Search Results (823)

The global Black Lives Matter movement and COVID-19 pandemic drew attention to the urgency of addressing entrenched structural dynamics such as racialization, gender, and colonization shaping health inequities for diverse racialized people. Canadian community-based research with racialized immigrant women recognized the need to enhance service provider capacity using a strengths-based activism approach to support client health and wellbeing. In this study, we aimed to understand the impacts of this mental health promotion practice on service providers and strategies to support them. Through purposeful convenience sampling, three focus groups were completed with 19 service providers working in settlement and mental health services in Toronto, Canada. Participants represented varied ethnicities and work experiences; most self-identified as female and racialized, with experiences living as immigrant women in Canada. Postcolonial feminist and critical mental health promotion analysis illuminated organizational and structural dynamics contributing to burnout and vicarious trauma that necessitate a focus on trauma- and violence-informed care. Transformative narratives reflected service provider resilience and activism, which aligned with and challenged mainstream biomedical approaches to mental health promotion. Implications include employing a postcolonial feminist lens to identify meaningful and comprehensive anti-oppression strategies that take colonialism, racialization, gender, and ableism and their intersections into account to decolonize nursing practices. Promoting health equity for diverse racialized women necessitates focused attention and multilevel anti-oppression strategies aligned with critical mental health promotion practices. Full article

The Red River Jig is a traditional Métis dance practiced among Indigenous and non-Indigenous Peoples. While exercise improves physical health and fitness, the impacts of cultural dances on wholistic health are less clear. This study aimed to investigate the psychosocial (cultural and mental), social, physical function, and physical fitness benefits of a Red River Jig intervention. In partnership with Li Toneur Nimiyitoohk Métis Dance Group, Indigenous and non-Indigenous adults (N = 40, 39 ± 15 years, 32 females) completed an 8-week Red River Jig intervention. Social support, cultural identity, memory, and mental wellbeing questionnaires, seated blood pressure and heart rate, weight, pulse-wave velocity, heart rate variability, baroreceptor sensitivity, jump height, sit-and-reach flexibility, one-leg and tandem balance, and six-minute walk test were assessed pre- and post-intervention. Community, family, and friend support scores, six-minute walk distance (553.0 ± 88.7 m vs. 602.2 ± 138.6 m, p = 0.002), jump, leg power, and systolic blood pressure low-to-high-frequency ratio increased after the intervention. Ethnic identity remained the same while affirmation and belonging declined, leading to declines in overall cultural identity, as learning about Métis culture through the Red River Jig may highlight gaps in cultural knowledge. Seated systolic blood pressure (116.5 ± 7.3 mmHg vs. 112.5 ± 10.7 mmHg, p = 0.01) and lower peripheral pulse-wave velocity (10.0 ± 2.0 m·s⁻¹ vs. 9.4 ± 1.9 m·s⁻¹, p = 0.04) decreased after the intervention. Red River Jig dance training can improve social support, physical function, and physical fitness for Indigenous and non-Indigenous adults. Full article

This study examines how a visitor-centered approach enhances engagement, participation, and intangible heritage transmission to support cultural sustainability in ethnographic museums. We conducted online and on-site behavioral observations, questionnaire surveys, and in-depth interviews at the She Ethnic Minority Museum to identify gaps in current visitor experience design. We combined the Analytic Hierarchy Process (AHP) with the Contextual Model of Learning (POE) and Emotional Experience Theory (EET) to develop a hierarchical evaluation model. The model comprises one goal layer, three criterion layers (Experience, Participation, Transmission), and twelve sub-criteria, each evaluated across People, Object, and Environment dimensions. Quantitative weighting revealed that participation exerts the greatest influence, followed by transmission and experience. Findings indicate that targeted interventions promoting active participation most effectively foster emotional resonance and heritage transmission, while strategies supporting intergenerational engagement and immersive experiences also play a significant role. We recommend prioritizing small-scale, low-cost participatory initiatives and integrating online and offline community engagement to establish a participatory chain where engagement leads to meaningful experiences and sustained cultural transmission. These insights offer practical guidance for museum practitioners and policymakers seeking to enhance visitor experiences and ensure the long-term preservation and vibrancy of ethnic minority cultural heritage. Full article

