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Objectives: The objective of this study is to analyze the content and volume of literature that has been written on cultural competency in emergency medicine since its educational imperative was first described by the Institute of Medicine in 2002.Methods: We conducted a comprehensive literature search through the PUBMED portal in January 2015 to identify all articles and reviews that addressed cultural competency in emergency medicine. Articles were included in the review if cultural competency was described or if its impact on healthcare disparities or curriculum development was described. Two reviewers independently investigated all relevant articles. These articles were then summarized.Results: Of the 73 abstracts identified in the initial search, only 10 met criteria for inclusion. A common theme found among these 10 articles is that cultural competency in emergency medicine is essential to reducing healthcare disparities and improving patient care. These articles were consistent in their support for cross-cultural educational advancements in the EM curriculum.Conclusion: Despite the documented importance of cultural competency education in medicine, there appears to be only 10 articles over the past 12 years regarding its development and implementation in emergency medicine. This comprehensive literature review underscores the relative dearth of publications related to cultural competency in emergency medicine. The limited number of article findings is striking when compared to the growth of emergency medicine research over the same time period and can serve as a stimulus for further research in this significant area of EM education.

Introduction: The objective of this study was to analyze the content and volume of literature that has been written on cultural competency in emergency medicine (EM) since its educational imperative was first described by the Institute of Medicine in 2002. Methods: We conducted a comprehensive literature search through the PubMed portal in January 2015 to identify all articles and reviews that addressed cultural competency in EM. Articles were included in the review if cultural competency was described or if its impact on healthcare disparities or curriculum development was described. Two reviewers independently investigated all relevant articles. These articles were then summarized. Results: Of the 73 abstracts identified in the initial search, only 10 met criteria for inclusion. A common theme found among these 10 articles is that cultural competency in EM is essential to reducing healthcare disparities and improving patient care. These articles were consistent in their support for cross-cultural educational advancements in the EM curriculum. Conclusion: Despite the documented importance of cultural competency education in medicine, there appears to be only 10 articles over the past 12 years regarding its development and implementation in EM. This comprehensive literature review underscores the relative dearth of publications related to cultural competency in EM. The limited number of articles found is striking when compared to the growth of EM research over the same time period and can serve as a stimulus for further research in this significant area of EM education. [West J Emerg Med. 2017;18(2)223-228.]

As part of a larger qualitative study using Life Story methods, an ethnically diverse, purposive sample (n = 27) of young adolescents (ages 12-14) and their mothers residing in four US domestic violence emergency shelters were interviewed about their perspectives of shelter life. Youth reported aspects they liked, most often expressing that they liked other families residing in the shelter. More than one-half expressed disliking shelter rules restricting their behaviour. Mothers expressed positive feelings about the shelters overall. They emphasised the package of services received, safety, the shelter's effectiveness in meeting their needs, and positive interactions with personnel. Mothers' most frequently suggested improvement was for more space and services for children and youth. Results of youth and mother interviews are contextualised by descriptions of the shelters they resided in, based on interviews with personnel at each shelter. This article discusses findings within developmental and human rights frameworks, considering participant views in terms of normative adolescent development and non-normative histories of violence exposure and residential instability, while highlighting the human rights-informed value of youth perspectives for research, programme development, and youth development. It discusses implications for research and practice, with recommendations for developing shelter environments, programmes and policies responsive to young adolescent residents.

This qualitative study explored school social workers' relationships during instances of abuse and neglect reporting, focusing on reports made for children and adolescents already receiving school social work services. Although school social workers frequently file abuse and neglect reports, little is known about how they manage clinical and professional relationships in the complex school environment when reporting. This study obtained rich descriptions of their reporting experiences. In-depth interviews and a focus group were conducted with 10 participants from Texas, Florida, and Colorado, representing all school levels. Findings describe complex clinical and professional relationship networks involved in reporting and school social workers' perspectives on case management during disclosure and reporting. Thematic analysis of interviews identified several themes pertaining, for example, to communications with caregivers and children about Child Protective Services reports, interprofessional collaboration, and management of dilemmas regarding trust and confidentiality with families and professionals. Participants sought to mitigate harm through their practices, yet practices varied. Further research on the effects of practices such as involving children in reporting is warranted. Implications for practice and education are discussed. The author recommends that discussions of legal and ethical aspects of reporting be augmented with discussion of interpersonal dynamics that come into play.

