Historical Barriers Research Articles

Commentary on “Racial and ethnic diversity in academic nursing leadership: A cross-sectional analysis” by Travers and colleagues (2024)

The purpose of this commentary is to highlight key points made by Travers and colleagues (2024) in their study entitled, “Racial and ethnic diversity in academic nursing leadership: A cross-sectional analysis” and provide additional recommendations for future research and policy related to diversity in academic nursing leadership. While there is a significant underrepresentation of racial and ethnic minoritized populations in academic leadership in nursing, the level of underrepresentation and contributors to underrepresentation are not the same across racial and ethnic minoritized populations. As we design strategies to promote diversity in academic nursing it is important to benchmark efforts to ensure representation from groups who experience the most significant health inequities, create tailored strategies that consider the unique historical and contemporary barriers to leadership in academic nursing across and within minoritized groups, and build upon evidence-based strategies, especially the important role that minority serving institutions have played.

What can we learn from pandemic educational methods?: military general practice trainees’ attitudes to feedback from recorded consultations

ABSTRACT Background Recorded consultations are a useful tool for developing consultation skills for general practice speciality trainees (GPSTs). Historical barriers to utility include a lack of recording equipment and trainee discomfort. Widespread use of online communication platforms during the pandemic led to the introduction of the Recorded Consultation Assessment (RCA), prompting an exploration of its impact on GPSTs’ attitudes and acceptability of using recorded consultations for feedback. Aim This sequential explanatory mixed methods study explored attitudes of military GPSTs towards using recorded consultations for feedback to develop consultation skills, and identify factors influencing GPST attitudes. Methods Participants of this study completed a questionnaire, followed by a representative sample focus group. Descriptive statistics were used to analyse quantitative data, reflexive thematic analysis was employed for qualitative data. Triangulation was conducted using a meta-matrix. Results Results indicated agreement among respondents on the usefulness of recorded consultations for developing consultation skills, particularly communication skills. Perceived trainer attitudes significantly influence the GPST utility of this tool. The RCA positively impacted attitudes, providing familiarity, free access to easy-to-use online recording platforms, simplified consenting procedures, secure data storage, and improved feedback quality from trainers. Conclusion Pre-pandemic studies cited equipment access and consent procedures as barriers to utilising recording as a method of feedback. The pandemic and RCA introduced online resources and imperative to utilise this method, resulting in largely positive GPST learning experiences. As we move away from the RCA it is important to retain institutional memory of the benefits gained from feedback using recorded methods.

The Next Era of Assessment Within Medical Education: Exploring Intersections of Context and Implementation.

In competency-based medical education (CBME), which is being embraced globally, the patient-learner-educator encounter occurs in a highly complex context which contributes to a wide range of assessment outcomes. Current and historical barriers to considering context in assessment include the existing post-positivist epistemological stance that values objectivity and validity evidence over the variability introduced by context. This is most evident in standardized testing. While always critical to medical education the impact of context on assessment is becoming more pronounced as many aspects of training diversify. This diversity includes an expanding interest beyond individual trainee competence to include the interdependency and collective nature of clinical competence and the growing awareness that medical education needs to be co-produced among a wider group of stakeholders. In this Eye Opener, we wish to consider: 1) How might we best account for the influence of context in the clinical competence assessment of individuals in medical education? and by doing so, 2) How could we usher in the next era of assessment that improves our ability to meet the dynamic needs of society and all its stakeholders? The purpose of this Eye Opener is thus two-fold. First, we conceptualize - from a variety of viewpoints, how we might address context in assessment of competence at the level of the individual learner. Second, we present recommendations that address how to approach implementation of a more contextualized competence assessment.

