The Influence of Social Dynamics on Biological Aging and the Health of Historically Marginalized Populations: A Biopsychosocial Model for Health Disparities.

Historically marginalized populations are susceptible to social isolation resulting from their unique social dynamics; thus, they incur a higher risk of developing chronic diseases across the course of life. Research has suggested that the cumulative effect of aging trajectories per se, across the lifespan, determines later-in-life disease risks. Emerging evidence has shown the biopsychosocial effects of social stress and social support on one's wellbeing in terms of inflammation. Built upon previous multidisciplinary findings, here, we provide an overarching model that explains how the social dynamics of marginalized populations shape their rate of biological aging through the inflammatory process. Under the framework of social stress and social support theories, this model aims to facilitate our understanding of the biopsychosocial impacts of social dynamics on the wellbeing of historically marginalized individuals, with a special emphasis on biological aging. We leverage this model to advance our mechanistic understanding of the health disparity observed in historically marginalized populations and inform future remediation strategies.

The potential and paradoxes of eHealth research for digitally marginalised groups: A qualitative meta-review.

Whilst the transformation towards digital healthcare is accelerating, there is still a substantial risk of excluding people with a distance to the online world. Groups like people with a low socioeconomic position, people with a migrant background or the elderly, who are already most at risk of experiencing health inequalities, are simultaneously experiencing increased digital exclusion. Researchers play a role in determining how eHealth access is framed and can thus impact how the barriers to its use are addressed. This qualitative meta-review critically evaluates the way researchers (as authors) discuss eHealth use in digitally marginalised groups. Specifically, it seeks to understand how eHealth is framed to address existing health systems problems; how the barriers to eHealth use are presented and which solutions are provided in response; and who authors suggest should be responsible for making eHealth work. The results of this review found four paradoxes in how current literature views eHealth use. Firstly, that health systems problems are complex and nuanced, yet eHealth is seen as a simple answer. Secondly, that there are many political, social and health systems-based solutions suggested to address eHealth use, however most of the identified barriers are individually framed. This focus on personal deficits results in misallocating responsibility for making these systemic improvements. Thirdly, although eHealth is meant to simplify the tasks of patients and healthcare workers, these are the groups most often burdened with the responsibility of ensuring its success. Lastly, despite tailoring eHealth to the user being the most suggested solution, researchers generally speak about groups as a homogenous entity - thus rendering tailoring difficult. Ultimately, this review finds that a shift to focus research on addressing systemic issues on a systems level is necessary to prevent further exacerbating existing health inequalities.

Pain experiences of marginalized children in the emergency department: A scoping review protocol.

INTRODUCTION: Pain affects all children, and in hospitals across North America, this pain is often undertreated. Children who visit the emergency department (ED) experience similar undertreatment, and they will often experience a painful procedure as part of their diagnostic journey. Further, children and their caregivers who experience social injustices through marginalization are more likely to experience healthcare disparities in their pain management. Still, most of our knowledge about children's pain management comes from research focused on well-educated, white children and caregivers from a middle- or upper-class background. The aim of this scoping review is to identify, map, and describe existing research on (a) how aspects of marginalization are documented in randomized controlled trials related to children's pain and (b) to understand the pain treatment and experiences of marginalized children and their caregivers in the ED setting. METHODS AND ANALYSIS: The review will follow Joanna Briggs Institute methodology for scoping reviews using the Participant, Concept, Context (PCC) framework and key terms related to children, youth, pain, ED, and aspects of marginalization. We will search Medline, Embase, PsychInfo, CINAHL, Web of Science, Cochrane Library Trials, iPortal, and Native Health Database for articles published in the last 10 years to identify records that meet our inclusion criteria. We will screen articles in a two-step process using two reviewers during the abstract and full-text screening stages. Data will be extracted using Covidence for data management and we will use a narrative approach to synthesize the data. ETHICS AND DISSEMINATION: Ethical approval is not required for this review. Findings will be disseminated in academic manuscripts, at academic conferences, and with partners and knowledge users including funders of pain research and healthcare professionals. Results of this scoping review will inform subsequent quantitative and qualitative studies regarding pain experiences and treatment of marginalized children in the ED.

The Impact of Social Determinants of Maternal Mental Health in Marginalized Mothers.

