Interventions to improve cultural competency in healthcare: a systematic review of reviews

Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area.

Patterns of intergroup contact in public spaces: micro-ecology of segregation in Australian communities

The use of public spaces can promote social cohesion and facilitate interpersonal interactions within the community. However, the ways racial and ethnic groups interact in public spaces can also reflect and influence informal segregation in the wider community. The present study aimed to examine patterns of intergroup contact within public spaces in Victoria, Australia through short-term observation in four localities. Data were collected on within-group, intergroup and absence of contact for people from minority and majority groups. A total of 974 contacts were observed. Findings indicate that in the observed public spaces, people from visible minority groups tended to have no contact with others or to interact with people from other ethnic/racial groups. In contrast, those from the majority group tended to interact predominately with other majority group members. This suggests that majority group members are more likely to ‘self-segregate’ in public spaces than those from minority groups.

All in the blood: a review of Aboriginal Australians' cultural beliefs about blood and implications for biospecimen research

Public participation in medical research and biobanking is considered key to advances in scientific discovery and translation to improved health care. Cultural concerns relating to blood have been found to affect the participation of indigenous peoples and minorities in research, but such concerns are rarely specified in the literature. This article presents a review of the role of blood in Australian Aboriginal cultures. We discuss the range of meanings and uses of blood in traditional culture, including their use in ceremonies, healing, and sorcery. We draw on more recent literature on Aboriginal Australians and biomedicine to consider how traditional beliefs may be changing over time. These findings provide an empirical basis for researchers and bioethicists to develop culturally grounded strategies to boost the participation of Aboriginal Australians in biomedical research. They also serve as a model for integrating anthropological literature with bioethical concerns that could be applied to other indigenous and minority groups.

Effects of parent and child behaviours on overweight and obesity in infants and young children from disadvantaged backgrounds: systematic review with narrative synthesis

BACKGROUND: Despite the crucial need to develop targeted and effective approaches for obesity prevention in children most at risk, the pathways explaining socioeconomic disparity in children's obesity prevalence remain poorly understood.

METHODS: We conducted a systematic review of the literature that investigated causes of weight gain in children aged 0-5 years from socioeconomically disadvantaged or Indigenous backgrounds residing in OECD countries. Major electronic databases were searched from inception until December 2015. Key words identified studies addressing relationships between parenting, child eating, child physical activity or sedentary behaviour and child weight in disadvantaged samples.

RESULTS: A total of 32 articles met the inclusion criteria. The Mixed Methods Appraisal Tool quality rating for the studies ranged from 25 % (weak) to 100 % (strong). Studies predominantly reported on relationships between parenting and child weight (n = 21), or parenting and child eating (n = 12), with fewer (n = 8) investigating child eating and weight. Most evidence was from socio-economically disadvantaged ethnic minority groups in the USA. Clustering of diet, weight and feeding behaviours by socioeconomic indicators and ethnicity precluded identification of independent effects of each of these risk factors.

CONCLUSIONS: This review has highlighted significant gaps in our mechanistic understanding of the relative importance of different aspects of parent and child behaviours in disadvantaged population groups.

As encruzilhadas da autogestão: imaginário e simbólico nas empresas assumidas por trabalhadores: uma análise de empreendimentos da economia solidária

Nesta pesquisa a economia solidária (ES) é o pano de fundo. O enfoque pretendido é uma aproximação pela perspectiva organizacional. O problema de pesquisa é definido pela ausência da questão organizacional, na construção teórica da ES. O objetivo do trabalho é compreender os fenômenos organizacionais gestados por trabalhadores, no âmbito da ES. A pesquisa está delimitada às empresas assumidas por trabalhadores (EAT), são empresas convencionais que entraram em processo de crise ou falência, sendo assumidas por ex-empregados. A questão de pesquisa recai sobre a maneira com que os trabalhadores reinventam a gestão dos empreendimentos assumidos, quais as transformações operadas e as mudanças realizadas nas práticas de gestão herdadas. O imaginário e o simbólico são as categorias analíticas utilizadas para acessar a realidade dessas organizações. Articuladas à aproximação pela ótica dos grupos minoritários permitem apreender a dinâmica das transformações gestadas, o sentido das novas práticas e mapear a trajetória percorrida pelo grupo de trabalhadores ao construí-las. Dois estudos de caso são utilizados para ilustrar a dinâmica dessas transformações.

