Transcultural skills content in a dental curriculum: a comparative study

Background: Australia has the highest proportion of immigrants in the world (24% of the population is overseas‐born, compared to 22% in New Zealand, 19% in Canada and 12% in the USA). In this context, dental students have become increasingly diverse in a milieu where patients are derived from increasingly diverse backgrounds. Aim: The study aims to analyse the degree to which transcultural and communication skills content is currently embedded in the medical, physiotherapy and dental curricula at a major Australian university. Materials and methods: Undergraduate dental, medical and physiotherapy curricula were compared and critically assessed. Researchers considered the amount of transcultural and communication skills content, the number of formal contact hours for each course and the number of teaching staff involved. In addition, 21 interviews were conducted with staff at the three schools, who were involved in the curriculum development process. Results: The medical and physiotherapy curricula had an explicit focus on transcultural and communication skills as a major and continuing element, delivered by teaching staff from a wide variety of academic and professional backgrounds. In contrast, the dental course showed an under‐representation of transcultural and communication skills content which was taught by a limited number of staff from the School of Dental Science. Conclusions: In marked contrast to medical and physiotherapy curricula, transcultural and communication skills content had a low formal profile in the dental curriculum. A curriculum review process may be a positive step towards the development of a new training curriculum giving higher priority to transcultural and communication skills to support more effective workforce development.     

Response to breast health screening program at a not‐for‐profit clinic for working poor,uninsured, ethnically diverse women

Aims and objectives. Examine the effect of an ongoing breast health screening program, at a not‐for‐profit, non‐government assisted, volunteer clinic, specifically examining mammography usage and to discover variables to improve the rate of mammography. Background. Detection of breast cancer in women of low socio‐economic status, lacking health insurance, can be improved by increasing annual mammography rates, yet little is known about their screening behaviour. Design. Quantitative, retrospective subject‐controlled study. Methods. Subject‐controlled, longitudinal study of English and Spanish‐speaking women 40 years old and over, working poor, and uninsured, who participated in a comprehensive screening program that included a 7‐minute breast health educational DVD (n = 223). Results. Radiology records, breast health behaviours and beliefs indicated 76% of women invited for a second test completed it over a year after viewing the educational DVD. Chi‐square and t‐test indicated two significant findings for completing annual mammography in the 12th month: receiving a reminder postcard and scoring lower on perceptions of breast cancer susceptibility. Two significant findings for completing annual mammography even if late are knowledgeable about screening recommendations and ethnically identifying as Hispanic. Conclusions. This study shows statistically significant actions that can be undertaken to strengthen programs: reminder postcards, assessing susceptibility score and screening recommendation education. Relevance to clinical practice. Simple, inexpensive interventions encourage working, uninsured, Hispanic women to complete mammography.     

辽吉两省部分鹿场鹿茸皮肤病的临床特征与真菌分离初探

目的 研究探讨生茸期梅花鹿、马鹿在鹿茸快速生长期常发生以“白皮茸”、“痂皮茸”为主要症状的皮肤病。方法 研究对吉林、辽宁8个梅花鹿、马鹿养殖场的20份患病鹿进行了临床观察、血细胞计数、病理观察、病原分离及ITS分子鉴定。结果 发现本病仅侵染鹿茸皮肤表层、主要病变为结痂处真皮组织坏死、炎性细胞浸润; 血液中淋巴细胞、白细胞和中性粒细胞数变化不明显。对茸皮患处分离菌的鉴定结果表明68株分离株中44株属于半知菌亚门(64.7%), 24株属于酵母亚门(35.3%), 其中, 半知菌亚门的毛癣菌属、表皮癣菌属以及酵母亚门的念珠菌等可能为本病的条件致病菌。结论 鹿茸“白皮茸”、“痂皮茸”病均符合真菌皮肤病的发病特征,为该类疾病的预防及治疗提供了一定的参考。     

Near full-length HIV type 1M genomic sequences from Cameroon : Evidence of early diverging under-sampled lineages in the country

Background: Cameroon is the country in which HIV-1 group M (HIV-1M) likely originated and is today a major hotspot of HIV-1M genetic diversity. It remains unclear, however, whether the highly divergent HIV-1M lineages found in this country arose during the earliest phases of the global HIV-1M epidemic, or whether they arose more recently as a result of recombination events between globally circulating HIV-1M lineages.Methodology: To differentiate between these two possibilities, we performed phylogenetic analyses of the near full genome sequences of nine newly sequenced divergent HIV-1M isolates and 15 previously identified, apparently unique recombinant forms (URFs) from Cameroon.Results: Although two of the new genome sequences were clearly classifiable within subtype G, the remaining seven were highly divergent and phylogenetically branched either outside of, or very near the bases of clades containing the well characterised globally circulating viral lineages that they were most closely related to. Recombination analyses further revealed that these divergent viruses were likely complex URFs. We show, however that substantial portions (>1 Kb) of three of the new genome sequences and 15 of the previously characterised Cameroonian URFs have apparently been derived from divergent parental viruses that branch phylogenetically near the bases of the major HIV-1M clades.Conclusions and implications: Our analyses indicate the presence in Cameroon of contemporary descendants of numerous early-diverging HIV-1M lineages. Further efforts to sample and sequence viruses from such lineages could be crucial both for retracing the earliest evolutionary steps during the emergence of HIV-1M in humans, and accurately reconstructing the ancestral sequences of the major globally circulating HIV-1M lineages.     

