecological schema with practices developed in response to biomedicine. This stymies health equity work before it begins—limiting the field's ability to broaden conceptions of well-being, redress histories of inequitable knowledge valuation, and advance systems-level change. To respond effectively to our knowledge of social determinants, public health must resolve the ongoing disconnect between social ecological theory and biomedically-driven practice. To that end, this article issues a clarion call to complete the shift from a biomedical to a social ecological paradigm, and provides a basis for moving theory into practice. It examines biomedicine's foundations and limitations, glosses existing critiques of the paradigm, and describes health equity challenges presented by over-reliance on conventional practices. It then offers theoretical and epistemological direction for developing innovative social ecological strategies that advance health equity.
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Affiliation(s)
- Tasha L Golden
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, United States.,International Arts + Mind Lab, Brain Science Institute, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Monica L Wendel
- Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville, Louisville, KY, United States
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187
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Mandlik N, Kamat D. Medical Anthropology in Pediatrics: Improving Disparities by Partnering with Families. Pediatr Ann 2020; 49:e222-e227. [PMID: 32413150 DOI: 10.3928/19382359-20200421-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Cultural health beliefs and practices often affect accuracy of diagnoses, health care delivery, and treatment plan adherence, which can lead to health disparity. However, the effect of these belief systems, and acceptance of health care provider recommendations is not commonly discussed. As the proportion of patients from a variety of ethnic and cultural backgrounds increases, an awareness of these belief systems can help achieve better health outcomes. A provider who is flexible and can understand and possibly integrate traditionally non-Western approaches into their treatment plans may build a stronger bond of trust with their patient, thus building a bridge to better health and well-being. [Pediatr Ann. 2020;49(5):e222-e227.].
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188
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Liu X, Li M. Safeguarding intangible cultural heritage to promote mental healthcare in China: Challenges to maintaining the sustainability of safeguarding efforts. Int J Soc Psychiatry 2020; 66:311-313. [PMID: 32009504 DOI: 10.1177/0020764020904752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Xiaodong Liu
- Fashion & Art Design Institute, Donghua University, Shanghai, China
| | - Meina Li
- Department of Health Service, College of Health Service, Second Military Medical University, Shanghai, China
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189
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Bradby H, Lindenmeyer A, Phillimore J, Padilla B, Brand T. 'If there were doctors who could understand our problems, I would already be better': dissatisfactory health care and marginalisation in superdiverse neighbourhoods. SOCIOLOGY OF HEALTH & ILLNESS 2020; 42:739-757. [PMID: 32020646 PMCID: PMC7318273 DOI: 10.1111/1467-9566.13061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
How people in community settings describe their experience of disappointing health care, and their responses to such dissatisfaction, sheds light on the role of marginalisation and underlines the need for radically responsive service provision. Making the case for studying unprompted accounts of dissatisfaction with healthcare provision, this is an original analysis of 71 semi-structured interviews with healthcare users in superdiverse neighbourhoods in four European cities. Healthcare users spontaneously express disappointment with services that dismiss their concerns and fail to attend to their priorities. Analysing characteristics of these healthcare users show that no single aspect of marginalisation shapes the expression of disappointment. In response to disappointing health care, users sought out alternative services and to persuade reluctant service providers, and they withdrew from services, in order to access more suitable health care and to achieve personal vindication. Promoting normative quality standards for diverse and diversifying populations that access care from a range of public and private service providers is in tension with prioritising services that are responsive to individual priorities. Without an effort towards radically responsive service provision, the ideal of universal access on the basis of need gives way to normative service provision.
