Background: Shared decision-making (SDM) is often considered the ideal for decision-making in oncology. Views of specific groups such as ethnic minorities have seldom been considered in its development. Aim: In this study we seek to assess in oncology if there is a need for adaptation of the current SDM model to ethnic minorities and to formulate possible adjustments. Design: This study is embedded in empirical bioethics, an interdisciplinary approach integrating empirical data with ethical reasoning to formulate normative conclusions regarding a practice. For the empirical social scientific part, a cross-sectional qualitative study will be conducted; for the ethical reflection the Reflective Equilibrium will be used to develop a coherent view on the application of SDM among ethnic minorities in oncology. Method: Semi-structured interviews combined with visual methods (timelines and relational maps) will be held with healthcare professionals (HCPs), ethnic minority patients, and their relatives to identify values steering the behavior of these actors in SDM. In addition, focus groups (FGs) will be held with ethnic minority community members to identify value structures at the group level. Respondents will be recruited through organizations with access to ethnic minorities and collaborating hospitals. Data will be analyzed using a reflexive thematic analysis through the lens of Schwartz’s value theory. The results of the empirical phase will be included in the RE to formulate possible adjustments of the SDM model, if needed. Discussion: The integration of empirical data with ethical reflection is an innovative method in decision-making. This method enables a systematic and profound assessment of the need for adaptation of SDM and the formulation of theoretically and empirically based suggestions for adaptations of the model. Findings of this study may enrich the SDM model.
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Optimizing protein intake is a novel strategy to prevent age associated loss of muscle mass and strength in older adults. Such a strategy is still missing for older adults from ethnic minority populations. Protein intake in these populations is expected to be different in comparison to the majority of the population due to several socio-cultural factors. Therefore, the present study examined the dietary protein intake and underlying behavioral and environmental factors affecting protein intake among older adults from ethnic minorities in the Netherlands. We analyzed frequency questionnaire (FFQ) data from the Healthy Life in an Urban Setting (HELIUS) cohort using ANCOVA to describe dietary protein intake in older adults from ethnic minorities in the Netherlands (N = 1415, aged >55 years, African Surinamese, South Asian Surinamese, Moroccan, and Turkish). Additionally, we performed focus groups among older adults from the same ethnic minority populations (N = 69) to discover behavioral and environmental factors affecting protein intake; 40-60% of the subjects did not reach minimal dietary protein recommendations needed to maintain muscle mass (1.0 g/kg bodyweight per day (BW/day)), except for Turkish men (where it was 91%). The major sources of protein originated from animal products and were ethnic specific. Participants in the focus groups showed little knowledge and awareness about protein and its role in aging. The amount of dietary protein and irregular eating patterns seemed to be the major concern in these populations. Optimizing protein intake in these groups requires a culturally sensitive approach, which accounts for specific protein product types and sociocultural factors.
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from the repository of Utrecht University: "PURPOSE: Previously, a high prevalence of certain psychiatric disorders was shown among non-Western immigrants. This study explores whether this results in more prescriptions for psychotropic medication. METHODS: Data on dispensing of medication among adults living in the four largest Dutch cities in 2013 were linked to demographic data from Statistics Netherlands. Incident (i.e., following no dispensing in 2010-2012) and prevalent dispensing among immigrants was compared to that among native Dutch (N = 1,043,732) and analyzed using multivariable Poisson and logistic regression. RESULTS: High adjusted Odds Ratios (ORadj) of prevalent and high Incidence Rate Ratios (IRRadj) of incident dispensing of antipsychotics were found among Moroccan (N = 115,455) and Turkish individuals (N = 105,460), especially among young Moroccan males (ORadj = 3.22 [2.99-3.47]). Among Surinamese (N = 147,123) and Antillean individuals (N = 41,430), slightly higher rates of dispensed antipsychotics were found and the estimates decreased after adjustment. The estimates for antipsychotic dispensing among the Moroccan and Turkish increased, following adjustment for household composition. Rates for antidepressant dispensing among Turkish and Moroccan subjects were high (Moroccans: ORadj = 1.74 [1.70-1.78]). Among Surinamese and Antillean subjects, the rates for antidepressant dispensing were low and the ORadjlagged behind the IRRadj(Surinamese: 0.69 [0.67-0.71] vs. 1.06 [1.00-1.13]). Similar results were found for anxiolytics. For ADHD medication, lower dispensing rates were found among all migrant groups. CONCLUSIONS: The findings agree with earlier reports of more mental health problems among Moroccan and Turkish individuals. Surinamese/Antillean individuals did not use psychotropic drugs at excess and discontinued antidepressants and anxiolytics earlier. The data strongly suggest under-treatment for ADHD in all ethnic minority groups."
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With an increasingly ageing population there will be a rising demand for palliative care, including from older migrants and ethnic minorities. While many (future) physicians are unfamiliar with specific needs of older migrants and ethnic minorities regarding care and communication in palliative care, this may be challenging for them to deal with. Moreover, even many medical teachers also feel unprepared to teach palliative care and culturally sensitive communication to students. In order to support medical teachers, we suggest twelve tips to teach culturally sensitive palliative care to guide the development and implementation of teaching this topic to medical students. Drawn from literature and our own experiences as teachers, these twelve tips provide practical guidance to both teachers and curriculum designers when designing and implementing education about culturally sensitive palliative care.
