Search results for: racial disparities

Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Mary T. McKinley

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As socio-economic globalization impacts education and turns knowledge into a commodity, institutions of higher education are becoming more intentional about infusing a global and intercultural perspective into education via the recruitment of international students. Coming from dissimilar cultures, many of these students are evaluated and held accountable to Euro-American values of independence, self-reliance, and autonomy. Not surprisingly, these students often experience culture shock with deleterious effects on their mental health and academic functioning. Thus, it is critical to understand the experiences of international students with the hope that such knowledge will keep the field of psychology from promulgating Eurocentric ideals and values and prevent the training of these students as good-enough White therapists. Using a critical narrative inquiry framework, this study elicits stories about the challenges encountered by international students as they navigate their clinical training in the presence of acculturative stress and potentially different worldviews. With its emphasis on story-telling as meaning making, narrative research design is hinged on the assumption that people are interpretive beings who make meaning of themselves and their world through the language of stories. Also, dominant socially-constructed narratives play a central role in creating and maintaining hegemonic structures that privilege certain individuals and ideologies at the expense of others. On this premise, narrative inquiry begins with an exploration of the experiences of participants in their lived stories. Bounded narrative segments were read, interpreted, and analyzed using a critical events approach. Throughout the process, issues of reliability and researcher bias were addressed by keeping a reflective analytic memo, as well as triangulating the data using peer-reviewers and check-ins with participants. The findings situate culture at the epicenter of international students’ acculturation challenges as well as their resiliency in psychology doctoral programs. It was not uncommon for these international students to experience ethical dilemmas inherent in learning content that conflicted with their cultural beliefs and values. Issues of cultural incongruence appear to be further exacerbated by visible markers for differences like speech accent and clothing attire. These stories also link the acculturative stress reported by international students to the experiences of perceived racial discrimination and lack of support from the faculty, administration, peers, and the society at large. Beyond the impact on the international students themselves, there are implications for internationalization in psychology with the goal of equipping doctoral programs to be better prepared to meet the needs of their international students. More than ever before, programs need to liaise with international students’ services and work in tandem to meet the unique needs of this population of students. Also, there exists a need for multiculturally competent supervisors working with international students with varying degrees of acculturation. In addition to making social justice and advocacy salient in students’ multicultural training, it may be helpful for psychology doctoral programs to be more intentional about infusing cross-cultural theories, indigenous psychotherapies, and/or when practical, the possibility for geographically cross-cultural practicum experiences in the home countries of international students while taking into consideration the ethical issues for virtual supervision.

Keywords: decolonizing pedagogies, international students, multiculturalism, psychology doctoral programs

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Authors: Lizinis Cassendra Frederick Dony, Jirom Jeremy Frederick Dony, Andrew Nicholas, Dewi Binti Tajuddin

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Starting and surviving a business is influenced by various entrepreneurship socio-economics activities. The study revealed that some of the entrepreneurs are not registered under SME but running own business as an intermediary with the private organization entrusted as “Self-Employed.” SME is known as “Small Medium Enterprise” contributes growth in Malaysia. Therefore, the entrepreneurialism business interest and entrepreneurial intention enhancing new spurring production, expanding employment opportunities, increasing productivity, promoting exports, stimulating innovation and providing new avenue in the business market place. This study has identified the unique contribution to the full understanding of complex mechanisms through entrepreneurship obstacles and education impacts on happiness and well-being to society. Moreover, “Ethnic” term has defined as a curious meaning refers to a classification of a large group of people customs implies to ancestral, racial, national, tribal, religious, linguistic and cultural origins. It is a social phenomenon.1 According to Sabah data population is amounting to 2,389,494 showed the predominant ethnic group being the Kadazan Dusun (18.4%) followed by Bajau (17.3%) and Malays (15.3%). For the year 2010, data statistic immigrants population report showed the amount to 239,765 people which cover 4% of the Sabahan’s population.2 Sabah has numerous group of talented entrepreneurs. The business environment among the minority ethnics are influenced with the business sentiment competition. The literature on ethnic entrepreneurship recognizes two main type entrepreneurships: the middleman and enclave entrepreneurs. According to Adam Smith,3 there are evidently some principles disposition to admire and maintain the distinction business rank status and cause most universal business sentiments. Due to credit barriers competition, the minority ethnics are losing the business market and since 2014, many illegal immigrants have been found to be using permits of the locals to operate businesses in Malaysia.4 The development of small business entrepreneurship among the minority ethnics in Sabah evidenced based variety of complex perception and differences concepts. The studies also confirmed the effects of heterogeneity on group decision and thinking caused partly by excessive pre-occupation with maintaining cohesiveness and the presence of cultural diversity in groups should reduce its probability.5 The researchers proposed that there are seven success determinants particularly to determine the involvement of minority ethnics comparing to the involvement of the immigrants in Sabah. Although, (SMEs) have always been considered the backbone of the economy development, the minority ethnics are often categorized it as the “second-choice.’ The study showed that illegal immigrants entrepreneur imposed a burden on Sabahan social programs as well as the prison, court and health care systems. The tension between the need for cheap labor and the impulse to protect Malaysian in Sabah workers, entrepreneurs and taxpayers, among the subjects discussed in this study. This is clearly can be advantages and disadvantages to the Sabah economic development.

