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Background: Healthcare workers (HCWs) in the United Kingdom (UK) have faced many challenges during the COVID-19 pandemic, some of these arising out of their social positions. Existing literature explicating these challenges (e.g., lack of appropriate PPE, redeployment, understaffing) have highlighted inequities in how these have been experienced by HCWs based on ethnicity, gender or, job role. In this paper, we move a step ahead and examine how the intersection of these social positions have impacted HCWs' experiences of challenges during the pandemic. Methods: We collected qualitative data, using interviews and focus groups, from 164 HCWs from different ethnicities, gender, job roles, migration statuses, and regions in the United Kingdom (UK) between December 2020 and July 2021. Interviews and focus groups were conducted online or by telephone, and recorded with participants' permission. Recordings were transcribed and a hybrid thematic analytical approach integrating inductive data-driven codes with deductive ones informed by an intersectional framework was adopted to analyse the transcripts. Results: Thematic analysis of transcripts identified disempowerment, disadvantage and, discrimination as the three main themes around which HCWs' experiences of challenges were centred, based on their intersecting identities (e.g., ethnicity gender, and/or migration status). Our analysis also acknowledges that disadvantages faced by HCWs were linked to systemic and structural factors at the micro, meso and macro ecosystemic levels. This merging of analysis which is grounded in intersectionality and considers the ecosystemic levels has been termed as 'intrasectionalism'. Discussion: Our research demonstrates how an intrasectional lens can help better understand how different forms of mutually reinforcing inequities exist at all levels within the healthcare workforce and how these impact HCWs from certain backgrounds who face greater disadvantage, discrimination and disempowerment, particularly during times of crisis like the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Palliative care practitioners are increasingly caring for patients and families from diverse cultural backgrounds. There is growing awareness of the influence of culture on many aspects of care in the palliative phase of an illness. However, disparities have been noted in the provision of palliative care to patients from culturally diverse backgrounds and challenges have been reported in meeting their needs and those of their families. Method: A qualitative systematic review of research papers identified through searching four databases. Papers were screened against inclusion criteria within the timeframe of January 2012 to March 2022. Data was extraction from all included studies and methodological quality assessed utilising the Critical Appraisal Skills Programme Tool. Thematic analysis followed Braun and Clarke's framework and the review is reported in line with PRISMA guidelines. Findings: The search yielded 1954 results of which 26 were included for appraisal and review. Four themes were identified: communication and connection, the role of the family in death and dying, the role of education in addressing uncertainty, and institutional and societal factors. The findings highlighted challenges of communication and a fear of acting in a culturally insensitive way, the pivotal role of the family, the need for an individualised approach to care, the universality of needs when approaching end of life and the need for education of practitioners. Conclusion: These findings suggest that healthcare practitioners draw on their existing skills to adapt their practice to meet the needs of patients from culturally diverse backgrounds. However, results also indicate a need for further education and identification of educational approaches best suited to supporting healthcare professionals in practice. [ABSTRACT FROM AUTHOR]

Background: Agri-silvicultures (ASC) are biocultural practices procuring either the maintenance of wild diversity in predominantly agricultural spaces or introducing agrobiodiversity into forests. In the Mesoamerican region, ASC contribute to food sovereignty and territorial conservation and provide strategies for dealing with global changes. Previous inventories of ASC identified gaps in information about these systems in the Mexican Arid America region. This article raises the general question: How have human interactions between cultural, wild, and domesticated biodiversity in this territory? The particular questions in this paper are: (i) How have historical processes shaped human interactions between wild and domesticated biodiversity in the region? and (ii) What types of agri-silvicultures have emerged in Mexican Arid America since these relationships? Methods: We trace a methodological border where archaeologists have identified the Mesoamerican region to define our study area as Arid America northern of this line in Mexico. We analyzed agriculturalization processes in Arid America through a historical review. Then, we carry out an inventory of Arid America ASC based on academic papers and other documented experiences. We constructed a spatial database and a typology to understand what kinds of agri-silviculture occur in the region. Results: We identified several pre-Hispanic agri-silvicultural practices in the region, like hunting, fishing, terraces, gathering, and irrigation systems. The cultivation of native species of maize, beans, and squash even was registered. The Spanish colonization forced the agriculturization in arid northern Mexico, where itinerant hunting-gathering patterns predominated. In the twentieth century, the Green Revolution adopted this area as the principal setting for industrialized agriculture. The industrialized irrigated systems expansion and other political strategies provoked the simplification of productive landscapes. The practices that integrate wild and agricultural diversity systems were marginalized and invisibilized in such a context. Our research group proposes seven types of agri-silvicultural systems (natives agrisilvicultures, the oases agroforestry, Mesquite and Huisache ASC, homegardens and other traditional forms of agroforestry or agri-silvicultures). These agri-silvicultures provide food, medicine, fodder, and other contributions, as income to the families that practice them and protect native and exotic species. Discussion and conclusion: The agriculturization of the arid environments initiated during Spanish colonization and the subsequent modernizing projects shaped dominant actors and ideologies in the arid north of Mexico. However, aridity has favored ancestral and agroecological relationships between cultures and biodiversity, emerging and subsisting Arid American agri-silvicultures. These agri-silvicultures deserve to be understood, adopted, and adapted to new contexts. They could be essential alternatives in the context of environmental changes. [ABSTRACT FROM AUTHOR]

