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The consequences of physical attractiveness (PA) are ubiquitous, however not often become a topic of discussion. The consequences, in general, are attributed to preference or discrimination without much deliberation. There is a very thin line between the two. The study makes an attempt to distinguish between preference and discrimination based on PA. In an organizational context, this distinction seems warranted since PA does impact work-related outcomes. The distinction was addressed by examining published studies between 1970 and 2021 on PA in the management and economics field of research. The study highlights when and how preference turns into discrimination and furthers discusses the causes of such discrimination. The causes are equivalent to antecedents; the antecedent to being physically attractive is mostly genes. The antecedents to the discrimination are the attributions that we have associated with being physically attractive. The study highlights these attributions and the reasons for these attributions. To completely understand a phenomenon, it is essential to understand what causes it. Therefore, this study tries to understand what causes discrimination based on PA. The study has implications for diversity and inclusion literature and practice. It also adds to the literature on PA., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: Women in our modern era are facing considerable challenges in the workplace, particularly in Cardiothoracic Surgery where women are underrepresented in leadership and academic roles. Returning to work after parental leave may potentially uncover or exacerbate existing gender biases within the workplace, with important consequences on professional and personal lives. Our goal was to characterize the experiences and the impact of return-to-work after parenting on Thoracic Surgery careers across Europe., Methods: All the participants to the European Society of Thoracic Surgeons Annual Meeting in 2023 were invited to complete this 32-items questionnaire. The Survey was subsequently distributed through the ESTS social media platform from November to January 2024. A descriptive and specific group analysis was performed according to the distribution., Results: There were 152 participants, 92 of whom were female (61.0%) and 66 (43%) were between 31 and 40 years, constituting the most heavily represented age group. More women parents reported their role as the primary care provider of their child (89% vs 34%; P < 0.00001). Moreover, presence of In-Hospital childcare facilities was evaluated as more important by women. Approximately half of the parent-respondents reported breastfeeding (42, 52%), but only 26% (11) of this group indicated having any type of flexible hours for breast-feeding. Compared to men, women more often agreed that parenting might affect their career (81% vs 53%; P = 0.040) and felt less supported by their employers when having children (45% vs 68%; P = 0.37)., Conclusions: This survey study identified main challenges to return to surgical work after parental leaves. Lack of structural or system-level support, and limited resources for childcare and breastfeeding were considerably affecting women surgeons. Institutional initiatives for new parents and breast-feeding colleagues are crucial for supporting a diverse workforce and any kind of discrimination derived by parental leaves should not be tolerated., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)

Background: The benefits of randomised trials are not shared equally, and people from ethnic minority groups are a key constituency under-served by clinical research and clinical care. The STRIDE project aimed to give trialists practical information about how to decide which ethnic groups should be in their trials, and at what proportion., Methods: We considered trials in six clinical areas: cancer, cardiovascular, diabetes, maternal health, mental health, and smoking cessation. We created a summary for each, including participants-intervention-comparators-outcomes, and data on disease prevalence by ethnicity. These were discussed with panels with clinical expertise, trial and methodology expertise, lived experience, funding, and experience of working with and on behalf of ethnic communities. For each trial, we asked panel members to decide which ethnic groups should have been involved and at what proportion., Results: We discussed 23 trials with 40 individual panel members. Panels found our questions difficult to answer. The lack of publicly available data on prevalence by ethnicity was central to this. Where data were available, decision-making was easier but not simple. The discussions led to eight STRIDE recommendations. We recommend that discussions involve diverse teams and that discussions need time, with access to the best available data. In the absence of data or consensus, we recommend the adoption of 'default' minimum rates of inclusion, with oversampling considered. These discussions should inform site selection, and the practical challenges of recruitment and retention should not determine which groups are to be included. We also suggest five policy initiatives to support implementation of the recommendations. Broadly, these are (1) funders need to signal that ethnic diversity is expected, (2) trial teams need access to better data, (3) funders and others need to signal that ethnic diversity means better science, (4) more funding is needed for evaluation, and (5) Good Clinical Practice training should cover ethnic diversity., Conclusions: Agreeing targets for which ethnic groups to involve in a trial is essential but difficult. Our eight recommendations could help to make trials more ethnically diverse if followed, and we suggest five policy initiatives that would create a supportive environment for their implementation., Competing Interests: Declarations Ethics approval and consent to participate Ethics approval was not required for this work. Members of the public who took part did so as patient and public partners helping to drive and shape the work, not as research participants. Consent for publication Not applicable for this article. Competing interests KK is Director for Centre for Ethnic Health Research, University of Leicester, UK. ST is an Editor-in-Chief of Trials. All other authors declare no competing interests., (© 2024. The Author(s).)

Background: Artificial Intelligence (AI) in the selection of residency program applicants is a new tool that is gaining traction, with the aim of screening high numbers of applicants while introducing objectivity and mitigating bias in a traditionally subjective process. This study aims to compare applicants screened by an AI software to a single Program Director (PD) for interview selection., Methods: A single PD at an ACGME-accredited, academic general surgery program screened applicants. A parallel screen by AI software, programmed by the same PD, was conducted on the same pool of applicants. Weighted preferences were assigned in the following order: personal statement, research, medical school rankings, letters of recommendation, personal qualities, board scores, graduate degree, geographic preference, past experiences, program signal, honor society membership, and multilingualism. Statistical analyses were conducted by chi-square, ANOVA, and independent two-sided t-tests., Results: Out of 1235 applications, 144 applications were PD-selected and 150 AI-selected (294 top applications). Twenty applications (7.3%) were both PD and AI selected for a total analysis cohort of 274 prospective residents. We performed two analyses: 1) PD-selected vs. AI-selected vs. Both and 2) PD-selected vs. AI-selected with the overlapping applicants censored. For the first analysis, AI selected significantly: more White/Hispanic applicants (p < 0.001), less signals (p < 0.001), more AOA honors society (p = 0.016), and more publications (p < 0.001). When censoring overlapping PD and AI selection, AI selected significantly: more White/Hispanic applicants (p < 0.001), less signals (p < 0.001), more US medical graduates (p = 0.027), less applicants needing visa sponsorship (p = 0.01), younger applicants (p = 0.024), higher USMLE Step 2 CK scores (p < 0.001), and more publications (p < 0.001)., Conclusions: There was only a 7% overlap between PD-selected and AI-selected applicants for interview screening in the same applicant pool. Despite the same PD educating the AI software, the 2 application pools differed significantly. In its present state, AI may be utilized as a tool in resident application selection but should not completely replace human review. We recommend careful analysis of the performance of each AI model in the respective environment of each institution applying it, as it may alter the group of interviewees., (Copyright © 2024 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Purpose: The diversity of authors in orthopaedic literature is fundamental to the distribution of unique discoveries, innovations, and advancements. The purpose of the current study was to create and validate a comprehensive Author Diversity Scoring System (ADSS) to quantify authorship diversity in orthopaedic manuscripts., Methods: Six items were included in the initial ADSS. The ADSS and associated survey were sent to 120 experts to evaluate the clarity, simplicity, and relevancy its components. Responses were used to validate the ADSS using Content Validity Ratio (CVR) and Content Validity Index (CVI)., Results: The initial ADSS contained author gender, ethnicity, academic rank/title, country of origin of the article, affiliated institution, and the publication history of the senior/corresponding author as representative items. Subsequently, 21 experts completed the survey (response rate 17.5%). Following validation, the final ADSS included author gender, ethnicity, and region of article origin, scored cumulatively on a 0-30 point scale with increasing scores indicating greater author diversity., Conclusion: The validated ADSS scoring system quantitatively assesses manuscript author diversity., (© 2024. The Author(s) under exclusive licence to SICOT aisbl.)

