National Identity Development Among Minority Youth: Longitudinal Relations with National Fit Perceptions and School Belonging.

Across Western Europe, immigrant-origin minority youth often struggle to belong socially and to develop national self-identification. Yet, almost no research to-date has asked how these youth perceive the cultural contents of the national identity in their residence country-or rather, to what extent they perceive youth like them to (mis)fit the national identity. The present study addressed this research gap by centering schools as developmental contexts of evolving belonging and national self-identification and newly inquiring into minority youth's perceptions of national (mis)fit as critical levers of their national identity development. Drawing on data from two annual waves of the Leuven-Children of Immigrants Longitudinal Study (Leuven-CILS), a sample of 942 Moroccan- and Turkish-origin youth (Mage-T1 = 14.98, SD = 1.22; 52% female) in 62 Belgian schools was used. Cross-lagged analysis combined repeated measures of school belonging and national self-identification with vignette measures of the perceived national fit of (imagined) culturally different peers. While school belonging and national self-identification were unrelated over time, earlier perceived national fit uniquely enabled more national self-identification one year later, over and above evolving school belonging. These findings suggest that experiencing belonging in school does not suffice for minority youth to develop national self-identification. Schools may, however, promote national identity development through redefining national identities to include cultural diversity-thereby signaling to minority youth that they can fit the national identity.

[The cultural diversity of professionals in migrant care]. / La diversité culturelle des professionnels au profit des soins aux personnes migrantes.

A qualitative study was carried out with five professionals in a pediatric intensive care unit in 2022. Semi-structured interviews were used to find out how they felt about patients from their own culture, and about the role of their mother tongue in hospital care. Caregivers find it difficult to bring their own culture to the fore when caring for their patients. A description of the obstacles they encounter, as well as the advantages, is included.

Uncovering gaps in women's authorship: A big data analysis in academic surgery.

INTRODUCTION: Women are underrepresented in surgical authorship. Using big data analyses, we aimed to investigate women's representation as first and last authors in surgical publications worldwide and identify underlying predictors. METHODS: We retrieved eligible surgical journals using Scimago Journal & Country Rank 2021. We queried articles indexed in PubMed from selected journals published between January 2018 and April 2022. We used the EDirect tool to extract bibliometric data, including first and last authors' names, primary affiliation country, and publication year. Countries and dependent territories were classified following World Bank income levels and regions. Women's representation was predicted from forenames using the Gender-API software. Citations were included if gender accuracy was ≥80%. RESULTS: We analyzed 210,853 citations containing both first and last authors' forenames, representing 158 countries and 14 territories. Women constituted 23.8% (50,161/210,853) of the first and 14.7% (31,069/210,853) of the last authors. High-income economies had more women as first authors than other income categories (p < 0.001), but fewer women as last authors than upper-middle- and lower-middle-income economies (p < 0.001). The odds of the first author being a woman were more than three times higher when the last author was also a woman (OR 3.21, 95% CI 3.13-3.30) and vice versa (OR 3.25, 95% CI 3.16-3.34) after adjusting for income level and publication year. CONCLUSIONS: Women remain globally underrepresented in surgical authorship. Our findings urge concerted global efforts to overcome identified disparities.

Adolescent Cultural Identity Development in Context: The Dynamic Interplay of the Identity Project With Classroom Cultural Diversity Climate in Italy and Germany.

While both the classroom cultural diversity climate and curriculum-based interventions can promote cultural identity development, they have not been studied together. Drawing on theories of ethnic-racial identity development, the current study aimed to understand the dynamic interplay of a curriculum-based intervention (the Identity Project) with the classroom cultural diversity climate (heritage culture and intercultural learning, critical consciousness socialization and equal treatment) on cultural identity exploration and resolution. Our sample included 906 mid-adolescents in Italy (32.36% immigrant descent, Mage (SD) = 15.12 (0.68) years, 51.73% female), and 504 early adolescents in Germany (53.86% immigrant descent, Mage (SD) = 12.82 (0.89) years, 42.37% female). Bayesian multivariate linear models show that the Identity Project and a stronger critical consciousness climate in the classroom before the intervention promoted cultural identity exploration at post-test in both countries. However, effects of the intervention and facets of the diversity climate on subsequent resolution were only observed in Italy. There was some evidence that the intervention could alter the classroom cultural diversity climate in Germany, while the intervention could compensate for a less positive diversity climate in the slightly older sample in Italy. Thus, it seems promising to systematically build in opportunities to engage with students' diverse heritage cultures and identities when developing new curricula, as well as to train teachers to implement such curricula.

