Cultural Diversity

文化多样性
  • 文章类型: Journal Article
    妇产科教授协会创造了多样性,Equity,和纳入指南工作组制定最佳做法,以建立多元化的医生队伍并消除医学教育中的种族主义。使用准则,教育工作者正在影响他们的社区,在某些地区,引导他们的机构走向更大的多样性和包容性。该指南由4个领域组织:学习环境,评分和评估,Pathwayprograms,和度量。本手稿使用该框架来强调个别教育工作者的工作,这些教育工作者正在朝着无种族主义的医疗保健迈进,并旨在激励其他人考虑将其纳入其计划。
    The Association of Professors of Gynecology and Obstetrics created the Diversity, Equity, and Inclusion Guidelines Task Force to develop best practices to establish a diverse physician workforce and eliminate racism in medical education. Using the guidelines, educators are impacting their communities and, in some areas, leading their institutions toward greater diversity and inclusion. The guidelines are organized by 4 domains: learning environment, grading and assessment, pathway programs, and metrics. This manuscript uses that framework to highlight the work of individual educators who are moving the needle towards racism-free health care and aims to inspire others contemplating incorporation into their programs.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:在粮食系统全球变化的背景下,本文探讨了桑塔尔部落独特的饮食习惯,印度东部的一个土著群体,为了了解健康,营养,以及他们传统食物系统的可持续性方面。这项研究与EAT-Lancet委员会2019年健康和可持续饮食的饮食指南相比,评估了Santal饮食的营养成分。
    方法:东英吉利大学,与NNedPro全球食品研究所合作,剑桥的营养与健康普拉丹;印度的同事和当地的桑塔尔青年,对传统的桑塔尔食谱进行了营养分析。两个菜单模板,KanhuThali和JhanoThali,根据他们在桑塔尔社区内不同饮食习惯的代表性,选择进行比较分析。营养数据,包括能量以及大量营养素和微量营养素的分布,编制并与EAT-Lancet指南进行比较。
    结果:Santal菜单模板(营养完整的膳食)在全谷物等方面与EAT-Lancet建议保持一致,淀粉蔬菜,蔬菜,植物性蛋白质来源,不饱和脂肪,和有限的添加糖。然而,显著的偏差包括缺乏动物来源的蛋白质和乳制品.桑塔尔饮食显示高蛋白摄入量,主要来自植物来源,并强调了全谷物的重要性。在两个模板之间观察到营养含量的季节性变化。
    结论:虽然Santal饮食与全球饮食指南的某些方面一致,存在显著的偏差,突显了将传统饮食与普遍推荐保持一致的复杂性.研究结果强调了对文化敏感的饮食建议的必要性,这些建议尊重传统饮食,同时促进可持续性。研究需要支持量身定制的全球准则,其中载有营养充足性的核心原则,这些原则在文化间具有可操作性,以适应文化多样性,当地做法,和季节性变化,对于在不同的社会人口背景下培养可持续和健康的饮食习惯至关重要。
    BACKGROUND: In the context of global shifts in food systems, this paper explores the unique dietary practices of the Santal tribe, an indigenous group in eastern India, to understand the health, nutrition, and sustainability aspects of their traditional food systems. This study evaluates the nutritional content of the Santal diet in comparison to the EAT-Lancet Commission\'s 2019 dietary guidelines for healthy and sustainable diets.
    METHODS: The University of East Anglia, in collaboration with the NNEdPro Global Institute for Food, Nutrition and Health in Cambridge, PRADAN; colleagues in India and local Santal youth, conducted nutritional analyses of traditional Santal recipes. Two menu templates, Kanhu Thali and Jhano Thali, were selected for comparative analysis based on their representation of diverse dietary practices within the Santal community. Nutritional data, including energy as well as the distribution of macronutrients and micronutrients, were compiled and compared with the EAT-Lancet guidelines.
    RESULTS: The Santal menu templates (nutritionally complete meals) demonstrated alignment with EAT-Lancet recommendations in aspects such as whole grains, starchy vegetables, vegetables, plant-based protein sources, unsaturated fats, and limited added sugars. However, notable deviations included the absence of animal-based protein sources and dairy. The Santal diet showed high protein intake, largely from plant-based sources, and emphasised the importance of whole grains. Seasonal variations in nutritional content were observed between the two templates.
    CONCLUSIONS: While the Santal diet aligns with some aspects of global dietary guidelines, there are notable deviations that underscore the complexity of aligning traditional diets with universal recommendations. The findings emphasise the need for culturally sensitive dietary recommendations that respect traditional diets while promoting sustainability. Research needs to support tailored global guidelines enshrining core principles of nutritional adequacy which are inter-culturally operable in order to accommodate cultural diversity, local practices, and seasonal variations, crucial for fostering sustainable and healthy eating habits in diverse sociodemographic contexts.
