Asynchronous Technologies in Mental Health Care and Education.

Purpose of review: Patients, providers, and trainees should understand the current types of asynchronous technologies that can be used to enhance the delivery and accessibility of mental health care. Asynchronous telepsychiatry (ATP) removes the need for real time communication between the clinician and patient, which improves efficiency and enables quality specialty care. ATP can be applied as distinct consultative and supervisory models in clinician-to-clinician, clinician-to-patient, and patient-to-mobile health settings. Recent findings: This review is based on research literature and the authors' clinical and medical training, using experiences with asynchronous telepsychiatry from before, during, and after the COVID-19 pandemic. Our studies demonstrate that ATP provides positive outcomes in the clinician-to-patient model with demonstrated feasibility, outcomes and patient satisfaction. One author's medical education experience in the Philippines during COVID-19 highlights the potential to utilize asynchronous technology in areas with limitations to online learning. We emphasize the need to teach media skills literacy around mental health to students, coaches, therapists, and clinicians when advocating for mental well-being. Several studies have demonstrated the feasibility of incorporating asynchronous e-tools such as self-guided multimedia and artificial intelligence for data collection at the clinician-to-clinician and patient-to-mobile health level. In addition, we offer fresh perspectives on recent trends in asynchronous telehealth in wellness, applying concepts such as "tele-exercise" and "tele-yoga." Summary: Asynchronous technologies continue to be integrated into mental health care services and research. Future research must ensure that the design and the usability of this technology puts the patient and provider first.

Embodied conversations: Culturally and trauma-informed healing practices in dance/movement therapy

We are in the 14th month of an unprecedented public health crisis, the COVID-19 pandemic. Brutality against Brown and Black bodies, systemic racism, oppression, and white supremacy continue sustaining the foundation of white domination and privilege in all of our institutions. As dance/movement therapists, educators, students, and supervisors, we are coming to terms with the fact that our field is no different: the lack of diversity, equity, and inclusion in our profession and harmful educational content/practices in our programs are a reflection of this reality. Living through trauma-filled times continuously filtered our conversations and themes emerged as important and necessary to unpack and explore: How do we engage in authentic relationships when we might be reinforcing dominant structures? How do we include, listen, and support those from marginalized identities both from a theoretical stance and a social action stance? How can we be held accountable? The authors came to this work with their own experiences, stories, memories, personal trauma, identities, and cultural backgrounds. Living through identity differences and acknowledging personal and political issues, this dialogue provides insight into our own healing journeys and offering a structure to remind ourselves how to recognize our shared humanity in the spaces we occupy. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Introduction of Implicit Bias Training to oncology faculty as a means to improve minority participation in cancer clinical trials

Background: Following George Floyd's murder in May 2020, conversations about equity and bias became part of our daily national conversation. Simultaneously the COVID-19 outbreak disproportionately affected people of color which further illuminated existing disparities in outcomes. Bias training was introduced in many sectors as a strategy to address inequity. Inclusivity in healthcare is essential to develop evidence-based therapies and treatment plans. Previous studies have demonstrated the consequences when racial and ethnic minorities are excluded from research. (Hamel et al, 2016). Racial and ethnic minorities disproportionately bear adverse outcomes from cancer. Cancer clinical trials would benefit from solutions to promote inclusivity. (Khan et al. 2021) Research Purpose: The purpose of our study was to assess whether Implicit Bias Training can increase minority participation in cancer clinical trials. Methodology: The Office of Diversity, Equity, and Inclusion offered Implicit Bias Training to all clinical oncologists at the Yale Cancer Center (YCC) between May and July 2021. While 109 physicians were eligible to participate, 57 physicians were required by the department to complete this training, and 84% of these physicians completed this opportunity. We analyzed YCC clinical trial enrollment data between two time periods defined as pre-intervention and post-intervention. We selected these periods to investigate not only the efficacy of bias training but specifically bias training as an adjunct to the national conversation during the time of our study. We selected the preintervention period as January 1, 2021, to June 30, 2021. The intervention was designed to be completed by July 1, 2021 therefore the post-intervention period is defined as July 1, 2021 to December 31, 2021. Results/Summary: Our analysis showed an increase of 2.5% in the participation of Black/African American patients. There was a slight (1.5%) decrease in Hispanic patient enrollment during this time. Conclusion(s): Our analysis suggested that implicit bias training delivered once had only a very modest, if any, improvement in racial minority participation in cancer clinical trials. Our project focused on participation by Black/African American patients. The impediment to Hispanic participation is quite nuanced. Hispanic patients, many of whom are non-English speaking with immigration/insurance issues face additional structural barriers. We think that a different strategy is needed to better serve this patient population. While we had hoped for metrics to demonstrate greater impact from bias training, our next investigation will look at if the intervention is best delivered repeatedly. Future Work: We have not abandoned the strategy of bias training to build trust and increase Black/AA participation. After the intervention, we are interested in whether greater impact is seen over time. We have designed a survey to look at the effects of the intervention after a year. Our next step is to examine whether repeated delivery of this intervention will amplify our results.