Objectives: The relationship between the onset of the COVID-19 pandemic and interest in master of public health (MPH) programs is unknown. We examined trends in MPH application rates for 31 MPH concentrations and specifically for the MPH concentration in epidemiology and differences by race and ethnicity before and after the onset of the COVID-19 pandemic., Methods: We constructed a quasi-experimental design to examine trends in MPH application rates from academic years 2015-2016 through 2022-2023 by using Centralized Application Service for Schools and Programs of Public Health data. We used an interrupted time-series analysis to test whether application rates surged after the pandemic's onset (academic years 2019-2020 through 2020-2021) and whether this increase persisted during the pandemic (academic years 2020-2021 through 2022-2023). We fit models for the overall sample, a combined racially and ethnically minoritized sample, each racial and ethnic group separately, and a non-US citizen sample., Results: The pandemic's onset correlated with an immediate increase in application rates across most samples: overall (38%) and among American Indian/Alaska Native/Native Hawaiian/Pacific Islander (91%), Asian (35%), Black (42%), Hispanic (60%), multiracial (30%), racially and ethnically minoritized (44%), and White (53%) samples. However, this trend was not sustained; application rate trends during the pandemic were significantly lower than prepandemic trends. Application rate trends for all MPH concentrations and the MPH in epidemiology concentration among non-US citizens were significantly higher during the pandemic than prepandemic., Conclusions: Our results highlight the need for innovative strategies to sustain MPH degree interest and a diverse applicant pool., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background While student entrepreneurial interest is significantly correlated with the intention to pursue innovative healthcare ventures, many medical schools lack formal programs to nurture entrepreneurial skills. To investigate student interest in entrepreneurship and their experiences with medical innovation, the Biomedical Entrepreneurship Network at Rutgers Robert Wood Johnson Medical School engaged students nationally in a Healthcare Innovation Summit , featuring a keynote address, pitch competition, and interactive workshops with accomplished innovators. Methods A Rutgers electronic Institutional Review Board (eIRB)-approved survey was disseminated to student attendees at the summit, with questions categorized into four themes: interest/motivation, barriers to ideation and execution, support for innovation, and confidence in entrepreneurial pursuits. Responses were quantified using a Likert scale, and qualitative feedback was thematically analyzed. Results Among the 54 respondents, 100% exhibited a significant interest in healthcare entrepreneurship. Students cited the following barriers: inaccessible resources (44%), insufficient funding (51%), lack of mentorship (60%), and time limitations (82%). The quantitative thematic analyses demonstrated that students desired formal education on pursuing innovation and dedicated assistance to foster critical thinking. While students were confident in their ability to pursue entrepreneurship, they were not confident in the necessary details required for successful endeavors and avenues for mentorship. Conclusions Pursuing healthcare entrepreneurship presents numerous barriers for medical students. Integrating formal entrepreneurship education - emphasizing mentorship and connection between medical students and postgraduate trainees, funding, and critical innovative thinking - into medical curricula can empower students in the pursuit of innovation-based projects and positive change throughout their careers, enhancing access, equity, and quality of healthcare., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Rutgers Institutional Review Board issued approval 2022002082. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Patel et al.)

Despite much research on improving intergroup relations, the evidence for long-term effects in real-world settings is mixed. We used the social marketing approach to create an "Inclusivity Page" that could be added to course syllabi. The page contained three targeted pro-diversity messages based on social norms, personal benefits, and concrete behavioral recommendations. We tested our intervention in a large randomized controlled trial in university classrooms ( N students = 1,799). We obtained students' course grades and overall college GPAs several years later. A subset of students also completed an outcome survey three months after the intervention. Students from underrepresented racial groups exposed to the intervention early in college had better course grades and GPAs. We also observed an enhanced sense of belonging and better emotional and physical health among students from all marginalized groups. Our research demonstrates the utility of employing a targeted approach to improve experiences of members of marginalized groups., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction Gender and sexually diverse (GSD) individuals disproportionately experience worse outcomes, bias, discrimination, and inequities in their care. Many avoid seeking healthcare due to fear of discrimination and mistreatment. One method for improvement focuses on specific GSD medical care training for undergraduate medical education (UME) learners. Efforts to standardize GSD care in UME are present, as displayed by the competencies put forth by the Association of American Medical Colleges (AAMC); however, these attempts resulted in broad themes that can be challenging to implement. The need for specific and easily implementable learning objectives exists. Methods We aimed to create a set of learning objectives specific to GSD care by utilizing the Delphi Method to develop consensus. Three hundred and seventy-nine individuals were invited to participate in this study, which involved four iterative rounds of expert participation. In round one, the expert panel received an initial questionnaire comprising published learning competencies and items. The panel was requested to review and propose additional items. The research team then consolidated and structured these items into learning objectives. In round two, the expert panel was asked to review these objectives and edit language to reflect appropriate, inclusive language. In round three, the expert panel was asked to rate the importance of each learning objective using a 5-point Likert scale (1 =not at all important; 5 =extremely important). In round four, experts were given the overall panel's mean and mode rating for each objective, reminded of their rating, and asked to make a final rating. Learning objectives rated 4 or 5 ("very important" or "extremely important") by at least 80% of experts were determined to be at consensus. The researchers then further examined objectives that had 100% respondent rating of either 4 or 5, thus achieving universal consensus by our expert panel. Results Although 59 individuals agreed to participate in the study, 31 individuals engaged in at least one round of the iterative process as part of the expert panel. The initial questionnaire comprised 30 competencies published by the AAMC and 32 published overlapping learning items. After round two, 79 learning objectives were created. This process eliminated 28 objectives, resulting in 51 succinct objectives that used inclusive and patient-centered language. Conclusion These learning objectives can easily be integrated into existing curricular structures in UME. They can be utilized to improve curricular education for future health professionals, with the final goal of improving health equity for GSD individuals., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. University of Utah issued approval 0. University of Utah IRB deemed our research as being exempt of the need for approval. . Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Reynolds et al.)

Background: This study aims to understand the demographic representation of patients in Traumatic Brain Injury (TBI) clinical trials by evaluating the proportions of patients from various demographic categories amongst completed TBI clinical trials in the United States., Methods: ClinicalTrials.gov was queried for active TBI clinical trials. One hundred and eight completed trials in the United States were selected based on inclusion criteria, and information regarding intervention, setting, age, sex, race, and ethnicity was extracted. 2002-2006 TBI incidence data was obtained from the CDC. Chi-squared testing was applied to analyze the relationship between distributions of race and sex in the collected clinical trials and the national TBI data, and logistic regression was conducted to identify variables that may predict reporting of race or ethnicity., Results: About 53.7% of selected clinical trials reported racial data and 34.3% reported ethnicity data. Logistic regression identified that clinical trials in defined phases were more likely to report racial data ( p = 0.047 [1.015, 9.603])., Conclusion: Current TBI trials do not consistently report race or ethnicity data. Future efforts to ensure equitable representation in clinical trials may involve reform of recruitment processes and accountability measures implemented within the grant application process to ensure proper racial and ethnicity data reporting.

