Sexual and gender minority identity in undergraduate medical education: Impact on experience and career trajectory

Introduction The wellbeing of sexual and gender minority (SGM) medical students and the impact of their experiences on career trajectory remain poorly understood. The present study aimed to characterize the incidence of mistreatment in SGM trainees as well as general perspectives on the acceptance of SGM individuals across medical and surgical specialties. Methods This was a cross sectional survey study of all actively enrolled medical students within the six University of California campuses conducted in March 2021. An online, survey tool captured incidence of bullying, discrimination, and suicidal ideation as well as perceived acceptance of SGM identities across specialties measured by slider scale. Differences between SGM and non-SGM respondents were assessed with two-tailed and chi-square tests. Qualitative responses were evaluated utilizing a multi-stage, cutting-and-sorting technique. Results Of approximately 3,205 students eligible for participation, 383 submitted completed surveys, representing a response rate of 12.0%. Of these respondents, 26.9% (n = 103) identified as a sexual or gender minority. Overall, SGM trainees reported higher slider scale scores when asked about being bullied by other students (20.0 vs. 13.9, P = 0.012) and contemplating suicide (14.8 vs. 8.8, P = 0.005). Compared to all other specialties, general surgery and surgical subspecialties had the lowest mean slider scale score (52.8) in perceived acceptance of SGM identities (All P < 0.001). In qualitative responses, students frequently cited lack of diversity as contributing to this perception. Additionally, 67.0% of SGM students had concerns that disclosure of identity would affect their future career with 18.5% planning to not disclose during the residency application process. Conclusions Overall, SGM respondents reported higher incidences of bullying and suicidal ideation as well as increased self-censorship stemming from concerns regarding career advancement, most prominently in surgery. To address such barriers, institutions must actively promote diversity in sexual preference and gender identity regardless of specialty.

Acceptance matters: Disengagement and attrition among LGBT personnel in the U.S. military

LAY SUMMARY The U.S. military has undergone several changes in policies toward lesbian, gay, bisexual, and transgender (LGBT) service members over the past decade. Some LGBT service members report continued victimization and fear of disclosing their LGBT identity, which can affect retention of LGBT personnel serving in the military. However, there is little research on this population. This study uses data from a survey funded by the U.S. Department of Defense (2017–2018) and completed by 544 active-duty service members (296 non-LGBT and 248 LGBT) to better understand the career intentions of LGBT service members. Of transgender service members, 33% plan to leave the military upon completion of their commitment, compared with 20% of cisgender LGB and 13% of non-LGBT service members. LGBT service members were twice as likely as non-LGBT service members to be undecided as to their military career path. Lower perceived acceptance of LGBT service members in the workplace was associated with a higher risk of leaving among LGBT service members. Lower perceived unit cohesion was associated with attrition risk for all members, regardless of LGBT status. These findings suggest that the U.S. military can do more to improve its climate of LGBT acceptance to prevent attrition.

The impact of belongingness and graphic-based emoticon usage motives on emoticon purchase intentions for MIM: an analysis of Korean KakaoTalk users

PurposeAlthough graphic-based emoticons in mobile instant messenger (MIM) services became an important revenue source for their service provider, empirical research investigating factors influencing graphic-based emoticon purchase from the consumer's perspective is insufficient. The authors explore how user's achieved belongingness (acceptance or rejection) affects graphic based emoticon usage motivations and its purchase intentions.Design/methodology/approachA structural model is used to examine the relationship among individual's overall achieved belongingness, motivation factors of graphic-based emoticon usage in MIM such as perceived usefulness, perceived enjoyment, perceived enjoyment for others, social norm and emoticon purchase intentions. The authors collected and analyzed survey data of 279 Korean KakaoTalk users.FindingsThe analysis shows that perceived acceptance/inclusion positively impacts perceived usefulness, enjoyment and enjoyment of others in graphic-based emoticon usage. Meanwhile, perceived rejection/exclusion positively impacts perceived enjoyment and enjoyment of others but negatively influences perceived social norms. Moreover, social norms and perceived enjoyment directly affect graphic-based emoticon purchase intentions. The authors also find that perceived enjoyment of others and perceived social norms in a serial causal order mediate the relationship between perceived acceptance/inclusion (and rejection/exclusion) and emoticon purchase intentions.Research limitations/implicationsAdditional research including users from other demographic groups, such as other age groups, is required to generalize our findings and to increase external validity.Originality/valueUnique implications related to the role of user's achieved belongingness and perceived enjoyment of others in graphic-based emoticon usage in purchase intentions are found.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/ 10.1108/OIR-02-2020-0036