Not by trees alone: Centering community in urban forestry

Urban forestry and urban greening efforts are blossoming as cities and towns work to enhance their open spaces as green infrastructure that provides multiple benefits. This work has reached new urgency given the need for both high-performance landscapes that can mitigate the effects of climate change and accessible, safe greenspaces that can support community well-being during the COVID-19 pandemic. At the same time, activists, practitioners, scholars, and decision-makers--particularly those within Black, Indigenous, People of Color, and frontline communities who bear the brunt of negative impacts--are calling for the need to attend to environmental justice implications of greening efforts. Following a review of the literature, we draw upon our observations as researchers embedded in the field of urban and community forestry to offer three themes and related guiding questions that can help advance that work: 1) supporting human capacity and care (investments in people and organizations);2) community organizing beyond the green silo (intersectional and cross-sectoral approaches);and 3) re-envisioning the functions of the urban forest (productive systems and biocultural approaches). Our perspective is inspired by the work of residents, practitioners, and decision-makers who are engaging in reflection and innovation in pursuit of “just cities” that can enhance diversity, equity, and inclusion as critical to and inseparable from sustainability and resilience. We suggest that the field of urban forestry draw upon a community forestry ethos as we center the needs, capacities, and priorities of historically marginalized communities at the heart of the work of creating more just, sustainable cities.

Becoming an anti-racist interprofessional healthcare organization: Our journey.

The COVID-19 pandemic amplified the egregious disproportionate burden of disease based on race, ethnicity, and failure of organizations to address structural racism. This paper describes a journey by members of the National Academies of Practice (NAP) who came together to address diversity, equity, and inclusion (DEI). Through collaborative efforts, a virtual, interactive workshop was designed and delivered at NAP's 2021 Virtual Forum to facilitate discussions about DEI priorities across professions and to initiate a sustainable action plan toward achieving inclusive excellence. Resulting discoveries and reflections led us to the essential question: can we truly become an anti-racist interprofessional healthcare organization?

The medical and societal impact of big data analytics and artificial intelligence applications in combating pandemics: A review focused on Covid-19.

With Covid-19 impacting communities in different ways, research has increasingly turned to big data analytics (BDA) and artificial intelligence (AI) tools to track and monitor the virus's spread and its effect on humanity and the global economy. The purpose of this study is to conduct an in-depth literature review to identify how BDA and AI were involved in the management of Covid-19 (while considering diversity, equity, and inclusion (DEI)). The rigorous search resulted in a portfolio of 607 articles, retrieved from the Web of Science database, where content analysis has been conducted. This study identifies the BDA and AI applications developed to deal with the initial Covid-19 outbreak and the containment of the pandemic, along with their benefits for the social good. Moreover, this study reveals the DEI challenges related to these applications, ways to mitigate the concerns, and how to develop viable techniques to deal with similar crises in the future. The article pool recognized the high presence of machine learning (ML) and the role of mobile technology, social media and telemedicine in the use of BDA and AI during Covid-19. This study offers a collective insight into many of the key issues and underlying complexities affecting public health and society from Covid-19, and the solutions offered from information systems and technological perspectives.

Strategies to address structural and institutional barriers to success among students of color in nursing programs.