Recruiting and retaining a diverse veterinary team requires intentionality. Without it, diversity initiatives often fall by the wayside. Implicit and explicit biases can occur at every stage of recruiting. To prevent them from disenfranchising candidates from historically devalued groups, it is important to enact best practices and policies. To prevent attrition, the work environment must be meticulously audited and primed to receive candidates from different backgrounds. Diverse teams outperform homogenous teams, but to unlock all the benefits of diversity, the work environment must be inclusive and have diverse leadership., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Black individuals are historically underrepresented in oncology clinical trials. One potential reason for this is the prevalence of kidney disease in Black individuals, utilization of estimated creatinine clearance as a surrogate for glomerular filtration rate (GFR) in oncology, and GFR-based trial eligibility criteria. We characterized the representation of racial minorities in anticancer agent pivotal trials and examined if GFR-based trial eligibility criteria impact the proportion of Black individuals in trial populations., Methods: We constructed a data repository for anticancer drugs FDA-approved from 2015 to 2019 and associated pivotal trials, from which we extracted trial population racial compositions and GFR-based trial eligibility criteria. We calculated the participation-to-incidence ratio (PIR) and participation-to-mortality ratio (PMR) for a variety of cancer sites, where PIR or PMR >1.2 and <0.8 indicate overrepresentation and underrepresentation, respectively. We evaluated the relationship between GFR eligibility cutoffs and the proportion of Black enrollees with Spearman rank correlation coefficient., Results: We assessed 24,698 patients in 74 trials. Black individuals were underrepresented in all trials (PIR ≤0.48, PMR ≤0.50). For trials with GFR-based eligibility criteria (n = 49), a lower GFR cutoff was modestly associated with a higher proportion of Black enrollees (r = -0.29, p = 0.039). This relationship was strengthened for trials that only used estimated creatinine clearance to estimate GFR (r = -0.43, p = 0.004)., Conclusions: GFR-related eligibility, and specifically the use of estimated creatinine clearance, may contribute to Black individuals being disproportionately excluded from cancer clinical trials. This highlights the need for implementation of contemporary GFR equations and other interventions to boost racial minority trial enrollment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The underrepresentation of women in leadership remains a pervasive issue, prompting a critical examination of support mechanisms within professional settings. Previous studies have identified challenges women face, ranging from limited visibility to barriers to career advancement. This survey aims to investigate perceptions regarding the effectiveness of women's leadership programs, mentoring initiatives, and a specialized communication course. Particularly it specifically targets addressing the challenges encountered by professional women., Methods: This multi-center, observational, international online survey was developed in partnership between ESICM NEXT and the ESICM Diversity and Inclusiveness Monitoring Group for Healthcare. Invitations to participate were distributed to both females and men through emails and social networks. Data were collected from April 1, 2023, through October 1, 2023., Results: Out of 354 respondents, 90 were men (25.42%) and 264 were women (74.58%). Among them, 251 completed the survey, shedding light on the persistent challenges faced by women in leadership roles, with 10%-50% of respondents holding such positions. Women's assertiveness is viewed differently, with 65% recognizing barriers such as harassment. Nearly half of the respondent's experience interruptions in meetings. Only 47.4% receiving conference invitations, with just over half accepting them. A mere 12% spoke at ESICM conferences in the last three years, receiving limited support from directors and colleagues, indicating varied obstacles for female professionals. Encouraging family participation, reducing fees, providing childcare, and offering economic support can enhance conference involvement. Despite 55% applying for ESICM positions, barriers like mobbing, harassment, lack of financial support, childcare, and language barriers were reported. Only 14% had access to paid family leave, while 32% benefited from subsidized childcare. Participation in the Effective Communication Course on Career Advancement Goals and engagement in women's leadership and mentoring programs could offer valuable insights and growth opportunities. Collaborating with Human Resources and leadership allies is crucial for overcoming barriers and promoting women's career growth., Conclusions: The urgency of addressing identified barriers to female leadership in intensive care medicine is underscored by the survey's comprehensive insights. A multifaceted and intersectional approach, considering sexism, structural barriers, and targeted strategies, is essential., (© 2024. The Author(s).)

Recent events, such as the COVID-19 pandemic, have drawn nationwide attention to systemic racism as a serious threat to public health in Canada. One promising approach to address such racism is through developing and implementing standardized procedures for collecting and using disaggregated, race-based data. In this commentary, we summarize why this approach is necessary to address systemic racism in Canada, and highlight municipal actions being taken in Edmonton, Alberta, to move this approach forward. In 2021, a Race-based Data Table, comprising 24 institutions and organizations affiliated with health, education, and policing systems, was formed in Edmonton. It aimed to engage practitioners, systems representatives, academics, and community members in collective advocacy around accessing race-based data to better understand and address disparate health outcomes associated with COVID-19 for racialized communities. Further, the Table intends to co-create a charter and toolkit outlining best practices for ethical, race-based data collection and use with local stakeholders and knowledge users. In documenting the beginning stages of the Table, and in evaluating its ongoing progress, we contribute to national conversations regarding the need for government institutions and other organizations to consistently collect and use race-based data as a means of increasing transparency and accountability in their actions., (© 2024. The Author(s) under exclusive license to The Canadian Public Health Association.)

Equity, diversity, and inclusion (EDI) and anti-oppression (AO) policies are implemented in research to address intersecting systemic barriers for marginalized populations. Grant applications now include questions about EDI to ensure researchers have considered how research designs perpetuate discriminatory practices. However, complying with these measures may not mean that researchers have engaged with AO as praxis. Three central points emerged from our work as a women's research collective committed to embedding AO practices within the research methodology of our community-based study. First, research ideas must be connected to larger pursuits of AO in and across marginalized communities. Secondly, AO as praxis in the research design is an exercise in centering cultural knowledge and pragmatic research preparation and response that honours the collective. Lastly, AO approaches are not prescriptive. They must shift, adapt, and change based on the research project and team, creating space for transformative resistance and emancipation of racialized researchers and community workers., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Objective: To provide an updated evaluation of otolaryngology residency program websites during a socially distanced application cycle. Criteria were selected to evaluate for level of comprehensiveness, new content accommodating a virtual interview cycle, and stated commitment to diversity and inclusion., Study Design: Review of otolaryngology residency program websites., Setting: Online websites between December 2020 and January 2021., Methods: Otolaryngology residency program websites were evaluated for selected criteria. Programs were categorized by geographic location, size, and Doximity rankings. Differences between groups were analyzed using Student's t-test and analysis of variance with a significance level of P < .05., Results: 118 otolaryngology residency program websites contained a mean (SD) of 16.3 (4.7) of 31 criteria (52.6%). Fewer than one third included virtual/video tours of facilities or the surrounding area. Only 33% had a stated commitment to diversity and inclusion. There was no difference in number of criteria included when categorized by geographic location ( P = .22). Larger programs (17.9 vs 14.5, P < .001) and programs ranked in the top 50 by Doximity (17.7 vs 15.2, P = .003) included a significantly greater number of criteria., Conclusion: While the comprehensiveness of otolaryngology residency program websites has improved, considerable room for improvement remains. Programs should strive to maintain updated websites that highlight training opportunities, program culture, and commitment to diversity and inclusion. Programs also should consider prioritizing the development of new online resources that may be especially useful to applicants during a virtual interview cycle., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Abuse, bullying, harassment, and discrimination are prominent workplace occurrences within cardiothoracic (CT) surgery that cause burnout and threaten the well-being of surgeons. Under-represented and marginalized groups experience higher incidences of these negative events, and CT surgery is one of the least diverse specialties. The CT surgery workforce and institutional leadership must prioritize mentorship, sponsorship, and allyship to promote a diverse and healthy specialty for surgeon recruitment, growth, and job satisfaction., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Access to independent research experiences is a persistent barrier that stifles the recruitment and retention of students from diverse backgrounds in ecology, evolution, and behavioral biology. The benefits of field experiences are not equitably available to historically excluded and minoritized students. In this article, we summarize evidence that indicates course-based undergraduate research experiences (CUREs) provide a solution to ensure equitable access to independent research experiences in the life sciences. We draw from our own experiences of teaching CUREs in ecology, evolution, and behavioral biology and provide the complete curriculum for our effective and largely materials-free CURE in behavioral ecology (CURE-BxEco). We advocate for greater access to and synthesize the benefits of CUREs to promote inclusivity in education. The proliferation of such innovative pedagogical practices benefits science because these classroom methods are critical in recruiting and retaining historically excluded and minoritized students, who offer diverse perspectives in research., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Institute of Biological Sciences.)