Childhood Apraxia of Speech: A Descriptive and Prescriptive Model of Assessment and Diagnosis.

Childhood apraxia of speech (CAS) represents a significant diagnostic and therapeutic challenge within the field of clinical neuropsychology, characterized by its nuanced presentation and multifactorial nature. The aim of this study was to distil and synthesize the broad spectrum of research into a coherent model for the assessment and diagnosis of CAS. Through a mixed-method design, the quantitative phase analyzed 290 studies, unveiling 10 clusters: developmental apraxia, tabby talk, intellectual disabilities, underlying speech processes, breakpoint localization, speech characteristics, functional characteristics, clinical practice, and treatment outcome. The qualitative phase conducted a thematic analysis on the most cited and recent literature, identifying 10 categories: neurobiological markers, speech motor control, perceptual speech features, auditory processing, prosody and stress patterns, parent- and self-report measures, intervention response, motor learning and generalization, comorbidity analysis, and cultural and linguistic considerations. Integrating these findings, a descriptive and prescriptive model was developed, encapsulating the complexities of CAS and providing a structured approach for clinicians. This model advances the understanding of CAS and supports the development of targeted interventions. This study concludes with a call for evidence-based personalized treatment plans that account for the diverse neurobiological and cultural backgrounds of children with CAS. Its implications for practice include the integration of cutting-edge assessment tools that embrace the heterogeneity of CAS presentations, ensuring that interventions are as unique as the children they aim to support.

Clinical Experience Comparison of Foreign-Trained Dentists and Domestic Dental Students: One Institution's Experience.

This study compared the clinical experiences of foreign-trained dentists (FTDs) enrolled in an Advance Standing DMD Dental Program (DMDAS) with those of the domestic dental students (DMD) at the University of Illinois Chicago, College of Dentistry (UIC-COD). A cross-sectional retrospective chart review of patients treated by 295 DMD and 253 DMDAS predoctoral dental students was completed at the UIC-COD. The data were retrieved from the electronic health record system (axiUm) for the graduated classes of 2018, 2019, 2020, 2021, and 2022 on various performed clinical procedures as measured by relative value units (RVUs). The retrieved data were used to compare the clinical experiences of DMDAS vs. DMD students. Descriptive (mean) and statistical (independent t-test) analyses were used (α = 0.05). The results indicated that DMD and DMDAS students had comparable clinical experiences in several disciplines, including diagnosis, prevention, direct/indirect restorations, endodontics, periodontics, complete dentures, removable partial dentures, implants/fixed partial dentures, and oral surgery. There was a statistical difference in total RVUs for diagnosis (p = 0.002) and direct restorations (p < 0.001), in which DMD students had more experience. The 28 month program for FTDs appeared to be a reasonable timeframe to obtain an adequate number of varied clinical experiences as compared with the traditional four-year program at the UIC-COD.

A service-learning framework to address accreditation standards: Self-Assessment, communication skills, health literacy, and cultural competence.

OBJECTIVES: Pre-doctoral dental programs must provide opportunities for students to become proficient in self-assessment, communication skills, health literacy, and cultural competence, essential for independent unsupervised practice. This study aimed to assess how student learning through a classroom education service-learning program addresses the Commission on Dental Accreditation (CODA) standards 2-11 and 2-17; specifically through the examination of self-assessment, communication skills, health literacy, and cultural competence. METHODS: This 2022 retrospective mixed methods cohort study examined unstructured faculty comments on drafted lesson plans and structured evaluations of classroom education service-learning rehearsal sessions. A random sample of faculty comments from three academic years, 2018, 2019, and 2020, were deidentified and analyzed by five researchers for emerging themes using NVivo. Quantitative data from rehearsal presentations were analyzed with descriptive statistics to assess the concordance of self and faculty feedback on specific evaluation criteria. RESULTS: Six major themes from faculty lesson plan feedback emerged: knowledge, professionalism, communication, presentation skills, cultural competence, and program logistics. Concordance between faculty feedback and student self-assessment ranged from 83% to 92.4% across all evaluation criteria over the 3 years: spoke clearly and confidently at the right pace, provided accurate dental terminology and facts, used grade-appropriate language, provided clear instructions to follow, appeared enthusiastic throughout the rehearsal presentation, and designed a well thought out lesson plan that will engage children for the entire presentation. CONCLUSION: Findings support the classroom education service-learning program as a framework to provide opportunities for student self-assessment and feedback on communication skills, health literacy, and cultural competence aligned with CODA standards 2-11 and 2-17.

