OTHR-01. SNO 2020 DIVERSITY SURVEY: DEFINING DEMOGRAPHICS, RACIAL BIASES, CAREER SUCCESS METRICS AND A PATH FORWARD FOR THE FIELD OF NEURO-ONCOLOGY

BACKGROUND Neuro-oncology has grown tremendously since 2010, marked by increasing society membership, specialized clinical expertise, and new journals. Yet, modest improvement in racial/ethnic diversity amongst clinical trial participants, researchers and clinicians led us to conduct a survey identifying opportunities to enhance diversity and inclusiveness amongst neuro-oncology professionals. METHODS Summer 2020, the Women and Diversity Committee of the Society for Neuro-Oncology (SNO) distributed an anonymous online survey to members and affiliates (European Association of Neuro-Oncology, Asian Society for Neuro-Oncology, Society for Neuro-Oncology Latin America and Society for Neuro-Oncology Sub-Saharan Africa). The survey captured personal and professional characteristics, biases, effective mentorship qualities, career success metrics, and suggested field/society changes. Results were analyzed by geography, profession, age, racial/ethnic and sexual identity. Standard descriptive statistics characterized the study population. RESULTS The 386 respondents were predominantly female (58%) with a median age range of 40-49 years (31%), White (65%), and SNO members (97%). Most worked in North America (77%) in a research profession (67%). A majority of White respondents reported never experiencing biases (64%), while the majority of non-White respondents reported unconscious biases/microaggressions, followed by a lack of/limited mentorship. Qualitative assessments showcased that personal/professional success metrics were linked to needed improvements in diversity and inclusion efforts within the neuro-oncology community. CONCLUSIONS: The prevalence of racial/ethnic biases and poor mentorship rates amongst underrepresented groups in neuro-oncology is high and potentially linked to the limited diverse representation amongst members and affiliates. These findings warrant a swift implementation of equity and inclusion practices within the neuro-oncology field.

A Multiethnic Asian Perspective of Presumed Consent for Organ Donation: A Population-Based Perception Study

Background: Organ shortage is still a world-wide problem, resulting in long waiting lists for kidney, liver, and heart transplant candidates across many transplant centers globally. This has resulted in the move toward presumed consent to increase deceased organ donation rates. However, there remains a paucity of literature on public attitude and barriers regarding the opt-out system, with existing studies limited to Western nations. Therefore, this study aimed to understand public sentiment and different barriers toward organ donation from the perspective of Singapore, a highly diverse and multiethnic Asian society.Methods: A cross-sectional community semi-structured interview was conducted in a public housing estate in Singapore. Pilot test was undertaken before participants were interviewed face-to-face by trained personnel. All statistical evaluations were conducted using Stata. The χ2-test compared subgroups based on patient characteristics while multivariable logistic regression identified predictors of willingness to donate/ assent. Effect estimates were quantified using odds ratio (OR).Findings: Out of 799 individuals, 85% were agreeable to organ donation after death and 81% were willing to assent to donations of family members' organs, which declined by 16% (p < 0.001) after a clinical scenario was presented. Demographic factors including ethnicity, education, marital, and employment status affected willingness to donate and assent. Knowledge correlated significantly with willingness to donate and assent. In particular, knowledge regarding brain death irreversibility had the strongest correlation (AOR 2.15; 95% CI 1.60–2.89).Conclusions: Organ donation rates remain low albeit presumed consent legislation, due to patient-level barriers, including but not limited to knowledge gaps, cultural values, religious backgrounds, and emotional impact at relatives' death. To effectively boost donor rates, it is crucial for policy makers to invest in public education and improve transplant provisions and family protocols.

Receptivity to different types of migrants in Taiwan: Civic behavior and support for same-sex marriage as novel correlates

In an era of rising global intra-regional migration, in-depth explorations of attitudes toward immigrants and immigration (ATII) in emerging migrant-receiving societies in Asia are scarce. Using Taiwan as a case of an emerging non-Western, democratic migrant-receiving context with a racially homogeneous population, aging social structure, and vibrant civic culture, this is the first study to examine receptivity to three major migrant types. The study contributes to the ATII literature and sociological research through discovering something old (perceived group threat of foreign professionals and labor migrants at the individual level), something new (link between positive attitudes toward same-sex marriage and higher receptivity to blue-collar migrants), something borrowed (civic behavior), and something context-specific (effect of the high visibility of marriage immigrants in certain places on receptivity). This study highlights the importance of uncovering patterns and mechanisms of nativity-, ethnicity-, and class-based foreigner exclusionism in emerging non-Western migrant destinations. The findings on receptivity toward intra-Asia migrants in a 21st-century Asian society illuminate possibilities for reinventing theories on the social organization of difference and the socio-cognitive construction of ethnicity, with broader relevance to inter-minority relations among Asians in traditional Western immigrant societies.

