Securing the rights and health of domestic workers: the importance of ratifying the ILO's C189.

This commentary highlights the critical importance of ratifying the International Labour Organization's (ILO) Domestic Workers Convention No. 189-2011 (C189) to secure the rights and health of domestic workers (DWs) worldwide, particularly in light of the World Health Organization's World Health Day 2024 theme 'My Health, My Right'. The ILO's C189 represents a significant advancement in labour rights, offering protection to a highly feminised sector where women make up 80% of the estimated 50-100 million DWs worldwide. The ILO's C189 aims to address the marginalisation and exploitation that DWs have historically faced by ensuring that they receive the same protections as other workers. This encompasses measures against abuse, harassment and violence, and the establishment of a secure and healthy working environment, as outlined in Article 13. The commentary emphasises the urgent need for the enactment of legal frameworks in countries such as Indonesia, where many of the approximately 10 million DWs encounter shocking abuses both within the country and abroad. The ratification of the C189 and the enactment of national laws, such as Indonesia's Draft Law on the Protection of Domestic Workers (RUU PPRT), are essential for the safeguarding of the rights and health of DWs. The commentary compares Indonesia with the Philippines, as the latter has been a signatory to the C189 since 2012 and has enacted its National Domestic Workers Act in 2013. The ratification of the C189, therefore, is imperative for igniting the protection and advancement of labour rights for DWs globally. This ILO's C189 represents a significant first step in addressing the long-standing and complex issues of marginalisation and exploitation prevalent in this predominantly female sector. It is also essential that the potential obstacles and concerns related to the ratification and implementation of the ILO's C189 are addressed collaboratively by stakeholders and not viewed as justifications for inaction.

Talking About Gene Drive in Uganda: The Need for Science Communication to Underpin Engagement.

Uganda may host the world's first field trials of gene drive mosquitoes for malaria control. Global North discourses pre-suppose African publics have access to information about gene drive and are ready to make decisions about its governance. We explore assumptions about the availability of this information in Uganda. We find a paucity of information available combined with a strong desire for information from lay publics. We discuss these findings in the context of Ugandan information infrastructures and political sensitivities to genetic technologies. If Ugandans are to decide about gene drive, they need independent information about the science to underpin engagement.

Social justice in Canadian nursing professional documents: A Foucauldian discourse analysis.

Social justice is widely advanced as a central nursing value, and yet conceptual understandings of social justice remain inconsistent and vague. Further, despite persistently articulated commitments to upholding social justice, the profession of nursing has been implicated in perpetuating inequities in health and health care. In this context, it is essential to establish both conceptual clarity and tangible guidance for nurses in enacting practices to advance social justice-particularly through regulatory, education and accreditation documents that shape the nursing profession. This Foucauldian discourse analysis examines how social justice is discursively positioned within nursing professional documents in Canada, and illustrates that social justice was largely discursively excluded from these texts. Where social justice discourses were invoked, we identified that four central discursive patterns obscured and de-centred this nursing value: (i) Vague language undermined professional commitments to social justice; (ii) Constructions of knowledge and awareness de-emphasized practice; (iii) Individualism discourses minimized institutional/professional responsibility; and (iv) Aspirational language obscured present action. Extending from this analysis, we contend that the nursing profession must re-examine how social justice is understood and articulated, and call for a re-conceptualization of social justice grounded in nursing practice toward remediating inequities in health and health care.

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.

Navigating the Landscape of Digital Twins in Medicine: A Relational Bioethical Inquiry.

This perspective article explores the use of digital twins (DTs) in medicine, highlighting its capacity to simulate risks and personalize treatments while examining the emerging bioethical concerns. Central concerns include power dynamics, exclusion, and misrepresentation. We propose adopting a relational bioethical approach that advocates for a comprehensive assessment of DTs in medicine, extending beyond individual interactions to consider broader structural relations and varying levels of access to power. This can be achieved through two key relational recommendations: acknowledging the impact of uneven relational structures on access to medical care and promoting social justice by evaluating resource allocation. While DTs in medicine offer promising advancements, a relational bioethical lens may provide a nuanced understanding, fostering equitable, inclusive and responsible integration of DTs into medical practice.