Societal Upheaval and the Contraceptive Transition

AbstractHuman development and family planning programs since the 1970s have led to a fast‐rising prevalence of modern contraceptive means at the global level. However, countries with rising but still low levels of contraceptive use experienced an increasing number of societal upheavals, including armed conflicts, sudden and high‐intensity natural disasters, as well as dramatic effects of health epidemics. This may challenge the continued diffusion of modern means of birth regulation as well as their adherent use. To better understand the role of societal upheavals in the contraceptive transition, we provide a narrative literature review of their multidimensional pathways of influence in the contraceptive decision‐making process. The review suggests four main findings. First, well‐known contemporary barriers to contraceptive use become more salient during societal upheavals. Second, historical barriers reemerge predominantly. Third, societal upheavals exert specific effects on the contraceptive transition, such as through birth replacement, the repopulation of communities, and the sexual vulnerability of girls and young women. Fourth, there are more pathways leading to a reduced (rather than a heightened) contraceptive prevalence. The conclusion discusses the implications of those insights for the contraceptive transition, provides a critical perspective of the literature, and draws avenues for future research.

The Roma Population: Migration, Settlement, and Resilience

The Roma population—with a unique history marked by migration, settlement issues, and ongoing resilience—has always faced significant social marginalization and has often been subjected to forced migration. Despite being one of the largest and most diverse ethnic groups in Europe, Roma continue to face systemic discrimination and social exclusion, leading to poor outcomes in education, employment, health, and housing. This article analyses the migration pathways, settlement experiences, and persistent obstacles faced by Roma. We argue that removing historical and systemic barriers to create a more equitable and welcoming environment for the Roma community is their right. The resilience of the Roma community in the face of adversity is a testament to their cultural strength and adaptability. This research aims to document these aspects and thus provide a basis for policies that promote social inclusion, equality, and respect for cultural diversity.

Using joint species distribution modelling to identify climatic and non‐climatic drivers of Afrotropical ungulate distributions

The relative importance of the different processes that determine the distribution of species and the assembly of communities is a key question in ecology. The distribution of any individual species is affected by a wide range of environmental variables as well as through interactions with other species; the resulting distributions determine the pool of species available to form local communities at fine spatial scales. A challenge in community ecology is that these interactions (e.g. competition, facilitation, etc.) often are not directly measurable. Here, we used hierarchical modelling of species communities (HMSC), a recently developed framework for joint species distribution modelling, to estimate the role of biotic effects alongside environmental factors using latent variables. We investigate the role of these factors determining species distributions in communities of Artiodactyla, Perissodactyla and Proboscidea in the Afrotropics, an area of peak species richness for hoofed mammals. We also calculate pairwise trait dissimilarity between these species, from a mixture of morphological and behavioural traits, and investigate the relationship between dissimilarity and estimated residual co‐occurrence in the model. We find that while ungulate distributions appear to be predominantly determined (~ 70%) by climatic variables, such as precipitation, a substantial proportion of the variance in ungulate species distributions (~ 30%) can also be attributed to modelled latent variables that likely represent a combination of dispersal barriers and biotic factors. Although we find only a weak relationship between residual co‐occurrence and trait dissimilarity, we suggest that our results may show evidence that biotic factors, likely influenced by historical barriers to species dispersal, are important in determining species communities over a continental area. The HMSC framework can be used to provide insight into factors affecting community assembly at broad scales, and to make more powerful predictions about future species distributions as we enter an era of increasing impacts from anthropogenic change.

