Calls for greater diversity, especially in relation to the appointment of arbitrators, have been prevalent for some time in the international arbitration community, followed by several initiatives being set up to address the issue. While the primary focus of the diversity debate has been on gender, there have also been calls to expand and diversify the profile of the arbitrator pool to include more non-Western and non-White arbitrators. For several years, scholars and practitioners have argued for countless benefits of increased racial diversity, such as an increased acceptability and legitimacy of the arbitration process. There is a consensus that in a deliberative process like ADR, practitioners should reflect their claimants’ demographics. The existence of diverse panels helps further the aims of meticulous and accurate fact-finding approaches. Similarly, they argue that the lack of racial diversity may directly and negatively affect the quality of arbitration awards. This blog post will focus on the lack of diversity of African arbitrators appointed to resolve international arbitration proceedings, as well as initiatives that are being set up to address such issues. The focus on African ethnicity is given for two reasons: 1) African countries are no strangers to arbitration. Nearly 100 arbitral institutions exist across Africa. 2) There has been an increase of arbitration proceedings emanating from African regions, while there has been a minimal growth in the ethnic diversity of arbitrators appointed to resolve these disputes. This article was originally published on https://commercialarbitrationineurope.wordpress.com/2021/06/29/diversity-in-arbitration-the-lack-of-racial-diversity-in-international-arbitral-tribunals/
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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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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.
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Background: Recent studies suggest that ethnic minority students underperform in standardised assessments commonly used to evaluate their progress. This disparity seems to also hold for postgraduate medical students and GP trainees, and may affect the quality of primary health care, which requires an optimally diverse workforce. Aims: To address the following: 1) to determine to what extent ethnic minority GP trainees are more at risk of being assessed as underperforming than their majority peers; 2) to investigate whether established underperformance appears in specific competence areas; and 3) to explore first and second-generation ethnic minority trainees’ deviations. Design & setting: Quantitative retrospective cohort design in Dutch GP specialty training (start years: 2015–2017). Method: In 2020–2021, the authors evaluated files on assessed underperformance of 1700 GP trainees at seven Dutch GP specialty training institutes after excluding five opt-outs and 165 incomplete datasets (17.4% ethnic minority trainees). Underperformance was defined as the occurrence of the following, which was prompted by the training institute: 1) preliminary dropout; 2) extension of the educational pathway; and/or 3) mandatory coaching pathways. Statistics Netherlands (CBS) anonymised the files and added data about ethnic group. Thereafter, the authors performed logistic regression for potential underperformance analysis and χ2 tests for competence area analysis. Results: Ethnic minority GP trainees were more likely to face underperformance assessments than the majority group (odds ratio [OR] 2.41, 95% confidence interval [CI] = 1.67 to 3.49). Underperformance was not significantly nested in particular competence areas. First-generation ethnic minority trainees seemed more at risk than their second-generation peers. Conclusion: Ethnic minority GP trainees seem more at risk of facing educational barriers than the majority group. Additional qualitative research on underlying factors is essential.
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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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This article is based on ethnographic research over recent years in eight Dutch police teams. It focuses on the othering process in which police officers define ‘crooks’ as the Other and chase, catch and arrest them. Catching crooks is perceived as an assignment as well as a game. Street cops construct detailed subcategories of the crook which influence their daily practices. They select crooks by recognition (the permanent suspects), by abnormalization (out of placeness) and by profiling (regardless of place). In addition to the discussion on ethnic profiling, we argue that profiling is a contextual practice. The contents of the profiles depend on the demographic characteristics of the district in which a police team operates. Interacting mediaframes of both the crook and the police reinforce the mutual caricatures and tense relationships.
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Een jongerennetwerk is een plek waar jongeren sociale contacten kunnen opdoen en onderlinge steun krijgen. Ook zorgt commissie- en bestuurswerk voor een groei van hun persoonlijke, professionele vaardigheden. Tijdens de eindconferentie deelde lectoraat Diversiteitsvraagstukken inzichten over hoe de deelname van jongeren aan een netwerk of community bij kan dragen aan het realiseren van hun toekomst. Ze leerden hoe deelname aan een jongerennetwerk bijdraagt aan een positief zelfbeeld, een positieve identiteit en het versterken van ambities. Hierdoor krijgen zij de kracht om vol zelfvertrouwen een plek te vinden binnen de onderwijs- of arbeidsomgeving.
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Overbruggend sociaal kapitaal door middel van sport: Een exploratief onderzoek naar (het verbeteren van) inter-etnische contacten bij twee voetbalverenigingen in Nederland In Nederland staat de sociale integratie van minderheden de laatste jaren ter discussie. Gebeurtenissen uit het verleden, zoals de moord op politicus Pim Fortuyn en publicist Theo van Gogh, en meer recent de opmars van internationale organisaties als Islamitische Staat (IS), hebben grote impact op het maatschappelijke debat in Nederland. Desalniettemin is het geloof in de sociaal integratieve functie van sport in Nederland niet afgenomen. Van sport, en dan vooral van sportdeelname binnen verenigingsverband, wordt verwacht dat het een positieve bijdrage levert aan de sociale cohesie en sociale integratie van minderheden. Uit onderzoek weten we al langer dat beleidsmakers de sociaal integratieve functie van sport overschatten. Sport is geen wondermiddel. Sport brengt mensen samen, maar kan mensen ook uitsluiten door het samenbrengen van gelijkgestemden. In dit artikel verkennen we of (en hoe) sport, en dan met name voetbal, kan leiden tot overbruggend sociaal kapitaal (“bridging social capital”), ondanks dat mensen vooral sporten met gelijkgestemden. We baseren onze resultaten op enquêtes en een beperkt aantal aanvullende interviews bij twee voetbalverenigingen in de stad Utrecht. We concluderen dat ondanks dat sport segregatie bevordert, er binnen sportverenigingsverband een ontwikkeling is van sociale inclusie en interetnische contacten. Het onderzoek geeft aan dat extra voorwaarden kunnen worden gecreëerd om begrip en onderling respect te vergroten
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Social work in the Netherlands is attracting an increasing number of Turkish and Moroccan Dutch professionals, mostly second-generation migrant women from a Muslim background. Inspired by Amartya Sen’s capability approach, this article presents the findings of a qualitative content analysis of 40 interviews with professionals by peers from the same background. The question is, what kind of professionals do these newly started social workers desire to be and what hindrances do they encounter? The professionals challenge the dominance of Western beliefs and values. This becomes tangible in their desires and constraints and especially in the process of choice.
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