Parkinson's Disease Inequities in Daily Cognitive Activities: An Intersectional Approach.

Objective: Intersectionality approaches to examining differences in Parkinson's disease (PD) based on racialized group, gender identity, and socioeconomic status (SES) are not well covered in the literature. Additionally, the differences in daily cognitive activities for persons diagnosed with PD by racialized group, gender, and SES are undetermined. This study was conducted to explore the differences in PD daily cognitive activities for diverse racialized groups by gender and SES. Methods: This study was a secondary analysis of the Michael J. Fox Foundation's Fox Insight online clinical dataset. Persons with PD were partitioned into 16 racialized by gender groups (Black women, Indigenous men, Latina/x women, Asian men, etc.) that were used in within-group comparisons of low-, middle-, and high-SES-a new variable comprising education and income. Results: Intersectional analyses revealed most items differed between low-SES and high-SES except for items associated with Black and Indigenous men, for whom significant differential item functioning was found between mid-SES and high-SES. Conclusions: These findings revealed that within-group differences exist and may be missed in research in which social factors are adjusted for instead of included in the model.

Sexual Identity and Heavy Drinking Among Adults in Canada by Racially Minoritized Status and Income, 2015-2020.

Purpose: Our objective was to estimate inequities in heavy drinking between heterosexual, gay or lesbian, and bisexual or pansexual individuals, by sex/gender, and to determine whether this association is heterogeneous across racially minoritized status and income groups in Canadians aged 15 and older. Methods: We pooled three Canadian Community Health Survey cycles (2015-2020) and used separate modified Poisson regressions to explore the sex/gender-specific association between sexual identity and heavy drinking prevalence by racially minoritized status, and income, adjusted for survey cycle, age, marital status, and region. Results: With racially minoritized status, and income categories collapsed, heavy drinking was 1.3 times higher (95% confidence interval [CI] = 1.0-1.7) among bisexual or pansexual women compared with heterosexual women, with no differences among men. Among racially minoritized women, heavy drinking was 2.9 (95% CI = 1.3-6.4) times higher among bisexual or pansexual women and 1.9 (95% CI = 0.7-5.2) times higher among gay or lesbian women compared with heterosexual women. Among racially minoritized men, heavy drinking was 1.9 (95% CI = 0.9-4.0) times higher among gay men compared with heterosexual men. No differences were observed across sexual identity in White men or women. Bisexual or pansexual women reported increased heavy drinking relative to heterosexual women across income quintiles. Conclusion: Heavy drinking is distributed heterogeneously across sexual identity, sex/gender, racially minoritized status, and income. These results encourage equity-focused interventions to reduce heavy drinking among intersecting sociodemographic groups experiencing a greater burden of heavy drinking.

The Concealment of Health Information at the Intersection of Sexual Orientation and Race.

Purpose: Sexually and racially minoritized people often have mistrust toward the healthcare system due to both perceived and actual experiences of discrimination. This may result in increased privacy concerns and a reluctance to share health-related information with health care providers. Drawing upon minority stress and an intersectionality framework, this study examines how rates of concealing health information differ between non-Hispanic White heterosexual people, non-Hispanic White lesbian, gay, and bisexual (LGB) people, racially minoritized heterosexual people, and those who are both sexually and racially minoritized. Methods: Using nationally representative cross-sectional data from the Health Information National Trends Survey from 2017 and 2018 (n = 4575), we fit logistic regression models to examine (1) whether sexually and racially minoritized people conceal health information from their providers more than their counterparts and (2) whether this tendency increases for those with multiple marginalized identities. Furthermore, we fit linear regression models to examine whether and how concealing health information from providers are linked to health outcomes. Results: Sexually and racially minoritized people had higher odds of concealing health information from providers than their counterparts. Those with multiple marginalized identities had even higher odds of withholding health information than other groups. Finally, we found a significant negative association between concealing health information and mental health. Conclusion: Our findings underscore the need to consider how the intersection of multiple marginalized identities shape health experiences and concerns over privacy in health care matters. We call for further research to better understand the complex dynamics of patient-provider relationships for marginalized populations.

Mapping intersectional sociodemographic inequalities in measurement and prevalence of depressive symptoms: A Intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (I-MAIHDA) using data from a population based nationwide survey in Germany.

