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The unprecedented transnational protests following the killing of George Floyd highlighted the need to re-examine institutions that uphold various social injustices experienced by racialised minorities. Black Lives Matter protests thus created a serious reckoning with racism and facilitated global conversations. Against the backdrop of these protests, we evaluate our study of healthcare workers, exploring racialisation in Swedish healthcare including the design and implementation of an anti-racist initiative in healthcare education. We reflect on how the silencing of discussion around racism in Sweden led to difficulties in recruiting participants and the effect of the shift in public discourse following the Black Lives Matter uprising of 2020. The project was ultimately successful in recruitment and outreach to professional and regional authorities. However, this success is contrasted by the lack of structural change in embedding anti-racism as a core value in healthcare practice. We conclude by noting that conversations about anti-racism differ from implementing anti-racist practice in commissioning, evaluation, and service delivery.

Research points to the existence of racial bias and beliefs among healthcare staff but does not explicate accounts of racialization in healthcare and the day-to-day utterances that have racializing effects excluding minoritized users' right to care. This study understands racism as structural and embedded in societies and institutions, including healthcare, as well as in interactions and talk. Through excavating accounts of healthcare staff's talk that devalues minoritized users, this study posits talk as reflective and constitutive of the dominant structure of racism within which it is situated. Drawing on qualitative interviews with 58 staff in Sweden, the study delineates three categories through which racialized talk differentiates between minoritized and majoritized users. These are: Characterizing minoritized users as ‘bad’ users, Characterizing minoritized users' health complaints as unworthy and finally, Devaluing minoritized users as justification for suboptimal and differential care. Healthcare staff accounts show that continuous racialization of minoritized users maintains existing power-relations representing Western users as civilized and non-Western users as uncivilized and problematic. Through reiteration, these practices of exclusion become invisible, normalized, and assume the status quo. It is imperative to address racialization as it has implications for the core ethics of healthcare.

An educational intervention, based on qualitative evidence of racism in healthcare, is described. Using vignettes from a previous project, interviews were conducted to gather qualitative evidence of racism in healthcare settings from a wide range of healthcare staff in Sweden. From this interview material, case studies were devised that were subsequently presented to trainee healthcare professionals, in a seminar discussion. After the seminar, trainees responded to reflective questions. The order of work, as well as the materials used, are described. This intervention was successful in facilitating discussion about racism in an educational context, despite the difficult nature of these conversations for some participants.

Objectives:

The presence of schistosomal eggs in the urine is a sufficient but not necessary condition for an individual to be diagnosed with urogenital schistosomiasis. The absence of eggs does not prove that a person is disease-free. Thus, when examining populations using egg occurrence, there is a real risk of underestimating the prevalence. The aim is to develop an easy to use model for improved prevalence estimates of urogenital schistosomiasis.

Design and methods:

Urine samples were taken from 161 schoolchildren and 124 adults on three different days for each individual. The probands were recruited from two areas in northern Tanzania with varying prevalence of urogenital schistosomiasis. The presence of eggs by microscopy and haematuria by dipstick were recorded for each sample and the measurements combined using the discordance of the outcomes.

Result:

As a consequence of applying the developed model, a substantial increase in the prevalence estimate was noted for groups displaying a low egg occurrence.

Conclusion:

By using the biological relationship that exists between the presence of eggs and blood in urine of an infected individual, we provide a way of adjusting the prevalence estimates of urogenital schistosomiasis, using the observed prevalence of haematuria, in the absence of competing causes.

Aim: The aim is to illustrate and analyse reflections from graduate nursing studentsover their experience of discussing racism in healthcare in an educational intervention.Design: A qualitative, descriptive design was adopted.Methods: Data were collected through written reflections and analysed through con-tent analysis. In total, 81 students participated in the intervention; 39 paediatric and42 public health care nursing students. Of those, 27 participants gave consent to havetheir written reflections included in the study.Results: Three main categories were developed in the content analysis of studentreflections: (a) the implicit embeddedness of racism in healthcare organization; (b) theeffect of racism on interactions with patients; and (c) a growing awareness of one'sown understanding of racism. This study indicates that student nurses discussed rac-ism as relevant to understanding good clinical practice for the benefit of patients andwork-based wellbeing of staff. This recognition of the organizational nature of racismwarrants nursing leaders and managers to include racism as a social determinant ofhealth in the undergraduate and graduate curricula to educate the next generation ofnursing about racism.

While regularly applied to globalized migration, conceptualizations of hospitality have rarely been used to understand healthcare settings. Drawing on interviews with healthcare staff in Sweden, our article contributes to the current conceptualization of hospitality accounting for: the internal contradictions of hospitality that racialized staff experience in their everyday interactions with patients and other staff; the shifting boundaries between host and guest in everyday healthcare practices, especially when examined through the lens of racialization and finally; the subtle though troubled coexistence of hostility and un(conditional) hospitality that weakens resistance against racism. The analysis maps the complex contingencies of professional, ethnic and national relations between staff and patients, in light of their racialized and gendered nature, to suggest that the ambivalences theorized as part of the concept of hospitality show how the hurts of racism are so hard to pinpoint.

Background: A health promotion approach to end-of-life (EoL) care is gaining traction internationally. However, there is a lack of evaluations of the impact of this approach, particularly regarding community-based initiatives. Conceptualizations of impact in participatory action research (PAR) may contribute to understanding ways in which impact can be investigated in community-based health promotion approaches to EoL issues. We aim to investigate impact and the process of impact development in our community-based PAR project, Studio DöBra, a Swedish health promotion initiative to engage communities in EoL issues.

Methods: We do this through a qualitative framework analysis expanding on Banks et al.’s theory of co-impact in PAR, based on longitudinal empirical data of Studio DöBra. Studio DöBra was developed in partnership with a range of community organizations and engaged children (9 years old) and older adults (most 80+) with topics related to dying, death, and loss through arts activities. The analyzed empirical data reflect the perspectives of community-partners and academic partners from interviews and meetings spanning 4.5 years.

Findings: We present a model of impact development consisting of impact on individual and group development, action-oriented impact, and strategy-oriented impact; ways they relate to and evolve from one another; and how they may be affected by contextual influences.

Conclusion: Besides contributing to conceptualizations of impact in PAR, findings contribute a community perspective to the limited literature investigating the impact of health promotion initiatives related to EoL issues.

The COVID-19 pandemic has made visible inequalities as exemplified by unequal access to COVID-19 vaccine across and within countries; inequalities that are also apparent in rates of testing, disease, hospitalization and death from COVID-19 along class, ethnic and racial lines. For a global pandemic such as the COVID-19 to be effectively addressed, there is a need to reflect on the entrenched and structural inequalities within and between countries. While many countries in the global north have acquired more vaccines than they may need, in the global south many have very limited access. While countries in the global north had largely vaccinated their populations by 2022, those in the global south may not even complete vaccinating 70% of their population to enable them reach the so-called herd immunity by 2024. Even in the global north where vaccines are available, ethnic, racialized and poor working classes are disproportionately affected in terms of disproportionately low rates of infection and death. This paper explores the socio-economic and political structural factors that have created and maintain these disparities. In particular we sketch the role of neoliberal developments in deregulating and financializing the system, vaccine hoarding, patent protection and how this contributes to maintaining and widening disparities in access to COVID-19 vaccine and medication.