Background: A deeper understanding of the key determinants of maternal mental health is important for improving care for women, especially women who are at an economic disadvantage. Objectives: To explore the associations of select social determinants: access, social support, and stress, with the onset of antepartum depression in low-income mothers. Participants: The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing, population-based surveillance system with selected data from 2016 to 2019, establishing a randomly selected sample of women with a recent live birth at most 4 months postdelivery, between 1,300 and 3,400 women per state (n ∼ 162,558). Methods: In this cross-sectional study, the phase 8 PRAMS was adapted to measure social support, access, stress, and their relationships with the onset of antepartum depression in low-income mothers. To assess low-income marginalization, a threshold was established based on income levels within 130% of the federal poverty level; antepartum (n ∼ 41,289). Results: The defined access, social support, and stress factors showed a statistically significant association with the onset of antepartum depression among low-income mothers. Of women in this sample, 22.6% indicated antepartum depression (p < 0.001; R2 = 0.066). Negative social support indicators were associated with an increased likelihood of antepartum depression; 3.71 increased odds of depression for abuse during pregnancy, and 0.79 decreased odds with positive acknowledgment of paternity. Access indicator terms showed an association with the decreased likelihood of antepartum depression through breastfeeding information support (Info from Baby Doc, odds ratio [OR] = 0.86), prenatal care utilization (12+ visits, OR = 0.82), and specific insurance type (insurance by job, OR = 0.82). All instances of stressful life events showed an increased likelihood of depression during pregnancy (for majority of stressful life events: OR >1.12). Conclusions: Economically marginalized mothers face unmet social and health care needs leading to poorer outcomes during pregnancy. These findings provide additional support for improved policy and public health efforts, such as assessment, education, and interventions, to decrease prevalence and improve treatment for antepartum depression among marginalized mothers.

Prevalência e fatores de riscos relacionados a comportamentos suicidas em profissionais do sexo / Prevalencia y factores de riesgo relacionados con la conducta suicidal en trabajadores sexuales / Prevalence and risk factors related to suicidal behavior in sex workers

Introdução: O trabalho sexual consentido é, historicamente, permeado por estigmas, proporcionando a marginalização social de profissionais do sexo e sua maior exposição a fatores de riscos que tendenciam a condutas suicidas. Objetivo: Identificar a prevalência e dos fatores de riscos relacionados a comportamentos suicidas em profissionais do sexo, tendo em vista a vulnerabilidade social desse grupo. Metodologia: Este estudo é uma revisão integrativa de literatura, determinada a partir da seguinte questão de pesquisa: "Qual a prevalência e os fatores de riscos relacionados a comportamentos suicidas entre profissionais do sexo?". Em seguida, aplicou os subsequentes Descritores em Ciências da Saúde: "Suicide" e "Sex workers", que foram combinados com o operador booleano "AND", nas plataformas National Library of Medicine, Science Direct, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Literatura Latino-americana e do Caribe, Scientific Eletronic Library Online, BioMed Central, Business Source Completee WorldWideScience. Foram selecionados 19 artigos relacionados ao objeto de estudo. Resultados: A prevalência de suicídio em profissionais do sexo foi classificada em três subcategorias: tentativas de suicídio, com predominância de 31,57% (n=6), ideação suicida com 15,78% (n=3) e o risco de suicídio com 5,26% (n=1). Os riscos de comportamentos suicidas foram associados a diversos fatores, sobretudo a violência (47,36%; n=9), depressão (26,31%; n=5) e a pobreza (15,78%; n=3). Conclusões: Há uma alta prevalência de comportamentos suicidas em profissionais do sexo que está associada a diversos fatores de riscos, verificando a carência de abordagens comunitárias direcionadas à vulnerabilidade social desse grupo (AU).

Introduction: Consensual sex work has historically been permeated by stigma, leading to the social marginalization of sex workers and their increased exposure to risk factors that tend to correlate with suicidal behaviors. Objective:To explore the prevalence and risk factors related to suicidal behavior in sex workers, considering the social vulnerability of this group. Methodology: This study is an integrative literature review, guided by the research question: "What is the prevalence and risk factors related to suicidal behaviors among sex workers?" The following Health Science Descriptors were applied: "Suicide" and "Sex workers," combined with the boolean operator "AND," on platforms such as the National Library of Medicine, Science Direct, Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Literatura Latino-americana e do Caribe, Scientific Eletronic Library Online, BioMed Central, Business Source Complete, and WorldWideScience. Nineteen articles related to the study's objectivewere selected. Results:The prevalence of suicide among sex workers were classified into three subcategories: suicide attempts, with a predominance of 31.57% (n=6), suicidal ideation with 15.78% (n=3) and the risk of suicide with a prevalence of 5.26% (n=1). The risks of suicidal behavior were associated with several factors, especially violence (47,36%; n=9), depression (26.31%; n=5) and poverty (15.78% /n=3). Conclusions: There is a high prevalence of suicidal behaviors among sex workers, associated with various risk factors, highlighting the need for community-based approaches addressing the social vulnerability of this group (AU).