OBJECTIVE: Understanding how social categories like gender, migration background, LGBT status (lesbian/gay/bisexual/transgender), education and their intersections affect health outcomes is crucial. Challenges include avoiding stereotypes and fairly assessing health outcomes. This paper aims to demonstrate how to analyse these aspects. STUDY DESIGN AND SETTING: The study used data from N=19,994 respondents from the German Socio-Economic Panel (SOEP) 2021 data collection. Variations between and within intersectional social categories regarding depressive symptoms and self-reported depression diagnosis were analyzed. We employed Intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (I-MAIHDA) to assess the impact of gender, LGBT status, migration, education and their interconnectedness. A Configuration-Frequency Analysis (CFA) assessed typicality of intersections. Differential Item Functioning (DIF) analysis was conducted to check for biases in questionnaire items. RESULTS: I-MAIHDA analysis revealed significant interactions between these categories for depressive symptoms and depression diagnosis. The CFA showed that certain combinations of social categories occurred less frequently compared to their expected distribution. The DIF analysis showed no significant bias in a depression short scale across social categories. CONCLUSION: Results reveal interconnectedness between the social categories, affecting depressive symptoms and depression probabilities. More privileged groups had significant protective effects while those with less societal privileges showed significant hazardous effects. Although statistical significance was found in interactions between categories, the variance within categories outweighs that between them, cautioning against individual-level conclusions.

"Where Are You From?"-on Separation, Belonging and Imposter Syndrome as an International Medical Graduate.

Minoritized international medical graduates (IMGs) in American graduate medical education (GME) programs face a disproportionately higher number of intersectional micro- and macroaggressions. In order to create a healthier, more equitable learning environment, GME programs must make greater efforts to understand intersectionality, provide IMG trainees with additional support systems, incorporate effective bystander training, and celebrate and acknowledge the contributions of their minoritized IMG trainees.

Intersectionality and school racial climate to create schools as sites of fairness and liberation for Black girls.

Within this article, we utilize intersectionality theory as a framework for understanding the experiences of Black girls who attend PK-12 schools in the United States. Black girls' experiences are then illuminated within the context of the school racial climate research. We then add an intersectional lens to the school racial climate research to demonstrate how specific aspects of the school environment influence the experiences and perceptions of Black girls and their developmental outcomes. Finally, we conclude with recommendations for helping schools become fair and liberatory spaces that honor the full humanity of Black girls, their current schooling experiences, and their visions for their future selves.

Triple Jeopardy in Oral Health: Additive Effects of Immigrant Status, Education, and Neighborhood.

PURPOSE: To estimate the additive effects of parent's nativity status/language spoken at country of birth, education, and area-level socioeconomic status (SES) on untreated dental caries among children aged 5 to 9 y in Australia. METHODS: Cross-sectional population-based data were obtained from the 2014 National Child Oral Health Study (N = 12,140). Indicators of social position used to explore additive effects on dental caries included nativity status, language, university degree, and neighborhood socioeconomic level. Multiple-way interactions were examined, and departure from additivity resulting from 2- and 3-way interactions were estimated as relative excess risk due to interaction (RERI). RESULTS: Children marginalized across multiple layers of disadvantage had substantially higher frequencies of dental caries compared with children in the most advantaged category. RERI for the 3-way interaction between immigrant status, education, and neighborhood SES was negative (RERI3: -0.14; 95% confidence interval [CI]: -1.68, 1.40). When operationalizing language, education, and neighborhood SES, the joint effect of the 3 marginalized positions was additive (RERI3: 0.43; 95% CI: -2.08, 2.95). CONCLUSION: Children marginalized across multiple intersecting axes of disadvantage bear the greatest burden of dental caries, with frequencies surpassing the cumulative effect of each social position alone. Findings emphasize the need to account for intersecting inequities and their oral health effects among children with immigrant backgrounds. KNOWLEDGE TRANSFER STATEMENT: Our analysis underscores the necessity for policies and public health strategies targeting dental caries-related inequities to comprehensively account for various indicators of social disadvantage, particularly encompassing language proficiency, educational attainment, and neighborhood socioeconomic status. Within the intricate interplay of these factors, we identify a vulnerable subgroup comprising children with the highest prevalence of dental decay. Therefore, prioritizing this specific demographic should be the focal point of policies and public health initiatives aimed at fostering equitable oral health outcomes.

Using an intersectionality lens to explore barriers and enablers to hepatitis C point-of-care testing: a qualitative study among people who inject drugs and service providers.