Keywords: entrepreneurial firms, self-employed, immigrants, minority ethnic, economic impacts

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Authors: Edward Shizha, Edward Makwarimba

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Newcomer and refugee youth feel excluded in the education system in Canada, and the formal education environment does not fully cater for their learning needs. The objective of this study was to build knowledge and understanding of the educational needs and experiences of these youth in Canada and how available afterschool programs can most effectively support their learning needs and academic outcomes. The Employment and Social Development Canada (ESDC), which funded this research, enables and empowers students to advance their educational experience through targeted investments in services that are delivered by youth-serving organizations outside the formal education system through afterschool initiatives. A literature review and a provincial/territorial internet scan were conducted to determine the availability of services and programs that serve the educational needs and academic outcomes of newcomer youth in 10 provinces and 3 territories in Canada. The goal was to identify intersectional factors (e.g., gender, sexuality, culture, social class, race, etc.) that influence educational outcomes of newcomer/refugee students and to recommend ways the ESDC could complement settlement services to enhance students’ educational success. First, data was collected through a literature search of various databases, including PubMed, Web of Science, Scopus, Google docs, ACADEMIA, and grey literature, including government documents, to inform our analysis. Second, a provincial/territorial internet scan was conducted using a template that was created by ESDC staff with the input of the researchers. The objective of the web-search scan was to identify afterschool programs, projects, and initiatives offered to newcomer/refugee youth by service provider organizations. The method for the scan included both qualitative and quantitative data gathering. Both the literature review and the provincial/territorial scan revealed that there are gender disparities in educational outcomes of newcomer and refugee youth. High school completion rates by gender show that boys are at higher risk of not graduating than girls and that girls are more likely than boys to have at least a high school diploma and more likely to proceed to postsecondary education. Findings from literature reveal that afterschool programs are required for refugee youth who experience mental health challenges and miss out on significant periods of schooling, which affect attendance, participation, and graduation from high school. However, some refugee youth use their resilience and ambition to succeed in their educational outcomes. Another finding showed that some immigrant/refugee students, through ethnic organizations and familial affiliation, maintain aspects of their cultural values, parental expectations and ambitious expectations for their own careers to succeed in both high school and postsecondary education. The study found a significant combination of afterschool programs that include academic support, scholarships, bursaries, homework support, career readiness, internships, mentorship, tutoring, non-clinical counselling, mental health and social well-being support, language skills, volunteering opportunities, community connections, peer networking, culturally relevant services etc. These programs assist newcomer youth to develop self-confidence and prepare for academic success and future career development. The study concluded that advantages of afterschool programs are greatest for youth at risk for poor educational outcomes, such as Latino and Black youth, including 2SLGBTQI+ immigrant youth.