The effectiveness of multidisciplinary, activity-based chronic pain interventions for adults of ethnoculturally diverse backgrounds: a systematic review with meta-analysis.

PURPOSE: The aim of this review was to assess the effectiveness of multidisciplinary, activity-based interventions on adults with chronic musculoskeletal or widespread pain who identify as ethnoculturally diverse (ECD) compared to adults belonging to the predominant culture of the host country. METHODS: Online databases Medline, CINAHL, AMED, Psych Info and PubMed were searched from the earliest date available until April 2023. The quality of the included studies were assessed against the Risk of Bias in Non Randomized Studies of Interventions (ROBINS-I). Postintervention data were analyzed using meta-analyses and the certainty of evidence determined using the Grading of Recommendation, Assessment, Development and Evaluation approach (GRADE). RESULTS: Nine cohort studies with 3467 participants living in America and north-western European countries were included. ECD adults had higher pain intensity (SMD 1.36, 95%CI 0.29 to 2.35, p = 0.03), higher levels of depression (SMD 0.96, 95%CI 0.40 to 1.52, p < 0.01) and a nonsignificant difference in pain-related disability (SMD -1.45, 95%CI -3.28 to 0.39, p = 0.12) following multidisciplinary pain intervention compared to adults of the predominant culture. CONCLUSION: Adults from ECD backgrounds in Western nations have poorer outcomes after multidisciplinary, activity-based chronic pain interventions compared to adults from predominant cultural groups in these countries suggesting program adaptations may be required.

Adults from ethnoculturally diverse backgrounds in Western nations have poorer outcomes after chronic pain interventions suggesting different approaches to management are needed.Programs can be adapted to reflect culture-specific beliefs, metaphors, language and concepts in their content to better address pain and improve outcomes among ethnoculturally diverse communities.

Climate, climate change and the global diversity of human houses.

Globally, human house types are diverse, varying in shape, size, roof type, building materials, arrangement, decoration and many other features. Here we offer the first rigorous, global evaluation of the factors that influence the construction of traditional (vernacular) houses. We apply macroecological approaches to analyse data describing house features from 1900 to 1950 across 1000 societies. Geographic, social and linguistic descriptors for each society were used to test the extent to which key architectural features may be explained by the biophysical environment, social traits, house features of neighbouring societies or cultural history. We find strong evidence that some aspects of the climate shape house architecture, including floor height, wall material and roof shape. Other features, particularly ground plan, appear to also be influenced by social attributes of societies, such as whether a society is nomadic, polygynous or politically complex. Additional variation in all house features was predicted both by the practices of neighouring societies and by a society's language family. Collectively, the findings from our analyses suggest those conditions under which traditional houses offer solutions to architects seeking to reimagine houses in light of warmer, wetter or more variable climates.

Institutional complexity emerges from socioecological complexity in small-scale human societies.

Human lifestyles vary enormously over time and space and so understanding the origins of this diversity has always been a central focus of anthropology. A major source of this cultural variation is the variation in institutional complexity: the cultural packages of rules, norms, ontologies and expectations passed down through societies across generations. In this article, we study the emergence of institutions in small-scale societies. There are two primary schools of thought. The first is that institutions emerge top-down as rules are imposed by elites on their societies in order to gain asymmetrical access to power, resources and influence over others through coercion. The second is that institutions emerge bottom-up to facilitate interactions within populations as they seek collective solutions to adaptive problems. Here, we use Bayesian networks to infer the causal structure of institutional complexity in 172 small-scale societies across ethnohistoric western North America reflecting the wide diversity of indigenous lifestyles across this vast region immediately prior to European colonization. Our results suggest that institutional complexity emerges from underlying socioecological complexity because institutions are solutions to coordination problems in more complex environments where human-environment interactions require increased management.

Assessing Growth of BACB Certificants (1999-2019).

Geographic distribution patterns of board certified behavior analysts may be useful in analyzing the growth of the field. First, we present an international snapshot of Behavior Analyst Certification Board (BACB) certificants, then analyze relative growth rates between countries from 1999 to 2019. This is followed by an in depth review of certificant distribution patterns in the United States and Canada, as well as the ratios of experienced behavior analysts to new certificants. These data highlight regions with a potential deficit of qualified supervisors. There are factors that influence different dispersal patterns, and without drilling deeper into the data we may be unable to effectively identify or influence them in order meet the specific needs of a geographic region. Supplementary Information: The online version contains supplementary material available at 10.1007/s40614-023-00370-5.