Inequalities in access to education and healthcare

The burden of disease is borne by those who suffer as patients but also by society at large, including health service providers. That burden is felt most severely in parts of the world where there is no infrastructure, or foreseeable prospects of any, to change the status quo without external support. Poverty, disease and inequality pervade all the activities of daily living in low-income regions and are inextricably linked. External interventions may not be the most appropriate way to impact on this positively in all circumstances, but targeted programmes to build social capital, within and by countries, are more likely to be sustainable. By these means, basic oral healthcare, underpinned by the primary healthcare approach, can be delivered to more equitably address needs and demands. Education is fundamental to building knowledge-based economies but is often lacking in such regions even at primary and secondary level. Provision of private education at tertiary level may also introduce its own inequities. Access to distance learning and community-based practice opens opportunities and is more likely to encourage graduates to work in similar areas. Recruitment of faculty from minority groups provides role models for students from similar backgrounds but all faculty staff must be involved in supporting and mentoring students from marginalized groups to ensure their retention. The developed world has to act responsibly in two crucial areas: first, not to exacerbate the shortage of skilled educators and healthcare workers in emerging economies by recruiting their staff; second, they must offer educational opportunities at an economic rate. Governments need to lead on developing initiatives to attract, support and retain a competent workforce.

Daspu e a redefinição da representação social da prostituta nos meios de comunicação de massa do Brasil

Pós-graduação em Comunicação - FAAC

Liberdade de expressão e discurso do ódio: um exame sobre as possíveis limitações à liberdade de expressão

In a view to determining the outlines of the Freedom of Speech and to specify its contents, we face hate speech as an offensive and repulsive manifestation, particularly directed to minority groups in contemporary society. Thus, the study sought to promote, in the foreground, a study of the Freedom of Speech, in the liberal molds. Considered this way, Freedom of Speech will tend to accept hate speech as a legitimate manifestation, albeit at the injury of the victims. On the other hand, when we are dealing with the exhaustion of the liberal paradigm and the affirmation of the Welfare State, we note the recognition by the social state of the asymmetries and commitment to redistributive justice. The Freedom of Speech, warded by welfare state will tend to suffer major restrictions on its self-determination power, rejecting hate speech.

A pedagogia histórico-crítica e o currículo: para além do multiculturalismo das políticas curriculares nacionais

Pós-graduação em Educação Escolar - FCLAR

Linguagens sincréticas e construção da identidade na Revista Unesp Ciência: um estudo semiótico

Pós-graduação em Linguística e Língua Portuguesa - FCLAR

Is Everyone Rated Equal? An Examination of Factors Related to Sexual Risk in Ethnically Diverse Male Adolescents Who Have Sexually Offended

As the juvenile justice system has evolved, there has been a need for clinicians to make judgments about risk posed by adolescents who have committed sexual offenses. There are inherent difficulties in attempting to assess risk for violence among adolescents due to the developmental changes taking place and the absence of well-validated instruments to guide risk prediction judgments. With minority groups increasing in numbers in the U.S., it is likely that professionals will encounter minority individuals when conducting risk assessments. Overall questions regarding race/ethnicity have been neglected and there are few if any published research that explores risk factors with minority juvenile sex offenders. The present study examined whether differences exist between Caucasian and racial/ethnic minority adolescent sexual offenders on four risk assessment measures (J-SORRAT-II, J-SOAP-II, SAVRY, and ERASOR). The sample of 207 male adolescent sexual offenders was drawn from treatment facilities in a Midwestern state. Overall results indicated that minority adolescent sex offenders had fewer risk factors endorsed than Caucasian youth across all risk assessment tools. Exploration of interactions between race and factors such as: family status, exposure to family violence, and family history of criminality upon the assessment tools risk ratings yielded non-significant findings. Limitations, suggestions for future directions, and clinical implications are discussed.