Introducción: El trabajo sexual consensuado ha estado históricamente impregnado de estigmas, llevando a la marginación social de los profesionales del sexo y a una mayor exposición a factores de riesgo que tienden a asociarse con conductas suicidas. Objetivo: Identificar la prevalencia y los factores de riesgo relacionados con comportamientos suicidas en profesionales del sexo, considerando la vulnerabilidad social de este grupo. Metodología: Este estudio es una revisión integradora de la literatura, derivada de la siguiente pregunta de investigación: "¿Cuál es laprevalencia y los factores de riesgo relacionados con comportamientos suicidas entre los profesionales del sexo?". Posteriormente, se aplicaron los siguientes Descriptores en Ciencias de la Salud: "Suicide" y "Sex workers", combinados con el operador booleano "AND", en plataformas como la Biblioteca Nacional de Medicina, Science Direct, Portal de Periódicos de la Coordinación de Perfeccionamiento de Personal de Nivel Superior, Literatura Latinoamericana y del Caribe, Scientific Electronic Library Online, BioMed Central, Business Source Complete y WorldWideScience. Se seleccionaron 19 artículos relacionados con el objeto de estudio. Resultados: La prevalencia de suicidio en profesionales del sexo se clasificó en tres subcategorías: intentos de suicidio, con una predominancia del 31,57% (n=6), ideación suicida con el 15,78% (n=3) y el riesgo de suicidio con el 5,26% (n=1). Los riesgos de comportamientos suicidas se asociaron con varios factores, especialmente la violencia (47,36%; n=9), la depresión (26,31%; n=5) y la pobreza (15,78%; n=3). Conclusiones: Existe una alta prevalencia de comportamientos suicidas en profesionales del sexo asociada con diversos factores de riesgo, destacando la necesidad de enfoques comunitarios dirigidos a la vulnerabilidad social de este grupo (AU).

'It has gotten a lot better, but it is still bad': Experiences with the police among marginalized PWUDs in a context of depenalization.

Based on a survey (n = 249) and qualitative interviews (n = 38) with marginalized people who use drugs (PWUDs) in Copenhagen, Denmark, we investigate the experiences of this group with the police in a context where drug possession had been depenalized in and around drug consumption rooms (DCRs). Our findings point to positive experiences with the police, especially with the local community police in the depenalization zone, who refrained from drug law enforcement and practiced 'harm reduction policing.' However, marginalized PWUDs also reported that they were still targeted for drug possession by other sections of the police despite the depenalization policy. Specifically, the drug squad of the police would continue to confiscate illicit drugs for investigatory purposes to counter organized drug crime, as well as continue to target user-dealers who were not formally included in the depenalization policy. The findings illustrate how marginalized PWUDs still found themselves in a precarious legal situation without any legal rights to possess the drugs that they were dependent on, even though possession of drugs had been depenalized in and around DCRs.

Patterns of Socioeconomic Marginalization among People Who Use Drugs: A Gender-Stratified Repeated Measures Latent Class Analysis.

Socioeconomic factors are important correlates of drug use behaviors and health-related outcomes in people who use drugs (PWUD) residing in urban areas. However, less is known about the complex overlapping nature of socioeconomic conditions and their association with a range of individual, drug use, and health-related factors in men and women who use drugs. Data were obtained from two community-recruited prospective cohorts of PWUD. Using a gender-stratified approach, we conducted repeated measures latent class analyses (RMLCA) to identify discrete latent socioeconomic subgroups. Multivariable generalized estimating equations were then used to identify correlates of class membership. Between June 2014 and December 2018, RMLCA of 9844 observations from 1654 participants revealed five distinct patterns of socioeconomic status for both men and women. These patterns were primarily distinguished by variations in income, material and housing security, income generation activity, exposure to violence, criminal justice involvement, and police contact. Across gender, progressive increases in exposure to multiple dimensions of socioeconomic disadvantage were found to be associated with frequent use of opioids and stimulants, accessing social services, and being hepatitis C virus antibody-positive. Similar but less congruent trends across gender were observed for age, binge drug use, engagement with opioid agonist therapy, and living with HIV. Gendered patterns of multiple and overlapping dimensions of socioeconomic adversity aligned with patterns of frequent drug use and health-related concerns, highlighting priority areas for gender-inclusive, multilevel responses to mitigate health disparities and meet the diverse socioeconomic needs of urban-dwelling men and women who use drugs.