The present study investigates how US Southerners perceive second language (L2) speech by recruiting 170 undergraduate students who spoke Southern American English to listen to recordings of four speakers (US, Bangladeshi, Chinese, and Saudi Arabian) and evaluate their attributes. The listeners were grouped based on their ethnic affiliation: African American, Anglo-American, and Asian/Hispanic/multi-racial. A random half were primed, being asked questions about whether/how other people had negatively commented on their accents. Results showed no effect of priming on speech ratings. Moreover, whilst African American and Anglo-American listeners rated L2 speakers lower than the L1 speaker in almost all aspects, Asian/Hispanic/multi-racial listeners did not. Full article

Highway construction in China has bolstered Chinese claims of having the longest highways in the world, yet it has led to the involuntary relocation and resettlement of millions of people all over China. This study examines the interplay of power relationships in modernity and ethnic cultures. Using interviews with 201 Zhuang ethnic minority people and participant observations from two years in the Southwest of China, this paper presents findings that show both the positive and negative effects of urbanization and modernization as the consequence of highway expansion. By discussing the removal of a religious Sacred Rock which was in the way of the highway construction, the authors reveal the subtleties of the power interplay of majority–minority relations and the meanings of cultures and rituals in the face of modernity. In the process of modernization, highway construction reconstructs new communities while deconstructing the old one. The authors argue that recognizing the meanings of ethnic cultures as defined by ethnic people themselves is the first step to the reconciliation of social relationships between the majority and minority people in created new communities. To enhance social integration, religion has an important role to play in Chinese society. Full article

Through an examination of his core doctrinal points, I argue that Shinran’s conception of Pure Land Buddhism (Jōdo Shinshū) should not be so readily dismissed as one that is only salvific in an otherworldly sense, with no relevance to contemporary, everyday life, nor should it be reduced to a purely ethnic form of Buddhism without any reference to its universal dimension. Through this analysis, we will find that Shinran’s adoption of a unique and honest evaluation of our inner lives through receiving the wisdom and compassion of Amida Buddha can offer people of today’s world a way to embrace a spirit of self-acceptance so that one can live with confidence, integrity, and a modest joy, despite the manifold shortcomings of the human condition. Through the radical transformation of one’s dissatisfaction and suffering, an uncontrived ethical impulse is able to emerge, accompanied by a keen awareness of deep empathy for others, leading to an existence informed by empathy instead of animosity. Full article

Rheumatoid arthritis (RA) is a progressive and systemic autoimmune disease, characterized by a chronic inflammatory process, affecting the lining of the synovial joints, many body organs/systems, and blood vessels. Its pathological hallmarks are hyperplasic synovium, bone erosion, and progressive joint destruction. Rheumatoid arthritis affects over 20 million people, with a worldwide prevalence of 0.5–1.0%, exhibiting gender, ethnic, and geographical differences. The progressive disability severely impairs physical motion and quality of life and is finally leading to a shortened life span. The pathogenesis of RA is a complex and still poorly understood process in which genetic and environmental factors are principally associated. Current treatment mostly relies on conventional/non-biological disease-modifying anti-rheumatic drugs (cDMARDs), analgesics, non-steroidal anti-inflammatory drugs, glucocorticoids, steroids, immunosuppresants, and biologic DMARDs, which only control inflammation and pain. Along with side effects (drug toxicity and intolerance), these anti-rheumatic drugs possess limited efficacy. Therefore, the discovery of novel multi-target therapeutics with an improved safety profile that function as inhibitors of RA-linked signaling systems are in high demand, and this is in the interest of both patients and clinicians. Plant-derived extracts, nutritional supplements, dietary medicine, and molecules with anti-inflammatory activity represent promising adjuvant agents or alternatives for RA therapeutics. This review not only aims to discuss the basic features of RA pathogenesis, risk factors, and signaling pathways but also highlights the research progress in pre-clinical RA in in vitro and in vivo models, revealing new avenues in the management of the disease in terms of comprehensive multidisciplinary strategies originating from medicinal plants and plant-derived molecules. Full article