Aging in Place

What Is the Issue? Canada is experiencing an important demographic transition toward an increasingly diverse aging population with an increased need for care and support during the later stages of life. Despite older adults’ strong preferences to live in their home or community for as long as possible, health systems are challenged to keep up with growing demands for home care, community care and support services to support conditions to age in place, when appropriate. What Did Canada’s Drug Agency Do? Canada’s Drug Agency prepared an Evidence Assessment report that identified and described the current context of aging and hinderances to aging in place in Canada, considerations relevant to aging in place for equity-deserving groups, strategies and initiatives intended to address unmet needs and improve outcomes, and systemic considerations related to implementing initiatives supporting aging in place. The Health Technology Expert Review Panel (HTERP) used the Canada’s Drug Agency Evidence Assessment report to inform deliberations and to develop objective, impartial, trusted pan-Canadian guidance for decision-makers when considering evidence-informed aging-in-place initiatives to support equitable aging in place in jurisdictions in Canada. What Is HTERP’s Position on Aging in Place? Everyone has the right to age with dignity. Aging is a normal part of life and may be accompanied by changes in health status and/or abilities to complete everyday self-care tasks. Older adults comprise a heterogenous population with a continuum of health care needs and risks, including people living with vitality, those with moderately complex care issues, and those with complex care issues. Health and social systems were originally designed to meet the less complex acute care needs of a younger population and operate largely in silos. They cannot adequately or proactively address the continuum of needs of many older adults and their caregivers. Aging in place is a dynamic and complex experience that occurs within a larger context that is not limited to health systems. Older adults’ autonomy and preferences for care are realized by the active role of informal unpaid caregivers. The population of older adults in Canada is diverse with varying needs, risks, and cultural norms and values related to aging in place. Barriers to aging in place may disproportionately affect members of equity-deserving groups that experience multiple and often intersecting historical, social, cultural, medical, structural, institutional, and environmental barriers to care and support. There must be equity in access to safe, appropriate, and ongoing care to support dignity in living in a place of one’s choosing for older adults as they age. What Is HTERP’s Guidance to Support Aging in Place? foster a system that prioritizes integrated models of care to address current and future unmet needs and bridge gaps in and between services identify interventions that are aligned within an integrated model of care and are responsive to the unique and complex needs of older adults and their unpaid caregivers ensure culturally appropriate and equitable opportunities for positive outcomes standardize core measures or indicators to guide data collection, analysis, use, and reporting that support robust evaluation and cross-jurisdictional comparisons of interventions.

When do Women Take the Lead? Exploring the Intersection Between Gender Equality and Women’s Environmental Political Participation from a Comparative Perspective

Research has long claimed that women engage less than men in environmental political participation (EPP) (protests, petitions), despite having higher levels of environmental concern and vulnerability. Using the ISSP’s 2020 Environment Module including 28 countries, we argue that higher gender equality and socio-economic development can allow women to voice environmental grievances. Using multi-level models, we examine the effects of gender equality on gender differences in protests, petitions, and boycotts. Offering a more encompassing approach, we distinguish individual from collective, and non-confrontational from confrontational engagement forms. We find that women actually participate more than men, but mainly in individual and non-confrontational EPP forms (petitions, boycotts), and with substantial cross-country variation. Moreover, considering women’s historical barriers from participating in politics, we argue that structural gender inequality remains an important limitation to women’s engagement. Cross-level interactions indicate that especially when in more egalitarian countries, women take the lead in several types of EPP.

Ecological niche modeling of the Leopardus tigrinus complex sheds light on its elusive evolutionary history

Abstract The evolutionary history and taxonomy of the Leopardus tigrinus species complex have been studied based on several approaches, mostly employing genetic and morphological data, leading to distinct classification schemes. We approached this problem from an ecological perspective, with 2 main goals: (i) to evaluate ecological niche differences among regional L. tigrinus populations to determine the extent of ecological divergence among them; and (ii) to identify environmental barriers to historical dispersal that could have driven differentiation among the proposed groups. We modeled the ecological niche of all taxonomic/geographic groups proposed so far to comprise the L. tigrinus complex using the Maximum Entropy algorithm, and evaluated geographic and ecological niche differences among them. Furthermore, we investigated possible environmental barriers to historical dispersal that could have driven differentiation among regional groups. We evaluated 4 hypothetical barriers across 3 time periods to assess their potential historical effect. We found high ecological divergence between northeastern tigrina populations and the northern Andean and Central American tigrinas. Other groups within the L. tigrinus complex are less divergent. In addition, the Guiana Shield tigrina, where the type locality of the species is located, seems to be ecologically similar to populations from northeastern Brazil while also showing some overlap with Andean populations. The Panama center, the Llanos of Colombia and Venezuela, and the Amazon region were identified as historical barriers for tigrina dispersal across all time periods. The inferred historical barriers and ecological divergence observed in this study contribute to the inference of evolutionary differentiation among geographic groups comprising the L. tigrinus complex, revealing areas of consistently low habitat suitability that have likely contributed to divergence among regional populations.