Accessibility as a determinant of environmental dynamics in socio-economic disparities in mainland Southeast Asia

Access and accessibility are important determinants of people’s ability to utilise natural resources, and have a strong impact on household welfare. Physical accessibility of natural resources, on the other hand, has generally been regarded as one of the most important drivers of land-use and land-cover changes. Based on two case studies, this article discusses evidence of the impact of access to services and access to natural resources on household poverty and on the environment. We show that socio-cultural distances are a key limiting factor for gaining access to services, and thereby for improved household welfare. We also discuss the impact of socio-cultural distances on access to natural resources, and show that large-scale commercial exploitation of natural resources tends to occur beyond the spatial reach of socio-culturally and economically marginalised population segments. We conclude that it is essential to pay more attention to improving the structural environment that presently leaves social minority groups marginalised. Innovative approaches that use natural resource management to induce poverty reduction – for example, through compensation of local farmers for environmental services – appear to be promising avenues that can lead to integration of the objectives of poverty reduction and sustainable environmental stewardship.

Interethnic Interaction Dynamics in the Russian Federation

The collapse of the Soviet Union at the beginning of the 1990s also meant the end of the idea of a common soviet identity incarnated in the "soviet man" and the new "historic community of the soviet people". While this idea still lives on in the generations of the 1920s to 1940s, the younger generations tend to prefer identification with family, profession, ethnic group or religion. Ms. Alexakhina set out to investigate different interethnic interaction strategies in the multi-ethnic context of the Russian Federation, with an emphasis on analysing the role of cultural and ethno-demographic characteristics of minority ethnic groups. It aimed to identify those specific patterns of interaction dynamics that have emerged in response to the political and economic transformation at present under way. The basic supposition was that the size and growth of an ethnic population are defined not only by demographic features such as fertility, mortality and net migration, but are also dependent on processes interethnic interaction and ethnic transition. The central hypothesis of the project was that the multi-ethnic and multi-cultural composition of Russia is apparently manifesting itself in the ethnic minority groups in various forms, but particularly in the form of ethnic revival and/or assimilation. The results of these complex phenomena are manifested as changes in ethnic attachments (national re-identification and language behaviour (multi-lingualism, language transition and loss of the mother tongue). The stress of the political and economic crisis has stimulated significant changes in ethnographic, social and cultural characteristics of inter-ethnic dynamics such as the rate of national re-identification, language behaviour, migration activity and the spread of mixed marriages, among both those minorities with a long history of settlement in Russia and those that were annexed during the soviet period. Patterns of language behaviour and the spread of mixed marriages were taken as the main indicators of the directions of interethnic interaction described as assimilation, ethnic revival and cultural pluralism. The first stage of the research involved a statistical analysis of census data from 1959 to 1994 in order to analyse the changing demographic composition of the largest ethnic groups of the Russian Federation. Until 1989 interethnic interaction in soviet society was distinguished by the process of russification but the political and economic transformation has stimulated the process of ethnic revival, leading to an apparent fall in the size of the Russian population due to ethnic re-identification by members of other ethnic groups who had previously identified themselves as Russian. Cross-classification of nationalities by demographic, social and cultural indicators has shown that the most important determinants of the nature of interethnic interaction are cultural factors such as religion and language affiliation. The analysis of the dynamics of language shift through the study of bilingualism and the domains of language usage for different demographic groups revealed a strong correlation between recognition of Russian as a mother tongue among some non-Russian ethnic groups and the declining size of these groups. The main conclusion from this macro-analysis of census data was the hypothesis of the growing importance of social and political factors upon ethnic succession, that ethnic identity is no longer a stable characteristic but has become dynamic in nature. In order to verify this hypothesis Ms. Alexakhina conducted a survey in four regions showing different patterns of interethnic interaction: the Karelian Republic, Buryatiya, the Nenezkii Autonomous Region and Tatarstan. These represented the west, east, north and south of the Russian Federation. Samples for the survey were prepared on the basis of census lists so as to exclude mono-Russian families in favour of mixed and ethnic-minority families. The survey confirmed the significant growth in the importance of ethnic affiliation in the everyday lives of people in the Federation following the de-centralisation of the political and economic spheres. Language was shown to be a key symbol of the consciousness of national distinction, confirmed by the fact that the process of russification has been reversed by the active mastering of the languages of titular nationalities. The results also confirmed that individual ethnic identity has ceased to be a fixed personal characteristic of one's cultural and genetic belonging, and people's social adaptation to the current political, social and economic conditions is also demonstrated in changes in individual ethnic self-identification. In general terms, the dynamic nature of national identity means that ethnic identity is at present acquiring the special features of overall social identity, for which the frequent change of priorities is an inherent feature of a person's life cycle. These are mainly linked with a multi-ethnic environment and high individual social mobility. From her results Ms. Alexakhina concludes that the development of national languages and multi-lingualism, together with the preservation of Russian as a state language, seems to be the most promising path to peaceful coexistence and the development of the national cultures of different ethnic groups within the Russian Federation.

