RESUMEN

BACKGROUND: ChatGPT is a novel and online large-scale language model used as a source providing up-to-date and useful health-related knowledges to patients and clinicians. However, its performance on Helicobacter pylori infection-related questions remain unknown. This study aimed to evaluate the accuracy of ChatGPT's responses on H. pylori-related questions compared with that of gastroenterologists during the same period. METHODS: Twenty-five H. pylori-related questions from five domains: Indication, Diagnostics, Treatment, Gastric cancer and prevention, and Gut Microbiota were selected based on the Maastricht VI Consensus report. Each question was tested three times with ChatGPT3.5 and ChatGPT4. Two independent H. pylori experts assessed the responses from ChatGPT, with discrepancies resolved by a third reviewer. Simultaneously, a nationwide survey with the same questions was conducted among 1279 gastroenterologists and 154 medical students. The accuracy of responses from ChatGPT3.5 and ChatGPT4 was compared with that of gastroenterologists. RESULTS: Overall, both ChatGPT3.5 and ChatGPT4 demonstrated high accuracy, with median accuracy rates of 92% for each of the three responses, surpassing the accuracy of nationwide gastroenterologists (median: 80%) and equivalent to that of senior gastroenterologists. Compared with ChatGPT3.5, ChatGPT4 provided more concise responses with the same accuracy. ChatGPT3.5 performed well in the Indication, Treatment, and Gut Microbiota domains, whereas ChatGPT4 excelled in Diagnostics, Gastric cancer and prevention, and Gut Microbiota domains. CONCLUSION: ChatGPT exhibited high accuracy and reproducibility in addressing H. pylori-related questions except the decision for H. pylori treatment, performing at the level of senior gastroenterologists and could serve as an auxiliary information tool for assisting patients and clinicians.

Asunto(s)

RESUMEN

BACKGROUND: Research has established the disproportionate impact of COVID-19 on Black, Indigenous, and People of color (BIPOC) communities, and the barriers to vaccine trust and access among these populations. Focusing on perceptions of safety, access, and trustworthiness, studies often attach barriers to community-members, and discuss vaccines as if developed from an objective perspective, or "view from nowhere" (Haraway). OBJECTIVE: We sought to follow Haraway's concept of "situated knowledges," whereby no one truth exists, and information is understood within its context, to understand the exertions of expertise surrounding vaccines. We focused on perceptions of power among a BIPOC community during a relatively unexamined moment, wherein the status of the pandemic and steps to prevent it were particularly uncertain. METHODS: We report the findings of ten focus groups conducted among members of Rhode Island's Latine/Hispanic communities between December 2021 and May 2022. We called this time COVID-19's liminal moment because vaccines were distributed, mandates were lifted, vaccine efficacy was doubted, and new strains spread. We translated, transcribed, and analyzed focus groups using thematic analysis. RESULTS: Community-member (n = 65) perceptions of control aligned with three key themes: (1) no power is capable of controlling COVID-19, (2) we are the objects of scientific and political powers, and (3) we, as individuals and communities, can control COVID-19 through our decisions and actions. CONCLUSIONS: By centering the perspectives of a minoritized community, we situated the scientific knowledge produced about COVID-19 within the realities of imperfect interventions, uncontrollable situations, and medical power-exertions. We argue that medical knowledge should not be assumed implicitly trustworthy, or even capable, but instead seen as one of many products of human labor within human systems. Trust and trustworthiness must be mutually negotiated between experts, contexts, and communities through communication, empowerment, and justice.

Asunto(s)

RESUMEN

OBJECTIVE: The aim of this study was to determine French psychiatrists' level of general knowledge about dissociative identity disorder and to evaluate their perceptions of this condition. METHODS: In this study, French psychiatrists were invited by e-mail to answer an online survey. The questionnaire asked about their general knowledge and perceptions of dissociative identity disorder. RESULTS: We received 924 answers including 582 complete questionnaires. The survey revealed that almost two-thirds (60.8%) of psychiatrists working in France had never received any training on dissociative disorders and 62% had never managed patients suffering from dissociative identity disorder. Only 19.5% of them claimed to believe unreservedly in the existence of the diagnosis of dissociative identity disorder. The psychiatrists' confidence in diagnosing or treating dissociative identity disorder was low (mean confidence in diagnosis: 3.32 out of 10 (SD 1.89), mean confidence in treatment: 3.1 out of 10 (SD 1.68)). Fifty percent believed that dissociative identity disorder is an entity created by cinema, medias or social networks. Seventy-seven point seven percent thought that confusion with borderline personality disorder is possible, and 41.3% with schizophrenia. CONCLUSION: In France, there is a lack of training and knowledge about dissociative identity disorder, as well as persistent skepticism about the validity of the diagnosis. Specific training seems essential for a better understanding of dissociative identity disorder.