Promoting a Culture of Care for College Students with Marginalized Identities Using an Embedded Prevention Navigation Model

ABSTRACT College students are at risk for mental and physical health concerns such as depression, anxiety, substance use, HIV, and other sexually transmitted infections, creating greater demands for timely and responsive services. However, students from marginalized groups often face greater challenges accessing physical and behavioral health services due to historic and systemic barriers. One unique and economical approach to helping students access care is to train peers to provide psychoeducation and timely and responsive linkages to behavioral and physical health resources and embed them in spaces where students naturally congregate. This approach has proven effective in reducing engagement in high-risk behaviors and encouraging resource utilization in community settings, but little research exists on using an embedded prevention navigator approach in college settings. The present study describes the development, implementation, and evaluation of such an approach piloted among 88 undergraduates, the majority of whom identified as students of color and first-generation college students. Findings support the feasibility of using a peer-delivered prevention navigation approach to provide students with mental health, substance use, and sexual health education and referrals to relevant resources. Lessons learned and recommendations for college mental health professionals are discussed.

Elite persistence in Sierra Leone: What can names tell us?

Is elite persistence weaker in Africa than in other parts of the world, given historical barriers to intergenerational inheritance of status, such as limited private property rights and frequent economic and political crises? In the absence of linked intergenerational data, we use name analysis to address this question. Using surnames associated with two Sierra Leonean elites, Krio descendants of settlers and members of chiefly lineages, we measure elite persistence in politics, education and business since 1960. Both groups were highly overrepresented in elite positions at independence, and remain overrepresented today. Benchmarking our results against other countries shows that Sierra Leone's educational elites are as persistent as elsewhere, but elite persistence in the political sphere is lower than in the United Kingdom, our main comparator. We also show marked path dependence: chiefly descendants remain more overrepresented in politics and mining, while the Krio are highly over-represented in education and the professions.

Neutral markers reveal complex population structure across the range of a widespread songbird.

Understanding how both contemporary and historical physical barriers influence gene flow is key to reconstructing evolutionary histories and can allow us to predict species' resilience to changing environmental conditions. During the last glacial maximum (LGM), many high latitude North American bird species were forced into glacial refugia, including mountain bluebirds (Silia currucoides). Within their current breeding range, mountain bluebirds still experience a wide variety of environmental conditions and barriers that may disrupt gene flow and isolate populations. Using single nucleotide polymorphisms (SNPs) obtained through restriction site-associated DNA sequencing, we detected at least four genetically distinct mountain bluebird populations. Based on this structure, we determined that isolation-by-distance, the northern Rocky Mountains, and discontinuous habitat are responsible for the low connectivity and the overall history of each population going back to the last glacial maximum. Finally, we identified five candidate genes under balancing selection and three loci under diversifying selection. This study provides the first look at connectivity and gene flow across the range of these high-altitude and high latitude songbirds.

Women’s Participation in Community-Based Adaptation to Climate Change (CBACC): An Intersectional Analysis

This study explores which women participate in community-based adaptation (CBA) from an intersectional perspective. This study followed in-depth interviews (IDIs) and key informant interviews (KIIs) methods for data collection in Latachapli, Bangladesh. It explores women from different ethnic and religious identities participating in community-based adaptation (CBA) activities. The diversity among women leads to varying levels of participation. Three main areas—sense of insecurity, support from family members, and women’s literacy—and the NGO’s administrative bias have been seen to influence different levels of women’s participation in CBA. All these findings suggest that women’s intersectional challenges when participating in activities must be considered. The problem with the NGOs that implement the CBA activities is that they focus on marginalized communities (Rakhine) and women in general without taking into consideration the cultural, religious, and historical barriers that these different women face.