Background: Pain is a common, often debilitating ailment that may necessitate considerable health service utilization. However, there is a need to assess the associations of pain intensity and other variables with health service utilization among United States adults who have pain. Methods: This cross-sectional database analysis made use of the Medical Expenditure Panel Survey full-year consolidated data file and included United States adults (≥18 years) who have pain. The dependent variables consisted of four health service utilization variables, which included the number of emergency room visits, inpatient discharges, office visits, and outpatient visits in 2021. The number of visits or discharges were categorized as either ≥1 or 0. The independent variable was pain intensity (extreme, quite a bit, moderate, or little pain). Other variables analyzed included age, race, ethnicity, sex, marriage, education, employment, income, insurance, chronic conditions, limitations, exercise, smoking, physical health, and mental health. Chi-squared tests compared differences between pain intensity groups, and multivariable logistic regression models assessed the associations of pain intensity and other variables with each of the four health service utilization variables. The analysis was weighted for national estimates. The significance (alpha) level was 0.05. Results: This analysis included 6280 adults, representing 89,314,769 United States adults with pain. In the multivariable analyses, there were statistically significant associations for extreme pain (odds ratio = 1.72, 95% confidence interval = 1.27–2.33), quite a bit of pain (odds ratio = 1.75, 95% confidence interval=1.37–2.24), and moderate pain (odds ratio = 1.28, 95% confidence interval = 1.02–1.60) versus little pain with emergency room visits, extreme pain (odds ratio = 2.10, 95% confidence interval = 1.44–3.08) and quite a bit of pain (odds ratio = 1.66, 95% confidence interval = 1.21–2.28) versus little pain with inpatient discharges, and quite a bit of pain (odds ratio = 1.47, 95% confidence interval = 1.03–2.11) versus little pain with office visits. There was no correlation between pain intensity levels and outpatient visits. In addition, several other variables were associated with various health service utilization variables. Conclusions: This database analysis discovered greater pain intensity levels were often correlated with increased health service utilization, including more emergency room, inpatient, and office visits. These findings may inform the development of targeted interventions for people with specific characteristics. Further work is needed to implement initiatives that optimize health service utilization and ultimately improve health outcomes for United States adults who have pain. Full article

Women disproportionately encounter negative affordances in urban environments—defined as features that severely restrict movement and impose harm. City venues are, thus, selectively permeable to women, though men face their own challenges, especially in intersectional contexts. The data in this study suggest that gender combines with ethnicity, socioeconomic status, and visible religious markers, making obstruction a shifting but nonetheless real phenomenon, much like a staircase genuinely impedes wheelchair access. Cultural context also matters: a Black woman may face one set of barriers in Paris, another in Seoul, with a Latin American woman encountering different ones in both. Building on these observations, the article argues that urban landscapes manifest gender-based political affordances—material configurations that reflect and reinforce social inequalities. As an affordance-based framework, the selective permeability model (1) draws on a well-supported theory of perception, where settings objectively present both favorable and hostile values relative to agents. The outlook (2) thereby challenges the stereotype that women’s spatial concerns are merely subjective. The position also (3) affirms that despite differences, people share bodily constraints and, hence, have largely overlapping values and experiences. The perspective accordingly avoids exaggerating divisions to the point of denying the mutual understanding that underlies empathetic norms. Full article

Introduction: In the United States, vaccine hesitancy is higher among rural and racially and ethnically diverse communities, and messaging from trusted individuals may increase vaccine acceptance. The purpose of this study is to understand vaccine hesitancy, messaging from trusted individuals, and vaccine acceptance strategies among racially and ethnically diverse, medically underserved rural populations. Methods: The researchers conducted 12 in-person focus groups, each consisting of 5 to 12 participants, with community members and trusted leaders from three rural counties in Eastern North Carolina (n = 119). Thematic analysis was used to synthesize insights from the discussions, allowing for the identification of recurring patterns and community-specific considerations regarding vaccine perceptions and messaging. Results: The researchers identified seven key themes within the primary focus areas of the study: factors influencing vaccine hesitancy, messaging from trusted individuals, and strategies to improve vaccine acceptance. Participants reported differences in trust based on how long a vaccine has been available, concerns about becoming sick after a vaccine, seeing the symptoms of vaccine-preventable diseases, and misinformation on social media. Overall, participants reported trust in messages from medical providers. Trusted leaders advised people to conduct their own research on vaccines when determining whether to receive vaccinations. Lastly, social determinants such as cost, education, and transportation were identified as key barriers to vaccination. Conclusions: Our findings indicate that medical providers are trusted messengers for vaccine information and the promotion of vaccine uptake. However, distrust linked to fear, misinformation, and structural barriers persist. Public health efforts to increase vaccination confidence among rural, racially and ethnically diverse populations in the United States Southeast should address these factors in future vaccine interventions and educational efforts. Full article