Navigating ecological novelty towards planetary stewardship: challenges and opportunities in biodiversity dynamics in a transforming biosphere.

Human-induced global changes, including anthropogenic climate change, biotic globalization, trophic downgrading and pervasive land-use intensification, are transforming Earth's biosphere, placing biodiversity and ecosystems at the forefront of unprecedented challenges. The Anthropocene, characterized by the importance of Homo sapiens in shaping the Earth system, necessitates a re-evaluation of our understanding and stewardship of ecosystems. This theme issue delves into the multifaceted challenges posed by the ongoing ecological planetary transformation and explores potential solutions across four key subthemes. Firstly, it investigates the functioning and stewardship of emerging novel ecosystems, emphasizing the urgent need to comprehend the dynamics of ecosystems under uncharted conditions. The second subtheme focuses on biodiversity projections under global change, recognizing the necessity of predicting ecological shifts in the Anthropocene. Importantly, the inherent uncertainties and the complexity of ecological responses to environmental stressors pose challenges for societal responses and for accurate projections of ecological change. The RAD framework (resist-accept-direct) is highlighted as a flexible yet nuanced decision-making tool that recognizes the need for adaptive approaches, providing insights for directing and adapting to Anthropocene dynamics while minimizing negative impacts. The imperative to extend our temporal perspective beyond 2100 is emphasized, given the irreversible changes already set in motion. Advancing methods to study ecosystem dynamics under rising biosphere novelty is the subject of the third subtheme. The fourth subtheme emphasizes the importance of integrating human perspectives into understanding, forecasting and managing novel ecosystems. Cultural diversity and biological diversity are intertwined, and the evolving relationship between humans and ecosystems offers lessons for future stewardship. Achieving planetary stewardship in the Anthropocene demands collaboration across scales and integration of ecological and societal perspectives, scalable approaches fit to changing, novel ecological conditions, as well as cultural innovation. This article is part of the theme issue 'Ecological novelty and planetary stewardship: biodiversity dynamics in a transforming biosphere'.

Validation of three health literacy screening questions compared with S-TOFHLA in a low-income diverse English- and Spanish-Speaking population.

BACKGROUND: Clinicians need a tool to gauge patients' ability to understand health conditions and treatment options. The Short-form Test of Functional Health Literacy in Adults (S-TOFHLA) is the gold standard for this, but its length is prohibitive for use in clinical settings. This study seeks to validate a novel three-item question set for predicting health literacy. METHODS: This cross-sectional study utilized an in-person questionnaire alongside the S-TOFHLA. The sample included 2027 English- and Spanish-speaking adults (≥18 years) recruited from primary care practices serving a low-income eastern Pennsylvania community. Most patients (57.7%) identified as Hispanic. Diagnostic accuracy of each question and aggregated scores were assessed against the validated survey by calculating the area under the receiver operating characteristic (AUROC) curve. RESULTS: Questions in the 'Problems Learning' and 'Help Reading' domains (AUROC 0.66 for each) performed better than the 'Confident Forms' question (AUROC 0.64). Summing all three scores resulted in an even higher AUROC curve (0.71). Cronbach's alpha of the combined items was 0.696. CONCLUSIONS: Study results suggest that any of the three questions are viable options for screening health literacy levels of diverse patients in primary care clinical settings. However, they perform better as a summed score than when used individually.

Self-reported cultural competence among Czech and Slovakian nurses: A comparative correlation study.

AIM: This study aimed to compare the level of cultural competence among nurses working in clinical practice in Slovakia and the Czech Republic. BACKGROUND: Demographic changes have greatly affected the health sector in Slovakia and the Czech Republic. By identifying the level of nurses' cultural competence, many of the complications encountered in caring for patients from different cultures can be avoided. However, few studies have explored the cultural competence of nurses in clinical practice in these countries. METHOD: This study was cross-sectional, descriptive, and comparative. It followed the STROBE checklist and used the Cultural Competence Assessment Tool questionnaire to collect data. Descriptive and inferential statistical tests were utilized for data analysis, using SASD 1.5.8 and IBM SPSS Statistics version 28.0.0. RESULTS: The sample comprised 424 nurses, with 202 from the Czech Republic and 222 from Slovakia, primarily female. Most nurses in both countries have not received cultural diversity training. Nevertheless, nurses in both countries indicate the necessity of conducting a cultural impact assessment of patients' health. Cultural diversity training significantly increases the level of cultural competence in nurses. DISCUSSION: Lower cultural competence scores can negatively impact nursing care for patients from different cultures, leading to additional cultural challenges. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The findings highlight the need for enhanced cultural competence among nurses. Nurses need to learn and utilize cultural information to help maximize healthcare for patients from different cultures. By providing nurses with cultural knowledge and skills, they will be able to deliver more effective and culturally competent care to patients from varied cultural backgrounds.