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Affiliation(s)
| | | | - Jenny Phillimore
- Institute for Research into Superdiversity (IRiS)School of Social PolicyUniversity of BirminghamBirminghamUK
| | - Beatriz Padilla
- Department of SociologyUniversity of South FloridaTampaUSA
- Instituto Universitario de Lisboa (ISCTE‐IUL)LisbonPortugal
| | - Tilman Brand
- Department Prevention and EvaluationLeibniz Institute for Prevention Research and Epidemiology – BIPSBremenGermany
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190
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Karim N, Boyle B, Lohan M, Kerr C. Immigrant parents' experiences of accessing child healthcare services in a host country: A qualitative thematic synthesis. J Adv Nurs 2020; 76:1509-1519. [PMID: 32189345 DOI: 10.1111/jan.14358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/02/2020] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Abstract
AIM To explore voluntary immigrant parents' experiences of child healthcare services in host countries. DESIGN Thomas and Harden's qualitative thematic synthesis method. DATA SOURCES Five electronic databases (CINAHL, Medline, PubMed, Psych INFO and Web of Science), were systematically searched from January 2000 - October 2018. REVIEW METHODS Included studies focused on voluntary migrant/immigrant parents' experiences of child healthcare services. Data were abstracted independently by two authors. Critical Appraisal Skills Programme tools were applied, and qualitative thematic synthesis was performed. FINDINGS Nine studies were eligible for inclusion. Five descriptive themes were identified: (a) seeking information and reassurance, (b) seeking information from "people like me", (c) comparison between child healthcare services in home and host countries, (d) effective communication, and (e) cultural isolation and perceived discrimination. Three analytical themes emerged: navigation of parenting in a health context in a new environment; trust; and balance. CONCLUSIONS Many immigrant families reported positive experiences, others felt patronized and disrespected, leading to a lack of trust and making them less willing to access universal child health care. Trusted advocates, who are culturally competent, have a role in helping immigrant parents navigate the child healthcare system and negotiate with healthcare professionals. Health registration of children of immigrants may encourage the uptake of universal healthcare services. More research is required into the specific health needs of voluntary immigrants. IMPACT Less is known about the experiences of voluntary immigrants than those of refugees/asylum seekers in accessing child healthcare. Navigating health systems is difficult. This can be due to language difficulties, differences in systems of healthcare, and differences in culture/health beliefs. When both parties have some understanding of the others' healthcare practices and beliefs, balance can be found; helping the families to positively compare healthcare and incentivising them to engage in universal child healthcare.
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Affiliation(s)
- Nadhira Karim
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Breidge Boyle
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Maria Lohan
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
| | - Claire Kerr
- School of Nursing and Midwifery, Queens University Belfast, Belfast, UK
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191
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Peres H, Sharaby R. To connect between worlds, to bridge over gaps: learning about the complex role of cultural mediators in perinatal health promotion from a case in Israel. Int J Equity Health 2020; 19:55. [PMID: 32334577 PMCID: PMC7183683 DOI: 10.1186/s12939-020-01161-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 03/16/2020] [Indexed: 11/30/2022] Open
Abstract
Background Reduction of health gaps between ethno-cultural groups has become a major concern for health services, with a strong emphasis on eliminating social and cultural barriers and improving accessibility for diverse populations. Methods The study is based on a Participatory Action Research where an involved researcher accompanied the project for a decade, as well as on eleven in-depth interviews with Bedouin women-mediators working in a perinatal health promotion project in Israel. Results The research analyzes the work of Bedouin women health mediators who mediate between their Bedouin community and institutional health services and bridge over cultural gaps. The study presents the complex task of transferring messages across cultures, dealing with socio-cultural imperatives and the intricacy of multilayered power relations. The findings reveal an evolving process, beginning with a pragmatic mediation model in which the mediators are limited to instruction of pre-defined health materials, toward a transformative model of creating a ground for encouraging the mediators to act creatively according to socio-cultural circumstances. Conclusion The research elaborates on the adoption and implementation of the transformative approach in mediation and provides further understanding of the complexity of mediation role in sensitive issues such as pregnancy, birth and infant care.
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Affiliation(s)
- Hagit Peres
- Ashkelon Academic College, Har Amasa, D.N. Drom Har Hebron, 9040300, Ashkelon, Israel.
| | - Rachel Sharaby
- Ashkelon Academic College, Har Amasa, D.N. Drom Har Hebron, 9040300, Ashkelon, Israel
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192
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Bretones FD, Jain A, Leka S, García-López PA. Psychosocial Working Conditions and Well-Being of Migrant Workers in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2547. [PMID: 32276385 PMCID: PMC7178116 DOI: 10.3390/ijerph17072547] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/30/2020] [Accepted: 04/06/2020] [Indexed: 11/23/2022]
Abstract
This study examines the relationship beween employment and psychosocial working conditions and well-being of native and migrant workers in the working population of Spain. Data from the 7th Spanish Survey of Working Conditions was used to conduct a confirmatory factor analysis (n = 8508) to identify the main latent variables that influenced well-being. Using structural equation modeling and multivariate analysis, we found different patterns and perceptions of well-being and working conditions in these two groups. We discuss the reasons for these differences and suggest directions for further research in this area.