BACKGROUND: Hepatitis C virus (HCV) infection is a significant global health burden, particularly among people who inject drugs. Rapid point-of-care HCV testing has emerged as a promising approach to improve HCV detection and linkage to care in harm reduction organizations such as needle and syringe programs. The objective of this study was to use an intersectionality lens to explore the barriers and enablers to point-of-care HCV testing in a needle and syringe program. METHODS: A qualitative study was conducted using semi-structured interviews with clients (people who inject drugs) and service providers in a large community organization focused on the prevention of sexually transmitted and blood borne infections and harm reduction in Montreal, Canada. An intersectionality lens was used alongside the Theoretical Domains Framework to guide the formulation of research questions as well as data collection, analysis, and interpretation. RESULTS: We interviewed 27 participants (15 clients, 12 providers). For clients, four themes emerged: (1) understanding and perceptions of HCV testing, (2) the role of an accessible and inclusive environment, (3) the interplay of emotions and motivations in decision-making, and (4) the impact of intersectional stigma related to HCV, behaviors, and identities. For providers, five themes emerged: (1) knowledge, skills, and confidence for HCV testing, (2) professional roles and their intersection with identity and lived experience, (3) resources and integration of services, (4) social and emotional factors, and (5) behavioral regulation and incentives for HCV testing. Intersectional stigma amplified access, emotional and informational barriers to HCV care for clients. In contrast, identity and lived experience acted as powerful enablers for providers in the provision of HCV care. CONCLUSION: The application of an intersectionality lens provides a nuanced understanding of multilevel barriers and enablers to point-of-care HCV testing. Findings underscore the need for tailored strategies that address stigma, improve provider roles and communication, and foster an inclusive environment for equitable HCV care. Using an intersectionality lens in implementation research can offer valuable insights, guiding the design of equity-focused implementation strategies.

Systemic biases promoting the under-inclusion of marginalized groups in randomized controlled trials for co-occurring alcohol use and posttraumatic stress disorder: an intersectional analysis.

Co-occurring posttraumatic stress disorder and alcohol use disorder is a major public health concern affecting millions of people. Although this disorder affects people from all groups, research shows that, when compared to White people, people of color systematically suffer worse chronicity and burden of disorder. Additionally, research shows that people of color endure a variety of barriers to accessing treatment and often require specialized or culturally appropriate care. Consequently, the array of treatments available must have been determined to be effective for people of color when they access treatment, and people of color must be well represented in research to ensure effective treatment. Therefore, randomized controlled trials testing treatments for this disorder must include racially diverse samples and ensure treatments are effective for all groups. Further, if they lack diversity, it is necessary to explore whether and how the process of conducting randomized controlled trials is biased toward the constrained inclusion of people of color. This study used a Matrix of Domination framework as an intersectional method to investigate this question. It assessed the inclusion of people by race and sex in randomized controlled trials for co-occurring posttraumatic stress disorder and alcohol use disorder. We found that people of color and White women are significantly underincluded in randomized controlled trials and that these studies are hegemonically, disciplinarily, and structurally biased in ways that facilitate the overrepresentation of White men and the underrepresentation of marginalized groups.

Are surveys blind to sexual and gender diversity? Reflections and an open proposal.

This article presents an open proposal on how to include questions that capture different gender identities and sexual orientations in quantitative research. Our theoretical framework is feminist theory and the evolution of feminist debates on identity categories, where the introduction of an intersectional gender perspective has been an important paradigm shift. We have compiled different previous categorization proposals and consider the consequences of not including categories that reflect identity diversity in surveys in order to finally offer our proposal for operationalizing identities. The proposal aims to ensure comparability in longitudinal studies and, at the same time, to incorporate new identity frameworks and an intersectional perspective in quantitative methodology research.

Applying an intersectional ecological framework to understand ableism and racism in employment among youth and young adults with disabilities.

PURPOSE: Youth with disabilities often face many barriers in finding employment. A knowledge gap exists surrounding the experiences of racially minoritized youth with disabilities who arguably encounter multiple and complex forms of discrimination. The purpose of this study was to understand the experiences of ableism and racism in employment among racially minoritized youth and young adults with non-apparent disabilities. METHODS: Individual semi-structured interviews were conducted with 19 racially minoritized participants aged 17-30 with non-apparent disabilities. Data were analyzed using a deductive thematic analysis approach informed by an intersectional ecological framework. RESULTS: Themes that affected racially minoritized youth's employment included: (1) microsystems (i.e., individual barriers and facilitators to employment); (2) mesosystems (i.e., peers, family, disability, race/ethnicity, and work); (3) exosystems (i.e., workplace policies, healthcare system, educational institutions, community organizations); (4) macrosystems (i.e., ableism, racism, gendered discrimination and intersectional forms of discrimination); (5) the chronosystem (i.e., timing of obtaining employment, diagnosis and discrimination); and (6) ecological niche, which involved the extent to which work environments were safe and inclusive. CONCLUSION: Applying an intersectional ecological framework facilitates our understanding of ableism and racism in employment among youth and young adults with disabilities. Further attention is urgently needed to minimize discrimination and enhance supportive, inclusive and psychologically safe, work environments for minoritized youth with disabilities.

