Search Results (1,584)

This theoretical article examines how belongingness, defined as the sense that one’s participation is legitimate and valued, interacts with cultural value orientations to help explain persistent disparities in U.S. technology engagement, including emerging technologies, across racial and ethnic groups. While structural barriers (e.g., racism, poverty, linguistic bias, etc.) remain essential to understanding such inequity, we argue that engagement patterns in technology also reflect how different cultural communities may define and experience belongingness in relation to digital domains. Drawing on Triandis and Gelfand’s (1998) framework, and focusing specifically on educational contexts, we propose the Belongingness through Cultural Value Alignment (BCVA) model, whereby belongingness serves as a catalyst between cultural value orientations and technology engagement, with vertical collectivism deriving belongingness primarily through structured skill development and validation while horizontal collectivism focusing instead on belonging based on community integration. When technological environments value practices that are consistent with vertical collectivist norms, individuals from horizontal collectivist cultures may experience cultural misalignment not from disinterest in technology or exclusionary efforts but, instead, because dominant engagement modes conflict with their familiar frameworks for fostering a sense of belonging. By examining how cultural value orientations mediate the sense of belonging in contexts involving modern technologies, the proposed perspective offers a novel framework for understanding why access alone may have proven insufficient to address technological participation gaps, and suggests directions for creating technology spaces where individuals from a wider range of communities can experience the authentic sense of belonging. Full article

Background: Investigating human exposure to toxic contaminants through dietary consumption is critical to identify disease risk factors and health guidelines. Methods: In this study, we developed a cross-sectional online survey to collect information about dietary patterns and related food consumption habits among adults (age ≥ 18) and adolescents (ages 13–17) in Southern California, focusing on popular staple foods and/or those targeted most commonly under California’s Proposition 65 law for lead and acrylamide exposure. Results: Results identified root vegetables, rice, leafy greens, pasta/noodles, tea, juice, and seafood to be among the most heavily consumed foods by mass, while the daily intake of many foods such as stuffed grape leaves, tamarind/chili candy and herbs/spices varied by age and race/ethnicity, suggesting that many of Proposition 65’s pollution allowances may be exacerbating issues of health inequity and environmental injustice. Moreover, findings from this study indicate that the methods of exposure assessment often applied under Prop 65, especially relating to herbs/spices, are likely to underestimate single-day exposures, thus allowing unsafe products on the market without warning labels. Conclusions: Study outcomes are broadly relevant to environmental health and nutrition science, with particular relevance to public health practitioners and California’s Prop 65 regulators and other stakeholders. Full article

This study evaluated emergency preparedness, covering knowledge, challenges, and culturally and linguistically appropriate resources among five resettled refugee communities in Central Ohio: Afghan, Bhutanese, Congolese, Ethiopian/Eritrean, and Somali. It also explored youth perceptions of community engagement and the effectiveness of current crisis support initiatives. A mixed-methods approach was used, consisting of a cross-sectional quantitative survey of 266 adults and a qualitative 60-min focus group discussion with 10 youth from the resettled communities. Quantitative data was analyzed with descriptive statistics and Chi-square tests assessing differences in preparedness across communities. Quantitative findings showed that the Bhutanese group reported the highest familiarity with preparedness concepts (33.3%), while Afghan and Congolese communities showed significant gaps. Of the 266 overall respondents, only 39.5% had an emergency plan, and 15.8% felt extremely confident in handling emergencies. Language barriers were major challenges, along with those related to race and ethnic identity, religious practices, and cultural norms. Effective platforms for engagement included community meetings, religious sites, and social media, with text messages and phone calls preferred for emergency communication. Youth discussion highlighted key public health concerns, particularly gun violence, substance abuse, and mental health crises, with stigma and limited resources further hindering preparedness efforts. Participants emphasized the need for culturally relevant interventions and stronger community engagement. Full article