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Affiliation(s)
- Francisco Díaz Bretones
- School of Labour Relations and Human Resource, Universidad de Granada, 18071 Granada, Spain;
| | - Aditya Jain
- Nottingham University Business School, University of Nottingham, Nottingham NG8 1BB, UK;
| | - Stavroula Leka
- Cork University Business School, University College Cork, T12 K8AF Cork, Ireland;
- Centre for Organizational Health and Development, School of Medicine, University of Nottingham, Nottingham NG8 1BB, UK
| | - Pedro A. García-López
- School of Labour Relations and Human Resource, Universidad de Granada, 18071 Granada, Spain;
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193
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Hilty DM, Gentry MT, McKean AJ, Cowan KE, Lim RF, Lu FG. Telehealth for rural diverse populations: telebehavioral and cultural competencies, clinical outcomes and administrative approaches. Mhealth 2020; 6:20. [PMID: 32270012 PMCID: PMC7136658 DOI: 10.21037/mhealth.2019.10.04] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/22/2019] [Indexed: 12/26/2022] Open
Abstract
Rural health care settings are challenged to provide timely and evidence-based care, particularly for culturally diverse patients with behavioral health disorders. Telepsychiatry and telebehavioral health improve access to care and leverage scarce resources. This scoping review from January 2000 - July 2019 was conducted to see if the literature had data for two related the research questions, "What are the components of culturally competent, telepsychiatric clinical care, and what approaches have clinicians and systems taken to implement and evaluate it?" The review focused on key words in four concept areas: (I) competencies; (II) telehealth in the form of telepsychiatry, telebehavioral or telemental health; (III) culture; and (IV) health. It was done in accordance with the six-stage scoping review process in PubMed/Medline and other databases. The screeners reviewed the full-text articles for final inclusion based on inclusion (mesh of the key words) and exclusion (e.g., need for only, skills abstractly discussed) criteria. From a total of 1,118 papers, the authors found 44 eligible for full text review and found 7 papers directly relevant to the concepts. Few studies specifically discuss skills and competencies of both telehealth and cultural factors. Many organizations are attending to cultural competencies and approaches to care, but there are no specific competencies that integrate telepsychiatry or telebehavioral health with culture. Existing telepsychiatric (i.e., video, social media, mobile health) and one set telebehavioral health competencies included cultural component, including use of interpreters and language matters. Administrative adjustments are suggested to promote culturally competent care by telehealth via clinical, educational, quality improvement, program/system evaluation, and other (e.g., finance and reimbursement) interventions. More structured research is needed on development, implementation and evaluation of combined competencies in rural settings.
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Affiliation(s)
- Donald M. Hilty
- Northern California Veterans Administration Health Care System, Mather, CA 95655, USA
- Department of Psychiatry & Behavioral Sciences, UC Davis, Mather, CA 95655, USA
| | - Melanie T. Gentry
- Geriatric Psychiatry Fellowship, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
| | - Alastair J. McKean
- Department of Psychiatry, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
| | - Kirsten E. Cowan
- Essentia Health and Child Psychiatrist Affiliated with Mayo Clinic Department of Psychiatry and Psychology, Hinckley, MN 55037, USA
| | - Russell F. Lim
- Emeritus Clinical Professor of Psychiatry & Behavioral Sciences, Emeritus Luke & Grace Kim Professor in Cultural Psychiatry, University of California, Davis School of Medicine, Sacramento, CA 95817, USA
| | - Francis G. Lu
- Clinical Psychiatry & Behavioral Sciences, Emeritus Luke & Grace Kim Professor in Cultural Psychiatry, University of California, Davis School of Medicine, Sacramento, CA 95817, USA
