An exploration of female underrepresentation on executive boards in the Dutch hotel industry through an ethical lens

PurposeThis paper elucidates female underrepresentation on executive boards in the Dutch hotel industry through a “feminist” stakeholder perspective, which persists despite public opinion and government initiatives to resolve this enigma. It contributes to this discussion by examining Rhenish governance structures through a “feminist” stakeholder-focused rationale, complementing prevailing Anglo-Saxon shareholder-focused governance research.Design/methodology/approachEleven in-depth, semi-structured interviews were conducted with hotel executive board representatives and five with sublevel management representatives. Saturation was achieved by interviewing all females on Dutch hotel corporate boards regarding their career experiences compared with those of female general managers and male counterparts.FindingsThis paper finds a prevailing “masculinist” perspective of an idealized shareholder-orientated executive and a “feminist” perspective of a humanized stakeholder-orientated executive expressed within the interviews. While the former sacrifices family for their career, the latter balances their family with their career. The former fosters presupposed gender norms, with females commonly sacrificing their careers while males sacrifice their families. Notably, most executives predominantly supported the humanized stakeholder-orientated executive, while recognizing that micro-, meso- and macro-structural barriers remain.Originality/valueThis paper addresses a lacuna in the ethical literature in exploring female executive representation in Rhenish stakeholder-focused governance structures, as opposed to Anglo-Saxon shareholder-focused ones. It found a “masculinist” perspective of an idealized shareholder-focused executive archetype and a “feminist” perspective of a humanized stakeholder-focused executive archetype. Notably, contrary to perceived business norms, several interviewees rejected the former as it is incompatible with family and work, instead seeking the latter which balances between family and work.

Project COALESCE—An Example of Academic Institutions as Conveners of Community-Clinic Partnerships to Improve Cancer Screening Access

In Virginia, 56% of colorectal cancers (CRC) are diagnosed late, making it one of three enduring CRC mortality hotspots in the US. Cervical cancer (CCa) exhibits a similar pattern, with 48% late-stage diagnosis. Mortality for these cancers is worse for non-Latinx/e(nL)-Black people relative to nL-White people in Virginia, but preventable with equitable screening access and timely diagnostic follow-up. However, structural barriers, such as fractured referral systems and extended time between medical visits, remain. Because Federally Qualified Health Centers (FQHCs) care for a large proportion of racial and ethnic minorities, and underserved communities, regardless of ability to pay, they are ideal partners to tackle structural barriers to cancer screenings. We piloted a quality improvement initiative at five FQHCs in southcentral Virginia to identify and address structural, race-related barriers to CRC, as well as CCa screening and diagnostic follow-up using evidence-based approaches. Uniquely, FQHCs were paired with local community organizations in a didactic partnership, to elevate the community’s voice while together, increase support, acceptance, uptake, and intervention sustainability. We report on project development, and share preliminary data within the context of project goals, namely, to increase cancer screenings by 5–10%, improve knowledge and diagnostic follow-up processes, and build longitudinal partnerships.

Nutrition Interventions Addressing Structural Racism: A Scoping Review

African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care, and other settings. Nutrition education and nutrition-focused policy, systems, and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarize the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them to the “Getting to Equity in Obesity Prevention” framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing 6 databases—MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX, and ProQuest Dissertations & Theses. A total of 30 sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems, and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the “reduce deterrents” and “improve social and economic resources” aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature.

Awareness and Use of Post-exposure Prophylaxis for HIV Prevention Among Men Who Have Sex With Men: A Systematic Review and Meta-Analysis

Background: The use of post-exposure prophylaxis (PEP) is effective in reducing HIV risk, but it is underused by men who have sex with men (MSM) due to certain psychological and sociostructural factors. This article assessed the awareness and use of PEP among MSM in an effort to increase the visibility and uptake of PEP among at-risk populations.Methods: We conducted a systematic literature search of the PubMed, Web of Science, PsycINFO, and Google Scholar electronic databases. Studies were screened for inclusion, and relevant data were abstracted, assessed for bias, and synthesized. Pooled effect estimates were calculated using random effects meta-analysis, meta-regression and subgroup analysis, and a qualitative review and risk of bias assessment were performed (PROSPERO, CRD42019123815).Results: Twenty eligible studies involving 12,579 MSM were included in the meta-analysis. The pooled estimate of the proportions of MSM who were aware of PEP was modest at 59.9% (95% CI: 50.5~68.7) and that of MSM who previously used PEP was very low at 4.9% (95% CI: 2.4~9.8). PEP awareness showed no clear change over time, while PEP use significantly changed over time. Multiple factors affected awareness, including educational attainment, race/ethnicity, levels of HIV stigma, access to condoms, and so on. Many factors could potentially impede or facilitate the use of PEP, such as income, lack of PEP information, and partnership.Conclusion: We observed that PEP is an underused HIV prevention strategy among MSM and that once MSM become aware of PEP, the majority are willing to use it if they are supported appropriately in terms of a range of individual, social, and structural barriers.Systematic Review Registration: http://www.cdr.york.ac.uk/prospero, PROSPERO [CRD42019123815].

