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Ethnic Differences in Colon Cancer Care in the Netherlands

Background Ethnic differences in colon cancer (CC) care were shown in the United States, but results are not directly applicable to European countries due to fundamental healthcare system differences. This is the first study addressing ethnic differences in treatment and survival for CC in the Netherlands. Methods Data of 101,882 patients diagnosed with CC in 1996–2011 were selected from the Netherlands Cancer Registry and linked to databases from Statistics Netherlands. Ethnic differences in lymph node (LN) evaluation, anastomotic leakage and adjuvant chemotherapy were analysed using stepwise logistic regression models. Stepwise Cox regression was used to examine the influence of ethnic differences in adjuvant chemotherapy on 5-year all-cause and colorectal cancer-specific survival. Results Adequate LN evaluation was significantly more likely for patients from ‘other Western’ countries than for the Dutch (OR 1.09; 95% CI 1.01–1.16). ‘Other Western’ patients had a significantly higher risk of anastomotic leakage after resection (OR 1.24; 95% CI 1.05–1.47). Patients of Moroccan origin were significantly less likely to receive adjuvant chemotherapy (OR 0.27; 95% CI 0.13–0.59). Ethnic differences were not fully explained by differences in socioeconomic and hospital-related characteristics. The higher 5-year all-cause mortality of Moroccan patients (HR 1.64; 95% CI 1.03–2.61) was statistically explained by differences in adjuvant chemotherapy receipt. Conclusion These results suggest the presence of ethnic inequalities in CC care in the Netherlands. We recommend further analysis of the role of comorbidity, communication in patient-provider interaction and patients’ health literacy when looking at ethnic differences in treatment for CC.

Inclusive Dialogues: WokeBot Engaging Diversity Dilemmas

In today's world, understanding different viewpoints is key for societal cohesion and progress. Robots have the potential to provide aid in discussing tough topics like ethnicity and gender. However, comparably to humans, the appearance of a robot can trigger inherent prejudices. This study delves into the interplay between robot appearance and decision-making in ethical dilemmas. Employing a Furhat robot that can change faces in an instant, we looked at how robot appearance affects decision-making and the perception of the robot itself. Pairs of participants were invited to discuss a dilemma presented by a robot, covering sensitive topics of ethnicity or gender. The robot either adopted a first-person or third-person perspective and altered its appearance accordingly. Following the explanation, participants were encouraged to discuss their choice of action in the dilemma situation. We did not find significant influences of robot appearance or dilemma topic on perceived anthropomorphism, animacy, likeability, or intelligence of the robot, partly in line with previous research. However, several participants hearing the dilemma from a first-person perspective changed their opinion because of the robot's appearance. Future work can expand with different measures such as engagement, in order to shed light on the intricate dynamics of human-robot interaction, emphasizing the need for thoughtful consideration in designing robot appearances to promote unbiased engagement in discussions of societal significance

Ethnicity and socioeconomic status are related to dietary patterns at age 5 in the Amsterdam born children and their development (ABCD) cohort

Urban Stories

This paper will query whether a dedicated news platform can attune to young people’s civic needs? That is to ask: can this be a space that follows a social media logic of conversation and ‘give and take’ – with producers and consumers changing roles or even losing the distinction? How could and would such a news source be of interest to urban young, arguably the group that feels most removed from citizen status and social acceptance for who they happen to be? ‘Urban youth’ for us refers to a very specific group of young people. They are Marokko.nl’s community members. As the name suggests a fair number of them will consider themselves to be Moroccan-Dutch. From our perspective it is important to understand this group as identifying with ethnic minority groups in the Netherlands, although most of them will have been born in the Netherlands and hold Dutch citizenship. More than other young people they will recognize Islam as the religion they feel closest to. They also share a sense, as will become clear below, that they are caught ‘between two worlds’ (Elias and Lemish, 2008; Singla, 2004; Gezduci and D’Haenens, 2010). Mainstream Dutch media cast preciously few actors, anchors, audience members and experts from ethnic minority groups. Not surprisingly, this is often given as a reason to distrust hegemonic media and as underlining a sense of distance and alienation from Dutch society (see also Awad and Roth, 2011: 401).

Care and decision-making at the end of life for migrants living in the Netherlands

As migrant populations age, the care system is confronted with the question how to respond to care needs of an increasingly diverse population of older adults. We used qualitative intersectional analysis to examine differential preferences and experiences with care at the end of life of twenty-five patients and their relatives from Suriname, Morocco and Turkey living in The Netherlands. Our analysis focused on the question how–in light of impairment–ethnicity, religion and gender intersect to create differences in social position that shape preferences and experiences related to three main themes: place of care at the end of life; discussing prognosis, advance care, and end-of-life care; and, end-of-life decision-making. Our findings show that belonging to an ethnic or religious minority brings forth concerns about responsive care. In the nursing home, patients’ minority position and the interplay thereof with gender make it difficult for female patients to request and receive responsive care. Patients with a strong religious affiliation prefer to discuss diagnosis but not prognosis. These preferences are at interplay with factors related to socioeconomic status. The oversight of this variance hampers responsive care for patients and relatives. Preferences for discussion of medical aspects of care are subject to functional impairment and faith. Personal values and goals often remain unexpressed. Lastly, preferences regarding medical end-of-life decisions are foremost subject to religious affiliation and associated moral values. Respondents’ impairment and limited Dutch language proficiency requires their children to be involved in decision-making. Intersecting gendered care roles determine that mostly daughters are involved. Considering the interplay of aspects of social identity and their effect on social positioning, and pro-active enquiry into values, goals and preferences for end-of-life care of patients and their relatives are paramount to achieve person centred and family-oriented care responsive to the needs of diverse communities.

Involving parents to help improve children’s energy balance-related behaviours through a school-based intervention

The Challenge Me intervention aimed to indirectly involve parents in a school-based intervention, by challenging primary school children to perform physical activity (PA) and nutrition-related activities with their parents. The aim of this study is to gain insight in whether this was a feasible strategy to engage children and parents, especially those of vulnerable populations. An exploratory cross-sectional study design was applied. Four primary schools implemented the intervention. Data consisted of challenges completed (intervention posters) and child and family characteristics (questionnaires and anthropometric measurements). Associations between challenges performed and child and family characteristics were assessed using linear regression analysis. Of the 226 study participants, 100% performed at least one challenge, and 93% performed at least one challenge involving parents. Children who performed more PA challenges were often younger, a sports club member, lived in higher socioeconomic status neighbourhoods, of Western ethnicity and from larger families. Regarding nutrition challenges involving parents, younger children performed more challenges. There was no difference in intervention engagement regarding gender, weight status, PA preference, healthy nutrition preference, or the Family PA and Family Nutrition Climate. Challenge Me has potential in involving parents in a school-based intervention. However, certain characteristics were associated with higher involvement