Keywords: afterschool programs, educational outcomes, newcomer youth, refugee youth, youth-serving organizations

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Authors: Benjamin J. Kuo, Silvia D. Vaca, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Lydia Nanjula, Christine Muhumuza, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

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Background: Traumatic Brain Injury (TBI) is disproportionally concentrated in low- and middle-income countries (LMICs), with the odds of dying from TBI in Uganda more than 4 times higher than in high income countries (HICs). The disparities in the injury incidence and outcome between LMICs and resource-rich settings have led to increased health outcomes research for TBIs and their associated risk factors in LMICs. While there have been increasing TBI studies in LMICs over the last decade, there is still a need for more robust prospective registries. In Uganda, a trauma registry implemented in 2004 at the Mulago National Referral Hospital (MNRH) showed that RTI is the major contributor (60%) of overall mortality in the casualty department. While the prior registry provides information on injury incidence and burden, it’s limited in scope and doesn’t follow patients longitudinally throughout their hospital stay nor does it focus specifically on TBIs. And although these retrospective analyses are helpful for benchmarking TBI outcomes, they make it hard to identify specific quality improvement initiatives. The relationship among epidemiology, patient risk factors, clinical care, and TBI outcomes are still relatively unknown at MNRH. Objective: The objectives of this study are to describe the processes of care and determine risk factors predictive of poor outcomes for TBI patients presenting to a single tertiary hospital in Uganda. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Research Electronic Data Capture (REDCap) was used to systematically collect variables spanning 8 categories. Univariate and multivariate analysis were conducted to determine significant predictors of mortality. Results: 563 TBI patients were enrolled from 1 June – 30 November 2016. 102 patients (18%) received surgery, 29 patients (5.1%) intended for surgery failed to receive it, and 251 patients (45%) received non-operative management. Overall mortality was 9.6%, which ranged from 4.7% for mild and moderate TBI to 55% for severe TBI patients with GCS 3-5. Within each TBI severity category, mortality differed by management pathway. Variables predictive of mortality were TBI severity, more than one intracranial bleed, failure to receive surgery, high dependency unit admission, ventilator support outside of surgery, and hospital arrival delayed by more than 4 hours. Conclusions: The overall mortality rate of 9.6% in Uganda for TBI is high, and likely underestimates the true TBI mortality. Furthermore, the wide-ranging mortality (3-82%), high ICU fatality, and negative impact of care delays suggest shortcomings with the current triaging practices. Lack of surgical intervention when needed was highly predictive of mortality in TBI patients. Further research into the determinants of surgical interventions, quality of step-up care, and prolonged care delays are needed to better understand the complex interplay of variables that affect patient outcome. These insights guide the development of future interventions and resource allocation to improve patient outcomes.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, prospective registry, traumatic brain injury

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Authors: Wafaa Hasan

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In May of 2022, Palestinian parents in Toronto, Canada, became aware that educators and staff in the Toronto District School Board were attempting to include the International Holocaust and Remembrance Definition of Antisemitism (IHRA) in The Child Abuse and Neglect Policy of the largest school board in Canada, The Toronto District School Board (TDSB). The idea was that if students were to express any form of antisemitism, as defined by the IHRA, then an investigation could follow with Child Protective Services (CPS). That is, the student’s parents could be reported to the state and investigated for custodial rights to their children. The TDSB has set apparent goals for “Decolonizing Pedagogy” (“TDSB Equity Leadership Competencies”), Culturally Responsive and Relevant Practices (CRRP) and inclusive education. These goals promote the centering of colonized, racialized and marginalized voices. CRRP cannot be effective without the application of anti-racist and settler colonial analyses. In order for CRRP to be effective, school boards need a comprehensive understanding of the ways in which the vilification of Palestinians operates through anti-indigenous and white supremacist systems and logic. Otherwise, their inclusion will always be in tension with the inclusion of settler colonial agendas and worldviews. Feminist maternalism frames racial mothering as degenerate (viewing the contributions of racialized students and their parents as products of primitive and violent cultures) and also indirectly inhibits the actualization of the tenets of CRRP and inclusive education through its extensions into the welfare state and public education. The contradiction between the tenets of CRRP and settler colonial systems of erasure and repression is resolved by the continuation of tactics to 1) force assimilation, 2) punish those who push back on that assimilation and 3) literally fragment familial and community structures of racialized students, educators and parents. This paper draws on interdisciplinary (history, philosophy, anthropology) critiques of white feminist “maternalism” from the 19th century onwards in North America and Europe (Jacobs, Weber), as well as “anti-racist education” theory (Dei), and more specifically,” culturally responsive learning,” (Muhammad) and “bandwidth” pedagogy theory (Verschelden) to make its claims. This research contributes to vibrant debates about anti-racist and decolonial pedagogies in public education systems globally. This paper also documents first-hand interviews and experiences of diasporic Palestinian mothers and motherhoods and situates their experiences within longstanding histories of white feminist maternalist (and eugenicist) politics. This informal qualitative data from "participatory conversations" (Swain) is situated within a set of formal interview data collected with Palestinian women in the West Bank (approved by the McMaster University Humanities Research Ethics Board) relating to white feminist maternalism in the peace and dialogue industry.