Background: Diabetes is rapidly increasing in developing and industrializing nations, primarily due to type 2 diabetes (T2DM). With the global prevalence of diabetes steadily increasing, estimates suggest that by 2045, nearly 548 million people will be living with the disease worldwide. Alzheimer’s disease (AD), recognized as the primary contributor to dementia in aging populations, exhibits an escalating prevalence that parallels the demographic shifts toward older age groups worldwide. This progressive neurodegenerative disorder has emerged as a critical public health challenge, with epidemiological patterns closely tracking the trajectory of population aging across industrialized and developing nations. This study investigates whether metformin may help reduce the risk of dementia. Previous studies from various countries have explored the association between metformin use and dementia risk; however, the findings have been inconsistent. Therefore, we conducted this study to examine whether the observed protective effect of metformin also applies to the Taiwanese (Han Chinese) population, potentially providing valuable insights into ethnic or regional differences in drug response. Methods: We conducted a retrospective cohort study using data from the Longitudinal Health Insurance Database 2000 (LHID2000), including 2 million individuals from 2000 to 2013. Patients with T2DM aged ≥40 years who initiated metformin between 2000 and 2005 formed the exposed group, while those starting other second-line antidiabetic medications formed the non-exposed group. Propensity score matching was used to control for age, sex, index date, and major comorbidities. Incident dementia (2007–2013) was identified using relevant ICD-9-CM codes. Adjusted hazard ratios were estimated using Cox regression with time-dependent covariates. Results: The metformin-exposed cohort demonstrated a risk reduction for dementia incidence relative to the comparator group (adjusted HR 0.472, 95% CI = 0.328–0.679). This protective association remained robust in sex-stratified analyses and age-stratified subgroups. Temporal analysis further revealed a duration-dependent risk attenuation, with extended therapeutic exposure correlating with progressive dementia risk decrement. Conclusions: Our findings suggest that metformin use may be associated with a lower risk of developing dementia in individuals with type 2 diabetes mellitus. Full article

The literature details the healthcare needs of migrant people living with chronic illnesses and the consequent economic, social, and healthcare needs of their caregivers. Similarly, some studies have underscored the social and healthcare needs of 2SLGBTQIA+ (two-spirit, lesbian, gay, bisexual, transgender, queer, and intersex individuals, including diverse sexual and gender identities under the “+” symbol) adults living with chronic illnesses and their caregivers. This narrative review presents the context of migrant 2SLGBTQIA+ unpaid caregivers and how their intersecting identities influence their caregiving roles for family members with chronic illnesses. In this article, caregivers are defined as family members or chosen families who provide unpaid support that may last for three months or longer for people living with chronic illnesses. Most studies and policies overlook 2SLGBTQIA+ migrants who are also unpaid caregivers of individuals living with chronic illnesses, leaving them unsupported through discrimination at the intersection of racism, homophobia, transphobia, ageism, and ableism, forcing them to remain vulnerable to increased emotional and physical strain. There is a presence of pervasive systemic barriers, including a lack of training and education among social and healthcare providers, about the needs of migrant 2SLGBTQIA+ unpaid caregivers. Additional challenges stem from inadequate policies and insufficient targeted resources, particularly for caregivers from marginalized racial and ethnic backgrounds. The findings of this study highlight the necessity for a call to action to address these gaps and improve support systems for these highly marginalized communities. Full article

