Evaluation of the Cultural, Social and Emotional Wellbeing Program with Aboriginal women in the Boronia Pre-Release Centre for Women: a mixed methods study.

OBJECTIVE: To assess the effectiveness of the Cultural, Social and Emotional Wellbeing Program for reducing psychological distress and enhancing the social and emotional wellbeing of Aboriginal women preparing for release from prison. STUDY DESIGN: Mixed methods; qualitative study (adapted reflexive thematic analysis of stories of most significant change) and assessment of psychological distress. SETTING, PARTICIPANTS: Aboriginal and Torres Strait Islander women at the Boronia Pre-release Centre for Women, Perth, Western Australia, May and July 2021. INTERVENTION: Cultural, Social and Emotional Wellbeing Program (two days per week for six weeks). The Program involves presentations, workshops, activities, group discussions, and self-reflections designed to enhance social and emotional wellbeing. MAIN OUTCOME MEASURES: Themes and subthemes identified from reflexive thematic analysis of participants' stories of most significant change; change in mean psychological distress, as assessed with the 5-item Kessler Scale (K-5) before and after the Program. RESULTS: Fourteen of 16 invited women completed the Program; ten participated in its evaluation. They reported improved social and emotional wellbeing, reflected as enhanced connections to culture, family, and community. Mean psychological distress was lower after the Program (mean K-5 score, 11.3; 95% confidence interval [CI], 9.0-13.6) than before the Program (9.0; 95% CI, 6.5-11.5; P = 0.047). CONCLUSION: The women who participated in the Program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship. Our preliminary findings suggest that the Program could improve the resilience of Aboriginal and Torres Strait Islander in contact with the justice system.

Social Justice and the Political Organization of Behavior Analysts: Changing the Institutional Practices of a Brazilian Association.

Given the advancement of behavioral research in culture and social behavior, it seems natural for the community of behavior analysts to progress towards increased political engagement and a dedication to social justice. To reach this goal, it is necessary to act inside one's own communities and organizations. The purpose of this article is to report on the efforts of the Brazilian Association for Behavioral Psychology and Medicine (ABPMC) to increase equity and social justice during the 2017-2018 term. First, we present an overview of the ABPMC. Next, we describe the process of identifying, planning, and implementing equity and social justice actions in the association. The problems targeted were the discontinuation of policies from one term to another, elitism and centralization, the lack of topics with social and political relevance in the annual conference's scientific program, and the lack of support for the participation of women (especially mothers) in clinical and academic practice. Supplementary Information: The online version contains supplementary material available at 10.1007/s40617-020-00510-2.

On the cost-effectiveness of Nature-based Solutions for reducing disaster risk.

The potential of ecosystem-based interventions, also known as Nature-based Solutions (NbS), for Disaster Risk Reduction (DRR) and Climate Change Adaptation (CCA) is now recognized by major national policies and international framework agreements. However, there is limited scientific evidence about their economic viability and equity impacts. We examined English-language peer-reviewed studies, published between 2000 and 2021, which undertook economic evaluations of NbS for DRR and CCA. Based on our results, 71 % of studies indicated that NbS have consistently proven to be a cost-effective approach to mitigating hazards and 24 % of studies found NbS cost-effective under certain conditions. The ecosystem-based interventions most frequently found effective in mitigating hazards are associated with mangroves (80 %), forests (77 %), and coastal ecosystems (73 %). Studies comparing the cost-effectiveness of NbS and engineering-based solutions for mitigating certain hazards showed that NbS are no less effective than engineering-based solutions. Among these studies, 65 % found that NbS are always more effective in attenuating hazards compared to engineering-based solutions and 26 % found that NbS are partially more effective. Our findings illustrate a range of factors, including the geographic locations of the NbS analyzed, their contribution to the restoration and increase of biodiversity, their property rights structure, their source of financing, and the economic methodologies employed to assess cost-effectiveness and distributional effects. The geographic location of the NbS observations included in this analysis was examined considering global projected temperature and precipitation changes.

Return to practice for allied health professionals with protected characteristics: a mixed-methods study.