Racially minoritized youth with disabilities experience multiple forms of discrimination including ableism and racism occurring at multiple levels.Clinicians and service providers should develop and implement more tailored supports to optimize the employment outcomes and work experiences for youth with multiple minoritized identities.Clinicians should consider enhancing their knowledge about the challenges that youth with multiple minoritized identities encounter and help to connect them with appropriate supports and opportunities.Clinicians and service providers should consider their own potential biases to help improve health delivery and outcomes for multiply marginalized clients.

The sociodemographic correlates of conspiracism.

Despite hundreds of studies examining belief in conspiracy theories, it is still unclear who-demographically-is most likely to believe such theories. To remedy this knowledge gap, we examine survey data containing various operationalizations of conspiracism across diverse sociopolitical contexts. Study 1 employs a 2021 U.S. survey (n = 2021) to examine associations between sociodemographic characteristics and beliefs in 39 conspiracy theories. Study 2 similarly employs a survey of 20 countries (n = 26,416) and 11 conspiracy theory beliefs. Study 3 reports results from a 2020 U.S. survey (n = 2015) measuring perceptions about which groups are engaging in conspiracies. Study 4 interrogates data from nine U.S. surveys (2012-2022; n = 14,334) to examine the relationships between sociodemographic characteristics and generalized conspiracy thinking. Study 5 synchronizes studies 1-4 to provide an intersectional analysis of conspiracy theory belief. Across studies, we observe remarkably consistent patterns: education, income, age (older), and White identification are negatively related to conspiracism, while Black identification is positively related. We conclude by discussing why conspiracy theories may appeal most to historically marginalized groups and how our findings can inform efforts to mitigate the negative effects of conspiracy theories.

Gender/Sex Disparities in the COVID-19 Cascade From Testing to Mortality: An Intersectional Analysis of Swiss Surveillance Data.

Objectives: This study investigates gender and sex disparities in COVID-19 epidemiology in the Canton of Vaud, Switzerland, focusing on the interplay with socioeconomic position (SEP) and age. Methods: We analyzed COVID-19 surveillance data from March 2020 to June 2021, using an intersectional approach. Negative binomial regression models assessed disparities between women and men, across SEP quintiles and age groups, in testing, positivity, hospitalizations, ICU admissions, and mortality (Incidence Rate Ratios [IRR], with 95% Confidence Intervals [CI]). Results: Women had higher testing and positivity rates than men, while men experienced more hospitalizations, ICU admissions, and deaths. The higher positivity in women under 50 was mitigated when accounting for their higher testing rates. Within SEP quintiles, gender/sex differences in testing and positivity were not significant. In the lowest quintile, women's mortality risk was 68% lower (Q1: IRR 0.32, CI 0.20-0.52), with decreasing disparities with increasing SEP quintiles (Q5: IRR 0.66, CI 0.41-1.06). Conclusion: Our findings underscore the complex epidemiological patterns of COVID-19, shaped by the interactions of gender/sex, SEP, and age, highlighting the need for intersectional perspectives in both epidemiological research and public health strategy development.

Students' perspectives on racism and anti-racism in physical education: a systematic review.

Sports, with their various social manifestations, exhibit racist structures and incidents. Physical education (PE) has the potential to serve as an environment to combat racism, but it can also perpetuate and (re)produce racist attitudes and behaviors. This study aimed to conduct a systematic review of national (German) and international literature concerning racism and anti-racism within the context of PE specifically from a students' perspective. The research methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard and encompassed a four-step process: (1) searching 11 electronic databases using 70 keyword combinations in both German and English; (2) selecting studies based on five predetermined inclusion criteria; (3) evaluating the quality of selected studies using established appraisal tools; and (4) conducting descriptive and template analyses. Of 5,213 publications, 16 met the inclusion criteria, demonstrating diverse theoretical frameworks and methodological approaches. Five themes were constructed: "How racism is understood" (1); "What students experience," encompassing discriminatory incidents in PE, sports, and daily life classified as racial stereotypes, prejudices, and everyday racism (2); and "What physical education teachers (3)/Institutions (4)/researchers (5) can and should do." These themes provided recommendations for teachers, institutions, and researchers, including training and curriculum reforms. While valuable international literature was identified, no German PE specific publications were found emphasizing the necessity of a local (German) survey to comprehend students' experiences, knowledge, and potential for anti-racism efforts. Such insights are crucial for shaping teacher-related training programs and policy demands in an informed and targeted manner.