The COVID-19 pandemic and the significant disparities experienced by Black, Indigenous, and people of color (BIPOC) in infections, hospitalizations, and deaths associated with the Coronavirus have underscored the imperative to increase the size and diversity of the healthcare workforce, including nursing. Academically focused pipeline development programs have led to some advances in minority recruitment and retention; however, emerging research highlights the importance of extra-academic factors that reduce the sense of belonging and persistence among underrepresented and minority students. The purpose of this manuscript is to describe the diversity, equity, and inclusion goals and activities of a college of nursing located in a minority-serving institution. Here, we emphasize the description of a range of activities aimed at meeting our diversity goals. Further, we highlight the actions initiated in response to emergent "extra-academic" student needs over the past year related to the COVID-19 pandemic and police brutality. The strategies described have implications for improving diversity, equity, and inclusion among higher education institutions in nursing.

Systemic Challenges in Internship Training for Health-Service Psychology: A Call to Action From Trainee Stakeholders.

The challenges observed in health service psychology (HSP) training during COVID-19 revealed systemic and philosophical issues that preexisted the pandemic, but became more visible during the global health crisis. In a position paper written by 23 trainees across different sites and training specializations, the authors use lessons learned from COVID-19 as a touchstone for a call to action in HSP training. Historically, trainee voices have been conspicuously absent from literature about clinical training. We describe longstanding dilemmas in HSP training that were exacerbated by the pandemic and will continue to require resolution after the pandemic has subsided. The authors make recommendations for systems-level changes that would advance equity and sustainability in HSP training. This article advances the conversation about HSP training by including the perspective of trainees as essential stakeholders.

IMPROVing communication about diversity, equity, and inclusion in health professions education.

There has never been a stronger call for authenticity in health professions education than this moment in time. The health inequities laid bare by the COVID-19 syndemic (a concept that describes the clustering of SARS-CoV-2 infection and disease by political, social, and economic factors) compels health professions educators to learn how to best engage in, sustain, and deepen conversations on diversity, equity, and inclusion (DEI) within our learning environments. Health professions curricula should address such concerns through explicit faculty training programs in dialogue models of communication. In this commentary, I propose that medical improv can help refocus health professions training to the humanistic values of empathy for others and respect for multiple viewpoints. Medical improv refers to teaching methods that adapt improvisation principles and exercises to enhance professional competencies in the health professions, such as communication. I describe a training series implemented at one institution to prepare faculty facilitators to engage in conversations about DEI in a discussion-based core course on the social determinants of health for first year medical students called "Humanity in Medicine." Key elements of dialogue training, including examinations of identity and positionality, caretaking and team-making, and conversations with a skeptic, are viewed through the lens of improv exercises as a pedagogy in communication. I report on facilitator and medical students' positive response to facilitator training and the Humanity in Medicine course. Potential next steps towards a formal evaluation of the method, and outcomes assessments of the use of improv in health professions training are discussed.

The COVID-19 Pandemic: Reflections of Science, Person, and Challenge in Academic Research Settings.

In spring of 2021, the Society on NeuroImmune Pharmacology (SNIP) organized a virtual workshop on the coronavirus disease 2019 (COVID-19). The daylong event's fourth and final symposium, "Well-being and reflections," offered a glimpse at the pandemic's impact on the lives of our scientists and educators. This manuscript includes a brief summary of the symposium, a transcription of our incoming president Dr. Santosh Kumar's lecture, titled "Intervention and improved well-being of basic science researchers during the COVID-19 era: a case study," and the panel discussion that followed, "Reflection and sharing," featuring Drs. Jean M. Bidlack, Sylvia Fitting, Santhi Gorantla, Maria Cecilia G. Marcondes, Loyda M. Melendez, and Ilker K. Sariyer. The conclusion of this manuscript includes comments from SNIP's president Dr. Sulie L. Chang and our Chief Editor, Dr. Howard E. Gendelman. Drs. Sowmya Yelamanchili and Jeymohan Joseph co-chaired the symposium.

The COVID-19 Pandemic: a Year Lost, or a Year Found?

This commentary is based on the Leadership Plenary at the IAMSE 2021 Virtual Conference and describes the response of the International Association of Medical Science Educators (IAMSE) to the COVID-19 pandemic.