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Despite decades of policies to widen participation in medical degrees, students selected for Medicine continue to reflect a socially elite group, rather than the diversity of the communities that graduates will serve. While research has documented experiences of students from disadvantaged backgrounds, this paper examines the "cultures of success" that enable advantaged students to gain entry to medical school. It documents how these students' school and home environments enable the development and realisation of "aspirational capacity". Aspirational capacity is not just about having a dream, but also the resources and knowledge to realise one's dream. The paper also examines a negative side of a narrow aspirational focus. "Aspirational constriction" describes the premature foreclosure of career ambitions, which can have negative implications for both the students and for society, and for less advantaged students, who are effectively excluded from degrees such as Medicine. [ABSTRACT FROM AUTHOR]

While historians have analyzed and discussed the fragmentation of life in transatlantic societies by focusing on economics, law, or politics, we propose that a focus on biomedicine in the period since 1970 adds important perspectives on the shifting public role of science and of medicine. Biomedicine (the convergence of biological research and of medicine within the life sciences) moved to the center of public debates after the end of the Cold War. The papers in this special issue highlight how it became a prism through which societies, governments, and states renegotiated the roles of the medical and scientific professions, the opportunities, risks, and limits associated with scientific research and medical technologies, the responsibilities of individuals and of the professions in making life-or-death decisions, and important norms shaping the lives of individuals, families, and communities. Historians have analyzed and discussed the impact of market-oriented governing rationalities and of shifting discourses about the societal roles of individuals by focusing on politics, economics, or law. The contributors to this special issue propose to expand the focus towards biomedicine in order to include developments that otherwise would remain distinct from evolving narratives in recent contemporary history. [ABSTRACT FROM AUTHOR]

Vision is considered one of the most important senses for the neuropsychomotor development of children and is essential for learning and socialization from the first years of life. However, the changes in anatomical and physiological conformations of the child's eye, which occur during growth, make children susceptible to eye health problems, requiring early identification and treatment so that they can be resolved. Therefore, this paper aims to present an experience report on the extension project "Visual Acuity Screening and Ametropia Identification in an Urban Terena Community in Campo Grande (Brazil)" developed by an academic team from the Medical School of the Mato Grosso do Sul State University. This project aimed at assessing the visual acuity in children aged 3 to 12 years old and was developed in four stages: planning of activities with the community, training of the work team, application of the visual acuity screening test, and strategies for health education in ophthalmology. Because the course of its development was affected by the Covid-19 scenario, it was essential for the academic team to make adaptations to minimize the negative impacts of the pandemic on the project, which had the participation of about 30 children. The results of this action provided early detection of low visual acuity in 4 children, 13% of the total surveyed. In addition, the action strengthened the institution-community relationship amid the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Recent studies have shown that groups sharing the same or very similar environments, but with diverse cultural backgrounds (e.g. different ethnos and/or religion) have considerably different knowledge of folk (medicinal) plant uses. Yet, it is not clear to what extent various factors (such as culture, economy, isolation, and especially social and political situations) contribute to such differences in the utilization of the same natural resources. Aim of the study This paper addresses the effect of border created in 1940 and subsequent separation of a single ethnic group on changes in their folk use of medicinal and wild food plants. The Hutsuls of Bukovina had been homogenous for centuries, but were separated in 1940 as a result of the formation of state borders between Romania and the former Soviet Union (now Ukraine). The aim of the study is to analyse if the belonging to this different states for 75 years have induced different changes in local plant use within communities that share a common historical legacy and environment. Materials and methods In depth semi-structured interviews were conducted with 42 people in May 2015. Collected data were analysed, and comparisons were made between the data gathered on the two sides of the border for different use categories: medicinal, wild food and veterinary plants, as well as other remedies. Recently collected data were also compared with historical data obtained for the region, medicinal plant folk uses in Romania and medicinal plant uses of The State Pharmacopeia of the Soviet Union. Results Divergences in current medicinal plant use are much greater than in the use of wild food plants. The majority of the wild food taxa, including those used for making recreational teas, are also used for medicinal purposes and hence contribute to the food-medicine continuum, representing emergency foods in the past and serving as memory markers for possible future food shortages. Compared with the historical data, considerable changes have occurred within specific medicinal applications and less in the taxa used. The influence of the Soviet State Pharmacopeia on present ethnomedicine on the Ukrainian side is minimal. Conclusions Hutsul herbal ethnomedicine on the Ukrainian side of the border has continued to evolve (the abandonment of some uses and the adoption of others), whereas on the Romanian side it has undergone significant erosion with a proportionally smaller adoption of new uses and the leaving behind of possibly more “traditional” uses than on the Ukrainian side. In sum, current ethnomedicinal practices of Hutsuls living on both sides of the border are more extensive than those reported in historical sources. Yet the unknown sampling method employed to collect the historical data and possible skipping of “ordinary” uses by folklorists and ethnographers does not allow for definitive conclusions to be drawn. Cross-cultural and cross-border ethnobotany represents one of the most powerful means for addressing the issue of change and variability of medicinal plant uses and heritage, and further studies in other areas of Eastern Europe and beyond need to address the trajectory proposed by the present study. [ABSTRACT FROM AUTHOR]

What is the relationship between community trust and household health? Scholars working to understand the effects of trust and social capital on human health tend to focus on individual characteristics or social environments, frequently without integrating these two dimensions. In light of this, the present paper makes contributions in both conceptualization and measurement. First, I develop a spatially-based approach for operationalizing community trust as the product of individual orientation and social environment. This approach highlights the need for a household to trust its neighbors and for those neighbors to reciprocate trust in order to constitute the psychological and material mechanisms critical for linking social context to individual health. Second, I illustrate the utility of this measure by evaluating the relationship between community trust and self-rated health status using an original population census survey from 2009 to 2010 for two municipalities in western Honduras (approximately 2800 households with a response rate of 94.9%). I implement spatial regression analysis and show that there is a positive and substantively meaningful relationship between community trust and household health; households that are trusting and surrounded by similarly trusting neighbors report better health status, while those in uncertain or mutually distrusting environments report worse health. The theory and results presented here suggest an important link between trust and social capital at the community level, which is particularly salient for rural regions in developing countries where health resources are scarce and community-based interventions are common. [ABSTRACT FROM AUTHOR]

Budget experiments can provide additional guidance to health system reform requiring the identification of a subset of programs and services that accrue the highest social value to ‘communities’. Such experiments simulate a realistic budget resource allocation assessment among competitive programs, and position citizens as decision makers responsible for making ‘collective sacrifices’. This paper explores the use of a participatory budget experiment (with 88 participants clustered in social groups) to model public health care reform, drawing from a set of realistic scenarios for potential health care users. We measure preferences by employing a contingent ranking alongside a budget allocation exercise (termed ‘willingness to assign’) before and after program cost information is revealed. Evidence suggests that the budget experiment method tested is cognitively feasible and incentive compatible. The main downside is the existence of ex-ante “cost estimation” bias. Additionally, we find that participants appeared to underestimate the net social gain of redistributive programs. Relative social value estimates can serve as a guide to aid priority setting at a health system level. [ABSTRACT FROM AUTHOR]