The analysis of the vulnerability of vernacular buildings to climatic hazards is nowadays a subject of significant importance due to the consequences of climate change. This study assesses the vulnerability of vernacular buildings to three climatic hazards (heavy rains, strong winds and high heat) in the Kara region to identify the vulnerable parts of these constructions that require reinforcement. It is based on PTVA (Papathoma Tsunami Vulnerability Assessment), a multi-hazard analysis methodology, which uses vulnerability indicators. It focuses on the Kabiyè and Nawdeba peoples, who are the major ethnic groups in the region. Focus groups with the population, interviews with professionals and a series of surveys of 125 households in the visited territories enabled us to identify, firstly, the types of vernacular constructions in the region, the climatic hazards that occur there and the indicators that affect the vulnerability of the constructions. Secondly, we calculated the vulnerability index for each type of construction to the three climatic hazards. The vulnerability index of Kabiyè vernacular architecture (KVA) to heavy rain, high heat and strong wind is 0.379, 0.403 and 0.356, respectively. The Nawdéba vernacular architecture (NVA) vulnerability score is 0.359 for heavy rain, 0.375 for high heat, and 0.316 for strong wind. The index of vulnerability to heavy rain, high heat and strong wind for contemporary architecture (CA), as we term the current state of evolution of these two forms of architecture, is 0.499, 0.522 and 0.456, respectively. This study reveals that contemporary architecture (CA) in the Kara region, regardless of the type of hazard considered, is the most vulnerable construction model in the region. It also highlights the indicators that accentuate the vulnerability of vernacular constructions. Regardless of the type of construction, special attention must be paid to features such as roof style (roof slope, shape and material) and building style (form and state of maintenance of the building) to increase the resilience of buildings to climatic hazards. Full article

People with migration backgrounds (PwM) and their loved ones living with dementia often encounter multiple disparities for appropriate care and support. Simultaneously, care professionals may feel inadequately prepared to address the needs of PwM effectively. As a response to these concerns, research and practice have increasingly emphasized the importance of culturally sensitive care. These efforts center on understanding the cultural norms and beliefs of migrant communities and developing professional strategies tailored to these cultural factors. However, while cultural factors clearly play a role in the care experiences of PwM, the emphasis on culture in research and practice has drawn criticism from various scholars. In our contribution to this debate, we highlight the shortcomings of the concept of culturally sensitive care within the context of dementia and propose a perspective that responds to these shortcomings. We present the following arguments: (1) The prevailing discourse, which treats culture and culturally sensitive care as fixed concepts and relies on separate tools for addressing the needs of PwM, fails to offer comprehensive guidance for inclusive care. (2) Instead of attributing care-related obstacles to cultural differences, we must shift our focus to understanding individual experiences of inequality as well as the systemic structures that perpetuate inequality. (3) To address the diverse needs of PwM and the challenges of ongoing diversity within Western societies, dementia care services should embrace diversity as the norm rather than an exception requiring separate tools. This requires a paradigm shift in which professionals are trained to navigate relationships in ways that minimize reliance on rigid (ethnic and cultural) categorizations. Full article

Accurate population counts and the identification of granularity within aggregated groups are essential for informing funding formulas and health policies, an issue of global significance. Relying solely on aggregated ethnicity-based population counts has limited utility for ethnic minority groups. Accurate and relevant population counts are critical for monitoring and improving outcomes related to health, social welfare, and education. This paper examines additional dimensions of identity to provide a revised estimate of the total population count for Peoples of Fiji (PF) living in Aotearoa. Customised data tables from the Census of Population and Dwellings, provided by Statistics New Zealand, were analysed using ethnicity and additional recorded characteristics, such as country of birth, and parents’ ethnicity, to obtain more accurate counts for the major ethnic groups from Fiji living in Aotearoa. Our analysis revealed that almost 50,000 Fijian Indians were misclassified. Utilizing additional variables, we estimate the revised count for the Fijian Indian ethnic group alone exceeds 70,000 and the PF total count exceeds 2% of Aotearoa’s current population. We highlight significant variations in ethnicity coding for PF and their implications for health monitoring and risk assessment, data quality, and interpretation. We make key recommendations to improve granular reporting for minority migrant groups in Aotearoa. Full article