A theory of geo-social marginalization: A case study of the licensed cannabis industry in California.

The licensed cannabis industry represents one of the top five most economically valued agricultural commodities in California, yet farming largely remains on remote, environmentally sensitive, "marginal" lands. Using mixed methods, this paper examines the determinants of this marginalization, their embedded elaboration, and their relation to historical policy regimes. We used Generalized Additive Models (GAMs) to determine the most important predictors of licensed cannabis industry development since the inception of a statewide licensing program in 2018 and to compare the distribution of licensed cannabis to other forms of rural agriculture, including vineyards and pasture, to understand landscape factors and environmental sensitivity of land uses. We found that a county's median income and the extent of traditional (non-cannabis) agriculture, as measured by the proportion of on-farm (non-cannabis) employment, were both negatively associated with its amount of licensed cannabis agriculture. Ethnographic data suggests that cannabis is often excluded from traditional agricultural areas, through formal local-level bans, restrictive zoning, high "prime" farmland values, and cultural exclusions from other powerful resource users. The resulting relegation to "marginal" lands foments conflicts with amenity land users and environmentalists, even as it partly supports "legacy" cultivators whose farms were established under prior policy regimes. Results suggest that cannabis is more likely to be grown under conditions that introduce regulatory hurdles, including farming on steeper slopes, with natural streams onsite, and without access to large groundwater aquifers for irrigation. Our findings suggest that failure to allow licensed cannabis farming in traditional agriculture regions has led to a self-fulfilling prophecy wherein cannabis cultivation is largely relegated to environmentally sensitive areas where cultivation activity has an elevated tendency for environmental impacts.

The Eschucha (Listen) Podcast Project: Psychosocial Innovation for Marginalized Mexican Youth and Young Adults.

The COVID-19 pandemic was a challenging period for young people in Mexico, particularly those already contending with social and structural inequality. In March 2021, the Colectivo Frontera, a research collective based in Mexico City, Mexico, which works on advancing equity and psychosocial wellbeing among marginalized communities, carried out an 8-week, online project to provide psychosocial support and promote resilience for marginalized young people from different locations in Mexico. The project entailed weekly journaling with the Pandemic Journaling Project (PJP), as well as weekly phone sessions with a mental health specialist who provided emotional support (acompañamiento emocional) through practices of active listening. The project culminated in the Escucha (Listen) Podcast for which each youth participant created an episode about their experiences during the pandemic. Many also submitted a photo to accompany their recording; one produced a song. Participant episodes were compiled into a series of five chapters. Each chapter of the podcast centers on a common theme, including reflections on loved ones lost to COVID-19, social fragmentation, gender-based constraints on expressing emotions, and the experiences and perspectives of children. The project provides a compelling example of a low-cost approach to providing support for the mental health and wellbeing of marginalized young people. It also demonstrates the importance of creating projects that help young people make meaningful connections and that leverage their creativity to foster resilience, improve social cohesion, and elevate their perspectives and voices.

Navigating healthcare systems: A qualitative study on socially marginalised patients' experiences of hospital transition and support by social nurses.