Keywords: decolonial feminism, maternal feminism, anti-racist pedagogies, settler colonial studies, motherhood studies, pedagogy theory, cultural theory

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Authors: Wenfan Yan, Yumei Han

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Objectives: Educational inequality persists between China's ethnic minority regions and the mainland. The key to rectifying this disparity lies in enhancing the quality of educators. This paper delves into the Chinese government's innovative policy, "Group Educators Supporting Tibet" (GEST), designed to bridge the shortage of high-quality teachers in Tibet, a representative underprivileged ethnic minority area. GEST aims to foster collective action by networking provincial expert educators with Tibetan counterparts and collaborating between supporting provincial educational entities and Tibetan education entities. Theoretical Framework: The unequal distribution of social capital contributes significantly to the educational gap between ethnic minority areas and other regions in China. Within the framework of social network theory, motivated GEST educators take action to foster resources and relationships. This study captures grassroots perspectives to outline how social networking contributes to the policy objective of enhancing Tibetan teachers' quality and eradicating educational injustice. Methodology: A sequential mixed-methods approach was adopted to scrutinize policy impacts from the vantage point of social networking. Quantitative research involved surveys for GEST and Tibetan teachers, exploring demographics, perceptions of policy significance, motivations, actions, and networking habits. Qualitative research included focus group interviews with GEST educators, local teachers, and students from program schools. The findings were meticulously analyzed to provide comprehensive insights into stakeholders' experiences and the impacts of the GEST policy. Key Findings: The policy empowers individuals to impact Tibetan education significantly. Motivated GEST educators with prior educational support experiences contribute to its success. Supported by a collective -school, city, province, and government- the new social structure fosters higher efficiency. GEST's approach surpasses conventional methods. The individual, backed by educators, realizes the potential of transformative class design. Collective activities -pedagogy research, teaching, mentoring, training, and partnerships- equip Tibetan teachers, enhancing educational quality and equity. This collaborative effort establishes a robust foundation for the policy's success, emphasizing the collective impact on Tibetan education. Contributions: This study contributes to international policy studies focused on educational equity through collective teacher action. Using a mixed-methods approach and guided by social networking theory, it accentuates stakeholders' perspectives, elucidating the genuine impacts of the GEST policy. The study underscores the advancement of social networking, the reinforcement of local teacher quality, and the transformative potential of cultivating a more equitable and adept teaching workforce in Tibet. Limitations of the Study and Suggestions for Future Research Directions: While the study emphasizes the positive impacts of motivated GEST educators, there might be aspects or challenges not fully explored. A more comprehensive understanding of potential drawbacks or obstacles would provide a more balanced view. For future studies, investigating the long-term impact of the GEST policy on educational quality could provide insights into the sustainability of the improvements observed. Also, understanding the perspectives of Tibetan teachers who may not have directly benefited from GEST could reveal potential disparities in policy implementation.

Keywords: teacher development, social networking, teacher quality, mixed research method

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Authors: Julien Caudeville, Muriel Ismert