INTRODUCTION: Return to practice is one mechanism for recruiting and retaining allied health professionals (AHPs) within the health and care workforce in England. It is not known how this affects persons with protected characteristics. AIM: To understand experiences of AHPs with protected characteristics of returning to the workforce through a return to practice programme. METHOD: A QUAL (semistructured interviews) + qual (focus group interviews) mixed-methods study. 12 online semistructured interviews with return to practice AHPs, followed by 2 online focus groups. RESULTS: Our research identifies a new type of returners who have to use the return to practice programme as a vehicle to step into health and social care as they have not been able to find employment. A main driver to return to practice was financial reason. CONCLUSION: To date there, is little evidence of leaders understanding the complexities of AHPs in a return to practice programme, the considerable contribution they can make to the workplace and the current inequities that exist.

Medical Nutrition Education for Health, Not Harm: BMI, Weight Stigma, Eating Disorders, and Social Determinants of Health.

Effective nutrition training is fundamental to medical education. Current training is inadequate and can cause harm to students and patients alike; it leaves physicians unprepared to counsel on nutrition, places undue focus on weight and body mass index (BMI), can exacerbate anti-obesity bias, and increase risk for development of eating disorders, while neglecting social determinants of health and communication skills. Physicians and educators hold positions of influence in society; what we say and how we say it matters. We propose actionable approaches to improve nutrition education to minimize harm and pursue evidence-based, effective, and equitable healthcare.

Analysing a private city being built from scratch through a social and environmental justice framework: A research agenda.

A growing body of scholarship examines new cities being built from scratch that are developed and governed by the private sector. While this scholarship explores discourse and rhetoric, economic objectives, and some social and environmental impacts of new private cities, scholars to date have not taken a social or environmental justice approach to analysing new city projects. In this article we examine Forest City, a private city project being built on artificial islands off the coast of Malaysia by one of China's largest property development companies, and its unique governance and claims to being 'eco', despite the significant environmental damage it has caused. Intended as a lush and exclusive gated enclave for Chinese nationals, Forest City is a productive case study through which to consider the consequences of a private city using the frameworks of social and environmental justice. We suggest more critical research that engages with social and environmental justice is needed on the many emerging projects branded as eco-cities of the future, a troubling claim that signals a growing normalisation of mega-scale privatisation and loose or absent regulations regarding social inclusivity and environmental protection.

The association between socioeconomic status perception and mental health among Chinese older adults: the mediating roles of social trust and justice.

BACKGROUND: Mental health is a matter of quality of life among older adults. This study aimed to explore the association between the socioeconomic status (SES) perception and mental health of older adults using data from 2017 Chinese General Social Survey (CGSS). METHODS: Ordinary least squares (OLS) regression was used to analyse the association between SES perception and mental health, and the substitution model and variable methods were used to check the robustness of the results. Moreover, we adopted the Sobel model to analyse the mediating roles of social trust and justice. RESULTS: SES perception was positively associated with mental health, and this association was mediated by social trust and justice. This kind of positive association was mainly embodied in those groups with the highest or lowest objective SES. In other words, this study confirmed the phenomenon of "a contented mind is a perpetual feast" in Chinese society. CONCLUSIONS: Higher SES perception is associated with improved mental health for Chinese older adults. It is imperative to prioritize efforts to enhance the perceptual abilities of older adults, particularly those with the highest or lowest objective SES, to promote their overall subjective well-being.

Examining differential effects of an equity-focused schoolwide positive behavioral interventions and supports approach on teachers' equity in school discipline.

Following a randomized controlled trial that showed effectiveness of an equity-centered positive behavioral interventions and supports (PBIS) professional development intervention on student discipline in elementary schools, we studied the extent to which the intervention had differential effects on individual teachers' use of exclusionary discipline. Using the sample of teachers from the randomized controlled trial (n = 348), we assessed whether (a) changes in teacher use of office discipline referrals over the course of 2 school years and (b) intervention acceptability were moderated by teacher demographic characteristics (e.g., race/ethnicity, experience) or teacher attitudes (e.g., awareness of biases and commitment to equity). Results from multilevel models using two discipline outcomes (i.e., office discipline referrals issued to Black students and equity in office discipline referrals) did not show significant moderation effects for any demographic or attitude variables. Results of intervention acceptability found that teachers with pre-existing commitments to bias reduction found the intervention more acceptable, although means were consistently high across the sample. Findings indicate that the intervention was similarly effective on teacher discipline practices, regardless of teacher demographics or pre-existing attitudes, lending more support to the intervention's promise.

Working Conditions, Worker Rights, and Managerial Domination During the COVID-19 Pandemic: Assessing Their Toll on Precariously Employed Workers and Family Well-Being.