The article is focused on the recent exegetical trend of “contextual” readings of the Bible, or context-sensitive exegesis in global Biblical scholarship. It is written by three authors from different ethnic and cultural contexts (German, Korean, Ethiopian) in order to emphasize the diversity to be considered. In the first part, the aims, history and relevant factors of contextual reading are described. The second part makes clear that also the traditional historical-critical exegesis is strongly contextual, drawing on Enlightenment thought and Western views of life. Therefore, any claims of “objectivity” or universality are problematic. In the third and fourth section of the article, two different contexts from global Christianity or the Majority World are introduced. first the African, especially Ethiopian context under the label of “vulnerability”, and then an Asian, precisely South Korean context with regard to the understanding of spirits and demons. The Ethiopian author describes how vulnerability has generally shaped the African cultural experience and specifically common language in Ethiopia, including religious attitudes which are characterized by a general openness for the divine. She also shows, that in such a culture, with the danger of naivete and acceptance of many problematic interpretations critical discernment is needed, as has already been stated by an Ethiopian philosopher of the 17th century. The part on Korean interpretation discusses the various views on spirits and demons in Korean Bible translations and the influence of Confucian thought and Shamanism on readings of the Bible. Using the example of the Gerasene demoniac, the author shows readers aware of shamanic ritual including pigs and intended to pacify the restless souls can impact the reading of this particular Biblical text even among modern Koreans. A brief concluding section draws some conclusions. Both examples demonstrate the diversity of contexts and their resonances with the Biblical texts when they are read in these different contexts. It is also obvious that there is not a single clear-cut dualism between Western and “postcolonial” readings. Neither the historical readings nor the contextual are “right” as such. Rather, there should be an open dialogue, on equal footing, that considers the context and also allows for critical interaction in order to prevent abuse of biblical texts, not only in colonial relations, but also within a given context by traditionalists, political powers, and spiritual authorities, so that the liberating power of the gospel can come into effect, for the benefit its readers. Full article

Background: Poor adherence to antihypertensive therapy is a major barrier to effective blood pressure control, particularly in countries with a high burden of non-communicable diseases. In Kazakhstan, improving adherence is a key objective of the “Densaulyk” State Health Program (2020–2025). Objective: To assess medication adherence among patients with arterial hypertension in Kazakhstan and identify associated socio-demographic and clinical factors. Methods: A cross-sectional survey was conducted among outpatient hypertensive patients at a major urban medical center. Adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8). Socio-demographic characteristics, disease duration, and the number of prescribed medications were analyzed in relation to adherence levels. Results: Adherence was significantly associated with age, ethnicity, education, marital and financial status, disease duration, and treatment complexity. A notable share of participants demonstrated low to moderate adherence. The use of self-reported data may have introduced bias. Conclusions: Medication adherence in Kazakhstan is influenced by multiple interrelated factors. Targeted and culturally appropriate interventions—such as simplified regimens, digital tools, and broader access to subsidized drugs—are essential to improve long-term outcomes in hypertension management. Full article

Background/Objectives: Type 2 diabetes (T2D) is a clinically and genetically heterogeneous disease. In this study, we aimed to stratify patients with T2D from the Volga-Ural region of Eurasia into distinct subgroups based on clinical characteristics and to investigate the genetic underpinnings of these clusters. Methods: A total of 254 Tatar individuals with T2D and 361 ethnically matched controls were recruited. Clinical clustering was performed using k-means and hierarchical algorithms on five variables: age at diagnosis, body mass index (BMI), glycated hemoglobin (HbA1c), insulin resistance (HOMA-IR), and β-cell function (HOMA-B). Genetic association analysis was conducted using logistic regression under an additive model, adjusted for age and sex, and corrected for multiple comparisons using the Benjamini–Hochberg method. Results: Four distinct T2D subtypes were identified—mild age-related diabetes (MARD, n = 25), mild obesity-related diabetes (MOD, n = 72), severe insulin-resistant diabetes (SIRD, n = 66), and severe insulin-deficient diabetes (SIDD, n = 52)—each with unique clinical and comorbidity profiles. SIDD patients exhibited the highest burden of microvascular complications and lowest estimated glomerular filtration rate. Nine genetic variants showed significant associations with T2D and/or specific subtypes, including loci in genes related to neurotransmission (e.g., HTR1B, CHRM5), appetite regulation (NPY2R), insulin signaling (TCF7L2, PTEN), and other metabolic pathways. Some variants demonstrated subtype-specific associations, underscoring the genetic heterogeneity of T2D. Conclusions: Our findings support the utility of clinical clustering in uncovering biologically and clinically meaningful T2D subtypes and reveal genetic variants that may contribute to this heterogeneity. These insights may inform future precision medicine approaches for T2D diagnosis and management. Full article