Barriers and facilitators to mental health treatment access and engagement for LGBTQA+ people with psychosis: a scoping review protocol

BackgroundThe prevalence of psychosis has been shown to be disproportionately high amongst sexual and gender minority individuals. However, there is currently little consideration of the unique needs of this population in mental health treatment, with LGBTQA+ individuals facing barriers in accessing timely and non-stigmatising support for psychotic experiences. This issue deserves attention as delays to help-seeking and poor engagement with treatment predict worsened clinical and functional outcomes for people with psychosis. The present protocol describes the methodology for a scoping review which will aim to identify barriers and facilitators faced by LGBTQA+ individuals across the psychosis spectrum in help-seeking and accessing mental health support.MethodsA comprehensive search strategy will be used to search Medline, PsycINFO, Embase, Scopus, LGBTQ+ Source, and grey literature. Original studies of any design, setting, and publication date will be included if they discuss barriers and facilitators to mental health treatment access and engagement for LGBTQA+ people with experiences of psychosis. Two reviewers will independently screen titles/abstracts and full-text articles for inclusion in the review. Both reviewers will then extract the relevant data according to pre-determined criteria, and study quality will be assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Key data from included studies will be synthesised in narrative form according to the Guidance on the Conduct of Narrative Synthesis in Systematic Reviews.DiscussionThe results of this review will provide a comprehensive account of the current and historical barriers and facilitators to mental healthcare faced by LGBTQA+ people with psychotic symptoms and experiences. It is anticipated that the findings from this review will be relevant to clinical and community services and inform future research. Findings will be disseminated through publication in a peer-reviewed journal and presented at conferences.Scoping review registrationThis protocol is registered in Open Science Framework Registries (https://doi.org/10.17605/OSF.IO/AT6FC).

Women's Participation in the Legal System: Challenges and Progress

This research paper delves into the multifaceted aspects of women's participation in the legal system, examining both historical barriers and contemporary challenges. It investigates the representation of women in various legal professions, their access to justice, and the impact of gender biases on their experiences within the legal framework. Moreover, it explores initiatives and strategies aimed at enhancing women's participation and achieving gender equality within the legal sphere. By analyzing existing literature and empirical data, this paper offers insights into the progress made, remaining obstacles, and future directions for advancing women's rights and representation in the legal system.

Mental health awareness effort targets Latinx youths to break stigma

Momentum to break down the historical barriers that have impeded mental health treatment access in the Latinx population is coming from a committed group of young people with rich lived experiences.

Areas of Endemism and Biogeographic Regionalization of the Iberian Peninsula Based on Ants (Hymenoptera: Formicidae)

Based on the distribution of 275 species of ants native to the Iberian Peninsula (IP), we identified areas of endemism (AE) within its geographical limits and present a biogeographic regionalization using two complementary methods and two types of operational geographical units. For endemicity analysis (EA), we used a 100 km2 grid cell, and for parsimony analysis of endemicity (PAE), we used hydrological basins as natural units. The EA revealed twelve areas of endemism that were grouped into five consensus areas. These are the Northeastern area, South plateau, Guadalquivir Valley, Baetic System, and Iberian Peninsula (whole). PAE resulted in a cladogram that classified hydrological basins into at least two successively nested subsets: an Atlantic group that is more related to northern European fauna and an Iberian subset that is well supported by synapomorphies. The Iberian subset was differentiated into four main areas: (a) a Northeastern area formed by the Pyrenees and the Catalan Coastal Range, (b) a mainland area containing the Central System and Guadiana and Tajo valleys, (c) a Southern area consisting of the Guadalquivir Valley and the Baetic System, and (d) a Northern coastal area. The results showed congruence between the two methods since many of the synapomorphies are shared among the diagnostic and IP endemic species of the EA. Both EA and PAE showed the relevance of the heterogeneous peninsular orography that combines mountainous regions with valleys and plateaus, which have acted as historical barriers or corridors. The presence of numerous endemic species, particularly in the southern third of the IP, suggests that several Iberian refuges for ants originated during glacial periods. These areas constitute priority sites for the conservation of ants in particular and biodiversity in general on the IP and allow further research about the processes that generated these distributional patterns.