We address the ethical implications of training and becoming family therapists in the United States when considering the colonial control and management of knowledge by the westernized institutionalized university. We do so decolonially. Through the work of decolonial thinkers, doers, and sensers, we center our discussion on the heteropatriarchal Eurocentric institutionalization of knowledge linked to the development and sustainability of structures of family therapy training through racialization and monetization. We discuss a decolonial understanding of race in relation to the liberalized politics of diversity, equity, and inclusion and upward mobility of family therapy education. Most importantly, we reflect upon the possibilities of reexistence within family therapy, fissuring the colonial structures of training tuition-based family therapists. We locate those possibilities through practices of crack-making, epistemic insurgence, and mischief. Our discussions and reflections are developed throughout by thinking, sensing, and speaking decolonially, storying our racialized incarnated lives from the saberes, ज्ञान, rhythms, vapors, or tastes of our communities, displaced by the European cannon. We embrace a decolonial pedagogy of learning without teaching, positioning family therapy education as a site for sociopolitical struggle and action toward possibilities of reexistence., (© 2024 The Author(s). Family Process published by Wiley Periodicals LLC on behalf of Family Process Institute.)

This paper contributes to geographic literature on the effects of inequity in citational practice and politics, focusing in particular on onto-epistemological diversity (or lack thereof) in animal geographies' citational structures. Through a bibliometric analysis of journal articles in Anglophone animal geographies (as a subdiscipline of human geography), we examine the intersections between citational trends, the contours of knowledge in the field and everyday academic lives. Our goal in this paper is to highlight some of the ways in which citational inequities are fueled. Specifically, our analysis shows that within Anglophone animal geographies, citational esteem can accrue through institutional networks and shared onto-epistemologies, which often go along with ethical and political orientations that refrain from explicitly contesting the status-quo of anthropocentrism. We ground our analysis with a reflective discussion of everyday academic practice to understand the multi-scalar dynamics and implications of citational politics and prompt heightened reflexivity among geographers concerning how animal and other geographies are constructed and reproduced - and how these reproductions can be contested., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Older employees often face discrimination and exclusion from work teams. In two scenario studies, we tested the impact of age diversity statements on the representation and inclusion of older employees in teams. In Study 1 ( N  = 304), participants had to create a team and were either exposed to a diversity statement or not before selecting two teammates from a list of four differing in age and gender. Then, we measured participants' inclusive behavioral intentions towards a new, older member joining this team. Age diversity statements increased the representation but not the inclusion of older individuals in teams. In Study 2 ( N  = 518), we further manipulated the content of the statement (diversity or diversity and inclusion) and the organizational motive (reputation or change). We replicated the effects of diversity statements on representation. Moreover, statements also increased certain inclusive behaviors, but only when they targeted diversity and inclusion and reflected an organizational commitment to change. Taken together, these results suggest that age diversity statements foster diversity, yet fail to systematically increase inclusion., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 De Saint Priest, Krings and Toma.)

Background: Inadequate inclusion in clinical trial enrollment may contribute to health inequities by evaluating interventions in cohorts that do not fully represent target populations., Objectives: The aim of this study was to determine if characteristics of patients with heart failure (HF) enrolled in a pivotal trial are associated with who receives an intervention after approval., Methods: Demographics from 2,017,107 Medicare patients hospitalized for HF were compared with those of the first 10,631 Medicare beneficiaries who received implantable pulmonary artery pressure sensors. Characteristics of the population studied in the pivotal CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Heart Failure Patients) clinical trial (n = 550) were compared with those of both groups. All demographic data were analyzed nationally and in 4 U.S. regions., Results: The Medicare HF cohort included 80.9% White, 13.3% African American, 1.9% Hispanic, 1.3% Asian, and 51.5% female patients. Medicare patients <65 years of age were more likely to be African American (33%) and male (58%), whereas older patients were mostly White (84%) and female (53%). Forty-one percent of U.S. HF hospitalizations occurred in the South; demographic characteristics varied significantly across all U.S. regions. The CHAMPION trial adequately represented African Americans (23% overall, 35% <65 years of age), Hispanic Americans (2%), and Asian Americans (1%) but underrepresented women (27%). The trial's population characteristics were similar to those of the first patients who received pulmonary artery sensors (82% White, 13% African American, 1% Asian, 1% Hispanic, and 29% female)., Conclusions: Demographics of Centers for Medicare and Medicaid Services beneficiaries hospitalized with HF vary regionally and by age, which should be considered when defining "adequate" representation in clinical studies. Enrollment diversity in clinical trials may affect who receives early application of recently approved innovations., Competing Interests: Funding Support and Author Disclosures Abbott provided resources for access and analyses of CMS claims data and demographic information from the CHAMPION trial. Dr Adamson is an employee of Abbott. Dr Echols is a consultant to Abbott. Dr DeFilippis serves on a clinical trial committee for Abiomed. Dr Morris has received research funding from the Agency for Healthcare Research and Quality (HS026081), the American Heart Association, Google, and Merck; and has received consulting fees from Abbott, Acorai, Boehringer Ingelheim, Eli Lilly, Cytokinetics, Edwards Lifesciences, Ionis, Merck, and Regeneron. Dr Bennett has received consulting fees and speaker honoraria from Abbott. Dr Abraham has received consulting fees from Abbott Vascular, AquaPass, Boehringer Ingelheim, Impulse Dynamics, Sensible Medical Innovations, V-Wave, and Zoll Respicardia. Dr Lindenfeld has received consulting and/or research support from Abbott, AstraZeneca, Boehringer Ingelheim, Boston Scientific, CVRx, Edwards Lifesciences, Impulse Dynamics, Merck, Medtronic, V-Wave, Vifor, and Volumetrix. Dr Teerlink has received research support from 3ive Labs, AstraZeneca, Bayer, Boehringer Ingelheim, Cardurion, Cytokinetics, EBR Systems, Edwards Lifesciences, Impulse Dynamics, Kaiser Permanente, LivaNova, Medtronic, Myovant Sciences, the Patient-Centered Outcomes Research Institute, RECARDIO, and V-Wave; and is a consultant for 3ive Labs, Arena, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cardurion, CorHepta, Cytokinetics, Daiichi-Sankyo, EBR Systems, Edwards Lifesciences, Eli Lilly Impulse Dynamics, JuvLabs, Kaiser Permanente, LivaNova, Medtronic, Myovant Sciences, Novartis, the Patient-Centered Outcomes Research Institute, Pfizer, ReCor Medical, Regeneron, Reprieve, Tectonic, V-Wave, Verily, ViCardia, and Windtree Therapeutics. Dr O’Connor has received research funding from Merck; and has received consulting fees from Bayer and Dey. Dr Connolly is an employee of Abbott. Dr Li is an employee of Abbott. Dr. Vaduganathan has received research grant support from, served on advisory boards for, or has had speaker engagements with American Regent, Amgen, AstraZeneca, Bayer, Baxter Healthcare, Boehringer Ingelheim, Bristol Myers Squibb, Chiesi, Cytokinetics, Lexicon Pharmaceuticals, Merck, Novartis, Novo Nordisk, Pharmacosmos, Relypsa, Roche Diagnostics, Sanofi, and Tricog Health; and has participated on clinical trial committees for studies sponsored by AstraZeneca, Galmed, Novartis, Bayer, Occlutech, and Impulse Dynamics. Dr Batchelor has received consulting fees from Boston Scientific, Medtronic, Edwards Lifesciences, V-Wave, Chiesi, Abbott, and Idorsia; and has received research support from Abbott and Boston Scientific. Dr McCants has received consulting fees and speaker honoraria from Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Public involvement and engagement (PI&E) is increasingly recognised as an important component of research. It can offer valuable insights from those with experiential knowledge to improve research quality, relevance, and reach. Similarly, schools are ever more common sites for health research and, more recently, PI&E. However, 'gold-standard' practice is yet to be established, and activities/approaches remain underreported. As a result, knowledge can remain localised or lost. Diversity and inclusion also remains a challenge., Methods: This protocol has been informed by UK national guidance, evidence-based frameworks and available implementation literature. It describes both rationale and approach to conducting PI&E activities within a secondary school context. Activities are designed to be engaging, safe and accessible to young people with diverse experiences, with scope to be iteratively developed in line with public collaborator preference., Discussion: Young people should be architects of their involvement and engagement. Ongoing appraisal and transparency of approaches to PI&E in school settings is crucial. Expected challenges of implementing this protocol include facilitating a safe space for the discussion of sensitive topics, absence and attrition, recruiting students with a diverse range of experiences, and potential knowledge and capacity barriers of both facilitator and contributors. Activities to mitigate these risks are suggested and explored., (© 2024. The Author(s).)