This study investigated how age, sex, and ethnicity relate to the severity of periodic limb movement index (PLMI) and obstructive sleep apnea (OSA) in a diverse clinical population. A retrospective analysis was conducted on 711 adults who underwent diagnostic polysomnography between June 2022 and July 2024. The mean age was 57.2 years; 55.6% were female, and the sample was ethnically diverse (53.7% White, 31.6% Hispanic, 6.8% Asian, 6.1% Black, 1.8% Other). PLMI was significantly higher in older adults, males, and White participants. AHI was higher in males and peaked in middle-aged adults (44–62 years). Multivariable regression models showed that male sex independently predicted higher PLMI and AHI, while increasing age was associated with higher PLMI only. Black ethnicity was linked to lower PLMI, and Hispanic ethnicity to higher AHI. These findings emphasize the role of demographic factors in the presentation of sleep disorders and support the need for personalized approaches in screening and diagnosis. Recognizing at-risk subgroups may improve early detection and targeted interventions for both PLMS and OSA in diverse populations. Full article

Prompted by participation gaps in the tech industry, this study explores the relationship between recent college graduates’ college experiences and their perceptions of their tech work environments. Using survey data from 15 research universities across the U.S., the findings suggest that gender and racial/ethnic identity influence the likelihood of viewing the field of computing as inclusive. Participants who were computing majors or felt a strong sense of belonging within the computing community were more likely to view the computing career environment positively. Notably, positive predictors of perceptions of an inclusive tech work environment, including majoring in computing as an undergraduate and feeling connected within computing, directly related to early career professionals’ undergraduate experiences. This study’s implications are relevant to various higher education stakeholders, including STEM department leaders, career development staff, and student affairs staff focused on fostering a strong pipeline from computing undergraduate programs to computing careers. Full article

Background: Physiologically based pharmacokinetic (PBPK) models utilize computer-based simulations to predict the pharmacokinetics of drugs. By using mathematical modeling techniques consisting of differential equations to simulate blood flow, tissue compositions, and organ properties, the pharmacokinetic properties of drugs can be better understood. Specifically, PBPK models can provide predictive information about drug absorption, distribution, metabolism, and excretion (ADME). The information gained from PBPK models can be useful in both drug discovery, development, and regulatory science. PBPK models can help to address some of the ethical dilemmas that arise during the drug development process, particularly when examining patient populations where testing a new drug may have significant ethical concerns. Patient populations where significant physiological change (i.e., pregnancy, pediatrics, geriatrics, organ impairment populations, etc.) and pathophysiological influences resulting in PK changes can also benefit from PBPK modeling. Additionally, PBPK models can be utilized to predict variations in drug metabolism resulting from genetic polymorphisms, age, and disease states. Methods: In this mini-review, we examine the various applications of PBPK models in drug metabolism. Current research articles related to drug metabolism in genetics, life-stages, and disease states were reviewed. Results: Several key factors in genetics, life-stage, and disease states that affect metabolism in PBPK models are identified. In genetics, the role of CYP enzymes, genetic polymorphisms, and ethnicity may influence metabolism. Metabolism generally changes over time from neonate, pediatric, adult, geriatric, and perinatal populations. Disease states such as renal and hepatic impairment, weight and other acute and chronic diseases also can also alter metabolism. Several examples of PBPK models applying these physiological changes have been published. Conclusions: The utilization and recognition of these specific areas in PBPK modeling can aid in personalized dosing strategy, clinical trial optimization, and regulatory submission. Full article