Human subjects consuming fish oil showed a significant suppression of cyclooxygenase-2 (COX-2) expression in blood monocytes when stimulated in vitro with lipopolysaccharide (LPS), an agonist for Toll-like receptor 4 (TLR4). Results with a murine monocytic cell line (RAW 264.7) stably transfected with COX-2 promoter reporter gene also demonstrated that LPS-induced COX-2 expression was preferentially inhibited by docosahexaenoic acid (DHA, C22:6n-3) and eicosapentaenoic acid (EPA, C20:5n-3), the major n-3 polyunsaturated fatty acids (PUFAs) present in fish oil. Additionally, DHA and EPA significantly suppressed COX-2 expression induced by a synthetic lipopeptide, a TLR2 agonist. These results correlated with the preferential suppression of LPS- or lipopeptide-induced NFκB activation by DHA and EPA. The target of inhibition by DHA is TLR itself or its associated molecules, but not downstream signaling components. In contrast, COX-2 expression by TLR2 or TRL4 agonist was potentiated by lauric acid, a saturated fatty acid. These results demonstrate that inhibition of COX-2 expression by n-3 PUFAs is mediated through the modulation of TLR-mediated signaling pathways.Thus, the beneficial or detrimental effects of different types of dietary fatty acids on the risk of the development of many chonic inflammatory diseases may be in part mediated through the modulation of TLRs.

An abusive partner's access to a firearm is one of the strongest predictors of intimate partner homicide, and there is evidence that laws limiting abusers' access to firearms are associated with fewer fatalities. Yet, there is a movement to increase access to firearms as a strategy for self‐protection among intimate partner violence (IPV) victims. The present study describes both firearm‐related and non‐firearm‐related protective actions among victims of IPV, and further examines which factors (e.g., pro‐gun attitudes) are associated with engaging in firearm‐related protective actions. Questionnaires were administered to women recruited from six domestic violence shelters in Texas from December 2017 to September 2018. Nearly 13 percent of victims in the analytic sample (N = 197) engaged in one or more forms of firearm‐related protective actions in the past year. Multivariate analyses revealed that participants were more likely to have engaged in firearm‐related protective actions if they experienced higher firearm‐related IPV and if they held stronger pro‐gun attitudes. The results highlight the importance of basing firearm policy on empirical evidence as firearms can have deadly consequences. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess emergency physicians' diagnostic approach to the patient with dizziness, using a multicenter quantitative survey. PARTICIPANTS AND METHODS: We anonymously surveyed attending and resident emergency physicians at 17 [...]

This study examined the successes and challenges of refugee entrepreneurs by interviewing 50 refugees, service providers, and technical assistance providers. Qualitative data analyses revealed that successes and challenges occurred both at the individual and family levels as well as at the community and agency levels. The findings underscore the need to acknowledge the importance of the personal characteristics of the individual entrepreneurs, to deal with the competing factors revolved around family commitments, to encourage agencies to provide sufficient literacy and financial training, and to have community collaborations for capacity-building. doi: 10.1300/J051v16n01_05 KEYWORDS. Refugees, refugee entrepreneurship, refugee employment, refugee service providers, refugee microenterprises

The objectives of this study were to determine changes in fat and energy intakes in the United States between 1989-199 1 and 1994-1996, and to examine the implications of expressing fat intake in grams vs as a percent of total energy intake. The source of data was the Continuing Survey of Food Intake by Individuals. The results suggest that intake of energy rose between the 2 time periods, primarily due to higher carbohydrate intake. There was also a modest increase in fat intake. However fat intake, as a percent of total energy, declined. The higher energy intakes were primarily from beverages, especially soft drinks, food mixtures, grain snacks, and pastries. The primary sources of higher fat intakes were meat mixtures, vegetables, and some categories of the grain group. Similar trends in the Food Supply Series suggested that the changes observed were not entirely due to changes in survey methodology. Because the increase in fat intake was masked by the increase in energy intake, we conclude that assessing trends in fat intake as a percent of energy consumption can be misleading, unless information on total energy and fat intake, in grams, is also provided. These preliminary findings should be interpreted cautiously until they are confirmed by formal secular trend analyses. JAm Diet Assoc. 2003;103:867-872., In 1990 the Dietary Guidelines for Americans, the Federal government's statement of policy that provide Americans with advice on the most important aspects of healthful eating, specifically recommended an intake [...]