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Gepubliceerd in Medical Teacher, 17-10-2020, Taylor & Francis Online https://www.tandfonline.com/toc/imte20/current?gclid=EAIaIQobChMI4bTGiZrs7wIVSBV7Ch3GzAAbEAAYASAAEgKAMfD_BwE CC-BY-NC-ND With an increasingly ageing population there will be a rising demand for palliative care, including from older migrants and ethnic minorities. While many (future) physicians are unfamiliar with specific needs of older migrants and ethnic minorities regarding care and communication in palliative care, this may be challenging for them to deal with. Moreover, even many medical teachers also feel unprepared to teach palliative care and culturally sensitive communication to students. In order to support medical teachers, we suggest twelve tips to teach culturally sensitive palliative care to guide the development and implementation of teaching this topic to medical students. Drawn from literature and our own experiences as teachers, these twelve tips provide practical guidance to both teachers and curriculum designers when designing and implementing education about culturally sensitive palliative care.
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Background to the problem Dutch society demonstrates a development which is apparent in many societies in the 21st century; it is becoming ethnically heterogeneous. This means that children who are secondlanguage speakers of Dutch are learning English, a core curriculum subject, through the medium of the Dutch language. Research questions What are the consequences of this for the individual learner and the class situation?Is a bi-lingual background a help or a hindrance when acquiring further language competences. Does the home situation facilitate or impede the learner? Additionally, how should the TEFL professional respond to this situation in terms of methodology, use of the Dutch language, subject matter and assessment? Method of approach A group of ethnic minority students at Fontys University of Professional Education was interviewed. The interviews were subjected to qualitative analysis. To ensure triangulation lecturers involved in teaching English at F.U.P.E. were asked to fill in a questionnaire on their teaching approach to Dutch second language English learners. Thier response was quantitatively and qualitatively analysed. Findings and conclusions The students encountered surprisingly few problems. Their bi-lingualism and home situation were not a constraint in their English language development. TEFL professionals should bear the heterogeneous classroom in mind when developing courses and lesson material. The introduction to English at primary school level and the assessment of DL2 learners require further research.
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Many developers are aware that introducing more diversity can make their games more interesting. But even the biggest and the most progressive studios, such as BioWare (Mass Effect Andromeda) or Beamdog (Baldur’s Gate: Siege of Dragonspear) often stumble when trying to represent minorities. Our panelists will think about how to write games, and whom and how they should be consulted with to avoid turning the other into a token or a comic relief. They will also discuss this year’s hit productions – The Last of Us II, Hades, Tell Me Why – whose authors have displayed high levels of sensitivity.
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Titel: The Exodus from the Netherlands or Brain Circulation: Push and Pull Factors of Remigration among Highly Educated Turkish Dutch Auteurs: Gürkan Çelik and Ton Notten In: European Review, 22 (3), 2014, pp. 403-413 The exodus from the Netherlands or brain circulation: Push and pull factors of remigration among highly educated Turkish-Dutch An increasing number of Turks, the Netherlands’ largest ethnic minority, are beginning to return to their country of origin, taking with them the education and skills they have acquired abroad, as the Netherlands faces challenges from economic difficulties, social tension and increasingly powerful right wing parties. At the same time Turkey’s political, social and economic conditions have been improving, making returning home even more appealing for Turkish migrants at large. This article gives explanations about the push and pull factors of return migration. The factors influencing return to one’s country of origin are “pulls”. It is assumed that remigration is more affected by positive developments in the country of origin than by negative developments in the country of residence. Civil society, business world and the Dutch government can develop policies to bind these capable people to the Netherlands, at least in the form of “brain circulation” so that they can serve as “bridge builders” between the two countries. Keywords Return migration, integration, Turkish-Dutch, Turkish migrants, brain circulation =============================================================================== SAMENVATTING De uittocht uit Nederland of breincirculatie: Push- en pull-factoren van remigratie onder hoogopgeleide Turkse Nederlanders. In Nederland zien we een lichte toename van het aantal Turken, de grootste etnische minderheidsgroep in Nederland, die terugkeren naar hun land van herkomst. Ze exporteren daarmee goede opleidingen en vaardigheden die ze in Nederland verwierven. De oorzaken: de economische neergang, sociale spanningen en de groeiende invloed van extreemrechtse partijen. Tegelijkertijd verbeteren in Turkije de politieke, sociale en economische omstandigheden die steeds meer aantrekkingskracht uitoefenen op immigranten in dat land. Dit artikel gaat in op de push- and pull-factoren voor remigranten. Pull-factoren beinvloeden iemands terugkeer naar zijn land van herkomst. Aangenomen wordt dat zo’n remigratie sterker wordt bevorderd door positieve ontwikkelingen in het land van herkomst dan door negatieve (push-factoren) in het land waar men op dat moment woont. De civil society, het bedrijfsleven en de Nederlandse overhead kunnen een beleid ontwikkelen dat verdienstelijke inwoners weet te behouden, hen op z’n minst kan inschakelen als bruggenbouwers en aldus kenniscirculatie mogelijk maakt tussen beide landen. Trefwoorden Retourmigratie, integratie, Turkse Nederlanders, Turkse migranten, kenniscirculatie, breincirculatie
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Qualitative and quantitative research methods were used to establish the role of the website in the educational process of Bedrijfsmanagement MKB students, and the use of the website in the student recruitment process.
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