Precarious Employment (PE) is characterized by job, income, and benefit insecurities. Studies surrounding PE and well-being have been predominantly quantitative, leaving a gap in rich descriptions of employment experiences. We recruited a sample of 40 adults aged 25-55 who were involved in PE during the beginning of the COVID-19 pandemic or lost employment due to the pandemic. Semi-structured interviews were administered. Employment and income insecurities were common and had negative impacts on the well-being of participants and their families. Uncertainty about future employment prospects and job and income loss resulted in chronic distress. Other insecurities-access to benefits, violation of worker rights, worker safety-was also reported as impacting well-being. The COVID-19 pandemic deepened insecurities, hardships, and distress among workers with PE conditions. Given the myriad insecurities experienced by those engaged in PE, the focus of precarious work research should also include working conditions, violation of worker rights, and managerial domination.

Learning to teach at a norm-critical clinical learning centre: A Phenomenographic study.

BACKGROUND: Campus-based clinical learning centres are used for practice and learning in nursing students' education and can be arenas in which to enhance students' awareness and competence in social justice issues. Norm-critical approaches can be used as pedagogical tools in these centres to prepare students for hands-on caring situations in which social norms can bias the outcome. OBJECTIVES: To describe nursing teachers' conceptions of learning norm-critical approaches and implementing them in a clinical training centre. SETTING AND PARTICIPANTS: The study is based on interviews with 10 teachers at a Swedish university college. METHODS: The data was analysed using a phenomenographic approach. RESULTS: Five categories of description emerged in the analysis that described conceptions related to norm-critical approaches. These categories were: personally developing and meaningful; easily integrated with established nursing concepts; highlighting surrounding power; something to lean on when letting students take the first steps in norm-critical initiatives; and helping implementation in teaching and education. CONCLUSIONS: Teachers who are facing the task of providing norm-critical, practical education to nursing students in campus-based clinical learning environments are ambivalent towards the core principles of norm criticism, which they conceive as natural and provoking, at the same time. We therefore need to un-dramatise norm criticism and better prepare teachers in how to use it. Teachers would benefit from follow-up activities and formal collaborations regarding norm-critical teaching, so that they are given context to discuss, reflect, and learn from each other.

"They bring the topic [of social justice] but stop there": Nursing students' perceptions of teaching practices that develop awareness and engagement with social justice.

BACKGROUND: Pedagogical frameworks grounded in social justice, such as decolonizing and anti-racist educational practices, are essential in nursing programs. While scholars have begun to examine nurse educators' conceptualizations of social justice, there remains a lack of knowledge about student perspectives regarding nurse educators' approaches to incorporating social justice in education. OBJECTIVE: To understand nursing students' perceptions about educational strategies that develop critical awareness and engagement with social justice and positively influence professional practice. DESIGN: A qualitative study informed by Critical Feminist Pedagogy and guided by Interpretive Description methodology. SETTINGS: A school of nursing in Western Canada. PARTICIPANTS: Ten undergraduate and graduate nursing students recruited through convenience sampling. METHODS: Students participated in one-on-one semi-structured interviews. A set of questions developed to facilitate data analysis allowed the deconstruction of the data to identify broad-based inductive categories. Contrast and comparison methods were also used. Members of the research team provided analytic insights into the categories, and subsequently, all members discussed the findings and developed the interpretive frame. RESULTS: Student participants reported that educational strategies promoting awareness and engagement with social justice need to go beyond superficial engagement and awareness of social justice. Researchers' analysis suggests that cohesiveness between awareness and action in social justice is urgently needed within academia to adopt a decolonizing and anti-racist pedagogy in nursing and better prepare students for professional practice. From the data analysis, teaching strategies that enhance cohesiveness include: embracing personal development, creating community spaces and disrupting knowledge and curriculum hierarchies. CONCLUSIONS: Understanding students' perceptions and incorporating their suggestions is critical to integrating socially just teaching practices that embrace a learner-centred pedagogy. Our findings offer suggestions for teaching strategies that foster critical awareness and engagement with social justice. Combined, these contribute to our understanding of signature pedagogies in nursing with the intention of increasing the adoption of anti-racist and decolonizing approaches.

Decolonizing nursing education: Reflecting on Paulo Freire's pedagogy of the oppressed.