Purpose: The objective of this report is to provide longitudinal insights on the impact of a health professions exposure program for high school students of underrepresented backgrounds in medicine., Context: Medical students at the University of Chicago reviewed data from their chapter of the Health Profession Recruitment and Exposure Program (HPREP) from 2016-2021 to discover trends in enrollment. This data is documented in the context of the program's mission to increase awareness of health disparities, the success of prominent alumni, and recent community efforts post-COVID-19 pandemic., Findings: Two hundred and ninety-nine high school students participated in the University of Chicago HPREP program between 2016 and 2021. Participants ranged in age from 12 to 18 years (mean = 16, SD = 1) and 74% ( n = 222) were female students. Of 252 respondents, 58% ( n = 147) identified as Black or African American, 31% ( n = 77) identified as Latinx or of Hispanic origin, and 10% ( n = 24) identified as another race or as bi-racial. Ten or fewer black male students participated in the program every year, including the 2020-2021 year in which 61 students participated., Conclusions: HPREP has played an important role in shaping the face of health care, especially in Chicago. The data suggests significant increases in the number of underrepresented minority women becoming physicians and serving Chicago communities in the next decade. Pathway programs for underrepresented students in medicine should be strategic in recruiting and educating future health professionals based on future workforce needs., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Affini, Diaz, Dolan, Fletcher, Hasnain, Selkridge, Washington and Pratt.)

Objectives: Actively addressing issues of equity, diversity, and inclusion (EDI) in healthcare guidelines provides an important avenue ensure that individuals and communities receive high-quality healthcare that meets their needs. In 2020, the National Clinical Evidence Taskforce was charged with developing Australian living guidelines for COVID-19 (the Guidelines). It was intended that the Guidelines would consider the biological and social determinants of health (BSDH) underpinning evidence-based recommendations for of the treatment of COVID-19. The objective of this paper is to describe the evidence available on BSDH that is reported in published trials of disease-modifying therapies for COVID-19., Study Design and Setting: Published papers of randomized controlled trials that informed clinical recommendations (for and against drug therapies for COVID-19) in the Guidelines were reviewed retrospectively using a case series design. We extracted reported characteristics relating to BSDH. These included age, sex, gender, geographical location, ethnicity (including indigenous), disability, migrant status, income, education, employment, and social support. A descriptive analysis was conducted to illustrate the characteristics available for use in guideline development., Results: A total of 115 peer-reviewed papers describing randomized control trials of drug interventions for the treatment of COVID-19 were included. BSDH characteristics were poorly reported. Geographical location of the study was the only category reported in all papers. While age and sex were reported in most papers (n = 109 and 108, respectively), ethnicity was reported in only one-third of papers (n = 40), social support was reported in only three papers, and employment in one paper. No paper reported on gender, disability, migrant status, income, or education., Conclusion: Consideration of EDI issues is a crucial component of guideline development. Although these issues were widely recognized to impact on health outcomes from COVID-19, reporting of these characteristics was poor in COVID trials. Urgent action is needed to improve reporting of EDI characteristics if they are to be meaningfully considered in guideline processes, and health inequity is overcome., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Robotics is entering our daily lives. The discipline is increasingly crucial in fields such as agriculture, medicine, and rescue operations, impacting our food, health, and planet. At the same time, it is becoming evident that robotic research must embrace and reflect the diversity of human society to address these broad challenges effectively. In recent years, gender inclusivity has received increasing attention, but it still remains a distant goal. In addition, awareness is rising around other dimensions of diversity, including nationality, religion, and politics. Unfortunately, despite the efforts, empirical evidence shows that the field has still a long way to go before achieving a sufficient level of equality, diversity, and inclusion across these spectra. This study focuses on the soft robotics community-a growing and relatively recent subfield-and it outlines the present state of equality and diversity panorama in this discipline. The article argues that its high interdisciplinary and accessibility make it a particularly welcoming branch of robotics. We discuss the elements that make this subdiscipline an example for the broader robotic field. At the same time, we recognize that the field should still improve in several ways and become more inclusive and diverse. We propose concrete actions that we believe will contribute to achieving this goal, and provide metrics to monitor its evolution.