No Man Is an Island: Resiliency Among Older African American Men Living with HIV.

African American men face chronic illness earlier in life and earlier death due to higher severity of illness and poor control of chronic diseases than their white male counterparts. Preexposure and post-exposure prophylaxis PrEP and PREP have improved the odds of survival among those living with HIV. However, the anti-retroviral treatments, though effective, are only as effective as early prevention and detection and in cases where patients can adhere to treatment regimens. The mean age of participants (N = 11) was 56.44 (SD = 5.175, range = 47-63). The current study employs qualitative methodology to propose an ecosystems-driven intersectional model to identify resilience and the influence of personal, social, and societal forces shaping the lives of older African American men living with HIV. Findings determine stigma, community violence, and structural barriers to care as crucial stress areas. Participants discussed self-advocacy and family as constituent elements of resilience. Several implications for practice and research emerged. Practice must design and deploy assessment instruments to include exposure to racism and violence, including emotional and structural violence. Practice must include advocacy at the micro, meso, and macro levels. Assessment must also be self-reflexive. Organizational assessment should involve internal and structural reviews of barriers to meeting client preferences.

Integrating Cultural Humility into Medical Education Using a Structured and Interactive Workshop.

Background: Cultural humility is a lifelong commitment to self-evaluation, redressing power imbalances in patient-physician relationships and developing mutually trusting beneficial partnerships. Objective: The objective of this study was to determine the feasibility and efficacy of cultural humility training. Methods: From July 2020-March 2021, 90-minute educational workshops attended by 133 medical students, resident physicians and medical education faculty included 1) pre- and post- intervention surveys; 2) interactive presentation on equity and cultural humility principles; 3) participants explored sociocultural identities and power; and 4) reflective group discussions. Results: There were significant increases from pre to post intervention assessments for perception scores (3.89 [SEM= 0.04] versus 4.22 [0.08], p<0.001) and knowledge scores (0.52 [0.02] versus 0.67 [0.02], p<0.001). Commonest identities participants recognized as changing over time were personality = 40%, appearance = 36%, and age =35%. Commonest identities experienced as oppressed/subjugated were race/ethnicity = 54%, gender = 40% and religion = 28%; whilst commonest identities experienced as privileged were gender= 49%, race/ethnicity = 42% and appearance= 25%. Male participants assigned mean power score of 73% to gender identity compared to mean power score of -8% by female participants (P<0.001). Non-Hispanic Whites had mean power score for race identity of 62% compared to 13% for non-white participants (p<0.001). English as a second language was only acknowledged as an oppressed/subjugated identity by those born outside the United States (p<0.001). Conclusion: An interactive educational workshop can increase participants' knowledge and perceptions regarding cultural humility. Participants can self-reflect to recognize sociocultural identities that are oppressed/subjugated or privileged.

Feminist perspectives on environmental justice and health in Jamaica.

Jamaica is an island nation with a history that is informed by Taino settlement, European colonisation, chattel slavery, disinvestment, and continued extractivism. This perspective paper leverages a historical analysis to explore environmental injustices affecting the health and quality of life of Jamaicans living in Jamaica. This article hopes to contribute to a growing but limited body of scholarly research that contends with environmental and climate justice in the context of the Caribbean. In discussing a lack of critical environmental infrastructure, such as reliable solid waste management, and the impacts of extractive industries, such as bauxite mining, the paper intends to highlight the environmental, public health, and social harms that are produced. Employing an intersectional approach grounded in Black feminist epistemology put forward by Patricia Hill Collins, the authors use their lived experiences as a source of knowledge. The paper analyses how these environmental injustices harm Jamaican communities at large but underscores the compounded challenges faced by Jamaican women who experience marginalisation on the basis of gender, urban/rural residency, and class. The paper concludes by urging researchers, policymakers, regulatory bodies, and other stakeholders to conduct further research and create sustainable and equitable environmental standards that have considerations for environmental injustice in Jamaica.

Sex differences in houselessness, injection drug use, and mental health conditions among people newly diagnosed with HIV in Manitoba, Canada from 2018 to 2021: a retrospective cohort study.