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  • 文章类型: Journal Article
    在最近关于对话共识的道德权威的评论的推动下,我们认为共识,特别是对话共识,具有独特的道德权威形式。鉴于我们的多元文化时代及其多元价值观,我们认为,传统的道德框架或从中衍生出来的原则不能被实质性地看待。哲学家和临床医生都优先考虑做出道德上合理的决定,也是为了指导行动。我们认为,特别是在我们多元化社会的背景下,只有通过非强制性的对话和适当的辩论,旨在达成共识,我们可以以规范的方式将正确或错误归因于困境。我们认为,无论是对话的过程,适当构成,而协商一致的结果本身就有道德权威。最后,我们认为,所做出的协商一致决定能够经受道德审查,并且具有行动指导性,而不在其他情况下声称绝对的道德权威。
    Prompted by recent comments on the moral authority of dialogic consensus, we argue that consensus, specifically dialogic consensus, possesses a unique form of moral authority. Given our multicultural era and its plurality of values, we contend that traditional ethical frameworks or principles derived from them cannot be viewed substantively. Both philosophers and clinicians prioritize the need for a decision to be morally justifiable, and also for the decision to be action-guiding. We argue that, especially against the background of our pluralistic society, it is only via unforced dialogue and properly founded argumentation, aiming for consensus, that we can ascribe rightness or wrongness in a normative fashion to dilemmatic situations. We argue that both the process of dialogue, properly constituted, and the consensual outcome itself have moral authority vested within them. Finally, we argue that the consensual decision made is able to withstand moral scrutiny and is action-guiding, without claiming absolute moral authority in other contexts.
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  • 文章类型: Journal Article
    几项研究强调了医学院课程中文化多样性的纳入不足,以及COVID-19大流行强调的健康不平等程度。这项研究旨在批判性地审查一系列GMC出版物,以确定其指南中是否包含文化多样性主题,根据最近的研究,医生没有做好充分的准备来为多样化的人群服务。
    分析了24篇相关的GMC出版物。进行了归纳主题分析以审查指南的内容;语篇分析用于批判性地理解所使用的语言学,同时还考虑了文化和社会背景。
    GMC的出版物主要侧重于阻止歧视和促进平等。医学实践中围绕多样性的主题不太常见。准则内部存在相当大的不一致。与针对医生的指南相比,针对医学院和医学生的指南更有可能考虑文化多样性问题。
    文化多样性教学只能与推动它的政策一样有效。尽管GMC指南中包含了文化多样性问题,这项研究表明,在如何表示和理解这些问题方面存在相当大的歧义。该指南需要仔细修订,并应编写以减少变量解释的可能性,从而促进医学院课程中更好的文化多样性包容,从而更好的病人护理。
    Several studies have highlighted the insufficient inclusion of cultural diversity in medical schools\' curricula and the extent of health inequalities highlighted by the COVID-19 pandemic. This study aimed to critically review a range of GMC publications to identify the inclusion of cultural diversity topics in their guidelines, as according to recent studies, doctors are inadequately prepared to serve a diverse population.
    Twenty-four relevant GMC publications were analysed. An inductive thematic analysis was conducted to review the content of the guidelines; and discourse analysis was used to critically understand the linguistics used whilst also considering the cultural and social context.
    The GMC publications primarily focused on discouraging discrimination and promoting equality. Themes around diversity in medical practice were less commonly covered. There was considerable internal inconsistency across the guidelines. Guidelines aimed at medical schools and medical students were more likely to consider cultural diversity issues compared to those intended for doctors.
    Cultural diversity teaching can only be as effective as the policy that drives it. Despite the inclusion of cultural diversity issues in GMC guidelines, this study suggests considerable ambiguity in how these issues are represented and understood. The guidelines require careful revision and should be written to reduce the likelihood of variable interpretation, thereby promoting better cultural diversity inclusion in medical schools\' curricula, and consequently better patient care.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    Background: As the rates of infection and mortality from COVID-19 have been higher in minority groups, the communication of health information in a way that is understood and accepted is of particular importance. Aims: To provide health professionals with a clinical practice guideline for clear and culturally sensitive communication of health information about COVID-19 to people of Indigenous and culturally and linguistically diverse (CALD) backgrounds. Assessment of Guideline Options: The authors conducted a review of the literature on health communication, and the guidelines were developed with particular reference to the SPIKES protocol of \"breaking bad news\" in oncology and the use of the DSM-5 Cultural Formulation Interview (CFI). Actionable Recommendations: The guideline combines two approaches, the Cultural Formulation Interview, developed for DSM-5, and the SPIKES protocol used for delivering \"bad news\" in oncology. The combined CFI-SPIKES protocol is a six-step clinical practice guideline that includes the following: (1) Set up (S) the interview; (2) Determine how the patient perceives the problem (P) using the Cultural Formulation Interview (CFI) to elicit the patient\'s cultural perception of the problem; (3) Obtain an invitation (I) from the patient to receive a diagnosis; (4) Provide the patient knowledge (K) of diagnosis in a non-technical way; (5) Address the patient\'s emotional reaction (E) to diagnosis; and (6) Provide the patient a summary (S) of healthcare and treatment. Conclusions and Relevance: This article presents guidelines for assessing the cultural dimensions of patients\' understanding of COVID-19 and delivering diagnostic and treatment recommendations in ways that are culturally safe and responsive, such as: (a) suspending the clinician\'s own cultural biases to understand the explanatory models and cultural values of their CALD or Indigenous patients; (b) encouraging the use of interpreters or cultural brokers to ensure that that the message is delivered in a way that the patient can understand; and (c) encouraging CALD or Indigenous patient to take an active part in the solution and treatment adherence, to minimize transmission of COVID-19 in CALD and Indigenous communities.
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  • 文章类型: Consensus Development Conference
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  • 文章类型: Journal Article
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  • 文章类型: Letter
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