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Analyzing the relationship between environment and health has become a major preoccupation for public health as evidenced by the emergence of the French national plans for health and environment. These plans have identified the following two priorities: (1) to identify and manage geographic areas, where hotspot exposures are suspected to generate a potential hazard to human health; (2) to reduce exposure inequalities. At a regional scale and fine resolution of exposure outcome prerequisite, environmental monitoring networks are not sufficient to characterize the multidimensionality of the exposure concept. In an attempt to increase representativeness of spatial exposure assessment approaches, risk composite indicators could be built using additional available databases and theoretical framework approaches to combine factor risks. To achieve those objectives, combining data process and transfer modeling with a spatial approach is a fundamental prerequisite that implies the need to first overcome different scientific limitations: to define interest variables and indicators that could be built to associate and describe the global source-effect chain; to link and process data from different sources and different spatial supports; to develop adapted methods in order to improve spatial data representativeness and resolution. A GIS-based modeling platform for quantifying human exposure to chemical substances (PLAINE: environmental inequalities analysis platform) was used to build health risk indicators within the Lorraine region (France). Those indicators combined chemical substances (in soil, air and water) and noise risk factors. Tools have been developed using modeling, spatial analysis and geostatistic methods to build and discretize interest variables from different supports and resolutions on a 1 km2 regular grid within the Lorraine region. By example, surface soil concentrations have been estimated by developing a Kriging method able to integrate surface and point spatial supports. Then, an exposure model developed by INERIS was used to assess the transfer from soil to individual exposure through ingestion pathways. We used distance from polluted soil site to build a proxy for contaminated site. Air indicator combined modeled concentrations and estimated emissions to take in account 30 polluants in the analysis. For water, drinking water concentrations were compared to drinking water standards to build a score spatialized using a distribution unit serve map. The Lden (day-evening-night) indicator was used to map noise around road infrastructures. Aggregation of the different factor risks was made using different methodologies to discuss weighting and aggregation procedures impact on the effectiveness of risk maps to take decisions for safeguarding citizen health. Results permit to identify pollutant sources, determinants of exposure, and potential hotspots areas. A diagnostic tool was developed for stakeholders to visualize and analyze the composite indicators in an operational and accurate manner. The designed support system will be used in many applications and contexts: (1) mapping environmental disparities throughout the Lorraine region; (2) identifying vulnerable population and determinants of exposure to set priorities and target for pollution prevention, regulation and remediation; (3) providing exposure database to quantify relationships between environmental indicators and cancer mortality data provided by French Regional Health Observatories.

Keywords: health risk, environment, composite indicator, hotspot areas

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Authors: Marthinus Conradie

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The conversational dynamics of democratically orientated deliberation continue to stimulate critical scholarship for its potential to bolster robust engagement between different sections of pluralist societies. Several axes of deliberation that have attracted academic attention include face-to-face vs. online interaction, and citizen-to-citizen communication vs. engagement between citizens and political elites. In all these areas, numerous researchers have explored deliberative procedures aimed at achieving instrumental goals such a securing consensus on policy issues, against procedures that prioritise expressive outcomes such as broadening the range of argumentative repertoires that discursively construct and mediate specific political issues. The study that informs this paper, works in the latter stream. Drawing its data from the reader-comments section of a South African broadsheet newspaper, the study investigates online, citizen-to-citizen deliberation by analysing the discursive practices through which competing understandings of social problems are articulated and contested. To advance this agenda, the paper deals specifically with user-generated comments posted in response to news stories on questions of race and racism in South Africa. The analysis works to discern and interpret the various sets of discourse practices that shape how citizens deliberate contentious political issues, especially racism. Since the website in question is designed to encourage the critical comparison of divergent interpretations of news events, without feeding directly into national policymaking, the study adopts an analytic framework that traces how citizens articulate arguments, rather than the instrumental effects that citizen deliberations might exert on policy. The paper starts from the argument that such expressive interactions are particularly crucial to current trends in South African politics, given that the precise nature of race and racism remain contested and uncertain. Centred on a sample of 2358 conversational moves in 814 posts to 18 news stories emanating from issues of race and racism, the analysis proceeds in a two-step fashion. The first stage conducts a qualitative content analysis that offers insights into the levels of reciprocity among commenters (do readers engage with each other or simply post isolated opinions?), as well as the structures of argumentation (do readers support opinions by citing evidence?). The second stage involves a more fine-grained discourse analysis, based on a theorisation of argumentation that delineates it into three components: opinions/conclusions, evidence/data to support opinions/conclusions and warrants that explicate precisely how evidence/data buttress opinions/conclusions. By tracing the manifestation and frequency of specific argumentative practices, this study contributes to the archive of research currently aggregating around the practices that characterise South Africans’ engagement with provocative political questions, especially racism and racial inequity. Additionally, the study also contributes to recent scholarship on the affordances of Web 2.0 software by eschewing a simplistic bifurcation between cyber-optimist vs. pessimism, in favour of a more nuanced and context-specific analysis of the patterns that structure online deliberation.