“You Have to be Resilient”: A Qualitative Study Exploring Advice Newcomer Youth Have for Other Newcomer Youth

Research infrequently includes the perspectives of vulnerable and marginalized youth. As the population of newcomer youth in Canada continues to grow, it is imperative that attention is devoted not only to challenges they experience, but also to resilience factors they perceive to support their adjustment and well-being. To address this gap, this qualitative research explored newcomer youths’ experiences and advice for other newcomer youth who have recently arrived in Canada. Thirty-seven newcomer youth from two medium-sized cities in Ontario participated in focus groups. Participants ranged from 14 to 22 in age and identified mostly as female refugees from the Middle East. Through thematic analysis, five overarching themes were found across groups: (1) moving to a new country is hard, (2) maintain a healthy mindset, (3) take an active role in the adjustment process, (4) stay true to who you are, (5) and you are not alone. Youth described hardships that make moving to a new country difficult including lack of belonging due to racism and bullying, insufficient orientation to new systems, language barriers, and high levels of stress. Findings demonstrated youths’ resilience, coping skills, and strategies to lead meaningful lives. Youth discussed resilience strategies such as maintaining a connection with home culture and religion, reframing thinking to be positive, receiving emotional support, accessing community support at newcomer agencies, and building language proficiency. Findings provide implications for professionals working with newcomer youth and reflect the importance of addressing structural barriers and racism. The opportunity for newcomer youth to share experiences as experts in research may also help to promote resilience.

Mapping of Financial Support Programs for Children With Neurodisabilities Across Canada: Barriers and Discrepancies Within a Patchwork System

A cross-jurisdictional pan-Canadian environmental scan was conducted to identify provincial, territorial, and federal financial supports available to families with children living with neurodisabilities. In partnership with the organization Childhood Disability LINK, flowchart-styled pathway documents were developed for each financial support identified, mapping out the processes required to access each support. A critical analysis was completed as it relates to structural barriers, accessibility of program information and geographic discrepancies. The results revealed that, despite almost universal availability of programs to support families of children living with neurodisabilities, significant barriers and inequity remain. This included considerable variation in access to financial support based on geographic and jurisdictional discrepancies, absence of adequate and accurate information about programs, and minimal support provided to families in the application process. We argue that the barriers and discrepancies identified were an inherent result of the Canadian federalist fragmentation of the delivery of social care and financial support programs for children living with neurodisabilities. A more unified response by Canadian provincial, territorial, and federal governments is clearly needed to take positive steps to address the consequences of federalist fragmentation and respond to the structural barriers and geographic discrepancies identified by this study.

Toxicants, entanglement, and mitigation in New England’s emerging circular economy for food waste

Drawing on research with food waste recycling facilities in New England, this paper explores a fundamental tension between the eco-modernist logics of the circular economy and the reality of contemporary waste streams. Composting and digestion are promoted as key solutions to food waste, due to their ability to return nutrients to agricultural soils. However, our work suggests that food waste processors increasingly find themselves responsible for policing boundaries between distinct “material” and “biological” systems as imagined by the architects of the circular economy—boundaries penetrable by toxicants. This responsibility creates significant problems for processors due to the regulatory, educational, and structural barriers documented in this research. This paper contributes to scholarship which suggests the need to rethink the modernist logics of the circular economy and to recognize the realities of entangled material and biological systems. More specifically, we argue that if circularity is the goal, policy needs to recognize the barriers food waste processors face and concentrate circularity efforts further upstream to ensure fair, just, and safe circular food systems.

Persistent Barriers to Colorectal Cancer Screening Completion Amid Centralized Outreach: A Mixed Methods Study

Purpose To understand patient experiences and persistent barriers to colorectal cancer (CRC) screening amid centralized outreach at urban family medicine practices. Approach Following a pragmatic trial assessing mailed fecal immunochemical test (FIT) outreach, we invited a subset of participants to complete a semi-structured qualitative interview and structured questionnaire. Setting Single urban academic healthcare system. Participants Sixty patients who were eligible and overdue for CRC screening at the time of trial enrollment. Method Using Andersen’s Behavioral Model, we developed an interview guide to systematically assess factors shaping screening decisions and FIT uptake. Close-ended responses were analyzed using descriptive statistics. Qualitative data were analyzed using the constant comparative method. Results Most participants (82%) self-reported that they had ever completed any modality of CRC screening, and nearly half (43%) completed the mailed FIT during the trial. Most patients (60%) preferred FIT to colonoscopy due to its private, convenient, and non-invasive nature; however, persistent barriers related to screening beliefs including fear of test results and cancer treatment still prevented some patients from completing any form of CRC screening. Conclusions Mailed FIT can overcome many structural barriers to CRC screening, yet clear communication and follow-up amid centralized outreach are essential. For some patients, tailored outreach or navigation to address screening-related fears or other screening beliefs may be needed to ensure timely completion of CRC screening.

Condemned to precarity? Criminalised youths, social enterprise and the sub-precariat

Purpose The paper aims to consider whether social enterprise, who are growing in number and seemingly a politically popular alternative to mainstream employment are a potential conduit for social change. Discussions relating to the value of (stable) employment in reducing and preventing (re)offending are not new. For many ex-offenders, a multitude of barriers stand between them and access to the labour market. As a potential conduit for social change, social enterprises are a growing and seemingly politically popular alternative to mainstream employment. Design/methodology/approach Focusing on the qualitative lived experiences of young people (aged between 16 and 18) with criminal convictions enrolled in one such enterprise, this paper examines the extent to which work-integrated social enterprise can assist in overcoming existing barriers to the labour market. Findings The paper highlights the value of social enterprise(s) in addressing the complex needs and precarities of criminalised youths, promoting social inclusion and assisting with progression into future employment. The paper also discusses the limitations of social enterprise(s) in overcoming external structural barriers to meaningful employment for those with an offending history and the implications for young people who aspire to more than precariat work. Originality/value Justice-orientated social enterprises are allowing young people with criminal records the opportunity to build social capita and access precarious work, previously unattainable for many. By focusing on the concept of “precarity”, this paper builds upon existing research on the collateral consequences of criminal convictions offering insights into the various challenges facing criminalised youths attempting to build a positive pro-social work identity within contemporary labour markets