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Berbyuk Lindström N, Rodríguez Pozo R. Perspectives of Nurses and Doulas on the Use of Information and Communication Technology in Intercultural Pediatric Care: Qualitative Pilot Study. JMIR Pediatr Parent 2020; 3:e16545. [PMID: 32181748 PMCID: PMC7109617 DOI: 10.2196/16545] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/09/2020] [Accepted: 01/27/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Sweden is rapidly becoming an increasingly multicultural and digitalized society. Encounters between pediatric nurses and migrant mothers, who are often primary caregivers, are impeded by language problems and cultural differences. To support mothers, doulas, who are women having the same linguistic and cultural backgrounds, serve as cultural bridges in interactions with health care professionals. In addition, information and communication technology (ICT) can potentially be used to manage interactions owing to its accessibility. OBJECTIVE The objective of this study was to investigate the role of ICT in managing communicative challenges related to language problems and cultural differences in encounters with migrant mothers from the perspectives of Swedish pediatric nurses and doulas. METHODS Deep semistructured interviews with five pediatric nurses and four doulas from a migrant-dense urban area in western Sweden were audio recorded, transcribed, and analyzed using thematic content analysis. RESULTS The results showed that ICT contributes to mitigating communicative challenges in interactions by providing opportunities for nurses and migrant mothers to receive distance interpreting via telephones and to themselves interpret using language translation apps. Using images and films from the internet is especially beneficial while discussing complex and culturally sensitive issues to complement or substitute verbal messages. These findings suggest that ICT helps enable migrant mothers to play a more active role in interactions with health care professionals. This has important implications for their involvement in other areas, such as child care, language learning, and integration in Sweden. CONCLUSIONS The findings of this study suggest that ICT can be a bridging tool between health care professionals and migrants. The advantages and disadvantages of translation tools should be discussed to ensure that quality communication occurs in health care interactions and that health information is accessible. This study also suggests the development of targeted multimodal digital support, including pictorial and video resources, for pediatric care services.
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195
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Ludwig S, Dettmer S, Wurl W, Seeland U, Maaz A, Peters H. Evaluation of curricular relevance and actual integration of sex/gender and cultural competencies by final year medical students: effects of student diversity subgroups and curriculum. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc19. [PMID: 32328521 PMCID: PMC7171359 DOI: 10.3205/zma001312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 07/16/2019] [Accepted: 09/26/2019] [Indexed: 06/02/2023]
Abstract
Background: Diversity issues play a key role in medical practice and have recently been more explicitly integrated into undergraduate medical curricula in Europe and worldwide. However, research on students´ perspectives on the relevance and curricular integration of diversity issues, such as sex/gender and culture-sensitive competencies, is still limited. Methods: The Charité Berlin (Germany) ran in parallel a traditional and a competency-based medical program. Diversity perspectives, especially sex and gender aspects, were systematically integrated into the new curriculum. In 2016, an online questionnaire was sent to all medical students in their final clerkship year of both programs. Students provided diversity-related information (sex/gender, age, number of children, migration background or disability) and rated the relevance of sex/gender and culture-sensitive competencies and the integration into their study program. They also rated their preparedness for the final year clerkships and for working as a physician. Results: The included 184 students considered sex/gender and culture-sensitive competencies to be very relevant or relevant (62%; 73%). The ratings of the relevance are independent of the curriculum and significantly higher in female students. Regarding curricular integration, 69% of the students of the traditional curriculum evaluated the degree of implementation as minor, whereas 83% students of the new curriculum rated the degree of implementation as extensive. Degrees of preparedness for the workplace were significantly higher in students from the new curriculum, with no significant effects by sex/gender. Age group, having a child, migration background or a disability had separate effects on the students' ratings. Conclusions: Medical students in their final clerkship year rated sex/gender and culture-sensitive competencies as relevant; this was independent from their study program. Their ratings provide complementary evidence that our systematic approach to implementation resulted in a successful curricular integration.