Keywords: online deliberation, discourse analysis, qualitative content analysis, racism

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Authors: Sujeeva Sebastian Pereira

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Language Anxiety (LA) – a distinct psychological construct of self-perceptions and behaviors related to classroom language learning – is perceived as a significant variable highly correlated with Second Language Acquisition (SLA). However, the existing scholarship has inadequately explored the nuances of LA in relation to South Asia, especially in terms of Sri Lankan higher education contexts. Thus, the current study, situated within the broad areas of Psychology of SLA and Applied Linguistics, investigates the impact of competency-based LA and identity-based LA on learner achievement among undergraduates of Sri Lanka. Employing a case study approach to explore the impact of LA, 750 undergraduates of the University of Sri Jayewardenepura, Sri Lanka, thus covering 25% of the student population from all seven faculties of the university, were selected as participants using stratified proportionate sampling in terms of ethnicity, gender, and disciplines. The qualitative and quantitative research inquiry utilized for data collection include a questionnaire consisting a set of structured and unstructured questions, and semi-structured interviews as research instruments. Data analysis includes both descriptive and statistical measures. As per the quantitative measures of data analysis, the study employed Pearson Correlation Coefficient test, Chi-Square test, and Multiple Correspondence Analysis; it used LA as the dependent variable, and two types of independent variables were used: direct and indirect variables. Direct variables encompass the four main language skills- reading, writing, speaking and listening- and test anxiety. These variables were further explored through classroom activities on grammar, vocabulary and individual and group presentations. Indirect variables are identity, gender and cultural stereotypes, discipline, social background, income level, ethnicity, religion and parents’ education level. Learner achievement was measured through final scores the participants have obtained for Compulsory English- a common first-year course unit mandatory for all undergraduates. LA was measured using the FLCAS. In order to increase the validity and reliability of the study, data collected were triangulated through descriptive content analysis. Clearly evident through both the statistical analysis and the qualitative analysis of the results is the significant linear negative correlation between LA and learner achievement, and the significant negative correlation between LA and culturally-operated gender stereotypes which create identity disparities in learners. The study also found that both competency-based LA and identity-based LA are experienced primarily and inescapably due to the apprehensions regarding speaking in English. Most participants who reported high levels of LA were from an urban socio-economic background of lower income families. Findings exemplify the linguistic inequality prevalent in the socio-cultural milieu in Sri Lankan society. This inequality makes learning English a dire need, yet, very much an anxiety provoking process because of many sociolinguistic, cultural and ideological factors related to English as a Second Language (ESL) in Sri Lanka. The findings bring out the intricate interrelatedness of both the dependent variable (LA) and the independent variables stated above, emphasizing that the significant linear negative correlation between LA and learner achievement is connected to the affective, cognitive and sociolinguistic domains of SLA. Thus, the study highlights the promise in linguistic practices such as code-switching, crossing and accommodating hybrid identities as strategies in minimizing LA and maximizing the experience of ESL.

Keywords: language anxiety, identity-based anxiety, competence-based anxiety, TESL, Sri Lanka