RESUMEN

Rapid climate change is altering Arctic ecosystems at unprecedented rates. These changes in the physical environment may open new corridors for species range expansions, with substantial implications for subsistence-dependent communities and sensitive ecosystems. Over the past 20 years, rising incidental harvest of Pacific salmon by subsistence fishers has been monitored across a widening range spanning multiple land claim jurisdictions in Arctic Canada. In this study, we connect Indigenous and scientific knowledges to explore potential oceanographic mechanisms facilitating this ongoing northward expansion of Pacific salmon into the western Canadian Arctic. A regression analysis was used to reveal and characterize a two-part mechanism related to thermal and sea-ice conditions in the Chukchi and Beaufort seas that explains nearly all of the variation in the relative abundance of salmon observed within this region. The results indicate that warmer late-spring temperatures in a Chukchi Sea watch-zone and persistent, suitable summer thermal conditions in a Beaufort Sea watch-zone together create a range-expansion corridor and are associated with higher salmon occurrences in subsistence harvests. Furthermore, there is a body of knowledge to suggest that these conditions, and consequently the presence and abundance of Pacific salmon, will become more persistent in the coming decades. Our collaborative approach positions us to document, explore, and explain mechanisms driving changes in fish biodiversity that have the potential to, or are already affecting, Indigenous rights-holders in a rapidly warming Arctic.

Asunto(s)

RESUMEN

OBJECTIVE: Culturally safe service provision is essential to improving social and emotional wellbeing among Aboriginal and Torres Strait Islander communities, and to eliminating health inequities. Cultural safety is about ensuring that all people have a safe and healing journey through services, regardless of their cultural background. In this project, we aim to (1) understand how Aboriginal and Torres Strait Islander peoples conceptualise cultural safety, and (2) co-design a qualitative interview for the next phase of this project, where we plan to learn about experiences of cultural safety within mental health services. METHODS: We conducted six focus groups (in one metro and two regional areas, Western Australia). Following an Aboriginal Participatory Action Research methodology, we yarned with Aboriginal and Torres Strait Islander mental health service users, carers, community members, mental health professionals and Cultural Healers about cultural safety. RESULTS: Participants described a culturally safe service as one where Aboriginal cultural knowledges, life experiences, issues and protocols are understood and acknowledged, and reported that mainstream mental health services are not currently culturally safe. Participants emphasised the importance of building trust, rapport, reciprocity and following appropriate relational processes when designing a qualitative interview for the next phase. CONCLUSIONS: A lack of cultural safety in mental health services is likely to contribute to the disparity in outcomes between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Embedding cultural safety into research design allows for authentic community engagement and facilitates knowledge sharing around ways to improve cultural safety in mental health services.

Asunto(s)

RESUMEN

Pacific young people living in Aotearoa New Zealand experience disparities in their sexual and reproductive health outcomes, thought to stem from cultural differences and educational inequities. Although these barriers have been characterised in literature, their influence on Pacific youth's understandings of sexual and reproductive health have been relatively unexplored. This study investigated the sexual and reproductive health knowledge of Pacific students enrolled at a university in Aotearoa New Zealand in 2020 and where they gained this knowledge. The study used the theoretical framework of the (revitalised) Fonofale health model and was guided by the Kakala research methodology. Data were collected by means of an online survey comprised of open-ended questions and Likert scales, completed by eighty-one eligible students. Open-ended questions were analysed for general themes and responses to Likert scale items are reported using descriptive statistical analysis. The study found that Pacific youth have strong foundations of health knowledge that is heavily influenced by Polynesian cultural beliefs. Both formal and non-formal learning environments were important in developing participants' health knowledge of these topics and for encouraging independent help-seeking behaviours. This is the first reported study to investigate the sexual and reproductive health knowledges of a pan-Pacific tertiary cohort of young people.