Data from the General Medical Council show that the number of female doctors registered to practise in the UK continues to grow at a faster rate than the number of male doctors. Our research critically discusses the impact of this gender-based shift, considering how models of medical training are still ill-suited to supporting equity and inclusivity within the workforce, with particular impacts for women despite this gender shift. Drawing on data from our research project Mapping underdoctored areas: the impact of medical training pathways on NHS workforce distribution and health inequalities, this paper explores the experiences of doctors working in the NHS, considering how policies around workforce and beyond have impacted people's willingness and ability to continue in their chosen career path. There is clear evidence that women are underrepresented in some specialties such as surgery, and at different career stages including in senior leadership roles, and our research focuses on the structural factors that contribute to reinforcing these under-representations. Medical education and training are known to be formative points in doctors' lives, with long-lasting impacts for NHS service provision. By understanding in detail how these pathways inadvertently shape where doctors live and work, we will be able to consider how best to change existing systems to provide patients with timely and appropriate access to healthcare. We take a cross-disciplinary theoretical approach, bringing historical, spatiotemporal and sociological insights to healthcare problems. Here, we draw on our first 50 interviews with practising doctors employed in the NHS in areas that struggle to recruit and retain doctors, and explore the gendered nature of career biographies. We also pay attention to the ways in which doctors carve their own career pathways out of, or despite of, personal and professional disruptions., (© 2024 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)

Objectives: This study developed multivariate law enforcement officer (LEO) body models for digital simulation of LEO accommodation in police cruiser cabs., Background: Anthropometrically accurate digital LEO body models, representing the United States LEOs, for computerized LEO cruiser interface simulations are lacking., Methods: Twenty body dimensions (with and without gear combined) of 756 male and 218 female LEOs were collected through a stratified national survey using a data collection trailer that traveled across the US. A multivariate Principal Component Analysis (PCA) approach was used to develop digital LEO body models., Results: Fifteen men and 15 women representing unique body size and shape composition of the LEO population were identified. A combined set of 24 male and female models (removal of 6 redundant models for which female and male models overlapped) is suggested., Conclusions: A set of 24 digital LEO body models in 3-dimensional form, along with their anthropometric measurements, were developed to facilitate LEO cruiser cab design., Application: Digital modeling software developers can use the models and their anthropometric data to build digital avatars for simulated evaluation of LEO cruiser cab configuration, console communication-equipment fitting, and cruiser ingress/egress access arrangement. LEO vehicle and equipment designers also can use eight key body dimensions (i.e., stature, buttock-popliteal length, eye height sitting, knee height sitting, shoulder-grip length, popliteal height, sitting height, and body weight) of the body models to recruit 24 human subjects to physically evaluate their vehicle prototypes for improved vehicle and equipment design.

Introduction: Gender Advisors (GENADs) have played a key role in the efforts of military organizations worldwide to integrate gender perspectives, and culture change, within the defence and security context. Military organizations, however, continue to face challenges in regard to diversity and inclusion, including limited representation of women and other diverse groups who do not fit the white male, masculine stereotype, and subtle and overt expressions of prejudice and stigma towards under-represented and marginalized groups. In such an organizational context, the integration of gender perspectives has faced challenges, and transformative culture change has remained elusive. In particular, the experience of GENADs suggests that there may be unique challenges to serving as "gender experts" within military organizations. This paper, therefore, examines the lived experience of GENADs within the context of military organizations, as illustrated by GENADs in the Canadian Armed Forces., Methods: We consider two qualitative studies on the lived experience of GENADs and focus on the shared theme of legitimacy of gender expertise at both individual and systemic levels., Results: This analysis highlights challenges that gendered power relations may pose for GENADs as individual change agents, and for systemic, transformative culture change, within existing military organizations, while reaffirming the importance of understanding the lived experience of GENADs in their pursuit of more equitable institutional and operational outcomes., Conclusion: Using social-psychological theories of tokenism, we consider more broadly what it means to be the gender person within masculinized military organizations and conclude with reflections on the potential contours of transformative culture change within the military context., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tait-Signal and Febbraro.)

Introduction: Surgical Critical Care (SCC) fellowship applications are made through March-July the year prior to the fellowship, while the match process takes place through the National Resident Matching Program (NRMP). There is paucity of high quality data on matching trends in SCC fellowship in the United States., Methods: We conducted a retrospective cohort study of all applicants in the SCC match over a period of fifteen years (2009-2023). Publicly published data about the SCC fellowship match were retrieved from the NRMP online portal. Mann Kendall trend test was used to obtain a Tau statistic and p-values for temporal trends over time. Chi-square test was used to investigate association between categorical variables., Results: From 2009 to 2023, the number of SCC fellowship positions increased from 143 to 340 (138% increase) while the number of applicants rose from 95 to 289 (204% increase). The overall match rate for applicants significantly rose from 89.5% to 93.4% (7.7% increase; t = 0.600, p = 0.002). The percentage of positions filled also increased from 59.4% in 2009 to 79.4% in 2023. The match rate over the past five years (2019-2023) was 90.8%. US-MD applicants had a significantly higher 94.8% match rate throughout the study period than non-US MD applicants (94.8% vs. 87.3%, p<0.001). While the match rate for US-MD applicants has stayed consistent from 2009 to 2023 (τ = 0.371, p = 0.054), the match rate for non-US-MD applicants increased from 77.3% in 2009 to 86.9% in 2023 (τ = 0.771, p<0.001)., Conclusion: SCC fellowship continues to grow with more positions and applicants. Match rates into SCC fellowships have increased over the past fifteen years, primarily helping non-US MDs match successfully., (Copyright © 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

Within the cardiothoracic surgery workforce, there are significant gaps in the numbers of women and underrepresented in medicine minorities, but some progress has been made in gender diversity at the resident level. Individual surgeons play an important role in combatting discrimination and harassment, while also promoting women and minorities through mentorship and sponsorship. More importantly, a multifaceted and structured approach is needed to increase diversity at the institutional level with strategies to create a culture of inclusion, working to retain underrepresented minority and female surgeons, and eliminating bias in the recruitment process., Competing Interests: Disclosure The author has nothing to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

In this review we examine two classes of interventions designed to achieve workplace gender equality: ( a ) those designed to boost motivations and ambition, such as those that aim to attract more women into roles where they are underrepresented; and ( b ) those that try to provide women with needed abilities to achieve these positions. While such initiatives are generally well meaning, they tend to be based upon (and reinforce) stereotypes of what women lack. Such a deficit model leads to interventions that attempt to "fix" women rather than address the structural factors that are the root of gender inequalities. We provide a critical appraisal of the literature to establish an evidence base for why fixing women is unlikely to be successful. As an alternative, we focus on understanding how organizational context and culture maintain these inequalities by looking at how they shape and constrain ( a ) women's motivations and ambitions, and ( b ) the expression and interpretation of their skills and attributes. In doing so, we seek to shift the interventional focus from women themselves to the systems and structures in which they are embedded.

In the first part of this article, I argue that transdisciplinary research can help address both the WEIRD problem of homogenous samples and the categorical problem of overgeneralized practice conceptions in performing arts psychology. Like other areas of performance science, performing arts psychology engages with practices and practice-based knowledge that are studied differently by subject-specific disciplines. I propose a transdisciplinary research model that facilitates greater overlap and transfer between the scientific, subject-specific, and practice-based forms of research and knowledge that surround a practice. The potential benefits of such a model are more inclusive samples, diversified methods, grounded research questions, and widely applicable results. The problems mentioned above are also ethical. Psychological definitions of performance that derive from overgeneralized conceptions and overreliance on homogenous samples are transferred to diverse peoples, practices, and contexts as general knowledge. This fails to apply principles of equity and relational ethics, which in turn reveals some limitations of established ethics procedures. In the second section of this article, I therefore revisit my argument for transdisciplinary research, now with a focus on the triad of research ethics that is brought into a transdisciplinary project through the different priorities of scientific, subject-specific, and practice-based research domains; namely, procedural ethics, relational ethics, and principles of equity. Transdisciplinary researchers are not only negotiating across methodological paradigms that determine research validity, they are also negotiating across ethical values. Combining the two sections of the article, I argue that the challenge of negotiation can be flipped into a solution to the WEIRD and practice conception problems in performing arts psychology. I argue that whereas critical calls for radical departures were needed to identify these problems, solutions are available in bridges between different ethical and methodological approaches., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hansen.)