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Authors: Jonathan Adeyemi

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Context: This study focuses on El Anatsui and his global acclaim in the art world despite his origins from the global artworld’s margins. It addresses the disparities in the treatment between Western and non-Western artists and questions whether Anatsui’s consecration is a result of exoticism or the growing consensus on decolonization. Research Aim: The aim of this study is to investigate how El Anatsui achieved global acclaim from the margins of the art world and determine if his consecration represents a mark of decolonization or the typical Western desire for exoticism. Methodology: The study utilizes a case study approach, literature analysis, and in-depth interviews. The artist, the organizers of the Venice Biennale, the relevant curators at Tate Modern London, and the October Gallery in London, and other galleries in Nigeria, which represent the artist were interviewed for data collection. Findings: The study seeks to determine the authenticity of the growing consensus on decolonization, inclusion, and diversity in the global artistic field. Preliminary findings show that domestic socio-economic and political factors debilitated the mechanisms for local validation in Nigeria, weakening the domestic foundation for international engagement. However, alternative systems of exhibition, especially in London and the USA contributed critically to providing the initial international visibility, which formed the foundation for his global acclaim. Out of the 21 winners of the Golden Lion for Lifetime Achievement since its inception at the 47th Venice Biennale in 1997, American artists have dominated with 10 recipients, 8 recipients from Europe, 2 recipients from Africa (2007 and 2015) and 1 from Asia. This aligns with Bourdieu’s concept of cultural and economic capital, which prevented Africa countries from participation until recently. Moreover, while the average age of recipients is 76 years, Anatsui received the award at the age of 71, while Malick Sidibé (Mali) was awarded at 72. Thus, the Venice Biennale award for El Anatsui incline more towards a commitment to decolonisation than exoticism. Theoretical Importance: This study contributes to the field by examining the dynamics of the art world's monopoly of legitimation and the role of national, ethnicity and cultural differences in the promotion of artists. It aims to challenge the Westernized hierarchy of valorization and consecration in the art world. The research supports Bourdieu’s artistic field theory, which emphasises the importance of cultural, economic and social capital in determining agents’ position and access to the field resources (symbolic capital). Bourdieu also established that dominated agents can change their position in the field’s hierarchy either by establishing or navigating alternative systems. Data Collection and Analysis Procedures: The opacity of art world’s operations places the required information within the purview of the insiders (agents). Thus, the study collects data through in-depth interviews with relevant and purposively selected individuals and organizations. The data was/will be analyzed using qualitative methods, such as thematic analysis and content analysis. The interpretive analytical approach adopted facilitated the construction of meanings that may not be apparent in the data or responses. Questions Addressed: The study addresses how El Anatsui achieved global acclaim despite being from the margins, whether his consecration represents decolonization or exoticism, and the extent to which the global artistic field embraces decolonization, inclusion, and diversity. Conclusion: The study will contribute to knowledge by providing insights into the extent of commitment to decolonization, inclusion, and diversity in the global artistic field. It also shed light on the mechanisms behind El Anatsui's rise to global acclaim and challenge Western-dominated artistic hierarchies.

Keywords: decolonisation, exorticism, artistic field, culture game

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Authors: Alexandria Carey, Angela Starkweather, Ann Horgas, Hwayoung Cho, Jason Beneciuk

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Background/Significance: Over 3.4 million acute axial low back pain (aLBP) cases are treated annually in the United States (US) emergency departments (ED). ED patients with aLBP receive varying verbal and written discharge routine care (RC), leading to ineffective patient self-management. Ineffective self-management increase chronic low back pain (cLPB) transition risks, a chief cause of worldwide disability, with associated costs >$60 million annually. This research addresses this significant problem by evaluating an ED digital pain self-management intervention (EDPSI) focused on improving self-management through improved knowledge retainment, skills, and self-efficacy (confidence) (KSC) thus reducing aLBP to cLBP transition in ED patients discharged with aLBP. The research has significant potential to increase self-efficacy, one of the most potent mechanisms of behavior change and improve health outcomes. Focusing on accessibility and usability, the intervention may reduce discharge disparities in aLBP self-management, especially with low health literacy. Study Questions: This research will answer the following questions: 1) Will an EDPSI focused on improving KSC progress patient self-management behaviors and health status?; 2) Is the EDPSI sustainable to improve pain severity, interference, and pain recurrence?; 3) Will an EDPSI reduce aLBP to cLBP transition in patients discharged with aLBP? Aims: The pilot randomized-controlled trial (RCT) study’s objectives assess the effects of a 12-week digital self-management discharge tool in patients with aLBP. We aim to 1) Primarily assess the feasibility [recruitment, enrollment, and retention], and [intervention] acceptability, and sustainability of EDPSI on participant’s pain self-management; 2) Determine the effectiveness and sustainability of EDPSI on pain severity/interference among participants. 3) Explore patient preferences, health literacy, and changes among participants experiencing the transition to cLBP. We anticipate that EDPSI intervention will increase likelihood of achieving self-management milestones and significantly improve pain-related symptoms in aLBP. Methods: The study uses a two-group pilot RCT to enroll 30 individuals who have been seen in the ED with aLBP. Participants are randomized into RC (n=15) or RC + EDPSI (n=15) and receive follow-up surveys for 12-weeks post-intervention. EDPSI innovative content focuses on 1) highlighting discharge education; 2) provides self-management treatment options; 3) actor demonstration of ergonomics, range of motion movements, safety, and sleep; 4) complementary alternative medicine (CAM) options including acupuncture, yoga, and Pilates; 5) combination therapies including thermal application, spinal manipulation, and PT treatments. The intervention group receives Booster sessions via Zoom to assess and reinforce their knowledge retention of techniques and provide return demonstration reinforcing ergonomics, in weeks two and eight. Outcome Measures: All participants are followed for 12-weeks, assessing pain severity/ interference using the Brief Pain Inventory short-form (BPI-sf) survey, self-management (measuring KSC) using the short 13-item Patient Activation Measure (PAM), and self-efficacy using the Pain Self-Efficacy Questionnaire (PSEQ) weeks 1, 6, and 12. Feasibility is measured by recruitment, enrollment, and retention percentages. Acceptability and education satisfaction are measured using the Education-Preference and Satisfaction Questionnaire (EPSQ) post-intervention. Self-management sustainment is measured including PSEQ, PAM, and patient satisfaction and healthcare utilization (PSHU) requesting patient overall satisfaction, additional healthcare utilization, and pain management related to continued back pain or complications post-injury.