Background: Manitoba saw the highest number of new HIV diagnoses in the province's history in 2021 and is the only Canadian province not meeting any of the previous UNAIDS 90-90-90 targets. Our goal was to describe sex differences and syndemic conditions within an incident HIV cohort in Manitoba, and the HIV treatment initiation and undetectable viral load outcomes. Methods: This was a retrospective cohort study of all people 18 years and older newly diagnosed with HIV in Manitoba, Canada between January 1st, 2018 and December 31st, 2021. Data was collected as follows: before HIV diagnosis: chlamydia, gonorrhoea, syphilis, and/or hepatitis C antibodies. At the time of HIV diagnosis: age, sex, gender, race/ethnicity, sexual orientation. During follow-up: CD4 counts, viral load, HIV treatment, hospitalizations, and number of visits to HIV care. Main exposures evaluated: methamphetamine use, injection drug use, houselessness, and mental health conditions. Outcomes: started antiretroviral treatment and achieved an undetectable viral load. A descriptive statistical analysis was used. Findings: There were 404 new HIV diagnoses in Manitoba from 2018 to 2021; 44.8% were female, 55.2% male; 76.% self-identified as Indigenous, 13.4% white/European, 4.7% African/black; 86.6% cis-gender; 60.9% heterosexual, 13.4% gay, bisexual and men who have sex with men, and 1.7% lesbian. Injection drug use was reported by 71.8% and 43.5% of females and males respectively. Methamphetamine was the most frequently injected drug (62.4%). Amongst females, 81.8% experienced at least one of the following: houselessness (43.1%), mental health comorbidities (46.4%), and injection drug use (71.8%). Only 64.9% of all individuals had an undetectable viral load (61.1% females and 67.9% males), 56.5% among people experiencing houselessness, 59% among young people (≤29 years), and 60.1% among people who inject drugs. Interpretation: People newly diagnosed with HIV in Manitoba are disproportionately experiencing houselessness, mental illness, and injection drug use (mostly methamphetamine). This pattern is more pronounced for female individuals. These findings highlight the need for syndemic and gender-specific approaches, simultaneously addressing social and health conditions, to treat HIV. Funding: This work was supported by the Canadian Institutes of Health Research, The Manitoba Medical Service Foundation, The James Farley Memorial Fund and the Canada Research Chairs Program.

Women in Radiology: Challenges and Opportunities.

Improving the status of women in radiology is crucial to better work environments. There is strong evidence in the business world that women leaders improve the workplace by making it more financially viable and by increasing collaboration, job satisfaction, and engagement. Diverse leadership fosters innovation, and women approach problem-solving with unique insights and collaborative styles. Gender diversity in leadership correlates with improved patient outcomes because women leaders prioritize patient-centered care and communication. Women create sustainable, productive work and improve radiology. Women serve as powerful role models, inspiring the next generation of women in radiology and addressing gender disparities. Increasing women leaders in radiology is essential to increase the number of women in radiology. This article summarizes many challenges women face when taking leadership roles: organizational biases prioritizing male viewpoints and marginalizing women's voices and contributions, a lack of role models, a lack of time ("second shift"), a lack of confidence, a lack of interest or perceived benefit, a lack of support, burnout, and previous poor experiences. While systemic issues are difficult to overcome, this article assists in the training and development of women radiologists by offering strategies to enhance job satisfaction and bring new and valuable perspectives to leadership.

Perspectives on vulnerability from the narratives of older migrants.

BACKGROUND: Older migrants are considered a vulnerable population group in many ways. Marginalization and social exclusion lead to unequal opportunities for social participation. AIM: In order to break down barriers for older migrants, the perspectives of people with migration biographies should be given greater consideration. MATERIAL AND METHODS: To this end, the results of an explorative intersectional ethical analysis of care narratives of older migrants are discussed in the light of aging studies research. The focus is on the ethical analysis of five guided interviews with older migrants between 65 and 80 years old, who have migrated from different countries in southeastern Europe. RESULTS AND DISCUSSION: In contrast to the prevalent expert perspective, the narratives of the older migrants interviewed revealed not only resistance to vulnerabilization but also multiple negotiations of autonomy and dependency. By making ambivalent narrative and action strategies visible and linking them to narratives of intergenerational care relationships, the significance of care-ethical interpretations of vulnerability and characterization of vulnerability as "a universal, inevitable, and anthropological feature of humanity resulting from the embodied, finite, and socially contingent structure of human existence" [4] can be demonstrated.