BACKGROUND: Socially marginalised patients face many challenges related to their health condition and often have several contacts with healthcare and social service workers. The Danish social nursing initiative, whose nurses have experience and knowledge about marginalisation, aims to support socially marginalised patients during hospital admission and through hospital transitions. However, there is limited knowledge about the hospital transitions of patients being supported by a social nurse. OBJECTIVES: The objectives of this study were to explore (1) the perspectives of socially marginalised patients on the transition from hospital to home and (2) how these patients experience the importance of social nursing on patient trajectories after hospital discharge. METHODS: A qualitative study with a phenomenological and hermeneutic approach was performed at a large hospital in southern Denmark. Adult patients who had contact with a social nurse during hospital admission were purposely sampled. Data were collected between January 2023 and March 2023. Initial patient interviews were conducted during hospital admission with a second interview 7-22 days after discharge. Systematic text condensation was used for the analysis, and Nvivo 12 supported data storage and coding. ETHICAL APPROVAL: The study is registered with the Danish Data Protection Agency (22/47509). Informed consent was given by the participants. RESULTS: Sixteen patients participated in the study. The participants experienced major challenges in their transitions from the hospital, which were generally related to their interactions with many different social and healthcare services. While the social nurses supported the patients and helped facilitate care during hospital admission and after discharge, the participants identified transitional care gaps related to multidisciplinary cooperation and standardised care options. CONCLUSIONS: This study identifies challenges related to the hospital transition of socially marginalised patients, which indicates a gap in healthcare services. Future research should focus on improving interprofessional collaboration with socially marginalised patients across healthcare services.

The impact of marginalization on diffuse large B-cell lymphoma overall survival: a retrospective cohort study.

The aim of this study was to describe the impact of marginalization on DLBCL overall survival (OS) within the Canadian setting. We conducted a population-based retrospective cohort study of adult patients with newly diagnosed DLBCL in Ontario between 1 January 2005 and 31 December 2017 receiving a rituximab-containing chemotherapy regimen with curative intent followed until 1 March 2020. Our primary exposure of interest was the Ontario Marginalization Index (ON-Marg). The primary outcome was 2-year OS, accounting for patient age, sex, cancer characteristics, comorbidity burden, and rural dwelling status. While two-year overall survival was inferior for individuals in the most deprived marginalization quintile (70.4% Q5 vs. 76.0% Q1), after adjustment for relevant covariates neither the composite ON-Marg nor any of its dimensions had a significant effect. Within the Canadian context, among patients who receive chemotherapy, marginalization may not have a significant association with overall survival when accounting for key patient covariates, lending support for preserved outcomes.

What are they in it for? Marginalised group members' perceptions of allies differ depending on the costs and rewards associated with their allyship.

Advantaged group allies can incur costs or rewards as a result of their allyship. The present work investigates whether such costs and rewards affect how marginalised group members perceive these allies. Across four experiments that collectively examine marginalised group members' perceptions of individual and corporate allies in the context of allyship for women's rights, Black Lives Matter and the LGBTQI+ community, we find that allies are perceived differently as a function of the costs and rewards associated with their allyship. Allies who face costs are perceived more positively in terms of tenacity and genuine motivations, and are generally evaluated more favourably compared to allies who do not face costs and those who, instead, garner rewards for their allyship. These findings demonstrate that marginalised group members are cognisant of the costs and rewards allies may reap, and that this information can shape their judgements of allies' investment in the cause.

Police in the rearview mirror: Social marginalization, trauma, and fear of being killed.

An online sample of 528 people was asked to respond to a hypothetical scenario: If a police car came up right behind you with its lights flashing, how much would you worry that you would be killed? Participants also reported on whether they experienced aggressive behavior by police in the past (provoked or otherwise) and, if so, completed a measure of associated posttraumatic stress. At least some fear of being killed by police (FKP) in the rearview mirror scenario was reported by the majority (56%) of Black participants, 39% of those self-describing as "other or mixed" race, and 31% of Hispanic participants, as compared to 26% of those of Asian descent and 19% of those identifying as White. When the highest level of FKP was considered, Black participants were 12 times more likely than White participants to report "extreme" fear of death at the hands of police. Lesbian, gay, bisexual, transgender, queer, and more participants were also more likely than cisgender/heterosexual respondents to report both FKP (35% vs. 20%) and "extreme" FKP (8% vs. 3%). FKP was also more prevalent among those self-reporting unprovoked police aggression in the past and those for whom police aggression had led to posttraumatic stress disorder. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Voices and challenges of marginalized and vulnerable groups in urban informal settlements in Nairobi, Kenya: building on a spectrum of community-based participatory research approaches.