The Sense of Belonging to the Country: Integrative Relationships and Spatiotemporal Commitment

The satisfaction of the need to belong reflects in the sense of being an integrative part of the group or social system. There is some lack of empirical evidence for the structure of this sense at the macro level. This study assessed a two-dimensional model of the sense of belonging to the country, which included relational and spatiotemporal components. Participants were 539 university students from 18 to 50 (74% females). Questions regarding involvement, perceived acceptance, sense of commonality, and feeling at home represented the relational component of the sense of belonging. Four temporal categories—the recent past, present, and the near and distant future—were included in the assessment of its spatiotemporal component. A confirmatory factor analysis revealed an acceptable fit of the two-factor model. Its convergent validity was demonstrated by the association with an explicit single-item measure of belonging. The predictive effect of the spatiotemporal component emphasized the importance of continuity of belonging in considering emigration. In sum, the results confirmed the complexity of the sense of belonging to the country and the interconnectedness of integrative relationships and spatiotemporal commitment and revealed functional differences between them.

Parents and Best Friends Perceived Reaction to Participant Deviance and Self-Reported Delinquency: Moderation by Sex and Mediation by Youth Attitude Toward Deviance in Mid- to Late Adolescence

The current study set out to determine whether youth perceptions of parental and best friends’ likely reactions to their involvement in deviant behavior influenced their own attitude toward deviance (AD) and propensity for future delinquency. It also asked whether the effect was conditional on participant sex. Relationships between time-ordered measures of youth perceptions of mother, father, and best friends’ likely reactions to participant deviance, the youth’s own AD, and the youth’s level of participation in subsequent delinquency were tested in a sample of 3,880 adolescents (mean age = 15.33 years at the start of the study, 50.6% male). A moderated mediation path analysis revealed that perceived acceptance of participant deviance by the individual’s best friends predicted a rise in participant positive attitudes toward deviance, which, in turn, led to a rise in future delinquency. There was no effect, however, for mother or father perceived attitudes toward participant deviance. These results further revealed that the effect was moderated by sex and only significant in boys. From these results, it can be surmised that best friends’ perceived reactions to deviance may have an indirect effect on future delinquency of male youth by shaping and influencing the youth’s own AD.

Worldwide Implications of Multiple Acceptance and Rejection on the Psychological Adjustment and Maladjustment of Children and Adults: A Global Multi-Cultural Study

The objectives of this study were to explore the combine effects on children’s psychological adjustment and maladjustment of perceived acceptance or rejection by mothers, fathers, and teachers; and also to examine the combine effects on adults’ current psychological adjustment and maladjustment of perceived acceptance or rejection by mothers and fathers in childhood and by intimate partners in adulthood. The samples consisted of 586 children (47% boys and 53% girls) and 1,709 adults (35% males and 65% females). Among the children 573 were in the multiple acceptance group and 13 were in the multiple rejection group, and among the adults 1,645 were in the multiple acceptance group and 64 were in the multiple rejection group. The samples were selected from 11 countries in four continents. Results showed that significantly more girls than boys, and more women than men experienced multiple acceptance. Regardless of age, gender, and culture, the majority of sample in the multiple acceptance group reported healthy psychological adjustment, and the majority of respondents in the multiple rejection group reported moderate to severe psychological maladjustment. Results also showed a significant tendency for adults to experience more rejection by all attachment figures than did children regardless of culture and gender.