Asunto(s)

RESUMEN

OBJECTIVES: The objective of this study was to develop and validate the Knowledge of Suicide Scale (KSS), elaborated to assess adherence to myths about suicide. METHODS: The KSS is a self-questionnaire including 22 statements relating to myths about suicide for which the respondent is asked to rate his degree of adherence on a scale ranging from 0 ("strongly disagree") to 10 ("completely agree"). Using the script concordance test scoring method, the respondents' scores were compared with those of experts to obtain, for each item, a score between 0 (maximum deviation with the experts) and 1 (minimum deviation with the experts). One thousand and thirty-five individuals (222 psychiatric interns, 332 medical interns in the first semester excluding psychiatry and 481 journalism students) were included. RESULTS: According to the exploratory factor analysis, the KSS is a two-dimensional scale: the first subscale includes 15 items and the second seven items. The tool showed excellent face validity, correct convergent and divergent validities (multi-method multi-feature analyzes), and good internal consistency (Cronbach's alpha coefficient between 0.66 and 0.83 for scales and subscales). The KSS is moderately and negatively correlated with the Stigma of Suicide Scale (r=-0.3). It significantly discriminates groups with different expected levels of knowledge regarding suicide (P<0.001). CONCLUSIONS: The KSS demonstrated good psychometric properties to measure adherence to myths about suicide. This tool could be useful in assessing the effectiveness of suicide prevention literacy improvement programs.

RESUMEN

BACKGROUND: In the modern era of antibiotics, healthcare-associated infections (HAIs) have emerged as a prominent and concerning health threat worldwide. Implementing an electronic surveillance system for healthcare-associated infections offers the potential to not only alleviate the manual workload of clinical physicians in surveillance and reporting but also enhance patient safety and the overall quality of medical care. Despite the widespread adoption of healthcare-associated infections surveillance systems in numerous hospitals across China, several challenges persist. These encompass incomplete coverage of all infection types in the surveillance, lack of clarity in the alerting results provided by the system, and discrepancies in sensitivity and specificity that fall short of practical expectations. METHODS: We design and develop a knowledge-based healthcare-associated infections surveillance system (KBHAIS) with the primary goal of supporting clinicians in their surveillance of HAIs. The system operates by automatically extracting infection factors from both structured and unstructured electronic health data. Each patient visit is represented as a tuple list, which is then processed by the rule engine within KBHAIS. As a result, the system generates comprehensive warning results, encompassing infection site, infection diagnoses, infection time, and infection probability. These knowledge rules utilized by the rule engine are derived from infection-related clinical guidelines and the collective expertise of domain experts. RESULTS: We develop and evaluate our KBHAIS on a dataset of 106,769 samples collected from 84,839 patients at Gansu Provincial Hospital in China. The experimental results reveal that the system achieves a sensitivity rate surpassing 0.83, offering compelling evidence of its effectiveness and reliability. CONCLUSIONS: Our healthcare-associated infections surveillance system demonstrates its effectiveness in promptly alerting patients to healthcare-associated infections. Consequently, our system holds the potential to considerably diminish the occurrence of delayed and missed reporting of such infections, thereby bolstering patient safety and elevating the overall quality of healthcare delivery.

Asunto(s)

RESUMEN

Greater engagement and representation of Indigenous voices, knowledges and worldviews in the biological sciences is growing globally through efforts to bring more Indigenous academics into scientific research and teaching institutions. Although the intentions of such efforts may be admirable, these spaces often become sites of great personal tension for the Indigenous scholars who must 'bridge' or 'facilitate' a dialogue between Indigenous and settler-colonial (predominantly Western) knowledge traditions and worldviews. We are a small collective of early career Indigenous scholars from Australia, the United States and Aotearoa New Zealand, and we have gained insights into this situation through the unique experiential learning afforded by navigating such tensions. Here, we discuss tensions that bear remarkable similarities across geographies, cultures and settler-colonial contexts. In doing so, we aim to support other Indigenous scientists and scholars navigating settler-colonial and Western research institutions, while offering guidance, suggestions and reflections for the scientific community to allow the development of more nuanced strategies to support Indigenous academics than simply increasing Indigenous representation. We imagine transformed, innovative research and teaching agendas where Indigenous knowledges can thrive, and Indigenous scientists can apply themselves with mutual and balanced respect and reciprocity.