Historically, nursing education's foundation has been framed by colonial practices of whiteness, which serves as a fulcrum for oppression, Western epistemic ideology, racial injustice, and health inequity. As a microcosm of the broader academy, nursing education must pivot to dismantle practices impeding the advancement of the profession and move to decolonize processes of professional edification. Decolonization is not a metaphor; it requires unlearning the deep socialization of Eurocentric perspectives embedded in nursing education and relearning in a new, inclusive manner that embraces historically marginalized knowledge systems and experiences. This paper aims to operationalize what this decolonization process would look like for nursing education while reflecting on Paula Freire's Pedagogy of the Oppressed. The authors will highlight the interrelationship of the main concepts of Paulo Freire's critical pedagogy, including liberation, critical consciousness, dialog, humanization, dehumanization, problem posing, and banking education.

The concept of intersectionality in bioethics: a systematic review.

BACKGROUND: Intersectionality is a concept that originated in Black feminist movements in the US-American context of the 1970s and 1980s, particularly in the work of feminist scholar and lawyer Kimberlé W. Crenshaw. Intersectional approaches aim to highlight the interconnectedness of gender and sexuality with other social categories, such as race, class, age, and ability to look at how individuals are discriminated against and privileged in institutions and societal power structures. Intersectionality is a "traveling concept", which also made its way into bioethical research. METHODS: We conducted a systematic review to answer the question of where and how the concept of intersectionality is applied in bioethical research. The PubMed and Web of Science databases were systematically searched and 192 articles addressing bioethical topics and intersectionality were finally included. RESULTS: The qualitative analysis resulted in a category system with five main categories: (1) application purpose and function, (2) social dimensions, (3) levels, (4) health-care disciplines and academic fields, and (5) challenges, limitations, and critique. The variety of academic fields and health-care disciplines working with the concept ranges from psychology, through gynaecology to palliative care and deaf studies. Important functions that the concept of intersectionality fulfils in bioethical research are making inequities visible, creating better health data collections and embracing self-reflection. Intersectionality is also a critical praxis and fits neatly into the overarching goal of bioethics to work toward social justice in health care. Intersectionality aims at making research results relevant for respective communities and patients, and informs the development of policies. CONCLUSIONS: This systematic review is, to the best of our knowledge, the first one to provide a full overview of the reference to intersectionality in bioethical scholarship. It creates a basis for future research that applies intersectionality as a theoretical and methodical tool for analysing bioethical questions.

Intersectionality as a tool for clinical ethics consultation in mental healthcare.

Bioethics increasingly recognizes the impact of discriminatory practices based on social categories such as race, gender, sexual orientation or ability on clinical practice. Accordingly, major bioethics associations have stressed that identifying and countering structural discrimination in clinical ethics consultations is a professional obligation of clinical ethics consultants. Yet, it is still unclear how clinical ethics consultants can fulfill this obligation. More specifically, clinical ethics needs both theoretical tools to analyze and practical strategies to address structural discrimination within clinical ethics consultations. Intersectionality, a concept developed in Black feminist scholarship, is increasingly considered in bioethical theory. It stresses how social structures and practices determine social positions of privilege and disadvantage in multiple, mutually co-constitutive systems of oppression. This article aims to investigate how intersectionality can contribute to addressing structural discrimination in clinical ethics consultations with a particular focus on mental healthcare. To this end, we critically review existing approaches for clinical ethics consultants to address structural racism in clinical ethics consultations and extend them by intersectional considerations. We argue that intersectionality is a suitable tool to address structural discrimination within clinical ethics consultations and show that it can be practically implemented in two complementary ways: 1) as an analytic approach and 2) as a critical practice.

Organizational and social justice paradoxes in EDI.

This perspective article positions social justice as an addition to the aims of organizational justice, and core to diversity, equality, and inclusion (DEI). It problematizes simplistic DEI rhetoric and positions paradoxes within DEI, as experienced by employers, based on an explanation of key justice concepts and the introduction of fairness, equality, desert, and need. The paper broadens perspective-taking beyond a sole focus on beneficiaries of DEI, towards tensions that employers experience in working towards the aims of workplace justice, including the embeddedness of social justice within both organizations and social systems. The paper concludes with avenues for future research and a call to carefully examine simplistic notions of organizational justice in effecting DEI, suggesting a paradoxical lens on embracing, rather than avoiding, multiple and often conflicting workplace justice imperatives.

Exploring Firearm Access, Carriage, and Possession among Justice-Involved Youth.