Background: Life insurance markets are experiencing unprecedented transformation in the wake of economic disruption, evolving consumer expectations, and behavioral shifts following the COVID-19 pandemic. Traditional economic models often fail to capture the complex interplay of attitudinal, and cognitive factors that now shape insurance demand and premium selection. Methods: This study analyzes nationally representative survey data from over 3600 U.S. adults (2024 NAIC Financial Inclusion Survey). It uses a weighted full maximum likelihood Heckman selection model to identify determinants of life insurance uptake and premiums. The main innovation is modeling psychological price, a composite of perceived affordability, with higher-order polynomials. The design integrates psychometrically validated measures of financial knowledge and risk tolerance. Political ideology, race and ethnicity, and sources of financial advice serve as exclusion restrictions in the selection equation. Results: Psychological price shows an inverse-U relation with term outcomes: uptake rises at low to moderate affordability and declines at high affordability; among purchasers, term premiums rise at low to mid affordability and decline at high levels. For cash value policies, premiums decrease as psychological price increases. Financial knowledge and risk tolerance increase term uptake; financial knowledge reduces cash premiums. Education and income increase term uptake and term premiums. Compared with respondents reporting no ideology, conservative and centrist respondents have lower term uptake and higher cash uptake; using a professional advisor is associated with higher cash uptake. The selection correlation is positive for term ($\rho \approx 0.98$) and negative for cash ($\rho \approx -0.38$), indicating non-random selection in both markets. Implications: In order to reduce disparities, insurers should target the mid-affordability threshold with term offerings, streamline options for high-affordability consumers, offer pricing support and guidance for low-affordability households, increase uptake through advice channels and financial education, and address affordability barriers. Conclusions: Nonlinear affordability effects shape both market entry and pricing choices. Modeling psychological price with higher-order polynomials identifies thresholds and turning points that linear specifications miss. The results support targeted product design and outreach when perceived affordability drives insurance participation and premium choices. Full article

Background: Residents of the US–Mexico border face cost-related barriers in accessing necessary medical care. Given the potential for individualized or broader tailoring of solutions to reflect community needs, we sought to identify risk factors for being uninsured and forgoing necessary medical care due to cost among a largely Hispanic adult population residing along the US–Mexico border. Methods: Surveys among adults in a major US–Mexico border area were used to investigate cost-related forgone medical care and lack of insurance. Binary Logit models were employed to model multiple binary outcomes informed by our theoretical frameworks. Results: Lower education, Hispanic ethnicity, being younger, lacking underlying illness and/or having obesity, forgoing medical care due to cost, and having lower income were associated with a higher likelihood of being uninsured; while being female, being younger, having underlying illness and/or having obesity (potential increased risk of severe illness due to COVID-19), lacking insurance, and having a lower income were risk factors for forgone medical care due to cost. Conclusions: This study adds novel insight into existing health inequities facing those residing along the US–Mexico border region, thereby holding timely public health implications. Full article

The United States ranks among the worst high-income countries for maternal health outcomes, with Black women experiencing disproportionately high and alarming rates of maternal mortality and morbidity. In Los Angeles County, Black women are four times more likely to die from pregnancy-related causes than women of other racial and ethnic groups. These disparities may partially be attributed to social determinants of health, including transportation access. Lack of transportation can hinder access to healthcare, with significant consequences for reproductive health. This study investigates how transportation barriers affect Black birthing people’s access to maternal healthcare in Los Angeles. In partnership with Black Women for Wellness, we conducted a descriptive, observational study using an online survey completed by 235 respondents, all of whom self-identified as women. Findings reveal that Black women in Los Angeles face substantial transportation barriers when seeking maternal healthcare, including limited public transportation, lack of personal vehicles, and challenges in securing rides. Many participants reported that these issues caused delayed or missed prenatal appointments. These results underscore the urgent need for policy interventions and systems-level solutions to improve transportation access. Addressing these barriers is essential for reducing maternal health disparities and improving outcomes for Black women. Full article