Asunto(s)

RESUMEN

This article unpacks the logic of the equivalence invoked by the Government of Canada between Indigenous consent and the inclusion of Indigenous peoples and knowledges in impact assessment. We situate the logic within the politics of recognition in Canada-a politics that aims to shore up national unity in the face of regular challenges to it. We use the Canadian results from a recent scoping review on conceptions of environmental justice in impact assessment to highlight the challenges of invoking recognition, and we provide a theoretical analysis of these challenges. To do this, we highlight the ways in which 'we-making' is 'knowledge-making' and 'knowledge-making' is 'we-making'. In this sense, recognizing Indigenous knowledges is part of Canada's answer to the challenge of constructing and stabilizing a political 'we': a community of political subjects with shared connection to a nation state via the institutional, social, and cultural apparatuses that generate the kind of publicly visible legal and technical knowledge upon which the state's authority depends. We show how this project relies on actively obscuring the relationship between 'we-making' and 'knowledge-making' by treating 'knowledge-making' as neutral and un-situated, putting into practice a universalist logic. This logic shores up power because obscuring the situatedness of dominant knowledges also obscures the situatedness of the dominant political orders with which they are intertwined. We ultimately argue that Canada's approach to recognizing Indigenous knowledges helps consolidate power by sidestepping ongoing jurisdictional struggles with Indigenous peoples.

Asunto(s)

RESUMEN

This essay encourages scholars of management and organization studies (MOS) to critically reflect on how Indigenous peoples and their knowledges have been, and continue to be, systemically discriminated against. This discrimination is the result of colonization; it has deeply impacted and continues to affect which knowledges and practices are valued and embraced. The impact of colonization is mirrored in MOS via processes and actions within the academic setting and our business schools. The result is the continued marginalization of Indigenous peoples and their knowledges. We propose a shift in how MOS scholars approach research in relation to non-western societies to counter, and hopefully end, these continued practices of discrimination in our business schools. Specifically, we argue that demarginalizing Indigenous research in academia and going beyond 'cosmetic indigenization' in our business schools are new, collaborative ways of rethinking indigeneity and breaking down the current barriers in MOS that reinforce and perpetuate the systemic discrimination against Indigenous peoples, their knowledges and practices.

RESUMEN

Physical literacy (PL) is gaining more attention from educational policy-makers, practitioners, and researchers as a way to improve health and wellness outcomes for children and youth. While the development of PL is important for early years children, there is limited attention in the literature that explores the political, cultural, and social discourses imbued in colonialism that implicate how PL is actualized in Indigenous early childhood education (ECE) contexts. This case assemblage explores how the culturally rooted, interdisciplinary, and community-based PL initiative, Nature's Way-Our Way (NWOW), negotiated movement with three early childhood educators in the pilot project with an early childhood education centre (ECEC) in Saskatchewan, Canada. Through postqualitative approaches to research, this case assemblage adopts new materialist methodologies to show how the natural order of knowing in movement was disrupted through moments of rupture generating stories of PL to encompass radical relationality with land. As land becomes a vital and lively part of PL storying, it can function as an important protective factor for Indigenous preschool-aged children's wholistic wellness.

Asunto(s)

RESUMEN

Indigenous Peoples and their deep knowledges offer a fundamentally important way of seeing the world and the environment. Through relationships to distinct ancestral homelands, Indigenous Peoples have developed unique ways of surviving, adapting, connecting, and relating to their respective environments. Indigenous Sacred Places themselves are connections to ancestors, to all beings on the planet, and to different planes of existence. Sacred Places serve an important environmental role in many Indigenous Nations around the globe. Yet, Indigenous Sacred Places, and in particular understandings of spirit that connect Sacred Places, have been historically and contemporarily marginalized and excluded from environmental health academic discourse and spaces. This despite concrete calls for the amplification of Indigenous traditional knowledges-that of which does not separate spirit from knowledge, or spirit from action-they are intertwined. With this, we sought to amplify in this Perspective, understandings and connectivity between Sacred Places, spirit, and environmental health through the stories from Indigenous Elders, processes of ceremony, and personal synthesis.

