Toronto Metropolitan University Open Journals
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Systemic and institutionalized racism, not achievement gap factors, limit the success of Black, Indigenous, and People of Color in dietetics education and credentialing
No full textOur aim was to explore racial/ethnic differences on achievement and opportunity gap factors in nutrition students and identify factors related to the pathway to become a Registered Dietitian Nutritionist (RDN). An online survey was completed by 1447 current or recent dietetic students and interns, some of whom identified as RDNs and/or Nutrition and Dietetic Technician, Registered (NDTRs). The survey consisted of validated scales measuring academic confidence, mentoring, racial climate, grit, and time management, and questions measuring socio-economic factors. Analysis included descriptive statistics, multiple regression, t-tests, and chi-squares. No differences were observed between the scores of Black, Indigenous, and participants of color (BIPOC) and White participants on academic scales. BIPOC experienced a more negative racial climate than White participants (p<0.05). Black dietetics students are also at particular economic disadvantage compared to other participants of color. Ultimately, Black and BIPOC are as academically prepared as White participants but institutionalized and structural racism (e.g., opportunity gap factors) limit their opportunities to succeed. 
A scoping review of insomnia treatments for people living with HIV: Insomnia treatments for people living with HIV
No full textAbstract
To date, little is known in terms of viable treatments for insomnia in people living with HIV. The primary aim of this scoping review is to identify non-pharmacological treatments for insomnia in people living with HIV (PLWH). A framework by Arksey and O’Malley was used to guide the conduct of this scoping review. Seven studies were identified. Three of the studies used cognitive-behavioral type of treatments versus physical or alternative types of treatment. The most effective treatments with the largest effect sizes were found to be cognitive-behavioral treatments for the sleep outcomes of sleep quantity (1.11-1.91) and sleep quality (1.11-1.91). This review found that cognitive behavioral interventions were found to be the most effective treatments for insomnia for PLWH. Further research would benefit from larger sample size studies in addition to focusing on the determinants of insomnia in PLWH in order to further provide a treatment that is focused on the needs of PLWH.
 
Organizational culture, diversity, and employees’ health in social/human services: A systematic review
No full textAbstractLeadership and organizational culture significantly impact employees\u27 work performance and job satisfaction, but less is known about employee health and well-being within a diverse work environment. This study systematically reviewed 23 studies published between 2007-2019 that addressed organizational culture, diversity/workplace, and employee health within North American social/human services organizations. Results highlighted three themes: 1) Organizational Culture within Social/Human Services, 2) Diversity and Workplace, and 3) Employee Health at the Intersection of Organizational Culture and Diversity. Conclusions emphasize the need for organizations to adjust to changing workforce demographics and promote an equitable workplace culture
The whiteness of the Mediterranean Diet: A historical, sociopolitical, and dietary analysis using Critical Race Theory
No full textAmple evidence indicates that adherence to the Mediterranean diet (MedDiet) decreases the risk of cardiovascular disease, stroke, heart failure, cancer mortality, type 2 diabetes, overweight, and obesity. The MedDiet is widely accepted as a gold standard diet, yet its adoption and promotion as the healthiest cultural diet reflects systemic racism and inherently biased research, rather than evidence-based science. This analysis establishes that while the Mediterranean region is multi-cultural and multi-ethnic, the MedDiet is a White diet. It also asserts that a lack of causal research and other methodologic issues in research about the MedDiet has resulted in a hyperfocus on the MedDiet over other cultural diets. Third, this essay compares the MedDiet to the traditional Chinese and African diets to assert that many cultural diets are healthy and may be as healthy as the MedDiet. Ultimately, health professionals promoting the MedDiet as a gold standard marginalize people from non-White cultures by maintaining White culture as normative. In order to better serve and include people of color, dietary recommendations need to become as diverse as the US population. Doing so will also improve cultural competence among professionals, lead to a more equitable professio
Influence of preferences in intervention research: A scoping review
No full textIntroduction: Accounting for treatment preferences is beneficial in practice, it increases adherence to treatment and improves health outcomes. The randomized controlled trial (RCT) is considered the most robust in generating valid evidence on effectiveness, yet it ignores participants’ preferences for treatment. This scoping review addressed three questions: 1) How are treatment preferences conceptualized in intervention research? 2) To what extent do treatment preferences affect participants’ enrollment in trials, withdrawal from the study, adherence to treatment, and outcomes? And 3) What designs are used to account for treatment preferences in intervention evaluation research?
Methods: The first five steps of the scoping review methodology framework were applied: 1) identifying the research questions; 2) searching the literature; 3) selecting articles; 4) charting data; and 5) summarizing findings.
Results: Treatment preferences refer to choice treatment; they are shaped by participants’ beliefs and appraisal of the interventions. Evidence from reviews and primary studies indicated that offering participants the opportunity to choose and receive the preferred treatment enhances enrollment and reduces withdrawal in trials; however, the evidence regarding the influence of treatment preferences on adherence to treatment and improvement in outcomes is inconclusive. Designs that account for treatment preferences include: RCT, RCT with a comprehensive cohort, partially randomized preference trial, and two-stage partially randomized trial.
Conclusion: The pattern of results may be attributed to the methods for assessing treatment preferences. A systematic method for assessing preferences is recommended
Perspectives of service agencies on factors influencing immigrants’ mental health in Alberta, Canada
No full textNewcomers to Canada experience resettlement challenges that affect their mental well-being. Guided by an intersectionality theoretical framework, we sought the perspectives of immigrant service agencies on factors influencing immigrants’ mental health in Alberta, Canada. Data were collected by means of qualitative interviews and focus groups with immigrant service providers. Our data analysis identified seven themes – precarious immigration status, employment discrimination, social isolation, socioeconomic pressures, sociocultural stress, gender and age-related vulnerabilities, and lack of appropriate mental health supports – reflecting the major intersecting determinants of immigrants’ mental health. We propose policy interventions for addressing the mental health vulnerabilities of immigrants.  
Head and neck cancer treatment and its sexual impact on quality of life: An integrative literature review.
No full textObjective: To identify the impacts of head and neck cancer treatment on the sexual health of patients. Methods: An integrative literature review was carried out from May to October 2020 using PubMed, CINAHL, Web of Science, LILACS, and the SciELO portal. A total of 287 primary articles were identified. After assessing them, 6 articles met the eligibility criteria, which were: all articles published in the last ten years that addressed the sexual impact of HNC treatment on people\u27s lives, without any language or age. Results: Patients with Head and Neck Cancer have to face aesthetic disfigurement challenges in post-treatment. This leads to a greater degree of suffering and social and sexual problems than is observed in other cancer patients. Health professionals do not feel safe to access the intimate and sexual demands of patients during the clinical treatment. Conclusions: Most of the studies included in this review focused on measuring the quality of life using only one or two variables related to sexuality. There is the need other research to explore how multiple factors, such as social, psychological, cultural, religious, ethnic, and ethical factors, affect sexuality. This promotes the creation of the paths for comprehensive care and management of patients