Keywords: digital, pain self-management, education, tool

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Authors: Tim Crocker-Buque, Sandra Mounier-Jack, Natasha Howard

Abstract:

Background: Due to both the increasing scale and speed of urbanisation, urban areas in low and middle-income countries (LMICs) host increasingly large populations of under-immunized children, with the additional associated risks of rapid disease transmission in high-density living environments. Multiple interdependent factors are associated with these coverage disparities in urban areas and most evidence comes from relatively few countries, e.g., predominantly India, Kenya, Nigeria, and some from Pakistan, Iran, and Brazil. This study aimed to identify, describe, and assess the main tools used to measure or improve coverage of immunisation services in poor urban areas. Methods: Authors used a qualitative review design, including academic and non-academic literature, to identify tools used to improve coverage of public health interventions in urban areas. Authors selected and extracted sources that provided good examples of specific tools, or categories of tools, used in a context relevant to urban immunization. Diagnostic (e.g., for data collection, analysis, and insight generation) and programme tools (e.g., for investigating or improving ongoing programmes) and interventions (e.g., multi-component or stand-alone with evidence) were selected for inclusion to provide a range of type and availability of relevant tools. These were then prioritised using a decision-analysis framework and a tool selection guide for programme managers developed. Results: Authors reviewed tools used in urban immunisation contexts and tools designed for (i) non-immunization and/or non-health interventions in urban areas, and (ii) immunisation in rural contexts that had relevance for urban areas (e.g., Reaching every District/Child/ Zone). Many approaches combined several tools and methods, which authors categorised as diagnostic, programme, and intervention. The most common diagnostic tools were cross-sectional surveys, key informant interviews, focus group discussions, secondary analysis of routine data, and geographical mapping of outcomes, resources, and services. Programme tools involved multiple stages of data collection, analysis, insight generation, and intervention planning and included guidance documents from WHO (World Health Organisation), UNICEF (United Nations Children's Fund), USAID (United States Agency for International Development), and governments, and articles reporting on diagnostics, interventions, and/or evaluations to improve urban immunisation. Interventions involved service improvement, education, reminder/recall, incentives, outreach, mass-media, or were multi-component. The main gaps in existing tools were an assessment of macro/policy-level factors, exploration of effective immunization communication channels, and measuring in/out-migration. The proposed framework uses a problem tree approach to suggest tools to address five common challenges (i.e. identifying populations, understanding communities, issues with service access and use, improving services, improving coverage) based on context and available data. Conclusion: This study identified many tools relevant to evaluating urban LMIC immunisation programmes, including significant crossover between tools. This was encouraging in terms of supporting the identification of common areas, but problematic as data volumes, instructions, and activities could overwhelm managers and tools are not always suitably applied to suitable contexts. Further research is needed on how best to combine tools and methods to suit local contexts. Authors’ initial framework can be tested and developed further.

Keywords: health equity, immunisation, low and middle-income countries, poverty, urban health

Procedia PDF Downloads 119