Cultural Competence: New Conceptual Insights into its Limits and Potential for Addressing Health Disparities

The increasing interest in the role of racism and racialization in health disparities, calls for exploring new paradigms in addressing and eliminating health disparities related to race/ethnicity. Cultural competence is conceptualized as one of the keys ways to address racial/ethnic disparities in public health and healthcare. However, for cultural competence to fulfill this role, it requires a critical understanding of the underlying socio-political and economic processes of power, privilege and institutional racism that create, support and maintain existing health disparities. This paper outlines how the concept of cultural competence can be made more robust, by incorporating concepts such as Public Health Critical Race praxis (PHCR) and cultural humility, to more fully tackle the impact of structural inequities on health disparities

Nebraska Sex Trafficking Survivors Speak – A Qualitative Research Study

This exploratory, qualitative research study was conducted by researchers Dr. Shireen S. Rajaram in the College of Public Health at University of Nebraska Medical Center (UNMC) and Ms. Sriyani Tidball in the College of Journalism and Mass Communication at the University of Nebraska at Lincoln (UNL), and was funded by the Women’s Fund of Omaha. The purpose of this study was to document the perspectives of adult women survivors of sex trafficking about the “3Ps” paradigm: to identify strategies to prevent sex trafficking, provide protection and support for survivors and prosecution of the perpetrators to reduce the demand for sex trafficking. The Victims of Trafficking and Violence Protection Act of 2000 defines sex trafficking as a commercial sex act that is induced by force, fraud, or coercion, or when there is a commercial sex act involving a person below 18 years of age. This study is the first of its kind in Nebraska that included the voices of survivors of sex trafficking. Qualitative research through one-on-one interviews provides information directly from survivors in their own words. Our goal was to ensure that the voices of trafficked women were included in on-going efforts to develop a comprehensive statewide plan to effectively combat sex trafficking in Nebraska. While sex trafficking of children and males is a serious issue, this study only focused on adult female sex trafficking survivors (i.e., they were prostituted against their will), 19 years and older, who may or may not have been sex trafficked while they were minors. To avoid re-traumatizing, we only included women who had not been sex trafficked within the past year. Through interviews, researchers obtained detailed, rich, and authentic descriptions from 22 women survivors of sex trafficking in Nebraska. Seventeen women lived in the Omaha-Lincoln area and 5 lived in rural Nebraska. Most women had children. Seven women were currently married. Thirteen women were white-Caucasian, four African American, three mixed race/ethnicity, and two Latino. As children, twelve of the women had been in foster care, and one woman had lived in a group home. The study revealed the complexity of the issue of sex trafficking. The high level of ignorance about sex trafficking among all segments of society allows for it to exist and thrive, largely undetected. Currently, active planning efforts are underway to create a comprehensive statewide plan to combat trafficking in Nebraska. However, given that very little has been done in Nebraska, there is an urgent need to implement strategies to address prevention, protection and prosecution simultaneously. Focusing on only one without the others will not benefit survivors

Building a Robust E-Learning Module Scorecard: The Nebraska E-Learning Scorecard (NEscore)

Teaching during a pandemic has compelled educators to transform traditional strategies towards more innovative solutions. These innovative solutions use a variety of educational technologies, and often, shift delivery modalities to an online or blended approach to learning. A key strategy in online teaching is the development of quality e-learning modules based on the core tenets of e-learning. E-learning modules aim to enhance knowledge, performance, and retention through interactive and engaging strategies. While the value of a quality e-learning module is well-supported in the literature, there are limited resources available for developers to assess if the module adheres to the core tenets of e-learning. The University of Nebraska Medical Center created a scorecard (Nebraska E-Learning Scorecard, NEscore) based on established core tenets for e-learning that was both useable and reliable in evaluating quality e-learning modules. To determine the usability and reliability of NEscore, we conducted a pilot study and six experts and six novice participants evaluated five e-learning modules utilizing NEscore. Reliability was calculated with Cronbach’s alpha and intra-class correlation coefficients. We also gathered data on demographic information and the perceived satisfaction of participants in using the NEscore. The findings showed strong internal consistency among scores with overall high reliability, and high consistency among participants, showing no significant difference between the two groups of experts and novices. Overall, participants were satisfied with the usability of NEscore. The NEscore offers institutions an established set of criteria to evaluate existing e-learning modules and also serves as a guide for the development of new e-learning modules

Building a Robust E-Learning Module Scorecard: The Nebraska E-Learning Scorecard (NEscore)