Urbanization is rapidly increasing across Africa, including in Nairobi, Kenya. Many people, recent migrants and long-term residents, live within dense and dynamic urban informal settlements. These contexts are fluid and heterogeneous, and deepening the understanding of how vulnerabilities and marginalization are experienced is important to inform pointed action, service delivery and policy priorities. The aim of this paper is to explore vulnerabilities and marginalization within Korogocho and Viwandani informal settlements in Nairobi and generate lessons on the value of a spectrum of community based participatory research approaches for understanding health and well-being needs and pinpointing appropriate interventions. In the exploratory stages of our ARISE consortium research, we worked with co-researchers to use the following methods: social mapping, governance diaries, and photo voice. Social mapping (including the use of Focus Group Discussions) identified key vulnerable groups: marginalized and precarious child heads of households (CHHs), Persons with disability who face multiple discrimination and health challenges, and often isolated older adults; and their priority needs, including health, education, water and sanitation. The governance diaries generated an understanding of the perceptions of the particularly vulnerable and marginalized informal settlement residents regarding the various people and institutions with the power to influence health and wellbeing; while photo voice highlighted the lived experiences of vulnerability and marginality. Understanding and responding to fluid and intersecting marginalities and vulnerabilities within growing urban informal settlements is particularly critical to achieving inclusive urbanization, where no one is left behind, a theme central to the Sustainable Development Goals and Kenya's Vision 2030.

Overcoming Marginalization by Creating a Sense of Belonging.

Marginalization encompasses structural, interpersonal, and intergroup dynamics that perpetuate inequality and exclusion. This manuscript advocates that the solution to marginalization lies in fostering a sense of belonging. Belonging is a fundamental human need, critical for mental well-being, academic success, and personal growth. It significantly impacts engagement, retention, and overall development, especially in health professional education settings like nursing schools. When individuals feel they belong, they are more likely to seek support, engage actively in learning, and perform better academically. However, achieving a sense of belonging is not straightforward, and many challenges at both individual and institutional levels hinder its realization. Individual challenges include resistance to change, implicit biases, and lack of awareness of the disparities caused by marginalization. Institutional challenges include insufficient commitment, inadequate resource allocation, and lack of representation from marginalized groups. In the United States, recent legislation obstructing initiatives toward diversity, equity, and inclusion poses additional obstacles. To overcome these challenges and promote belonging, this manuscript offers strategies that highlight the importance of aligning institutional values with policies and practices, recognizing and rewarding inclusive efforts, and actively seeking diverse perspectives.

Impact of social marginalization on oral health-related quality of life in older adults.

The aim of this study was to determine the association between oral health-related quality of life (OHRQoL) and social marginalization in people aged 60 years and older enrolled in social security in Mexico. A cross-sectional and analytical study was carried out in older adults. To assess the OHRQoL, the OHIP-14 instrument was applied, and the degree of social marginalization and sociodemographic characteristics were analyzed. Measures of central tendency and dispersion, simple frequencies and proportions were estimated. Student's t-test was used for comparison of means, and prevalence ratio (PR) and logistic regression were used to assess associations, all with a significance value of 0.05 and 95% confidence intervals. Perceived OHRQoL in the population measured through the OHIP-14 reached an average value of 9.84 ± 8.91, with the highest value in the dimension of physical pain (2.06 ± 1.91). Perceived treatment need was higher among people with social marginality (p = 0.011). The multivariate analysis shows that marginalized people have a lower OHRQoL. Socially marginalized older adults showed a low a better perception of OHRQoL, independent of demographic and clinical factors.

La inteligencia artificial en el cine / Artificial intelligence in movies

La mayor parte de los films sobre inteligencia artificial hacen de esta un pretexto para tratar otras cuestiones: los peligros de la tecnociencia al servicio de intereses económicos, bélicos o políticos, la violencia de género, la segregación, los riesgos de un sistema político totalitario, o la deshumanización de la sociedad consumista en que vivimos. Las películas que optan por imaginar un futuro cercano en que se produzca la "singularidad" de un programa que se subjetive y empiece a desear, odiar o amar, pueden ordenarse en cinco grandes escenarios típicos: programas autoconscientes empoderados, subjetividades humanas transformadas en programa computacional, androides diseñados mediante biotecnología, robots que devienen humanos, y robots que semejan a humanos, pero no lo son

Most films about artificial intelligence make this a pretext to address other issues: the dangers of technoscience at the service of economic, war or political interests, gender violence, segregation, the risks of a totalitarian political system, or the dehumanization of the consumerist society in which we live. The films that choose to imagine a near future in which the "singularity" of a program that becomes subjective and begins to desire, hate or love occurs, can be organized into five large typical scenarios: empowered self-conscious programs, human subjectivities transformed into a computer program, androids designed through biotechnology, robots that become humans, and robots that look like humans, but are not.