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Affiliation(s)
- Sabine Ludwig
- Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Susanne Dettmer
- Charité - Universitätsmedizin Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Wiebke Wurl
- Charité - Universitätsmedizin Berlin, Institute of Medical Sociology and Rehabilitation Science, Berlin, Germany
| | - Ute Seeland
- Charité - Universitätsmedizin Berlin, Institute of Gender in Medicine, Berlin, Germany
| | - Asia Maaz
- Charité - Universitätsmedizin Berlin, Dean's Office of Student Affairs, Dieter Scheffner Center for Medical Education and Educational Research, Berlin, Germany
| | - Harm Peters
- Charité - Universitätsmedizin Berlin, Dean's Office of Student Affairs, Dieter Scheffner Center for Medical Education and Educational Research, Berlin, Germany
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196
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Ludwig S, Gruber C, Ehlers JP, Ramspott S. Diversity in Medical Education. GMS JOURNAL FOR MEDICAL EDUCATION 2020; 37:Doc27. [PMID: 32328529 PMCID: PMC7171352 DOI: 10.3205/zma001320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 02/17/2020] [Accepted: 02/17/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Sabine Ludwig
- Charité – Universitätsmedizin Berlin, Berlin, Germany
- University of Applied Sciences, Department of Applied Health Sciences, Bochum, Germany
| | - Christian Gruber
- University of Veterinary Medicine, Foundation, Hannover, Germany
| | - Jan P. Ehlers
- Witten/Herdecke University, Didactics and Education Research in the Health Sector, Faculty of Health, Witten, Germany
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197
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Marom BS, Sharabi M, Carel RS, Ratzon NZ. Returning to work after a hand injury: Does ethnicity matter? PLoS One 2020; 15:e0229982. [PMID: 32155201 PMCID: PMC7064188 DOI: 10.1371/journal.pone.0229982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 02/19/2020] [Indexed: 11/19/2022] Open
Abstract
Background Hand injuries (HI) are common and may limit participation in work. The objective of this study is to examine the effect of ethnicity and other prognostic variables on return-to-work (RTW) among male manual workers after acute HI. Methods A cohort of 178 subjects (90 Arabs, 88 Jews) aged 22 to 65 was studied. Trained bilingual occupational therapists evaluated and interviewed the subjects, using structured validated questionnaires for evaluating personal and environmental factors, body function and structure, and activity limitation and participation restrictions. Employment status 3 months post injury was assessed by a telephone interview. To establish a predictive model for RTW, ethnicity and certain variables of the four domains mentioned above were analyzed using logistic regression analysis. Results A significant difference in the rate of RTW between Jews and Arabs was found (45.5% for Jews, 28.9% for Arabs, p = 0.03) three months post HI. In the univariate regression analysis, ethnicity was associated with RTW (OR = 2.05; CI: 1.10–3.81) for Jews vs. Arabs. Using a multivariate analysis, only legal counseling, educational attainment, and the severity of disability were significantly associated with RTW. Conclusion RTW three months post HI among manual workers is directly related to variables such as education and legal counseling and only indirectly related to ethnicity. Patients with a lower level of education and those who were engaged in legal counseling need special attention and close guidance in the process of RTW.
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Affiliation(s)
- Batia S. Marom
- Occupational Therapy Unit, Clalit Health Services, Tiberias, Israel
- * E-mail:
| | - Moshe Sharabi
- Sociology and Anthropology Department, Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - Rafael S. Carel
- School of Public Health, The University of Haifa, Haifa, Israel
| | - Navah Z. Ratzon
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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198
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Teles S, Napolskij MS, Paúl C, Ferreira A, Seeher K. Training and support for caregivers of people with dementia: The process of culturally adapting the World Health Organization iSupport programme to Portugal. DEMENTIA 2020; 20:672-697. [PMID: 32151166 DOI: 10.1177/1471301220910333] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Informal caregivers of people with dementia often struggle with several stressors, and their mental and physical health can be negatively affected by providing care. iSupport is an online self-help programme designed by the World Health Organization to provide education, skills training, and support to those caregivers. PURPOSE This paper describes the development of an adapted version of iSupport to the Portuguese culture. We present the adaptation process, methods used and results for the country-specific version. METHODS The adaptation of iSupport was operationalised in five steps: needs assessment; content translation by an authorised translator and technical accuracy check by health professionals; cultural adaptation; independent appraisal of contents by an expert panel; and fidelity check by programme authors. RESULTS Findings indicated the adjustments needed in the original iSupport contents. Overall, 323 text excerpts were proposed to adaptation, comprising semantic and conceptual equivalence of expressions, and adjustments to cultural habits, customs, traditions, local resources, and practices. The expert panel identified the need to reformulate definitions, designations, recommendations, and case studies to fine-tune the original contents to local knowledge and practices. Most adaptations were considered to be in line with the core concepts of the original programme. CONCLUSIONS iSupport is an innovative tool capturing the attention of several organisations around the world interested in translating, adapting, and using the programme. This paper is the first describing the methodological approach for culturally adapting iSupport, constituting an essential resource for those aiming to replicate the process or culturally adapting evidence-based interventions. Tailoring iSupport to the Portuguese context was critical to accommodate the cultural experiences of the target group as well as the knowledge, theoretical approaches, and practices of local professionals. The European-Portuguese version of iSupport introduces the adjustments needed to implement a useful new intervention programme aimed at minimising the psychological distress of Portuguese caregivers.