‘WAR AS REMEDY OR POISON’: READING THE BLIND MAN'S GARDEN AND THE KITE RUNNER WITH A CRITICAL LENS OF MBEMBE’S NECROPOLITICS

Purpose of the Study: This study emphasizes the contribution of fiction in highlighting the American exercise of power around the world predominantly Pakistan and Afghanistan. It investigates how America has become a dictating body deciding the life and death of human beings mainly in South Asian developing countries. Methodology: Being Qualitative, this study uses Eaglestone’s (2000) close reading technique to analyze words and structure of the texts of Khalid Hosseini's The Kite Runner and Nadeem Aslam Khan’s The Blind Man’s Garden. It develops a descriptive thesis leading to construct arguments by drawing a theoretical framework from Mbembe’s necropolitics (2003). Mbembe took his inspiration from Foucault’s idea of bio-power. Modern narrative discourse on sovereignty and its relation to war is taken as the main subject of necropolitics. Mbembe’s idea of sovereignty as an exercise to get control of the mortality of the enemy helps to interpret the texts via the close reading method. Main Findings: This study evaluated two novels to assert that necropolitics by taking its four basic concepts, power, war, politics, and death was the actual controlling power of a country. It analyzed fictional characters to argue how individuals endured hardships because of the necropolitical exercise of America and Russia in Afghanistan. Mbembe’s conception of necropolitics helps in understanding fiction. Applications of this study: The present study has significant implications from both theoretical and interpretative perspectives. Necropolitics, originally a political notion is reworked in fiction, which asserts that using this concept, power relations, their roots, and exercise around the world can be explored in various fields. This study contributes to dismantling the latent necropolitics in the society represented in fiction. It elevates the social and political consciousness of the general public of South Asia, particularly Pakistan and Afghanistan. This study can be helpful in the field of psychology to popularize the notion of necropolitics in contemporary society. Novelty/Originality of this study: Comparatively a new field, Necropolitics has been discussed in the fields of medical sciences and education. This study significantly highlights its existence in the field of literary studies. Fiction as a direct reflection of society helps in deconstructing the prevailing exercise of necropolitics in South Asian society. It is also helpful in raising the social and political consciousness of South Asian people.

INVESTIGATION OF POSSIBLE ORGANIZATIONAL CHANGES TO THE HEALTH INSURANCE SYSTEM IN VIETNAM

Purpose – to identify the prerequisites for organizational changes of the emerging health insurance system in Vietnam. Research methodology - comparative analysis, statistical analysis, case study. Findings – the obligatory health insurance in Vietnam performs its functions only partially. There is still high level of out-of-pocket spending on medical services. First we identified one of the most important challenges to the health insurance system in Vietnam, namely, the population aging. Secondly, we identified and analyzed and the prerequisites (the pre-existing conditions), which can become the basis for the reorganization of the existing health insurance system without major reforms: (1) the cultural values of Asian society, which allow to build a community-based type model of living for the elderly on the basis of “equal with equal”; (2) technological advances in medicine that extend the healthy life of the elderly, (3) trust in traditional medicine, which allows widen the coverage of the poorest “elderly households”. Practical implications - the results of the study require attention from the government and insurance providers when rethinking of organizing process for mandatory medical insurance. Originality/Value – we have identified the ways of possible organizational changes for the health insurance system, making the most of the existing prerequisites. This can help to get closer to the goal of full coverage with health insurance services while achieving a positive social effect. The identified internal reserves make it possible to imple- ment organizational changes without major reforms of the established health insurance system. No studies have been conducted in this perspective.

Skilful predictions of the Asian summer monsoon one year ahead

The interannual variability of the Asian summer monsoon has significant impacts on Asian society. Advances in climate modelling have enabled us to make useful predictions of the seasonal Asian summer monsoon up to approximately half a year ahead, but long-range predictions remain challenging. Here, using a 52-member large ensemble hindcast experiment spanning 1980–2016, we show that a state-of-the-art climate model can predict the Asian summer monsoon and associated summer tropical cyclone activity more than one year ahead. The key to this long-range prediction is successfully simulating El Niño-Southern Oscillation evolution and realistically representing the subsequent atmosphere–ocean response in the Indian Ocean–western North Pacific in the second boreal summer of the prediction. A large ensemble size is also important for achieving a useful prediction skill, with a margin for further improvement by an even larger ensemble.

Adaptation and Validation of a Short Acculturation Scale in a Multi-Ethnic Asian Population

The Short Acculturation Scale (SAS) has been widely used for assessing the level of the acculturation of migrants in Western countries. However, the validity of SAS for use in cosmopolitan settings without a single prevailing culture is unclear. We examined the validity and reliability of a version of the SAS adapted to a multi-ethnic Asian society. We used cross-sectional data from 12,610 Singaporean citizens and permanent residents, aged 21–75 years, of Chinese, Malay, and Indian ethnicity. Our version used 11 items, with 5 questions on language use, 3 on media use, and 3 on ethnic social relations, to measure acculturation. Our version of the SAS had good internal consistency. The three-factor CFA model had a good fit to our data. The results from the multiple group CFA supported metric invariance and partial scalar invariance across the three ethnic groups. The total score was positively correlated with generation in Singapore and the number of languages spoken. Among first generation immigrants, country of origin, but not the duration of residence was significantly associated with the acculturation score. Our three-factor version of the SAS is a reliable and valid tool for measuring acculturation in Singapore residents. These findings indicate that adapted SAS can be used to assess acculturation in multicultural settings.