The mission of the National Institute of Mental Health (NIMH) is to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure. This mission can only be realized if full participation in the research enterprise is open to all. Nevertheless, systemic racism and other barriers remain significant obstacles to achieving a diverse workforce. To address these barriers, NIMH must ensure a just and equitable funding process, support diversity-focused training opportunities, and encourage research into mental health disparities and other areas of interest to a diverse array of scientists., Competing Interests: Disclosure The authors declare no commercial or financial conflicts of interest., (Published by Elsevier Inc.)

Decades of research on how to improve intergroup relations have primarily examined ways to change prejudiced attitudes. However, this focus on negative intergroup attitudes has yielded few effective solutions. Because intergroup relations are shaped by behavior during intergroup interactions, it is necessary to identify constructs that have a strong causal impact on intergroup behavior change. In this article, I will discuss evidence showing that intergroup attitude change is neither a sufficient nor necessary cause for intergroup behavior change. Empirical research suggests that intergroup attitudes are difficult to change and have a limited effect on intergroup behavior. I also distinguish between constructs that primarily affect intergroup attitude change (e.g., counterstereotypical exemplars, evaluative conditioning) and constructs that primarily affect intergroup behavior change (e.g., social norms, self-efficacy). Further, suggestions for future research will also be provided to advance understanding of the various psychological constructs that influence intergroup behavior change, which will help us develop effective methods of improving intergroup relations.

Health professionals do not reflect the broader racial/ethnic diversity of the United States. Historical barriers to accessing health professions education have played a major role in initiating and perpetuating these disparities. Sociologists of professions have highlighted the role of educational reform in professions' efforts to enhance their status, but have overlooked the central role of government bodies in facilitating or impeding these strategies. The Flexner Report (1910) enhanced the status of medicine, but only after state medical boards adopted its recommendations, leading to the closure of half of the nation's medical schools and limiting opportunities for marginalized populations to enter the medical profession. Physical therapy leaders have espoused Flexner's precepts in seeking to advance their field's professionalization. In doing so, they consistently overlooked the more insidious impacts of Flexnerian approaches on student and practitioner diversity. This article examines how physical therapy's Flexnerian ambitions disrupted its parallel efforts to increase the field's racial/ethnic diversity. I argue that physical therapy leaders' focus on enhancing their profession's status and indifference toward facilitating educational access and mobility played a significant role in the field's racial/ethnic homogeneity. To increase practitioner diversity in the future, especially following the 2023 US Supreme Court decision (600 U.S. 181) restricting race conscious affirmative action, health professions must do more to address barriers to student access. This will involve moving away from the Flexnerian model and pursuing approaches that have helped more diverse and inclusive health professions, like nursing, to achieve greater educational opportunity and mobility., (Copyright © 2023 The Author. Published by Elsevier Ltd.. All rights reserved.)

Purpose: For cancer survivors, insomnia is highly prevalent and debilitating. Although cognitive behavioral therapy for insomnia (CBT-I) is recognized as a gold standard treatment, it is unclear whether benefits of treatment generalize to racial and ethnic minorities in the USA. This systematic review characterizes the representation of racial and ethnic diversity among cancer survivors in CBT-I clinical trials and provides recommendations for research in sleep/cancer survivorship., Methods: Literature searches were conducted in five electronic databases (PubMed, Cochrane Library via Ovid, PsycINFO via Ovid, Embase, Web of Science Core Collection) using concepts of CBT, insomnia, and cancer survivors. Information about CBT-I intervention details, sample racial demographics, and whether authors explicitly analyzed race and ethnicity were recorded., Results: A total of 1673 citations were retrieved, and 967 citations were uploaded to Covidence. Of these, 135 articles went through full-text review and 13 studies were included. Race and ethnicity were reported in 11/13 trials (84.6%). Of those reporting race and ethnicity, 8/11 (72.7%) trials were comprised of samples that were ≥ 85% non-Hispanic White. Among the trials that explicitly analyzed race and ethnicity, CBT-I was more effective among cancer survivors who were White and highly educated, and non-White cancer survivors were less likely to have private insurance and ability to participate in clinical trials., Conclusion: Non-Hispanic White cancer survivors are overrepresented in CBT-I trials, the best available treatment for insomnia. Underrepresentation of racial and ethnic minorities likely contributes to barriers in access and uptake. Recommendations include implementing sustained efforts to expand diversity in CBT-I clinical trials for cancer survivors., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Children in sub-Saharan Africa (SSA) remain the most vulnerable to malaria and malaria mortality. This study estimated the disease burden and distribution of Plasmodium falciparum malaria among children with age categories (0 to < 2 years, 2 to < 6 years, 6 to < 12 years, ≥ 12 years) in SSA., Methods: Data on the number of cases and incidence rates of P. falciparum malaria by age group from the Institute of Health Metrics and Evaluation (GBD 2019) for 11 countries in SSA was employed in this study. The best-fitting distribution of P. falciparum malaria cases by prespecified age categories was derived using a combination of a Log-normal and Weibull distribution., Results: Plasmodium falciparum malaria was 15.4% for ages 0 to < 2 years, 30.5% for 2 to < 6 years, 17.6% for 6 to < 12 years, and 36.5% for ≥ 12 years based on data from countries in SSA. The results have important implications for the current drive by the FDA and EMA to ensure the representativeness of real-world populations in clinical trials evaluating the safety and efficacy of medication exposure., Conclusions: The theoretical distributions of P. falciparum malaria will help guide researchers in ensuring that children are appropriately represented in clinical trials and other interventions aiming to address the current burden of malaria in SSA., (© 2023. The Author(s).)

Medical training occurs during peak childbearing years for most medical students. Many factors influence specialty selection. The aims of this study were (i) to determine whether being a parent is a major deciding factor when picking a specialty and (ii) whether parents are more drawn to family-friendly specialties than non-parents. The authors performed a multicenter web-based survey study of medical students enrolled in Oregon Health and Science University, Dartmouth's Geisel School of Medicine, and University of Michigan Medical School. The 27-item instrument assessed parenthood status, specialty preference, specialty perceptions, and factors influencing specialty choice. A total of 537 out of 2236 (24.0%) students responded. Among respondents, 59 (10.9%) were current or expecting parents. The majority (359, 66.8%) were female and 24-35 years old (430, 80.1%). Of the students who were parents or expecting, 30 (50.9%) were female, and the majority (55, 93.2%) were partnered. Top specialties preferred by both parents and non-parents were family medicine, emergency medicine, obstetrics and gynecology (OB/GYN), internal medicine, psychiatry, and pediatrics. Specialties rated most family-friendly included family medicine, dermatology, pediatrics, psychiatry, radiology, emergency medicine, and pathology. The specialties rated least family-friendly were surgery, neurosurgery, orthopedic surgery, plastic surgery, and OB/GYN. These rankings were the same between groups. Passion for the field, culture of the specialty, and quality of life were the top three factors students considered when choosing a specialty. Being a parent or future parent ranked more highly for parents than non-parents, but was not in the top three factors for either group. US Medical School parents report that being a parent influenced their medical specialty choice "strongly" or "very strongly." However, being a parent was not weighed as heavily as passion for the field, culture of the specialty, and quality of life. These student-parents are entering perceived "non-family friendly" specialties at similar rates as their peers. US Medical school training and simultaneous parenting is daunting, yet student parents are putting their passion first when making a career choice. They must be supported., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

This study examines the paradoxical effects of a perceived inclusive environment for ethnic minorities. We argue that while perceptions of an inclusive environment may be associated with more positive intergroup attitudes and affect among minority groups, they may instill a sense of threat among the majority group, resulting in negative intergroup sentiments and attitudes towards minorities. We analyzed data from two waves of a nationally representative survey conducted in the Netherlands ( n total  = 11,897) comprising minority and majority groups. We find support for the proposed paradoxical relationship between the perceived inclusionary climate towards minorities and the attitudes of the majority and minority groups. The results indicate that when perceiving the national climate to be more inclusive towards minorities, the majority group tends to report higher levels of ethnocentrism, avoid direct inter-ethnic contact, and oppose ethnic diversity in general. Among minority groups, a perceived inclusive climate is linked to lower levels of ethnocentrism and a higher willingness to engage in inter-ethnic interactions with the majority group. The results unexpectedly also show that the perception of an inclusionary climate is positively related to opposition to increased ethnic diversity among minority groups. We discuss theoretical and societal implications, while also considering the contextual relevance and limitations of our approach., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Andriessen, Gündemir, Kappelhof and Homan.)