RESUMEN

This qualitative study integrates key theories on epistemic decolonization from Asia, Africa, and Latin America to investigate the decolonial awareness and curriculum practices of teachers and international students in an English as a medium of instruction (EMI) program on Chinese philosophy and culture at a top-rated university in China. Content analysis of the in-depth, semi-structured interviews with 17 informants reveals that the teachers and students all demonstrated varying degrees of decolonial awareness related to the marginalized status of Chinese philosophy in Anglo--Eurocentric disciplinary systems and adopted the following strategies to decolonialize the curriculum and foster epistemic justice in the unequal geopolitics associated with knowledge production: (1) historicizing Chinese philosophy as a modern discipline that has emerged from inter-knowledge dialogues across philosophical traditions and is still in constant tension with the complex interplay of the semi-colonial, imperial, and Cold War legacies; (2) abandoning the Anglo-Eurocentric benchmark by pluralizing the disciplinary contemporaneity, and (3) cultivating epistemic trust in Chinese through intercultural translation. Moreover, the flexible shuttling between Chinese and English in EMI classrooms and tutorial sessions helped the informants to observe the decolonial awareness that was inherent in their understanding of the discipline-specific ontology. The findings suggest the agentive potential of teachers and international students to foster epistemic justice in EMI curriculum design and implementation that counters the hegemony of English as a colonial force. Finally, implications for decoloniality-informed EMI policymaking and curriculum internationalization are discussed.

RESUMEN

The inclusion of Indigenous cultures, known as the cultural determinants of health, in healthcare policy and health professional education accreditation and registration requirements, is increasingly being recognised as imperative for improving the appalling health and well-being of Indigenous Australians. These inclusions are a strengths-based response to tackling the inequities in Indigenous Australians' health relative to the general population. However, conceptualising the cultural determinants of health in healthcare practice has its contextual challenges, and gaps in implementation evidence are apparent. In this paper, we provide a case example, namely the Katherine Hospital, of how healthcare services can implement the cultural determinants of health into clinical practice. However, to be effective, health professionals must concede that Australia's Indigenous peoples' knowledges involving cultural ways of being, knowing and doing must co-exist with western and biomedical knowledges of health practice. We use the Katherine Hospital ABC Radio National Background Briefing interview, which was mentioned by two research participants in a 2020 study, as an example of good practice that we can learn from. Additionally, the six Aboriginal and Torres Strait Islander Health actions contained in the 2nd Edition of the Australian National Safety and Quality Health Service Standards provide governance and accountability examples of how to enable Indigenous people's cultures and their knowledges in the provision of services. The role of non-Indigenous clinical allies and accomplices is imperative when embedding and enacting Indigenous Australians' cultures in service systems of health. When Indigenous Peoples access mainstream hospitals, deep self-reflection by allies and accomplices is necessary to enable safe, quality care, and treatment that is culturally safe and free from racism. Doing so can increase cultural responsiveness free of racism, thereby reducing the inherent power imbalances embedded within mainstream health services.

Asunto(s)

RESUMEN

The primary aim of this article is to use Foucault's idea of subjugated knowledges to search out areas and viewpoints within Fiji soccer which are suppressed by the governing authorities. To fulfill this aim, we explore and assess, via ethnographic research, the racial and ethnic aspects of Fiji soccer, from the 1970s to the 2010s, and how cultural hegemony facilitates continued Fiji Indian control and dominance within the sport. Next, and although we note the positive dimension of Fiji Football Association's 2014 Veterans' Dinner, we suggest that some ex-Ba players were apparently discriminated against by, puzzlingly, not being invited. The regulator was also unaware of, or insensitive to, ex-players' transportation needs as some were poor or invalid. We then look at the cases of Sweats Soccer Club (SSC) and Nadi Legends Football Club (NLFC) to show how, in the face of the regulator's indifference to the financial plight of an Indigenous village club (SSC), the ex-Nadi players set up instead a self-help organization (NLFC) to assist and encourage ex-players going through hard times. The latter was a cross-ethnic group/cross-class collaboration between ex-officials and ex-players and was largely outside the regulator's sphere of interest or intent.