Phylogeographic Substructuring in the Southernmost Refugium of the European Common Frog Rana temporaria.

Rana temporaria is one of the most widespread Palearctic brown frogs. We aimed to clarify distribution pattern of two main genetic clades in the understudied Balkan peninsula by using 16SrRNA and MT-CYTB sequences, already widely applied in analyses of populations from other parts of Europe, while focusing on the broad area along the Morava river (central Balkans) as a known gap in the species distribution. Additionally, we were interested in revealing the extent of haplotype diversity within the main genetic clades in the Balkans, particularly around the supposed suture zone. The results revealed a suture zone between the Western and Eastern Clades in the central part of the Balkan Peninsula. This indicated the existence of a historical barrier between the Balkan Mountain Belt and geographically close mountains surrounding the Vlasina Plateau (Rhodope/Serbian-Macedonian Massif). The overall observed haplotype diversity in populations of R. temporaria from the Balkan Peninsula seems high. Harboring both main genetic clades of R. temporaria qualifies the Balkan Peninsula as another important center of species' genetic diversity, as well as rich in unique haplotypes. This points out the necessity of applying conservation measures focused on the common European frog populations and habitats in this part of the species' distribution area.

Julian Hart Lewis. 12 August 1946—30 April 2014

Julian Hart Lewis was an outstanding embryologist and mathematical biologist whose breadth of interests and skills helped re-establish the importance of quantitative thinking to modern molecular developmental biology. He was most interested in the fundamental question of how the single-celled fertilized egg generates many different types of cells (e.g. nerves, skin, muscle) at the correct time and arranged in the right place. This remarkable generation of complexity is fundamental to an understanding of how animals develop and how this is orchestrated by their genes. Julian was exceptional in combining a ‘feel’ for biological questions and the ability to utilize rigorous and revealing mathematical models. He was also an outstanding mentor, writer and polymath, who was ahead of his time in breaching historical barriers between different scientific disciplines.

SME FINANCING THROUGH FINTECH: AN ANALYTICAL STUDY OF TRENDS IN NIGERIA AND THE USA

In this comprehensive review, we examine the burgeoning influence of Financial Technology (FinTech) on Small and Medium Enterprises' (SMEs) financing, with a focus on comparative trends between Nigeria and the USA. The paper aims to dissect how FinTech innovations have redefined the landscape of SME financing, facilitating enhanced accessibility and efficiency in financial services. Through an extensive literature review that spans academic journals, industry reports, and case studies, this study synthesizes current knowledge on the subject, offering a panoramic view of the FinTech ecosystem and its implications for SMEs in both developed and developing economies. Our analysis reveals that in the USA, FinTech has dramatically transformed SME financing by introducing alternative lending platforms, which provide more agile and less cumbersome financing options than traditional banks. This shift has not only improved the speed of funding but also expanded the availability of capital to a broader range of businesses. Conversely, in Nigeria, FinTech's impact is seen in the democratization of financial services, where mobile money and digital banking platforms have significantly increased SMEs' access to financial resources, overcoming historical barriers such as lack of collateral and banking infrastructure. The paper identifies key factors driving FinTech adoption in SME financing, including regulatory environments, technological advancements, and SMEs' growing demand for flexible financial solutions. It also highlights the challenges and opportunities inherent in leveraging FinTech for economic development and SME growth in both countries.
 Conclusively, the study underscores the transformative potential of FinTech in bridging the financing gap faced by SMEs, while also pointing out the necessity for supportive policies, digital literacy, and infrastructure development to fully harness FinTech's benefits. This review contributes to the ongoing dialogue on FinTech's role in economic empowerment, offering insights that could inform policymakers, practitioners, and researchers interested in the nexus between technology and small business financing.
 Keywords: Internet of Things (IoT), oil industry, efficiency, innovation, sustainability, challenges, strategies, emerging trends, cross-country collaboration, USA, Nigeria..