Global disease registries are critical to capturing common patient related information on rare illnesses, allowing patients and their families to provide information about their condition in a safe, accessible, and engaging manner that enables researchers to undertake critical research aimed at improving outcomes. Typically, English is the default language of choice for these global digital health platforms. Unfortunately, language barriers can significantly inhibit participation from non-English speaking participants. In addition, there is potential for compromises in data quality and completeness. In contrast, multinational commercial entities provide access to their websites in the local language of the country they are operating in, and often provide multiple options reflecting ethnic diversity. This paper presents a case study of how the Global Angelman Syndrome Registry (GASR) has used a novel approach to enable multiple language translations for its website. Using a "semi-automated language translation" approach, the GASR, which was originally launched in English in September 2016, is now available in several other languages. In 2020, the GASR adopted a novel approach using crowd-sourcing and machine translation tools leading to the availability of the GASR in Spanish, Traditional Chinese, Italian, and Hindi. As a result, enrolments increased by 124% percent for Spain, 67% percent for Latin America, 46% percent for Asia, 24% for Italy, and 43% for India. We describe our approach here, which we believe presents an opportunity for cost-effective and timely translations responsive to changes to the registry and helps build and maintain engagement with global disease communities. [ABSTRACT FROM AUTHOR]

Background: Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. Methods: A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. Results: Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. Conclusions: Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking. Highlights: What is already known: Transcultural care promotes satisfaction among diverse populations. Cultural competence promotes an inclusive environment and mutual benefit. Cultural competence reduces biased decision making and promotes cultural awareness. What this paper adds: Transcultural learning in nursing is a complex learning process. Transcultural nursing learning is multifactorial and has an impact on students' personal and professional lives. Transcultural nursing learning experiences involve self-awareness, reflective thinking, cultural encounters, cultural skills, cultural desires and cultural knowledge. [ABSTRACT FROM AUTHOR]

Background: International and migrant students face specific challenges which may impact their mental health, well-being and academic outcomes, and these may be gendered experiences. The purpose of this scoping review was to map the literature on the challenges, coping responses and supportive interventions for international and migrant students in academic nursing programs in major host countries, with a gender lens. Methods: We searched 10 databases to identify literature reporting on the challenges, coping responses and/or supportive interventions for international and migrant nursing students in college or university programs in Canada, the United-States, Australia, New Zealand or a European country. We included peer-reviewed research (any design), discussion papers and literature reviews. English, French and Spanish publications were considered and no time restrictions were applied. Drawing from existing frameworks, we critically assessed each paper and extracted information with a gender lens. Results: One hundred fourteen publications were included. Overall the literature mostly focused on international students, and among migrants, migration history/status and length of time in country were not considered with regards to challenges, coping or interventions. Females and males, respectively, were included in 69 and 59% of studies with student participants, while those students who identify as other genders/sexual orientations were not named or identified in any of the research. Several papers suggest that foreign-born nursing students face challenges associated with different cultural roles, norms and expectations for men and women. Other challenges included perceived discrimination due to wearing a hijab and being a 'foreign-born male nurse', and in general nursing being viewed as a feminine, low-status profession. Only two strategies, accessing support from family and other student mothers, used by women to cope with challenges, were identified. Supportive interventions considering gender were limited; these included matching students with support services' personnel by sex, involving male family members in admission and orientation processes, and using patient simulation as a method to prepare students for care-provision of patients of the opposite-sex. Conclusion: Future work in nursing higher education, especially regarding supportive interventions, needs to address the intersections of gender, gender identity/sexual orientation and foreign-born status, and also consider the complexity of migrant students' contexts. [ABSTRACT FROM AUTHOR]

Mental health is impacted by social, economic, and environmental factors, the Social Determinants of Health (SDH). Migrants experiencing precarious living and working conditions may be more at risk of poor mental health than the majority population. This paper aims to evaluate the relationship of educational attainment and other SDH with depressive symptoms among the resident population, including Italians and migrants. This study examined the respondents to the Italian "Progressi delle Aziende Sanitarie per la Salute in Italia" (PASSI) surveillance system, 2014–18. The sample of 144.055 respondents is composed of the resident working adults aged 25–69 with Italian citizenship (n = 136.514) and foreign citizenship (n = 7.491). Findings show that among Italians high level of education appears to be a protective factor for mental health, in accordance with the international evidence (adjPR: tertiary education 0,74 p-value = 0.000). However, among immigrants high level of education is associated with the presence of depressive symptoms (adjPR: tertiary education: 1.61 p-value = 0.006), particularly for men (adjPR: tertiary education: 2.40 p-value = 0.006). The longer the length of stay in Italy for immigrants the higher the risk of depressive symptoms: adjPR for 10+ years: 2.23 p-value = 0.005. The data show that high education could represent a risk factor for mental health of immigrants. Moreover, among migrants there are some significant mental health inequities between male and female related to the duration of stay in Italy, economic activity and educational level. Considering that health is related to the nature of society as well as to access to technical solutions, multicultural societies require culturally oriented interventions for tackling health inequities. This means developing evidence-based policies in order to tackle health inequalities in the population as a whole, including culturally oriented measures in the larger framework of developing diversity sensitive services. [ABSTRACT FROM AUTHOR]