RESUMEN

AbstractRacism and colonialism within restoration science continue to perpetuate exclusionary and oppressive paradigms in ecosystem restoration and in wider societal contexts, from setting scientific agendas to translating findings into policy. These paradigms impair progress and cause harm by (1) tokenizing epistemic diversity, (2) perpetuating injustice in frontline communities by ignoring power dynamics and other local contexts, and (3) rejecting "unconventional" methods for connecting knowledge to action. To challenge exclusion, biological scientists must listen to path-making conversations in Native American and Indigenous studies on grounded normativity, an ethical framework informed by place-based practices that make respectful, nonexploitative coexistence between human and nonhuman communities possible. Rather than treat Western science as the objective arbiter of truth, Indigenous and feminist science approaches can draw on multiple sciences to design restoration interventions and unsettle power dynamics and historical legacies in the biological sciences. We put these approaches into practice and discuss the methodologies and outcomes of two restoration projects, one on the Duwamish River and one on the Klamath River. We use the lessons learned to discuss how scientists in all biological fields can prevent harmful inequities in restoration work while building capacity in and supporting crucial work by frontline communities.

Asunto(s)

RESUMEN

Knowledge translation (KT) is a critical component of any applied health research. Indigenous Peoples' health research and KT largely continues to be taught, developed, designed, regulated, and conducted in ways that do not prioritize local Indigenous Peoples' ways of sharing knowledges. This review was governed and informed by Indigenous health scholars, Knowledge Guardians, and Elders. Our systematic review focused on answering, what are the promising and wise practices for KT in the Indigenous health research field? Fifty-one documents were included after screening published literature from any country and grey literature from what is now known as Canada. This included contacting 73 government agencies at the federal, territorial, and provincial levels that may have funded Indigenous health research. Only studies that: a) focused on Indigenous Peoples' health and wellness; b) documented knowledge sharing activities and rationale; c) evaluated the knowledge sharing processes or outcomes; and d) printed in English were included and appraised using the Well Living House quality appraisal tool. The analysis was completed using an iterative and narrative synthesis approach. Our systematic review protocol has been published elsewhere. We highlight and summarize the varied aims of Indigenous health research KT, types of KT methodologies and methods used, effectiveness of KT efforts, impacts of KT on Indigenous Peoples' health and wellness, as well as recommendations and lessons learned. Few authors reported using rigorous KT evaluation or disclosed their identity and relationship with the Indigenous communities involved in research (i.e. self-locate). The findings from this review accentuate, reiterate and reinforce that KT is inherent in Indigenous health research processes and content, as a form of knowing and doing. Indigenous health research must include inherent KT processes, if the research is by, for, and/or with Indigenous Peoples.

Asunto(s)

RESUMEN

This article locates its roots/routes in multiple disciplinary formations and it seeks to advance critical thinking about an aspect of our contemporary socio-technical challenges by bracketing three knowledge formations-artificial intelligence (AI), economics, and epistemology-that have not often been considered together. In doing so, it responds to the growing calls for the necessity of further transdisciplinary engagements that have emanated from work in AI and also from other disciplines. The structure of the argument here is as follows. First, I begin by demonstrating how and why explanation is a problem in AI ("XAI problem") and what directions are being taken by recent research that draws upon social sciences to address this, noting how there is a conspicuous lack of reference in this literature to economics. Second, I identify and analyze a problem of explanation that has long plagued economics too as a discipline. I show how only a few economists have ever attempted to grapple with this problem and provide their perspectives. Third, I provide an original genealogy of explanation in economics, demonstrating the changing nature of what was meant by an explanation. These systematic changes in consensual understanding of what occurs when something is said to have been "explained", have reflected the methodological compromises that were rendered necessary to serve different epistemological tensions over time. Lastly, I identify the various relevant historical and conceptual overlaps between economics and AI. I conclude by suggesting that we must pay greater attention to the epistemologies underpinning socio-technical knowledges about the human. The problem of explanation in AI, like the problem of explanation in economics, is perhaps not only, or really, a problem of satisfactory explanation provision alone, but interwoven with questions of competing epistemological and ethical choices and related to the ways in which we choose sociotechnical arrangements and offer consent to be governed by them.