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Affiliation(s)
- Soraia Teles
- Department of Behavioral Sciences, Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Milaydis Sosa Napolskij
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal; Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Constança Paúl
- Department of Behavioral Sciences, Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Ana Ferreira
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal; Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Katrin Seeher
- Department of Mental Health and Substance Use (MSD), World Health Organization, Geneva, Switzerland
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199
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Shooshtari S, Menec V, Swift A, Tate R. Exploring ethno-cultural variations in how older Canadians define healthy aging: The Canadian Longitudinal Study on Aging (CLSA). J Aging Stud 2020; 52:100834. [PMID: 32178804 DOI: 10.1016/j.jaging.2020.100834] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 02/24/2020] [Accepted: 02/26/2020] [Indexed: 11/25/2022]
Abstract
An understanding of how older adults conceptualize healthy aging is important for the development of policies, programs, and services designed to promote health; this understanding must reflect the ethno-cultural diversity of the population. This pilot study aimed to examine Canadians' definitions of healthy aging and ethno-cultural variations in these definitions. The baseline data for a sub-sample (n = 535) of the Canadian Longitudinal Study on Aging (CLSA) Tracking Cohort (n = 21,241) were examined. Narrative responses to an open-ended question on healthy aging were analyzed using a previously developed coding system. The most common themes for all the ethno-cultural groups were "lifestyle", "physical activity", and "attitude"; other themes varied by ethno-cultural background. These findings demonstrate that older Canadians from various ethno-cultural backgrounds define healthy aging differently. These variations must be taken into consideration for developing culturally sensitive programs to promote healthy aging among all Canadians. Theorizing on healthy (or 'successful') aging must envision it as a subjective and multidimensional concept.
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Affiliation(s)
- Shahin Shooshtari
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada.
| | - Verena Menec
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada.
| | - Audrey Swift
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada.
| | - Robert Tate
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Canada.
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Achim MV, Văidean VL, Borlea SN. Corruption and health outcomes within an economic and cultural framework. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:195-207. [PMID: 31587123 DOI: 10.1007/s10198-019-01120-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 09/23/2019] [Indexed: 06/10/2023]
Abstract
The purpose of this paper is to investigate the relationship between corruption and population health. Our cross-sectional sample covers 185 countries (54 high-income and 131 low-income countries) and the period of the analysis is 2005-2017. This research provides clear evidence that the level of corruption significantly affects physical health (expressed as life expectancy and Mortality rate) and mental health (expressed by happiness), under the moderating role of economic development and cultural framework. Moreover, we validate a powerful and positive correlation between the income level and both physical and mental health. Culture also has an important role in the corruption-health nexus, because we find evidence supporting four out of the six dimensions of culture (individualism versus collectivism, indulgence versus restraint, uncertainty avoidance and masculinity vs femininity) as having influence upon the physical and mental health of individuals. When we estimate the results on subsamples of countries (high-income and low-income countries), we validate a crisscross effect of corruption. Thus, a high level of corruption more deeply affects the physical health of population in low-income countries than in high-income countries. On the other hand, mental health is more pronouncedly affected by corruption in high-income countries than in low-income countries. This study may have important implications for national or international policy makers who need to acknowledge that anti-corruption policies play an important role in increasing population health, but they also need to adopt them according to the economic and cultural context of each nation.
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Affiliation(s)
- Monica Violeta Achim
- Faculty of Economics and Business Administration Cluj-Napoca, Department of Finance, "Babeş-Bolyai University", Street Teodor Mihali, No. 58-60, Cluj-Napoca, Romania.
| | - Viorela Ligia Văidean
- Faculty of Economics and Business Administration Cluj-Napoca, Department of Finance, "Babeş-Bolyai University", Street Teodor Mihali, No. 58-60, Cluj-Napoca, Romania
| | - Sorin Nicolae Borlea
- Faculty of Economics, Informatics and Engineering, Department of Economics, 'Vasile Goldis' Western University of Arad, B-dul Revolutiei, No. 94, Arad, Romania
- Faculty of Economics, Doctoral Scool of Economics, University of Oradea, Street Universitatii No. 1, Oradea, Romania
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