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.

Developing an initial programme theory for a model of social care in prisons and on release (empowered together): A realist synthesis approach.

Many people are living in prison with a range of social care needs, for example, requiring support with washing, eating, getting around safely, and/or maintaining relationships. However, social care for this vulnerable group is generally inadequate. There is uncertainty and confusion about who is legally responsible for this and how it can best be provided, and a lack of integration with healthcare. We used realist-informed approaches to develop an initial programme theory (IPT) for identifying/assessing social care needs of, and providing care to, male adults in prison and on release. IPT development was an iterative process involving (a) an initial scoping of the international prison literature; (b) scoping prison and community social care policy documents and guidelines; (c) full systematic search of the international prison social care literature; (d) insights from the community social care literature; (e) stakeholder workshops. Information from 189 documents/sources and stakeholder feedback informed the IPT, which recommended that models of prison social care should be: trauma-informed; well integrated with health, criminal justice, third-sector services and families; and person-centred involving service-users in all aspects including co-production of care plans, goals, and staff training/awareness programmes. Our IPT provides an initial gold standard model for social care provision for people in prison and on release. The model, named Empowered Together, will be evaluated in a future trial and will be of interest to those working in the criminal justice system, care providers and commissioners, local authorities, housing authorities, voluntary groups, and service-users and their families.

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.

Using Concept Mapping to Identify Community Partners' and Researchers' Perceptions of Social Justice: A Path Toward Eliminating Chronic Disease Disparities.

Background: A social justice framework can be used to inform healthy equity-focused research, and operationalizing social justice can inform strategic planning for research and practice models. This study aimed to develop a working definition of social justice based on input from a diverse group of collaborators to better inform the work conducted within the Center for Research, Health, and Social Justice. Methods: A concept mapping study was conducted from March to May 2022. A prompt designed to elicit social justice themes was developed (phase 1). At a study website, participants brainstormed statements that represented their definition of social justice (phase 2). Participants then sorted statements based on similarity and rated statements on importance (phase 3). Multidimensional scaling and hierarchical cluster analysis were used to identify nonoverlapping thematic clusters of statements (phase 4). Models were reviewed for best fit, and clusters were assigned names based on theme (phase 5). Results: Participants (n = 49) generated 52 unique statements that were sorted into 5 clusters describing social justice themes. Clusters included (1) Empathy, Awareness, and Understanding (n = 11); (2) Education and Systems Change (n = 10); (3) Policy Design and Implementation (n = 9); (4) Equity and Leveling the Playing Field (n = 11); and (5) Access to Services and Fair Living Standard (n = 11). High mean cluster ratings ranging from 5.22 to 6.02 out of 7 indicated all clusters were rated as being very important aspects of social justice. Conclusions: These data can guide the restructuring of research ecosystems that help eliminate race- and place-based health disparities.

Decolonially speaking, sensing, and thinking: Racialized tuition-based family therapists learning without teaching.

We address the ethical implications of training and becoming family therapists in the United States when considering the colonial control and management of knowledge by the westernized institutionalized university. We do so decolonially. Through the work of decolonial thinkers, doers, and sensers, we center our discussion on the heteropatriarchal Eurocentric institutionalization of knowledge linked to the development and sustainability of structures of family therapy training through racialization and monetization. We discuss a decolonial understanding of race in relation to the liberalized politics of diversity, equity, and inclusion and upward mobility of family therapy education. Most importantly, we reflect upon the possibilities of reexistence within family therapy, fissuring the colonial structures of training tuition-based family therapists. We locate those possibilities through practices of crack-making, epistemic insurgence, and mischief. Our discussions and reflections are developed throughout by thinking, sensing, and speaking decolonially, storying our racialized incarnated lives from the saberes, ज्ञान, rhythms, vapors, or tastes of our communities, displaced by the European cannon. We embrace a decolonial pedagogy of learning without teaching, positioning family therapy education as a site for sociopolitical struggle and action toward possibilities of reexistence.

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.

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.

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.

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.

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.

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.

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.