Teaching during a pandemic has compelled educators to transform traditional strategies towards more innovative solutions. These innovative solutions use a variety of educational technologies, and often, shift delivery modalities to an online or blended approach to learning. A key strategy in online teaching is the development of quality e-learning modules based on the core tenets of e-learning. E-learning modules aim to enhance knowledge, performance, and retention through interactive and engaging strategies. While the value of a quality e-learning module is well-supported in the literature, there are limited resources available for developers to assess if the module adheres to the core tenets of e-learning. The University of Nebraska Medical Center created a scorecard (Nebraska E-Learning Scorecard, NEscore) based on established core tenets for e-learning that was both useable and reliable in evaluating quality e-learning modules. To determine the usability and reliability of NEscore, we conducted a pilot study and six experts and six novice participants evaluated five e-learning modules utilizing NEscore. Reliability was calculated with Cronbach’s alpha and intra-class correlation coefficients. We also gathered data on demographic information and the perceived satisfaction of participants in using the NEscore. The findings showed strong internal consistency among scores with overall high reliability, and high consistency among participants, showing no significant difference between the two groups of experts and novices. Overall, participants were satisfied with the usability of NEscore. The NEscore offers institutions an established set of criteria to evaluate existing e-learning modules and also serves as a guide for the development of new e-learning modules

Nebraska E-Learning Scorecard (NEscore)

https://digitalcommons.unmc.edu/elearning_tools/1000/thumbnail.jp

Health Profile of Nebraska\u27s Latino Population

The University of Nebraska at Omaha’s (UNO) Office of Latino and Latin American Studies (OLLAS) has released a report and policy brief, in conjunction with the University of Nebraska Medical Center (UNMC), describing the serious health problems facing the growing Latino and immigrant populations in Nebraska and Iowa, particularly the Omaha-Council Bluffs metropolitan area

Incidence of Gastric Cancer in Marrakech and Casablanca, Morocco

Gastric cancer is the fifth most common cancer globally with over 70% of new cases occurring in developing countries. In Morocco, oncologists in Marrakech suspected higher frequency of gastric cancer compared to Casablanca, a city 150 kilometers away. This study calculated age-specific, sex-specific, and total incidence rates of gastric cancer in Marrakech and was compared to the Casablanca population-based cancer registry. Using medical records from Center Hospital University Mohammad VI and reports from 4 main private pathology laboratories in Marrakech, we identified 774 patients for the period 2008–2012. Comparison of rates showed higher age-specific incidence in Marrakech in nearly all age groups for both genders. A higher total incidence in Marrakech than in Casablanca was found with rates of 5.50 and 3.23 per 100,000, respectively. Incidence was significantly higher among males in Marrakech than males in Casablanca (7.19 and 3.91 per 100,000, resp.) and females in Marrakech compared to females in Casablanca (3.87 and 2.58 per 100,000, resp.). Future studies should address possible underestimation of gastric cancer in Marrakech, estimate incidence in other regions of Morocco, and investigate possible risk factors to explain the difference in rates

Breast cancer management pathways during the COVID-19 pandemic: outcomes from the UK ‘Alert Level 4’ phase of the B-MaP-C study

Abstract: Background: The B-MaP-C study aimed to determine alterations to breast cancer (BC) management during the peak transmission period of the UK COVID-19 pandemic and the potential impact of these treatment decisions. Methods: This was a national cohort study of patients with early BC undergoing multidisciplinary team (MDT)-guided treatment recommendations during the pandemic, designated ‘standard’ or ‘COVID-altered’, in the preoperative, operative and post-operative setting. Findings: Of 3776 patients (from 64 UK units) in the study, 2246 (59%) had ‘COVID-altered’ management. ‘Bridging’ endocrine therapy was used (n = 951) where theatre capacity was reduced. There was increasing access to COVID-19 low-risk theatres during the study period (59%). In line with national guidance, immediate breast reconstruction was avoided (n = 299). Where adjuvant chemotherapy was omitted (n = 81), the median benefit was only 3% (IQR 2–9%) using ‘NHS Predict’. There was the rapid adoption of new evidence-based hypofractionated radiotherapy (n = 781, from 46 units). Only 14 patients (1%) tested positive for SARS-CoV-2 during their treatment journey. Conclusions: The majority of ‘COVID-altered’ management decisions were largely in line with pre-COVID evidence-based guidelines, implying that breast cancer survival outcomes are unlikely to be negatively impacted by the pandemic. However, in this study, the potential impact of delays to BC presentation or diagnosis remains unknown

Perceptions of Sexual Health Interventions among Urban, Midwestern Female African American Youth

Pregnancy and sexually transmitted diseases (STDs) among youth ages 15-24 persist as important public health issues in spite of significant investments in the development and implementation of evidence-based preventive interventions. Further, female African American youth are disproportionately affected by teen pregnancy and STDs. The purpose of this study was to better understand female African American youth’s perceptions of teen pregnancy and STDs, and the characteristics they desire in sexual and reproductive health interventions. Interviews with 19 African American females ages 13-24 were conducted. Results indicated that participants perceived teen pregnancy to be common, but STDs to be rare. Overall, participants desired more information about contraceptive methods and different types of STDs, and frequently noted youth facilitators in school and community-based programs who had experienced these issues would be more impactful than adult facilitators. Participants also suggested that parents and clinical providers should play larger roles in educating youth about teen pregnancy and STDs. Intervention developers should capitalize on the important role of peers, parents, and medical providers in female African American youths’ lives by developing teen pregnancy and STD interventions that incorporate parents, peers, and medical providers in integral ways