Objective: Use of traditional scoring metrics for residency recruitment creates racial and gender bias. In addition, widespread use of pass/fail grading has led to noncomparable data. To adjust to these challenges, we developed a holistic review (HR) rubric for scoring residency applicants for interview selection., Design: Single-center observational study comparing the proportion of underrepresented in medicine (URM) students and their United States Medical Licensing Exam (USMLE) scores who were invited for interview before (2015-2020) and after (2022) implementation of a holistic review process., Setting: General surgery residency program at a tertiary academic center., Participants: US allopathic medical students applying for general surgery residency., Results: After initial screening, a total of 1514 allopathic applicants were narrowed down to 586 (38.7%) for HR. A total of 52% were female and 17% identified as URM. Based on HR score, 20% (118/586) of applicants were invited for an interview. The median HR score was 11 (range 4-19). There was a fourfold higher coefficient of variation of HR scores (22.3; 95% CI 21.0-23.7) compared to USMLE scores (5.1; 95% Cl 4.8-5.3), resulting in greater spread and distinction among applicants. There were no significant differences in HR scores between genders (p = 0.60) or URM vs non-URM (p = 0.08). There were no significant differences in Step 1 (p = 0.60) and 2CK (p = 0.30) scores between those who were invited to interview or not. On multivariable analysis, USMLE scores (OR 1.01; 95% CI 0.98-1.03), URM status (OR 1.71 95% CI 0.98-2.92), and gender (OR 0.94, 95% CI 0.60-1.45) did not predict interview selection (all p > 0.05). There was a meaningful increase in the percentage of URM interviewed after HR implementation (12.9% vs 23.1%, p = 0.016)., Conclusion: The holistic review process is feasible and eliminates the use of noncomparable metrics for surgical applicant interview invitations and increases the percentage of URM applicants invited to interview., (Copyright © 2023 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)

By nature, humans are " tojisha (participating subjects/player-witnesses)" who encounter an unpredictable real world. An important characteristic of the relationship between the individual brain and the world is that it creates a loop of interaction and mutual formation. However, cognitive sciences have traditionally been based on a model that treats the world as a given constant. We propose incorporating the interaction loop into this model to create "world-informed neuroscience (WIN)". Based on co-productive research with people with minority characteristics that do not match the world, we hypothesize that the tojisha and the world interact in a two-dimensional way of rule-based and story-based. By defining the cognitive process of becoming tojisha in this way, it is possible to contribute to the various issues of the real world and diversity and inclusion through the integration of the humanities and sciences. The critical role of the brain dopamine system as a basis for brain-world interaction and the importance of research on urbanicity and adolescent development as examples of the application of WIN were discussed. The promotion of these studies will require bidirectional translation between human population science and animal cognitive neuroscience. We propose that the social model of disability should be incorporated into cognitive sciences, and that disability-informed innovation is needed to identify how social factors are involved in mismatches that are difficult to visualize. To promote WIN to ultimately contribute to a diverse and inclusive society, co-production of research from the initial stage of research design should be a baseline requirement., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background Instagram, a widely used social media platform with over two billion active users, has the potential to propagate dermatologic health information within the public sphere. However, there is a lack of representation of people of color (POC), making it crucial to share accurate and inclusive posts to increase awareness about dermatologic conditions. It is also necessary to address the misconceptions about skin diseases and other hereditary conditions within various ethnic groups. To combat this, a group of medical students created South Jersey Skin Talk (SJST), an initiative aimed to improve dermatologic health literacy in skin-of-color communities, particularly in underserved areas like Camden County, NJ. Using reliable sources to prevent the spread of misinformation, SJST's accessible Instagram page explains skin conditions, especially emphasizing appearances and manifestations in POC. The hypothesis being investigated by this group is that the implementation of SJST as a community intervention is expected to improve dermatologic health literacy in POC. Methods A 13-question survey was conducted via Qualtrics (Seattle, Washington) and was distributed on social media (Instagram, Facebook, Reddit, Twitter, TikTok, and GroupMe). It remained open for eight weeks during which users 18 years or older were invited to participate. The survey was divided into four sections: demographics, Instagram usage, knowledge of dermatology, and inclusion and diversity on SJST's page. A total of 184 total responses were collected, which were compared using chi-squared analyses on Qualtrics software. Results POC felt less represented on social media compared to White respondents prior to visiting SJST on Instagram (p < 0.00001). However, after viewing SJST, 87.5% of White participants and 88% of POC reported feeling represented on the page. Additionally, both groups of respondents indicated that they felt more knowledgeable about their primary skin concern after viewing the SJST's posts. Furthermore, 86.8% of POC reported that they would feel more confident participating in a conversation with their dermatologist regarding their primary dermatologic concern. Conclusion SJST is a community outreach organization focused on improving health literacy for POC and bridging the gap in healthcare disparities between White and POC populations. The results from this survey confirm the hypothesis and illustrate that community interventions targeted at education for POC increase health literacy and patient autonomy. These results also show that there is a need for more representation and diversity in medical dermatology on social media. Further studies should be done to investigate other disparities affecting adequate representation for POC., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Fliorent et al.)

Rationale and Objectives: Over 20% of the Lesbian, Gay, Bisexual, Queer or Questioning, Intersex, Asexual or Ally, and more (LGBTQIA+) community reports experiencing discrimination upon accessing health care, causing many to defer access to care and resulting in poorer outcomes. While members of this community routinely undergo imaging studies, little formal education exists within the field of radiology to review the unique health care needs of this population and the specific relevance to imaging, in addition to actionable methods to promote inclusion., Materials and Methods: A 1-hour educational conference was held for a cohort of radiology resident physicians at our institution, in which topics including LGBTQIA+ health care disparities, clinical nuances relevant to the field of radiology, and actionable suggestions that both academic and private-practice centers can adopt to foster inclusion were presented. All attendees were required to complete a 12-question, multiple-choice preconference and postconference examination., Results: Median prelecture and postlecture quiz scores for four first-year radiology residents were 29% and 75%, for two second-year radiology residents were 29% and 63%, for two third-year radiology residents were 17% and 71%, and for three fourth-year radiology residents were 42% and 80%., Conclusion: Multiple areas of opportunity to foster LGBTQIA+ inclusion at the provider and administration levels currently exist throughout the field of radiology. A radiology-focused education module regarding clinical nuances, health care inequities, and ways to foster an inclusive environment with the LGBTQIA+ community is an effective way to promote learner knowledge., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)