Romany Families in Romania: Intelligence and Personality of Children Cross-cultural and Specific Problems of Development

Psychogenetic research has emphasised the influence of social factors on a child's intellectual development. In her work, Ms. Dumitrascu examines two such factors; family size and order of birth. However, since these formal parameters tend to be unstable, other more informal factors should be taken into consideration. Of these, perhaps the most interesting is the "style" of parental education, which Ms. Dumitrascu regards as an expression of national traditions at the family level. This educational style is culture dependent. Only a comparative, cross-cultural study can reveal the real mechanism through which educational style influences the development of a child's intellect and personality. Ms. Dumitrascu conducted an experimental cross-cultural study aimed at examining the effects of the family environment on a child's intellectual development. Three distinct populations were involved in her investigation, each having quite a distinct status in their geographical area; Romanians, Romanies (Gypsies) from Romania, and Russians from the Republic of Moldova. She presented her research in the form of a series of articles written in English totalling 85 pages, and also on disc. A significant difference was revealed between the intelligence of a child living in a large family, and that of a child with no brothers or sisters. In the case of Romany children, the gap is remarkably large. Ms. Dumitrascu concludes that the simultaneous action of several negative factors (low socio-economic status, large family size, socio-cultural isolation of a population) may delay child development. Subjected to such a precarious environment, Romany children do not seek self-realisation, but rather struggle to survive the hardship. Most of them remain out of civilisation. Unfortunately, adult Romanies seldom express any concern regarding their children's successful social integration. The school as main socialisation tool has no value for most parents. Ms. Dumitrascu argues the need for a major effort aimed at helping Romany's social integration. She hopes this project will be of some help for psychologists, social workers, teachers, and all those who are interested in the integration into society of minority groups.

Racism, Youth Violence and the New Right: A Comparative Study of the Political Transformation of Extremism in Hungary and Romania

This research focused on the re-emerging of national and minority identities and the concomitant hostilities emerging from them in Hungary and in Romania. In particular the findings indicate that extremist incidents against members of minority groups on the local level seem to follow patterns in publicised media events. Violent attacks by skinheads against Gypsies in Hungary are often isolated incidents but are also inadvertently supported by biased media coverage, hostile majority attitudes and stereotyped behaviour reproduced in the media. The research also indicates that extremism both in Hungary against Gypsies and in Romania against Hungarians is of three kinds: organised within the framework of extremist groups, state-supported violence (both real and symbolic), and isolated, local instances with a few perpetrators committing atrocities. However, and this is a positive development, with rising interethnic tensions and extremist attacks prevalent in Hungary and Romania, there is also a parallel emergence of a more sophisticated human and minority rights campaign to combat them.