Fostering Diversity in Urology: Addressing Ethnic Disparities in Applicant and Resident Recruitment.

INTRODUCTION: In this retrospective database review, the objective was to investigate the ethnic composition of urology applicants and residents in recent years and assess whether any advancements have been made in enhancing the recruitment of candidates from historically underrepresented groups in medicine. METHODS: A retrospective database review was conducted on self-reported data on the ethnicity of urology applicants from academic year 2016 to 2017 (AY2016) to AY2021 and urology residents from AY2011 to AY2021. Applicant data were collected from the Association of American Medical Colleges, and resident data were collected from the Accreditation Council for Graduate Medical Education. The ethnic proportions of applicants and residents within cohorts were analyzed using χ2 tests, and differences between cohorts were analyzed using Z tests. RESULTS: There was a statistically significant decrease in the proportion of White applicants from 61.4% to 50.5% from AY2016 to AY2021 and a statistically significant increase in the proportion of applicants of multiple race/ethnicity from 4.7% to 12.0% from AY2016 to AY2021. There were disproportionately more Hispanic/Latino residents than applicants and disproportionately fewer residents of multiple race/ethnicity than applicants in the 2 cycles analyzed. There were disproportionately fewer Black residents than applicants only in the comparison of AY2016 to AY2020 applicants to AY2020 residents. CONCLUSIONS: There continues to be a lack of ethnic representation among applicants and residents in urology from underrepresented groups in medicine, despite some measurable improvement over the years. This deficit highlights the important need for new and ongoing efforts to diversify the field.

Development of a mentor training curriculum to support LGBTQIA+ health professionals.

While mentors can learn general strategies for effective mentoring, existing mentorship curricula do not comprehensively address how to support marginalized mentees, including LGBTQIA+ mentees. After identifying best mentoring practices and existing evidence-based curricula, we adapted these to create the Harvard Sexual and Gender Minority Health Mentoring Program. The primary goal was to address the needs of underrepresented health professionals in two overlapping groups: (1) LGBTQIA+ mentees and (2) any mentees focused on LGBTQIA+ health. An inaugural cohort (N = 12) of early-, mid-, and late-career faculty piloted this curriculum in spring 2022 during six 90-minute sessions. We evaluated the program using confidential surveys after each session and at the program's conclusion as well as with focus groups. Faculty were highly satisfied with the program and reported skill gains and behavioral changes. Our findings suggest this novel curriculum can effectively prepare mentors to support mentees with identities different from their own; the whole curriculum, or parts, could be integrated into other trainings to enhance inclusive mentoring. Our adaptations are also a model for how mentorship curricula can be tailored to a particular focus (i.e., LGBTQIA+ health). Ideally, such mentor trainings can help create more inclusive environments throughout academic medicine.

Racial Inequities in Female Family Physicians Providing Women's Health Procedures.

Patient-physician race concordant dyads have been shown to improve patient outcomes; the race and ethnicity of family physicians providing women's health procedures has not been described. Using self-reported data, this analysis highlights the racial disparities in scope of practice; underrepresented in medicine (URiM) females are less likely to perform women's health procedures which may lead to disparities in care received by minority women.

The importance of worldwide linguistic and cultural diversity for climate change resilience.

Local minority languages and dialects, through the local knowledge and expertise associated with them, can play major roles in analysing climate change and biodiversity loss, in facilitating community awareness of environmental crises and in setting up locally-adapted resilience and sustainability strategies. While the situation and contribution of Indigenous and Tribal Peoples are of emblematic importance, the issue of the relationships between cultural and linguistic diversity and environmental awareness and protection does not solely concern peripheral highly-specialized communities in specific ecosystems of the Global South, but constitutes a worldwide challenge, throughout all of the countries, whatever their geographical location, their economical development, or their political status. Environmental emergency and climate change resilience should therefore raise international awareness on the need to promote the survival and development of minority languages and dialects and to take into account their creativity and expertise in relation to the dynamics of their local environments.