Gastrointestinal (GI) interventional endoscopy has evolved into a cornerstone of modern gastroenterology, offering minimally invasive solutions for complex conditions. However, these procedures are not without risk, particularly with respect to post-procedural infections. While rare, such infections can have significant clinical consequences and are increasingly recognized as a public health concern. This narrative review provides a comprehensive overview of infections associated with GI endoscopy, focusing on transmission mechanisms, microbial agents involved, host susceptibility, preventive strategies, and diagnostic and therapeutic approaches. Infections following GI endoscopy remain infrequent but clinically significant, particularly in high-risk procedures such as endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. Duodenoscopes represent a major vector for exogenous infection, often involving multidrug-resistant bacteria such as Klebsiella pneumoniae, Pseudomonas aeruginosa, and Enterococcus spp. Host-related factors increase the risk of infection. Risk factors associated with post-endoscopic infections include advanced age, male sex, non-white ethnicity, immunosuppression, presence of cholangiocarcinoma, autoimmune diseases, liver cirrhosis of viral and/or alcoholic etiology, chronic kidney disease, high-risk cardiac conditions, or chemotherapy. New reprocessing methods, such as ethylene oxide gas sterilization, automated endoscope reprocessors, and selective use of single-use endoscopes and duodenoscopes, may contribute to lowering infection rates. Greater awareness of infection risks, improved infection control practices, and adherence to updated guidelines are crucial for enhancing patient safety in digestive endoscopy. Multidisciplinary strategies, including surveillance, device innovation, and personalized risk assessment, are needed to address this evolving challenge. Full article

Introduction: The implementation of pedagogical tactics with ethnic-cultural approaches represents essential mechanisms for promoting breastfeeding, ensuring greater effectiveness in knowledge dissemination. These are supported by cultural ideologies that integrate didactic processes tailored to the beliefs and practices of each ethnic group, thus facilitating greater acceptance and adherence to health recommendations. Objective: The study aims to analyze the effectiveness of culturally sensitive educational strategies from the prenatal stage at the Quiroga Health Center, Ecuador, exploring how indigenous cultural dynamics influence the receptivity of education. Methodology: The research is quantitative, quasi-experimental, and employs a descriptive, documentary, bibliographic, and analytical cross-sectional cohort design to thoroughly analyze collected data and identify cause-and-effect factors influencing breastfeeding knowledge and practice. Results: The effectiveness of the educational intervention in promoting cognitive awareness of breastfeeding was confirmed using the McNemar statistic applied to related samples. Conclusions: Breastfeeding knowledge levels are closely tied to reproductive history, a constantly evolving process affected by various social factors. Health education is implemented and strengthened through teaching programs as these strategies can significantly contribute to maternal and child health promotion, adapting to the specific needs and contexts of each community. Full article

Background: Copper is an essential trace element involved in antioxidant defense and mitochondrial function. Evidence suggests that copper homeostasis may also influence metabolic liver diseases. We investigated the association between hepatic copper levels (HCLs) and liver-related outcomes among patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Methods: In this retrospective cohort study, we analyzed 215 MASLD patients who underwent liver biopsy with copper quantification. Patients were categorized based on hepatic copper content; normal < 50 vs. high ≥ 50 μg/g dry tissue (165 vs. 50 patients, respectively). The primary outcomes were progression in non-invasive fibrosis score (FIB-4) and incidence of clinical events (cirrhosis, liver transplantation, cardiovascular events or death) during a median follow-up of 4.9 ± 4.2 years. Multivariable linear and logistic regression models were adjusted for metabolic and demographic confounders. Results: Both liver copper groups shared similar baseline characteristics. High hepatic copper levels independently predicted higher FIB-4 scores at the end of follow-up in the fully adjusted linear regression model (β = 0.41; 95% CI: 0.05–0.76; p = 0.026). Logistic regression confirmed that high HCLs were associated with significant FIB-4 deterioration (OR = 41.3; 95%; p = 0.008). Kaplan–Meier analysis revealed significantly reduced overall survival among patients with high HCLs (Log-Rank p = 0.034), and multivariable Cox regression showed a markedly increased mortality risk (HR = 18.51; 95%; p = 0.032). Subgroup analyses highlighted greater risk among females, patients with diabetes or dyslipidemia, and individuals of Arab ethnicity. Conclusions: Elevated hepatic copper levels are associated with long term worsened liver fibrosis and higher mortality in MASLD. These findings support hepatic copper as a potential nutritional biomarker for risk stratification. Further studies are needed to explore copper modulation as a therapeutic target in MASLD. Full article