Mental health is impacted by social, economic, and environmental factors, the Social Determinants of Health (SDH). Migrants experiencing precarious living and working conditions may be more at risk of poor mental health than the majority population. This paper aims to evaluate the relationship of educational attainment and other SDH with depressive symptoms among the resident population, including Italians and migrants. This study examined the respondents to the Italian "Progressi delle Aziende Sanitarie per la Salute in Italia" (PASSI) surveillance system, 2014–18. The sample of 144.055 respondents is composed of the resident working adults aged 25–69 with Italian citizenship (n = 136.514) and foreign citizenship (n = 7.491). Findings show that among Italians high level of education appears to be a protective factor for mental health, in accordance with the international evidence (adjPR: tertiary education 0,74 p-value = 0.000). However, among immigrants high level of education is associated with the presence of depressive symptoms (adjPR: tertiary education: 1.61 p-value = 0.006), particularly for men (adjPR: tertiary education: 2.40 p-value = 0.006). The longer the length of stay in Italy for immigrants the higher the risk of depressive symptoms: adjPR for 10+ years: 2.23 p-value = 0.005. The data show that high education could represent a risk factor for mental health of immigrants. Moreover, among migrants there are some significant mental health inequities between male and female related to the duration of stay in Italy, economic activity and educational level. Considering that health is related to the nature of society as well as to access to technical solutions, multicultural societies require culturally oriented interventions for tackling health inequities. This means developing evidence-based policies in order to tackle health inequalities in the population as a whole, including culturally oriented measures in the larger framework of developing diversity sensitive services. [ABSTRACT FROM AUTHOR]

Background: The Republic of Georgia is part of the Caucasus biodiversity hotspot, and human agricultural plant use dates back at least 6000 years. Over the last years, lots of ethnobotanical research on the area has been published. In this paper, we analyze the use of food plants in the 80% of Georgia not occupied by Russian forces. We hypothesized that (1) given the long tradition of plant use, and the isolation under Soviet rule, plant use both based on home gardens and wild harvesting would be more pronounced in Georgia than in the wider region, (2) food plant use knowledge would be widely and equally spread in most of Georgia, (3) there would still be incidence of knowledge loss despite wide plant use, especially in climatically favored agricultural regions in Western and Eastern Georgia. Methods: From 2013 to 2019, we interviewed over 380 participants in all regions of Georgia not occupied by Russian forces and recorded over 19,800 mentions of food plants. All interviews were carried out in the participants' homes and gardens by native speakers of Georgian and its dialects (Imeretian, Rachian, Lechkhumian, Tush, Khevsurian, Psavian, Kakhetian), other Kartvelian languages (Megrelian, Svan) and minority languages (Ossetian, Ude, Azeri, Armenian, Greek). Results: The regional division was based primarily on historic provinces of Georgia, which often coincides with the current administrative borders. The total number of taxa, mostly identified to species, including their varieties, was 527. Taxonomically, the difference between two food plant groups—garden versus wild—was strongly pronounced even at family level. The richness of plant families was 65 versus 97 families in garden versus wild plants, respectively, and the difference was highly significant. Other diversity indices also unequivocally pointed to considerably more diverse family composition of wild collected versus garden plants as the differences between all the tested diversity indices appeared to be highly significant. The wide use of leaves for herb pies and lactofermented is of particular interest. Some of the ingredients are toxic in larger quantities, and the participants pointed out that careful preparation was needed. The authors explicitly decided to not give any recipes, given that many of the species are widespread, and compound composition—and with it possible toxic effects—might vary across the distribution range, so that a preparation method that sufficiently reduces toxicity in the Caucasus might not necessary be applicable in other areas. Conclusions: Relationships among the regions in the case of wild food plants show a different and clearer pattern. Adjacent regions cluster together (Kvemo Zemo Racha, and Zemo Imereti; Samegrelo, Guria, Adjara, Lechkhumi and Kvemo and Zemo Svaneti; Meskheti, Javakheti, Kvemo Kartli; Mtianeti, Kakheti, Khevsureti, Tusheti. Like in the case of the garden food plants, species diversity of wild food plants mentioned varied strongly. Climate severity and traditions of the use of wild food plants might play role in this variation. Overall food plant knowledge is widely spread all-across Georgia, and broadly maintained. [ABSTRACT FROM AUTHOR]