Firearm carriage and possession predicts youth firearm violence victimization and perpetration. This study describes self-reported factors associated with firearm access, carriage, and possession among justice-involved youth. We conducted an exploratory, mixed-methods study. Participants were recruited from May 2022 to February 2023 from the Juvenile Justice Collaborative, a diversion program for justice-involved youth. We used online anonymous surveys to investigate exposures related to firearm access, carriage, and possession. We performed semi-structured interviews using the phenomenology framework. We used descriptive statistics to examine firearm exposures by participant demographics. We performed qualitative analyses using an iterative approach with constant comparison to identify key themes. We completed 28 surveys and 5 interviews. Most survey participants identified as male (57%) and Black (61%) with a median age of 18 years. Interview participants described the socialization and cultural normalization of firearms, most prominently among peers. Survey participants reported whether they had ever carried (25%) or possessed (21%) a firearm. Survey and interview participants endorsed protection in the context of increasing violence exposure over time as the primary motivation for firearm possession. Interview participants describe accessing firearms primarily through social networks while survey participants also reported access from strangers (25%) and licensed sellers/gun dealers (18%). In conclusion, justice-involved youth believe firearm carriage and possession may be needed for protection due to increasing violence exposure. Further investigation is necessary to determine interventions that may decrease firearm access, carriage, and possession among justice-involved youth.

Overcoming barriers to equality, diversity, inclusivity, and sense of belonging in healthcare education: the Underrepresented Groups' Experiences in Osteopathic Training (UrGEnT) mixed methods study.

BACKGROUND: Individuals from minority groups have historically faced social injustices. Those from underrepresented groups have been less likely to access both healthcare services and higher education. Little is known about the experiences of underrepresented students during their undergraduate studies in osteopathy in the UK. The aim of this project was to explore awareness of cultural diversity and beliefs about patients from underrepresented groups in current osteopathic educational environments and evaluate students' preparedness to manage patients from diverse groups. The project also aimed to investigate the educational experiences of students from underrepresented backgrounds during their training and their opinions on changes that could support better levels of recruitment and achievement. The findings were discussed with stakeholders in interactive workshops with the aim to develop recommendations for action and change. METHODS: A transformative action research paradigm informed this mixed methods project. It included: 1/ a survey of students from all seven osteopathic educational providers in the UK using the Multidimensional Cultural Humility Scale (MCHS); 2/ a series of focus groups with students from underrepresented groups (women, students with disabilities, students from minority ethnic backgrounds, and students identifying as LGBTQIA+); and 3/ a workshop forum to discuss findings. RESULTS: A total of 202 participants completed the MCHS and demographic questionnaire and seven focus groups were conducted. A model was developed to describe participants' training experiences comprising two main themes: institutional contextual obstacles (with four sub-themes) and underrepresented students' conceptual understanding of Equity, Diversity and Inclusion (EDI). Recommendations for change identified in the workshops were based on three topics: institutions, staff, and students. CONCLUSION: Our findings confirm conclusions from other institutions that staff education is urgently needed to create and maintain equitable, inclusive environments in osteopathic educational institutions in the UK to support all students, particularly those from underrepresented groups. Institutional EDI processes and policies also need to be clarified or modified to ensure their usefulness, accessibility, and implementation.

Engaging Students and Teachers as Community Scientists in DNA Barcoding Initiatives.

Historically, contributions to scientific knowledge have been perceived as something that only professional scientists have the ability to affect. This has led to the belief that scientific pursuits are done not by everyday people but by individuals who have no connection to the communities that their discoveries might impact. DNA barcoding initiatives have the potential to bridge this gap. Community leaders, students, teachers, and other community members can come together with engaged scientists to solve relevant issues that affect them. Over the last 20 years, DNA barcoding has been used successfully in a variety of educational contexts to incorporate original research into school curricula and informal outreach and education programs. DNA barcoding is especially suitable for educational settings because it is conceptually and technically straightforward, the workflow is adaptable to a variety of situations, and free and open-access online tools exist that allow participants to contribute high-quality data to international research efforts. DNA barcoding also offers a unique service-learning opportunity, where participants gain both knowledge and confidence in science. This is important because a growing body of evidence suggests that actively conducting research increases student and teacher engagement and retention of students in science. Here, we describe a framework and case studies in different educational settings that can be modeled and adapted to various educational contexts.