Developing cultural competence through self-reflection in interprofessional education: Findings from an Australian university

Interprofessional education and cultural competence are both necessary for health professionals working in interprofessional teams serving diverse populations. Using a pre–post-survey case series design, this study evaluates a novel learning activity designed to encourage self-reflection and cultural competence in an Australian interprofessional education context. Undergraduate health professional students in a large subject viewed three 7–15 minute videos featuring interviews with persons of a minority cultural, linguistic, or sexual group who were living with a disability or managing a health condition. Immediately afterwards, students in interprofessional groups completed a structured activity designed to promote interprofessional and cultural reflection. A localised version of a validated scale measured cultural competence before and after the learning activity. Results suggest the value of video-based learning activities based on real-life examples for improving cultural competence. Despite initially rating themselves highly, 64% of students (n = 273) improved their overall cultural competence, though only by M = 0.13, SD = 0.08, of a 5-point rating-scale interval. A nuanced approach to interpreting results is warranted; even slight increases may indicate improved cultural competence. Suggestions for improving the effectiveness of video-based cultural competence learning activities, based on qualitative findings, are provided. Overall the findings attest to the merit of group discussion in cultural competence learning activities in interprofessional education settings. However, the inclusion of group discussions within such learning activities should hinge on group dynamics.     

Proceedings from the Inaugural Conference of the Society of Women in Maxillofacial Surgery, 18th May 2019, Bristol

The number of women studying in medical schools is increasing, and the relative proportion of female consultants in surgical and leadership roles is lagging behind, relatively, and so a new drive for promoting and supporting women in surgery has evolved. A part of this was the creation of the Society of Women in Oral and Maxillofacial Surgery. This short communication gives proceedings of the inaugural conference of SWiMS and discusses the need for greater promotion of women in the speciality (and the profession at large) and how the society has addressed the need for resilience and community in surgical training and beyond.     

Mapping physical therapy research: The geographical affiliations and methodological quality of 2,959 randomized controlled trials

Evidence suggests that research benefits from diversity, yet science is concentrated to a small group of countries. Diversity in physical therapy research has so far not been studied thoroughly, and this is the first study to map physical therapy research geographically. The objective was to study the frequency and methodological quality of physical therapy-related randomized controlled trials (RCTs) across the world. PEDro was searched for RCTs in physical therapy published between January 1 2015 and December 5 2016. For each trial, the first and last authors’ affiliations and the PEDro scale were extracted. Using the first and last authors’ affiliations, each article was geocoded using the Data Science Toolkit API. The search located 2,959 RCTs, which were affiliated primarily with a small cluster of countries. The median PEDro score for all trials was 5 (IQR 4:7). The geographical spread of the RCTs was focused around Europe, the Middle East, Southeast Asia, Oceania, the United States, and parts of South America. The lack of diversity might be problematic for the research field, even though the average clinical trial in physical therapy is of fair quality.     

Celebrating diversity in early care and education settings: moving beyond the margins

As the USA continues to live up to its historical reputation as a nation of immigrants, early childhood professionals are increasingly faced with the challenge of supporting children and families from diverse cultural milieu. However, to truly celebrate diversity in early childhood settings, early childhood teachers and caregivers must engage in a careful examination of their own cultural biases and assumptions, and be willing to consider differences not as deficient but as potential sources of strength. In short, providing care and education in which all children can thrive requires moving diversity out of the margins of the curriculum, and infusing principles of diversity, equity and social justice into our teaching and our interactions with children and families.     

Ethnic inequalities in psychological distress among urban residents in the Netherlands: A moderating role of neighborhood ethnic diversity?

The main purpose of this study was to investigate whether neighborhood ethnic diversity moderated the association between ethnicity and psychological distress in the four largest cities of Netherlands. Multilevel linear regression analysis was used to assess whether the association between ethnicity and psychological distress differed by levels of neighborhood ethnic diversity. Results showed that the Turkish and Moroccan residents reported significantly higher psychological distress than native Dutch and Surinamese residents. In high ethnic diverse neighborhoods Turkish residents reported significantly less psychological distress than in low ethnic diverse neighborhoods. Ethnic diversity amplifies the risk of depression for some but not all ethnic minorities.     

Dietary Diversity and Vegetable and Fruit Consumption of Households in a Resource-Poor Peri-Urban South Africa Community Differ by Food Security Status

Sociodemographic, living standard measure, consumption of vegetables and fruit, and dietary diversity in relation to household food security were assessed. Using a hunger score, households were categorized as food secure (n = 125) or food insecure (n = 273). Food secure respondents had a higher mean dietary diversity score (3.98; 95%CI [3.79, 4.18] versus 3.65; 95% [CI 3.53, 3.77]), were more likely to eat vitamin A–rich foods (OR 1.15; 95% CI [1.05, 1.26]), a more varied diet (DDS ≥ 4, OR 1.90; 95% CI [1.19, 3.13]), and vegetables daily (OR 3.37; 95% CI [2.00, 5.76]). Cost limited daily vegetable/fruit consumption in food insecure households. Respondents with ≥ 8 years of schooling were more likely (OR 2.07; 95% CI [1.22, 3.53]) and households receiving social grants were less likely (OR 0.37; 95% CI [0.19, 0.72]) to be food secure. Results highlight the association between dietary diversity and household food security.