A framework for neurodiversity-affirming interventions for autistic individuals.

Despite being targets of intervention practice and research for over 60 years, autistic people have been left out of the conversation. Until recently, nearly no research or implementation work has sought the input of autistic people in regard to the design of interventions and, more importantly, how the goals for such interventions are prioritized and determined. This reframe has profound implications for autism-focused interventions and research, most of which have aimed to reduce or eliminate autism symptoms, with variable empirical support (Bottema-Beutel, 2023). These outcomes are practically and ethically incompatible with a neurodiversity perspective. Most prominently, applied behavior analysis (ABA), which was the first intervention approach widely applied to autistic people, has come under increasing scrutiny and criticism for failing to include autistic people in the design of intervention elements and consideration of goals; moreover, autistic people are increasingly identifying iatrogenic effects they have experienced when receiving ABA (Bottema-Beutel, 2023), with these concerns often being met with minimization rather than an endorsement of their validity and willingness to hear them out. Thus, there is a pressing need for a neurodiversity-affirming interventions (NAI) framework for autism. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Workplace Harassment, Cyber Incivility, and Climate in Academic Medicine.

Importance: The culture of academic medicine may foster mistreatment that disproportionately affects individuals who have been marginalized within a given society (minoritized groups) and compromises workforce vitality. Existing research has been limited by a lack of comprehensive, validated measures, low response rates, and narrow samples as well as comparisons limited to the binary gender categories of male or female assigned at birth (cisgender). Objective: To evaluate academic medical culture, faculty mental health, and their relationship. Design, Setting, and Participants: A total of 830 faculty members in the US received National Institutes of Health career development awards from 2006-2009, remained in academia, and responded to a 2021 survey that had a response rate of 64%. Experiences were compared by gender, race and ethnicity (using the categories of Asian, underrepresented in medicine [defined as race and ethnicity other than Asian or non-Hispanic White], and White), and lesbian, gay, bisexual, transgender, queer (LGBTQ+) status. Multivariable models were used to explore associations between experiences of culture (climate, sexual harassment, and cyber incivility) with mental health. Exposures: Minoritized identity based on gender, race and ethnicity, and LGBTQ+ status. Main Outcomes and Measures: Three aspects of culture were measured as the primary outcomes: organizational climate, sexual harassment, and cyber incivility using previously developed instruments. The 5-item Mental Health Inventory (scored from 0 to 100 points with higher values indicating better mental health) was used to evaluate the secondary outcome of mental health. Results: Of the 830 faculty members, there were 422 men, 385 women, 2 in nonbinary gender category, and 21 who did not identify gender; there were 169 Asian respondents, 66 respondents underrepresented in medicine, 572 White respondents, and 23 respondents who did not report their race and ethnicity; and there were 774 respondents who identified as cisgender and heterosexual, 31 as having LGBTQ+ status, and 25 who did not identify status. Women rated general climate (5-point scale) more negatively than men (mean, 3.68 [95% CI, 3.59-3.77] vs 3.96 [95% CI, 3.88-4.04], respectively, P < .001). Diversity climate ratings differed significantly by gender (mean, 3.72 [95% CI, 3.64-3.80] for women vs 4.16 [95% CI, 4.09-4.23] for men, P < .001) and by race and ethnicity (mean, 4.0 [95% CI, 3.88-4.12] for Asian respondents, 3.71 [95% CI, 3.50-3.92] for respondents underrepresented in medicine, and 3.96 [95% CI, 3.90-4.02] for White respondents, P = .04). Women were more likely than men to report experiencing gender harassment (sexist remarks and crude behaviors) (71.9% [95% CI, 67.1%-76.4%] vs 44.9% [95% CI, 40.1%-49.8%], respectively, P < .001). Respondents with LGBTQ+ status were more likely to report experiencing sexual harassment than cisgender and heterosexual respondents when using social media professionally (13.3% [95% CI, 1.7%-40.5%] vs 2.5% [95% CI, 1.2%-4.6%], respectively, P = .01). Each of the 3 aspects of culture and gender were significantly associated with the secondary outcome of mental health in the multivariable analysis. Conclusions and Relevance: High rates of sexual harassment, cyber incivility, and negative organizational climate exist in academic medicine, disproportionately affecting minoritized groups and affecting mental health. Ongoing efforts to transform culture are necessary.