Why the Chosen Ones May Not Always Be the Best Leaders: Criteria for Captain Selection as Predictors of Leadership Quality and Acceptance

There seems to be some initial evidence that team captains are selected based on non-leadership factors such as team tenure, technical abilities, being the daughter of the club president, or playing position. This is concerning since players expect their ideal team captain to have superior motivational and social skills. Adding to this literature on captain selection, the present study investigates relationships between the reasons for which team captains are selected and their (a) perceived leadership quality; and (b) perceived acceptance. To accomplish this, we recruited 450 coaches and 198 players from Flemish football and volleyball teams. Participants evaluated 41 reasons on the extent to which they played a role in the selection of their team captain. Additionally, participants rated their team captain’s leadership quality and level of acceptance. The results consistently indicated that captains who were selected for having good motivational and social competencies were given higher ratings on perceived leadership quality and acceptance by participants. In conclusion, athletes who are motivated, good at motivating others and have superior social skills tend to be better suited for captaincy than those selected based on non-leadership factors.

Parents’ Acceptance of Learning about Mindfulness for Managing Pediatric Asthma

Background: Emerging research suggests mindfulness may reduce stress and asthma symptoms in children, yet there is a gap in understanding parental views towards learning about mindfulness. Objective: This study aimed to compare the perceived acceptance to learn about mindfulness among parents of children with and without asthma, and to understand differences across income levels. Methods: This was a national, cross-sectional, online survey of parents of children 0–18 years. Acceptance was measured with questions on whether parents believe mindfulness could be beneficial while parenting, and if they would be willing to learn about mindfulness. Comparisons of mindfulness acceptance between income level were conducted using chi-square and Fisher’s exact test. Results: Parents of children with asthma were more likely to be interested in learning about mindfulness from their health care provider compared to those without asthma (46% vs. 38%, p < 0.0001). At all income levels examined in the study, parents (63–75%) of children with asthma indicated that they agreed or strongly agreed that mindfulness can be beneficial when parenting. Conclusion: Findings suggest an opportunity to incorporate mindfulness teaching into asthma care for pediatric patients of all income levels.

Peer Support and Family Acceptance with Quality of Life of MSM Living With HIV and Antiretroviral

Men who have sex with men (MSM) comprise a population at risk for HIV infection. Quality of Life (QOL) becomes the main goal to lengthen their life span. This study was conducted to determine the relationship between peer support and family acceptance toward QOL of MSM living with HIV and ARV in Medan. A total of 175 respondents were involved in this cross-sectional study that was carried out via purposeful sampling. Data were collected by means of the Perceived Acceptance Scale, Peer Group Caring Interaction Scale, and WHOQOL-HIV BREF. Results showed that QOL was significantly associated with peer support (p= 0.023; OR= 2.070) and family acceptance (p= 0.001; OR= 2.766). Thus, peer support and family acceptance are important variables affecting well-being and QOL of MSM living with HIV and ARV. This finding can be used for the improvement of QOL in PLWH. AbstrakDukungan Sebaya dan Penerimaan Keluarga terhadap Kualitas Hidup LSL dengan HIV dan Antiretroviral. Laki-laki yang berhubungan seks dengan laki-laki (LSL) merupakan populasi yang berisiko terinfeksi HIV. Kualitas hidup (QOL) menjadi tujuan utama untuk memperpanjang umur mereka. Penelitian ini dilakukan untuk mengetahui hubungan dukungan sebaya dan penerimaan keluarga terhadap kualitas hidup LSL yang hidup dengan HIV dan antiretroviral (ARV) di Medan. Sebanyak 175 responden dilibatkan dalam studi cross-sectional yang dilakukan melalui purposive sampling. Data dikumpulkan dengan menggunakan Skala Perceived Acceptance, Skala Interaksi Peduli Peer Group, dan WHOQOL-HIV BREF. Hasil penelitian menunjukkan bahwa kualitas hidup secara signifikan berhubungan dengan dukungan teman sebaya (p = 0,023; OR = 2,070) dan penerimaan keluarga (p = 0,001; OR = 2,766). Dengan demikian, dukungan sebaya dan penerimaan keluarga merupakan variabel penting yang mempengaruhi kesejahteraan dan kualitas hidup LSL yang hidup dengan HIV dan ARV. Temuan ini dapat digunakan untuk peningkatan QOL pada ODHA.Kata Kunci: dukungan sebaya, HIV, kualitas hidup, penerimaan keluarga